Commonwealth of Massachusetts Department of Public Health Bureau of Substance Addiction Services

1. Commonwealth of Massachusetts Department of Public Health Bureau of Substance Addiction Services Residential Rehabilitation Services Co-Occurring Disorders Enhanced 3.1 RFR# 190527 Bidders’ Conference November 5, 2018

2. Background Information • The DPH/BSAS seeks to purchase Residential Rehabilitation Services (RRS)/Co-Occurring (COE) services through this procurement. • Specialized RRS/Co-Occurring Enhanced (COE) programs must provide treatment for individuals with both a substance use disorder AND moderate to severe mental health disorder who can benefit from a safe, structured, and developmentally appropriate environment and are stable enough upon admission to benefit from this level of care. • RRS/COE services are licensed as a 3.1 level of care (LOC), with programming, staffing, and space requirements that are appropriate for the treatment of individuals with a moderate to severe substance use and mental health disorder.

3. RFR Overview • The Bureau of Substance Addiction Services is seeking to fund up to 25 RRS/COE programs across the state at per diem rate of $239.89. • Priority will be given to programs proposing new RRS/COE beds for expanded capacity versus conversion of existing RRS beds to RRS/COE beds. • Co-Occurring Enhanced Residential Rehabilitation Services (RRS) are provided in a 24-hour, safe, structured environment, located in the community, which supports residents’ recovery from addiction and moderate to severe mental health conditions as they reintegrate into the community and return to social, vocation/employment, and/or educational roles.

4. Provider Eligibility • Programs must all offer comprehensive primary healthcare services to address the uniquely complex medical needs of individuals with co-occurring substance use disorder and mental health disorders. • Services must be delivered onsite or at an affiliated clinic or outpatient prescriber that has shared infrastructure with the residential program. • Providers of co-occurring enhanced RRS must meet all requirements related to the integration of pharmacological and non-pharmacological treatments of substance use disorder, mental health disorders, and primary health conditions as appropriate to meet the needs of each resident in the program. • These requirements include formalized relationships with prescriber entities, which must be demonstrated in this application process and reflected in the program and staffing models.

5. Licensing/EHS Siting Approval • Providers of RRS/COE will be required to have a current Residential Rehabilitation Services license in good standing with the Bureau of Substance Addiction Services (BSAS). • As part of the intent to award process applicants will be required to submit EHS New Group Home Request Form as part of the application and receive approval for program siting.

6. Persons utilizing Medication Assisted Treatment (MAT) • Service providers must be able to serve clients on medication assisted treatment including: • Buprenorphine • Methadone • Extended release naltrexone

7. RFR Specifications • To ensure continuity of care RRS/COE providers must collaborate in the: • Admission • Transfer • Referral • Discharge planning process from or to another treatment setting • with client consent

8. Service Elements Application and Admission: • Information and Waitlist Management for Potential Applicants: • RRS/COE providers will be expected to keep current their program’s relevant descriptive and referral information on the Massachusetts Substance Use Helpline system (or other system as identified by BSAS). • Providers are expected to maintain protocols and practices for maintenance of current lists of all individuals on their waitlist including daily updates to the waitlist.

9. Service Elements Resident Services: Assessment: • In order to accept an individual into RRS/COE, the individual must meet the ASAM level of care for admission into the RRS and must be assessed before admission into the program. Individual Recovery Treatment and Service Plan: • Providers of RRS/COE must complete an individual recovery treatment and service plan, tailored to the need of each resident, in collaboration with the resident.

10. Service Elements Resident Services: Aftercare Plan: • Providers must ensure that residents and staff work together to identify action to be taken and resources needed in relation to the resident’s aftercare goals. Case Management Services • RRS/COE programs must provide case management referrals that address both substance use and mental health disorders in an integrated manner.

11. Service Elements Daily Programming: • Providers will establish a program of daily activities which are designed to facilitate stabilization of substance use and mental health symptoms, establishment maintenance of medication regimens, resident participation in community interaction, and promotion of resident recovery. Response to Relapse: • Psychiatrist or other mental health licensed professional will assess a recurrence of acute mental health symptoms that may require medication evaluation and adjustment or a different level of care • Providers must work to keep residents engaged in treatment while residents work to achieve and maintain recovery, by assisting residents who lapse or relapse to develop individualized action plans.

12. Service Elements Other Services and Program Components: • Safe Storage and monitoring of medications stored in the facility, and observation of residents taking medications as prescribed. • Primary healthcare services: • Providers will ensure that residents have regular access to primary healthcare services.

13. Staffing Requirements RRS/COE programs are expected to have the following staff with both mental health and substance use expertise integrated equally in the program: • Medical staff, which may include psychiatrists, addiction physicians, mid-level practitioners, and registered nurses. • Medical staff shall deliver medical and psychiatric services as allowable under the affiliated clinic license and in keeping with their supervisory requirements. • The Co-Occurring Enhanced RRS per diem rate includes overhead to support integration of medical staff with program based clinical and direct care staff to ensure coordinated treatment planning and service delivery according to the requirements in the components of service section.

14. Staffing Requirements Program staff positions funded through the per diem rate include: • A full-time program director who carries full responsibility for the administration and operations of the program • A full-time clinical director • A distinct, full-time recovery specialist supervisor • A mix of clinical and paraprofessional, and recovery specialist staff

15. Training and Supervision • Providers must provide ongoing staff supervision and training • A written plan for supervision shall specify the frequency and goals of supervision for all staff. • Providers must provide, over the course of a year, monthly scheduled in-service training sessions which are scheduled so that all staff have opportunities to participate.

16. Staffing Requirements • A part time registered nurse to support medication compliance, and monitoring of symptoms • The staffing patterns shall support the delivery of the program services. • Programs providing co-ed services will have male and female staff coverage 24/7. Male and female residential programs will have 24/7 shift coverage representative of the population being served (male:male, female:female).

17. Staffing Patterns The staffing patterns shall support the delivery of the program services. Staff coverage according to the following based on a 16 bed program size (cooks, drivers and maintenance staff are not included in determining coverage): • Minimum of 16 hours of Recovery Specialist and/or Counselor coverage every day over both 1st and 2nd shifts. • Minimum of 16 hours of awake coverage per overnight 3rd shift (programs with multiple program buildings must provide awake staff coverage in all buildings). • Programs providing co-ed services will have male and female staff coverage 24/7. Male and female residential programs will have 24/7 shift coverage representative of the population being served (male:male, female:female).

18. Electronic Submission • All responses to be submitted electronically using the online submission tools available to Vendors registered in COMMBUYS. • All Quotes must be received by the Department of Public Health before: Tuesday, December 4th , 2018 at 4:00 P.M. • DPH is not responsible for delays encountered by Bidders or their agents, or for a Bidder’s local hardware failures, such as computers or related networks, associated with bid compilation or submission.

19. COMMBUYS Item Screen • All bidders are required to enter a Unit Cost amount on the Item Screen in COMMBUYS in order to submit a quote. • The acquisition method for this RFR is Unit Rate Reimbursement • These will be Class Rate Unit Contracts where the rates have been established by the Commonwealth check off the No Charge check box. • Clicking No Charge will allow the bidder to create a valid quote and then upload all requested Bid documentation as attachments on the Attachments tab. • The “No Charge” selection will not be construed by the Purchaser to mean an offer to provide services or products at no charge.

20. INK Signatures • The Commonwealth of Massachusetts requires Contractors to submit original ink-signature only if not on file with the comptroller: • Commonwealth Terms and Conditions • Request for Taxpayer Identification and Verification (Mass. Substitute W9 Form) • Electronic Funds Transfer Sign Up Form

21. File Format and Naming Conventions • For additional instructions about naming conventions and the document titles see the Checklist of Attachments found in the Application Response Form on page 8. • The description entered during the file upload process ensures each file is readily identified by Company Name, RFR and content.

22. Scanned Documents • Scanned documents will be accepted and must be scanned in such a way that they can be read on a computer monitor and printed on 81/2” x 11” paper, unless otherwise specified. • DPH is requiring that all response attachments that are uploaded in COMMBUYS include the company name of the Bidder and the RFR number.

23. RFR Attachments • The forms listed on the COMMBUYS Bid Solicitation; File attachment section for this RFR must be submitted with your response where indicated. • To assist bidders in identify the purpose of the attachments for this procurement; the forms posted on the COMMBUYS attachment section have a prefix according to the following chart:

24. Thank you! Questions? • Written questions must be sent to: Kevin.P.Stanton@state.ma.us • Questions deadline: • Monday, November 19th 2018 • Questions and answers will be posted on COMMBUYS