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Act 114 Independent Study Request Date: 3/30/2021 11:10:28 AM
Open Date: 
Closing Date: 6/18/2021 4:30 PM
Intent To Bid Deadline: 
Est. Dollar Value: $20,000.00
RFQ Number: RFP66
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Department of Mental Health

280 State Drive
WaterburyVT 05671-2010

Bid Type:
Request for Proposal

Research and Development, Consultant Services, Health Care Services

Bid Description:
STATE OF VERMONT AGENCY OF HUMAN SERVICES DEPARTMENT OF MENTAL HEALTH REQUEST FOR PROPOSALS for Act 114 Independent Study RFP66 ISSUE DATE: March 30, 2021 QUESTIONS DUE: April 30, 2021 RFP RESPONSES DUE BY: June 18, 2021 OVERVIEW The Department of Mental Health (the State) is soliciting competitive sealed, fixed proposals from qualified offerors for an independent study to be undertaken in 2021, with a report of the findings to the general assembly by January 15, 2022. Proposal responses may not exceed $20,000.00 annually. If a suitable offer is made in response to this Request for Proposal (RFP), the State may enter into a contract (the Contract) to have the selected offer perform work outlined in the Scopes of Work section. RFP OBJECTIVE DMH is seeking applications from experienced mental-health, human-services, legal, and/or medical professionals to carry out this annual study and to write the required report for the legisla-ture. Applicants should have highly developed skills in establishing trust and interviewing people; analyzing, organizing, and describing the information thus obtained; and putting it into a formal report. Their experience should include the conduct of similar independent qualitative studies in the past. A record of publication in referenced journals would be helpful. REQUIREMENTS FOR SUBMISSION Please provide an electronic copy of the proposal no later than May 7, 2021 at 4:30 pm EST to: SCOPE OF SERVICES REQUESTED Persons who have a conflict of interest in conducting this study may be disqualified from the review process. Examples of a conflict of interest would include direct involvement in the judicial, service provision, or oversight functions associated with the implementation of Act 114. Interested applicants should send proposals with the following information: • applicant's experience and qualifications for performing the study and writing the report, • a description of the approach and methodology to be used, • specification of discrete activities to be undertaken to gather information for each of the four major sections of the report, • maximum hours anticipated for each of the four tasks involved in the study, • maximum hours anticipated for completing the report, • hourly (or daily) rate for work performed, • estimates of other expenses (for example, telephone calls, travel, postage) connected with carrying out the study, • projected completion date of the report for the legislature, and • relevant supporting materials DMH will provide (or help to arrange for the provision of) pertinent available information to the person(s) or entity conducting the study (for example, names of individuals who received involuntary medication under Act 114 and names of family members, contacts and staff of the Vermont Psychiatric Care Hospital l or other hospitals or correctional facilities, if necessary, where involuntary non-emergency psychiatric medication may be administered). The only permissi¬ble use of the information so provided will be for the report required by the law, and it must be used in such a way as to respect at all times the confidentiality of the people concerned and to be in com-pliance with the provisions of the Health Insurance Portability and Accountability Act (HIPAA). 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 provided • Statement and discussion of anticipated major difficulties and problem areas (if any), together with potential or recommended approaches to their solution. 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 Any vendor requiring clarification of any section of this RFP or wishing to comment or take exception to any requirements of the RFP must submit specific questions in writing no later than the deadline for questions indicated on the first page of this RFP. Questions may be emailed to:, the point of contact. Any comments, questions, or exceptions not raised in writing on or before the last day of the question period are waived. SCOPE OF WORK 1. Evaluate performance of hospitals and staff in implementing Act 114 1.1: Meet with designated Department of Mental Health (State) staff. Prior to implementing annual assessments, meet with State staff for the following purposes: a. To identify and review the logistical tasks and details required to carry out the assessment and to agree on who will be responsible for these. b. To review the current status of Act 114 and identify additional issues that should be addressed prior to beginning the assessment. c. To identify stakeholders to include in interviews. d. To review existing structured interview tools to gather information on • the performance of hospitals and their staff in the administration of involuntary psychiatric medications • the experiences of persons who were subject of a petition for Act 114 nonemergency medication, but no order resulted. • the experiences of person who have received medication under Act 114. • any attestation of the experiences of person who received nonemergency involuntary medication from any year prior to the present reporting year. 1.2: Review outcome data provided by the State. Typically, data will include time between hospital admission and filing petition for involuntary medication, length of hospital stay, and length of community stay as available. Additional outcome data will be gathered through interviews with hospital staff at up to five facilities regarding: a. Knowledge of Act 114 requirements. b. Procedural implementation. c. Documentation requirements; and d. Degree of satisfaction of hospital staff, patients, and family members with court-ordered involuntary medication process. 1.3: Discuss logistics with hospitals. Telephone contact with individuals identified as contact persons by State at each of the five hospitals for logistics of activities, including site visits to conduct staff interviews; review of documentation for individuals receiving psychiatric medication under Act 114, including protection of patient confidentiality; and interviews with patients receiving medication under Act 114. 1.4: Conduct interviews with hospital staff. Leadership and direct care provider group interviews will be scheduled and conducted on-site at each of the five hospitals. Leadership interview will discuss hospital practices and/or changes that may have an impact on the implementation of Act 114. Direct care provider interviews will address questions about the administration of medication under Act 114. 1.5: Gather and review documentation. Upon request, hospitals will provide hard copies of the following documents for review at the hospital site visit: • Patient Information: Implementation of Nonemergency Involuntary Medication • Implementation of Court-Ordered Involuntary Medication. • 7-Day Review of Nonemergency Involuntary Medications by Treating Physician. • Certificate of Need (CON) Packet. Completed any time emergency involuntary procedures, such as seclusion or restraint, are used. 2. Interview persons subjected to orders of involuntary medication and their families 2.1: Prospective participants. As available, interview: three groups of persons who were subject of petitions/ orders of involuntary medication in 1.1 (d) above. DMH will provide contact information for persons subject to Act 114 medication orders or petitions in the current reporting year. Other persons for possible interview will be solicited through organizations outlined in 2.2 below. Family members may be interviewed with consent of the person subject to medication orders under Act 114 or if family members voluntarily step forward to provide family perspective for their family member who was subject to an Act 114 court order or petition. 2.2: Develop an informational brochure that can be used for solicitation and circulated by involved organizations that outlines interview process, purpose of report, honorarium, and instructions on how to participate. 2.3: Vermont Legal Aid Mental Health Law Project and NAMI-VT contacts will be provided to recruit persons subject to medication under Act 114, persons with petitions for involuntary medication orders, and family members. Contacts for other provider organizations will also be provided by the DMH. Informational brochures with contact information will be provided to the organizations who can then contact potential interviewees for possible participation in the annual report. 2.4: Schedule all interviews and provide informed consent form for completion prior to interview to ensure proper consent is documented. All interviews are conducted to ensure individual confidentiality is maintained. An interview template for each potential interview group will be provided by DMH. Interviews may be conducted by phone, virtually, or in-person. For phone or virtual interviews, the Contractor will send the consent form with a self-addressed, stamped envelope and the person must sign and return it prior to the interview. A $50.00 honorarium for persons who were subject of Act 114 medication will be provided for completed interviews. Honorariums may be provided by cash or check with signed receipt. 3. Identify steps taken to achieve a mental health system free of coercion 3.1: Schedule and conduct interviews with State staff. Upon request annually, DMH will coordinate a group interview of State staff who are involved in efforts to create a mental health system free of coercion. Information will be compiled to reflect any qualitative steps/practices and/or quantitative measures to track efforts and progress to reduce coercion. 4. Identify what is working well, challenges, and recommendations from the perspective of judges, lawyers, and patient representatives 4.1: Conduct interviews with members of the judiciary who preside over Act 114 application hearings, lawyers from the Mental Health Law Project who represent patients in application hearings, lawyers from Disability Rights Vermont who interact with persons receiving Act 114 medication, NAMI organization who may interact with persons or family members of persons receiving Act 114 medication, representatives from Vermont Psychiatric Survivors and other Peer-Run Organizations who also may interact with patients receiving Act 114 medication during hospitalization. 5. Summarizing and Reporting Requirements 5.1: Analyze and summarize information gathered into Draft Report. Once all interviews are completed and documents reviewed, comprehensively compile, and summarize the qualitative and quantitative information into findings and recommendations: ? Overview of information gathering and assessment process, statutory requirements of the annual evaluation, and an Executive Summary of the annual review. ? Assessing the performance of each hospital in implementing Act 114 provisions ? Assessing the perspectives of persons receiving involuntary medication and their families ? Assessing the perspectives of persons for whom a filed application did not result in a court order for medication ? Presenting the perspectives and recommendations of legal and patient-representative stakeholders who have a role to play in Act 114 legal proceedings and/or with patients receiving medication through Act 114 court orders. ? Evaluating outcomes, including time between admission dates and dates Act 114 petitions were filed, hospital lengths of stay, and readmission rates, while adhering to rigorous statistical methods. ? Improving the implementation of Act 114 and/or furthering movement toward a noncoercive mental health system. 5.2: Draft report. Draft annual report that describes the assessment process, presents findings of the study, and provides recommendations based on those findings. 5.3: Review draft report with State. The draft report will be presented to State staff for review by December 1, 2021. The State will be asked to examine the report for accuracy regarding discussions of policy and references to documentation and to identify any areas of the report needing additional clarification. 5.4: Complete final report and submit copies to legislative committees. State will complete its review and return the report by December 15, 2021. The Contractor will finalize the written evaluation report and submit copies to the state librarian, the appropriate legislative committees, committee staff, and any other required recipients by January 15, 2022. 5.5: Review final report with Adult State Program Standing Committee. Contractor will meet with the Adult Standing Committee to review the findings and receive input toward improving the assessment in the future. DELIVERY OF PROPOSALS Proposals must be received no later than June 18, 2021 at 4:30 pm EST at the following email: Please use MS Office and/or standard PDF files. ADDITIONAL INFORMATION DMH reserves the right to accept or reject any or all bids. If a contractor is selected, representatives will be invited to negotiate a contract. DMH will not pay any bidder costs associated with preparing or presenting any proposal in response to this RFP. The contractor 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

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