|
|
Promoting Integration of Pediatric Primary and Behavioral Health Care
|
Request Date: 1/23/2020 1:03:58 PM
Open Date:
Closing Date: 2/21/2020 4:30 PM
Intent To Bid Deadline:
Est. Dollar Value: $0.00
RFQ Number: RFP55
|
 |
Dept. of Mental Health
280 State Drive
Waterbury,
VT
05671
|
Bid Type:
Request for Proposal
Locations:
State-Wide
Keywords:
Administrative Support Services, Health Care Services
Bid Description:
STATE OF VERMONT
AGENCY OF HUMAN SERVICES
DEPARTMENT OF MENTAL HEALTH
REQUEST FOR PROPOSALS
RFP 55
FOR: Promoting Integration of Pediatric Primary and Behavioral Health Care
ISSUE DATE: January 23, 2020
QUESTIONS DUE: February 5, 2020
RFP RESPONSES DUE BY: February 21, 2020
OVERVIEW
This Department of Mental Health Children’s Unit RFP is soliciting proposals for the expansion of an existing, grant-funded project to two additional grant sites. The CHILD grant (Children’s Health Integration, Linkage and Detection) is a 5 year Promoting Integration of Primary and Behavioral Health Care grant from SAMHSA.
This was the first time SAMHSA awarded the grant to states instead of directly to mental health agencies. Vermont was the first state to focus on pediatric populations under this grant. The population served are children and youth ages 0-22 with or at risk for serious emotional disturbance and their families. Vermont was the first state to address the at-risk population.
We entered FFY 3 of 5 grant years for the CHILD grant in October 2019. We intend to expand our CHILD grant to two additional community mental health agencies to hire Behavioral Health Consultants and wellness staff to be embedded in private pediatric or family practice offices (in an extension of the FQHCs the first cohort was partnered with).
Grant goals: promote collaborative, integrated primary and behavioral health care, defined as a whole person approach to health and wellness that makes receiving care seamless for the patient and family. Services include brief mental health interventions in primary care offices, consults, intensive care coordination, and health promotion activities such as wellness, child yoga and health coaching. Grant activities include services to increase resiliency and coping skills for children and families. We will prioritize the use of evidence-based practices and collaborative approaches. The grant aims to address social determinants of health and to integrate peer and family voice by identifying, training, and mentoring family members and youth to provide advisory and support roles in the integration activities.
Current pilot regions hired nurses, clinicians, care coordinators, social workers, and wellness coaches, based on regional need. We have been transitioning to Michelle Duprey’s model for integrating mental health services into pediatric practices. Her model is flexible and acknowledges that successful integration requires a long-term process of structural transformation. The manual supports this process with guidance including position descriptions and sample interview questions, along with a suggested list of foundational trainings for the Behavioral Health Consultants. Michelle Duprey trained in Vermont several times and recently offered two presentations at the DMH conference in October, which were well received. Below are links to two short videos about her work and the methods she has developed.
Innovations in Integrated Care: https://www.youtube.com/watch?v=IfHOByXYD-o
Partnering with Integrated Care: Models: https://www.youtube.com/watch?v=5qWkaIV3Ot0
RFP OBJECTIVE
Target group and scope of services:
Program-Specific Population: 1) Children and their families who are at risk of Severe Emotional Disturbance (SED), 2) children and their families who have been diagnosed with SED, including those with co-occurring physical health conditions or chronic diseases, and 3) youth and young adults transitioning from children’s services to adult health services. Age for enrollment: 0-22.
? Goal of full integration and collaboration in clinical practice for pediatric and behavioral healthcare
? Provide safe, accessible and family-centered healthcare home for children, youth, and families to receive comprehensive, integrated and holistic pediatric and behavioral health care services to improve the overall wellness and physical health status of children with or at risk of a serious emotional disturbance (SED)
? Address social determinants of health and integrate youth and family voice through collaboration with the Vermont Federation for Families. The Federation has funds to allow stipends for youth and family input and engagement. We envision a participatory process for youth and family clients to determine what would be the best activities for building community connectedness and/or increased health and wellness activities for their community at large. This participatory process will simultaneously empower the families involved, bring community voice into action and improve community health and wellness. This process is expected to be an integral part of the grant proposal. Through the Federation grant, we also collaborate with Youth in Transition, which may be particularly pertinent in regard to the age groups covered under the grant
? Activities will adhere not only to the Principal Culturally and Linguistically Appropriate Services (CLAS) Standard in Health and Health Care but also to the following CLAS standards elements (go to http://ThinkCulturalHealth.hhs.gov):
o Governance, Leadership and Workforce: The partnering agencies in all regions will “educate and train governance, leadership, and workforce in culturally and linguistically appropriate policies and practices on an ongoing basis”.
o Communication and Language Assistance: The partnering agencies will ensure that “language assistance to individuals who have limited English proficiency and/or other communication needs, at no cost to them, to facilitate timely access to all health care and services”.
o Engagement, Continuous Improvement, and Accountability: The agencies will “partner with the community to design, implement, and evaluate policies, practices, and services to ensure cultural and linguistic appropriateness”.
? The enrollment target is 50 new clients per year per region
? The evaluation contract with VCHIP requires data collection according to federal guidance
? Work collaboratively with local and state staff, and VCHIP to improve data collection tools
? Identify gaps in data and strategize with local and state staff and VCHIP to identify areas for quality improvement in data collection
? Complete updates and reports, such as an annual report, as stipulated by SAMHSA and requested by Project Director. This should include the goals of the grant, the progress and success of the grant, as well as provide suggestions for improvement.
Budget: This RFP is looking to fund two Designated Agencies in the amount of $300,000 per grant year per region. In addition to that sum, respondents may submit a budget for initial wellness supplies for the primary care provider sites of up to a sum of $25,000. The budget for subsequent years depends on the continuation of current funding levels under the grant. We currently have no information that would lead us to anticipate any changes in funding levels. DAs are to hire staff that will be located in pediatric or family practice offices. We envision the option of two clinicians, of which at least one is located full-time at a pediatric office, and two wellness staff per region; there is flexibility to explore other options if a compelling argument is made. We strongly encourage DA’s to partner with primary care providers involved in either CHAMP and/or the AYA-BH COIIN. This will allow us to combine the CHILD Integration model roll-out with technical assistance for clinical practice improvement in the Primary Care settings. Federal requirements stipulate 50 new enrollees per region per calendar year.
RFP posted January 23, 2020
Deadline for clarification questions about RFP to Connie.schutz@vermont.gov
February 5, 2020
Proposal submission deadline February 21, 2020
Selection notification February 28, 2020
Anticipated commencement of agreement April 1, 2020
REQUIREMENTS FOR SUBMISSION
Please provide both an electronic and hard copy of the proposal on¬¬¬¬¬¬¬ February 21, 2020, to:
Jennifer Rowell, Administrator
280 State Drive, NOB 2 North
Waterbury, Vermont 05671-2010
Jennifer.Rowell@vermont.gov
PROPOSAL FORMAT
Use standard 8.5” X 11” page size. Documents must be single-spaced and use not less than a twelve-point font. Pages must be numbered. The proposal should be comprehensive, yet concise. The proposal must follow the sequence of information requested in the “Bid Requirements” section below. State your organization’s name on each page of your program proposal/bid and on any other information you are submitting.
1. A brief description of the organization which includes its history, organization structure and size, and qualifications to provide the required services.
2. A statement and discussion of the Proposer’s analysis of the RFP requirements. This should include.
• How the staff and services needed will be provided
• Statement and discussion of anticipated major difficulties and problem areas (if any), together with potential or recommended approaches to their solution.
• Include a timeline for implementation, including a budget
3. Acknowledgement of agreement with customary State and Agency terms and conditions contained in Attachments C-F.
COVER LETTER
Please provide an introduction to your company and proposal via a cover letter. All bids submitted to the State are considered public records. Please note in your cover letter if any information in your proposal is considered proprietary and confidential.
a. Confidentiality. To the extent your bid contains information you consider to be proprietary and confidential, you must comply with the following requirements concerning the contents of your cover letter and the submission of a redacted copy of your bid (or affected portions thereof).
b. The successful response will become part of the contract file and will be a matter of public record, as will all other responses received. If the response includes material that is considered by the bidder to be proprietary and confidential under the State’s Public Records Act, 1 V.S.A. § 315 et seq., the bidder shall submit a cover letter that clearly identifies each page or section of the response that it believes is proprietary and confidential. The bidder shall also provide in their cover letter a written explanation for each marked section explaining why such material should be considered exempt from public disclosure in the event of a public records request, pursuant to 1 V.S.A. § 317(c), including the prospective harm to the competitive position of the bidder if the identified material were to be released. Additionally, the bidder must include a redacted copy of its response for portions that are considered proprietary and confidential. Redactions must be limited so that the reviewer may understand the nature of the information being withheld. It is typically inappropriate to redact entire pages, or to redact the titles/captions of tables and figures. Under no circumstances can the entire response be marked confidential, and the State reserves the right to disqualify responses so marked.
QUESTION AND ANSWER PERIOD
All communication regarding this RFP shall be in writing and addressed to Connie.Schutz@vermont.gov. Any interested party requiring clarification of any section of this proposal or wishing to comment or take exception to any requirements or other portion of the RFP must submit specific questions in writing no later than February 5, 2020. Questions should be e-mailed to Connie.Schutz@vermont.gov. Any objection to the RFP, or to any provision of the RFP, that is not raised in writing on or before the last day of the question period is waived.
Proposals must be received no later than at 4:30 pm EST on February 21, 2020 at the following address:
Jennifer Rowell
280 State Drive, NOB 2 North
Waterbury, Vermont 05671-2010
Jennifer.Rowell@vermont.gov
Please provide both an electronic and hard copy of the proposal as standard PDF file.
Evaluation criteria:
? Commitment to integration planning and implementation
? Outline of organizational readiness to engage in the work
? Willingness to participate in workforce development
? Fit of proposal within organizational context
? Plan for integration of youth and family voice to increase engagement
? Level of proposed connection to regional integration efforts
? Joint letter of intent from proposed providers
? Ability to reach enrollment target of 50 new clients per each calendar year per region
Context on grant opportunities and challenges:
The Vermont Department of Health/Division of Maternal and Child Health, in collaboration with DMH, commissioned a children’s mental health needs assessment with Vermont pediatric primary care providers in July 2019. The PCPs surveyed were chosen based on previous engagement with quality improvement initiatives and the majority (over 85%) were non-FQHC affiliated.
It is important to note at the outset that PCPs surveyed were chosen based on previous engagement with mental health related activities and therefore the data regarding their comfort with handling certain children’s mental health treatment should not be construed as typical of PCPs in Vermont as a whole.
74% of respondents were seeing more than 6 children a week with mental health related complaints, and many were writing the majority of prescriptions for psychotropic medication their patients were taking.
75% of respondents had moderate to severe complexity patients they were treating without specialty input. PCPs felt that especially with these cases they were operating at the outer edge of their scope of practice and comfort.
65% of providers report families are not interested or do not follow through with non-medication treatments for mental and behavioral disorders and many cited limited access. In general, difficulties of access, communication, coordination and consultation on high acuity cases were noted.
The needs assessment identified the following suggested next steps: advocate for required reimbursement of wraparound services; establish written consent to all members of treatment teams as standard on initiation of care; standardize and make transparent agency policies on definition of acute cases and triage process; expanded access to Child Psychiatrists through a monthly case meeting model; on-going professional interactions with the consultants. Several of these will be addressed directly by the grant moving forward.
Pediatric and family practices, Vermont’s Departments of Health and Mental Health, and VCHIP (Vermont Child Health Improvement Program at the University of Vermont) have a long history of collaborative CQI work as a solid foundation which will be built upon and further supported by this grant. VCHIP leads a CQI project each year with 45 pediatric and family practices, called Child Health Advances Measured in Practice (CHAMP). CHAMP child health projects have recently focused on improving developmental screening, adolescent mental health, ADHD, and screening for maternal depression in these PCP practices. Additionally, VCHIP, VDH Maternal & Child Health, and DMH are engaged in an Adolescent and Young Adult Behavioral Health Collaborative Improvement and Innovation Network (AYA-BH COIIN) to “achieve an 80% screening rate of patients ages 12-25 for a major depressive episode using an age-appropriate standardized tool with documentation of a follow-up plan if the screen in positive” by December 2020. The partnership between state health & mental health, practice improvement center (VCHIP), designated agencies and the primary care providers will improve outcomes through clinical practice improvements, policy/funding/access changes and further integration of services for pediatric clients and their families.
We are currently in the planning stages of a Project ECHO for pediatric psychiatry at AHEC/UVM. ECHO offers a year-long program on case consultation that will support communities of learning and practice, enhance cross training, and support clinical professional development. This is a model already familiar to many pediatric practices in the state. It will allow physicians to bring forth the cases most challenging to them on a monthly basis. Direct impact would be clinical support for the case, along with direct knowledge of an expert to turn to in the future if needed. Indirect consequences would be an opportunity to experience how many of these challengers are shared among practices, and to support the growth of learning communities that are bi-directional.
The CHILD grant has supported workforce development for the current sites in the areas of Collaborative Documentation, Child Light Yoga, Cultural and Linguistic Competence, Family Trauma, and others. A significant number of staffs attended Michelle Duprey’s online course on integration at the University of Michigan. The grant’s primary purpose is to support the pilot regions, but we have a strong interest in supporting the foundational work needed for integration to move forward across the state. To that end, we offered Michelle Duprey’s course (34 CEU’s) to all DAs for the fall semester and had a number of interested persons participate from outside the current pilot regions. The grant also supported the most recent ARC training and will support another one in the spring. Our trainer for collaborative documentation is in the process of producing a webinar laying out the basics of the process and the ways in which it can support our goals. This will be hosted on the VCPI website to be accessible to all DAs and other interested parties. We have a grant with the Vermont Cooperative for Practice Improvement (VCPI) for technical assistance, workforce development, and implementation support, which will cover expenses in those regards.
Additional supports come from the evaluation contract with the Vermont Child Health Improvement Program (VCHIP) at the University of Vermont, which includes guidance and support of CQI measures such as Plan-Do-Study-Act cycles.
The grant has a contract with Cultural Solutions to offer assistance with cultural and linguistic issues, as well as Cultural Competence training.
We have a grant with the Vermont Federation of Families for Children’s Mental Health (VFFCMH) to include youth and family voice. This grant offers a stipend for youth and family participation in grant work, which is expected to be an integral part of the grant.
CRITERIA FOR SCORING Total Applicant
possible Score
points
Quality of Experience and Capacity to Deliver 40
1. Understanding, experience and knowledge needed for the project
2. Experience with similar projects/fit within organizational context
3. Organizational readiness to begin the work
4. Accreditations, good standing with DMH, licensures or other indicators of quality that attest to the ability to do the work
Responsiveness to Specifications 40
1. Commitment to integration, planning and implementation
2. Level of proposed connection to regional integration efforts
3. Joint letter of intent from proposed providers
4. Plan for reaching enrollment targets and integrating family voice
3. Program Budget 20
1. Budget reasonably reflects project needs
OVERALL TOTAL SCORE 100
ADDITIONAL INFORMATION
DMH reserves the right to accept or reject any or all bids. If a vendor is selected, representatives will be invited to negotiate an agreement.
DMH will not pay any bidder costs associated with preparing or presenting any proposal in response to this RFP.
The vendor will agree to the State of Vermont usual contract and payment provisions. These specifications are posted with this RFP and include:
• Attachment C: Customary Provisions for Contracts and Grants
• Attachment E: Business Associate Agreement
• Attachment F: AHS Customary Contract Provision
|
