Request for Proposals for Transitional Living Centers

Request for Proposals for Transitional Living Centers I. Introduction: Central Iowa Community Services (CICS) is announcing this Request for Proposals (RFP) for the following counties: Boone, Franklin, Hamilton, Hardin, Jasper, Madison, Marshall, Poweshiek, Story, and Warren. The Applicant must certify and provide evidence that the TLC is not replacing another program operated by the Applicant in the counties identified. A. Service Description: This RFP is specifically for the provision Transitional Living Centers (TLC) in the following sites: 1) Indianola Primarily serving Boone, Madison and Warren Counties. 2) Iowa Falls - Primarily serving Franklin, Hamilton, Hardin and Marshall Counties. 3) Newton - Primarily serving Jasper, Marshall, Poweshiek and Story Counties. The successful applicant (s) shall be expected to provide services according to Attachment A and is encouraged to consider alternative, non-traditional approaches to providing the services. The successful applicant (s) may submit a proposal for one site or multiple sites. Since the RFP is designed to develop or expand the capacity of service delivery with the counties identified above, the individuals served must be clients who are eligible to receive services with primarily focus on Medicaid funding and regional/county funds secondarily. B. Conditions: CICS shall follow a competitive selection process, which is a formal process established to compare provider qualifications, terms, conditions, prices of equal or similar services, and historical outcome data in order to determine the best candidate from whom to purchase services. The successful candidate shall demonstrate quality of services, ability to meet performance measures, support from the Community Service Directors in the site(s) served, and a proven track record of providing quality follow along services that minimize displacement of individuals with disabilities. This competitive process allows individual providers as well as a consortium of providers to apply. A consortium applying to serve multiple sites must designate one provider to act as the fiscal agent, and all providers in the consortium must provide a letter of support for the fiscal agent in the proposal. Creative alignment of services and partnerships are encouraged in this RFP. Establishment, Development, or Expansion Allowances: Proposals may request compensation for staffing, other ongoing expenditures related to the TLC, and development or expansion costs as necessary for the purpose of providing the services identified that would not otherwise be reimbursable by other funders. II. Proposal Requirements: The purpose of these services is to develop and enhance programming that shall promote integration of people with disabilities into the community. The funds through this grant are to be used for initial and additional staffing and costs of the TLC and initial and additional equipment. Applicants must be private or public not-for-profit organizations that specialize in providing services to individuals with disabilities. Proposals that fail to demonstrate the above evidence shall be determined as not having met the requirements of the grant and, therefore, shall not be considered in the bid process. 1

A. Eligible Applicants: All providers are eligible to apply for this grant. Applicants that do not currently have a contract must also obtain a contract with CICS for the services to be rendered in this grant. Applicants that do not have the appropriate accreditation must provide evidence within three months of the start date of the TLC of the organization s application for accreditation, if applicable. Applicants that do not have the accreditation must comply with all CICS Program Review expectations until accreditation is secured. CICS Program Reviews require the applicant to meet quarterly with CICS Administrative Team, and apply the recommendations for improvement provided by the Team. Should an applicant fail to obtain appropriate accreditation within the first six months, the funding shall be discontinued. B. Goals and Objectives: 25 points possible Applicants must identify the goals and objectives that shall be met in measurable terms. Applicants should address not only outcomes but activities that shall lead to individuals transitioning to stable affordable housing that meets the individual s needs. Proposals that address creative measures and actions to try and curb this trend are encouraged. Goals and objectives must be written that address: 1. Outcomes expected per year. 2. Service delivery plan per site (i.e. application process, staffing levels, response time to requests, timeframe to develop TLC, etc.) C. Planned Activities: 25 points possible Describe the planned activities that shall enhance the applicant s ability to meet the stated goals and objectives as well as address the following: 1. Describe the plan to develop sustainability. 2. Explain why the grant is necessary to establish the services instead of simply providing the service. 3. Describe the proposed population(s) to be served by the TLC (i.e. mentally ill, intellectually disabled, etc.) 4. Provide projections on local housing availability and local job availability. 5. Describe the proposed method of accessing continued funding. 6. Describe the proposed accountability and sustainability timeframes. 7. Provide evidence of support from the Community Services Directors covered by the site. D. Budget and Budget Narrative: 25 points possible The allowable costs for this grant are salaries and benefits along with equipment that is necessary to establish the project. The budget must provide line item costs for each of the allowable costs noted, and the rate of match required by the project. The Budget Narrative should align with the budget and concisely describe the nature of the line item cost in the budget and shall provide justification and a rationale for the line item requested. E. Consistency with Attachment A: 25 points possible Proposals shall state how they will provide services consistent with the protocols identified in Attachment A. In areas where they will diverge from the protocols in Attachment A, an explanation of the benefit of doing it differently will be included. F. Contract Period: Starting no later than July 1, 2016 and ending June 30, 2017. Renewable annually, at the discretion of CICS, based upon outcomes and availability of funds. 2

III. Contracting Clauses: A. Monitoring, Review and Payment: The purpose of monitoring is to assist the successful applicant in: 1. Complying with the terms and conditions of the contract and applicable laws and regulations. 2. Preventing non-compliance by identifying and resolving potential problems by providing constructive and timely feedback. 3. Making progress toward the expected results and outcomes. 4. Reducing fiscal or program risks as early as possible. 5. Determining a need for technical assistance. 6. Determining if the contract should continue. The following summarizes the expectations and timeframes for monitoring: 1. The contractor shall submit progress reports concerning the progress and contractor performance on the goals and objectives on a quarterly basis. 2. The contractor shall submit invoices and billings on a monthly basis. 3. The contractor shall submit updated summary reports of work with the clients served on a monthly basis. 4. The contractor shall participate in all on site contract reviews which shall include at least one per year where the financial and programming performance is reviewed. 5. The contractor shall follow recommendations sited by the review. 6. The contractor shall correct identified deficiencies or findings by CICS staff and submit progress reports to any such corrective action plan. B. Contract Specifics: Either party may terminate the contract according to the terms of the contract. The contractor agrees to indemnify and hold harmless CICS, shall maintain insurance and shall be an independent contractor according to the terms of the contract. The contractor, its employees, agents and subcontractors shall comply with all applicable federal, state, and local laws, rules, including without limitation, all laws applicable to the prevention of discrimination in employment and the use of targeted small businesses as vendors or suppliers. The contractor, its employees, agents and vendors shall comply with all federal, state and local laws regarding business permits and licenses that may be required to carry out the work performed under this contract. C. Purchasing Requirements: The contractor agrees that any equipment purchased under this grant shall do so as efficiently and effectively as possible and make every reasonable effort to ensure that the commitment of public funds obtains the most value for the money spent. Competition for the purchase of equipment should be fair, open and objective. Misappropriation or abuse of this process shall result in the contractor reimbursing CICS for the funds used in the purchase price. D. Persons Served: The contractor agrees to serve only those individuals with disabilities identified by CICS. IV. Proposal Process: Date by when RFP s mailed to applicants: May 1 st, 2016 Date by when proposals must be submitted to CICS: August 1 st, 2016 Date by when proposals shall be reviewed by CICS: August 15 th, 2016 Date by when successful applicants shall be notified September 1 st, 2016 Date by when contract is mailed to successful applicant(s) September 1 st, 2016 Date of final contract approval by CICS September 22 nd, 2016 Date when the grant begins October 1 st, 2016 3

Proposals must be submitted to: Russell Wood, Community Services Director Central Iowa Community Services, Franklin County Office Russell.Wood@cicsmhds.org PO Box 58 Hampton, IA 50441 V. Standards for Review of Applications: Each proposal shall be reviewed according to the established number of points possible, the quality of the proposal in addressing the areas, and the outcomes achieved historically. CICS reserves the right to decline any and all applications and choose to not award a grant. Attachment A Program Description The Transitional Living Center (TLC) is designed for residents of the CICS region that have the desire to live in an environment where they will create and carry out a plan to transition to a stable, affordable living arrangement that meets their needs. Residents may stay up to three months at the TLC while they are working to complete the steps necessary to reach the goals identified in their transition plan. During that time, they connect to a network of community resources to assist in reaching their goals. This network of resources includes regional service coordinators and employees of PROVIDER. PROVIDER is the agency contracted to provide the TLC. Admission criteria: The TLC is available to individuals with an intellectual disability, brain injury, or mental health diagnosis. People with a substance abuse diagnosis are welcome as long as there is a cooccurring intellectual disability, brain injury, or mental health diagnosis. All participants must meet CICS eligibility requirements. All participants will need to be able take care of their bathing, dressing, feeding, mobility, and hygiene needs. There is a possibility that some limited supports may be implemented. Participation is voluntary and centers around identifying a plan to transition to a stable, affordable living arrangement that meets participant s needs and participating in completing the goals to fulfill the plan. The following criteria prohibit consideration of admission to the TLC: The individual is under arrest The individual is actively psychotic, suicidal or homicidal The individual is over the legal limit or impaired due to drug use The individual has acute medical needs The individual has a high risk of violence or is otherwise a danger to themselves or others 4

Transportation to the TLC: A person may have a friend or family member transport them or drive themselves. If they do not have a way to get to the program, Central Iowa Community Services has a contract with Central Iowa Juvenile Detention for transportation in a non-law enforcement vehicle. Call 641-858-3852 to use that transportation. PROVIDER may also be able to provide transportation. Coordination of Services Participants in transitional living services receive coordinated services. Transitional living staff, regional service coordinators, mental health professionals, stake holders, physicians, and families are part of the services offered and transition plans. At the initial plan meeting, the team will identify who is responsible to ensure all individuals have adequate contact with outside resources to ensure an ongoing support system to facilitate transition. Identified staff initiate contact with outside agencies, resources and providers to enable individuals to have resources in place and the initial paperwork completed. Individuals with co-occurring disorders or multi-occurring disorders receive integrated and coordinated treatment services and support without regard to which condition is primary. Transitional living services are not denied due to non-mental health co-occurring disorders, rather services are coordinated with other providers and professionals to address all aspects of the individuals needs for proper treatment and stabilization. Transitional living services are short term services intended to stabilize and reintegrate individuals back into the community. Assessment Assessments are utilized to determine the precipitating factor of the need for transitional living services, the individual and family functioning needs, and the diagnosis if present, and to initiate a transition plan. Comprehensive assessments are completed upon admission by the provider. Assessments include: Action plan including individual strengths, preference or needs. Active symptoms of psychosis Alcohol use Coping ability History or trauma Impulsivity or absences of protective factors Intensity and duration of depression Lethality assessment Level of external support available Medical history Physical health Prescription medication Crisis details Stress indicators and level of stress Substance use 5

Transition plans are utilized to ensure the needs of the individual are being met. Transition plans are available to family only with a written release from the individual receiving services. Staffing The TLC is staffed by PROVIDER. Transition Plan Service Coordinators contact the individual within 3 business days to assess needs and begin coordination of transition plan. All individuals receiving services have a written transition plan. Within five days of admission, all residents develop a written transition plan with a team consisting of PROVIDER staff, a regional service coordinator, and input from others as needed or desired. This plan is reviewed weekly to assess progress towards goals and to determine whether any adjustments need to be made. The initial plan is for 30 days, with the potential for extension up to 60 or 90 days. Extension of the transition plan is dependent upon evaluation of the resident s demonstration of their investment in completing the plan. Progress on the plan is evaluated weekly during meetings between the resident, service coordinator, and other team members as necessary. The decision to extend the plan will be based upon these meetings and determined by CICS, with input from the team, at the end of each 30 day segment. The individual is involved collaboratively in all aspects of the plan. At a minimum, the plan includes: Criteria for discharge, including referrals and linkages to appropriate services and coordination with other systems. Description of any physical disability and accommodations necessary to provide the same or equal services and benefits as those afforded nondisabled individuals. Evidence of input by the individual, including the individual's signature. Goals and action steps consistent with needs and projected length of stay. Objectives that are built on strengths and allow measurement of progress. Rights restrictions. Signatures of all participating in the development of the plan. Identification of team member responsibilities for completion of action steps. Documentation Requirements All information related to the individual receiving services is documented. Records include: Transition plan, including goals and action steps to meeting the transition plan Treatment summary Additional supports and programming provided. Discharge location State of client access to benefits, housing, and supports before, during, and after their time at the TLC. All activities that affect completion of transition plan goals will be documented in writing by the client and the staff involved in completion. This written documentation will be gathered weekly by the Regional Service Coordinator and reviewed with the client. Narrative on weekly meetings 6

will identify progress made on goals and identify actions taken to mitigate any barriers to progress on goals. CICS Service Coordinators upload documentation into the client s CSN account within five days of receipt or development. Privacy Individuals receiving transitional living services are afforded the maximum amount of privacy dictated by individual needs and safety. Individual sleeping quarters and rooms have locking doors for privacy. Transitional living staff have access to the rooms in the event of an incident or emergency. Assessment and plans are developed, explained and implemented with an emphasis on individual's privacy as dictated by individual needs. Individuals have designated space for personal and private possessions and space to allow for private conversation with family, friends and additional members of the treatment team. Occupancy Space Medications are managed by PROVIDER staff if the need is identified during the assessment. Rent and utilities are in PROVIDER s name. Residents pay their share of rent and utilities. If a resident is unable to afford rent and utilities, they will apply to Central Iowa Community Services for rent and utilities payment assistance. The house is furnished. If a client has an immediate need for clothes or food, PROVIDER can assist them. Residents sign a 30-day lease upon occupancy. It may be renewed monthly, but will not exceed 90 days, unless an exception to policy is made. Overnight time away from the home is only allowed if it is related to goal fulfillment. Referral Process Enrollment Procedure A complete referral consists of a CICS Application, necessary releases of information including the CSN release of information, PROVIDER Application for Services, and Social History. If the referral is for an applicant transitioning from a hospitalization, a treatment plan and social history need to be provided. A write up from the doctor will be accepted as a Social History. If the referral comes from a CICS service coordinator, the service coordinator ensures that a completed CICS application exists. If one does not exist, the service coordinator assists in completing the application. The application is reviewed and an NOD is issued to the applicant and PROVIDER before the applicant is admitted to the program. The service coordinator completes a social history on the applicant if there is not one completed. If the referral comes to PROVIDER from an outside source, such as a hospital or jail, or if a referral is identified by PROVIDER from within their other services, PROVIDER 7

will email intakes@cicsmhds.org. The Service Coordination Officer or designee will assign the referral to the appropriate service coordinator. The service coordinator ensures that a completed CICS application exists. If one does not exist, the service coordinator assists in completing the application. The application is reviewed and an NOD is issued to the applicant and PROVIDER before the applicant is admitted to the program. A social history will be completed by the referral source. If the referral is for an applicant transitioning from a hospitalization, a treatment plan and social history need to be provided. A write up from the doctor will be accepted as a Social History. Waiting List and Intake Process: PROVIDER will establish a waiting list of individuals that have applied for the TLC. This will be reviewed each month with the CICS Coordination Officer or designee to determine if an individual needs to remain on the waiting list. When an opening occurs, the waiting list will be reviewed between the CICS Coordination Officer or designee and PROVIDER. At this time, a determination will be made as to whether there is an urgent mental health need anywhere within the CICS region. Once a determination is made as to who is eligible, a prior authorization will be completed by the appropriate service coordination staff. Priority Waiting List: 1. Individuals needing mental health stabilization as documented by a mental health professional. 2. If there are two high priority individuals, the one who is on the waiting list the longest would get opening. Claims Review and Processing Payment Procedures Providers submit billing to the Program Manager within 60 days following the month the service was provided. The Program Manager reviews claims to ensure clients have been approved and are in CSN. If the client is not in CSN or does not have an NOD, the Program Manager contacts the Service Coordinator for the County of Residence to get the required information entered within the five days. The Program Manager contacts the provider to resolve any billing issues, then communicates the result to Finance. The Program Manager forwards the claims to Finance by the 20 th of the month if the claim is accurate. The Program Manager keeps a running total of the amount billed. If an individual is currently residing at the TLC and needs to be out of the home, a request for absence will be submitted to the regional service coordinator one day prior to the date the individual is requesting to be out of the home. CICS will fund up to three consecutive days out of the home. The need to be out of the home must relate to the client s goals (PROVIDER will report for each day absent and how it relates to the client s goals). If an individual is out more than six days within a month, a team meeting will be held to determine appropriateness for their continued stay at the TLC. This policy applies regardless of funder. In all cases, a current regional application must be on file. Reporting Procedure 8

Client Goal Progress Monitoring Written documentation is shared with CICS for each client. Service Coordinators upload the shared information into the client s CSN account within five days of receipt. Provider Outcomes Reporting Central Iowa Community Services receives a monthly occupancy report from PROVIDER by the 10 th working day of each month. PROVIDER staff and service coordinators log dates of contact and transfer of data. CICS and PROVIDER meet quarterly to review the program. Effectiveness of discharge from the program is tracked by the CICS Compliance Officer. Performance indicators include re-entry into the program, community tenure, arrests, etc. 9