1 YUROK TRIBE REQUEST FOR PROPOSAL & QUALIFICATIONS (RFP & RFQ) Mental Health Clinician (LCSW or MFT) to provide clinical expertise to the Department/Program strategic planning process, and inform culturally-appropriate approaches to children s health and wellness program development Bid Release Date: December 23, 2013 Bid Closing Date: January 24, 2014 Bid Contact Person: Allyson McCovey, Circles of Care Program Manager Phone: (707) 445-2422 ext 1206 Email: allyson@yuroktribe.nsn.us Introduction: The Yurok Social Services Department requests bids from qualified consultants (LCSW or MFT) to assist in the Yurok Tribe s strategic planning process for development of a comprehensive Yurok children s mental health system. The consultant will be providing technical support to the Circles of Care (CoC) year 3 objectives. CoC is in the third year of a 3 year planning grant focused on the mental health and wellness of Yurok children and their families and is funded through the Substance Abuse and Mental Health Services Administration (SAMHSA). Circles of Care provides the Tribe with the opportunity to plan services and programs to support tribal children by listening and gathering information from the community to determine the needs and shape the future of service delivery. Circles of Care gives the Tribe s families and youth a voice to determine how the mental health needs and other wellness challenges of the children and youth are to be met in our communities. 1
2 Scope of Work: The purpose of this contract is to increase the capacity of the Circle of Care project and enable the program staff with identifying future service delivery that could be administered by the Yurok Tribe. The Mental Health clinician(s) contractor is expected to complete the following tasks: Outreach to build relationships with service providers and agencies including school districts/stakeholders located in the Northern California region and provide technical support to CoC project staff in crafting MOUs with these partnering agencies that reflect the process for referrals; legal obligations of partnering agencies that provide service to our tribal members to ensure that the Mental Health and Wellness needs of our tribal member children and their families are met. Consultant will provide recommended solutions to the identified mental health service gaps including access to culturally appropriate assessment, treatment and follow-up mental health care for American Indian children and families. Help to provide training on culturally competent mental health service development, strategic planning, and training of staff/partnering agencies that provide services to our tribal member children and their families. Supervision and participation in implementing pilot project that will create a process for easily accessible and comprehensive services to tribal member children and their family. Provide technical assistance with building capacity to incorporate third party billing and to navigate a plan for the changes of services provided brought on by Affordable Care Act. The Yurok Tribe has adopted a Tribal Employment Rights Ordinance ( TERO ); all bidders must comply with the requirements set forth in the TERO, including all applicable taxes, forms, and hiring practices. This project will be subject to a ½ of 1% TERO fee. See attached TERO Policy for additional information. Bid Requirements: The proposal must be submitted to the Yurok Tribe Social Services Department in Klamath, California by 3:00 p.m. (P.D.S.T.) on January 24, 2014. All bids must be submitted in a sealed envelope clearly marked on the front of the envelope with: 2 PO Box 1027 Klamath, CA 95548
3 Each Proposal Must Contain the Following Elements: Qualifications: (75 Points) Attach resume and work experience, including professional licenses and certifications (25 Points) Statement of Qualifications Questionnaire (See below) : (25 points) Project references and descriptions of two most recent comparable projects; include project owner and contact information, project location and project description (15 Points) Documentation of Federally recognized Tribal member (10 Bonus Points) Rate Schedule: (25 Points) Please attach a rate schedule that includes hourly rate of the bidder and provide estimates all associated costs, including, travel, equipment, report production and reproduction costs, etc Fees for the requested service(s) will be reimbursed on a time- and-materials, not-to-exceed basis. Firms are required to submit a rate schedule for all personnel that would bill to the project. Non-Collusive Affidavit (See Attached) Statement of Qualifications Legal Name of Bidder: 3
4 Are you a member of a federally recognized Tribe or married to a Federally recognized Indian?. If yes attach documentation verifying enrollment and/or marriage certificate. What is your educational background? Do you have experience working in the Yurok or other Native American communities? If Yes, specifically describe the type of work along with dates: Describe your experience in developing and providing mental health services. Give examples of practices, frameworks, and approaches that you have been trained in or used. Describe your experience with evaluation. Describe specific experience with community based evaluation. Have you ever been subject to an administrative sanction issued by any department or agency of the Federal Government? Yes No 4
5 If Yes, complete: Name of Person/Business Date of Action Type of Action Department or Agency Have you ever been subject to a judgment of any court or administrative sanction (Federal, State, or Tribal)? Yes No If the answer is yes to either question, furnish details in a separate attachment. Have you ever been arrested or convicted for any misdemeanor or felony? If yes, provide date, location, and description. Professional References (include name, position/business type, addresses, phone numbers, and emails of at least 3 references): State of ) County of ) 5 NON-COLLUSIVE AFFIDAVIT FORM OF NON-COLLUSIVE AFFIDAVIT AFFIDAVIT
6, being first duly sworn, deposes and says: That he is, the party making the foregoing proposal for bid, that such proposal or bid is genuine and not collusive or sham; that said bidder has not colluded, conspired, connived or agreed, directly or indirectly, with any bidder or person, to put in a sham bid or to refrain from bidding, and has not, in any manner, directly or indirectly, sought by agreement or collusion, or communication or conference, with any person, to fix the bid price of affiant or of any other bidder, or to fix any overhead, profit or cost element of said bid price, or of that of any other bidder, or to secure any advantage against the Owner or any person interested in the proposed contract, and that all statements in said proposal for bid are true. Project Title. Signature Name and title (Signature should be notarized.) State of County of } SS Date Subscribed and sworn to (or affirmed before me on this (Date the Signer personally appeared and signed the document) by (Name of Notary) (Name of document signer (affiant)) Personally known to me or who appeared before me. Proved to me on the basis of satisfactory evidence to be the person WITNESS my hand and official Seal Signature of Notary Public (notary seal) 6