Youth Suicide Campaign RFP.pdf

Revised October 2025

The Ohio Department of Behavioral Health (DBH), Office of Community and Family Resiliency, is requesting proposals for:

Ohio Youth Suicide Prevention Messaging & Outreach Campaign

For the Period: State Fiscal Year 2026 –January 5, 2026 through June 30, 2026

Submit Proposals through the Ohio|Buys website for this particular RFP.

This RFP consists of 47 pages. Please verify that you have a complete copy.

Please submit all inquiries about this RFP through the Ohio|Buys website for this particular RFP. Please refer to Part Three of this RFP, “General Instructions”, for more information about submitting inquiries. All responses to inquiries submitted by Proposers will be posted on the RFP Inquiry tab for viewing by all prospective Proposers.

REQUEST FOR PROPOSALS (RFP)

PART ONE: STRUCTURE OF THIS RFP

PARTS

Part One Structure of this RFP Part Two Information on requested services Part Three General Instructions Part Four Evaluation of Proposals Part Five Contract Award

ATTACHMENTS

Appendix 1 – Standard Affirmation and Disclosure Form o Standard Affirmation and Disclosure Form must be signed by an authorized official of Proposer’s organization and must be included for any proposal to be scored

Appendix 2 – Contractor Information Form o Contractor Information Form must be completed and submitted with the proposal.

PART TWO: SERVICES REQUESTED INFORMATION

I. MISSION & GUIDING PRINCIPLES

The mission of the Ohio Department of Behavioral Health (DBH) is to provide statewide leadership of a high-quality mental health and addiction prevention, treatment and recovery system that is effective and valued by all Ohioans. DBH strives to be a national leader in implementing a comprehensive, accessible, and quality-focused system of addiction and mental health care and wellness for all Ohio citizens.

II. PURPOSE

The Ohio Department of Behavioral Health (DBH) is seeking proposals from qualified contractors to plan, design, develop, pilot, and implement a statewide youth suicide prevention messaging and outreach campaign. The campaign will amplify youth voice, incorporate perspectives of suicide loss survivors, and deliver evidence-informed content that strengthens protective factors, increases help-seeking behaviors, and supports early intervention among youth. Required activities include community engagement, youth and loss survivor collaboration, content development, testing, distribution planning, evaluation, and the creation and management of the campaign’s digital ecosystem, including a standalone campaign website and campaign-branded social media channels. All messaging must align with DBH priorities, including clear connections to 988 and Mobile Response and Stabilization Services (MRSS).

III. BACKGROUND

Youth suicide continues to be a significant public health concern in Ohio, with elevated rates of suicide deaths and self-harm behaviors in several high-need and high-prevalence counties. There is a need for modernized, culturally responsive, and youth-centered messaging that resonates with diverse communities across the state.

Ohio’s youth, families, caregivers, and prevention partners have expressed a need for updated public content that is relatable, accessible, and grounded in real experiences. Youth leaders, suicide loss survivors, and credible messengers such as athletes have demonstrated strong potential to reduce stigma and normalize conversations around mental health.

DBH seeks a Contractor with expertise in suicide prevention, youth engagement, creative strategy, and behavior-change communication to develop a cohesive statewide campaign that elevates youth voice and expands access to accurate, hopeful, and actionable information.

IV. SCOPE OF WORK AND DELIVERABLES

The Contractor shall complete all work and deliverables outlined in Goal Areas 1 through 5.

Goal 1: Establish a coordinated engagement process to ensure youth, loss survivors, and community partners inform campaign development.

Objective 1.1: By February 7, 2026, establish a Content Advisory Team composed of youth and suicide loss survivors and other subject matter experts representing high-need and high-prevalence communities.

Objective 1.2: By February 28, 2026, convene at least two virtual planning meetings with the Content Advisory Team and DBH to refine campaign messaging priorities, tone, local context, and alignment with

988/MRSS.

Objective 1.3: Throughout the contract period, engage at least three Alcohol Drug and Mental Health (ADAMH) Boards and/or community coalitions to gather input on local needs, and effective rollout pathways.

Goal 2: Develop, test, and refine campaign messages and materials that promote youth suicide prevention, protective factors, and help-seeking behaviors.

Objective 2.1: By March 20, 2026, produce at least eight (8) draft campaign assets informed by youth and loss survivor input.

Objective 2.2: By April 30, 2026, test at least two innovative campaign concepts (e.g., storytelling, peer-to-peer challenges, athlete-amplified content) with youth and community partners.

Objective 2.3: By May 31, 2026, finalize a minimum of fifteen (15) campaign assets based on pilot testing and stakeholder feedback.

Objective 2.4: By May 31, 2026, develop a campaign customization toolkit for local partners, including guidance for adapting materials and integrating local resources and 988/MRSS information.

Goal 3: Support statewide reach by preparing for implementation with local partners.

Objective 3.1: By March 31, 2026, develop and submit a county and school-based outreach plan outlining dissemination strategies, youth engagement approaches, and integration with local prevention systems.

Objective 3.2: Throughout the contract period, collaborate with ADAMH Boards, youth-led groups, and community coalitions to prepare campaign materials for local adaptation and dissemination.

Objective 3.3: Throughout the contract period, document local adaptations and implementation insights to support statewide scaling.

Goal 4: Design, develop, host, and maintain the campaign’s full digital ecosystem, including the standalone campaign website, campaign-branded social media channels, and the online hosting of all campaign materials.

Objective 4.1: By May 1, 2026, develop and launch a standalone campaign website, including domain procurement, content development, site architecture, accessibility compliance, secure hosting, analytics setup, SEO, and a downloadable resource library

Objective 4.2: Establish and manage official campaign social media channels (e.g., Instagram, TikTok, YouTube), including posting, engagement moderation, and analytics reporting.

Objective 4.3: Host all campaign materials, videos, graphics, print files on the Contractor-managed campaign website in accessible, web-ready and print-ready formats.

Objective 4.4: By June 30, 2026, prepare and submit a full transfer package to DBH containing domain ownership documentation, hosting credentials, backend files, analytics documentation, and a website maintenance guide.

Goal 5: Assess campaign effectiveness and support ongoing refinement.

Objective 5.1: By May 15, 2026, develop an evaluation plan identifying outcomes, indicators, and data collection methods aligned with campaign goals.

Objective 5.2: Throughout the contract period, collect analytics from the campaign website, social media channels, and community partners to assess reach, engagement, and early behavior-change indicators.

Objective 5.3: By June 30, 2026, submit a final evaluation summary including quantitative metrics, qualitative insights, and recommendations for future statewide dissemination.

V. MINIMUM QUALIFICATIONS OF CONTRACTOR

Contractors must possess the personnel, technical capabilities, and operational infrastructure required to complete every component of the Scope of Work.

Applicants unable to demonstrate the capacity to fulfill all required objectives will not be eligible for award.

Sarah Kunkler Sticky Note Completed set by Sarah Kunkler

Contractor shall not be subject to an “unresolved” finding for recovery under Section 9.24 of Ohio Revised Code.

VI. ETHICAL AND CONFLICT OF INTEREST REQUIREMENTS

No contractor or individual, company or organization seeking a contract shall promise or give to any DBH employee any item of value that is of such character as to manifest a substantial and improper influence upon the employee with respect to his or her duties.

No contractor or individual, company or organization seeking a contract shall solicit any DBH employee to violate any of the conduct requirements for employees.

Any contractor acting on behalf of DBH shall refrain from activities that could result in violations of ethics and/or conflicts of interest. Any contractor or potential contractor who violates the requirement and prohibitions defined Section 102.03 or Section 102.04 of the Ohio Revised Code is subject to termination of the contract or refusal by DBH to enter into a contract.

PART THREE: GENERAL INSTRUCTIONS

The following sections provide a calendar of events, details on how to respond to this RFP and how to get more information about this RFP. All responses must be complete and in the prescribed format.

I. CALENDAR OF EVENTS & ONLINE INFORMATION

The schedule for this RFP is given with the Ohio|Buys solicitation and is subject to change.

DBH may change this schedule at any time. If DBH changes the schedule before the Proposal Due Date, it will do so through an announcement on the Ohio|Buys web site area for this. The web site announcement will be followed by an addendum to this RFP, which also will be made available through the same Ohio|Buys web site, a possible new round or lot may be started.

It is each prospective Proposer’s responsibility to check the Ohio|Buys web site’s solicitation area for this RFP for current information and the calendar of events scheduled through award of any contract.

Other than by adherence to the RFP Inquiry process, set forth within Ohio|Buys, no contact related to this RFP shall be made with DBH until a contract award is announced.

Notwithstanding this prohibition, DBH, at its sole discretion, may request additional information as part of the review process outlined below.

II. PROPOSAL FORMAT

Proposals must be prepared in accordance with instructions in this section. The proposal must clearly outline how each of the deliverables of Part 2 Section IV will be completed and with the time frames specified in that same section.

To be accepted, a proposal must include a technical proposal and a cost proposal as described in this section, contain all the information specified for each of the categories listed in this section, and meeting the requirements of this section. Both technical and cost proposal will be identified within the RFP on the Ohio|Buys web site and must be filled out in its entirety to be accepted.

A. Technical Proposal

a. Transmittal letter includes:

• Identifies the bidder

• The name, title, address, and telephone number of the proposer’s contract person with authority to answer questions concerning the RFP

• The name, title, address, telephone number, and email address of the proposer’s contact person with authority to execute a contract on behalf of the proposer.

b. Organizational experience including:

• Information on the background of the firm or individual, including background information of any subcontractor(s)

• Any prior experience relevant to this RFP (includes current contact names and phone numbers for these references), and a list of similar projects currently underway by the proposer or by any subcontractor(s) as well as completed over the past three (3) years unless requested otherwise within the Evaluation Section of this RFP. The Evaluation/Selection Review Committee will consider these additional references and may contact each of these sources.

c. Technical Approach and work plan that indicates how the proposer plans to address the purpose, objectives and deliverables, within the timeframes as stated in this RFP.

• A procedure for reporting the status of the project, including work completed.

• A proposal for how coordination will occur and how information will be shared with DBH

• A chart indicating the names of staff and staff hours/activities/tasks linked to the responsibility of each of those individuals involved in each deliverable of the project

• Samples of previous related projects

d. Personnel Qualifications

• Must include names, resumes, education, and experience of personnel listed in the table of organization/personnel chart for this project (including any subcontractors), and fully explain how their education and experience is relevant to this RFP.

• DBH shall require a clause in the resulting contract regarding key personnel that any person identified as critical to the success of the project may not be removed without reasonable notice to DBH.

• One Project Manager shall be named on behalf of the proposer. All correspondence shall be directed through this named individual.

B. Cost Proposal

The cost proposal must indicate the total cost for the entire project and a separate cost breakdown for state fiscal year 2026 for the following elements, each of which will be identified within the Financial Questionnaire in Ohio|Buys for the RFP.

Cost Proposal should include at least the following elements:

1. Project Management and Administration

Includes overall project oversight, staffing, coordination with DBH, scheduling, reporting, and contract management.

2. Youth and Loss Survivor Engagement Includes advisory team stipends, facilitation costs, engagement materials, meeting coordination, and other support activities.

3. Community Engagement and Partner Coordination Includes engagement with MHRBs, youth-led organizations, schools, and community coalitions, including stakeholder meetings and outreach planning.

4. Content Development and Creative Production Includes concept development, messaging, scriptwriting, graphic design, video production, revisions, and quality assurance.

5. Pilot Testing and Concept Refinement Includes youth focus groups, testing sessions, data collection, analysis, and refinement of campaign assets.

6. Campaign Asset Production Includes production of final campaign materials such as videos, digital graphics, social media content, print-ready files, toolkits, and templates.

7. Website Development, Hosting, and Maintenance Includes design, development, hosting, security, accessibility compliance, SEO, analytics setup, maintenance, and creation of a downloadable resource library.

8. Social Media Development and Management Includes creation and management of campaign social media channels, content planning, posting, moderation, influencer coordination, and analytics reporting.

9. Distribution and Implementation Support Includes preparation of materials for statewide distribution, partner adaptation support, and coordination with ADAMH Boards and community partners.

10. Evaluation and Reporting Includes development of evaluation tools, data collection, website and social media analytics, interim progress updates, and final evaluation reporting.

11. Project Closeout and Asset Transfer Includes transfer of hosting credentials, domain ownership documentation, backend files, campaign assets, analytics documentation, and maintenance guides to DBH.

Travel cost should be encompassed within the cost of the deliverables. Travel is not to be listed separately. For purposes of this RFP, travel includes all modes of transportation (airfare, tax, car rentals, etc.), lodging expenses, meals, and cost of communications by phone, mail, e-mail, or fax.

III. PROPOSAL SUBMITTAL

Proposals must be submitted in the following manner:

• Proposals must be submitted via the Ohio|Buys website by no later than 2:00 pm EST on the date indicated on the sourcing project.

No proposals or corrections/additions to submitted proposals will be accepted after the Proposal Due Date and time. Proposals that are submitted after the Proposal Due Date and time will not be scored.

Proposals that are not submitted in the format requested will not be scored. Proposals that do not contain all of the required information will not be scored.

All costs incurred in the preparation of the Proposal shall be borne by the Proposer alone, and DBH shall not contribute, in any way, to the cost of the preparation of the Proposal.

Any and all documents developed by the Proposer during the course of this project will be provided to DBH upon request and will become the property of DBH, and the Proposer shall not assert any claims arising under copyright or otherwise inconsistent with the transfer of ownership of such documents.

All information submitted by the Proposer will be considered to be public information unless the proposer specifically demonstrates, in writing, which information it considers to be proprietary. “Proprietary information” is information which, if made public, would put the proposer at a disadvantage in the market place and trade in which the proposer is a part.

Consequently, an assertion of “proprietary” information must be clearly identified and the basis of the assertion must be included. It is not adequate for the bidder to simply state that disclosure of the information will put it at a disadvantage in the market place. DBH will make the final decision as to whether information is “public” or “proprietary”.

DBH reserves the right to:

Accept or reject any and all Proposals and/or bids if DBH determines that it is in the best interests of the State to do so.

Rebid this RFP, requesting new Proposals from qualified firms.

Waive or modify minor irregularities in Proposals received.

Negotiate with Proposer(s), within the requirements of this RFP, to best serve the interests of the State of Ohio.

Require the submission of modifications or additions to Proposals as a condition of further participation in the selection process.

Fund any Proposal in full or in part; any assignments of work by DBH under the scope of this RFP will be made dependent on need and the availability of adequate, specific funding.

Not make an award at the end of the evaluation process; this RFP is not to be interpreted or construed to guarantee that one or more Proposers submitting responses will be awarded contracts.

Adjust the RFP Calendar of Event dates for whatever reason it deems appropriate.

Contact Proposer to clarify any portion of the Proposer’s submittal.

If, during the review process, DBH determines that it is necessary to make further distinctions between certain Proposers, DBH may request certain selected Proposers to interview or make a presentation to staff and reviewers. The Proposer shall bear the cost of travel to any scheduled interview.

In accordance with federal and state statutes and DBH policy, no person shall be excluded from participation or subject to discrimination in the RFP process on the basis of race, color, age, sex, national origin, military status, religion, or disability.

IV. INQUIRIES

From the issuance date of this RFP, until a contract is awarded to a proposer, there may not be communications concerning the RFP between any supplier who expects to submit a proposal and any employee of DBH involved in the issuing of the RFP. The only exception is provided through the submission of written requests for clarification/interpretation via the RFP through the Ohio|Buys website during the specified inquiry period.

Prospective Proposers may make inquiries or seek clarifications regarding this RFP any time during the inquiry period listed in the RFP Calendar of Events. To make an inquiry, prospective Proposers must use the Inquiry tab on the RFP in Ohio|Buys to submit all inquiries or to seek clarification.

Prospective Proposers submitting inquiries will receive an immediate acknowledgement by e-mail that their inquiry has been received. The prospective Proposer who submitted the inquiry will not receive an e-mail response to the question, but will need to view the response on the State Procurement web site where it will be posted for viewing by all prospective Proposers.

Prospective Proposers may all view inquiries through the Inquiry tab located within the

RFP.

DBH will try to respond to all properly posed inquiries within 48 hours, excluding weekends and state holidays. DBH will not respond to any inquiries received after the date and time indicated on the RFP. Prospective Proposers who attempt to seek information or clarifications verbally will be directed to reduce their questions to writing in accordance with the terms of this RFP and state purchasing policy. No other form of communication is acceptable and use of any other form of communication or any attempt to communicate with DBH staff or any other agency of the State to discuss this RFP may result in the Proposer being deemed ineligible.

PART FOUR: EVALUATION OF PROPOSALS

I. EVALUATION PROCESS

DBH’s evaluation process of responses submitted to this request may consist of up to four distinct phases:

1. DBH’s initial review of all proposals for timely submission;

2. An evaluation committee review of the proposals for defects and scoring;

3. DBH’s request for more information (clarifications, interviews, presentations, and/or demonstrations); and,

4. Negotiations or best offer requests.

At its sole discretion, DBH will determine whether phases three and/or four are necessary under this RFP, reserving for itself the ability to eliminate or add phases three or four at any time during the evaluation process. DBH may add or remove sub-phases to phases 2 through 4 at any time if DBH believes doing so will improve the evaluation process.

II. PROPOSAL EVALUATION CRITERIA

In the proposal evaluation phase, DBH staff or reviewers selected by DBH (the committee) will rate the proposals submitted in response to this RFP based on the following criteria and weight assigned to each criterion.

Evaluation Criteria Weight Rating Extended Score

The proposal demonstrates the applicant’s organizational experience and capacity to successfully perform work relevant to this RFP.

The proposal clearly describes the applicant’s technical approach for carrying out the Scope of Work and completing all required objectives.

The proposal outlines a comprehensive digital strategy that explains how the applicant will develop, host, and manage the campaign website, social media channels, and digital assets.

The proposal clearly describes how the applicant will engage and mobilize ADAMH Boards, youth-led organizations, schools, and community coalitions to support localized implementation of the campaign.

The proposal explains how the applicant will measure campaign performance through analytics, partner feedback, and other evaluation methods.

The proposal presents a clear and reasonable cost proposal that aligns with the Scope of Work and reflects efficient use of project resources.

Total: 150

III. SCORING

Each proposal will be scored, and numerical technical point values will be assigned according to the criteria listed below. The scale (0-5) will be used to rate each Proposal response to the RFP on the technical evaluation sections.

The Ohio Department of Behavioral Health will score the Proposal responses by multiplying the score received in each category by its assigned weight and adding all categories together for the Offeror’s total technical score.

RATINGS DEFINED:

Point Value

Explanation

0 DOES NOT MEET: Response description does not comply substantially with requirements or is not provided.

1 WEAK: Response description is poor related to meeting the objectives.

2 WEAK TO MEETS: Response description indicates the objectives will not be completely met or at a level that will be below average.

3 MEETS: Response description generally meets the objectives or expectations.

4 MEETS TO STRONG: Response description indicates the objectives will be exceeded.

5 STRONG: Response description significantly exceeds objectives or expectations in ways that provide tangible benefits or meets objectives or expectations and contains at least one enhancing feature that provides significant benefits.

The minimum acceptable score to award a contract will be: 95

PART FIVE: CONTRACT AWARD

I. CONTRACTUAL REQUIREMENTS

Any contract(s) resulting from this issuance of this RFP are subject to the terms and conditions as provided in the personal services contract. The information contained in the RFP and in the proposal submitted by the selected contractor shall be considered part of the contract.

Payments for any and all services provided pursuant to the contract are contingent upon the availability of state and federal funds.

All aspects of the contract apply equally to work performed by any and all subcontractors.

The Contractor, and any subcontractor(s), will not use or disclose any information made available to them for any purpose other than to fulfill the contractual duties specified in the RFP. The Contractor, and any subcontractor(s), agrees to be bound by the same standards of confidentiality including federal and state statutory and regulatory requirements that apply to the employees of DBH and the State of Ohio.

Before a contract can be awarded, an Affirmative Action Program Verification Form must be completed using the Ohio Business Gateway Electronic filing website (https://ohiobusinessgateway.ohio.gov). Contractor must have an approved Affirmative Action plan recorded with the State of Ohio Department of Administrative Services.

II. CONTRACT AWARD PROCESS

It is DBH’s intention to award one or more contract(s) under the scope of this RFP and as based on the RFP Calendar of Events schedule, so long as DBH determines that doing so is in the State’s best interests and DBH has not otherwise changed the award date.

Any award decision by DBH under this RFP is final. After DBH makes its decision under this RFP, all Contractors will be notified (in writing or by phone, at DBH’s discretion) of the final evaluation and determination as to their Proposals.

DBH will issue a notice of contract award to the selected Contractor(s) and finalized contract terms and conditions will be forwarded for signature. Contract will include RFP and attachments and the Contractor’s accepted proposal. Once executed copies of the contract are submitted by the Contractor(s) and pending any further approvals that may be required (e.g., State Controlling Board), DBH will fully execute the contract.

Once the contract is fully executed, DBH will issue a purchase order (PO). DBH will issue to the Contractor(s) one (1) copy of the signed instrument and one (1) copy of the PO for its/their files.

Unless otherwise negotiated and included in the executed contract/scope of work, the selected contractor(s) shall be bound by all outlined services, policies and procedures as contained in the contractor’s submitted and evaluated proposal.

Contractor may commence work upon receipt of a state issued purchase order.

The selected contractor(s) shall be compensated based on deliverables listed in the RFP.

The personal services contract issued will further specify the timelines for completion of each deliverable and payment structure.

III. NUMBER OF AWARDS

It is DBH’s intention to award one or more contract(s) depending on programs’ needs and the fit of the Contractor(s) to the scope of this RFP.

IV. FUNDING APPROVAL THRESHOLD

In the event that contractual expenditures with the selected Contractor(s) will exceed $50,000 in spending under any contract that results from this RFP, or that otherwise exceed $50,000 in aggregate spending across all contracts between the contractor and DBH, the contract will be subject to the approval of the State of Ohio Controlling Board.

Appendix 1:

Executive Order 2019-12D

Governing the Expenditure of Public Funds for Offshore Services

No Contract Funds May be Spent Offshore

Executive Order 2019-12D “Governing the Expenditure of Public Funds for Offshore Services” prohibits the use of any public funds within the control of an executive agency to purchase services which will be performed outside of the United States. The Executive Order can be found at the following website:

https://governor.ohio.gov/wps/portal/gov/governor/media/executive-orders/2019-12d

To be considered by the DBH, a bid response must be accompanied by an Affirmation and Disclosure in the form attached to this RFP.

https://governor.ohio.gov/wps/portal/gov/governor/media/executive-orders/2019-12d

STANDARD AFFIRMATION AND DISCLOSURE FORM -EXECUTIVE ORDER 2019-12D

Governing the Expenditure of Public Funds on Offshore Services

By the signature affixed hereto, Contractor affirms, understands and will abide by the requirements of Executive Order 2019-12D. Both Contractor and any of its subcontractors shall perform no services under any contract with the Department of Behavioral Health outside of the United States.

The Contractor shall provide all the name(s) and location(s) where services under any contract with the Department of Behavioral Health will be performed in the spaces provided below or by attachment.

Failure to provide this information may subject the Contractor to sanctions. If the Contractor will not be using subcontractors, indicate “Not Applicable” in the appropriate spaces.

1. Name/Principal location of Contractor:

(Name) (Address, City, State, Zip)

2. Name/Principal location of subcontractor(s):

(Name) (Address, City, State, Zip)

(Name) (Address, City, State, Zip)

3. Location(s) where services will be performed by Contractor or by subcontractors if different from principal location(s):

(Address, City, State, Zip) (Address, City, State, Zip)

4. Location where state data will be stored, accessed, tested, maintained or backed-up, by Contractor or subcontractors if different from principal location(s):

(Address, City, State, Zip) (Address, City, State, Zip)

Contractor affirms that Contractor and all subcontractors shall immediately disclose to the Department of Behavioral Health any change or shift in location of services performed by Contractor or subcontractors after execution of any Contract with the Department. On behalf of the Contractor, I am duly authorized to execute this Affirmation and Disclosure form and have read and understand that this form is a part of any Contract that Contractor may enter into with the Department and is incorporated therein.

By: ____________________________________ ____________________________________ Contractor Signature Printed Name and Title

Date: ___________________________________

Appendix 2:

Contractor Information Form

The Contractor Information Form must be filled out and returned with a bid response.

CONTRACTOR INFORMATION FORM

THIS FORM MUST BE SUBMITTED WITH YOUR PROPOSAL

CONTRACTOR NAME:

STREET ADDRESS:

CITY: STATE: ZIP CODE:

AUTHORIZED CONTACT NAME:

PHONE NUMBER: EMAIL:

1. Identify all of contracts currently with the State of Ohio (including DBH).

Total # of Contracts:

State Agency: Amount:

Contracted Services:

Duration of Contract:

(Attach additional sheets if necessary.)

2. Provide current employee information on both a nationwide basis (including Ohio), and Ohio’s based operations.

NATIONWIDE OHIO

Total # of Employees:

Percent of Women:

Percent of Minorities:

3. Provide OAKS Supplier ID or Tax Identification Number:

4. If your billing address is different than mailing address above, please provide below:

Contractor Name:

Street Address:

City: State: Zip Code:

Authorized Signature Date

Appendix 3:

Example of DBH’ Personal Service Contract

The Example Personal Service Contract (PSC) does not need to be filled out and returned with a bid response. The Contractor that is selected will be supplied with a completed DBH PSC to sign, once this has been determined.

AGREEMENT BETWEEN THE

OHIO DEPARTMENT OF BEHAVIORAL HEALTH AND

THIS AGREEMENT is between the Ohio Department of Behavioral Health (hereinafter the “DBH”), 30 E.

Broad St. Columbus, Ohio 43215, and ( ) (hereinafter “Contractor”), .

Contract Information Overview Contractor Name Contractor’s Address Contractor’s OAKS ID End date of Agreement Renewal additional terms Total Compensation of Agreement DBH Billing Address DBH Department DBH Contract holder’s name DBH Contract holder’s email

Department of Behavioral Health Personal Service Contract

The parties agree as follows:

I. NATURE OF AGREEMENT

A. Contractor shall be employed as an independent contractor, to fulfill the terms of this Agreement and to act as a contractor to DBH. It is specifically understood that the nature of the services to be rendered under this Agreement are of such a personal nature that DBH is the sole judge of the adequacy of such services.

B. DBH enters into this Agreement in reliance upon Contractor’s representations that it has the necessary expertise and experience to perform its obligations hereunder, and Contractor warrants that it does possess the necessary expertise and experience.

C. Contractor shall perform the services to be rendered under this Agreement and DBH shall not hire, supervise, or pay any assistants to Contractor in its performance of services under this Agreement.

II. SCOPE OF WORK

A. Contractor shall perform the services (the “Work”) set forth in Exhibit 1, Scope of Work, attached hereto and made a part hereof.

B. Contractor shall, prior to undertaking any work, complete the following (select all that apply):

☐ Contractor who will be undertaking work at an DBH facility, or any personnel employed by Contractor who will be undertaking work at an DBH facility, shall, at Contractor’s expense, undergo a background investigation in the same manner as set forth in Ohio Administrative Code 5122-7-21(E)(1)(e). If the background investigation reveals a conviction or guilty plea that would disqualify an employment candidate according to Ohio Administrative Code 5122-7-21(D), Contractor must immediately provide new personnel or DBH may unilaterally terminate this contract.

☐ Contractor who will be undertaking work at an DBH facility, or any personnel employed by Contractor who will be undertaking work at an DBH facility, shall provide results of a negative tuberculosis test conducted within six months prior to Contractor or employee beginning work at the DBH facility.

☐ Contractor who will be undertaking work at an OMHAS facility, or any personnel employed by Contractor who will be undertaking work at an DBH facility to provide care, treatment, or other services for patients, shall provide proof of vaccination for COVID-19 in accordance with the facility policy before entering the OMHAS facility, as well as proof of receipt of immunization against any other disease specified in facility policy and in accordance with that policy. (Note: Some services and tasks performed in or for an DBH facility may be conducted so infrequently that COVID-19 vaccination is not required, such as ad hoc non-healthcare services (annual elevator inspection) or services that are performed exclusively off-site and not at or adjacent to any site of patient care (such as accounting services). However, DBH may choose to extend COVID-19 source control measures as appropriate. DBH facilities should consider the frequency of presence, services provided, and proximity to patients and staff.)

III. TIME OF PERFORMANCE

A. The Work shall be commenced on or after the date of an approved purchase order.

The Work shall be concluded on or before . This Agreement shall terminate on the earlier to occur of: (i) the date on which the Work is completed to the satisfaction of DBH or (ii) the date on which this Agreement is terminated as provided in Article VI, Termination of Contractor’s Services.

B. As the current General Assembly cannot commit a future General Assembly to expenditure, this Agreement expires no later than June 30, 2027. Prior to expiration, DBH may renew this Agreement for an additional term of on the same terms and conditions by giving Contractor written notice of DBH’s desire to renew.

C. It is expressly agreed by the parties that none of the rights, duties, and obligations herein shall be binding on either party if award of this Agreement would be contrary to the terms of Ohio Revised Code (“R.C.”) 3517.13, 127.16 or Chapter 102.

IV. COMPENSATION

A. DBH shall pay Contractor no more than for the Work.

B. The total amount due shall be computed according to the following cost schedule (lump sum for work produced, installment payments on a schedule, hourly pay, etc):

Insert payment schedule

C. Travel – (choose one)

☐ No Travel - Contractor shall not be separately reimbursed for travel, lodging or any other expenses incurred in the performance of the Work.

☐ Travel Reimbursement - Contractor shall be reimbursed for Contractor’s reasonable, actual and necessary travel, lodging, and other travel-related expenses incurred in the performance of the Work to the extent that such reimbursement is in the best interest of the state.

1. Only travel expenses which are pre-approved by DBH will be reimbursed.

2. Travel expenses shall be reimbursed under the same rules and conditions that apply to state employees under Ohio Adm.Code 126-1-02, pursuant to the Ohio Office of Budget and Management (“OBM”) Travel Policy, attached as Exhibit 2.

3. If it is not possible to follow the OBM Travel Policy, with prior approval of DBH, Contractor shall be reimbursed pursuant to the federal rates for reimbursement in the Continental United States.

4. Meals shall not be reimbursed unless overnight travel is both critical and essential.

D. Contractor must receive a purchase order from DBH prior to filling an order or performing any of the Work.

E. After Contractor receives a purchase order, Contractor shall submit an invoice for the Work performed consistent with this Article IV, Compensation. Each invoice shall contain an itemization of the Work performed, including dates the Work was performed and total hours worked, if required by Paragraph B.1., above, the location or address where the Work was performed, and the sum due at that time pursuant to this Agreement. All invoices shall contain Contractor's name and address and shall reference DBH and list the billing address as , Attn: , . All invoices must be submitted no later than sixty days after the Work performed. After receipt and approval by DBH of a proper invoice, as defined by Ohio Adm.Code 126-3-01(A)(5), payment will be made pursuant to Ohio Adm.Code 126-3-01. Unless otherwise directed by DBH, invoices should be directed via email to: .

F. In the event that any customer of Contractor negotiates a lower fee structure for the Work or comparable services, Contractor shall promptly notify DBH and shall extend the lower negotiated rate to DBH retroactively to the first date the lower rate was offered to another customer.

V. CERTIFICATION OF FUNDS

A. It is expressly understood and agreed by the parties that none of the rights, duties, and obligations described in this Agreement shall be binding on either party until all relevant statutory provisions of the Ohio Revised Code, including, but not limited to, R.C. 126.07, have been complied with, and until such time as all necessary funds are available or encumbered and, when required, such expenditure of funds is approved by the Controlling Board of the State of Ohio, or in the event that grant funds are used, until such time that DBH gives Contractor written notice that such funds have been made available to DBH by DBH’s funding source.

VI. TERMINATION OF CONTRACTOR’S SERVICES

A. DBH may, at any time prior to completion of the Work, suspend or terminate this Agreement with or without cause by giving written notice to Contractor.

B. In the event that the Work includes divisible services, DBH may, at any time prior to completion of the Work, by giving written notice to Contractor, suspend or terminate any one or more such portions of the Work.

C. Contractor, upon receipt of notice of suspension or termination, shall cease work on the suspended or terminated activities under this Agreement, suspend or terminate all subcontracts relating to the suspended or terminated activities, take all necessary or appropriate steps to limit disbursements and minimize costs, and, if requested by DBH, furnish a report, as of the date Contractor receives notice of suspension or termination, describing the status of all Work, including, without limitation, results, conclusions resulting there from, and any other matters DBH requires.

D. Contractor shall be paid for services rendered up to the date Contractor received notice of suspension or termination, less any payments previously made, provided Contractor has supported such payments with detailed factual data containing Work performed and hours worked. In the event of suspension or termination, any payments made by DBH for which Contractor has not rendered services shall be refunded.

E. In the event this Agreement is terminated prior to completion of the Work, Contractor shall deliver to DBH all work products and documents which have been prepared by Contractor in the course of performing the Work. All such materials shall become, and remain the property of, DBH, to be used in such manner and for such purpose as DBH may choose.

F. Contractor agrees to waive any right to, and shall make no claim for, additional compensation against DBH by reason of any suspension or termination.

G. Contractor may terminate this Agreement upon sixty (60) days’ prior written notice to DBH.

H. If Contractor fails to perform any of the requirements of this contract, or is in violation of a specific provision of this contract, DBH may provide Contractor written notice of the failure to perform or the violation and may provide a specified period to cure any and all defaults under this contract. During the cure period, Contractor shall incur only those obligations or expenditures which are necessary to enable Contractor to continue its operation and achieve compliance as set forth in the notice. Should Contractor fail to comply within DBH's cure period, Contractor shall be held in default of this contract and the contract shall terminate at the end of the cure period.

VII. RELATIONSHIP OF PARTIES

A. Contractor shall be responsible for all of its own business expenses, including, but not limited to, computers, email and internet access, software, phone service and office space. Contractor will also be responsible for all licenses, permits, employees’ wages and salaries, insurance of every type and description, and all business and personal taxes, including income and Social Security taxes and contributions for Workers’ Compensation and Unemployment Compensation coverage, if any.

B. While Contractor shall be required to render services described hereunder for DBH during the term of this Agreement, nothing herein shall be construed to imply, by reason of Contractor’s engagement hereunder as an independent contractor, that DBH shall have or may exercise any right of control over Contractor with regard to the manner or method of Contractor’s performance of services hereunder.

C. Except as expressly provided herein, neither party shall have the right to bind or obligate the other party in any manner without the other party’s prior written consent.

D. It is fully understood and agreed that Contractor is an independent contractor and neither Contractor nor its personnel shall at any time, or for any purpose, be considered agents, servants, or employees of DBH. Unless Contractor is another State of Ohio entity or a participant in the Ohio Public Employees Retirement System (OPERS), Contractor and its personnel shall not be considered agents, servants, or employees of the State of Ohio, or public employees for the purpose of OPERS benefits.

E. Unless Contractor is a “business entity” as that term is defined in R.C. 145.037 (“an entity with five or more employees that is a corporation, association, firm, limited liability company, partnership, sole proprietorship, or other entity engaged in business”), Contractor shall have any individual performing services under this Agreement complete and submit to DBH the Independent

Contractor/Worker Acknowledgement form found at https://www.opers.org/forms-archive/PEDACKN.pdf. This paragraph is not applicable to OPERS member employers.

F. Contractor’s failure to complete and submit the Independent Contractor/Worker Acknowledgement form linked in Paragraph VII(E) at the time Contractor executes this Agreement shall serve as Contractor’s certification that Contractor is a “business entity” as that term is defined in R.C. 145.037.

G. Contractor declares that it has complied with all applicable federal, state, and local laws regarding business permits and licenses of any kind, including, but not limited to, any insurance coverage that is required in the normal course of business.

H. Contractor agrees that it does not have any authority to sign agreements, notes, and/or obligations or to make purchases and/or dispose of property for, or on behalf of, the State of Ohio or DBH.

I. Contractor agrees that while operating in an DBH facility, Contractor and/or any employee or subcontractor of Contractor,shall follow all applicable rules and regulations for that facility.

VIII. RECORD KEEPING

A. Contractor must keep all financial records in a manner consistent with generally accepted accounting principles. Additionally, Contractor must keep separate business records for this project, including records of disbursements and obligations incurred that must be supported by contracts, invoices, vouchers and other data as appropriate.

B. During the period covered by this contract and until the expiration of three (3) years after final payment under this contract, Contractor agrees to provide the State, its duly authorized representatives, or any person, agency or instrumentality providing financial support to the work undertaken hereunder, with access to and the right to examine any books, documents, papers, and records of Contractor involving transactions related to this contract.

C. Contractor shall, for each subcontract in excess of two thousand five hundred dollars ($2,500), require its subcontractors to agree to the same provisions. Contractor may not artificially divide contracts with its subcontractors to avoid requiring subcontractors to agree to this provision.

D. Contractor must provide access to the requested records no later than five (5) business days after the request by the State or any party with audit rights. If an audit reveals any material deviation from the contract requirements, and misrepresentations or any overcharge to the State or any other provider of funds for the contract, the State or other party will be entitled to recover damages, as well as the cost of the audit.

E. If this contract or the combination of all other contracts with Contractor exceeds ten-thousand dollars ($10,000) over a twelve (12) month period, Contractor agrees to allow federal government access to the contracts and books, documents, and records needed to verify Contractor’s and/or subcontractor's costs.

F. Contractor must comply with any direction from DBH to preserve documents and information, in both electronic and paper form, and to suspend any scheduled destruction of such documents and information.

https://www.opers.org/forms-archive/PEDACKN.pdf https://www.opers.org/forms-archive/PEDACKN.pdf

IX. RELATED AGREEMENTS

A. All Work is to be performed by Contractor, who may subcontract without DBH’s approval for the purchase of articles, supplies, components, or special mechanical services that do not involve the type of work or services described in Exhibit 1, Scope of Work, but which are required for satisfactory completion of the Work.

1. Contractor shall not enter into subcontracts related to the Scope of Work without prior written approval by DBH. All work subcontracted shall be at Contractor’s expense.

2. Contractor shall furnish to DBH a list of all subcontractors; their addresses; tax identification numbers; current licensure, certification, or accreditation, incuding any renewal or re-issuance thereof; and the dollar amount of each subcontract.

B. Contractor shall bind its subcontractors to the terms of this Agreement, so far as applicable to the work of the subcontractor, and shall not agree to any provision which seeks to bind DBH to terms inconsistent with, or at variance from, this Agreement.

C. Contractor warrants that it has not entered into, nor shall it enter into, other agreements, without prior written approval of DBH, to perform substantially identical work for the State of Ohio such that the Work duplicates the work called for by the other agreements.

X. RIGHTS IN DATA AND COPYRIGHTS/PUBLIC USE

A. DBH shall have unrestricted authority to reproduce, distribute, and use (in whole or in part) any reports, data, or materials prepared by Contractor pursuant to this Agreement. No such documents or other materials produced (in whole or in part) with funds provided to Contractor by DBH shall be subject to copyright by Contractor in the United States or any other country.

B. Contractor agrees that all original works created under this Agreement shall be made freely available to the general public to the extent permitted or required by law until and unless specified otherwise by DBH. Any requests for distribution received by Contractor shall be promptly referred to DBH.

XI. CONFIDENTIALITY

A. Contractor shall not discuss or disclose any information or material obtained pursuant to its obligations under this Agreement without the prior written consent of DBH.

B. If applicable, Contractor agrees to execute the DBH business associate and/or qualified service organization agreement, or acknowledge receipt of HIPAA/42 CFR Part 2 training by executing the DBH Assurance of Preservation of the Confidentiality and Security of Protected Health Information prior to accessing any PHI or PII relating to services rendered under this contract.

C. Contractor agrees not to use advertising, news releases, sales promotions, or other publicity matters relating to any product or service furnished by Contractor wherein DBH’s name is mentioned, or language used from which a connection with DBH may be reasonably inferred, without the prior, written consent of…