Description

Amendment 1/Addendum 1, 09/11/19, please refer to the following sections for details:  Staff Administration and Qualifications At time of Contracting, #4  PRE-PROPOSAL CONFERENCE:  There will be an optional pre-proposal conference for this sourcing event on September 4, 2019 at 1:00PM at Tabor Square Office Building, Basement Conference Room 100, 4610 SE Belmont Street, Portland, OR 97215. Attendance is: Optional SERVICE DESCRIPTION, FUNDING AND CONTRACTING INFORMATION PURPOSE AND OVERVIEW  The Multnomah Department of County Human Services (DCHS), Aging and Disability and Veterans Services Division (ADVSD) is seeking Proposers from whom it may purchase mental health services for older adults and persons with disabilities.  DCHS / ADVSD  is seeking to contract with one qualified mental health provider to meet the needs of seniors and persons with disabilities who require mental health assessments, treatment and intervention services including advocacy, counseling and linkage to ongoing service coordination. The clients served under this contract are individuals who may qualify for mental health services, but are unable to enroll due to abuse, isolation, physical disability, cognitive difficulties or self-neglect such as inability to care for self. These services will be provided in collaboration and coordination with the Multidisciplinary Team (MDT) through Multnomah County ADVSD Adult Protective Services (APS). These services are for adults 18 years and older.  Major service components include: Mental Health Assessments (general and geriatric); Mental health outreach to vulnerable adults; Provide Consultation to ADVSD staff on Mental Health issues; Engage clients in services; Participate on the MDT; Write Reports; Produce statistical reports on interventions; Provide case management services to mentally ill clients; and Link clients to ongoing mental health services The awarded contractor will provide a total of five Mental Health Specialists (MH Specialist), one stationed at each of the five Multi-Disciplinary locations (see Geographic Borders/Limitations & Service Locations). A typical day for a MH Specialist will involve checking in at their assigned MDT location, meeting with MDT staff to coordinate and collaborate on client cases and conducting field visits to clients, either in their home or at a location of their choice. Upon return to their assigned MDT location the MH specialist may consult with their agency Clinical Supervisor on a particular case, refer a client to additional mental health services to ensure ongoing needs are being met and prepare any case notes, assessments or statistical reporting.  The MH Specialist will typically spend the majority of their day conducting field visits to clients, and time spent in the MDT office will be primarily for completing required reporting, attending team meetings, consulting an collaborating with MDT staff, and conducting phone calls related to the client case load.  INTRODUCTION AND PROGRAM HISTORY  Historical Overview of MDT In 1986, the Portland Multnomah Commission on Aging (PMCOA), which later became Elders In Action, along with Multnomah County’s Aging and Disabilities Services Division (ADSD) adopted criteria designed to guide the development of services to meet the mental health needs of the elderly living within Multnomah County. Recognizing the multiple and often-interrelated problems at-risk seniors can experience, a multi-disciplinary approach was viewed as essential. The initial program consisted of one Geriatric MH Specialist that worked with County Community Health Nurses to provide consultation to Case Managers within ADSD. In addition to the consultation service, a small intervention project that addressed depression within the elderly population was contracted out to Mt. Hood Community Mental Health.  In 1997, the State Disability Service Offices in Multnomah County were transferred to Multnomah DCHS / ADSD. Due to the importance and success shown by the original MDT, the Disability Services Advisory Committee (DSAC) advocated for and received funding from Multnomah County to support a Multi-Disciplinary Team (MDT) approach to serve younger persons with disabilities. This team included a Social Worker, Case Manager, Registered Nurse (RN), Mental Health Specialist, and other disciplines as needed (Public Guardian, Protective Services, and Law Enforcement). Each MDT now serves both the elderly and persons with disabilities.  Currently, ADVSD has five Multidisciplinary Teams located throughout the service system. All five of these teams have core member representation based on the original MDT approach. The team members consist of: Clinical Service Specialist, a Registered Nurse, and a Mental Health Specialist. The teams provide MDT services to both the older adults and younger disabled population, as well as to the corresponding District Senior Center clients located within their geographic area. All teams have access to additional expertise for mental health and intellectual and developmental disability issues through an inter-agency agreement between DCHS ADVSD, Intellectual and Developmental Disabilities (IDD) program, and Mental Health and Addiction Services Division (MHASD). GOALS, VALUES AND OTHER IMPORTANT CONSIDERATIONS  Evidence-Based Practices   It is the expectation of the County that the agency awarded a contract as a result of this RFP will provide Evidence-Based Practices according to the state definition (Levels I-III) on or before the date set by the state for adoption. A strong preference will be given to proposers who have created the infrastructure and completed the workforce development needed to conform to the State Evidence-based Practices (EBP) rules. For a current version of “Operational Definition for Evidence-based Practices Addiction and Mental Health Division,” refer to:   https://www.oregon.gov/OHA/HSD/AMH/Pages/EBP.aspx  Elder Abuse Reporting         The Awarded Contractor is a mandatory reporter of suspected elder abuse under ORS 124.055, and disability abuse ORS 430.735 – 430.765. Refer to: https://www.oregonlegislature.gov/bills_laws/ors/ors124.html https://www.oregonlegislature.gov/bills_laws/ors/ors430.html The Awarded Contractor will notify the case manager and/or designated staff if there are circumstances which might place a client in imminent danger. All cases of alleged elder abuse will be reported immediately to the APS screening line at 503-988-4450 by Contractor staff. If a crime is in progress report it immediately to local law enforcement - 911 or other assigned public emergency number.  Abuse is defined as the mistreatment or neglect of a person. It may include:   Physical abuse; Financial exploitation; Neglect; Abandonment; Self neglect; verbal or emotional abuse; Involuntary seclusion; Sexual abuse Wrongful use of a restraint  For the Multnomah County ADVSD website regarding Preventing Elder Abuse, refer to: https://multco.us/ads/preventing-abuse-older-people  In addition, the contractor is required to report abuse suspected and / or observed in long term care facilities. Refer to:  https://www.oregon.gov/DHS/ABUSE/Pages/mandatory_report.aspx Transition Planning  If a change in contractor is necessary, three months before the scheduled contract expiration of services under this RFP, the current contractor will present to Adult Protective Services (APS) management staff a transition plan. The plan will minimize the risk to MDT clients that will be/may be transitioning to a new MDT services contractor and allow timely and professional transition management to occur.  This transition plan will ensure: Client safety; Minimize disruption of services; This transition plan will include: Transfer of all open MDT client notes, assessments and documentation to the awarded provider Transfer of all open MDT clients to the awarded provider TARGET POPULATION SERVED  This program is intended to help clients who are elderly or physically disabled, aged 18 and older and who are served by Aging, Disability and Veterans Services Division (ADVSD) case management system and / or Adult Protective Services. Target Population includes but is not limited to: Eligible for services under the Oregon Health Plan (OHP), or Supplemental Nutrition Assistance Program (SNAP); Enrolled in long term care services; and / or Receiving Oregon Project Independence or case management services through contracted ADVSD District Senior Centers and Enhancing Equity Partners. Served by Adult Protective Services. Clients who are uninsured and unable to access services elsewhere Furthermore, they may be unwilling or unable to engage in traditional mental health services, and may need outreach and engagement services provided through home visits and community engagement GEOGRAPHIC BORDERS/LIMITATIONS & SERVICE AREAS  ADVSD currently has five Multidisciplinary operational teams located throughout the service system, located within the borders of Multnomah County. The teams work out of these locations. The addresses of the five geographic ADSD areas are: East Area                                   600 NE 8th, St. Room 100                         Gresham, OR 98030                                Mid County Area                                     10615 SE Cherry Blossom Drive             Portland, OR 97216                            North/Northeast Area  5325 NE Martin Luther King Jr. Blvd Portland, OR 97221 Southeast Area                                4610 SE Belmont                              Portland, OR 97215    West Area  209 SW 4th Ave Portland, OR 97204 See Buyer Attachment A – Site Locations, located in the Buyer Attachment page of this sourcing event, for a map of service areas. FUNDING  DCHS has budgeted approximately $$381,728 annually ($1,908,640 over five years) a mix of state and local funding for geographic area services. The awarded contractor will receive equal monthly payments based on the estimated annual budget.  Funding of the work described in this RFP is not guaranteed. Fluctuations in funding year-to-year should be expected. The County cannot assure that any particular level of work will be assigned and the contract will permit the County to add or remove work as necessary depending on availability of funding. MATCH REQUIREMENTS  Match Requirements are not part of this sourcing event. SCOPE OF SERVICES   Each of the five MDT sites will consist of: Staffed by Awarded Contractor:  A Mental Health Specialist (MH Specialist), at a minimum of a dedicated .8 Full Time Equivalent (FTE) A Clinical Supervisor at a minimum of ten hours per month total Consultation from a psychiatrist, psychiatric nurse practitioner or neuropsychologist at a minimum of 1 hour per month total Staffed by Multnomah County:   The following co-located MDT positions: A Clinical Service Specialist A Registered Nurse The primary function of the selected contractor is to work with the MDT to assist seniors and persons with disabilities in accessing Mental Health Services (MHS). Agency staff must demonstrate client engagement in MHS, resulting in improved client living situation and mental health status.  MDT services fit into the broader system of care for seniors and persons with disabilities. The system of care is based on the following values: Care that centers around the needs of seniors and persons with disabilities to ensure improvement in mental health status and living situation after the MH Specialist’s intervention; Individualized care that promotes and supports a community-based and strengths oriented model of care that promotes independence, dignity, and choice;  Care that is culturally competent; programs, and services are responsive to the cultural, racial, and ethnic strengths of seniors and vulnerable adults;  Care that is integrated across health care and other systems of care; and,  Sharing of information between the Mental Health provider and the ADVSD MDT staff is essential to the success of this program and the establishment of a good care plan. The awarded contractor will provide five .80 Full Time Equivalent (FTE) Mental Health Specialists (MH Specialist), a Clinical Supervisor, and access to consultation from a psychiatrist, psychiatric nurse practitioner or neuropsychologist. One MH Specialist will be assigned to each of the five MDT locations (see Geographic Borders/Limitations & Service Locations), and will conduct all functions of their work out of their assigned MDT base. The MH specialist will work closely with the MDT staff located at their assigned location and will participate in MDT meetings, client coordination and service collaboration. The MH Specialist will spend the majority of their time conducting client field visits, and time spent at the MDT location is for completing case notes, conducting phone calls, case coordination and collaboration with MDT staff. Consulting with psychiatrist, psychiatric nurse practitioner or neuropsychologist, or engaging with a clinical supervisor may be conducted at the awarded provider’s home agency. The provider who is awarded this Aging, Disability and Veterans Services Division (ADVSD) contract for Mental Health Services (MHS) coordination for seniors and persons with disabilities must: Work in the field;         Provide laptop computer and all equipment necessary for the laptop to function, for each MH Specialist for their use at their assigned MDT branch office. Laptop computers must be equipped with the ability to connect to the internet wirelessly. ADVSD will provide internet access at the branch offices. Provide MH Specialist and agency supervisor with cellular phones and ongoing cellular service so they can be reached by MDT staff on short notice. Conduct assessments and provide client assistance in the client’s home or at the client’s place of choice (clinic, hospital or temporary residence, etc) to assist clients’ enrollment in ongoing Mental Health Services. Client visits will be conducted primarily alone, however members of the MDT staff may accompany the MH Specialist on client visits when necessary. Provide outreach and short term counseling, up to 10 field/home visits per client / per referral. Work directly with identified clients through face-to-face visits and/or by telephone depending on the client’s preference; Attend and actively participate in weekly and other scheduled MDT meetings by consulting with team members on mental health needs and conditions, providing follow up on previously staffed cases;  and taking new referrals; Provide written cognitive evaluations and mental health assessments; complete documentation within one week of the client interaction; Share client case information regarding ongoing treatment and service planning with MDT members; Enroll clients with long term mental health needs into ongoing mental health services and programs; Mental Health Specialists will develop knowledge of mental health services and resources across programs and agencies throughout Multnomah County. Spend 85% of working hours at the ADVSD MDT office or in the field on seeing clients. Only 15% of time will be spent at the awarded agency’s location; Devise effective treatment plans that reduce use of emergency psychiatric services such as emergency room visits; Accompany protective service staff on field visits to evaluate and assess mental health status. Prioritize same day home visits with Adult Protective Services (APS) staff over scheduled counseling visits when assistance needed by APS team. Provide intensive mental health services to clients who need a higher level of engagement until the client can be enrolled in ongoing mental health care. This may mean a greater frequency of home/field visits or a longer visit time while linkage to ongoing care is established. Provide outreach to clients who are reluctant to engage with the mental health system. Provide crisis intervention and stabilization to clients not engaged in the mental health system until other resources are established. Provide a psychiatrist, psychiatric nurse practitioner or neuropsychologist to consult with the Mental Health Specialist at a minimum of one hour per month total. Provide monthly clinical consultation to the Mental Health Specialists, not less than ten hours per month total; Provide a total of 5,320 hours of service to MDT per year, consisting of: 4,600 Direct Client Service hours of: face-to-face assessments, intervention, outreach, counseling and consultations; and 720 Administrative Service hours of: staff development, training, travel in support of clients, case management, data collection, report writing and distribution, and staff supervision. Provide training to ADVSD staff at least two times a year on mental health diagnoses, treatment and services. Trainings must cover current practices on mental health diagnoses, treatment and services and must be offered two times per year in two hour sessions. Service Standards   The program goals include, but are not limited to, improved client mental health through: Assessment of client needs Crisis stabilization - which may include increased frequency of home/field visits or a longer visit times. Short term counseling Collaboration with MDT and ADVSD system Communication with clients’ mental health and medical providers Linking clients to ongoing services MDT Mental Health Specialists are required to be acquainted with: Adult Protective Service requirements: https://www.oregon.gov/DHS/abuse/Pages/index.aspx and Multnomah County ADSD website regarding Preventing Elder Abuse. Refer to: https://multco.us/ads/preventing-abuse-older-people Additionally; The laws and rules governing Adult Protective Services (APS), and notification to law enforcement; Investigation protocols; Organizational structure of Multnomah County APS; APS client screening; APS triage and response; Consultation; and APS confidentiality. Minimum Contractor Service Response Intervals Qualifying Events, Outcomes and Linkage To Appropriate Mental Health Services and Resources Qualifying Event / Needs  Expected Response Within  Outcomes  Qualifying Event / Needs  Expected Response Within  Outcomes  1st Appointment – Non Urgent  7  working days  Assessment, Short Term Intervention, Stabilization,  and Established Linkage to Appropriate Services  Chronic  5 working days  Assessment, Short Term Intervention, Stabilization,  and Established Linkage to Appropriate Services  Hazardous  Next working day  Assessment, Short Term Intervention, Stabilization,  and Established Linkage to Appropriate Services  Immediate Danger –  Response Priority  Same day  Assessment, Short Term Intervention, Stabilization,  and Established Linkage to Appropriate Services  Emergency  Immediate  Call 911  Staff Administration and Qualifications (This section was updated via Amendment 1/Addendum 1 on 09/11/19) Mental Health Specialist (MH Specialist) - Qualified Mental Health Professional:  Two years of professional experience in the provision of behavioral health services to adults as a Qualified Mental Health Professional (QMHP) as defined in the current Oregon Administrative Rule (OAR), and with knowledge and expertise working with older adults and persons with disability. Geriatric certification is preferred. QMHP means a mental health practitioner with qualifications defined in OAR 309-032-0311(16)  or https://secure.sos.state.or.us/oard/viewSingleRule.action?ruleVrsnRsn=44377 Training: Equivalent to a Master’s degree from an accredited college or university in the mental health field with major coursework in social science, social service, or a related field. Mental Health Specialists shall meet qualifications as identified below, and maintain current licensing/certification: A minimum of: One year paid, professional experience working with seniors and persons with disabilities who have mental health symptoms;         One year providing mental health services in the field. Ability to access more complex mental health continuum of services for MH clients. Agency provided clinical consultation and access to a psychiatrist, psychiatric nurse practitioner or neuropsychologist. Knowledge and expertise working with older adults and persons with disabilities. Geriatric certification is preferred. The awarded agency will provide comprehensive training in field assessment of cognitive impairment, depression and use of the current Diagnostic and Statistical Manual of Mental Disorders (DSM). Mental Health Specialists should know how to administer the SLUMs, Royall’s Clox, caregiver depression scale, trail making test. Mental Health Specialist must maintain a current driver’s license, and have ready access to a non-County working vehicle. Clinical consultative staff who supervise the Mental Health Specialists must be licensed or certified to practice in the State of Oregon as identified in their professional field. Example:  Psychiatric Nurse Practitioner to be licensed as a Psychiatric Nurse Practitioner by the State of Oregon. All five positions are required to be filled at all times. Qualified backfills are required when a Mental Health Specialist is away from the job in excess of seven calendar days. Backfills are required to cover MDT meetings, client meetings and provide consultation to APS staff.  Backfills are required to cover all absences including illness, injury, vacations, training, jury duty, military activation, leaves of absence, resignations, terminations and / or sequential combinations of these absences. Mental Health Specialist staff will not be pulled from one MDT position to cover another MDT position. FISCAL REQUIREMENTS AND REPORTING  Records Documentation  Providers must maintain accurate fiscal records that conform to accepted accounting principles and be in compliance with all State and County audit accounting procedures and requirements.  Providers must create and maintain significant documentation, including basic demographics, intake assessment data, individual treatment plans with current updates to capture clinical contacts, patient rights statements and forms, test results, and referral follow-up.  In addition to awarded contractor’s agency required documentation, the Mental Health Specialist must document in the Multnomah County MDT database.  Reporting Requirements  Send required Monthly Reports to Multnomah County ADVSD APS program manager senior and program supervisors. See table below for required reporting details due from contractor. â€‹ PERFORMANCE MEASURES / PERFORMANCE CONTRACTING  See Buyer Attachment B - Performance Measures, located in the Buyer Attachment page of this sourcing event, for Program required. Performance Measures: Contractor will use provided standard ADVSD forms for reporting required information client / services data to the County. All data requested is to be identified by the Contractor and sent electronically to the ADVSD management team. At the discretion of the County, the County may require modification to programs goals, measurements, target numbers, and requirements to meet new service levels / requirements, as well as modify the presentation and content of the forms. Statistical data / service outcomes are governed by OARs 309-032-0301 through 309-032-0890, Community Treatment and Support Services, Integrated Services and Support Rules.  Refer to: https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=1016 The following demonstrates representative outcome tools / forms that the awarded Contractor will input client statistical data and service outcomes and is not intended to be an all-inclusive list.  Adult Behavioral Health Assessment;                        Individual Treatment Plan;                              Preliminary Brief Treatment Plan;                  Progress Notes; and                                       Termination of Services Summary.               The following identifies the minimum Performance Measures that will be tracked for all elements of services provided: The number of clients, service hours, and encounters per month; The cumulative number of clients, hours and / or encounters since start of contract per month; The percentage of change from previous month; As a mental health service provider, Proposer must also hold a “Certificate of Approval” as governed under  OAR 309-008, and any such rules as they are revised from time to time.  Refer to: https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=1006 DCHS requires its contract service providers to develop and maintain internal quality assurance and evaluation practices to determine the quality of their services, compliance with regulations, stability of operations, consumer satisfaction, and appropriateness of the services. These practices are to include problem identification, problem resolution, and follow-up to assure that program improvements are sustained over time. If baseline numbers are not currently identified in Buyer Attachment B, then numbers are to be established by the County during the first six (6) months of the start of the executed contract. CONTRACT NEGOTIATION The County will initiate contract negotiations with the responsive and responsible Proposer with the highest scoring proposal. Multnomah County may, at its option, elect to negotiate general contract terms and conditions, services, pricing, implementation schedules, and such other terms as the County determines are in the County’s best interest. If negotiations fail to result in a contract, the County reserves the right to terminate the negotiations and initiate contract negotiations with the next highest scoring responsive and responsible Proposer. This process may continue until a contract agreement is reached. CONTRACT AWARD  Through this RFP process, the County is seeking to award one contract. Award, as determined by the County, will be made to the responsible Proposer whose Proposal the County determines is most advantageous to the County based on the evaluation process and evaluation factors described in this RFP. The County reserves the right to select a Proposer who has submitted a proposal scoring fewer points than a higher scoring proposal based on the Proposer’s ability to best meet the County’s programmatic needs. If a Proposer who has submitted a proposal that has scored fewer points is recommended for selection, the Board of County Commissioners must approve the award. Multnomah County strongly encourages the participation of Minority-Owned, Women-Owned, and Emerging Small Businesses and Organizations in providing these services.  CONTRACT TERM  Fixed term. The contract term shall be five years with an approximate start date of January 1, 2020, expiring December 31, 2024.  COMPENSATION AND METHOD OF PAYMENT The method of payment shall be based on a fixed monthly allocation / service capacity, upon submission of monthly invoice, and required monthly reporting details by Contractor.  COOPERATIVE PURCHASING Cooperative Purchasing does not apply to this sourcing event. INSURANCE REQUIREMENTS  The Proposer awarded a Contract as a result of this RFP will be required to provide the insurance described in Exhibit 2 of the attached Multnomah County Services Contract. Exhibit 2 of the attached Sample Contract reflects the minimum insurance required of a Contractor to provide this service. Additional insurance coverage may be required depending on the key features of service delivery chosen by the Contractor.  Minimum insurance requirements: Type of Insurance        Amount     Per Occurrence      Aggregate     Professional Liability        $1,000,000        $1.000,000        $2,000,000     Commercial Gen Liability        $1,000,000        $1.000,000        $2,000,000     Commercial Auto Liability        $1,000,000        $1,000,000         Sex Abuse/Molestation Liability*        $1,000,000        $1.000,000        $2,000,000     Workers Compensation   Required per ORS 656.017 *Sex Abuse/Molestation Liability Insurance Required. Insurance does not need to be a stand-alone insurance, it can be an endorsement of the Commercial General Liability insurance, or it can be part of the Contractor’s Professional Liability, if the Contractor carries Professional Liability. Sex Abuse/Molestation insurance coverage needs to be specifically stated in the insurance certificate. $1,000,000 each occurrence, with an annual aggregate limit of $2,000,000. This requirement may be revised or eliminated with an awarded supplier during Contract Negotiations depending on the specific scope of services for the awarded contract. Additional Requirements. Coverage must be provided by an insurance company authorized to do business in Oregon or rated A- or better by Best’s Insurance Rating. Contractor shall pay all deductibles and retentions. A cross-liability clause or separation of insureds condition must be included in all commercial general liability policies required by this Contract. Contractor’s coverage will be primary in the event of loss. The County must be listed as an Additional Insured by Endorsement on to any general Liability Policy on a primary and non-contributory basis. Such coverage will specifically include products and completed operations coverage. OWNERSHIP OF WORK PRODUCTS All work products created by a Contractor as part of a Contractor’s performance shall be the exclusive property of the County.  PRICE ESCALATION  The County will not consider or approve any requests for per unit rate increases of contractor funding for services provided during the first year of the executed contract.  MINIMUM REQUIREMENTS At the time of proposal submission, Proposers must meet the following minimum requirements. Failure to provide any of the required documents or meet any of the below requirements shall result in rejection of the proposal. The Proposal response must be received by Multnomah County Purchasing no later than 4:00 P.M. local Portland time on the proposal submission deadline. Proposer Representations and Certifications The Proposer must certify that they agree to the Proposers Representation and Certification terms in the Pre-requisite page of the Sourcing Event. At the time of Contracting, Proposers must meet the following minimum requirements. Failure to provide any of the required documents or meet any of the below requirements shall result in cancellation of the contract (#4 of this section was added via amendment 1/addendum 1 on 09/11/19) Proposers must be legal entities, currently registered to do business in the State of Oregon (per ORS 60.701). Proposers must submit verification that all insurance requirements are met. Proposers must have a completed Pre-Award Risk Assessment if federal funds are used for this Sourcing Event. (See Procedural Instructions in the Buyer Attachments page of this Sourcing Event) Each Proposer must provide documentation showing: individuals employed by the Proposer have the following licenses/certification: Qualified Mental Health Professional (QMHP) - Master's Level Clinician; and that the Proposer/Organization holds a "Certificate of Approval" for operating as a mental health service provider (CMHP), and meets all requirements as governed under OAR 309-02-0130 through 309-012-0220, and any such rules as they are revised from time to time.

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