department of behavioral health services - pay for success · department of behavioral health...

DEPARTMENT OF BEHAVIORAL HEALTH SERVICES

REQUEST FOR PROPOSALS (RFP)

Acute Mental Health: Frequent Users Care Coordination Pay for Success Project

RFP RELEASE DATE: Friday, December 12, 2014

RFP RESPONSES DUE DATE:

Friday, February 17, 2015 by 3:00pm Proposals submitted late will not be considered

Proposals must be delivered to:

Santa Clara Valley Health & Hospital System Department of Behavioral Health Services

Attention: Don Casillas, Contracts Manager 828 S. Bascom Avenue, Suite 200

San Jose, California 95128

RFP CONTACT:

Address all questions and clarifications to BidSync, www.bidsync.com

http://www.bidsync.com/

Santa Clara County –Department of Behavioral Health Services RFP-MHS-FY15-0238: Acute Mental Health: Frequent Users Care Coordination Pay for Success Project

TABLE OF CONTENTS

SECTION TITLE PAGE

I PROJECT OVERVIEW 3

II RFP TIMELINE AND EVENTS 11

III CONDITIONS GOVERNING THE PROCUREMENT 14

IV RESPONSE FORMAT AND CONTENT 20

V REQUIREMENTS AND BIDDER’S SUBMITTAL 22

VI EVALUATION 27

APPENDICES All applicable Appendices must be submitted with the proposal. Appendix A – Cover Sheet Appendix B – Projected Budget and Instructions Appendix C – Designation of Subcontractors Appendix D – Customer References Appendix E – Vendor’s Questionnaire Appendix F – Non-Collusion Declaration Appendix G – Confidential Information Public Record Act Appendix H – Cultural Competence Form Appendix I – Declaration of Local Preference ATTACHMENTS The Attachments listed below are reference materials and do not have to be submitted with the proposal. Attachment A – Contracting Principles Attachment B – Insurance Requirements Attachment C – County Local Preference Policy Attachment D – Sample Agreement Attachment E – Pay for Success / Social Impact Bonds Reference Materials Attachment F – Fact Sheet Regarding Massachusetts Juvenile Justice Pay for Success Project Attachment G – Pay for Success Project Flow Chart

2

Santa Clara County –Department of Behavioral Health Services RFP-MHS-FY15-0238: Acute Mental Health: Frequent Users Care Coordination Pay for Success Project SECTION I – PROJECT OVERVIEW

A. PURPOSE Since early 2013, the County of Santa Clara (the “County”) has been developing a Pay for Success (“PFS”) project, the goal of which is to provide more optimal care for frequent users of the County’s emergency and in-patient mental health system. Specifically, this project will focus on clients who have frequent or extended stays in psychiatric emergency, in-patient, and other institutional settings, ensuring they are stabilized in community-based, less restrictive environments. The community-based care provided through this project will be designed to improve the overall wellness of these clients, measured by the reduced utilization of emergency and inpatient acute psychiatric hospitalizations. By improving the wellness of these clients, this project aims to (1) better serve and meet the needs of these clients in the least restrictive setting and (2) avoid costs to the County by reducing bed days purchased from contract psychiatric hospitals, reducing utilization of Emergency Psychiatric Services (EPS), and improving the efficiency of bed use in the Barbara Arons Pavilion (BAP). The County plans to more fully develop and implement the project in two stages. First, through this Request for Proposals (“RFP”), the County will identify a lead agency (“Lead Agency”) that will work with the County and its consultant – Third Sector Capital Partners, Inc., (“Third Sector”) – with finalizing the service model and financing structure for the project, securing operating capital, identifying additional service providers to partner with the Lead Agency and developing the performance-based contract that will memorialize the project. In the second stage, the Lead Agency and the County will execute a PFS contract, following approval by the Board of Supervisors. Under the PFS contract, the Lead Agency will coordinate the PFS project, manage any subcontractors, and provide direct services to the project’s participants. We expect the PFS contract will have a term of seven years, including a six-year service delivery period.

B. ABOUT PAY FOR SUCCESS AND SOCIAL INNOVATION FINANCING PFS is a performance-based approach to contracting and procurement in which a state or local government makes payments only if and when a service provider achieves specified social outcomes. This approach is fundamentally different from traditional fee-for-service or cost-reimbursement models of government-funded social service provision. Governments across the country have begun to explore the use of PFS to invest in preventive social services for vulnerable populations, seeking more effective and efficient ways to meet the needs of these populations. PFS contracts typically incorporate a rigorous evaluation, in order to objectively determine whether the services are achieving the intended social outcomes, and therefore whether “success payments” should be made by the government. This approach has the benefit of ensuring that public resources are only expended for demonstrated “successful outcomes.” To ensure service providers have the working capital necessary to provide services before success payments are made, PFS projects are generally funded by Social Innovation Financing (“SIF”), a mechanism through which third party funders support the delivery of services until an independent evaluator determines whether government success payments should be made. These funders can be philanthropic entities, independent social investors, commercial banks, or a combination of these

3

Santa Clara County –Department of Behavioral Health Services RFP-MHS-FY15-0238: Acute Mental Health: Frequent Users Care Coordination Pay for Success Project entities. The funders bear most or all of the risk associated with the potential that the PFS provider fails to meet the desired outcomes, resulting in non-payment by the government. In exchange for bearing this risk, the funders often receive a return on their investment, if the desired outcomes are achieved or exceeded. The return to the funders often varies depending on the level of “success” achieved by the PFS project. The PFS service provider may also receive performance incentives or success payments based on the achievement of outcomes and contract terms. An overview of Social Impact Bonds, a type of SIF, created by the Center for American Progress, and a case study on the origin of Santa Clara’s PFS projects are included as an additional resource in Attachment E.

C. PAY FOR SUCCESS IN OTHER JURISDICTIONS

Several PFS projects have launched in other jurisdictions across the country addressing different issue areas, including Chicago, IL (early childhood education); Cuyahoga County, OH (family homelessness and foster care); New York City, NY (juvenile justice); New York State (recidivism of incarcerated young adults); Salt Lake City, Utah (early childhood education); and the Commonwealth of Massachusetts (juvenile justice). For example, the Massachusetts PFS project, which launched in early 2014, aims to reduce recidivism and improve employment outcomes for young men emerging from the juvenile justice and dependency systems who are at high risk of re-offending. The PFS service provider for this project is Roca, Inc., a nonprofit that delivers an evidence-based intervention for at-risk young men, training them in job readiness, educational readiness, and life skills. Over the course of the seven-year project, Massachusetts will make up to $27 million in success payments based on metrics demonstrating decreases in incarceration, increases in job readiness, and increases in employment attained by the young men participating in the Roca program. Massachusetts’ success payments are generally calibrated to correlate with the decrease in state expenditures as a result of improved outcomes for this population (e.g., fewer days of incarceration resulting in decreased public safety costs). The project received $18 million in upfront financing from commercial and philanthropic funders with additional capital from $3.3 million in deferred service fees from the service provider. The project is the largest financial investment in a PFS initiative in the U.S. to date. A fact sheet for the project is provided in Attachment F as an additional resource to this RFP.

D. PAY FOR SUCCESS IN SANTA CLARA COUNTY Santa Clara County’s interest in PFS grew from a community-based exploration, led by Catholic Charities of Santa Clara County and Step Up Silicon Valley, with technical assistance from Third Sector and funding from The Health Trust. The County worked closely with these partners to fully understand PFS’s implications for the County, to engage with potential service providers and funders, and to identify areas where PFS might be best suited to address the County’s social challenges. In August 2013, the County Board of Supervisors engaged Third Sector (with support from the Sobrato Family Foundation and the Silicon Valley Community Foundation) to finalize and implement two PFS projects to improve outcomes for two target populations: the chronically homeless and those suffering from acute mental illness. The County was later awarded a grant from the Irvine Foundation and Nonprofit Finance Fund’s California Pay for Success Initiative to continue pursuing the two projects in the County and work towards constructing a PFS contract for each

4

Santa Clara County –Department of Behavioral Health Services RFP-MHS-FY15-0238: Acute Mental Health: Frequent Users Care Coordination Pay for Success Project project. The County previously issued an RFP for a Lead Agency for the chronic homelessness PFS project and is currently in negotiations with the Lead Agency and prospective funders to finalize all project-related contracts. This RFP will be the second PFS RFP released in the County, and seeks to identify the Lead Agency for the PFS project serving clients with acute mental illness.

E. FREQUENT USERS OF EMERGENCY AND IN-PATIENT MENTAL HEALTH SERVICES IN SANTA CLARA COUNTY

The County’s Department of Behavioral Health Services operates the safety net for County residents who are experiencing or are at risk of experiencing serious mental illness. The County provides psychiatric emergency and in-patient services through the Valley Medical Center (VMC) Emergency Psychiatric Services (EPS), a 24-hour psychiatric emergency service; through the adjacent psychiatric inpatient facility known as the Barbara Arons Pavilion (BAP); and through several contracted inpatient psychiatric hospitals. These secure facilities are designated under the Lanterman-Petris-Short Act (LPS) as facilities authorized to provide involuntary evaluation and treatment to persons who are a danger to themselves or others, or who are gravely disabled.

The large majority of Santa Clara County residents who experience emergency psychiatric crises are initially evaluated and treated at EPS. This is because EPS is the only LPS-designated psychiatric emergency room in the County. As is true in other emergency room settings, EPS clients are expected to stay less than 24 hours. Once the evaluation and emergency treatment are completed, a psychiatrist determines if the client is stable enough to return to the community with follow-up care, or whether continued inpatient treatment is necessary. For those who require continued hospitalization, EPS staff facilitate their transfer to BAP, a contracted hospital, or another appropriate available inpatient setting.

In Fiscal Year 2012-2013, for example, EPS provided approximately 9,500 evaluations to approximately 6,000 unique clients. Of those 6,000 clients, 1,600 (27%) had more than one EPS visit in the year. This group of 1,600 clients had an average of over 3 visits within the year and accounted for approximately 5,000 EPS admissions (53% of total admissions). We consider these 1,600 clients “high users” of EPS.

Some of these “high users” of EPS were also high users of the County’s psychiatric inpatient facilities. For example, in FY13, BAP treated approximately 900 unique clients, of whom approximately 225 (25%) were readmitted within the same year. These 225 clients accounted for almost 600 BAP admissions (46% of total annual admissions) and roughly 10,000 total bed days (57% of total annual bed days) in that year.

Not all high users of EPS are also high users of inpatient services. However, because EPS is the entry point for most adult psychiatric hospitalizations, virtually all high users of inpatient services are also EPS high users. The FY13 data illustrates that there were 225 high users of EPS that were also identified as high users of BAP in the same 12-month period. This group accounted for roughly 600 BAP admissions and 10,000 inpatient days in that one year. This project will focus on individuals with similar utilization patterns, who are high users of both EPS and inpatient psychiatric services.

In addition to severe mental health conditions, this group is often impacted by co-occurring substance use disorders, ineffective care coordination, lack of access to housing and other supportive services, and/or non-adherence to medication regimens. Without timely and appropriate discharge

5

Santa Clara County –Department of Behavioral Health Services RFP-MHS-FY15-0238: Acute Mental Health: Frequent Users Care Coordination Pay for Success Project plans for these clients, two things happen: (1) clients stay in inpatient beds unnecessarily, which lowers the reimbursement rate the County receives for that bed from the “acute” rate to the lower “administrative” rate, and forces the County to purchase additional inpatient beds from contract hospitals (i.e., delayed discharge leads to increased cost); and (2) clients are released without a plan that fully addresses readmission risks (i.e., lack of appropriate resources increases risk of readmission, which leads to increased cost).

F. THE LEAD AGENCY

The organization selected through this RFP process will be afforded the opportunity to enter into exclusive contract negotiations with the County to serve as the Lead Agency for this Project. During the negotiation process, the Lead Agency will work closely with the County to finalize the project’s service model and financing structure, secure operating capital, identify any additional service providers that will partner with the Lead Agency, and construct the contract(s) that will memorialize the project. Although the County does not necessarily expect the Lead Agency to provide all the services needed to achieve its desired outcomes, the Lead Agency must possess the knowledge, resources, and sophistication necessary to oversee all aspects of the program and will ultimately be responsible for delivering the desired social outcomes. The Lead Agency must demonstrate the capacity to perform the following functions:

• Enter into a PFS contract with the County; • Develop a robust, coordinated, evidence-based service delivery model that includes

mental health services, intensive case management, and drug treatment services; • Provide all of these services or assemble and closely manage partnerships with other

organizations as needed to provide these services to the target population; • Conduct ongoing administration and/or management of the program to achieve the

negotiated outcome(s) with a specific intervention for the target population, as described;

• Has the flexibility to change or modify the service delivery methods and service providers to ensure outcomes are achieved;

• Collect and provide data for the independent evaluator to measure program outcomes; • Provide relevant information for and participate in discussions with the County and

Third Sector to raise SIF for the project; and • Manage the overall PFS project day-to-day operations.

Because many of the mental health, intensive case management, drug treatment, and medical services we anticipate will be provided through this project will be Medi-Cal funded, the Lead Agency must possess a sophisticated understanding of the rules and requirements governing provision of Medi-Cal-funded services in the County. To ensure that the Lead Agency possesses the skills and resources necessary to successfully integrate Medi-Cal-funded services into the overall program, the Lead Agency must either:

(1) Be a current Medi-Cal provider certified by the Santa Clara County Department of Behavioral Health Services, or

6


(2) Be a current Medi-Cal provider certified by another county mental health department and has the capacity to become a Medi-Cal certified provider in Santa Clara County during the project construction process.

G. PROJECT GOALS AND DESIRED OUTCOMES The project seeks to improve the coordination of care for clients who are frequent users of the County’s emergency and inpatient psychiatric services by stabilizing these clients through appropriate and cost-effective services provided in a less restrictive, community-based setting. Specifically, this PFS project will seek to reduce the use of emergency and inpatient psychiatric services by creating greater wellness and stability in clients served, thereby reducing the County’s expenditures (1) on bed days purchased from contract psychiatric hospitals, (2) from utilization of EPS, and (3) by reallocating reduced “administrative” BAP beds to become available “acute” BAP bed days. The program should be designed such that the total anticipated cost of the PFS program for the County is less than the anticipated net cost savings for the County. In addition, this project will involve a rigorous evaluation of the effectiveness of the services provided in both achieving stability and wellness and reducing overall costs to the County’s mental health system. To measure progress towards achieving this desired outcome, the County’s working definition of the “success” that would trigger a payment under this project is the significant reduction of visits to EPS and admissions to BAP and/or contract hospitals for clients enrolled in the program. In addition to advancing the goals described above, the County’s use of PFS will help it to:

• Implement performance-based contracting; • Leverage outside funding to enable service providers to scale up effective programs; • Assess whether performance-based service delivery using rigorous evaluation is a cost-

effective and efficient way to invest in preventive services; and • Determine whether (and to what extent) County investments in best practices for acute

mental health treatment services achieve cashable fiscal savings, increased revenues, and improved efficiency of services.

H. PARTNERS AND ROLES

i. County of Santa Clara

The County will enter into a contract with the Lead Agency under which it will make success payments if and when successful outcomes are achieved. The County Executive’s Office will oversee the project, in collaboration with the Department of Behavioral Health Services, Office of Supportive Housing, and Office of the County Counsel.

ii. Third Sector Capital Partners, Inc.

Thanks to the generous support of the Health Trust, the Sobrato Family Foundation, the Silicon Valley Community Foundation, the Nonprofit Finance Fund and Irvine Foundation’s California PFS Initiative, the County has contracted with Third Sector, a

7


non-profit organization with substantial expertise in the PFS arena, to advise the County on its exploration and development of its two PFS projects. Third Sector has supported the County by:

• Identifying potential sources of cost avoidance from PFS projects; • Identifying target populations that might benefit from a PFS project; and • Educating potential funders and service providers in the County about the PFS

model. Going forward, Third Sector will assist the County with crafting the overall financial structure and economic modeling of the project, the development of the PFS contracts, and identifying and engaging local and national funders that have interest in supporting a PFS project in Santa Clara County.

iii. Lead Agency

As detailed above in Section F, the Lead Agency will oversee all aspects of service delivery and will ultimately be responsible for delivering the desired social outcomes.

iv. Funder(s)

Funders are the institutions or individuals that provide the SIF necessary to provide the working capital funds for the PFS service provision. Funders may or may not expect a return of their principal along with some interest, depending on their individual preferences. They accept some or all of the inherent risk of non-payment if outcomes are not achieved.

v. Independent Evaluator

An independent evaluator has been selected to be responsible for designing the evaluation methodology and plan for the project. The independent evaluator will also verify and validate whether the success outcome(s) for which the County will make success payments are achieved.

vi. Other Service Provider(s)

While not required, the Lead Agency may choose to subcontract with other service providers to provide specific services and/or interventions. The County anticipates that organizations other than the Lead Agency may provide services under a subcontract with the Lead Agency, with the exception of any Medi-Cal funded services. NOTE: Service providers that do not wish to serve as the Lead Agency will not be selected through this RFP process, and therefore should not submit a bid. Instead, Lead Agency Bidders will identify any other service providers with which they intend to collaborate in providing services. These other service providers are encouraged to collaborate with Lead Agency Bidder(s) in creating the Lead Agency Bidder’s response to this RFP, and to provide that Lead Agency Bidder with a letter of support.

8

Santa Clara County –Department of Behavioral Health Services RFP-MHS-FY15-0238: Acute Mental Health: Frequent Users Care Coordination Pay for Success Project See Attachment G for an overview of the flow of funds and services for a PFS program.

I. TARGET POPULATION

The County intends this project to benefit individuals who have experienced frequent, acute mental health crises, and who are the highest users of County emergency and inpatient mental health services. These individuals will likely be identified and referred into the program at EPS. The target population is expected to include individuals who:

• Present acute psychiatric/behavioral issues; • Have been admitted to an inpatient setting at least once in the prior year and/or have a

high potential for a future inpatient admission; • Are culturally and linguistically diverse; • Have experienced or are experiencing institutionalization, substance abuse, poor

adherence to medication regimens, difficulties participating in structured activities, and/or difficulties living independently;

• Have a history of assaultive behavior, incarceration, and/or suicidal behaviors; • Are eligible for Medi-Cal and/or Supplemental Security Income (“SSI”) or are

uninsured; • Have experienced episodes of homelessness; and • Lack family or other support networks.

An individual will be disqualified from the target population if he/she:

• Will likely be transferred to a state psychiatric hospital; • Has significant complicating medical conditions that require placement in a skilled

nursing facility (SNF) or similar setting; and/or • Is enrolled in the Santa Clara County Chronic Homelessness PFS project.1

Based on an initial assessment of the target population, the County anticipates that roughly 1,000 adults will be eligible for this project each year. Of this eligible population, this project will seek to serve 40-500 clients at any given time, and no fewer than 250 individuals over the six-year service delivery period. During the project construction phase of this project, the selected Lead Agency will work closely with all partners identified in Section H to further specify and refine the target population criteria for this project.

J. INTERVENTION The County is seeking a Lead Agency that will implement evidence-based interventions and best practices for treating the acute mental health population. The Lead Agency is expected to provide the appropriate coordination of care for all patients referred to the program. We anticipate that the proposed program may incorporate, but not be limited to, the following services for the target population:

1 Note: At the time of this RFP, the referral program for Chronic Homelessness project is still being refined. The County, Third Sector, and Evaluator(s) will work closely with the Lead Agency to account for the potential overlap of target populations of these two projects.

9


• Integrated and intensive case management, including assistance with enrolling in benefit and government assistance programs, assistance with maintaining stable living situations, and assistance with developing support networks and meaningful daily activities;

• Providing or facilitating access to primary medical care, outpatient mental health services, and substance abuse treatment services, as needed;

• Pre-crisis and crisis intervention with 24/7 access to care; • Connections to community recreational, social, educational, and/or occupational

services/resources; • Peer support and socialization/consumer engagement activities, such as peer mentoring; • Recovery-oriented treatment services (e.g., individual or group therapy, medication

management, residential treatment); • A culturally and linguistically diverse service delivery model; • A staff psychiatrist to provide care in coordination with County doctors; • Field-based care; • Providing or facilitating access to housing or alternative living situations; and • Providing services which utilize flexible funding to purchase additional resources or

supports that benefit the client’s overall health / wellness.

K. CONTRACTING PROCESS

As noted above, the organization selected through this RFP process will be afforded the opportunity to enter into exclusive contract negotiations with the County to serve as the Lead Agency for the Acute Mental Health: Frequent Users Care Coordination Pay for Success Project. The contracting process will have two phases: Phase I – Project Construction: The selected organization will collaborate with the County to finalize the details of the project (e.g., services, outcomes, contracting and financing structure, evaluation process, etc.) and prepare the contractual agreement(s) memorializing the project. We anticipate this process will take approximately 6-9 months. Phase II – Contract Execution and Service Provision: After the completion of the project construction phase, the Lead Agency and the County will execute a PFS contract, subject to approval by the Board of Supervisors. Service provision will begin thereafter. The County has identified some funding to cover costs that the selected Lead Agency may incur during the project construction process. Because provision of such funding is limited, a successful Bidder will demonstrate the capacity to undertake this effort regardless of the availability of such funding. Accomplishing the goals of this RFP and the subsequent project construction process will require the coordinated efforts of multiple stakeholders. As such, a successful Bidder must demonstrate the willingness and skills necessary to collaborate effectively with other service providers, the County, potential funders, and the evaluator.

L. ANTICIPATED COMPENSATION STRUCTURE

10

Santa Clara County –Department of Behavioral Health Services RFP-MHS-FY15-0238: Acute Mental Health: Frequent Users Care Coordination Pay for Success Project PFS is a performance-based approach to contracting that is fundamentally different from traditional fee-for-service or cost-reimbursement models generally utilized in the County’s service contracts. The details of the compensation structure for the Acute Mental Health: Frequent Users Care Coordination Pay for Success Contract will be negotiated during the project construction process (Phase I), but the County anticipates the compensation provisions of the contract will utilize the following structure:

• To ensure the Lead Agency and any subcontracted service providers have the working capital necessary to provide services, third party funders (as detailed in Section H) will provide the Lead Agency with working capital commensurate with the cost of service delivery;

• The County will make payments if and only if the specific outcomes set forth in the contract are achieved;

• Because the third party funders bear most or all of the risk associated with the potential failure to achieve desired outcomes, the success payments made by the County will exceed the amount paid to the Lead Agency by the third party funders by an amount calibrated to provide the funders with a reasonable rate of return; and

• The Lead Agency can also elect to bear some risk of non-success and receive performance incentives or a portion of the success payments if “success” is achieved.

The County intends to allocate a substantial portion of the estimated cost savings from the project as success payments. The County is seeking to construct a total program that achieves at least $5 million of cost savings over 6 years. The County’s working definition of “success” for purposes of this project is the significant reduction of visits to EPS and admissions to BAP and/or contract hospitals for clients enrolled in the program.

Along with the minimum $5 million target for cost savings over 6 years, the County requests that bidders construct a proposed project that serves 40-500 clients at any given time, and no fewer than 250 individuals over the six-year service delivery period. Accordingly, as set forth in the section regarding budgets below, Bidders should construct a program where the total cost of the program (both intervention costs and PFS-related costs), excluding the costs of Medi-Cal-funded services, does not exceed the annual projected cost savings for the County as a result of the intervention. Further details on the budget submission can be found in Section V.D. and Appendix B. SECTION II – RFP TIMELINE AND EVENTS A. CALENDAR OF EVENTS NOTE: Dates and/or the process in this timeline may be changed by the DBHS if deemed necessary. The DBHS will make every effort to adhere to following anticipated schedule: Event Date

1 RFP Release December 12, 2014

2 Requested RSVPs for the Pre-Proposal Conference January 6, 2015

3 Pre-Proposal Conference from 10:00 AM – 12:00 PM PST January 9, 2015

4 Requested Non-binding Letter of Intent to Submit a Proposal by 3:00 PM PST January 13, 2015

11


5 Deadline to submit RFP questions through BidSync - 3:00 PM PST February 2, 2015

6 PROPOSALS DUE by 3:00 PM PST February 17, 2015

7 Proposal Evaluation March 2, 2015

8 Vendor interviews (if needed). Note: All vendors must keep this date available for interviews and/or to respond to supplemental questions.

March 13, 2015

9 Notice of Intent to Award Sent March 20, 2015 10 Protest Deadline by 3:00 PM PST March 27, 2015 11 Estimated date for Notice of Award April 3, 2015 12 Estimated Contract Negotiation Start Date April 14, 2015

Communication with County Employees As of the issuance date of this RFP and continuing until the final date for submission of proposals, contact with Santa Clara County employees is strictly limited. All personnel representing the County are specifically directed not to hold meetings, conferences or technical discussions with any vendor for purposes of responding to this RFP. Any vendor found to be acting in any way contrary to this directive will be disqualified from entering into any contract that may result from this RFP. B. EXPLANATION OF EVENTS

1. RFP Release This RFP is being issued by the Santa Clara Valley Health & Hospital System Department of Behavioral Health Services (“DBHS”). Copies of this RFP including supporting documents may be obtained from BidSync’s web site at http://www.bidsync.com.

2. Pre-Proposal Conference RSVP

The County requests that parties who are interested in attending the Pre-Proposal Conference submit their intention to attend by email to [email protected] by January 6, 2015. This email should include the following:

• Name of organization and • Contact information for participating representatives (names, titles, addresses, phone

numbers, and email addresses).

3. Pre-Proposal Conference

A pre-proposal conference has been scheduled as specified in Section II.A., “Calendar of Events.” The agenda for the Pre-Proposal Conference will be distributed along with a time and location via BidSync by January 9, 2015. The pre-proposal conference will include a review of the RFP and response to questions. Although the pre-proposal conference is optional, providers are strongly encouraged to attend this conference.

12



Please bring copies of this RFP and its correlating appendices and attachments to the pre-proposal conference. Copies will not be provided by the County in efforts to conserve resources.

Oral responses given at the conference are not binding on the County. Any responses submitted or asked at the conference that, in the County’s judgment, alter the content of the RFP, will be provided in writing, as an addendum to the RFP. All addenda will be posted on www.bidsync.com.

4. Letter of Intent to Submit a Proposal

The County will be able to develop a more efficient process for reviewing responses if the staff understands the number of applicants that intend to submit responses. Though not required, each organization intending to submit a response to this RFP is requested to send an email indicating their interest to [email protected] by 12:00 PM PST on January 13, 2015. The email should contain the subject line “Intent to Submit a Proposal” and briefly describe the proposed project and any identified potential partner organizations. Organizations that submit a Letter of Intent may ultimately decline to submit a proposal.

5. Deadline to Submit RFP Questions through BidSync

Potential Bidders may submit written questions regarding this RFP via BidSync until the deadline as indicated in Section II.A., “Calendar of Events.” The County will not respond to questions submitted in any other manner or format. Please cite the RFP Section, subsection and page number that each question is in reference to. Example: [RFP Section I, subsection F, pg. 6]. Answers to questions received by the deadline will be responded to on the bid management site www.bidsync.com. The County does not guarantee that it will respond to questions submitted after the closing date and time for written questions. Written responses to written questions regarding the substance of the RFP, and any material changes to the RFP, will be issued as an addendum, and posted on www.bidsync.com. The County reserves the right to post addenda until the RFP closing date and time.

6. Proposal Due Date

Proposals must be received no later than the deadline specified in Section II.A., “Calendar of Events.” All proposals received will be time stamped. Late proposals will not be accepted. All deliveries via express carrier should be addressed as follows:

Santa Clara Valley Health and Hospital System Department of Behavioral Health Services Attention: Don Casillas, Contracts Manager 828 South Bascom Avenue, Suite 200 San Jose, California 95128

13





Proposals must be sealed and labeled on the outside of the package to clearly indicate that they are in response to the RFP # and title as referenced on the cover page.

7. Proposal Evaluation

An Evaluation Committee (“EC”) will review and evaluate the proposals and make a recommendation for an award. The EC will evaluate proposals in accordance with scoring criteria published in this RFP.

8. Vendor Interviews

At the County’s option, one or more bidders may be selected as a finalist and invited to proceed to the next round of evaluations and/or interviews. All bidders must keep the possible interview date available as indicated in Section II.A., “Calendar of Events.”

9. Notice of Intent to Award Contract

The County will e-mail notification letters to bidders advising them of the County’s intent to award the contract. At County’s option, multiple bidders may be selected

10. Protest

Bidders whose proposals were not selected may file a written protest. Please see Section III of this RFP for a detailed description of the protest procedures.

SECTION III – CONDITIONS GOVERNING THE PROCUREMENT This section of the RFP describes the procurement events as well as the conditions governing the procurement.

A. PROTEST PROCEDURES The County will send an email to all proposers informing them of the proposal that was selected. Proposers whose proposals were not selected may file a written protest (“Protesters”) as set forth below.

1. Filing a Protest

The protest of an award must be in writing. The following must be written on the cover of the protest: “Protest Relating to RFP-MHS-FY15-0238: Acute Mental Health: Frequent Users Care Coordination Pay for Success Project.” The written protest must be emailed, faxed, or mailed to the DBHS at the following address:

Santa Clara Valley Health and Hospital System Department of Behavioral Health Services RFP-MHS-FY15-0238 Attention: Don Casillas, Contracts Manager

14

http://as/


828 South Bascom Avenue, Suite 200 San Jose, California 95128 E-mail: [email protected] Fax: (408) 885-5792

All protests must be received by the designated Contracts Manager within five (5) business days after the DBHS issued the Notice of Intent to Award. Any protests received after this time will not be considered.

2. Contents of Protest The written protest must contain the following information: (1) the name, street address, electronic mail address, telephone, and facsimile number of the protesting party (“Protester”); (2) signature of the Protester or its representative; (3) clearly stated grounds for the protest as set forth in Section (A)(3) “Grounds for Protest” below; (4) copies of any relevant documents referred to by the protest; (5) the form of relief requested; and (6) the method by which the Protester would like to receive the Department’s written protest decision. The written protest must clearly state the grounds for the protest. Protests should be concise and logically arranged.

3. Grounds for Protest Protests shall be based only on one or more of the following grounds:

a. The Protester believes the County failed to follow the procedures and adhere to

requirements set forth in the solicitation or any addendum thereto.

b. The Protestor believes there was misconduct or impropriety by County officials or evaluation team members.

c. The Protester believes there was abuse of process or abuse of discretion by County

officials or evaluation team members.

4. Protest Resolution Process a. Informal Review by the Chief Operating Officer

The County’s Chief Operating Officer (“COO”), or his designee, will review a timely protest and attempt to informally resolve it expeditiously. Upon review of the protest, the COO will determine whether the protest has any merit and will send the Protester a written protest decision.

b. Request for Independent Review by the County Executive

If the Protester believes the COO’s written response did not resolve the protest, the Protester may send a request to have the protest formally reviewed by the County Executive or his designee. Requests for a formal review by the County Executive must be in writing and submitted

15


no later than five (5) days from the date the COO sent out the protest decision. If no request is received with the five (5) days, the COO will determine that the Protester does not seek further review. The written request independent review must be emailed, faxed, or mailed to the DBHS at the same address listed under Section III (A)(1) “Filing a Protest.”

c. Formal Review by County Executive

The COO, or his designee, will forward the protest to the County Executive within two (2) business days after receiving Protester’s written request for formal review. The COO is required to provide the Protester with the following: 1) written notification that the protest is being forwarded to the County Executive; 2) the County Executive’s contact information; and 3) notification that the Protester has ten (10) business days to provide the County Executive with any additional documents that the Protester believes is relevant to the review of the protest. The COO will also have ten (10) business days from the date of the written notification to forward any additional documents relevant to the County Executive. Protester may not present any additional grounds for protest, arguments, or narratives that were not included in the original protest. The County Executive shall conduct an independent review of the protest to determine whether the grounds for the protest have merit. Only the information contained in a timely protest shall be considered by the County Executive. The County Executive shall only consider the documents each party has submitted, grounds for protest, and grounds to reject the protest.

The County Executive will issue a written decision to both the COO and the Protester within twenty five business (25) days of receiving a protest. However, if extended time is necessary for the County Executive to issue a decision, a notification to both parties will be sent. If the Protester failed to specify in its written protest the method by which the Protester would like to receive the County Executive’s written decision, the decision will be sent via U.S. mail. All decisions of the County Executive shall be final.

5. Remedies

If the County Executive sustains a protest in whole or in part, the County Executive shall refer the matter back to the COO for redress in conformance with the County Executive’s decision. If the County Executive rejects the protest, then the County may proceed with awarding the contract(s).

B. GENERAL

1. INCURRING

This RFP does not commit the County to award, nor does it commit the County to pay any cost incurred in the submission of the Proposal, or in making necessary studies or designs for the preparation thereof, nor procure or contract for services or supplies. Further, no reimbursable cost may be incurred in anticipation of a contract award.

16


2. CLAIMS AGAINST THE COUNTY OF SANTA CLARA Neither your organization nor any of your representatives shall have any claims whatsoever against the County or any of its respective officials, agents, or employees arising out of or relating to this RFP or these RFP procedures, except as set forth in the terms of a definitive agreement between the County and your organization.

3. BASIS FOR PROPOSAL

Only information supplied by the County in writing in connection with this RFP should be used as the basis for the preparation of Bidder’s proposal.

4. FORMS OF PROPOSALS

No oral, telephone, facsimile, or electronic proposals will be accepted.

5. AMENDED PROPOSALS

A Bidder may submit an amended proposal before the deadline for receipt of proposals. Such amended proposals must be complete replacements for a previously submitted proposal and must be clearly identified as such in the Letter of Transmittal, (Section III, Response Format and Organization). The County personnel will not merge, collate, or assemble proposal materials.

6. WITHDRAWAL OF PROPOSAL

Bidders will be allowed to withdraw their proposals at any time prior to the deadline for receipt of proposals. The Bidder must submit a written withdrawal request signed by the Bidder’s duly authorized representative addressed to the Contracts Manager at:

Santa Clara Valley Health and Hospital System Department of Behavioral Health Services Attention: Don Casillas, Contracts Manager 828 South Bascom Avenue, Suite 200 San Jose, California 95128

Withdrawal requests should also be sent via email to [email protected].

7. LATE RESPONSES In order for a proposal to be considered, the proposal must be received in person or via courier or mail to the place specified above no later than the RFP due date and time. The DBHS time and date stamp will be the basis for determining timeliness of proposals.

8. NO PUBLIC PROPOSAL OPENING

There will be no public opening for this RFP.

9. CALIFORNIA PUBLIC RECORDS ACT (CPRA)

17

mailto:[email protected]


All proposals become the property of the County, which is a public agency subject to the disclosure requirements of the California Public Records Act (“CPRA”). If Bidder proprietary information is contained in documents submitted to County, and Bidder claims that such information falls within one or more CPRA exemptions, Bidder must clearly mark such information “CONFIDENTIAL AND PROPRIETARY,” and identify the specific lines containing the information. In the event of a request for such information, the County will make best efforts to provide notice to Bidder prior to such disclosure. If Bidder contends that any documents are exempt from the CPRA and wishes to prevent disclosure, it is required to obtain a protective order, injunctive relief, or other appropriate remedy from a court of law in Santa Clara County before the County’s deadline for responding to the CPRA request. If Bidder fails to obtain such an order prior to the County’s deadline for responding to the CPRA request, County may disclose the requested information.

Bidder further agrees that it shall defend, indemnify, and hold the County harmless against any claim, action, or litigation (including but not limited to all judgments, costs, fees, and attorney’s fees) that may result from denial by County of a CPRA request for information arising from any representation, or any action (or inaction), by the Bidder.

10. CONFIDENTIALITY

All data and information obtained from the County of Santa Clara by the Bidder and its agents in this RFP process, including reports, recommendations, specifications and data, shall be treated by the Bidder and its agents as confidential. The Bidder and its agents shall not disclose or communicate this information to a third party or use it in advertising, publicity, propaganda, or in another job or jobs, unless written consent is obtained from the County. Generally, each proposal and all documentation, including financial information, submitted by a Bidder to the County is confidential until a contract is awarded, when such documents become public record under state and local law, unless exempted under CPRA.

11. ELECTRONIC MAIL ADDRESS

Most of the communication regarding this procurement will be conducted by electronic mail (e-mail). Potential bidders agree to provide the Contracts Manager with a valid e-mail address to receive this correspondence.

12. USE OF ELECTRONIC VERSIONS OF THE RFP

This RFP is being made available by electronic means. If accepted by such means, the Bidder acknowledges and accepts full responsibility to insure that no changes are made to the RFP. In the event of conflict between a version of the RFP in the Bidder’s possession and the version maintained by the Department of Behavioral Health Services the version maintained by the Department of Behavioral Health Services must govern.

13. ASSIGNMENT OF CLAYTON ACT, CARTWRIGHT ACT CLAIMS

In submitting a response to a solicitation issued by the County, the responding person and/or entity offers and agrees that if the response is accepted, it will assign to the County all rights, title, and interest in and to all causes of action it may have under Section 4 of the

18


Clayton Act (15 U.S.C. Sec. 15) or under the Cartwright Act (Chapter 2 (commencing with Section 16700) of Part 2 of Division 7 of the Business and Professions Code), arising from purchases of goods, materials, or services by the responding person and/or entity for sale to the County pursuant to the solicitation document. Such assignment shall be made and become effective at the time the County tenders final payment to the responding person and/or entity.

15. CONFLICTS OF INTEREST

Bidder is subject to all federal, state and local conflict of interest laws, regulations and policies applicable to public contracts and procurement practices, including but not limited to California Government Code section 1090 et seq. and section 81000 et seq.

If awarded this Contract, Bidder will covenant that it presently has no interest, and will not acquire any interest, direct or indirect, financial or otherwise, which would conflict in any manner or degree with the performance of this Contract. Bidder will further covenant that, in the performance of this Contract, it will not employ any contractor or person having such a conflict of interest.

16. POLITICAL REFORM ACT DISCLOSURE REQUIREMENT

Bidder, including but not limited to contractor’s employees and subcontractors, may be subject to the disclosure and disqualification provisions of the California Political Reform Act of 1974 (the “Act”), which (1) requires such persons to disclose economic interests that may foreseeably be materially affected by the work performed under the Contract, and (2) prohibits such persons from making or participating in making decisions that will foreseeably financially affect such interests.

If the disclosure provisions of the Act are applicable to any individual providing service under the Contract, Bidder shall, upon execution of the Contract, provide the County with the names, description of individual duties to be performed, and email addresses of all individuals, including but not limited to Bidder’s employees, agents and subcontractors, that could be substantively involved in “making a governmental decision” or “serving in a staff capacity and in that capacity participating in making governmental decisions or performing duties that would be performed by an individual in a designated position,” (2 CCR 18701(a)(2)), as part of Bidder’s service to the County under the Contract. Such individuals shall file Statements of Economic Interests within 30 days of commencing service under the Contract, annually by April 1, and within 30 days of their termination of service under the Contract.

17. COUNTY RIGHTS

The County reserves the right to do any of the following at any time:

a. Reject any proposal without indicating any reason for such rejection; b. Waive or correct any minor or inadvertent defect, irregularity or technical error in a

proposal, or in the RFP process, or as part of any subsequent contract negotiation; c. Request that bidders supplement or modify all or certain aspects of their proposals or

other documents or materials submitted;

19

http://web2.westlaw.com/find/default.wl?tf=-1&rs=WLW11.01&fn=_top&sv=Split&docname=15USCAS15&tc=-1&pbc=E97C9F93&ordoc=1238703&findtype=L&db=1000546&vr=2.0&rp=%2ffind%2fdefault.wl&mt=222

http://web2.westlaw.com/find/default.wl?tf=-1&rs=WLW11.01&fn=_top&sv=Split&docname=CABPS16700&tc=-1&pbc=E97C9F93&ordoc=1238703&findtype=L&db=1000199&vr=2.0&rp=%2ffind%2fdefault.wl&mt=222


d. Request the Bidder make an oral and/or written presentation if more information is deemed necessary;

e. Terminate this RFP and issue a new RFP; f. Modify the selection process, the specifications or requirements for materials or

services, or the content or format of the proposals; g. Extend a deadline specified in this RFP, including deadlines for accepting proposals; h. Negotiate with any or none of the bidders; i. Modify the final contract from terms described in this RFP; j. Terminate failed negotiations with a Bidder without liability, and negotiate with other

bidders; k. Disqualify any Bidder on the basis of a real or apparent conflict of interest, or evidence

of collusion that is disclosed by the proposal or other data available to the County; l. Disqualify any Bidder on the basis of non-compliance with obligations under existing or

past contracts with the County and any related obligations; m. Request that services be provided by certain staff of a Bidder, or request that certain

staff of a Bidder be excluded from providing services as determined by the County to be in its best interest;

n. Award multiple contracts if it is deemed necessary to provide the specified services; o. Reject a Bidder’s proposal if any of the RFP forms are left blank or are materially

altered; p. Reject a Bidder’s proposal if any document or item necessary to the proposal is

incomplete, improperly executed, indefinite, ambiguous, or is missing; q. Reject a Bidder’s proposal for any attempt to improperly influence any member of the

Evaluation Panel; r. Reject any proposal if your agency or a related agency is currently in litigation with the

County of Santa Clara, or the County is contemplating litigation against your agency or a related agency relating to contract performance;

s. Reject any proposal for any false, misleading or otherwise unresponsive statements, documents or information provided to the County either through disclosure or non-disclosure if, in the County’s judgment, the false, misleading or otherwise unresponsive statements, documents or information are material.

t. Reject a Bidder’s proposal where the Bidder is in breach of, or in default under, any other agreement with the County;

u. Reject any proposal if your agency or a related agency is currently being investigated by the County of Santa Clara for non-performance of obligations under any contract with the County, and such non-performance or alleged non- performance has resulted in actual non-renewal or termination of your contract with the County.

SECTION IV – RESPONSE FORMAT AND CONTENT These instructions outline the guidelines governing the format and content of the proposal and the approach to be used in its development and presentation. Only that information which is essential to an understanding and evaluation of the proposal should be submitted. No limitation on the content of the proposal is intended in these instructions and inclusion of any pertinent data or information is permitted within the page requirements. A. NUMBER OF RESPONSES

20


Bidders shall submit only one proposal, but may include more than one option or alternative offer of service in the proposal.

B. NUMBER OF COPIES

Bidders must provide one (1) original and nine (9) identical copies of their proposal. All documents must be three-hole punched. The original must be stamped “original” and contain original signatures on the necessary forms. The remaining sets should be copies of the originals. Only one copy of the Bidder’s financial statements (as required by Section IV.D. of this RFP) is required to be included with the original proposal. Do not staple the proposal. Use tab dividers to separate each copy of the proposal (not each section of the proposal). Each tab divider should clearly show the Bidder’s name. Bind each copy using binder clips. Bidders must also provide ONE electronic copy of their complete proposal in CD-ROM media, prepared in a format that is compatible with Microsoft Office 2007 (Word and Excel). The Bidder’s financial statements (as required by Section IV.D. of this RFP) may be in PDF format. However, the PROPOSALS AND BUDGETS MUST BE IN WORD AND EXCEL RESPECTIVELY. The CD shall be included in the envelope/package that contains the original proposal and its copies.

C. PROPOSAL FORMAT The County will not accept handwritten proposals. Offers shall type or computer generate their proposals on standard 8 1/2 x 11 paper (larger paper is permissible for charts, spreadsheets, etc.) using 12 point font with 1.5 line spacing and 1 inch margins. The entire proposal must be paginated. Hard copies should utilize both sides of the paper where practical. Proposals must have a table of contents that corresponds to the sections and appendices.

Do not attach any information that is not requested.

D. PROPOSAL PACKET SEQUENCE AND CHECKLIST

Proposal Packet Assembly Checklist

Order Document Format Completed

1 Appendix A “Coversheet” – Signed and notarized

Word document provided on BidSync.

2 Appendix I “Local Preference” - Declaration of Local Business Form. NOTE: Only if declaring Local Preference.


3

Executive Summary Word document; Times New Roman with font size of 12 on letter size paper; 1.5 spacing and 1 inch margins.

21


4

Organizational Information: Bidder should provide charts, outlines and brief biographies of only the staff that will be directly providing the proposed services. Limit each biography to 1 page.

Word document; Times New Roman with font size of 12 on letter size paper; 1.5 spacing and 1 inch margins.

5

Proposal Narrative Requirement: A.1. – Organizational Overview A.2. – Program Description and Scope of Services.

Word document; Times New Roman with font size of 12 on letter size paper; 1.5 spacing and 1 inch margins.

6

Appendix B “Projected Budget and Cost Response.” All amounts must be projected in U.S. dollars and shall be accompanied by a budget narrative.

Excel and Word documents provided on BidSync.

7 Appendix C “Designation of Subcontractors” Word document provided on BidSync.

8 Appendix D “Customer Reference” Word document provided on BidSync.

9 Appendix E “Vendor’s Questionnaire”


10 Appendix F “Non-Collusion Declaration” Word document provided on BidSync.

11 Appendix G “Confidential Information Public Records Act”


12 Appendix H “Cultural Competence Form” Word document provided on BidSync.

13 Audited Financial Statement and Management Letter.

Bidder Generated Standard Format for the Audited Financial Statement and Management Letter.

The County does not guarantee the accuracy of the formulas in these forms nor is responsible for any errors or omissions. Bidders assume all responsibility for the accuracy of the information provided either on the forms included with this RFP or other formats. E. INSTRUCTIONS TO BIDDERS

A proposal and all attachments shall be in English, complete, and free of ambiguities, alterations, and erasures. The proposal must be executed by a duly authorized officer or agent of Bidder. In the event of conflict between words and numerals, the words shall prevail.

F. NON-CONFORMING SUBMISSIONS

A submission may, at the sole discretion of the County, be construed as a non-conforming proposal, ineligible for consideration or incomplete if it does not comply with the requirement of this Request for Proposal.

SECTION V – REQUIREMENTS & BIDDER’S SUBMITTAL A. EXECUTIVE SUMMARY

22


This section must include a summary of the key aspects of the PFS program proposed by the Bidder, and principal reasons the Bidder should be selected as the Lead Agency. It must not exceed one page. This summary is separate from the maximum allowable number of pages.

B. BASIC ORGANIZATONAL INFORMATION This section must not exceed four pages and relates only to the “Lead Agency” and not any potential subcontractors. Please include the following: 1. Your company’s complete name, business address, including headquarters and all local

offices, and telephone numbers. The name, mailing address, and telephone number of the person the County should contact regarding the proposal.

2. Indicate any offices or facilities located within the Santa Clara County that have meaningful delivery of service capabilities and directly enhance your firm’s ability to perform services throughout Santa Clara County.

3. A basic description of your organization, including the number of employees, longevity of the organization, client base, areas of specialization, and expertise.

4. The jurisdiction in which your company is organized and the date of such organization.

5. A complete disclosure if your company has defaulted in its performance on a contract during

the past five years which has led the other party to terminate the agreement, and if so, the identity of the parties involved and the circumstances of the default or the termination.

6. A list of any lawsuits filed against your company, its subsidiaries, parent, other corporate affiliates, or subcontractors in the past five years and the outcome of those lawsuits.

C. PROPOSAL NARRATIVE

The proposal narrative should reflect the Bidder’s understanding of PFS and SIF and should explain how the Bidder intends to use this opportunity to provide services that improve the current coordination of care for the acute mental health population in the County, reduce costs to taxpayers, and improve outcomes for the target population. The proposal narrative should be written in a concise manner. The County will disregard material that is not directly relevant to the information requested below. The proposal narrative should be limited to 20 pages, with 1.5 spacing, 12-point font, and one-inch margins.

1. Organization Overview (25 points)

a. Describe the Bidder’s mission and programs;

b. Describe the Bidder’s organizational infrastructure and management team as they

relate to its capacity to serve as the Lead Agency for this project;

23


c. Indicate prior experience in collaborating with or coordinating public and/or private entities for service delivery, and provide letters of support (if applicable) from at least one such entity in an appendix to the proposal;

d. Discuss past experiences and current relationships that demonstrate the Bidder’s ability to partner with the County and Third Sector to obtain private financial resources in support of this project;

e. Demonstrate familiarity with the target population and the delivery of services to that population either in Santa Clara County or other similar geographies; and

f. Identify areas of training or capacity building necessary to successfully deliver the required services.

2. Program Description and Scope of Services (45 points)

a. Describe the components of the Bidder’s proposed PFS program model(s), including

individual services that have the potential to meet the outcomes and objectives of this RFP. Please cite existing evidence that supports the effectiveness of the proposed model(s), and its components;

b. Indicate how the proposed model is designed to best serve the specific target

population for this project. Explain how the level of treatment required by and, consequently, delivered to clients, may vary over time and the best indicators of when such changes are most appropriate;

c. If applicable to the proposed intervention, describe the strategy for identifying and

securing housing and ensuring that clients face minimal delays in getting discharged to a stable living situation. Please describe any existing relationships with relevant community providers;

d. If applicable to the proposed intervention, describe how the Bidder intends to identify

and build upon clients’ existing natural and peer supports and/or develop new supports to promote long-term wellness;

e. Identify any other public and/or private entities, including subcontractors, with which the Bidder intends to collaborate in order to execute programming;2

f. Confirm that the Bidder (1) is a current Medi-Cal provider certified by the Santa Clara County Department of Behavioral Health Services or (2) is a current Medi-Cal provider certified in another county and has the capacity to become a Medi-Cal certified provider in Santa Clara County during the project construction process;

g. Please describe how the Bidder’s proposed PFS program will leverage Medi-Cal funding in order to maximize the resources available to this program;

2 NOTE: The County expressly reserves the right to approve or disapprove a Lead Agency’s use of particular subcontractors; final selection of any subcontractors by the Lead Agency will occur during the project construction process, and will occur in consultation with the County and subject to the County’s approval.

24


h. Describe the means and methods the Bidder intends to use to pursue data-driven

performance management throughout the duration of a multi-year contract as it relates to this specific RFP, and its past experience using similar means and methods;

i. Describe how your program will provide physician and/or psychiatric support to coordinate with inpatient physicians as clients transition to outpatient care;

j. Provide a projection of the anticipated level of success for program participants annually for each of the six years of the project. The projection should estimate the reduced bed days in EPS, contract hospitals, and reduced acute/administrative bed days in the BAP. Cite existing evidence that supports the effectiveness of the proposed intervention(s) to achieve these levels of success;

k. Provide feedback on the County’s working definition of “success” for purposes of this project, which is reduced bed days in EPS, contract hospitals, and reduced acute/admin bed days in the BAP, and propose any alternative “success” definitions that should be considered;

l. Propose appropriate metrics and outcomes for assessing the success of the PFS intervention and describe how the necessary data could be acquired and used to assess the impact of the provided services;

m. Identify any potential funders that the Bidder suggests approaching as potential SIF funders, and describe current relationships with these parties; and

n. Identify any questions or concerns related to the County’s program goals set forth in this RFP and/or obstacles to achieving such goals, including the Bidder’s ability gaps.

D. BUDGET AND COST RESPONSE (25 Points)

The Cost Response should include a narrative and a proposed budget for implementation and execution of the PFS project. Please note that the proposed budgets are not binding, but should be thoughtful and thorough. Written responses should be limited to three pages with 1.5 spacing, with 12-point font and one-inch margins. Budget proposals will not count against the overall page limit. Phase I - Project Construction. Propose a budget of costs the Bidder expects to incur during the project construction process, prior to the execution of the PFS contract (e.g., staff costs during project construction, expanding the Bidder’s current capacity to fulfill the requirements as a lead agency, etc.). This budget should be completed using the spreadsheet provided as Appendix B and should be accompanied by a narrative, which explains and describes the Bidder’s projected costs.

Note: The County has secured some funding to cover expenses incurred by the Lead Agency during the project construction process. Furthermore, the County is not liable for any costs incurred by vendors in the preparation and presentation of response proposals submitted in response to this RFP.

25


Phase II – Service Provision. Bidders should submit a pro forma PFS budget for a six-year service delivery period by completing the spreadsheet provided as Appendix B. The first worksheet of Appendix B provides specific guidance on completing the Phase II pro forma budget, which should include:

• The full costs of service delivery and any applicable revenues; • The number of individuals to be served each year; • The projected number of successful outcomes; and • The projected levels of cost savings accruing to the County after all project costs and

anticipated revenues.

The costs of service delivery should include the costs of all services to be provided to the target population, including Medi-Cal-funded services. Any anticipated revenues that will offset the total cost of the program (e.g., Medi-Cal federal reimbursements and local match, etc.) should also be included in the budget proposal. For purposes of constructing a budget, assume the following: 1) The project will attempt to serve 40-500 clients at any given time, and no fewer than 250

individuals over the six-year service delivery period. 2) For the cost savings accruing to the County, the following table describes the daily or hourly

net estimated costs to the County for in-patient facilities:

The project seeks to reduce expenditures (a) on bed days purchased from contract psychiatric hospitals at $638/bed day reduced, (b) from utilization of EPS at $122/hour reduced, and (c) from reallocation of reduced “administrative” BAP beds to become available “acute” BAP bed days at $846/bed day (=$1,900/bed day for “administrative” bed day - $1,054/bed day for “acute” bed day).

3) The total amount of cost savings for the County should be at least $5 million. 4) The overall cost of the project will need to cover some PFS-related fixed expenses (currently

estimated $100,000 annually) and variable expenses (currently estimated to be 7% of the overall project costs).

5) The County seeks to have the budgetary cost of the project to be no greater than the projected cost savings as a result of the intervention.

In addition to the proposed budget, please provide a budget narrative that describes and explains: 1) The nature of expenses included in each category; 2) Rationale for any increases/decreases in expenses over time (particularly as the result of any

expected changes in patients’ required level of care); 3) How the cost associated with each category was derived, including the basis for the cost

estimates (e.g., costs previously incurred in the provision of the same or similar services, studies estimating the costs of provision of the same or similar services, etc.);

4) The source of any projected cost savings and the basis for the estimated level of impact to achieve the cost savings amount; and

Contract EPS Acute Admin Hospital

Net Cost to the County $122 per hour $1,054 per day $1,900 per day $638 per day

BAP

26


5) Any identified revenue streams that will offset overall program costs, including how the amount of revenue attributed to each of these sources was derived. The Bidder’s overall budget projections should indicate and account for the anticipated percentage of clients qualifying for Medi-Cal and/or other benefits, and how those figures were derived.

Optional alternative budget(s):

Bidders may also submit one or more alternative six-year pro forma budgets, which can incorporate

o a different suggested metric or definition of a “successful outcome” and/or o a different projected number of clients served over the course of the project, which still

produces a budget where the cost of the PFS program is less than the projected cost savings for the County. The proposal should achieve at least $5 million of cost savings over the 6 year program.

For any alternative budget, the Bidder should include a description and justification for its alternative in the budget narrative.

E. FINANCIAL STABILITY/BIDDER FINANCIAL INFORMATION

1. Bidder shall provide documentation that the organization has sufficient reserves to maintain the program. Documentation may include cash and/or credit reserves. In addition, the Bidder shall provide the following information for the last two (2) fiscal years: 1.1. Audited financial statements with the applicable notes; 1.2. Independent Auditor’s Report on Compliance and Internal Control over Financial

Reporting based on an Audit of the Financial Statements in Accordance with Government Accounting Standards;

1.3. Independent Auditor’s Statement of Findings and Questioned costs.

2. Bidder shall submit documentation that it meets solvency standards and shall state its intention to meet those standards throughout the contract period.

SECTION VI – EVALUATION A. FACTORS

The Evaluation Criteria listed below will be utilized in the evaluation of the Bidder’s written proposals and, if interviews are conducted, responses to interview questions. The proposal should give clear, concise information in sufficient detail to allow an evaluation based on the criteria below. To receive the award, a Bidder’s proposal must be deemed acceptable under each of the criteria below. The contract will be awarded to the Bidder whose proposal provides the best value to the County. Bidders who do not score a minimum of 70 points shall not move forward in the selection process.

27


1. Organization Overview Maximum 25 Points 2. Program Description & Scope of Services Maximum 45 Points 3. Budget and Cost Response Maximum 25 Points 4. Local Preference Maximum 5 Points

B. OTHER FACTORS

The proposal(s) with the highest score(s) will not automatically be awarded a contract. In making the final selection, the Director will consider the Evaluation Committee’s recommendation and the County’s overall needs. The funding level for the selected programs will be determined in the overall needs of the County. The final selection and contract award will be within the sole judgment and discretion of the County.

28

department of behavioral health services - pay for success · department of behavioral health...

Documents