______Area Community Based Flexible Supports Request for Response

COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF MENTAL HEALTH

RFR File Name/Title: ______AREA COMMUNITY BASED FLEXIBLE SUPPORTS REQUEST FOR RESPONSE

RFR File Number: 2010-______3054-01

Contact Person:

Address:

Fax #:

E-mail Address:

Procurement Category: ______Area Community Based Flexible Supports Request For Response RFR# 2010 _____ 3054-01 December 18, 2008

Table of Contents

SECTION 1 REQUEST FOR RESPONSE (RFR) SUMMARY...... 1 1.1 Issuing Entity/Contact Person and RFR Distribution...... 1 1.2 Description and Purpose of Procurement...... 2 1.3 Acquisition Method...... 2 1.4 Single or Multiple Contractors...... 2 1.5 Use of Procurement...... 2 1.6 Expected Duration of Contract (Initial Duration and Any Options to Renew)...... 3 1.7 Bidders’ Conference...... 3 1.8 Written Inquires...... 3 1.9 Procurement Time Table...... 4 1.10 Anticipated Expenditures, Funding or Compensation for Expected Duration...... 4 1.11 RFR Forms & Definitions...... 4 1.12 Definition of Terms...... 5 1.13 Bidder Communications...... 7 1.14 Public Records...... 7 1.15 Reasonable Accommodation...... 8 1.16 Minimum Bid Duration...... 8 SECTION 2 PROCUREMENT OVERVIEW...... 8 2.1 DMH Mission Statement...... 8 2.2 CBFS Service Description...... 9 2.3 CBFS Procurement Goals...... 11 SECTION 3 SERVICE SPECIFICATIONS...... 12 3.1 Referral to CBFS...... 12 3.2 Screening and Enrollment...... 12 3.3 Assessment...... 13 3.4 Individualized Action Plan...... 13 3.5 Service Components...... 14 3.6 DMH Affiliated Housing...... 17 3.7 Co-occurring Mental Illness and Substance Disorders...... 18 3.8 Individual Placement & Support...... 18 3.9 Peer Support...... 19 3.10 Notes...... 19 3.11 Client Record & Documentation...... 20 3.12 Crisis Management...... 20 3.13 Risk Management...... 20 3.14 Third Party Billing...... 21 3.15 Quality Management (QM) and Performance Outcomes...... 21 3.16 Contingency Payments...... 23 3.17 Meetings with DMH...... 23 3.18 Discharge Planning and Disenrollment...... 24 3.19 Staffing...... 25 3.20 Guardianships...... 25 3.21 Representative Payees...... 25 ______Area Community Based Flexible Supports Request For Response RFR# 2010 _____ 3054-01 December 18, 2008

3.22 Privacy and System and Data Security...... 25 3.23 DMH Standards, Regulations and Policies and State and Federal Rehab Option Requirements...... 26 3.24 Transition to CBFS...... 26 SECTION 4 FISCAL SPECIFICATIONS...... 27 4.1 Basis of Reimbursement...... 27 4.2 Fiscal Reporting Requirements...... 28 SECTION 5 RESPONSE REQUIREMENTS...... 29 5.1 Submission Deadline...... 29 5.2 Submission Format...... 29 5.3 Response Format...... 29 5.4 Response Requirements...... 31 5.5 RFR Response Cover Sheet...... 32 5.6 Service Proposal (75 page limit)...... 32 5.7 Cost Proposal...... 42 5.8 Affirmative Market Program Plan...... 46 5.9 Separate Responses for Each Contract...... 48 SECTION 6 REVIEW AND SELECTION PROCESS...... 48 6.1 Compliance with Submission Requirements...... 48 6.2 Review Process...... 48 6.3 Oral Presentations...... 49 6.4 Rejection of Responses...... 49 6.5 Recommendation for Award...... 49 6.6 Best and Final Offer...... 50 6.7 Selection and Contract Negotiations...... 50 6.8 Contract Award Decision and Award Notification...... 51 6.9 Debriefing...... 51 6.10 Administrative Appeals...... 51 SECTION 7 CONTRACTING POLICIES...... 53 7.1 Mandatory Contract Provisions...... 53 7.2 Completion of Work...... 53 7.3 Contract Authorization and Effective Start Date...... 54

APPENDICES

Appendix A DMH Community Based Flexible Supports Standards Appendix B The Massachusetts Standardized Documentation Project (MSDP):  Adult Comprehensive Assessment Tool*  Individualized Action Plan Format*  Progress Note Format* *The attached forms are currently in draft form and are expected to be finalized no later than the contract start date. Appendix C Recovery Learning Communities Appendix D DMH CBFS Contingency Fund Procedures Appendix E Client Scenario ______Area Community Based Flexible Supports Request For Response RFR# 2010 _____ 3054-01 December 18, 2008

Appendix F Existing Activity Codes for 3049, 3059 and 3013

Contract Descriptions Appendix 1 Client Population Description for the ______Appendix 2 Client Population Description for the ______Area Community Based Flexible Supports Request For Response RFR# 2010 _____ 3054-01 December 18, 2008

SECTION 1 REQUEST FOR RESPONSE (RFR) SUMMARY

1.1 Issuing Entity/Contact Person and RFR Distribution

Issuing Entity: ______Area of the Department of Mental Health RFR File Title: ______Area Community Based Flexible Supports Request for Response RFR File Number: 2010-____-3054-01 Contact Person: ______Address: Department of Mental Health ______Area Office ______Fax #: ______E-Mail Address: ______

This RFR has been distributed electronically using the Commonwealth of Massachusetts Procurement Access and Solicitation (Comm-PASS) system. Comm-PASS is the official system of record for all procurement information. It is publicly accessible at no charge at www.comm-pass.com. All records on Comm-PASS consist of multiple tabs, or pages. For example, Solicitation records contain Summary, Rules, Issuer(s), Intent or Forms & Terms and Specifications, and Other Information tabs. Each tab may contain data and/or file attachments provided by DMH. All are incorporated into this RFR.

It is the responsibility of every bidder to check Comm-PASS for any addenda or modifications to a solicitation for which they intend to respond. The Commonwealth and its subdivisions accept no liability and will provide no accommodation to bidders that submit a response based upon an out-of-date solicitation document. Potential bidders are advised to check the “last change” field on the summary page of solicitations to which they intend to respond to ensure they have the most recent solicitation files.

The bidder may not alter the RFR or its components except for those portions intended to collect the bidder’s response (cost pages, etc.). Modifications to the body of the RFR, specifications, terms and conditions, or any other documents that would change the intent of this RFR are prohibited. Any modifications other than where the bidder is prompted for a response will disqualify the response.

For more information about Comm-PASS see the Operational Services Division RFR Required Specifications that are included under the “Forms & Terms” tab of the Comm-PASS file of this RFR.

- 1 - 1 ______Area Community Based Flexible Supports Request For Response RFR# 2010 _____ 3054-01 December 18, 2008

1.2 Description and Purpose of Procurement

The Massachusetts Department of Mental Health (DMH), through this RFR, is seeking to procure Community Based Flexible Supports (CBFS) for the ______Area. The Area anticipates awarding one contract for each of the client populations described in the Contract Descriptions attached to this RFR for a total of ____ (--) contracts. (See also Subsection 1.10 for more information on the different contracts that may be awarded under this RFR.)

CBFS is a new activity code for DMH. CBFS contractors are responsible for providing rehabilitation, support, supervision, and housing/room and board where needed to a defined set of DMH adult clients in the Area. Housing/room and board may only be provided by CBFS contractors to clients receiving rehabilitation in accordance with the clients’ Individualized Action Plans (see Subsections 3.4 and 3.5) unless approved by the Area Director in writing. CBFS is designed to increase clients’ capacity for independent living and their recovery from mental illness. It is the role of CBFS contractors to individualize the delivery of services in partnership with each client. A contractor is required to adjust the mix and intensity of CBFS provided to individual clients to meet their changing needs and goals as they move toward recovery and to coordinate CBFS with the clients’ other DMH services and, to the extent feasible non-DMH services.

The CBFS activity code replaces in full the following existing DMH adult activity codes: 3049 Adult Residential Services; 3059 Community Rehabilitative Support (CRS); and 3013 Rehabilitative Treatment in the Community (RTC). The descriptions for these existing codes are attached to this RFR as Appendix F.

CBFS contractors must be able to provide the full array of CBFS directly or through subcontracts, affiliate agreements or other arrangements approved by the applicable DMH Area Office. The role of DMH, relative to CBFS, will be to award contracts, determine individuals eligibility for DMH continuing care services, refer clients, monitor client outcomes and activities, engage in collaborative risk management with clients and contractors, perform utilization review and contract management activities, conduct audits, and reimburse contractors for services rendered.

1.3 Acquisition Method

__X___ Fee For Service ______Other (Specify):

1.4 Single or Multiple Contractors

____ Single Contractor __ X___ Multiple Contractors

1.5 Use of Procurement

____ Open for use under separate contract execution

____ Open to all eligible public entities

____ Restricted to use by defined entities only:______

_X_ Restricted to use by issuing entity only

1.6 Expected Duration of Contract (Initial Duration and Any Options to Renew)

Initial Duration: up to __5__ year(s)

Renewal Options: up to __3__ options for up to __1__ year each option (DMH reserves the right to exercise more than one option at any given time).

Any contract award made as a result of this RFR and all contract renewals are subject to appropriations and contractor performance on an on-going basis.

1.7 Bidders’ Conference

A bidders’ conference ____ WILL NOT be offered.

A bidders’ conference __X__ WILL be offered.

Date: January 8, 2009 Time: 10:00 – 11:30 AM Location: Hoagland-Pincus Conference Center University of Massachusetts Medical School Address: 222 Maple Avenue, Shrewsbury, MA

1.8 Written Inquires

There ____WILL NOT be an opportunity for written questions.

There __X__WILL be an opportunity for written questions. Questions may be submitted to the Contact Person named in Subsection 1.1 by mail, fax, or e-mail. To be considered, questions must be submitted by 4 p.m. EST on January 13, 2009. DMH will review questions received before the deadline and, at its discretion, prepare written answers to questions of general interest. Written answers, if any, will be posted on Comm-PASS as indicated in Subsection 1.9. DMH is not bound by any oral comments or representations made by the Contact Person and/or any other employee of DMH.

Except as set forth in 5.6.2.h (Qualification), telephone calls will NOT be accepted regarding this RFR.

1.9 Procurement Time Table

RFR Release Date: December 18, 2008 Statewide Bidders’ Conference: January 8, 2009 Written Inquiries Due: January 13, 2009, 4:00 pm EST Anticipated Answers to Written Inquiries Posted on Comm-PASS January 20, 2009 Response(s) Due: February 27, 2009, 4:00 pm EST Send responses to the Contact Person at the address specified in Subsection 1.1 Review of Responses and Contract Negotiations March 2 – April 3, 2009 Anticipated Award Announcement April 6, 2009 Contract Start Date: July 1, 2009

1.10 Anticipated Expenditures, Funding or Compensation for Expected Duration

__X__ Contract(s) will have a Maximum Obligation Amount.

_____ Contract will NOT have a Maximum Obligation Amount (Rate Contract).

_____ Subject to Quotes by Pre-Qualified List of Contractors.

The estimated annualized maximum obligation amounts for the different contracts that may be awarded under this RFR are as follows:

Contract Description Estimated Annualized Maximum Obligation Amount Appendix 1 $ Appendix 2 $ Appendix 3 $ Appendix 4 $

Federal funds __X__ MAY be used to fund part/all of Contract(s)

Federal funds ____ WILL NOT be used to fund part/all of Contract(s)

DMH reserves the right at any time to change the maximum obligation of any contract awarded under this RFR and/or to award subsequent or additional contracts to other bidders when DMH considers it necessary or appropriate. Examples of when this may be necessary or appropriate include, but are not limited to, (a) the early termination or non- renewal of another contract, (b) an increase in the need for services and in availability of funding; and (c) a programmatic decision to reallocate funds due to the under-utilization of services in other existing contracts.

1.11 RFR Forms & Definitions

All forms and terms included under the "Forms & Terms" tab of the Comm-PASS file of this RFR are expressly incorporated herein by reference and made a part of this RFR. These forms and terms include, but are not limited to, the following:

 Operational Services Division RFR Required Specifications. The “Required for POS Only” provisions contained in these Specifications are applicable to this RFR and the contracts to be awarded as a result of the RFR.  Commonwealth Terms and Conditions for Human and Social Services  Commonwealth of Massachusetts Standard Contract Form and Instructions  DMH Additional Contract Terms and Conditions  List of Permitted Response Attachments  POS Attachments 3 – 6  UFR Titles  Affirmative Market Program Plan Form  Authorized Signatory Listing  Authorization for Electronic Funds Payment  RFR Evaluation Tool  MA Form W-9  WTO Government Procurement Agreement Link  RFR Cover Sheet  DMH CBFS Business Associate Terms and Conditions  Staffing Chart

1.12 Definition of Terms

Affirmative Market Program Plan (AMPP): Specifies how a contractor will utilize and/or mentor M/WBEs under the contract awarded as a result of this RFR.

Area Director: The senior DMH administration official in a DMH Area.

Culturally and Linguistically Competent Services: Services that demonstrate an integration and transformation of knowledge, information, and data about individuals and groups of people into specific clinical standards, skills, service approaches, techniques, and marketing services that match the culture and language of the individual receiving services so that there is an increase in the quality and appropriateness of health and behavioral care and outcomes.

Day: A calendar day including weekends and holidays.

Disenrollment: When a client stops receiving CBFS services from a CBFS contractor as specified in Subsection 3.18.

DMH Area: The geographic subdivision within the state that is responsible for providing access to comprehensive mental health services for individuals within its boundaries. There are six (6) DMH Areas. Each Area is administered by an Area Director who is supported by an Area Office. Areas are further divided into “Sites” that are managed by Site Directors at Site Offices.

DMH Client: An individual who has been determined to be eligible for DMH continuing care services according to clinical and need-for-services criteria contained in 104 Code of Massachusetts Regulations (CMR) 29.04 and is receiving at least one DMH funded service.

Enrollment: A DMH client who has been referred to and screened by a CBFS contractor (Subsection 3.2) and who has not been disenrolled pursuant to Subsection 3.18.

Evidence Based Practices: Approaches to prevention or treatments that are based in theory and have undergone scientific evaluation. "Evidence-based" stands in contrast to approaches that are based on tradition, convention, belief, or anecdotal evidence.

Full-Time Equivalent (FTE): Forty (40) hours a week defines a full time employee.

Legally Authorized Representative (LAR): The LAR is a guardian or other fiduciary granted applicable authority by a court of competent jurisdiction. It also includes a Health Care Agent who is authorized to make health care decisions under a valid Health Care Proxy.

Licensed Practitioner of the Healing Arts (LPHA): A practitioner who has the authority within the scope of his or her practice under State law to recommend Rehabilitative Services when, in his or her judgment, the provision of medical or remedial services would promote maximum reduction of physical or mental disability and restore a DMH client to his or her best possible functional level. The following is a list of LPHAs currently recognized under state law:

a. Physicians licensed pursuant to the requirements of M.G.L. c.112 §§ 2, 9, and 9B, which authorizes the person to engage in the practice of medicine (243 CMR 2.00). b. Registered Nurses licensed pursuant to M.G.L. c.112 (244 CMR 3.00). c. Psychologists licensed pursuant to M.G.L. c.112 (251 CMR 1.00-4.00). d. Licensed Independent Clinical Social Workers, Licensed Certified Social Workers and Licensed Social Workers licensed pursuant to M.G.L. c.112 (258 CMR 12.00). e. Registered Occupational Therapists licensed pursuant to M.G.L. c.112 (259 CMR 3.00). f. Licensed Rehabilitation Counselors licensed pursuant to M.G.L. c.112 (262 CMR 4.00.)

g. Licensed Mental Health Counselors licensed pursuant to M.G.L. c.112 (262 CMR 2.00.) h. Other persons who become licensed in a mental health related discipline or profession in accordance with state law and regulations and subject to the approval of the Commissioner of DMH.

M/WBE: A Minority Owned Business or a Woman Owned Business certified as such by the State Office of Minority and Woman Business Assistance (SOMWBA). For a list of M/WBEs, go to: http://www.somwba.state.ma.us/BusinessDirectory/BusinessDirectory.aspx.

Person Centered Planning: A process in which a client’s strengths, experiences, culture, values, preferences, needs, hopes and life goals guide the type, intensity, and duration of the services provided.

Recovery: The process by which people are able to live, work, learn, and participate fully in their communities. For some individuals, recovery is the ability to live a fulfilling and productive life despite a disability. For others, recovery implies the reduction or complete remission of symptoms. President's New Freedom Commission Report

Resilience: The personal and community qualities that enable individuals to rebound from adversity, trauma, tragedy, threats, or other stresses – and to go on with life with a sense of mastery, competence, and hope. President's New Freedom Commission Report

Strength-Based: An approach to service delivery that utilizes a client’s existing competencies and abilities to guide and implement the client’s Individualized Action Plan. Strengths are maximized and used in areas where the client wants help in reaching his/her goal. This approach is supported by a framework of hope, healing, and empowerment.

1.13 Bidder Communications

Bidders are prohibited from communicating directly with any employee of DMH regarding this RFR, except as specified in this RFR; and no other individual Commonwealth employee or representative is authorized to provide any information or respond to any question or inquiry concerning this RFR. Bidders may contact the Contact Person for this RFR (Subsection 1.1) if this RFR is incomplete or the bidder is having trouble obtaining any required attachments electronically through Comm-PASS.

1.14 Public Records

All responses and information submitted in response to this RFR are subject to the Massachusetts Public Records Law, M.G.L. c.66, §10, and to c.4, §7, Subsection 26. Any statements in submitted responses that are inconsistent with these statutes will be disregarded.

1.15 Reasonable Accommodation

Bidders with disabilities that seek reasonable accommodation, which may include the receipt of RFR information in an alternative format, must communicate such requests in writing to the Contact Person identified in Subsection 1.1. Requests for accommodation will be addressed on a case-by-case basis. The request must state that it is based on a disability and specifically identify the accommodation desired. Although DMH will make all reasonable efforts to accommodate the requests of bidders with disabilities, DMH reserves the right to reject unreasonable requests.

1.16 Minimum Bid Duration

Pursuant to M.G.L. c.106, §2-205, bidders’ responses/bids submitted in response to this RFR must remain in effect for 90 days from the date of submission.

SECTION 2 PROCUREMENT OVERVIEW

2.1 DMH Mission Statement

An organization awarded a contract as a result of this RFR will be responsible for ensuring that the mission and values of DMH, and when applicable DMH policies, directives, procedures and initiatives, are integrated and adhered to in all contract activities and by all staff members. DMH’s vision and mission statements are as follows:

Vision Mental health is an essential part of health care. The Massachusetts Department of Mental Health, as the State Mental Health Authority, promotes mental health through early intervention, treatment, education, policy, and regulation so that all residents of the Commonwealth may live full and productive lives.

Mission Statement The Department of Mental Health, as the State Mental Health Authority, assures and provides access to services and supports to meet the mental health needs of individuals of all ages, enabling them to live, work, and participate in their communities. The Department establishes standards to ensure effective and culturally competent care to promote recovery. The DMH sets policy, promotes self determination, protects human rights and supports mental health training and research. This critical mission is accomplished by working in partnership with other state agencies, individuals, families, providers, and communities.

DMH has an overall goal of promoting Recovery and Resiliency through Partnership. This goal is fostered by the principles of: meaningful client and

family involvement; self- and family-direction; dignity and respect; culturally and linguistically competent care; elimination of disparities; use of evidence-based practices; and operational efficiencies.

2.2 CBFS Service Description

DMH provides services to adults with serious and persistent mental illness to facilitate and support their maximal integration in the community. This is accomplished by providing services that are responsive to the preferences and needs of individuals and their families and focused on rehabilitation and recovery.

Mental illness affects thousands of individuals of all ages, ethnicities, gender, and social backgrounds including subpopulations such as transitional age youths, elders, homeless individuals, parents with mental illness, individuals who are deaf and hard of hearing, individuals with substance use disorders, and individuals with co-morbidity.

Recent data from Massachusetts and other states show that those with psychiatric disabilities die from treatable medical illnesses at rates that are significantly higher than those in the general population, dying up to 25 years earlier from cardiovascular disease, respiratory illness, and lung cancer. (National Association of State Mental Health Program Directors: October 2006). Additional noteworthy data regarding individuals with serious mental illness include:

 75% are tobacco-dependent compared to about 22% of the general population.  70% have a chronic health problem, most prevalent is pulmonary disease.  42% have a chronic health problem severe enough to limit functioning.  Individuals with depression or bipolar disorder are twice as likely to be obese as the general population; with schizophrenia the likelihood is three times greater.  34% have hypertension.  13% of schizophrenic adults in their 50s have also been diagnosed as diabetic as compared to 8% of 50 year olds in the general population.

CBFS is the cornerstone of DMH’s community mental health system for adults. Through the procurement of CBFS, DMH intends to continue the transformation of its adult community based system of care into one that embraces the values of recovery and resiliency with emphasis on rehabilitation and person-centered care. The flexible nature of CBFS is consistent with these values and allows for services to be offered in a manner that cultivates resiliency and recognizes, encourages, nurtures, and supports each client’s path to recovery.

In addition to Service Specifications (Section 3) and Service Standards (Appendix A,) each CBFS contractor must fully integrate into its service delivery structure the following:

 Assessments, treatment planning, and service delivery are done in collaboration with clients, utilizing a person-centered planning process.

 A trauma informed approach to treatment planning and service delivery. Effective trauma informed care includes an understanding of a client’s symptoms in the context of the client’s life experiences and history, social identity, and culture.

 Growth and recovery involve taking reasonable risk and that clients must be supported through that process.

 Services are individualized and provided, to the extent feasible, in the least restrictive clinically appropriate setting using the least intrusive interventions.

 Services are age and developmentally appropriate, including services for transitional age youth and elders.

 Culturally and linguistically competent services, including assessment and treatment planning (Subsection 1.12) that are sensitive and responsive to cultural, ethnic, linguistic, sexual orientation, gender differences, parental status, and other individual needs of the clients.

 Culture of wellness is promoted by facilitating access to needed medical and dental services.

 Peer-to-peer services and peer-to-peer education is embraced and cultivated.

 Working relationships with other relevant community organizations and natural supports to help facilitate clients leading full lives in the community with the support networks of their choosing.

 The principles of the Individual Placement and Support (IPS) model to support clients interested in maintaining or obtaining employment. Becker, D.R. and Drake, R.E. (1993) Awaking Life: The Individual Placement and Support (IPS) Program, N.H.: New Hampshire-Dartmouth Psychiatric Research Center.

 Evidenced based practices and best practices when appropriate.

As described in detail in Section 3, CBFS encompasses four key service components: Rehabilitation, Supervision, Support, and Housing/Room and Board. Housing/Room and Board may only be provided by CBFS contractors to clients receiving rehabilitation in accordance with the clients’ Individualized Action Plans unless approved by the Area Director in writing. In addition, CBFS contractors are responsible for: client screenings and enrollment; assessments and integrated treatment planning; quality and utilization

management; data collection and reporting; service documentation and discharge planning.

Each CBFS contractor must have the capacity to provide, directly or through subcontracts, the full array of CBFS components and service specifications. A CBFS contractor will be responsible for a client population that includes individuals who need intensive services as well as those who require less intensive supports. A contractor is required to adjust the mix and intensity of CBFS provided to each client to meet each client’s changing needs and goals as the client moves toward recovery. The individual clients served will change as new clients enter the service system and current clients achieve their recovery goals and are discharged or otherwise leave the applicable service area or DMH.

Each CBFS contractor has the responsibility and the authority for making decisions about utilization, resource allocations and service delivery. Such decisions are not subject to prior approval by DMH. DMH will measure performance through client and administrative outcomes and through quality and utilization review. DMH will also be responsible for contract monitoring and auditing. DMH will work collaboratively with the contractor to manage high risk clients. (See Subsection 3.13)

CBFS contractors will be compensated for services rendered on a unit rate basis, as described in Section 4.

2.3 CBFS Procurement Goals

DMH has two sets of overarching goals for the CBFS procurement.

2.3.1 Service Delivery Goals. The focus of CBFS service delivery is on rehabilitative interventions that facilitate recovery and achieve the following outcomes for the clients being served:

 Safe, stable housing  Full participation in the community  Self management  Self determination and empowerment  Wellness and improved physical health  Independent employment

2.3.2 Administrative Goals. To maximize the effectiveness of available resources this procurement is designed to achieve the following system outcomes:

 Administrative efficiencies  The payment of a fair price for the services contractors provide  Enhancement of DMH’s ability to collect Federal Financial Participation (FFP) for the rehabilitation services rendered

 Contractors’ maximize third party payments (e.g., food stamps, housing subsidies) and use of generic services (e.g., Visiting Nurses Association Home Health agencies, Massachusetts Rehabilitation Commission)  An efficient system of care that is supported by meaningful utilization management and financial oversight  An integrated and flexible system of care that is driven by clinical, rehabilitative, and recovery expertise  Reduced number of group living situations, as appropriate

SECTION 3 SERVICE SPECIFICATIONS

CBFS contractors must provide Rehabilitation, Support, Supervision, Housing/Room and Board to their assigned clients as needed to facilitate each client’s recovery in a safe and clinically appropriate manner. Key features of CBFS are: person-centered planning, flexibility, movement towards independence and community integration, and service coordination across the continuum of services needed by the clients served. CBFS is provided in accordance with each client’s Individualized Action Plan (Subsection 3.4). The service components and other service features are described in this Section 3.

3.1 Referral to CBFS

DMH is responsible for determining eligibility for DMH continuing care services and for referring DMH clients to a specific CBFS contractor. Referrals are made by the applicable DMH Area Office and/or Site Office. Referral information includes materials gathered through the eligibility determination process, as appropriate; as well as documents that identify the reasons for the referral. The CBFS contractor must accept all referrals within its negotiated capacity (for capacity see Subsection 5.7.1). DMH only pays for CBFS rendered to DMH clients who have been referred to a CBFS contractor by DMH.

3.2 Screening and Enrollment

A Licensed Practitioner of the Healing Arts as defined by Subsection 1.12 must meet and screen each DMH client who is referred to a CBFS contractor within 72 hours, including holidays and weekends, of the referral. The purpose of the screening is to determine if any immediate interventions are needed to maintain the client’s health and safety until a full Individualized Action Plan (IAP) is completed. If urgent needs are identified, the clinician and client must develop and implement a critical needs plan. Upon completion of the screening, the client will be considered enrolled into CBFS. The screening and the critical needs plan and the documentation of such must meet DMH CBFS Standard I.A (Appendix A). Within one (1) business day of a DMH client being enrolled into CBFS, the CBFS contractor must notify the applicable DMH Site Office in accordance with the procedures established by the Site Office. Upon notification, the enrollment information will be entered by DMH into DMH’s Mental Health Information System

(MHIS) to facilitate payment to the CBFS contractor. See Section 4 for more information on payments to CBFS contractors.

When a CBFS contractor is unable to screen a client due to circumstances related to the client (e.g., client is not able to make a scheduled appointment within 72 hours, client is unable to be located, client is resistant to services), the reasons must be documented as well as all attempts to engage the client. If after 7 days of referral, the CBFS contractor is unable to screen the client, the contractor must notify the DMH Site Office so next steps can be determined.

3.3 Assessment

Each newly enrolled CBFS client must be assessed within twenty (20) days of enrollment and, at a minimum, annually thereafter. CBFS contractors are required to use the Adult Comprehensive Assessment tool developed by the Massachusetts Standardized Documentation Project (MSDP) and corresponding instructions, which are attached as Appendix B or comparable forms and procedures as approved by DMH. The assessment must also be completed, documented and updated in compliance with DMH CBFS Standard I.B (Appendix A). For clients who will be transitioned into CBFS from DMH existing service activities see Subsection 3.24.

3.4 Individualized Action Plan

CBFS contractors must complete an integrated Individualized Action Plan (IAP) for each of its clients within ten (10) days of a client’s assessment being completed. The IAP is a comprehensive plan for all DMH services received by a client and, if feasible, also includes non-DMH services and supports. The IAP planning process is intended to be multidiscipline in nature in that all staff are expected to work in collaboration with the client (e.g., direct care staff, nurse, employment specialist). The CBFS contractor must collaborate with all of the client’s DMH operated or funded service providers and, to the extent feasible, the client’s other service providers. Clients/LARs may invite persons of their choice to be present at meetings regarding the development of their IAPs. It is DMH’s intention that clients receiving CBFS will not receive DMH case management services. However, in limited situations, when determined necessary by DMH, a CBFS client may receive case management services. If a CBFS client is receiving DMH case management services, the DMH case manager must be included in the IAP process.

In developing IAPs, CBFS contractors are required to use the IAP form developed by the Massachusetts Standardized Documentation Project (MSDP) and corresponding instructions, which are attached as Appendix B or comparable forms and procedures as approved by DMH. In addition, the IAP must be developed, documented and revised in accordance with DMH CBFS Standard I.C (Appendix A).

DMH intends to eliminate the requirement for Program Specific Treatment Plans as set forth in 104 CMR 29.07 and 29.08 and develop regulations for IAPs. CBFS contractors will be obligated to comply with the IAP regulations once promulgated.

3.5 Service Components

3.5.1 Rehabilitation: “Medical and remedial services recommended by a physician or other Licensed Practitioner of the Healing Arts, within the scope of his practice under state law, for maximum reduction of physical or mental disability and restoration of a recipient to his best possible functional level.” (Title XIX, Social Security Act.) For a service to be considered Rehabilitation, it must meet this definition; be identified as a rehabilitative service in the client’s IAP (see Subsection 3.3) and have a duration for authorized services based on the client’s assessed needs and anticipated progress. Services provided under the Rehabilitation component include, but are not limited to:

a. Interventions performed in partnership with the client designed to promote recovery: i. Manage psychiatric symptoms in community setting: self management plans, crisis management plans, cognitive behavioral therapy plans, dialectic behavioral therapy ii. Restore or maintain the skills needed to secure and maintain housing in the community iii. Restore or maintain the skills needed to maintain a stable home life (e.g. meeting financial obligations related to home expenses; addressing issues with property owners, utility companies and other parties; maintaining adequate supply of items needed to furnish the home) iv. Restore or maintain skills needed to access self-help options in the community v. Restore or maintain the skills needed to utilize various means of transportation vi. Restore or maintain daily living skills, including physical health maintenance (e.g. diet, exercise, receiving regular primary medical and dental care), self-care, purchasing and caring for personal items including clothing, etc vii. Restore or maintain the skills needed to manage money viii. Restore or maintain the skills needed to manage time, including: scheduling appointments, attending appointments and other events in a timely manner, calling when running late for or needing to postpone appointments ix. Restore or maintain the skills needed to take medications as prescribed

b. Pre-vocational related services that are not job specific, that assist clients to restore or maintain and utilize the skills necessary to undertake employment c. Informal supportive counseling and problem solving d. Social and recreational skill training to improve communication skills, encourage clients to utilize recreation and leisure resources, and facilitate appropriate interpersonal behavior e. Face-to-face crisis intervention to aid the client in managing a crisis, and intensive short-term interventions to stabilize behavior f. Telephone outreach to perform a brief assessment of client well being, including extent of presence of symptoms, and to prompt the client to follow treatment regimen, including taking medications and engaging in other therapeutic or rehabilitative activities g. Medication training that focuses on the role and effects of medication in treating symptoms of mental illness to include, but not be limited to, collaborating with prescribers to achieve the fewest number of medications at the lowest effective doses

3.5.2 Support: Any of the activities listed above for Rehabilitation could be support activities if they are performed on behalf of clients but do not meet the definition of Rehabilitation. Other examples of activities constituting Support include, but are not limited to, the following:

a. Participation in case conferences; providing family consultations; functioning as a liaison with community resources; providing consultations with state and community agencies; developing Individualized Action Plan b. Provision of reasonable furnishings and equipment to help maintain community tenancy c. Educational support; which may include assessing the effects mental illness has had on an individual’s ability to achieve educational goals within a normal timeframe d. Wellness promotion and support of the management of medical conditions. e. Assistance and support to access other services as needed such as:  psychiatric and medical  entitlements and benefits  generic education and employment services f. Support in exploring housing options and assistance with housing applications and housing search g. Assistance in maintaining community tenancy h. Assistance with management of client funds including serving as representative payee i. Assistance with obtaining access to, or providing, transportation j. Assistance with obtaining and maintaining employment

k. Assistance with organizing pillbox or blister packs, creating schedule for self administration and adhering to schedule l. Delivery of pre-packed medications m. Telephone contact and conferencing with pharmacies, primary care clinicians, hospitals, service programs and significant members of a client’s social network regarding medication regimes, side effects and desired effects of medication n. Preparation of correspondence when medical documentation is needed for collateral services to a client o. Client and family training about mental illness, the treatment of mental illness, the effects of mental illness on family members and resources available to family members

3.5.3 Supervision: Activities performed by staff to help maintain a safe environment for clients. Examples of activities constituting Supervision include, but are not limited to, the following:

a. Provide varying levels of staff supervision in a setting where the client is living b. Promote safety within the living environment and the community c. Provide ongoing monitoring of the client’s symptoms and response to treatment d. Provide assistance with taking medications as needed e. Monitor compliance and accuracy when assisting clients with medication

3.5.4 Housing/Room and Board. Housing/Room and Board where needed may only be provided by CBFS contractors to clients receiving Rehabilitation in accordance with the client’s Individualized Action Plan unless approved by the Area Director in writing. Housing/Room and Board is typically provided in group living situations for clients who are unable to maintain community placement without intensive and consistent supervision and structure.

Housing/Room and Board is the provision of sleeping accommodations to clients together with food and/or meals. If this definition is met, the following costs may be subsidized with contract funds: rent or mortgage payments (interest only and not principal), insurance, real estate taxes; utilities, food and maintenance costs. Cost for capital improvement is not considered an allowable expense. Housing provided to clients pursuant to the Housing First Model for engagement purposes will be considered housing done in support of Rehabilitation for purposes of this Subsection 3.5.4. If a CBFS contractor provides Housing/Room and Board, it must collect client contributions for such in accordance with DMH regulation and policy and 808 CMR 1:00. In addition, the CBFS contractor is required to provide handicapped accessible housing to clients if need is identified in the applicable Contract Description Appendix and/or as negotiated with DMH.

DMH intends to revise its community licensing standards set forth in 104 CMR 28.00. It is anticipated DMH will require physical site licensure only when the contractor leases or has a direct or indirect ownership interest in the property occupied by the client (see 104 CMR 28.15 (7)(a) and (b)). If licensure is applicable, the physical site will need to meet the current requirements of Subpart B of 104 CMR 28.00, with the exception of 28.15(5). Appropriate staffing for any residential site will need to be agreed upon by DMH and the applicable contractor based on client need and service model. Documentation requirements previously reviewed as part of licensing will be incorporated into DMH’s contract and utilization review processes.

3.6 DMH Affiliated Housing

DMH has had a long and successful history leveraging affordable housing resources for its clients, usually in the form of housing grants from federal, state, and local housing agencies. DMH services have been used to support clients living in the housing developed through such grants to maintain stable tenancies. In many instances, the value of these supportive services has been used to meet local matching requirements required by many federal housing programs.

Based on these commitments and the long-term benefit to DMH clients, DMH has the responsibility and interest to ensure that these identified housing resources are utilized to their fullest extent. This responsibility has been established and documented generally through one of four ways. First, DMH may have a direct ownership interest in the residential property. Second, housing may have been developed by third parties using capital financing and rent subsidy programs that restrict occupancy to DMH clients referred to by DMH. Third, access to housing may have been accomplished through rental subsidy programs exclusively available to DMH clients referred by DMH. Fourth, DMH may have written agreements with certain housing providers that give the DMH the exclusive right to refer clients for tenancy in specified housing units.

Included in the attached Contract Descriptions Appendices is a listing of the DMH affiliated housing leveraged by DMH as described above and which is currently available to the client population to be served under the applicable CBFS contract. It is DMH’s intent/expectation that these DMH affiliated housing resources identified in the Contract Description Appendices will be utilized by the CBFS contractors to the extent possible permitted by the applicable owners. This will require contractors to negotiate with the owners and may require the contractor to enter into grant, contract and/or other such administrative as well as reporting arrangements with state, local, federal, or private housing entities sponsoring the leveraged housing programs. As necessary and appropriate DMH will work with CBFS contractors to facilitate the creation of these arrangements and agreements, in order that the housing can continue to be available to DMH.

In addition, DMH intends to continue its strategy for leveraging external housing resources on behalf of clients. In recent years, DMH has focused its leveraging strategy on creating a supply of affordable apartments that provide clients with more independent supported living opportunities under their own leases. DMH expects CBFS contractors to collaborate with respective Area Offices in implementing this strategy.

3.7 Co-occurring Mental Illness and Substance Disorders

CBFS contractors must have the capacity to provide or arrange for:

 Engagement - interventions that are designed to facilitate the individual’s ability and motivation to initiate and maintain participation in dual diagnosis treatment services,  Relapse prevention  Use of self-help groups such as AA, NA, Al-Anon  Peer counseling

CBFS contractors may address the needs of its clients through collaboration, coordination consultation and linkage to providers with specialized knowledge of alcohol and drug services.

In providing CBFS services, the contractor must recognize that some clients may be actively using substances, that relapse is part of recovery, that safety remains a priority and that the sobriety of other clients may be jeopardized. The contractor must have protocols that address:

 Substance use  The handling of illicit and/or licit drugs brought to a service site by a client including actions that are to be taken by the contractor when a client is using substances onsite  Relapse prevention with procedures on how to handle relapse including time away from a group setting

3.8 Individual Placement & Support

CBFS contractors must provide Individual Placement and Support (IPS) for clients participating in or seeking vocational activities. This model must be embedded into all aspects of the contractor’s service model. The key principles of the IPS model are: (a) participation is based on client choice; (b) no one is excluded who wants to participate; (c) supported employment is integrated with treatment, (d) employment specialists collaborate with clinicians to ensure that employment is part of the IAP; (e) job search starts as soon as a client expresses interest in working; (f) follow-along supports are continuous as long as the client wants the assistance; (g) client preferences are important; and (h) benefits counseling is part of the employment decision-making process. A CBFS

contractor must have the capacity to provide or arrange for the provision of vocational services that assist clients with job placement and support.

In addition, CBFS contractors must establish, maintain, and utilize relationships with employment related services including but not limited to the following: Massachusetts Rehabilitation Commission (MRC), Career Centers, job training programs, Clubhouses, local colleges and universities, and disability services.

3.9 Peer Support

The CBFS contractors must ensure that clients have access to peer support services either directly or through subcontract. Peer support services are activities performed by individuals with lived experience whose knowledge about mental illness comes from the experience of being diagnosed and treated for his/her own mental illness, including co- occurring disorders. These activities include, but are not limited to, the following:

a. Provide advocacy, support, and education during intake and transition processes across the spectrum of services and transition to independence b. Serve as team members and assist the clients to communicate the goals of their personal recovery action plans to treatment teams c. Provide information and training on recovery tools and techniques, self management strategies, and when desired, assistance in developing a self management plan. (e.g., Wellness Recovery Action Plan) d. Support the development of self-advocacy skills e. Facilitate linkage to community services and networks f. Provide training and consultation to CBFS contractor staff to facilitate understanding clients’ perspectives

The amount of access to information and involvement of peers providing supports must be determined by each DMH client individually.

3.10 Notes

CBFS contractors must regularly document a DMH client’s progress towards the attainment of IAP goals and objectives. Progress notes are to be used to inform the IAP process. DMH requires the contractor to use the Progress Note forms and corresponding instructions developed by the Massachusetts Standardized Documentation Project (MSDP), which are attached as Appendix B, or comparable forms and procedures as approved by DMH. When using the MSDP progress note forms the contractor must, at a minimum, use the monthly note form and otherwise comply with current or future Medicaid Rehab Option requirements. Other MSDP notes may be used at the contractor’s discretion. In addition, the contractor must maintain other notes regarding the client’s life events. Progress Notes and other notes must meet DMH CBFS Standard I.D (Appendix A).

3.11 Client Record & Documentation

In delivering the CBFS service components, a CBFS contractor must maintain sufficient documentation to meet medical records standards, Medicaid Rehabilitation Option (Rehab Option) and contract billing requirements. The tools and forms developed by the Massachusetts Standardized Documentation Project (MSDP) currently meet generally acceptable medical records documentation standards. (See Subsections 3.3, 3.4, 3.10) Use of these forms is also sufficient to meet the requirements of Rehab Option. Documentation will need to be modified should standards or Rehab Option requirements change. Client records and documentation must meet DMH Standards I.E (Appendix A).

It is anticipated that the requirements set forth in Subpart A of 104 CMR 28.00 (28.02- 28.12) will be incorporated into DMH’s contract and utilization review processes, not as part of licensing. CBFS contractors must comply with these regulations and any subsequent changes made to these regulations. (See Subsection 3.5.4 regarding licensing changes.)

CBFS contractors must maintain a central CBFS file for each client containing all screenings, assessments, IAPs, and notes whether provided directly by the contractor or subcontractor.

3.12 Crisis Management

CBFS contractors must have and implement written protocols for developing crisis management plans for each of their CBFS clients. Crisis management plans must be developed through a collaborative process with the clients/LARs and, to the extent possible and authorized, individuals of the clients’ choosing, the clients’ other DMH service providers, applicable Emergency Service providers, and insurers as appropriate. Crisis management plans must be developed and maintained in accordance with DMH CBFS Standard VI (Appendix A).

As part of the above described protocol, or as a separate protocol, CBFS contractors must have procedures to respond to clients in crisis 24 hours a day, 7 days a week. The protocol must provide for CBFS staff availability 24 hours a day, 7 days a week and include provisions for the appropriate staff training thereby reducing the use of Emergency Service Program level of care.

CBFS contractors must have the capability to increase and change interventions in a timely manner in response to changes in client’s needs. This includes providing additional staff time with the client in the community, increasing client contacts (face-to- face or by phone), and, when indicated, relocating the client to a community-based staffed facility and/or a crisis stabilization bed (via the Emergency Service provider.)

3.13 Risk Management

Accepting risk is a fundamental dimension of supporting persons in their recovery. CBFS contractors must have a risk management protocol(s) which is consistent with DMH Area risk management protocols. DMH and CBFS contractors must work collaboratively on risk management activities. Contractors must participate in Area risk management activities and attend meetings as required.

3.14 Third Party Billing

CBFS contractors are responsible for billing third parties as applicable for services delivered to clients other than those specified in Subsection 3.5.1. Contractors must maximize third party offsets (e.g., food stamps, housing subsidies) and the use of generic services (e.g., Visiting Nurses Association, Home Health Care agencies, Massachusetts Rehabilitation Commission) when available.

3.15 Quality Management (QM) and Performance Outcomes

3.15.1 Quality Management Structure. DMH expects CBFS contractors to maintain internal quality and utilization management systems and to engage in activities to ensure the safety, quality and effectiveness of the services they provide through systematic performance improvement. Performance improvement is a continuous process that involves measuring, assessing, and improving systems and outcomes. An important aspect of performance improvement is reducing the likelihood and recurrence of adverse events and/or outcomes.

CBFS contractors must have in place mechanisms to gather and evaluate data regarding the quality of programmatic and administrative operations. This generally involves identifying certain crucial measures indicating performance, collecting and analyzing relevant data, and incorporating the analysis into the design of the service through ongoing planning and monitoring.

Specifically, CBFS contractors must collect and analyze data to:

a. Measure individual client outcomes to inform the IAP process b. Determine efficient use of programmatic resources c. Monitor effectiveness of services, particularly those focused on rehabilitation d. Inform workforce development including: staff recruitment, retention, training, supervision, and staff competencies e. Identify needs to modify delivery of services for individual clients f. Establish and monitor performance benchmarks and goals g. Inform quality management and improvement activities

CBFS contractors must also participate in quality improvement activities as required by DMH and to collect and analyze data to assist in facilitating such activities.

QM functions and responsibilities must be assigned to individuals with the appropriate skill set to oversee and implement organization-wide quality activities that apply to all clinical and non-clinical aspects of a contractor’s service delivery system.

In addition, CBFS contractors must have a process to review client records for monitoring compliance with the specifications of the RFR and DMH and contractors’ policies and procedures. The review must also monitor clients’ utilization of CBFS and the appropriateness of services. CBFS contractors must submit their process for client record review and annually submit a summary of the record reviews to DMH.

CBFS contractors must conduct an annual evaluation of their QM program. Also contractors must submit data from quality reviews and QM initiatives to DMH annually.

CBFS contractors must incorporate clients and family members into their QM structure.

3.15.2 Performance Outcomes, Performance Measures, Reporting. DMH will establish statewide performance outcomes and measures upon which all CBFS contractors will be required to report. Upon contract award, a contractor must collaborate with DMH to:

a. Develop specific outcome measures that will be used to determine achievement of the goals set forth in Subsection 2.3.1. This will include: defining terms, establishing numerators and denominators, determining the frequency of data collection, and identifying the applicable measurement tools. b. Establish specific performance targets during the first year of the contract. During the first six months of the contract baseline data will be collected and used to set the performance targets. c. Establish a pre-determined minimum data set that will be required to be submitted to DMH at set intervals which will include, but not be limited to, demographic information and service utilization data.

Further, DMH may require CBFS contractors to report outcomes using a tool selected by DMH.

Below are examples of potential performance outcomes related to service delivery and administrative goals:

 Increase in the percentage of clients who move to a less restrictive living arrangement  Increase in the percentage of clients who achieve their individualized discharge criteria and are discharged from CBFS in accordance with their discharge plan  Increase in the amount of third party revenues collected (e.g., food stamps, fuel assistance, community nursing services)  Increase community tenure (e.g., reduction in psychiatric hospitalizations, number of hospital days, jail stays)  Increase in the percentage of clients who are non-smokers  Increase in the percentage of clients who participate in wellness and fitness activities  Increase in the percentage of clients who are employed  Increase participation in self help groups for addictions  Increase in the percentage of clients who report satisfaction with their level of participation in their treatment planning.

3.15.3 Audits. DMH may at any time, but at a minimum yearly, audit a contractor’s performance, including compliance with the requirements of this RFR. As part of such audits, DMH will review client record and billing documentation, including Rehab Option requirements and other information the contractor is required to maintain and/or develop as part of its contract. Changes in the services to be delivered under the contract may be made as a result of these audits.

3.15.4 Client Satisfaction Survey. DMH intends to retain the services of a third party to assess client satisfaction with CBFS. CBFS contractors must participate and cooperate with DMH and the selected third party responsible for administering the survey. CBFS contractors are prohibited from retaliating against clients who participate in the survey. Findings from the survey will be used to inform quality improvement activities and will not be used to penalize CBFS contractors.

3.16 Contingency Payments

CBFS contractors may provide funds for incidental expenses to assist the DMH clients they serve to remain in the community. This may include, but is not limited to, payments for one-time rent expenses and for basic furnishings. The CBFS contractor must follow guidelines set forth in the DMH Contingency Fund Procedures. (See Appendix D)

3.17 Meetings with DMH

A CBFS contractor must participate in regular and ad hoc meetings with DMH. These meetings will be on topics including but not limited to:

 Individual client care;  Quality improvement; and  Contract compliance.

At a minimum, a contractor will be required to meet with DMH bi-annually to review the success of services purchased pursuant to this RFR. The review will be based upon outcomes developed pursuant to the procedures outlined in Subsection 3.15.

3.18 Discharge Planning and Disenrollment

3.18.1 Client meets IAP Goals. CBFS contractors in partnership with each client/LAR must develop discharge criteria at the time of the client’s initial IAP development. Discharge criteria are to be reviewed regularly and modified as necessary. As a client nears meeting his/her established IAP goals, the CBFS contractor must work with the client and the client’s other service providers, including DMH and non-DMH service providers to the extent authorized, to develop a discharge plan and identify a projected disenrollment date. Prior to a client’s disenrollment from CBFS, the discharge plan and disenrollment date must be reviewed and approved by the Area Director, or designee.

3.18.2 Other Circumstances Impacting Enrollment. If any of the following events occur, the contractor must notify the DMH Site Office immediately:

a. Client expresses the intention to move or actually moves outside of the geographic boundary of the contractor’s responsibility b. Client death c. Client is hospitalized (medically or psychiatrically), referred to a skilled nursing facility, incarcerated, is enrolled in another comprehensive program paid by another third party source d. Client requests discharge from the service e. Contractor requests disenrollment after the contractor has made repeated efforts to engage and reengage the client in rehabilitation

If (a) or (b) above is applicable, then a client shall be disenrolled from CBFS on the date of death or date he or she moves out of the geographic boundary.

If (c) is applicable the client shall be disenrolled from CBFS after 30 days of placement in one of the entities listed in (c) unless otherwise authorized by the Area Director. Contractor must document ongoing contact with client to qualify for payment.

If (d) or (e) is applicable DMH shall review the request using the appropriate protocol (e.g., risk review). If the request is approved, the client will be disenrolled.

Upon disenrollment, information will be entered by DMH into MHIS to discontinue payment to the CBFS contractor for that client. See Section 4 for more information on payments to CBFS contractors.

3.19 Staffing

DMH is not issuing specific qualifications and staffing patterns for CBFS. However, it is DMH’s goal to enhance clinical expertise in its community services, including CBFS.

3.20 Guardianships

In most cases, DMH is responsible for obtaining and maintaining guardianships for DMH clients in the community who have been determined to lack the capacity to give informed consent to treatment, especially with antipsychotic medications. CBFS contractors are required to work with designated DMH personnel, guardians and medication monitors to gather information and paperwork necessary to obtain and maintain guardianships. This includes information necessary to complete petitions, medical certificates, IAP and affidavits, monitor reports and other documents that may be required by a Court. Without necessarily limiting the necessary activities, CBFS contractors may be required to assist clients in scheduling and getting to appointments with prescribing or treating clinicians, and to follow up with such clinicians to obtain necessary paperwork.

3.21 Representative Payees

If a CBFS contractor serves as a Representative Payee as identified in Subsection 3.5.2, the contractor must comply with Social Security Administration regulations and policies and the contractor cannot charge the client for such services.

3.22 Privacy and System and Data Security

CBFS contractors are considered to be Business Associates of DMH, as that term is defined in the Health Insurance Portability and Accountability Act (HIPAA) and also will be a holder of Personal Data for the purpose of Massachusetts Fair Information Practices Act. The contractor must comply with the CBFS Business Associate Terms and Conditions which are found under the “Forms & Terms” tab of the Comm-PASS file of this RFR.

Section 6 of the Commonwealth Terms and Conditions for Human and Social Services states: “Confidentiality. The Contractor shall comply with M.G.L. C. 66A if the Contractor becomes the ‘holder’ of ‘personal data.’ The Contractor shall also protect the physical security and restrict any access to personal or other Department data in the Contractor’s possession, or used by the Contractor in the performance of a Contract, which shall include, but not is not limited to the Department’s public records, documents, files, software, equipment or systems.”

In addition to the foregoing requirements, CBFS contractors MUST agree and acknowledge that as part of their work efforts under a contract entered into pursuant to the RFR, the contractors will use the following Commonwealth personal data under MGL c.66A and/or personal information under MGL c.93H, or to work on or with information technology systems that contain such data, such as DMH clients’ personal health information, names, addresses and social security numbers, insurance information, benefits information, etc., in order to fulfill part of its specified tasks. For the purpose of their work efforts, electronic personal data and personal information includes data provided by DMH to the contractors which may physically reside at a location owned and/or controlled by the Commonwealth or DMH or by a contractor. In connection with such data, each CBFS contractor must implement the maximum feasible safeguards reasonably needed to:

 Ensure the security, confidentiality and integrity of electronic personal data and personal information;  Prevent unauthorized access to electronic personal data or personal information or any other Commonwealth Data from any public or private network;  Prevent unauthorized physical access to any information technology resources involved in the contractor’s performance of its contract awarded under this RFR.  Prevent interception and manipulation of data during transmission to and from any servers; and  Notify DMH immediately if any breach of such systems or of the security confidentiality, or integrity of electronic personal data or personal information occurs.

3.23 DMH Standards, Regulations and Policies and State and Federal Rehab Option Requirements

CBFS contractors must meet all DMH CBFS standards (Appendix A), and all applicable DMH regulations and policies (see DMH additional terms and Conditions included under the “Forms & Terms” tab of the Comm-PASS file of this RFR). Additionally, CBFS contractors must meet all applicable federal and state Rehab Option requirements.

3.24 Transition to CBFS

Current providers of 3049 Residential Services, 3059 Community Rehabilitative Support (CRS), and 3013 Rehabilitative Treatment in the Community (RTC), that are being collapsed into CBFS, will be required to prepare with the local Area/Site Office for each client a plan for transitioning into CBFS. Each CBFS contractor will be required to work with the current providers to implement and, where necessary, to modify the transition plans. Between the contract award and June 30, 2009, DMH will adjust the number of clients receiving services under the existing activity codes to meet the negotiated CBFS capacity. Any client receiving services under the existing activity codes on June 30, 2009 will be deemed enrolled in CBFS services. For clients who are

deemed enrolled in CBFS services, the CBFS contractor will be required to complete the assessment and IAP processes as soon as possible but no later than six (6) months of a contract start date or a date to be otherwise negotiated between DMH and the contractor. For clients not enrolled in any of the existing activity codes on June 30, 2009, the assessments and IAP must be completed in accordance with Subsections 3.3 and 3.4.

SECTION 4 FISCAL SPECIFICATIONS

4.1 Basis of Reimbursement

A bidder awarded a contract under this RFR will be reimbursed on a unit rate basis. The invoicing unit for the contract is a Client Enrolled Day which is defined as each day that a client is enrolled (see Subsection 3.2 “enrollment” and Subsection 3.18 “disenrollment”) with a CBFS contractor as noted in DMH’s Mental Health Information System (MHIS). The final contract budget(s) and unit rate will be negotiated between DMH and the selected bidder(s). See Subsection 5.7 for more information.

For the contract(s) resulting from this procurement at any time during the duration of the contract period, DMH reserves the right to change the reimbursement method, which may include pricing options such as, but not limited to, cost reimbursement, accommodation rate, risk sharing, and capitated rates.

Enacted in August of 2008, Chapter 257 of the Acts of 2008, “An Act Relative To Rates For Human And Social Service Programs,” (“Chapter 257”) specifies that the Secretary of the Executive Office of Health and Human Services (EOHHS) shall have the sole responsibility for establishing rates of payment for social service programs. As such, all social service programs will have rates set and regulated by the Division of Health Care Finance and Policy. EOHHS will implement this law beginning in state fiscal year (SFY) 2010 and the implementation will be completed by SFY 2013. This law will affect most social service programs under contract with EOHHS Agencies. This law does not affect rates for services purchased under the Medicaid program.

Procurements and contracts for social services where rates have been set and/or are currently regulated will reference the regulations pertaining to those services. Beginning July 1, 2009, procurements and contracts issued for social services where rates have not been set or regulated are subject to change as a result of implementation of Chapter 257. This change may affect both service rates and reimbursement structures. These changes may occur at anytime throughout the duration of the affected procurement.

Currently there are two payment options available to a contractor: the Regular Payment Plan and the Ready Payment System.

Regular Payment Plan: all contractors are eligible for regular payment, which is a monthly invoice system. This is the standard payment system under which contractors are paid once a month after rendering one month’s service and submitting a payment voucher.

Ready Payment System: under this plan contractors may be paid on a predetermined schedule.

DMH is seeking approval to permit CBFS contractors to be paid under one of the following approaches that will not require the submission of an actual payment voucher to DMH.

Monthly Payment Plan: Contractors are paid monthly through the Commonwealth’s accounting system, MMARS, for the total number of enrolled days during a given month. DMH calculates that figure based on the number of days per month each client is enrolled with a CBFS contractor as noted in DMH’s Mental Health Information System (MHIS) and populated to EOHHS’s Enterprise Invoice Management (EIM) system. Contractors will be required to approve the enrollment data in EIM to initiate the payment process. Discrepancies or errors must be reviewed with the appropriate Area Contract Manager and/or other designated Area staff person.

Semi-Monthly Payment Plan: Contractors are paid twice a month based on the same methodology noted above, but with one payment for the first 15 days of each period and a second one for the 16th day to the close of the respective month.

If one of these methods is used, Ready Payments will not be available.

4.2 Fiscal Reporting Requirements

The CBFS contractor will be required to have in place mechanisms to gather and submit to DMH monthly:

 A report of the four (4) service components (see Subsection 3.5) rendered to clients during the month and other services. The format of the report will be established by DMH. At a minimum, the reporting will be designed to allow DMH to bill for rehabilitation in accordance with Federal Rehab Option requirements and to support utilization review as required of this RFR.  An itemization of any contingency payments made.  Additional information as may be necessary to implement Chapter 257, The Acts of 2008.

The CBFS contractor and subcontractors, if any, must participate in DMH time studies or other mechanisms that are done for the purposes of establishing rates for billing Medicaid for reimbursement.

SECTION 5 RESPONSE REQUIREMENTS

5.1 Submission Deadline

A bidder’s response must be received by DMH by the date and time and at the place specified in Subsection 1.9.

Under limited exceptional circumstances, e.g., state government closure due to inclement weather conditions, postal or courier service delayed due to a strike, or some other unforeseen “Act of God”, the Assistant Commissioner for Administration and Finance has the authority to approve the acceptance of a late response. It is anticipated that this will be a rare occurrence, which was out of the control of the bidder. Except as permitted by this paragraph, a response received after the due date and time will not be reviewed.

5.2 Submission Format

A response shall be submitted in a package/box labeled with a copy of the completed RFR Response Cover Sheet. The RFR Response Cover Sheet can be found on the “Forms & Terms” tab of the Comm-PASS file for this RFR. The label must be visible on the outside of the package/box.

5.3 Response Format

5.3.1 Style. The Service Proposal must be in the following format:

 type-written 12 point Times New Roman font  8 ½ X 11 inch paper  double sided  fully justified (print fully abuts both margins)  one-inch margins  single-spaced

The Service Proposal must contain a Table of Contents and each section of the Service Proposal must be separated by a tabbed page that includes reference to the RFR Subsection number and the heading (e.g., Subsection 5.6.2 Bidder’s Qualifications) which that section of the response is addressing.

The Cost Proposal must be in the following format:

i POS Attachments must be used as indicated

ii UFR Pricing Titles must be used to complete the POS Attachments iii Budget narrative (the budget narrative must be in the same style as the Service Proposal but tabs and table of contents is not required); and iv DMH staffing chart must be used as indicated.

The Affirmative Market Program Plan (AMPP) must be submitted on the AMPP Form.

The POS and AMPP Forms, the UFR Pricing Titles and the DMH staffing chart may be found under the “Forms & Terms” tab of the Comm-PASS file for this RFR.

Each part of the response, the Service Proposal (Subsection 5.6), Cost Proposal (Subsection 5.7), and the Affirmative Market Program Plan (Subsection 5.8) must include only information specific to the topic of that part of the response.

5.3.2 Number of Copies. Responses to this RFR must consist of two (2) originals, eight (8) copies, and one (1) electronic copy on CD-ROM to be saved using MicroSoft Word. Documents that require signatures are not required to be included on the CD-ROM.

The three parts of a response (Service Proposal, Cost Proposal and Affirmative Market Program Plan) shall be bound together and submitted in one binder (three ringed binders are preferred). Each part shall be separated by tab that clearly identifies which part is behind it. The two originals must be clearly marked as “Original.” All must be clearly labeled and must state: I. The title of the RFR and the number of the appendix for which the bid is being submitted II. The bidding entity's legal name III. The titles of the documents contained in the binder (i.e., Service Proposal; Cost Proposal or Affirmative Market Program Plan)

Other electronic media such as videotapes and audiotapes will not be accepted. Facsimile responses will not be accepted.

5.3.3 Page Limits and Attachments. The bidder must adhere to page limits where specified. Attachments and other supporting documentation specifically asked for by this RFR are not counted in calculating if the bidder’s response exceeds the page limits. However, attachments must be limited to those specifically asked for by this RFR. A listing of permitted attachments is set forth in the List of Permitted Response Attachments under the “Forms & Terms” tab of the Comm- PASS file for the RFR. Any attachment that is submitted which is not in the List of Permitted Response Attachments will be removed from the response and will not be reviewed.

All pages in excess of the stated limits will be removed from the bidder’s response prior to the response being forwarded to the Review Committee. They will not be reviewed or considered in making any recommendation or award relative to this RFR. All excess pages will be removed from the end of the relevant section.

5.3.4 Environmental Response Submission Compliance. In an effort to promote greater use of recycled and environmentally preferable products and minimize waste, all responses submitted should comply with the following guidelines:

 All submittals and copies should be printed on recycled paper with a minimum post-consumer content of 30% or on tree-free paper (i.e., paper made from raw materials other than trees, such as kenaf). To document the use of such paper, attach a photocopy of the ream cover/wrapper should be included with the response.  Unless absolutely necessary, all responses and copies should minimize or eliminate use of non-recyclable or non re-usable materials such as plastic report covers, plastic dividers, vinyl sleeves, and GBC binding. Three ringed binders, glued materials, paper clips, and staples are acceptable.  Bidders should submit materials in a format which allows for easy removal and recycling of paper materials.  Bidders are encouraged to use other products which contain recycled content in their response documents. Such products may include, but are not limited to, folders, binders, paper clips, diskettes, envelopes, boxes, etc. Where appropriate, bidders should note in an attachment which products in their responses are made with recycled materials.

5.4 Response Requirements

A response must consist of the following parts: ___ RFR Response Cover Sheet (Subsection 5.5). This should be used as a label to the package/box in which the response is submitted to DMH (Subsection 5.2) and the first page of the Service Proposal. ___ Service Proposal (Subsection 5.6) ___ Cost Proposal (Subsection 5.7) ___ A completed Affirmative Market Program Plan Form (Subsection 5.8). ___ An executed Commonwealth Terms and Conditions for Human and Social Services (1 original, submit with Cost Proposal)* ___ An executed MA Form W-9 (1 original, submit with Cost Proposal)* ___ A Contractor Authorized Signatory Listing (1 original, submit with Cost Proposal) ___ An Executed Standard Contract Form (2 Originals, submit with Cost Proposal) ___ Authorization for Electronic Funds Payment (1 original, submit with Cost Proposal)*

*Note: If a bidder has already submitted signed Terms and Conditions, Form W-9, and/or Authorization for Electronic Funds Payment as listed here, it does not need to

submit another. If these forms are not included in the RFR Response, DMH will verify that they have been submitted to the Office of the Comptroller.

5.5 RFR Response Cover Sheet

The bidder must submit a completed RFR Response Cover Sheet that is located in the Comm-PASS posting of this RFR under the “Forms & Terms” tab. The Cover Sheet must be signed by an individual authorized to negotiate for and execute the contract on behalf of the bidder.

5.6 Service Proposal (75 page limit)

A bidder’s Service Proposal must provide the following information in the order that it is asked and the bidder should cite the applicable subsection number and heading at the beginning of each new section of the Service Proposal. In preparing its Response, a bidder should refer to the Evaluation Tool. The Tool identifies specific information the Bidder should include in its Response under each Subsection.

5.6.1 Executive Summary. (4 page limit) The Executive Summary should condense and highlight the contents of the bidder’s response in such a way as to provide reviewers with a broad understanding of the entire response. It must contain a narrative description of the bidder’s proposed service delivery structure, emphasizing how the principles set forth in Subsection 2.2 will be incorporated into the service delivery structure and how the structure will facilitate the achievement of the procurement goals set forth in Subsection 2.3.

The Executive Summary should summarize the bidder’s understanding of the scope of services to be provided, the necessary qualifications of key personnel, the identity and qualifications of any subcontractor personnel or organizations, highlights of its quality management and utilization management mechanisms, and the capability of the bidder to meet the requirements of this RFR.

5.6.2 Bidder’s Qualifications

a. Background and Experience. Describe your organization’s history and work experience (include number of years) as it is relevant to providing CBFS. Identify the length of time your organization has served adults with serious mental illness and identify the types of services provided, including experience with specific age groups and culturally and diverse populations as described in the applicable Contract Description Appendix. In addition, identify three other contracts that you currently hold or have held that are similar in total dollar values, number of clients served and scope to that of the contract for which you are submitting a bid. If unable to provide this information, describe why you feel your organization is qualified to manage a

contract of this size and scope. Describe other qualifications the organization has that DMH should consider in making the contract award.

b. Mission. Describe your organization’s mission and philosophy and how you think they relate to CBFS. Describe how CBFS will fit within the overall mission and direction of your organization. Also describe how your organization’s mission and philosophy are consistent with DMH’s vision, mission and goal identified in Subsection 2.1. Preference will be given to bidders that have incorporated recovery principles into its mission statement and policies and submit documentation of such as attachments to its response.

c. Recovery Oriented Services. Describe your organization’s experience providing recovery oriented services including strength based, person centered assessment and treatment. In your response, indicate how these recovery principles have been incorporated into your day to day operations. Describe relevant training and support for staff and clients. Preference will be given to bidders that have provided recovery oriented services for 3 or more years.

d. Peer Involvement. Describe your organization’s experience employing individuals with a history of mental illness and/or substance use and utilizing peer workers. Describe the roles these individuals have played and the support and supervision they have received. Be specific in your response. Preference will be given to bidders that identify specific peer workers and roles within the organization to promote recovery.

e. Organizational Chart. Submit as an attachment to your response an organizational chart showing how your CBFS service delivery structure fits into your overall organization. In addition to the chart, describe briefly the oversight this service will receive from the parent organization.

f. Towns Served. Explain how, if at all, the CBFS service delivery structure described in your organization’s response will benefit from the experience and relationships your agency has had in the towns and cities to be served under the contract. If the contract you are bidding for includes communities that you have not served in the past, describe how your organization’s experience will be relevant to the communities to be served.

g. Community-Based Integrated Services. Describe your organization’s experience providing community-based integrated services including specific linkages utilized to promote community integration as related to behavioral health, physical health, employment, education, socialization, and other community resources. Describe your experience in providing community- based interventions that maintain housing and respond to changes in acuity.

h. Qualification. Prior to entering into a contract with DMH, a bidder must demonstrate that it meets minimum administrative and fiscal standards (Qualification) established by the Executive Office of Health and Human Services (EOHHS). Provider Qualification is the process EOHHS uses to: minimize financial and administrative risk to the Commonwealth and the people served through the Purchase of Service (POS) system; promote familiarization and enforce compliance with applicable state and federal regulations; and maintain current, accurate information on POS organizations, including contact names, addresses, and other information critical to the effective and efficient management of the POS system. If a bidder has not been Qualified by EOHHS, the bidder should review the information about the Qualification Process for Potential New POS Providers available at: http://www.mass.gov/hhs/contracting. For further information on Qualification, the bidder may contact Greg Drouin, Department of Mental Health, 25 Staniford Street, Boston, MA 02114; (617) 626-8183. A bidder that is not yet qualified by EOHHS should submit to Greg Drouin a completed “Contracting Qualification Form and Supplement” on or before the date and time responses are due. A contract can only be awarded to a Qualified bidder.

i. Debarment. Indicate if your organization is now or ever has been subject to a state or federal debarment order. If your organization has ever been subject to a debarment order, specify the date and the circumstances surrounding it. DMH cannot award the contract to a bidder currently subject to a state or federal debarment order.

j. Confidentiality and Security. Describe your organization’s and your proposed subcontractors’ (if any) respective internal security procedures and policies applicable to work performed for individuals/clients and the particulars of any circumstances over the past five (5) years in which your organization, or your proposed subcontractor(s), has caused a breach of the security, confidentiality or integrity of an individual/client’s data. (See Subection 3.22)

5.6.3 Service Delivery Structure

a. Service Delivery Structure. Describe your proposed service delivery structure. Indicate what, if anything, and why you propose to subcontract. If a subcontractor is indicated, the bidder must identify each proposed subcontractor, describe briefly its background and experience, and submit documentation from each subcontractor confirming the proposed subcontract arrangement. Describe how your service delivery structure will integrate the various components to create a single CBFS service. Also explain how the services to any one client will be integrated across your service delivery structure and how this will be monitored.

b. Recovery Based. Describe how: i. Your service delivery structure reflects the values of recovery and resiliency and emphasizes rehabilitation, person-centered care and trauma informed care. ii. Your service delivery structure will facilitate client movement towards independence and community integration. iii. The staff will work with clients to identify and utilize the clients’ preferred recovery tools and self care techniques. iv. Staff will assist clients to assess the effectiveness of their self management plans and work with clients to develop modifications, if needed. v. Principles of client self determination and empowerment will be incorporated into the service model. vi. Staff will address risk assessment and management while promoting self determination.

c. Service Flexibility. Describe how the service delivery structure will ensure that services will be individualized to meet the needs and preferences of the clients which will change over time.

d. Client Record and Documentation. Describe how you will maintain a central CBFS file for each client containing all screenings, assessments, IAPs, progress notes and other relevant documentation whether provided directly by you or a subcontractor. Describe how you will ensure compliance with Rehab Option billing requirements.

e. Peer Support. Identify how you will incorporate peer services into your service model. Indicate if you are using outside resources. Indicate what the scope of peer services will be. Describe the supervision and support available to peer staff. Further describe the efforts you will take to orient and train staff to work collaboratively with peer staff and/or services. Also indicate how you will utilize the local Recovery Learning Community (Appendix C) to support the clients you serve.

f. Linkages. Identify the local community providers, education institutions, places of worship, cultural and ethnic services, and health providers, etc. with which you will establish working relationships. With regard to each, indicate why they were selected and how you think clients will benefit from the relationship. Preference will be given to bidders that submit as attachments to their responses up to five memoranda of understanding from institutions, organizations, etc., describing the type of support or linkage they will form with the CBFS contractor. Preference will be given to bidders submitting memoranda of understanding which include a number of cultural and ethnic and/or consumer-operated organizations.

g. Physical Sites. Describe each of the proposed physical sites, other than housing, that you may use in your delivery of CBFS. Include meeting spaces, etc. Do not include space that will be used for administrative purposes only or that is leased directly to an individual client. For each site indicate how the site will be used and describe why the site was selected. Also, provide the following information: address, owner’s name, the basis of your use of the property (e.g., lease, subcontract, etc.), availability to public transportation and parking, compliance with the ADA, and zoning and occupancy requirements.

Identify the number of group settings you are initially proposing based on the client profile in the applicable Contract Description Appendix. Identify the criteria you will use or have used in selecting the housing location(s). Describe how you will ensure that secured housing sites are safe, promote community integration, and are of a size and design that is consistent with the proposed use of the site. Describe how the agency will ensure that settings utilized by the service for residential purposes will meet the physical site requirements for DMH licensing.

Describe how you will identify and secure the physical sites described above. Indicate how you will work to ensure that there is flexibility in how the physical sites can be used and/or in your ability to cease using one site in favor of another as the needs of your client population changes.

5.6.4 Service Specifications

In responding to each part of this Subsection 5.6.4, a bidder should address the client population described in the applicable Contract Description Appendix. In addition, a bidder should indicate how it will provide culturally and linguistically competent services in each of the specific areas.

a. Screening, Assessment and Individualized Action Plan (IAP). Describe the following: i. How you will ensure that the IAP goals, objectives, and interventions reflect a need assessed by a Licensed Practitioner of the Healing Arts and which are determined medically necessary. How you will engage and support clients through a strength-based, person centered planning process. Identify how this will be monitored. Specifically identify and address how you will engage clients who are difficult to connect, including individuals who are homeless, with services. ii. How you will support clients to enable them to participate during the IAP process. iii. The specific staff positions that are involved and at what point(s) in the screening, assessment and IAP processes.

iv. How IAPs will be designed so that interventions are delivered in a way that incorporates consistency, flexibility and responsiveness to changing client needs. v. What procedures you will use to ensure the development and implementation of an IAP that integrates all DMH community services provided to a CBFS client. Also, describe the efforts you will take to incorporate other non-DMH service providers into the IAP process. vi. What potential barriers exist that may impede the development and implementation of fully integrated IAPs and how your agency or DMH will need to address them.

In your response, address your procedures for obtaining necessary authorizations and scheduling of meetings.

b. Rehabilitation and Community Integration i. Describe in detail the process for developing an individual’s rehabilitation interventions that utilize natural opportunities and community resources for practice and skill building. ii. Describe the role of professional staff in ensuring the appropriateness of these interventions and their implementation. iii. Describe what you think the challenges will be to developing individualized rehabilitation goals and interventions and ensuring their effectiveness in a 24 hour staffed setting. Provide specific practices that the CBFS service will use to overcome these challenges. iv. Provide two (2) detailed examples that demonstrate how community resources could be integrated with an individual’s rehabilitative treatment in a manner that is most consistent with CBFS standards. One example should include the need for culturally sensitive and appropriate resources. v. Describe how in your CBFS service delivery structure the service will develop and facilitate housing environments that are recovery oriented and support the individual rehabilitation goals and interventions of clients. vi. Identify the services, interventions and supports used to engage clients that are currently not involved in any community–based activities and not engaged in working with staff. vii. Describe in detail the process for determining the effectiveness of a client’s interventions and if not effective the process for modification.

Preference will be given to bidders that propose a method for ensuring that rehabilitation interventions will utilize a client’s existing support system and community resources when available. Preference will be given to bidders that propose the use of evidence based practices in their interventions strategies.

c. Medications. Describe how in your CBFS service delivery structure clients will be assisted with medication administration and monitoring, including

storage and re-filling of prescribed medication. Describe how, when and by whom medication administration and monitoring will be provided and how you will ensure that such is done in accordance with DMH and DPH regulations and policies, including the provision that only appropriately licensed or MAP certified staff may administer medication. Describe education and training regarding psychotropic medications and the attendant risks of polypsychopharmacy. Also describe your procedures and protocols for ensuring that clients will be evaluated regarding their ability to self- administer their medications in accordance with DMH CBFS Standard IV.C

d. Employment. Identify how, when, and by whom the employment services described in Subsections 2.2, 3.8, and the DMH CBFS Standards will be provided to clients. Explain how the principles of the Individual Placement and Support (IPS) model of supported employment will be incorporated into your service delivery structure. Specifically address how the principles will be incorporated into each of the CBFS service components (Subsection 3.5), screenings (Subsection 3.2), assessments (Subsection 3.3), IAPs (Subsection 3.4), and discharge planning (Subsection 3.18). Include in this description how non-CBFS providers and services will be utilized in providing clients with assistance and support in obtaining and maintaining employment.

e. Wellness. Describe the following: i. The specific interventions staff will employ to assist and/or encourage clients in managing existing chronic medical conditions, such as diabetes, asthma, chronic obstructive pulmonary disease, or hypertension. ii. The process you will implement for monitoring acute medical conditions and accessing necessary medical care. iii. How staff will be able to access health care consultants or clinical staff (such as Nurses or Physician Assistants) to assist in promoting wellness, and what specific roles the clinical staff will have in the service with regard to this. iv. How medical and dental care will be monitored to determine whether such care is regularly received by individual clients. v. Strategies for increasing opportunities for physical activities for clients, promoting the treatment of nicotine addiction and smoking reduction, and improved nutritional offerings.

Preference will be given to bidders that demonstrate provision of timely access to health care professionals to provide proactive consultation and direction regarding medical/medication issues.

f. Benefits, Entitlements and Subsidized Housing. Identify how you will provide assistance to and support clients in accessing entitlements, benefits and housing. Specify the entitlements (including financial entitlements and health insurance), benefits and subsidized housing that will be the focus of

such assistance. Describe how your CBFS service delivery structure will develop and facilitate housing environments that are recovery oriented and support the individual rehabilitation goals and interventions of residents.

g. Transportation. Describe how clients will be assisted in accessing transportation as needed, including public transportation.

h. DMH Affiliated Housing. Identify action steps you will need to take to meet the requirements set forth in Subsection 3.6.

i. Co-occurring Mental Illness and other Substance Disorders. Describe how your services will ensure the following: i. Based on the assessed needs of the client, the IAP addresses engagement, relapse prevention and the use of self help groups and peer counseling. ii. Staff members are knowledgeable about self help groups and peer counseling. iii. Staff members and clients are educated about mental illness and substance use and the ways in which their co-existence impacts daily living through the use of training materials, outside speakers, and individuals in recovery from dual diagnosis. iv. Information on dual diagnosis treatment is incorporated into staff development activities.

j. Crisis Management. Attach your proposed protocol(s) for developing crisis management plans in accordance with Subsection 3.12. Also attach your protocol for responding to clients in crisis thereby reducing the use of Emergency Service Program level of care. Describe how 24 hour access to staff will be ensured.

k. Risk Management. Attach your proposed protocol(s) for risk management. Provide an example of where a client’s priorities or choices could present a risk concern to staff. Describe how you would manage this situation.

l. Discharge Readiness. Describe appropriate criteria for determining readiness for discharge from CBFS services. Also, describe how you will monitor and communicate information about discharge readiness to client/LAR and DMH.

5.6.5 Staffing

For each response given to Section 5.6.5, a bidder must include the staffing of any proposed subcontractors.

a. Staffing Pattern and Staff Qualifications. Describe the proposed staffing pattern for your service delivery structure based on the client population described in the relevant Contract Description Appendix. Include as

attachments job descriptions, including education, training, and experience requirements, for all Direct Care Supervisors, all Direct Care Program Staff IIIs, individuals identified as Licensed Practitioners of the Healing Arts, and managerial and key executive staff. For each position indicate the relevant FTE. Describe how staff will be deployed to ensure that the requirements of Section 3 of the RFR and the Standards are met. Attach sample staff schedules. Identify time allotted for supervision, consultation, training, and internal communication. Which positions are assigned to be on-call during off-hours? Describe your on-call system. Further, describe the role played by Licensed Practitioners of the Healing Arts in your service delivery structure. How does staff access needed consultations or the expertise of other staff? Preference will be given to bidders that address DMH’s goal to enhance clinical expertise in their response by indicating the roles to be played by professional clinical staff in service delivery. The highest preference is for bidders that exercise creativity in the use of nurses, social workers, occupational therapists, and others in the healing arts in their staffing patterns.

b. Recruitment, Retention, and Transition. In this section describe the following: i. Proposed process for hiring your staff by the contract start date. ii. How you will ensure that services will be provided in a culturally and linguistically competent manner either through the hiring process or training. iii. Describe your ongoing recruitment efforts to fill staff vacancies as they occur so that the required staffing levels will be maintained at all times. iv. Describe your strategies for facilitating the retention of staff.

c. Organizational Chart. Attach an organizational chart for your service delivery structure, showing supervision responsibility. Describe the frequency and approaches used in supervision. Include names and attach resumes for currently filled positions that would have service director or supervisory responsibility. Preference will be given to bidders that describe effective supervision practices, including mentoring programs, field supervision and direct observation.

d. Orientation/Training. Attach a proposed training plan listing: orientation activities, mandatory trainings, annual trainings, and trainings for required competencies. Identify proposed frequency and times of trainings and resources available to implement the proposal. What are the numbers of hours per year direct service staff have available for training? How are training topics selected and prioritized? Give an example of this process. Describe how the agency will develop and sustain a CBFS workforce that has the knowledge and competency to provide services that are consistent with the best practices of rehabilitation and recovery. How will competency be

assessed on a regular basis to ensure that minimum expectations are met or exceeded?

5.6.6 Implementation and Transition Plans

a. Client Transition. If you are proposing to use housing other than those listed in the applicable Contract Description Appendix and/or intend to otherwise change how housing is used, describe how you will help clients maintain social supports or create new ones.

b. Barriers. Identify potential barriers to the success of fully implementing the contract and meeting performance goals and indicate how you will address each of these barriers. Provide examples of how you have successfully managed similar types of barriers in the past.

c. Start-Up. Identify all programmatic, administrative and fiscal actions, and tasks with specific milestones (e.g., securing a line of credit) that you will need to take to ensure that services are available to meet the needs of current DMH clients receiving services as described in the relevant Contract Description Appendix, as of the Contract start date.

d. Client/LARs Involvement. Provide a plan of communication about CBFS to clients and families. Describe the role of clients and families in the start-up and implementation of your service delivery structure, in its ongoing operation, and evaluating the delivery of services.

5.6.7 Quality Management and Performance Outcome

a. Quality Management (QM). Describe the information and the process you will use to monitor the effectiveness of your services. In your response address the items (a–h) in Subsection 3.15.1. Identify the resources that will be dedicated to QM including staff, data sources, or IT systems. For each staff identified indicate specifically their QM functions and qualifications. Indicate how clients and family members will be incorporated in the QM structure.

b. Performance Measures. Based on the procurement goals set forth in Subsection 2.3.1 and Subsection 3.15.2, propose six possible performance measures. For each performance measure include relevant definitions (i.e., specify the nominator and the denominator), and identify the method and frequency of data collection. Describe how data will be used to inform training needs, resource allocations and service modifications Preference will be given to bidders that identify six performance measures and provide a definition, methodology, and data collection frequency for each performance measure. Preference will be given to bidders having a

proposed process for data collection based on the use of the clients’ Individualized Action Plans.

c. Human Rights. Explain how you will meet the human rights requirements set forth in DMH regulations, policy (policy #03-1), and Human Rights Handbook.

i. How will you ensure timely access to a Human Rights Officer (HRO) across all services and varieties of settings? In responding, be certain to address rights of clients who are served outside of group living situations. ii. Submit as an attachment a list of your proposed Human Rights Committee members and the capacity in which they will serve. iii. Describe how staff and clients will be informed and educated regarding clients’ human rights and the complaint process. iv. Describe additional procedures that will ensure the integration of human rights into the organization’s day-to-day decision-making regarding individual clients. v. Describe how the HRO is insured autonomy. Attach a job description.

5.6.8 Client Scenarios

Given the information contained in this RFR and DMH CBFS Standards, respond to the client scenario outlined in Appendix E and the client scenario included in the applicable Contract Description Appendix. Describe how you would successfully deliver CBFS to the clients described in the scenarios. In your response state specifically how you will address stated client preferences, including independent living, and special client circumstances that are identified. Describe the types of staff and any evidence based practices appropriate to the interventions the bidder used with this client. Describe how you will assess and adjust the mix, frequency and intensity of CBFS services to address clients’ changing needs.

5.7 Cost Proposal

A bidder’s Cost Proposal must consist of the following parts (1) a budget as required by Subsection 5.7.1, (2) a Budget Narrative as required by Subsection 5.7.2, and (3) a staffing chart as required by Subsection 5.7.3.

5.7.1 Budgets

A bidder must submit a budget as set forth in this Subsection 5.7.1 for FY2010. If the bidder is proposing to use subcontractor(s) a separate POS Attachment 3 must be included for each subcontract.

A bidder must complete and submit the following POS Attachment Forms using the UFR Pricing titles. The POS Forms and the UFR Pricing Titles can be found under the “Forms and Terms” tab of the RFR’s Comm-PASS File. The budget should reflect twelve (12) months of total expenses and offsets. DMH views any offsets (non-DMH funds/resources which support the program) a bidder projects should be based somewhat on historical UFR information (for the current services), be reasonable, realistic and DMH will require the Contractor to utilize such offsets. Please note that the processes defined in 3.1 through 3.4 may provide the awarded contractor with opportunities to generate third party offsets.

The applicable POS Forms are as follows:

POS Attachment 3: Fiscal Year Program Budget.

 A bidder that is a for-profit entity must include a commercial earning factor on POS Attachment 3 to retain any DMH funds as a profit. Revenues generated by for-profit organizations may not exceed expenses incurred except in cases where a “for profit earnings fee” has been negotiated between DMH and the contractor. If an earnings factor is not set forth in POS 3, the earnings factor will be assumed to be zero.

 If a bidder offers a Cafeteria Plan, then for the purposes of this RFR, the bidder in completing the POS Attachment forms must exclude from the salary line item any cost related to the Cafeteria Plan. The Cafeteria Plan costs must be included within the fringe benefit line item. During negotiation with the awarded bidder, the budget will be modified to reflect the Cafeteria Plan within the appropriate salary line item.

POS Attachment 4: Rate Calculation/Maximum Obligation Calculation Page. A bidder must propose a unit rate by establishing a Net Adjusted Program Cost (noted on Items 1 through 3 in the Unit Rate Calculation Section of Attachment 4) and dividing that Cost by the average number of DMH clients* the bidder believes that it can have enrolled in its CBFS service each day and then multiplying that sum by 365 days (which should be noted in Item 4 in the Unit Rate Calculation Section of Attachment 4).

Rate: Net Adjusted Program Costs (which may not exceed the annualized maximum obligation amount set forth in Subsection 1.10) ÷ average number of clients* the bidder believes it can serve per day x 365 days.

There will be no negotiated utilization factor.

*The number of clients that the bidder believes that it can have enrolled in its CBFS service each day must be based on the funds that are available for the CBFS service for which it has elected to submit a bid (Subsection 1.10), the description of the proposed client population (number of clients served and the range of services currently delivered) for that contract as described in applicable Contract Description, and its proposed service model. At a minimum, the contractor must provide services to clients who are currently receiving 8-15 hours and 16 to 24 hours of adult residential services as indicated in the applicable Contract Description Appendix.

In completing POS Attachment 4, a bidder must itemize sources of Program Offsets.

POS Attachment 5: Non-Reimbursable Cost Program Offset Schedule. A bidder must provide information on non-reimbursable costs, and the source of private funds used to offset those costs, and identify if the non-reimbursable costs are a result of related party transactions. This form is required for all human and social service responses if non-reimbursable costs appear in the budget.

POS Attachment 6: Capital Budget. A bidder must specify any and all capital items needed to be purchased for the services under the proposed contract. The bidder’s capitalization level must also be included on POS Attachments 3 and 6. Contractors will be required to follow OSD capital purchasing policies and procedures. Any requests for capital items will be a point of contract negotiations with the selected bidder. Contractors are required to maintain an inventory system for all capital items that are purchased.

Federal Funds cannot be utilized to purchase capital items.

Costs that are not specifically identified in a bidder's response, and accepted by DMH as part of the contract, will not be compensated by DMH.

5.7.2 Budget Narrative (10 page limit)

A bidder must submit a budget narrative that further defines the proposed line item budget. The narrative should include a delineation and explanation of staff salaries and benefits, identification of offsets, if any, and provide a general description for all line items listed in budget categories II, III, and IV. The description should be detailed enough so that an individual reviewing the budget would be able to determine both the appropriateness and reasonableness of the cost. If offsets are part of the cost proposal, include in the narrative the basis for these offsets, the source of the offsets, and the methodology for calculating the amount of offsets.

The Budget Narrative provides the bidder with an opportunity to highlight what is unique or different about their budget/service delivery structure. Bidders should not repeat the staffing titles in this section. The Budget Narrative must include:

 An explanation as to how it determined the number of clients it can serve daily for purposes of determining the rate in POS Attachment 4.  A description of the cost effectiveness of the service delivery structure proposed.  If you are proposing to subcontract, describe the financial benefits (see Evaluation Tool Cost Proposal, Step 2). At a minimum, both dollars and ratios for the following information need to be provided by subcontract:  Ratio of Agency Administrative Support Allocation (UFR Title #410)/Program Total Cost  Ratio of Direct Administrative Expense (UFR Title #T500)/Program Total Cost  Ratio of Payroll Tax (UFR Title #150) and Fringe (UFR Title #151) /Salary (Total of all salaries shown above UFR Title #150)  Ratio of the Sum of UFR Component Titles 101,102, 103, 104 Cost (salaries only)/Total Direct Care Staff Cost (salaries only)  Ratio of Licensed Practitioner of the Healing Arts Cost (salaries only)/Direct Care Staff Cost (salaries only)  Ratio of Program Total Offsets/Program Total Cost  Ratio of Training Costs (UFR Title #201 if for training and UFR Title #204)/Program Total Cost  Ratio of For-Profit Earnings Factor/Total Program Cost  An explanation as to when the Bidder will use relief, overtime, and/or on-call staff. Include the method for determining the appropriateness of each.  Any costs in your budget associated with transition costs specific to housing.  A breakout of any rental subsidies or housing grants that the Bidder possesses that benefits the continuum.  A statement of how the current year offsets, if any, that are projected will benefit the provision of services. Bidders should also provide a statement as to the source of the offsets, how and when they will be collected, and how they were projected.  How you arrived at your estimate for general and administrative expenses in POS Attachment 3 and what you are allowing for subcontracting arrangements, if applicable.  Any and all anticipated variations regarding expenses and offsets that will affect this contract over its duration and explain how you arrived at those variations.  Itemize proposed training costs (see Evaluation Tool, Cost

Proposal, Step 2).

5.7.3 Staffing Chart. A bidder must complete and attach a Staffing Chart that breaks out by functional title by the proportion of time (FTE) and salary included in the proposed budget for the following individuals: all Direct Care Supervisors, all Direct Care Program Staff IIIs, individuals identified as Licensed Practitioners of the Healing Arts, managerial and key executive staff (see Subsection 5.6.5). The Staffing Chart must list each staff person individually. The Staffing Chart will provide a crosswalk to the staffing identified on the budget. The Staffing Chart Form is located under the RFR “Forms & Terms” tab of the Comm.-PASS file of this RFR. A separate Staffing Chart must be completed and submitted for each proposed subcontractor.

5.8 Affirmative Market Program Plan

Massachusetts Executive Order 390 establishes a policy to promote the award of State contracts in a manner that develops and strengthens Minority and/or Women Business Enterprises (M/WBEs). As a result, M/WBEs are strongly encouraged to submit bid responses to this RFR.

Additionally, the Operational Services Division (OSD) for contracts over $50,000 and that are subject to OSD regulations mandates that contractors participate in the State’s Affirmative Market Program. Bidders for such contacts, regardless of their M/WBE certification status, must submit as part of their responses completed Affirmative Market Program Plans (AMPPs). In evaluating responses, State agencies must factor AMPPs at 10% or more of the total weight given to all items considered for the contract award. Higher weight may be given to AMPPs that show more commitments for use of certified vendors in the primary industry directly related to the scope of the RFR, subcontracting expenditures and partnerships for the purpose of contracting with the Commonwealth. Further, an agency can not award a contract without an AMPP being incorporated into it. The final AMPP will be negotiated between the state agency and the successful bidder.

For more information about the Affirmative Market Program, visit the Operational Services Division Internet site, in particular the Commonwealth Affirmative Market Program Services Guide that is posted on that site.

The AMPP must be submitted on the AMPP form that is included under the "Forms & Terms" tab of the Comm-PASS file of this RFR. A narrative statement can be included to supplement the AMPP Form providing further details of the AMPP commitments. However, the submission of this narrative statement does not replace the requirement of completing the AMPP Form.

Bidders must submit one Form for each M/WBE AMPP relationship it proposes. Note an M/WBE bidder may not list itself as being an AMPP partner to its own company.

A bidder will not be awarded a contract unless and until it agrees to commit to at least one (1) of following three (3) AMPP Components:

a. Subcontracting: If a bidder commits to Subcontracting in their AMPP, then they must commit to subcontract a specific dollar amount, or a minimum percentage of dollars earned through an awarded contract, with a SOMWBA-certified M/WBE or a company that has applied for certification. Although this is only one of several options to meet the requirements for participation in the Affirmative Market Program, a bidder’s submission of subcontracting commitments may be weighted most heavily. DMH will set timelines for progress reviews (either quarterly or semi-annually) for the purpose of compliance and tracking of submitted commitments. All subcontracting partnerships require inclusion of that contract between the bidder and the M/WBE subcontractor in the bidder’s bid package.

b. Growth & Development: If a bidder commits to Growth and Development in their AMPP, then they must submit a plan for education, training, mentoring, resource sharing, joint activities, and assistance that would increase industry capacity and the pool of qualified SOMWBA-certified M/WBEs.

c. Ancillary Uses of Certified M/WBE Firm(s): If a bidder commits to Ancillary Uses of SOMWBA-certified M/WBE Firm(s) (or companies that have applied for certification) in their AMPP, then they must include dollar or percentage expenditure commitments for use of these firm(s) with or without the use of written commitments between the bidder and the M/WBE Firm(s). A description of the ancillary uses of certified M/WBEs, if any, must be included on the AMPP Form.

A bidder must indicate on the AMPP(s) that it submits whether the activity as stated on the plan is new to a bidder and/or an expansion of an activity currently performed by the bidder. If an expansion, the bidder must describe the current level of activity and how that activity will be expanded if the bidder is awarded a contract under this RFR.

If applicable, a bidder is encouraged to include additional information for the following components on its AMPP Form:

 Past Performance: A bidder must include information on past expenditures with SOMWBA certified M/WBEs for the previous two (2) years.

 Other Creative Initiatives with SOMWBA certified companies: A bidder must include any additional AMPP Partnership initiatives that further support its AMPP in a narrative format. If a bidder commits to Other Creative Initiatives in its

AMPP, then the bidder is encouraged to commit to at least one certified MBE and at least one certified WBE in the submission of its plans. In addition, a bidder can outline its own Diversity programs available to SOMWBA vendors.

Once an AMPP is submitted, negotiated and approved, DMH will then monitor the contractor’s performance.

Resources available to assist bidders in finding potential AMPP partners can be found at http://www.mass.gov/Aosd/docs/mwbe/AMP Resources and Guidance.doc

5.9 Separate Responses for Each Contract

A bidder may elect to submit a response for one or more of the contracts that may be awarded as a result of this RFR. The potential contracts are listed in Subsection 1.10; however, a bidder must submit a complete and separate response for each contract for which it wants to be considered for a contract award. Each response must stand on its own.

SECTION 6 REVIEW AND SELECTION PROCESS

It is anticipated that this RFR will result in the award of multiple contracts. DMH may establish different Review Committees to evaluate responses for each contract to be awarded under this RFR, or it may elect to have a Review Committee review responses for more than one contract. For each proposed contract, DMH will select the bidder whose response, in the aggregate, provides the best value to DMH and the Commonwealth. All bids for any one contract will be reviewed by the same Review Committee. The Awarding Authority will appoint the members of the Review Committee(s). A Review Committee can consist of DMH personnel, DMH clients, clients’ family members, and/or other non-DMH personnel. An individual may serve on more than one Review Committee. A Review Committee will evaluate the responses as stated in this Section 6.

6.1 Compliance with Submission Requirements

DMH Contract Office staff will first evaluate the responses to determine if they satisfy the submission and response requirements set forth in Subsections 5.1 to 5.5. A response that meets these requirements is considered a “qualified response.” Any response that does not meet these requirements may be considered non-responsive and may be disqualified by a Review Committee without further evaluation. A Review Committee may, at its discretion, determine that noncompliance is insubstantial and can be corrected, or that an alternative proposed by the bidder is an acceptable substitute. In such case, a Review Committee may seek clarification, allow the bidder to make minor corrections, apply appropriate penalties in the evaluation, or apply a combination of all three remedies.

6.2 Review Process

A Review Committee will evaluate each response that satisfies the submission requirements (a "qualified response") using the criteria set forth in the Evaluation Tool developed for the RFR. The Evaluation Tool can be found under the “Forms and Terms” tab of the RFR’s Comm-PASS file. In addition to the bidder’s response, a Review Committee may consider any relevant information about the bidder known to DMH. Any additional information that is considered will be noted by the Review Committee in the Evaluation Tool

A Review Committee may ask the Area or Central Office Contracts Unit and/or others to do a preliminary review of the Cost Proposals and/or the Affirmative Market Program Plans of all qualified responses.

After reviewing each part of a response, Service Proposal, Cost Proposal, and the Affirmative Market Program Plan, a Review Committee will consolidate the different evaluations and review and rate the response in its entirety. For this purpose, the Service Proposal evaluation will be given the weight of 45%, the Cost Proposal the weight of 45%, and the Affirmative Market Program Plan the weight of 10% for a total of 100%.

6.3 Oral Presentations

A Review Committee and/or Awarding Authority may, in its sole discretion, invite those bidders whose responses have been judged competitive and responsive in the course of the evaluation to attend an Oral Presentation/Demonstration. At that time, the bidder’s response may be discussed and clarified, but not changed in any way. DMH reserves the right to apply restrictions to the structure and content of the Oral Presentation/Demonstration, and to instruct the bidder regarding attendees. Oral Presentations/Demonstrations shall not be open to the public nor to any competitors. Failure of a bidder to agree to a date and time for an Oral Presentation/Demonstration may result in rejection of the bidder’s response.

A Review Committee and/or Awarding Authority, at its discretion, may in lieu of oral presentations request bidders to submit written clarification of their responses. The Review Committee or Awarding Authority will send written questions for clarification to bidders for the bidders to respond in writing. Clarifications are explanations of what has been stated in the response and may not be used as an opportunity to submit supplemental information or change a response, unless DMH specifically requests these submissions or changes as part of the clarification of all responses.

6.4 Rejection of Responses

A Review Committee may disqualify any response that it deems unresponsive pursuant to 801 CMR 21.06 (10). In addition a Review committee may disqualify as unresponsive a response that receives a rating of “poor” in two or more parts of the Service Proposal.

6.5 Recommendation for Award

After a Review Committee completes its evaluation, compares and ranks all qualified responses (and if applicable oral presentations), the Review Committee will make its recommendation for contract award to the Awarding Authority. The Awarding Authority for contracts under this RFR is the Area Director.

6.6 Best and Final Offer

DMH reserves the right to offer selected bidders an opportunity to submit a “Best and Final Offer” (BAFO) pursuant to 801 CMR 21.06(11). DMH may restrict the number of bidders selected for an opportunity to submit a BAFO and may ask selected bidders to propose additional discounts, benefits, cost reductions or savings that were not factored into their original Response. A selected bidder may choose not to submit a BAFO by responding to DMH that its Response remains as originally submitted. The BAFO process will be part of the evaluation of the response and will be conducted by the Awarding Authority.

The use of this process for one of the potential contracts that may be awarded as a result of this RFR does not commit DMH to using the process for any of the other contracts to be awarded.

6.7 Selection and Contract Negotiations

Upon receipt of the Review Committee’s recommendation, the Awarding Authority will establish a prioritized list of the bidders’ responses for contract negotiations. The Awarding Authority shall prioritize the responses based on what is in the best interest of DMH. The Awarding Authority is not bound by the evaluations or rankings given to the responses by the Review Committee; however, the Awarding Authority must review them and give them some consideration. The Awarding Authority will document within the procurement file any decision to prioritize the responses on a basis other than the evaluations and rankings they received in the Review Committee process.

Contract negotiations will then commence with the bidder selected by the Awarding Authority, if any. Negotiations will occur prior to the decision to formally award a contract. Negotiations shall be limited to those matters specified in 801 CMR 21.07. The identification of a selected bidder(s) does not create a contractual obligation of DMH or the Commonwealth until negotiations are successfully completed and a contract is executed.

DMH reserves the right to negotiate a change to any specification contained in a bidder’s original response that will result in a lower cost or a more cost effective or better value of service to the Commonwealth.

If DMH is unable to satisfactorily negotiate the terms of the contract with the initially selected bidder in a reasonable period of time, DMH may disqualify that bidder and begin negotiations with the next bidder on the Awarding Authority’s prioritized list.

6.8 Contract Award Decision and Award Notification

To award or not award a contract is the decision of the Awarding Authority. All bidders that submitted a response to the RFR will be notified in writing of the contract award decision regarding the contract on which they bid and notice will be provided on Comm- PASS.

Pursuant to 801 CMR 21.06(13), no bidder shall have any press conferences, or make any news releases or announcements concerning its selection or non-selection for a contract prior to DMH’s public release of said information, or prior to the written approval of DMH. Violation of this Subsection may be considered grounds for disqualification.

6.9 Debriefing

Any non-selected bidder may request a debriefing to understand the basis for the award decision, and review all materials relevant to the procurement process. The request must be in writing and received within fourteen (14) calendar days of the award notification being posted on Comm-PASS. A bidder aggrieved by the award decision must participate in a debriefing as a prerequisite to filing a request for an Administrative Appeal. All requests for a debriefing must be addressed to the Awarding Authority as follows:

______Area Director Department of Mental Health ______Area Address

If a debriefing is properly requested, the Awarding Authority must schedule the debriefing within fourteen (14) calendar days of the date the request was received. If necessary, a brief extension shall be allowed by mutual agreement of DMH and the bidder. At the debriefing, a bidder shall be allowed to review all documents related to the award. Additionally, the Awarding Authority will discuss with the bidder the award decision. Summary notes of the debriefing will be kept by DMH. The notes will include the debriefing date, time, place, and attendees, the documents reviewed, and an overview of the discussion with the Awarding Authority.

6.10 Administrative Appeals

6.10.1 Request for Appeal to DMH. Only Qualified bidders that have attended a debriefing may appeal the award decision to the Commissioner of DMH. The

appeal must be filed within fourteen (14) calendar days of the debriefing meeting. The appeal must be in writing specifying the basis for the appeal and it must be based on one or more of the following grounds:

a. The competitive procurement conducted by DMH failed to comply with applicable regulations and guidelines. These would be limited to the requirements of 801 CMR 21.00 or any successor regulations, the Procedures Handbook, subsequent policies and procedures issued by OSD and the specifications of the RFR, or

b. There was a fundamental unfairness in the procurement process.

The burden of proof rests with the bidder to provide sufficient and specific evidence in support of their claim.

Requests for an appeal must specify in sufficient detail the basis for the appeal. Sufficient detail requires an identification of an applicable regulation or guideline that was not complied with or the specified facts that demonstrate that the procurement was unfair. DMH reserves the right to reject appeal requests based on grounds other than those stated above, or those submitted without sufficient detail on the bases for the appeal.

Administrative appeals are not subject to the formal procedures specified in M.G.L. c. 30A, §§10 and 11.

Requests for appeal must be sent to:

Barbara A. Leadholm, M.S., M.B.A. DMH of Mental Health 25 Staniford Street Boston, MA 02114

Pending appeals at the DMH level shall not prohibit DMH from proceeding with the procurement activities and executing contracts.

6.10.2 Acceptance/Denial of the Appeal. Within ten (10) calendar days of the Commissioner’s receipt of request for an appeal, the Commissioner will determine if the appeal meets the requirements set forth in Subsection 6.10.1, above. If it does not, the bidder will be sent written notice that its appeal has been denied. If the requirements are met, written notice of the acceptance of the appeal will be sent to the bidder that sent the request (the “appellant”), the Awarding Authority and the winning bidder.

6.10.3 Appeal Review. DMH will appoint an employee or an agent to investigate the basis for the appellant’s appeal as set forth in the appeal request. Upon completion of this investigation, the employee or agent will submit a written recommendation to the Commissioner and/or designee. The employee or agent investigating the appeal may do any or all of the following as he or she determines are needed: (1) review the Procurement file; (2) interview the appellant, the winning bidder, other bidders, the Awarding Authority, any member of the Review Committee or any other individual that was involved in the review and selection process; (3) submit questions to any or all the parties listed in (2) above for written responses; and (4) conduct a hearing pursuant to procedures established by DMH.

DMH’s final decision will be issued by the Commissioner within sixty (60) days of receipt of the initial appeal request, or thirty (30) days after the hearing in the event one is held. If the Commissioner overturns the contract award decision, the Commissioner will decide the appropriate remedy to be taken. All bidders must cooperate in the appeal review.

6.10.4. Appeals to the Operational Services Division. Non-successful bidders that participated in DMH’s appeal process and remain aggrieved by the decision of DMH may appeal that decision to the Operational Services Division (OSD). For more information see the Operational Services Division RFR Required Specifications in the “Forms & Terms” tab of the RFR’s Comm-PASS file.

SECTION 7 CONTRACTING POLICIES

7.1 Mandatory Contract Provisions

The contract will consist of the following:

 RFR including all attachments to the RFR as set forth in the “Forms & Terms” Section of the Comm-PASS posting.  Bidder’s Response to the RFR and all attachments.  Other terms and conditions which both parties agree upon. These terms and conditions must be in writing.

In addition, any contract awarded as a result of this RFR will include language developed by ITD, the Office of the Comptroller and the Operational Service Division regarding the implementation of Section 9 of Executive Order 504 regarding the security of personal information. A copy of that Order may be found at http://www.mass.gov/Eoca/docs/idtheft/eo504.pdf

7.2 Completion of Work

Upon the termination of the contract the contractor must work cooperatively with any successor contractor to ensure an orderly transition and that services are not interrupted. This requirement shall survive the expiration or termination of the contract.

7.3 Contract Authorization and Effective Start Date

The “Effective Date” of the Contract or Amendment is determined by the execution dates of the Contract and any required approvals as outlined in Paragraph 1 of the Commonwealth Terms and Conditions for Human and Social Services.

 "the effective start date of a Contract shall be the later of: the date the Contract was executed by an authorized signatory of the Contractor; the date the Contract was executed by an authorized signatory of the DMH; the date specified in the Contract; or the date of Secretariat authorization pursuant to G.L. c. 29, §. 29B."

Services under the contract(s) may not be rendered until the effective start date, as specified above. Bidders will receive written notification of the effective start date.

- 54 - 54