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Behavioral Health Crisis Treatment Center and Supports

Grant to a New Hampshire Vendor for
Mental Health Crisis Treatment Services

Agency Type:

State

Funding Source:

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New Hampshire Department of Health and Human Services (DHHS) - Division of Behavioral Health

Conf. Date:

01/05/18

LOI Date:

01/10/18

Deadline Date:

02/13/18 2:00 PM

Description:

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Grant to a New Hampshire qualified vendor to provide treatment services to adults (18 years or older) who are experiencing a mental health crisis, including individuals with co-occuring substance abuse disorders. Proposals are invited from vendors qualified to develop and operate a Behavioral Health Crisis Treatment Center (BHCTC) and related support services in a New Hampshire Community Mental Health Region or subsection that has high rates of admissions to and discharges from New Hampshire Hospital.

DHHS seeks a proposed BHCTC model and Vendor, or collaborating Vendors, that meet the following criteria:

1.1.1. Demonstrate a comprehensive and collaborative approach to provide intensive, short term stabilization treatment services, that are available twenty-four (24) hours per day, seven (7) days per week, for individuals experiencing a mental health crisis, including those with a co-occurring substance use disorder. The approach must maximize collaboration between existing treatment providers, community resources and Integrated Delivery Networks (IDN) within the proposed Community Mental Health Region(s) and the BHCTC.

1.1.2. The BHCTC will effectively increase the regional capacity to treat such individuals, and decrease the demand of higher levels of care when inpatient hospitalization or emergency department care is contraindicated.

1.1.3. The BHCTC will fill an existing gap in the behavioral health treatment and service continuum within the proposed Community Mental Health Region(s), and has the support of the treatment providers and community resources within the region(s) to fill this gap.

1.1.4. The BHCTC will be responsive to the identified need for such services within the proposed Community Mental Health Region(s), and that the BHCTC will effectively address barriers to treatment and services unique to the proposed Community Mental Health Region(s).

1.1.5. The BHCTC staff composition will be highly qualified and its facility design appropriately equipped to meet the immediate treatment and service needs of the individuals to be served.

1.1.6. The BHCTC will receive and treat individuals on a walk-in basis and those transported for treatment by first responders or from other treatment sites.

1.1.7. The BHCTC will deliver an array of treatment services to de-escalate and stabilize individuals experiencing a mental health crisis at the intensity and for the duration necessary to quickly and successfully discharge the individual back into the community or to a step-down treatment site.

1.1.8. The BHCTC treatment and service array will coordinate with the individual’s external treatment providers and natural supports in order to ensure continuity of care.

1.1.9. The BHCTC treatment and service array will be provided to individuals regardless of the individual’s ability to pay, and will be structured:

1.1.9.1. To maximize the BHCTC’s ability to seek reimbursement from public and private insurers, including the Department’s Managed Care Organizations, Medicaid, Medicare, and private payers; and

1.1.9.2.To minimize the BHCTC’s reliance on State funds to support operational costs ineligible for reimbursement from third-party payers.

1.1.10. The BHCTC will raise public awareness of BHCTC services, and communicate how these services fit within the regional behavioral health treatment system, and how to access BHCTC services.

1.1.11.The BHCTC will develop an effective strategy to engage and coordinate access to BHCTC services with regional first responders, law enforcement, peer support agencies, Community Mental Health Centers (CMHCs), hospitals, the applicable Integrated Delivery Networks’ providers, and mobile crisis response teams.

Qualified Vendors – Initial Screening Requirements:

1.2.1. The Department encourages the selected Vendor to collaborate with community treatment providers and stakeholders, as appropriate, to ensure that it develops and operates a BHCTC that is accessible twenty-four (24) hours a day/seven (7) days per week as an alternative to higher levels of care, including emergency departments, designated receiving facilities and New Hampshire Hospital, and to ensure an integrated approach to service delivery is achieved.

1.2.2. The selected Vendor must ensure the treatment setting is appropriate to safely treat individuals experiencing a mental health crisis and is in compliance with all local and state life safety codes and, if applicable, state health facilities’ licensing requirements.

1.2.3. All initial services to be provided by the Vendor must begin within 120 days of the contract effective date.

1.2.4. Initial Screening: Proposals received in response to this RFP will undergo an initial screening to determine whether a Vendor is a ‘qualified Vendor.’ All Vendors must submit a completed Appendix D, Details of Behavioral Health Crisis Treatment Center.

BHCTC services eligible for reimbursement under New Hampshire’s Medicaid program will be processed through the Medicaid Fee-for-Service and Managed Care Organizations (MCOs), as applicable to the individuals served. The Medicaid funding will not be included in the agreed upon maximum price limitation for the resultant contract. Only the General Funds supporting the BHCTC will be processed through the contract, subject to the agreed upon maximum price limitation.

Background:

2.1.1. The Department of Health and Human Services (DHHS) seeks to promote full community inclusion for adults (18 years or older) having severe mental illness (SMI), severe and persistent mental illness (SPMI) or who are severely mentally disabled. The State places a high emphasis on supporting individuals in their community with a broad range of supports and services that reduce the need for inpatient care.

2.1.2. As part of New Hampshire’s implementation of the Community Mental Health Agreement, the Division for Behavioral Health, Bureau of Mental Health Services implemented three (3) Mobile Crisis Services and Supports (MCSS) programs under previous procurements. The Legislature, through HB517, authorized the release of an RFP for the provision of a fourth MCSS program in a geographic location that has a high rate of residents being admitted to and discharged from New Hampshire Hospital; there were no respondents to that RFP, or a subsequent RFP released by DHHS that provided greater flexibility to potential Vendors. As a result, this new RFP releases a different approach to treat individuals experiencing a mental health crisis. Through the BHCTC approach, individuals will receive appropriate treatment in the BHCTC:

2.1.2.1. During the crisis to avoid unnecessary accessing of services through the emergency department setting and before the crisis escalates to the level that inpatient psychiatric treatment may be needed;

2.1.2.2. Upon discharge from the emergency department, after it has been medically determined that the individual no longer needs emergency department level services and it has been clinically determined that the BHCTC is an appropriate stepdown treatment site.

2.1.2.3. On a voluntary basis.

2.1.3. The BHCTC will assess the individual and provide treatment in response to the immediate crisis. In order for the individual to return to the community as soon as practicable, the BHCTC will collaborate with existing behavioral health treatment providers and support systems. Collaborative discharge planning with providers and third party payers will take place to ensure continuity of care and wrap-around services upon discharge. Services provided at the BHCTC are intended to supplement existing services that may not be immediately available to an individual in crisis but are not intended to replace services for which the Community Mental Health treatment providers under contract with the State are already obligated to provide. As such, the successful Vendor will be obligated, post crisis assessment and immediate treatment, to connect individuals to existing service providers, including the applicable CMHC. If the individual is not already a client of a CMHC, the Vendor will be obligated to help them engage with engaging the appropriate Community Mental Health Center provider for ongoing treatment and services, if the individual is agreeable.

Statement of Work:

3.1. Covered Populations and Geographic Location

3.1.1. The Vendor will provide treatment and support services to individuals accessing the BHCTC, in the proposed geographic location and Community Mental Health Region(s), to individuals eighteen (18) years or older who are experiencing a mental health crisis, including those with a co-occurring substance use disorder. Vendors may propose to serve more than one region or combined subsections of more than one region.

3.2. Scope of Services

3.2.1. Within 120 days of contract approval, the selected Vendor must initiate treatment and support services as a BHCTC. The BHCTC operation and services shall include, at minimum:

3.2.1.1. A method(s) of providing individuals experiencing a mental health crisis, family members and natural supports, and first responders prompt access to a clinically qualified BHCTC team member, or other BHCTC authorized and clinically qualified resource, to determine if the individual in crisis may be in clinical need of services from the BHCTC, or if other available behavioral health services would be more appropriate for the individual to access. The method(s) must ensure that such inquiries can be made and promptly responded to twenty-four (24) hours per day, seven (7) days per week. The method(s) must ensure that information about the individual in crisis is obtained and that a clinically appropriate referral regarding the service level and treatment site the individual should access is provided to the inquirer during the initial inquiry. The referral provided by the Vendor must consider, at minimum: the severity of crisis the individual is experiencing, safety protocols, the individual’s proximity to an appropriate treatment site or provider, the individual’s ability to self-access an appropriate treatment site or provider, and whether the individual is already engaged with a first responder available to transport the individual to a treatment site or the BHCTC if needed. Referrals may include but are not limited to referring the individual to:

3.2.1.1.1. Receive treatment from his or her regular treatment provider – which may include the applicable Assertive Community Treatment (ACT) team;

3.2.1.1.2. Access the applicable Community Mental Health Center’s Emergency Services team to receive Emergency Services from the Center;

3.2.1.1.3. Access, where available, the applicable Mobile Crisis Team to receive assistance at the individual’s location;

3.2.1.1.4. The BHCTC to receive immediate treatment and services; or

3.2.1.1.5. His or her local ED.

3.2.1.2. Face-to-face clinical assessments for individuals experiencing a mental health crisis, including those individuals with a co-occurring substance use disorder, to identify and determine the treatment and supports the individual needs to receive to deescalate from the crisis. The clinical assessment must begin within forty-five (45) minutes of the individual’s arrival at the BHCTC unless safety protocols preclude performance of the assessment within that timeframe.

3.2.1.3. Development of an immediate treatment plan that authorizes the treatment and support services the consumer will receive from the BHCTC to de-escalate from the crisis. The immediate treatment plan must provide sufficient detail to ensure BHCTC staff fully understand and are able to provide appropriate services to the individual at the correct intensity and duration needed. The immediate treatment plan shall be developed as a result of the information learned from the clinical assessment referenced in 3.2.1.2.

3.2.1.4.Delivery by the BHCTC team of treatment and services identified in the individual’s immediate treatment plan, at the prescribed level of intensity and duration. Treatment and services shall be limited to those authorized by DHHS under the Governor and Council approved contract awarded as a result of this RFP, if any, for the Vendor to provide, subject to the applicable Medicaid requirements or applicable restrictions within the contract for General Fund supported services. Services provided must be limited to serving persons who are eligible under RSA 135-C:13 and He-M 401, subject but not limited to the following conditions:

3.2.1.4.1. No person determined eligible shall be refused any of the services provided hereunder because of an inability to pay a fee. For individuals not already determined eligible by the applicable CMHC, the Vendor must provide services under a presumption that the consumer is eligible for services within the NH Mental Health System. NOTE: DHHS shall work with the successful Vendor to formalize the process for the Vendor to document presumptive eligibility.

3.2.1.4.2. The services provided shall not supplant or replace those services already available within the regional CMHC. Individuals shall be transitioned to community as soon as linkages to existing services are in place. The Vendor shall make every effort to coordinate services with the applicable region’s CMHC so that the individual’s treatment can be timely transitioned to the CMHC for ongoing treatment and support services.

3.2.1.4.3. The Vendor shall provide services to de-escalate the individual’s immediate crisis, and to support the individual as clinically needed and appropriate until access to ongoing treatment and support from the applicable CMHC, or where applicable – Mobile Crisis Team. In the event the individual is not, and does not wish to become, a client of the applicable CMHC, or the individual has other treatment providers he or she wishes to use for ongoing treatment, the Vendor shall provide services for the intensity and duration as is necessary to de-escalate the crisis.

3.2.1.4.4. For individuals who require onsite continuous treatment and support to de-escalate from the crisis for a period longer than the BHCTC can directly accommodate, the Vendor shall attempt to transfer the individual to other available community-based providers and resources, such as peer respite, mobile crisis, CMHC emergency services supervision, etc.

3.2.1.5. Provide BHCTC services, as described in 3.2.1.4., for individuals accessing the BHCTC in conjunction with discharge from the ED.

3.2.1.6.Collaborate and coordinate with the individual’s choice of treatment providers. The Vendor must collaborate with the individual’s existing treatment providers, if any, in the development of the immediate treatment plan to ensure medication management and other treatment considerations are effectively researched and coordinated. If such providers are not immediately available for this purpose, the Vendor must proceed with the development of the immediate treatment plan and connect with such providers as soon as practical. If the individual elects to receive ongoing treatment, upon discharge from the BHCTC, the Vendor must collaborate with external treatment providers to ensure that treatment and support services are coordinated to engage the individual on a timely basis upon discharge.

3.2.1.7. Provide clinically appropriate physical and environmental accommodations to individuals receiving treatment and supports within the BHCTC. The accommodations must take into consideration individual privacy rights, safety protocols, nutrition and sustenance, the individual’s physical and health related needs, and meet all applicable municipal, state and federal life and safety codes.

GrantWatch ID#:

GrantWatch ID#: 182687

Number of Grants:

1

Estimated Size of Grant:

For the biennium ending June 30, 2019, the maximum amount of General Funds to support a contract awarded as a result of this RFP in State Fiscal Year 2018 are $866,667, and in State Fiscal Year 2019 are $1,300,000. Additionally, Medicaid funding up to the amount of $631,884 in State Fiscal Year 2018, and $2,121,696 in State Fiscal Year 2019 is available.

Term of Contract:

The Contract is anticipated to be effective upon date of Governor and Executive Council approval, through December 31, 2021.

Funding to support the BHCTC for the period July 1, 2019 through December 31, 2021 will be subject to the continued availability of funds appropriated by the Legislature in future biennia.

DHHS reserves the right to renew the contract for up to two (2) additional years, subject to continued availability of funds, satisfactory performance of services, and approval by the Governor and Executive Council.

Additional Eligibility Criteria:

Qualified vendors may apply.

More information about becoming an Authorized Vendor may be found here:
https://das.nh.gov/purchasing/vendor.asp

Pre-proposal Conference:

The Vendor's Conference will be held January 5, 2018, 10:00 AM. The conference will be held at:

Department of Health and Human Services
Brown Auditorium
129 Pleasant Street
Concord NH 03301

Participation is encouraged but not-mandatory; pre-registration is recommended but not required.

Pre-Application Information:

DHHS encourages interested Vendors to submit a non-binding Letter of Intent to submit a proposal in response to this RFP. The Letter of Intent is not required but is preferred and should be received by January 10, 2017.

DHHS will be provide Vendors submitting a Letter of Intent with notice of any RFP amendments, in the event such are produced, or any further materials on this project, including electronic files containing non-protected, able to be edited tables or templates that may be required for response to this RFP, any addenda, corrections, schedule modifications, or notifications regarding any informational meetings for Vendors, and DHHS responses to comments or questions.

The closing date for proposals is February 13, 2018, 2:00 PM ET.

Timetable:
-Release RFP: 12/18/17
-Vendor Question Submittal Period Begins: 12/18/17
-Vendors Conference: 1/5/18
-Non-binding Letter of Intent (Optional) Due Date: 1/10/18
-Vendor Question Submittal Period Ends: 1/10/18
-DHHS Answers to Technical Questions Posted: 1/17/18
-Proposal Due Date: 2:00 PM 2/13/18

Contact Information:

Before starting your grant application, please review the funding source's website listed below for updates/changes/addendums/conferences/LOIs.

Catherine Cormier
(603) 271-9076
catherine.cormier@dhhs.nh.gov

State of New Hampshire
Department of Health and Human Services
Contracts & Procurement
Brown Building
129 Pleasant Street
Concord, New Hampshire 03301

Funding or Pin Number:

RFP-2018-DBH-10-BEHAV

URL for Full Text (RFP):

Geographic Focus:

USA: New Hampshire