Request for Proposal FOR SCHOOL-BASED THERAPY SERVICES MAY 1, 2018

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Request for Proposal FOR SCHOOL-BASED THERAPY SERVICES MAY 1, 2018 This solicitation should not be interpreted as a contract (implicit, explicit, or implied), nor does it imply any form of agreement to any potential candidate. In addition, no inference should be made that Trillium will purchase and/or implement in the future any of the programs or services proposed by the respondents. 201 West First Street Greenville, NC 27858-1132

Table of Contents EXECUTIVE SUMMARY... 3 GENERAL/BACKGROUND INFORMATION... 3 SCOPE OF WORK... 3 COMPLIANCE... 4 TIMELINE/SCHEDULE REQUIREMENTS... 5 APPLICATION SUBMISSION INFORMATION... 5 ELIGIBILITY REQUIREMENTS... 5 FORMATTING REQUIREMENTS... 6 REQUIRED PROPOSAL COMPONENTS... 6 PROPOSAL EVALUATION INFORMATION... 8 ADMINISTRATIVE INFORMATION... 8 TRILLIUM CONTACT INFORMATION... 9 FOR QUESTIONS ABOUT THIS RFP CONTACT:... 9

Page 3 of 10 EXECUTIVE SUMMARY Trillium Health Resources is a Local Management Entity (LME)/Managed Care Organization (MCO) that oversees publicly funded behavioral health, substance use, and intellectual/developmental disabilities for 25 counties in Eastern North Carolina. The mission of Trillium Health Resources is Transforming lives of people in need by providing them with ready access to care. The primary purpose of this RFP is to establish school-based services for the upcoming school year 2018-19 to address the treatment needs of children and adolescents, through co-locating a MH/IDD/SU clinician in each of the school systems for each county identified. This RFP will develop a network that will provide eastern North Carolina counties with a connection to care within the System of Care. The clinician working in each school system would be identified as a local contact. The clinician will provide assessments, groups, individual, and family services to school age children and adolescents within their assigned school district. The intent of this RFP is to develop the ability to provide culturally competent treatment that consists of individual, group, and family services to school age children and adolescents. This service will also refer to other needed services/agencies if deemed appropriate. GENERAL/BACKGROUND INFORMATION There has been a need identified to provide assessment and outpatient treatment services to students in several school districts. Trillium Health Resources will support the expansion of services to this region with Medicaid funding. No startup funding is available related to this RFP. Trillium Health Resources will work closely with the selected provider(s) to ensure services are being provided as clinically indicated. The provider will be subject to monitoring by Trillium Health Resources Network staff, and may be subject to additional reviews as needed. SCOPE OF WORK The primary purpose of this RFP is to meet a need for School-Based Therapy Services in the following counties: Brunswick, Carteret, Chowan, Columbus 1, Craven, Gates, Hertford, Jones, Nash, New Hanover, Northampton, Onslow, Pender, and Washington counties. Providers may apply to provide services in one or more of the counties listed above, but no other counties than those listed above may be targeted for this RFP. The target populations for the services to be offered are school age children and adolescents with mental health and/or substance use disorders, and/or intellectual or developmental disabilities. Services will include: Outpatient Therapy. 1 Note: Columbus County will become part of the Trillium region effective July 1, 2018.

Page 4 of 10 Trillium Health Resources is seeking the following: Implementation of Evidence-Based Practice Models Capacity to develop relationships with the school system in order to co-locate services within the school settings Adherence to all rules and regulations Access to services for all eligible members The following questions will require answers in your Agency s RFP response: Is your agency currently contracted with Trillium Health Resources? Is your practice enrolled in NC TRACKS? Please describe what steps you will take, including adhering to the aggressive timeline, to implement the components of a School-Based Therapy Services program for the identified children and adolescents. What evidence-based practices will be utilized? Describe anticipated capacity per school per week. Describe how staff will collaborate with MCO staff and the school system. Describe your organization s use of an Electronic Health Record. COMPLIANCE The selected provider MUST agree to: 1. Complete steps to demonstrate readiness to begin service provision effective August 1, 2018: a. Obtain equipment needed for provision of services 2. Provide weekly updates on progress to the Trillium Development Coordinator until the project is complete and service provision has been implemented. Updates are to be provided via email to the Development Coordinator. 3. Comply fully with the following: a. Clinical Coverage Policy 8C Outpatient Behavioral Health Services Provided by Direct-Enrolled Providers b. APSM 45-2: Records Management and Documentation Manual c. APSM 95-2: Clients Rights Rules in Community Mental Health, Developmental Disabilities and Substance Abuse Services d. 42 CFR, Part 2 e. HIPAA f. Any applicable local, state, and federal regulations g. The Trillium Health Resources Benefit Plan h. Submission of TARs and claims in accordance with the State and Medicaid Benefit Plans i. The Trillium Health Resources Provider Manual

Page 5 of 10 j. Service documentation must be through an industry standard Electronic Health Record (EHR) or Electronic Medical Record (EMR) system capable of HL7 data exchange. Eligible providers must fully comply with North Carolina Health Information Exchange Authority (NCHIEA) Healthcare provider information exchange guidelines and implementation timelines documented here https://hiea.nc.gov/. If the selected provider is unable to comply with the contract requirements, Trillium Health Resources has the right to cancel the contract for default and hold the provider liable for dollars spent and for the increased costs of obtaining substitute goods or services elsewhere. TIMELINE/SCHEDULE REQUIREMENTS Question & Answer (Q&A) Submission Deadline Send via e-mail to: Jennifer Clapton@TrilliumNC.org; Insert 5/10/18 Questions RFP School-Based Therapy Services in email subject line Q&A results posted on Trillium Website 5/18/18 Proposal Submission Deadline 6/29/18 RFP Award Notification 7/15/18 Date work to begin (projected) 8/1/18 ***All timelines are tentative and subject to change. APPLICATION SUBMISSION INFORMATION Applications will be received until 5:00pm June 29, 2018. Proposal may be mailed or emailed. Please send to: Jennifer Clapton, Development Coordinator Trillium Health Resources 3809 Shipyard Blvd. Wilmington, NC 28403 Email: Jennifer.Clapton@trilliumnc.org ELIGIBILITY REQUIREMENTS Selected provider(s), if contracted, must be in good standing with Trillium Health Resources. Must be willing to co-locate within existing school systems for the following counties: Brunswick, Carteret, Chowan, Columbus, Craven, Gates, Hertford, Jones, Nash, New Hanover, Northampton, Onslow, Pender, or Washington counties. In-network providers will receive preference for this RFP. Must deliver an evidence-based model

Page 6 of 10 Must have the capacity to provide or arrange for transportation when needed for members and families to participate in treatment. Must be able to provide for or arrange linkage to primary care and psychiatric services when needed. Selected provider must adhere to all requirements set forth in: Clinical Coverage Policy 8C - Outpatient Behavioral Health Services Provided by Direct-Enrolled Providers Selected provider must adhere to all regulatory requirements listed in the above Compliance section. Providers who deliver day treatment are not eligible to apply. FORMATTING REQUIREMENTS Trillium s goal is to review all proposals. However, this goal must be balanced against Trillium s obligation to ensure equitable treatment of the received proposals. For this reason, Trillium has established the following formatting requirements. If you do not adhere to these requirements, your proposal will be screened out and returned to you without review. Any attachment pages must be typed in black, double-spaced, 12pt Times New Roman font, with 1 margins. Any specified page limits cannot be exceeded. Applicants must use the sections/headings listed under Required Proposal and place the required information in the correct section. Black print should be used throughout your application, including any charts and graphs. Materials with printing on both sides will be excluded from review. Attached pages should be clearly labeled and numbered consecutively from beginning to end so that information can be located easily. REQUIRED PROPOSAL COMPONENTS Face Sheet - organizational information such as legal name, employer/taxpayer number, address, contact information for leadership, etc. Cover Letter (Attachment A) Summary of proposed project and intent to submit proposal Summary description of strategy/plan and how it meets project goals and measurable objectives Letter must be signed by an officer of the company Project Narrative including all 3 sections listed below and supporting documentation, as needed (insert # of characters or pages under each Section) Section A: Company/Organizational Information

Page 7 of 10 Description of the company and its professional history as it relates to the services sought under this RFP. Description of services to be offered and method of access/referral. What evidence-based practices will be utilized? Describe anticipated capacity per school per week. Describe how staff will collaborate with MCO staff and the school system. Describe your organization s use of an Electronic Health Record. A Letter of Support from the School Superintendent and/or Principal where services will be co-located. A Letter of Support from the Mobile Crisis Provider in the area you are proposing to serve. A Letter of Support from the County Manager in the area(s) you are proposing to serve. Licensing and/or bonding information. Complete copies of the organization s last fiscal year s financials including the audit opinion, the balance sheet, statements of income, retained earnings, cash flows, management letters, and the notes to the financial statements OR If independently audited financial statements do not exist, the provider(s) should state the reason and submit sufficient information to be evaluated. Section B: Project Plan Description of what is being proposed and how it will be accomplished as related to the intent of the RFP and performance measures identified. Schedule/timeline for the service or project, which will serve as the basis for monitoring progress and adjusting activities as necessary, including: All activities required to accomplish the key objectives of the project Target dates for the proposed activities, where appropriate Information on the proposed start and completion dates of the key objectives and activities The timeline form should be completed within this section. Technical Specification: Include any equipment, software, facility impact, etc., if applicable Installation and Maintenance plans, if applicable Project Management, including Performance Management and Security/Fault Management, if applicable Education/Training and Supervision Section C: Personnel Provide comprehensive chart of personnel positions for the project/service, including the CEO any other executive/leadership positions, to reflect the role of each position, their level of effort, and qualifications.

Page 8 of 10 Personnel charts for any subcontractors used, if applicable. Personnel charts may be submitted as attachments, labeled, and paginated. PROPOSAL EVALUATION INFORMATION All proposals will be reviewed for compliance with the mandatory requirements stated within the RFP. Proposals deemed non-compliant will be eliminated from further review. The Trillium Development Coordinator (or appointed person) may contact the Provider(s) for clarification of any response. Responsive proposals will be evaluated on the factors that have been assigned a point value. The proposal will be reviewed and scored according to the quality of your response to the requirements in Sections A-C. The responsible Provider(s) with the highest score(s) will be selected as a finalist or the finalist based upon the proposals submitted. Finalist Provider(s) may be asked to submit revised proposals or make a presentation for the purpose of obtaining best and final offers. If so, points will be recalculated accordingly, and points awarded will be added to the previously assigned points to attain final scores. The responsible Provider(s) whose proposal is most advantageous to Trillium, taking into consideration the evaluation factors, will be recommended for contract award. Please note, however, that a serious deficiency in the response to any one factor may be grounds for rejection regardless of overall score. It is Trillium s intent to award this service to the most qualified applicant, though Trillium reserves the unlimited right to not make an award based upon this RFP. Recommendations are made to Executive Management who has the final decision-making authority. ADMINISTRATIVE INFORMATION Award Notices All organizations will receive notification from Trillium when awards are determined via Trillium s website. Administrative Requirements The organization awarded the RFP must comply with all terms and conditions of the awarded contract. These terms and conditions will be provided in the award contract for signature. The awardee will be held accountable for the information provided in the proposal relating to performance targets. Trillium will consider the organization s progress in meeting goals, objectives, and schedules based on the contracted criteria. Failure to meet stated goals, objectives, and

schedules may result in suspension or termination of the contract, or in reduction, withholding, and/or repayment of funding. Page 9 of 10 TRILLIUM CONTACT INFORMATION For questions about this RFP contact: Name: Jennifer Clapton Position: Development Coordinator Address: 3809 Shipyard Blvd, Wilmington, NC 28403 Phone Number: 1-866-998-2597 Email Address: Jennifer.Clapton@TrilliumNC.org

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