CRISIS INTERVENTION SERVICES

Transcription

1 Erie County Medical Center Corporation RFP # Addendum Number 1 Erie County Medical Center Corporation Addendum Number 1 to RFP # CRISIS INTERVENTION SERVICES The deadline for submission still remains: Tuesday, March 13, 2018 at 11am EST. The following questions were submitted to the Designated Contact: 1. In reference to Program Mission on page 2 of the RFP: The Emergency Community Outreach Provider must provide a dedicated team of skilled, trauma informed mental-health professionals to provide 24/7/365 crisis intervention services, including psycho-education, emergency counseling, patient advocacy, and referrals for the purpose of maintaining the safety and stability of individuals, families, and members of the community. Is the RFP solicitation for a new service, or does a similar contract already exist? If so, what is the agency? ECMCC currently has an existing contract with Crisis Services of Buffalo and Erie County. Are data available on potential demand for the required services; e.g. anticipated number of calls, direct response in the community, numbers of law enforcement staff to be trained, etc.? There are approximately 77,000 phone calls per year and approximately 2200 field assessments. Is there a projected or required implementation timeframe after contract award by which time services must be available? Immediately. Are start-up funds available for this program? 1 P a g e

2 No. 2. In reference to Scope of Service on page 2 of the RFP: Requirements: 1. 24/7/365 coverage on a secured telephone hotline. Immediate access for callers to a secured call center / hotline, with live 24-hour crisis counselors answering calls. This secured hotline must provide for the recording of all calls, utilizing a call-tracking software system. The Respondent will also collaborate with local and regional law enforcement agencies and the 911 emergency dispatch system allowing for all incoming calls to be traced in the event of an emergency. Does this project require a physical call center, or if all requirements are met, can hotline be managed remotely? Theoretically, calls could be managed remotely, but would have to be coordinated with the mobile crisis outreach team. If there is a current vendor, are their existing agreements in place with all local law enforcement and 911 emergency dispatch systems to trace inbound calls? No, I don t think so. What are the historical call volumes for this program? In 2017, there were 77,000 calls. What are anticipated call volumes for this program? This trend is expected to continue. Does Erie County Medical Center require URAC or JCAHO accreditation for the hotline, or is CARF accreditation acceptable? ECMCC is accredited by the Joint Commission. There is no separate accreditation for the hotline. 3. Rapid response time. 4. Visits made directly to the client s home, or other locations within a reasonable time frame as appropriate to client needs. 2 P a g e

3 Does ECMC have a defined standard for rapid response time and reasonable time frame for visits to client s home, or are these timeframes to be defined by the bidder? We do not have a defined standard. 3. In reference to Clinical Service Task and Requirements on pages 2-3: 1. Telephonic Consultation: Is this service available to inbound callers from Erie County? What is the expectation for triage and linkage for calls originating outside of the county? The agency is only expected to handle calls from Erie County. Who is able to call in a referral (i.e., individuals seeking services, families, law enforcement, local hospitals, schools)? All of the above. Is it required that the psychiatrist be available 24/7 for telephonic consultation with callers, including professional referrals, such as emergency department physicians? A consulting psychiatrist is always available through the ECMC Comprehensive Psychiatric Emergency Program (CPEP). Is there a defined triage process already, or would the bidder be required to develop the triage process? The vendor would design their own triage process. 2. Outreach Visits a. Crisis intervention b evaluation RFP Form Rev. 4/15 3 c. Emergency mental health assessment d. Lethality assessment e. Assistance with triage and transportation (via collaboration with police, ambulance, & hospital-based personnel) f. Psychiatric consultation (available 24/7/365 with psychiatrists based in the ECMCC Comprehensive Psychiatric Emergency Program - CPEP) g. Written dispositions after transport (with direct input to the ECMCC electronic medical record and/or provided by secure fax in the event of computer system downtime ) h. Intake services i. Follow-up services with clients, family members, and community providers when appropriate 3 P a g e

4 Does this program include coverage to complete face-to-face evaluations/level of care assessments for local emergency department(s)? If this includes emergency department evaluations, what are the anticipated volumes? Approximately 700 per year. Are psychiatrists in this crisis intervention services program in addition to the Comprehensive Psychiatric Emergency Program, or are they expected to staff that program? All psychiatrists are part of the ECMCC-CPEP. Do psychiatrists and/or licensed clinicians need to be credentialed by ECMC? The clinicians are not credentialed by ECMC. Is the vendor for this service required to utilize an electronic health record? The incumbent vendor documents directly in the ECMC EMR. Will the vendor have access to ECMC electronic medical record (EMR)? See above. If the vendor will utilize the ECMC EMR, is the vendor expected to purchase the user licenses for staff? The vendor is not expected to purchase user licenses. 5. Data collection. The Respondent must collect and organize all applicable data relating to emergency outreach, including but not limited to number of calls, number of visits, number of visits with police involvement, number of visits resulting in transport to CPEP, number of CPEP presentations resulting in admission to ECMCC, etc. Is there an existing database/software for this data collection, or would the vendor develop it? Both ECMC and the incumbent vendor keep their own unique, but complementary databases. Are there specific reporting requirements in place, including frequency, data points, and format? The incumbent vendor reports a set of statistics to ECMC on a monthly basis. 6. Collaboration with Law Enforcement 4 P a g e

5 a. Require 30 minute response for all local law enforcement b. Jail diversion initiative with ECDMH c. Police / mental health coordination Is the 30 minute response time requirement an average response time expectation? Do responses for law enforcement calls take place anywhere in the community or at jail/precincts only? Calls may originate from anywhere in the community. Do face-to-face in home responses with law enforcement require 2 staff, or can law enforcement be utilized as the second staff member? The incumbent vendor uses two clinicians on every call, and law enforcement as required. 7. Coordination with Assisted Outpatient Treatment / Single Point-of Access Clients a Transports b. Priority response to clients linked to AOT and/or SPOA c. Collaboration with treatment providers, pre- and post-intervention. Are there secure transport requirements for 9.60 transports? Does law enforcement assist if the individual refuses transport? Is there a real time database, including clinical information and treatment plan, available for individuals linked to AOT and/or SPOA? No. 8. Program marketing / community education a. Community education on the appropriate use of Crisis Mobile Outreach and CPEP. b. Educate law enforcement officers, EMT professionals and/or first responders using an evidence-based Crisis Intervention Teams (CIT) Training. CIT Training is designed to inform officers and first responders about the signs and symptoms of mental illness, teach de-escalation techniques, and encourage CIT-trained officers to utilize community services to divert individuals from unnecessary hospital presentations and jail time. 5 P a g e

6 c. Successful respondent will provide thirty-two (32) hours of evidence-based classroom instruction, including coordination of local guest speakers, facilitating role play activities with trainees and providing DCJS Certificate at the completion of program. d. Vendor will also offer each trainee eight (8) hours of field time with members of the Crisis Services Mobile Outreach team to assist the CIT officers in further RFP Form Rev. 4/15 4 learning to devise response plans, help link high utilizers to local services, minimize unnecessary CPEP presentations and secure connections to mental health system. Is there an existing CIT program in place? If so, which curriculum does it follow (i.e. Memphis Model)? We do not know which curriculum it follows. Is CIT currently taught in collaboration with the National Alliance on Mental Illness (NAMI) or similar organization? Don t know. How many times monthly/annually is this training performed? This is a 32 hour training usually offered over the course of 4 days How many officers and other first responders are trained annually? A productive class would not exceed 30 participants. Does the training include all officers and first responders in Erie County, or only a portion? Only a portion are trained. If all are not trained in CIT, what are the selection requirements? Selection of training participants is based on police districts serving in hot spotter zip codes as well as officer/responders availability and interest. Are officers and first responders retrained annually in CIT, or do the go through the training only once? Training participants complete all portions of the Evidence Based training only once. If CIT training is not annual, do they receive any other behavioral health training on an annual basis? Who teaches those annual trainings, if applicable? We do not know the answer to this question. 4. In reference to Hours/Staffing page 4: 6 P a g e

7 Outreach Staff available from 8am-11pm (weekdays) and 9am-11pm (weekends) c. Agency immediately accepts calls 24 hours a day via agency crisis hotline, which then triages calls out (24 hours a day) to the emergency outreach service d. On-call staff for remaining hours that can be accessed when a call is received that requires an immediate response e. Staff has access to immediate 24/7/365 supervisory consultation and immediate 24/7/365 psychiatric consultation with the CPEP psychiatric staff Are outreach staff expected to make same day face-to-face contact during designated hours that they are available, or is the time-frame for face-to-face outreach determined based on the individual triage? Based on the individual triage. Does on-call staff for after-hours triages respond to all crisis calls face-to-face, or is there another community response team that may be dispatched? Calls are evaluated as they come in. Face-to-face contacts are only made if deemed necessary. There is no other community response team. To what type of call locations is this team responsible for responding (i.e., home, ED, hospital floors, jail, etc.)? Calls may come from any location in the community except jails. Does this program provide psychiatry coverage for CPEP, or is CPEP a distinct program with its own dedicated psychiatrists? CPEP is a distinct program with its own dedicated psychiatrists. If CPEP is a distinct program, how does its scope of services compare with this Crisis Intervention Services program? CPEP further evaluates the patient and makes every attempt to stabilize and discharge to a lesser level-of-care. ECMC admits approximately 70% of all patients brought to the CPEP by the Crisis Intervention Services Program to its acute inpatient psychiatry service. What are the specific requirements for staff background / criminal records screening? Don t know. Is there a years of experience requirement for staff? No. 7 P a g e

8 Will the selected Contractor be required to hire a certain percentage of New York residence to fill the positions? No. 5. In reference to vendor & service requirements on page 4: 12. Vendor should submit a proposed charge per screening/visit with their proposal. Does this mean that an additional proposed budget is to be submitted to cover other program costs or are all program costs to be incorporated in these proposed rates? All program costs are incorporated in the proposed rates. Are all inbound calls billable, even if there is no face-to-face intervention or follow-up? Inbound calls are not billable. Do services that are typically reimbursed by Medicaid need to be billed through Medicaid, or are all services billed directly to Erie County Medical Center? ECMC bills Medicaid directly for all face-to-face contacts. If services must be billed through a 3rd party, if there is one, are those services which are ineligible for reimbursement (i.e. individual has Medicare or commercial insurance which do not cover crisis services), be reimbursed through Erie County Medical Center? ECMC does all the billing for face-to-face contacts. The incumbent vendor is paid by ECMC. If we are required to bill insurance, would we be required to bill insurance first, receive the denial, then bill Erie County Medical Center? See above. ECMC does all billing. 6. In section 4 Scope of Services/Specification, then Clinical Service and Task Requirements, then bullet number 14, it references Crisis Residence Services. In addition to this service, ECMCC also receives a service called Interim Visits and this is noticeably absent from the RFP. Is this an oversight or intentionally removed? This is an oversight. 8 P a g e