BOSTON PUBLIC HEALTH COMMISSION Bureau of Child, Adolescent and Family Health Division of Violence Prevention Neighborhood Trauma Team Dorchester The Boston Public Health Commission (BPHC) is the local public health department for the City of Boston. Public service and access to quality healthcare is the cornerstone of our mission - to protect, preserve, and promote the health and well-being of all Boston residents, particularly the most vulnerable. August 15, 2018
Monday, August 13, 2018 Request for Proposal Timeline Publication of RFP in the Boston Globe Wednesday, August 15, 2018 Request for Proposal available online at www.bphc.org at 10:00 AM Thursday, August 23, 2018 Friday, August 31, 2018 Wednesday, September 5, 2018 Friday, September 14, 2018 Friday, October 5, 2018 Letter of Intent due by 5:00 PM Questions regarding RFP due by 5:00 PM Responses to questions will be posted by 5:00 PM on www.bphc.org Proposal due by 3:00 PM Notification of Decision The desired date for notification of award to the proposer, BPHC has the discretion to extend this date without notice. The contract(s) results from this RFP shall be in effect when all necessary contract documentation is fully executed by BPHC and awarded vendor(s). Monday, October 22, 2018 Services commence. Date may be subject to change. Page 2 of 30
Overview The Boston Public Health Commission (BPHC) is seeking applications for new partnerships to serve as Neighborhood Trauma Team (NTT) in the Boston community of Dorchester. The NTT will offer a continuum of individual and community response and recovery services that attend to the immediate (0-72 hours), short-term (up to 1 month) and long-term (1 month or more) needs of residents impacted by violence and trauma. Partnerships should be comprised of two (2) organizations at minimum, one of which must be a healthcare provider. The partners that comprise each NTT will work as a team to achieve the full scope of services. Funded NTTs will be part of a larger city system of coordinated response and recovery, and NTTs will partner at all-time points with BPHC, the Justice Resource Institute s Boston Trauma Response Team (BTRT), the Boston Police Department (BPD), Boston Centers for Youth and Families (BCYF), hospitals, other NTTs, Boston Public Schools (BPS), Louis D. Brown Peace Institute, and other community-based organizations. Background and Justification As a result of Mayor, Martin J. Walsh s commitment to improve coordination and care services for residents affected by violence, BPHC conducted a community assessment process May through July 2016, that engaged over 350 individuals, including youth, parents, and service providers, in 14 listening sessions in Roxbury, Dorchester, Mattapan, Jamaica Plain and East Boston. The results of these listening sessions informed this RFP and its requirements for a program to respond to individual and community needs following a traumatic event, by providing: 1. Immediate in-home or community-based services for survivors of violence and their immediate family members and friends; 2. Prompt planning and implementation of efforts to meet community needs for healing, information, and input into response to violent incidents; 3. Connection between residents and availability of behavioral health and related supportive services as needed. Many key themes emerged from the diverse listening sessions as significant elements of an effective trauma response and recovery system. While some of the needs identified by residents cannot be addressed by NTTs alone, all should inform the broader citywide response that will provide the context for NTT activities: Ensure coordination among city and community providers supporting impacted families and communities across the response continuum; Integrate and enhance provision of basic needs resources and specific behavioral health service interventions that are trauma-informed 1 and culturally appropriate to community needs; Provide residents with access to accurate and ongoing information about incidents of community violence in their neighborhood, including safety details and available support services; Ensure staff competency in trauma-informed approaches 2 across city agencies that engage with affected families (i.e. BPD, Boston Public Schools, BCYF, and BPHC); 1 By trauma-informed we mean a multi-level, strengths-based framework that is grounded in an understanding of and responsiveness to the impact of trauma. It emphasizes physical, psychological, spiritual and emotional safety, and creates opportunities for people to heal and thrive. It also recognizes and addresses the impact of racism and other forms of structural violence. (Based on Hopper et al. (2010) Shelter from the Storm: Trauma-Informed Care in Homelessness Services Settings) 2 By trauma-informed approach we mean to operate with an understanding of and sensitivity to the vulnerabilities of people who have been exposed to trauma in order to avoid aggravating those vulnerabilities and thus enhancing resiliency. This is achieved by integrating a set of principles that often require increased awareness and change on Page 3 of 30
Develop opportunities to celebrate the strengths of a community, establish connections within and between families, and provide opportunities to reduce the negative impact of community violence. Definition of Trauma Psychological trauma is caused by distressing events that occur outside the realm of normal human experience. The Diagnostic and Statistical Manual (DSM) of mental disorders defines extreme stressors as violent crime, rape, abuse, natural disasters, and terrorism. For the purposes of this Request for Proposals (RFP), traumatic events are defined as chronic or acute exposure to violence, including being a victim of or witness to: school violence, community violence, or the accidental death or suicide of a youth or child. Communities in Boston that are chronically impacted by the trauma associated with exposure to violence are the same neighborhoods that are disproportionately impacted by the effects of racism, poverty, and poor health outcomes associated with chronic stress. Based on this reality and the input of community respondents at listening sessions, this RFP calls for services to address individual, family and community needs in the immediate aftermath of a traumatic event but also for supports to help those impacted gain access to longer-term health and social services. Current Structure With the support and leadership of the Mayor s office and the Office of Health and Human Services, The Boston NTT Network (BNTTN) began operation in early 2017. The BNTTN includes: the Dorchester Neighborhood Trauma Team (focused on Bowdoin/ Geneva and Greater Four Corners neighborhoods), the Roxbury Neighborhood Trauma Team, the Jamaica Plain Neighborhood Trauma Team, the Mattapan Neighborhood Trauma Team, and the East Boston Neighborhood Trauma Team, as well as the Louis D. Brown Peace Institute and the BTRT. The BTRT serves as the Network s mobile team, providing citywide crisis response services such as on scene psychological first aid, stabilization services and coping groups and short-term clinical case management, as well as back-up to the Neighborhood Trauma Teams when needed and appropriate. The additional team in Dorchester will focus on neighborhoods that are not the focus of the current Dorchester NTT (Appendix 2 pg. 14). Eligible Organizations To be eligible, a team must be composed of at minimum two (2) organizations, one of which must be a healthcare provider with capacity to provide behavioral health services. The healthcare provider must be the Lead Agency (see Lead Agency definition below). At least one of the participating agencies must also have experience in civic engagement, a successful history of working with community residents impacted by violence, and experience partnering with mental health or healthcare providers. Examples of participating agencies that are not healthcare providers include, but are not limited to: grassroots organizations, social service agencies, housing developments, and faith-based organizations. All staff assigned to the NTT should have direct knowledge of the community they are working with and organizations should make every effort to hire individuals assigned these teams who are from and/or reflect the community they are serving. An eligible team may serve more than one neighborhood, but the many levels, including: 1) Understanding trauma and its impact, 2) Promoting physical and emotional safety, 3) Providing voice and choice, 4) Practicing cultural humility, 5) Increasing access to resources, 6) Supporting socialemotional learning, 7) Creating a culture of self-care for providers, and 8) Nurturing positive, empowering relationships. Page 4 of 30
healthcare partner must be based within Dorchester and the team as a whole must be able to clearly document their connection to their identified catchment area. Eligible Events NTTs will be expected to respond to events that involve: 1. Gun related homicide; 2. Any shooting or stabbing incident that impacts more than one victim and/or someone under the age of 18; 3. Any traumatic event that impacts a broader community (examples of which include suicide or the accidental death of a youth or child). Note that these criteria (1-3) apply specifically to the activities described in the scope (below), falling within the immediate and short-term time following an event. Given that residents who are affected by community violence may have had multiple past exposures to violence, these criteria do not apply to the provision of behavioral health care to traumatized individuals. While behavioral health services are part of the overall scope of trauma response and recovery services described here, residents may seek those services at any time based on their own cumulative exposure to violence of any kind. Scope of Services The goal of this RFP is to develop a neighborhood level trauma response and recovery structure by funding an additional Neighborhood Trauma Team (NTT). The funded NTT will establish an on-call system to receive event notifications in their catchment, from BPHC 24 hours a day and 7 days a week. Following receipt of a report, each NTT will offer: (1) individualized services as soon as feasible to family and friends of affected individuals; (2) outreach, community engagement, information and, as needed, referral services for the community as a whole; and (3) behavioral health and related support services to community members of all ages who are vulnerable to lasting adverse effects of exposure to violence. The NTT is meant to work in collaboration with, and support of, existing community efforts and are not intended to replicate or supplant existing services. To ensure coordination of response and recovery efforts and consistency of service provision across neighborhoods, at each step in service delivery each NTT will work with BPHC, BPD, BCYF, BPS, hospitals, survivor support organizations, community-based organizations, other NTTs, and the BTRT. The NTT must establish a core set of services to be offered at the individual and community level. Depending on the type of incident and its impact, services can start anywhere from 0-72 hours to 1-week post incident and ongoing. BPHC worked in close collaboration with the existing funded NTTs and the BTRT to establish protocols related to timing of services across neighborhoods. Required Networking Activities Communication and Collaborative Leadership: As a foundation for the three types of services entailed in this scope, the NTT will be required to: 1) Establish a system to receive incident information 24 hours a day and 7 days a week; 2) Hold or participate in a briefing call within (0-72 hours or up to 1 week depending on the nature of the incident) to coordinate support services for immediate family and friends of affected individuals and the larger community; and 3) Collaborate on service activities and needs during each phase of intervention for each event with BPHC, BTRT, BPD, BCYF, BPS, other NTTs, and community partners. Page 5 of 30
Community Outreach and Engagement: In addition, as a basis for providing required services, the NTT will be required to conduct community outreach efforts to ensure community agencies and resident groups are familiar with the NTT s core services and how to access those services. The NTT will also develop partnerships with key community groups to ensure ongoing communication and support around trauma response and recovery services. BPHC will help facilitate this outreach by providing a tool to help NTT s identify and inventory the community resources in their catchment area. The NTT will develop an engagement and communication plan that includes a process for feedback with its community partners, to ensure the alignment of services and supports at the community level. The NTT will also be required to document communication and collaboration activities throughout the course of each community response. Required Services Individual/family services: Services must be available for individuals and families who are directly impacted by an event. These services must be available in the immediate aftermath of the event or whenever sought by those affected. Services provided by the NTT for these individuals and families will include: Immediate crisis response: clinical and community support services to family and friends impacted by the traumatic event (to be offered within (0-72 hours or up to 1 week depending on the nature of the incident), including: o Psychological first aid o Home and community-based grief counseling Connection to community supports, including resources for the provision of basic needs One-on-one support for individuals and families during community events, vigils, memorial and funeral services Referral to/and or provision of ongoing behavioral health services, including evidence-based clinical models for treating families impacted by trauma, provided by the NTT s healthcare partner. Follow up at 3, 6, 12, and 18-month intervals, and at key time points such as the anniversary of a death, to ensure that immediate needs are met and later emerging needs are identified and addressed. Community Support: Staff from each NTT will establish methods to engage the broader community impacted by an event both in the immediate aftermath of the event and long-term. These community support activities will create a visible community presence to ensure that residents feel connected and informed, ensure widespread dissemination of basic information about the signs and impact of trauma, and make residents aware of the availability of ongoing services to address trauma within the community. Page 6 of 30
Activities conducted by the NTT will include: Outreach and distribution of information in a variety of settings, including door- to-door visits and flyer drops; being present to hand out information or setting up a table in high traffic areas in the community; Scheduling and facilitation of community meetings to provide safety information, debunk rumors about the incident, and offer information about services available to residents; Neighborhood-based healing and psycho-educational sessions for impacted residents. These sessions must be facilitated by a behavioral health NTT staff. Ensuring availability of a safe space or center where residents can come to receive information and support one another; Promotion of community activities that build social connections among residents and focus on the strengths of the community. Examples of these events could include organizing block parties, peace walks, and/or family nights. Additional detail about these activities can be found in Appendix 3 (pgs. 15-17). Ongoing Behavioral Health Services: The healthcare provider(s) offering behavioral health services for the NTT will offer a combination of short- and longer-term evidenced-based trauma treatment models intended for individuals and families impacted by trauma with the goal of promoting positive protective factors, focusing on positive social and emotional development, reducing traumatic stressors, and decreasing traumatic reactions. In addition, the team providing the behavioral health services will provide case management to all clients, navigating referrals for treatment and care to other health and human services as needed. Behavioral health services will be an ongoing resource providing continuity of care for residents impacted by violent or traumatic events, with services available on an on-going basis after the short-term crisis response needs are addressed. Residents will be able to use these services regardless of when a precipitating incident took place and services will be available for as long as community members need support with coping and rehabilitation. Additional detail on behavioral health services can be found in Appendix 4 (pgs. 18-21). I. Structure and Funding of the Neighborhood Trauma Team (NTT): Team Employment Structure: The NTT can be made up of one or more healthcare providers and one or more additional community partner organizations, so long as the full complement of services is provided. The number of partners and the placement of different roles may vary from neighborhood to neighborhood, particularly in regard to the provision of community based/ response services, support during community meetings, and the facilitation of healing sessions. However, it is expected that the division of labor between teams will be such that the healthcare provider(s) will offer evidence based clinical support through all time points as needed and appropriate and the community based organization s (CBO s) role will focus on community response, outreach and engagement, provision of psychological first aid, hosting community meetings and ensuring warm handoffs (facilitated, supported referrals) to clinical staff. Applicants must make clear where responsibility will lie for each identified task, and it is expected all staff funded by this initiative will work as a team. In addition, applicants must be able to articulate how they will provide flexibility for all staff members to accommodate immediate, short and long-term response needs. Page 7 of 30
Lead Agency: The healthcare provider member of the team will serve as the Lead Agency. The Lead Agency will provide fiscal and administrative oversight for the team. This will include but not be limited to: entering into a contract with BPHC, sub-contracting with community partners, team coordination, data collection, and documenting team activities. Coordinate and assure at least monthly meetings that include all team members from all funded organizations. Meetings should be to review active and closed cases and to address any challenges and opportunities related to the day to day functioning of the team. The lead agency will identify one person to serve as the point of contact with BPHC, and their partner agency/agencies. Staffing: All job descriptions for members for the NTT must be approved by BPHC. Sample job descriptions can be found in Appendix 5 (pgs. 22-29). The NTT must be staffed and able to provide the full complement of services within two (2) months of acceptance of the award. The healthcare provider will be expected to retain at least one (1) licensed Behavioral Health Clinician (LICSW, LMHC or equivalent, PhD or PsyD) who will provide recovery and care services for the NTT and one (1) full time Family Partner/Therapeutic Mentor/Community Support Person who will provide recovery services for the Neighborhood Trauma Team. In addition, the lead community partner agency will designate one (1) staff person to be the main point of contact for the NTT working with the healthcare provider and BPHC. BPHC will work with the NTT to train team staff. NTTs are strongly encouraged to hire diverse staff that represents the community they serve. Catchment Area: The NTT will describe the neighborhood and catchment area they intend to serve. NTTs must serve at least one neighborhood and may expand their services to include full or partial areas of geographically adjacent communities. The catchment area must show a high level of need related to gun related violence. Period of Performance: The funding period for this award will be on or about October 2, 2018 through June 30, 2019. Awards beyond June 30, 2019 are subject to the availability of funds. Contracts will be prorated accordingly. Budget: The total annual contract amount for the healthcare provider Agency will be up to $100,000 to support a Family Partner/Therapeutic Mentor/Community Support Person, Clinician and administrative costs associated with this award. The partner CBO will receive up to $47,000 in total to support an onsite staff coordinator to oversee NTT responsibilities for the CBO site as well as support staff time for outreach and engagement. The healthcare provider Lead Agency may choose to share funds allocated to the Lead Agency across more than one healthcare provider. However, one healthcare provider must be the Lead Agency, and fulfill all Lead Agency requirements as described the Lead Agency section of this RFP. Funding for the Community Partner Agency can also be for one CBO or shared among more than one partner CBO. Page 8 of 30
II. Service Documentation and Metrics Data Collection: BPHC will work with the awarded grantees to establish performance measures and benchmarks for productivity and for quality of services provided. Metrics may include: referrals received, services provided including type of treatment modality and length of time in care, referrals made to other service providers, violence exposure type and frequency, number of residents attending community activities, doors knocked, events held, number of consultations provided, change in symptoms over time, satisfaction with care, timeliness of service provision, community knowledge of services, and attitudes towards the services offered. Quality Improvement: In addition to the collection of required performance measures, the NTT will be responsible for participating in quarterly site visits, during which BPHC will review service delivery data and ensure that objectives are being met. This regular review of data will alert program management to any shortfalls in outreach, enrollment, retention, fidelity and other potential barriers to implementation. When challenges and areas for improvement are identified, sites will receive coaching from BPHC to create a quality improvement plan to identify clear aims for improvement and rapidly test changes to address those concerns. Teams will review performance measures with the goal of improving the quality, satisfaction, fidelity, effectiveness and equitable access of program services. Resident Feedback: The NTT must work with BPHC to develop a strategy for gathering resident feedback, at least annually, on the role and impact of the NTT. The NTT must use trauma-informed community engagement models that include facilitated listening sessions, resident surveys, and/or focus groups. Information gathered from community members must be used to inform work and continuous improvement of the NTT. III. Funder s Role and Responsibility: Technical Assistance: BPHC will provide coaching and technical assistance to the NTT and will bring the BNTTN together for required monthly collaborative learning sessions. Sessions will cover: 1) crisis response models; 2) trauma-informed service delivery; 3) evidence-based trauma treatments; and 4) other service supports available to individuals, families and communities impacted by violence. At these monthly meetings, BPHC will also provide an opportunity for presentations by and collaborative planning with providers not funded through this contract, facilitate team discussions on challenges that emerge and potential solutions, and support collaborative development of communication and service protocols. These protocols will build on already established BNTTN protocols and their emerging best practices. All staff funded by or assigned to this initiative are required to attend all monthly meetings. The Boston Public Health Commission will: Provide funding to the grantees; Oversee the larger city funded trauma response initiative and assure collaboration between funded partners; Promote broad public awareness of the establishment of the BNTTN and the availability of services in each community; Ensure strong partnerships and facilitate the development of all communication and operation protocols across BPHC, other city agencies, and community funded partners; Develop and implement training, technical assistance, and performance management systems; Provide collaborative learning opportunities; and Ensure active, accurate, and consistent communication between BPHC and the grantees. Page 9 of 30
Notification of Award BPHC will convene a review board comprised of BPHC staff, members of the BNTTN partner agencies, community service providers and residents from the communities outlined in this RFP. The committee will review all proposals, and make recommendations of funding to BPHC. BPHC at its own discretion will make the final determination of funding for each team. BPHC will notify applicants on or about October 5, 2018. Organizations that receive grants will be required to submit a budget and sign a Boston Public Health Commission standard contract. Inquiry and Submission Process A letter of intent is requested, but is not mandatory, for all interested applicants, no later than 5:00PM on August 23, 2018. Letters can be referred to mvscott@bphc.org with the subject line: Neighborhood Trauma Team Letter of Intent. Questions about this RFP can be referred in writing to mvscott@bphc.org by August 29, 2018 at 5:00 PM. Questions and Responses will be shared with all applicants at the BPHC website under Working with Us RFPs (bphc.org/rfp). Complete a proposal of no more than 20 pages, consisting of double-spaced typed responses to the application questions, and a signed cover sheet. The Letter of Intent for collaboration and partnership from each partner agency will be required as part of the application. Completed proposals must be submitted in triplicate to: Boston Public Health Commission Division of Violence Prevention 1010 Massachusetts Avenue, Floor 2 Boston, MA 02118 All proposals must be received by 3:00 PM on September 14, 2018. There will be no exceptions to this deadline. Please be advised that an application is not considered complete until BPHC provides written confirmation of receipt. Incomplete applications will not be reviewed. Page 10 of 30
Application Grant Application Questions Please provide a written response to the following questions: 1. Provide a map or other visual aid of your team s proposed catchment area and describe the need for this service in that area, including a narrative concerning the prevalence of violence and the impact of exposure to violence. Please include any supporting data on the nature and impact of violence in your proposed catchment area. (5 points) 2. Identify the agencies participating in this team, the role each partner will play towards fulfilling the scope of services and a description of the staffing and supervision structure in place across all partnering agencies. (12 points) a. Briefly describe how the agencies will support employees and accommodate the flexibility needed for those doing the work outlined in this RFP (i.e. responding to and providing support at all three time points [immediate, short, and long-term]; including but not limited to: meeting with an individual and/or family impacted by an incident of violence, community meetings, facilitating or attending community peer support groups, providing outreach and psychological first aid following an event, and consultation to outside community service providers. Please include how you will support staff participation in events during days or times that may not be typical hours of operation for your agencies. Please also include models for providing support for staff following neighborhood events that promote staff self-care and mitigate the impact of vicarious trauma. b. Please include resumes for all staff that will fulfill NTT roles. 3. Describe your team s experience with community engagement, community organizing and providing community support services in diverse neighborhoods and your team s experience providing services in your catchment area. (10 points) 4. Provide a description of the capacity the NTT will have to communicate and collaborate with BPHC, BPD, BCYF, BPS and community partners to provide immediate crisis support, community support services and trauma recovery services to individuals, families and communities impacted by violence. This should include the NTTs capacity to receive incident notifications 24 hours a day, 7 days a week. (12 points) 5. Provide a description of how referrals to short and longer-term trauma treatment services will be coordinated for individuals and families, including services for residents who are not patients of your healthcare partner agency. (10 points) 6. Demonstrate your NTT s ability to conduct tracking of referrals and clients over time and to collect data on reach, engagement, and impact measures. (10 points) 7. Provide a description of existing clinical and community based services offered by your team and how the work of your team will be linked to those services (10 points) 8. Describe how your NTT currently reflects and/or will meet the cultural needs of individuals and families in in your catchment area (e.g. addressing needs regarding age, race, language, gender, immigration status, disability, etc.) (10 points) 9. Provide some examples of trauma prevention, response and recovery services your organization and/or members of your proposed NTT currently offer and how you would link those services into this model. (8 points) 10. Please affirm your commitment to participating in Boston Public Health Commission quality improvement activities and learning sessions such as; monthly meetings, mandatory trainings, interagency working groups and committees. (5 points) 11. Using the format in the enclosed Sample Budget Template (Appendix 1, pg.13), provide a tentative budget proposal for 9 months, to include in the grant budget application. Include names, hours or days of effort, and hourly or daily rates for staff; indirect rate (if applicable, with justification of percentage); and other expected incidental expenses. (8 points) Page 11 of 30
Grant Application Checklist Answer all of the grant application questions Complete budget template (Appendix 1, Pg.13). The budget is not included in the page limit. Provide a map or other visual aid of your team s proposed catchment area. This aid will not be included in the page limit. Proposals shall not exceed 20 double-spaced pages, including agencies coversheet. Application typed in 12-point font. Attach a signed coversheet from the lead agency. An authorized signatory of the 501(C) (3) organization must sign the coversheet. Completed proposal (in triplicate) must be received by 3:00 PM, Friday, September 14th, 2018 at: Boston Public Health Commission Division of Violence Prevention 1010 Massachusetts Avenue, Floor 2 Boston, MA 02118 Page 12 of 30
APPENDIX 1 Provide the following documents (not included in page limit) 1. Using the format in the enclosed Sample Budget Template, provide a tentative budget proposal for 8 months, to include in the grant budget application. Include names, hours or days of effort, and hourly or daily rates for staff; indirect rate (if applicable, with justification of percentage); and other expected incidental expenses. SAMPLE BUDGET TEMPLATE Budget Category Salaries and Wages Budget Justification Amount Requested Fringe Benefits Consultant Costs Supplies Other please specify Direct costs Indirect cost (maximum 20% of direct) TOTAL BUDGET (Sum of direct and indirect costs) Note: The organization may include expenses to cover general indirect costs up to 20% of total direct costs, or the approved administrative overhead, whichever is lower. Page 13 of 30
APPENDIX 2 Page 14 of 30
APPENDIX 3 Scope of Services: Community-Based Organization Provider Funding for the community-based organization provider will support community engagement and outreach efforts both after a specific incident of violence and on an ongoing basis to promote the resiliency of individuals, families and communities impacted by trauma. The Community-Based Organization Provider will: 1) Designate one staff person to be the main point of contact for the Neighborhood Trauma Team (NTT) working with the Healthcare Provider and BPHC. 2) Identify additional staff to support functions of community outreach, engagement and crisis response. Community-Based Organizations may stipend community members or members of other organizations to fulfill this role as long as: a) all staff doing any work for the NTT receive appropriate supervision and support, and b) all staff doing work for the NTT attend all trainings as required by BPHC. 3) Ensure all staff on the NTT receives ongoing supervision and opportunities for support following each event in order to promote self-care and mitigate the impact of vicarious trauma. 4) Address staff rollover in a timely manner. a. No community provider will be without a primary contact that will work with the healthcare partner or community staff person to support community outreach, engagement and crisis response for more than 1 month (30 days). All staff will be required to complete the existing training and meeting requirements. 5) Work with the Healthcare Partner to establish a set of internal protocols including but not limited to; an on-call system to receive incident information 24 hours a day (e.g. a dedicated phone number or email address), coordination of immediate/community/recovery services after an incident of violence, supported referrals for residents in need of clinical services, follow-up procedures, and data collection and reporting. a. Teams will work together to meet all expectation attributed to an incident s classification (Appendix 6, pg. 30). b. Teams will be expected to identify a primary contact for their Neighborhood Trauma Team. 6) Be responsible for planning and implementing a set of outreach services to impacted communities immediately following an incident of violence: a. Provide standardized trauma and health education and up-to-date information about support services through various methods, including: going door-to-door in impacted neighborhoods, being present to hand out information or setting up a table in high traffic areas in the community, and identifying a safe space in the community to hold a drop-in event for residents to receive information and support one another. Page 15 of 30
b. Plan and implement community meetings to provide safety information about an event, debunk rumors about the incident, provide information on services available and trauma and health education, and link residents to short- or long-term care or other health and social services. c. Support community healing or psycho-educational sessions for impacted residents that are facilitated by behavioral health NTT staff. d. Coordinate with Clinician and Family Partner/Therapeutic Mentor/Community Support Person staff of the NTT to offer a menu of crisis response services (a standard set of support services to immediate family and friends of affected individuals immediately following an incident.) Examples of services include: psychological first-aid, home- and community-based grief counseling, a standard strengths and needs assessment to determine the individual/families' existing supports and potential physical and behavioral health needs, referral to burial support services such as the Louis D. Brown Peace Institute, case management and resource navigation to in-house and external short- and longer-term behavioral health services, and other health and social support services. e. Immediate crisis response services offered to families and close friends will be provided by known or trusted sources in the community whenever possible. For each incident the CBO staff will coordinate with the Clinician and Family Partner/Therapeutic Mentor/Community Support Person and the JRI Boston Trauma Response Service to determine the best person(s) within the NTT to provide crisis support services to the identified family members and close friends. Both the behavioral health staff and the CBO staff will be trained in psychological first aid and other crisis support best practices. 7) In collaboration with the Clinician and Family Partner/Therapeutic Mentor/Community Support Person NTT staff, conduct community outreach efforts with other community agencies and resident groups to ensure that they are familiar with the NTT s core menu of services and how to access those services, and develop partnerships with key community groups to ensure ongoing communication and support around trauma response services. 8) Wear designated clothing and other materials provided and required by BPHC. Clothing items and materials are identifiable by the NTT logo, and must be worn by all staff representing the NTT when conducting community outreach or engagement services or when participating in other NTT related activities. 9) Adhere to NTT protocols developed in collaboration with other NTTs, BPHC, the Boston Trauma Response Teams and other city agencies and providers. 10) Conduct a community supports and partnerships inventory using a tool that will be provided by BPHC, and develop an engagement and communication plan that includes a process for feedback with community partners, in order to build relationships and proactively offer services to the community following an eligible traumatic event. 11) Track and report on all community engagement efforts, and participate in data collection and documentation procedures required by BPHC. 12) Establish a set of internal protocols including but not limited to; an on-call system to receive incident information 24 hours a day/ 7 days a week (e.g. a dedicated phone number or email address), coordination of immediate/community/recovery services after an incident of violence, supported referrals for residents in need of clinical services, follow-up procedures, and data collection and reporting. Page 16 of 30
a. Teams will work together to meet all expectation attributed to an incident s classification (Appendix 6, Pg. 30) 13) Teams will be expected to identify a primary contact for their Neighborhood Trauma Team. 14) Fully participate in technical assistance, protocol development, training, and quality improvement efforts for the NTTs. BPHC staff will develop a modified quality improvement model to track the progress of each of the sites and ensure high quality delivery of services. 15) Hold or participate in a briefing call with NTTs and identified partners, within the required time for qualified incidents to coordinate support services for immediate family and friends of affected individuals, as well as the community as a whole. Level 2 and level 3 incidents will require NTT s to assess for impact and to help facilitate identification of other community partners to support community engagement efforts. a. Participate in the development of communication and collaboration protocols with BPHC, Boston Trauma Response Team, other city agencies supporting individuals and families impacted by community violence and service providers; to ensure coordinated trauma services. 16) Provide services to family, close friends and the community impacted by a traumatic event (to be offered within 0-72 hours or 72 hours-1 week depending on the incident classification and expectations assigned to the incident). 17) Collaborate throughout all time-points with other NTT staff, BPHC and City partners. 18) Participate in at least one (1) internal monthly team meeting and learning community where staff can problem solve together, discuss community outreach, work on quality improvement projects, discuss implementation, staff awareness, etc. a. Ensure attendance of staff in any additional training/meetings needed due to special issues/needs 19) Comply with administrative requirements, including: billing for activities each month, reporting of gaps in staffing, and prompt submission of reports required for completion of annual reports and applications. Page 17 of 30
APPENDIX 4 Scope of Services: Healthcare Provider Funding for the healthcare provider will support a Behavioral Health Clinician (LICSW, LMHC or equivalent, PhD or PsyD) and Family Partner/Therapeutic Mentor/Community Support Person teams trained in evidence-based trauma treatment models to deliver short- and long-term recovery services to community members impacted by an acute traumatic event or ongoing trauma exposure. The healthcare provider should be equipped to serve residents of all ages through this effort. However, each healthcare provider can decide which of the three roles (Family Partner, Therapeutic Mentor or Community Support Person) is most appropriate to partner with their clinician and fills the most needed gap in trauma services for their community. The Healthcare Provider will: 1. Establish a subcontract with the community partner agency to fulfill the full scope of services for the NTT. 2. Retain at least one licensed Behavioral Health Clinician (LICSW, LMHC or equivalent, PhD or PsyD) who will provide recovery and care services for the Neighborhood Trauma Team (NTT). The healthcare provider may identify other auxiliary behavioral health team members to support this work. 3. Retain one (1) full time Family Partner/Therapeutic Mentor/Community Support Person who will provide prevention and recovery services for the Neighborhood Trauma Team. It is suggested that it be at least one (1) year since the Family Partner/Therapeutic Mentor/Community Support Person became personally connected to the issue of violence and trauma. a. A Family Partner is a paraprofessional who has relevant lived experience as a parent or caregiver of a child or youth who has special healthcare needs and provides structured support, training, and education to caregivers in home, community and clinic setting. b. A Therapeutic Mentor provides structured, one-on-one, strengths-based support services to youth (under the age of 21) in any setting that the youth resides. Services include supporting, coaching and training the youth in navigating services, in age-appropriate behaviors, interpersonal communication, problem solving and conflict resolution, and learning new skills. c. A Community Support Person provides one-on-one, strengths-based support services to adults. Services include support enhancing daily living skills, coordinating services, meeting basic needs (shelter, food, healthcare, etc), developing crisis plans, and fostering empowerment and recovery. 4. Address staff turnover in a timely manner. No healthcare provider will be without a Clinician and/or a Family Partner/Therapeutic Mentor/Community Support Person for more than three (3) months at a time and all staff will be required to complete all training and meeting requirements. BPHC teams will work with teams to identify training opportunities for new staff. If staff turnover does occur, the healthcare provider will identify another behavioral health staff person to bridge the scope of services until they are able to fill the vacant position. 5. Ensure the Clinician and Family Partner/Therapeutic Mentor/Community Support Person work together as a team to meet the needs of their clients. 6. Identify existing resources and staff to supplement the funded support in order to build out the full complement of required services. Page 18 of 30
7. Ensure Clinician and Family Partner/Therapeutic Mentor/Community Support Person receive appropriate clinical supervision in alignment with the standards afforded to all others within the institution and ensure that the Clinician and Family Partner/Therapeutic Mentor/Community Support Person are allowed the schedule flexibility needed to meet the needs of families and community. a. The Clinician and Family Partner/Therapeutic Mentor/Community Support Person should receive joint supervision. The Clinician should not supervise the Family Partner/Therapeutic Mentor/Community Support Person. b. The Clinician and Family Partner/Therapeutic Mentor/Community Support Person should receive supervisory support following each event in order to promote self-care and mitigate the impact of vicarious trauma. 8. Ensure that the Clinician and Family Partner/Therapeutic Mentor/Community Support Person both have office space within the healthcare providing agency and sufficient access to a private room in which to meet with individuals and families for assessment and follow up visits. 9. Ensure that the Clinician and Family Partner/Therapeutic Mentor/Community Support Person accommodate both internal and external referrals. This includes both patients referred by other NTT staff, community partners, healthcare providers (e.g. primary care provider, pediatrician, etc) as well as community member self-referrals and walk-ins who either receives their care at a different behavioral health providing agency, cannot identify their health insurance carrier, or do not have health insurance. The funding provided here is intended to support the non-billable services that may accrue through this initiative. 10. Establish a set of referral protocols with NTT CBO staff to assure a warm handoff (i.e. a facilitated, supported referral) for residents in need of clinical services 11. Identify and offer a combination of short and long-term evidenced-based trauma treatment modalities for individuals and families. The Boston Public Health Commission emphasizes the use of evidencebased or evidenced-informed trauma mental health treatments by Behavioral Health Providers and will provide training and consultation to support this. 12. Work with the CBO partner to establish a set of internal protocols including but not limited to; an oncall system to receive incident information 24 hours a day and 7 days a week (e.g. a dedicated phone number or email address), coordination of immediate/community/recovery services after an incident of violence, supported referrals for residents in need of clinical services, follow-up procedures, and data collection and reporting. a. Teams will work together to meet all expectation attributed to an incident s classification (Appendix 6, pg. 30). b. Teams will be expected to identify a primary contact for their Neighborhood Trauma Team. 13. Coordinate with CBO NTT staff to offer a menu of immediate response services (a standard set of support services to immediate family and friends of affected individuals immediately following an incident.) Examples of services include: psychological first-aid, home and community-based grief counseling, a standard strengths and needs assessment to determine the individual/families' existing supports and potential physical and behavioral health needs, referral to burial support services such as the Louis D. Brown Peace Institute, case management and resource navigation to in-house and external short- and longer-term behavioral health services, and other health and social support services. a. Immediate crisis response services offered to families and close friends will be provided by known or trusted sources in the community whenever possible. For each incident the Clinician and Family Partner/Therapeutic Mentor/Community Support Person will coordinate with CBO NTT staff to determine the best person(s) within the NTT to provide crisis support services to the identified family members and close friends. Both the behavioral health staff and the CBO staff will be trained in psychological first aid and other crisis support best practices. Page 19 of 30
14. Wear designated clothing and other materials provided and required by BPHC. Clothing items and materials are identifiable by the NTT logo, and must be worn by all staff representing the NTT when conducting community outreach or engagement services or when participating in other NTT related activities. 15. Adhere to NTT protocols developed in collaboration with other NTTs, BPHC, the Boston Trauma Response Teams and other city agencies and providers 16. The Clinician and Family Partner/Therapeutic Mentor/Community Support Person will maintain a caseload of clients, and will make referrals for treatment and care to outside agencies where needed and appropriate. 17. Ensure an external referral process for enrolled clients requiring higher intensity services (i.e. specialty consultation, additional therapy). 18. Establish relationships with victim services agencies in and outside of the neighborhood of the site. Examples include but are not limited to the Boston Area Rape Crisis Center, a domestic violence shelter, the Children s Advocacy Center, the Child Witness to Violence Project and neighborhoodbased organizations with experience working with children, adults and families experiencing trauma. 19. The Clinician and Family Partner/Therapeutic Mentor/Community Support Person will make multiple and varied attempts to follow-up with clients referred to their team. If the first visit is completed, a variety of follow-up methods will be used to ensure a client continues to engage with the Clinician and Family Partner/Therapeutic Mentor/Community Support Person. In addition, despite the length of time a client receives care, follow-up phone calls will be made at minimum at months 3, 6, 12, and 18 months to ensure clients have multiple opportunities to loop back into services if they so desire. Exceptions may be made for clients still actively engaged in services at the time of follow-up. In addition to these regularly scheduled follow-up calls, the Clinician and/or the Family Partner/Therapeutic Mentor/Community Support Person will contact clients during anniversaries, holidays and other significant dates identified by clients to ensure support is being provided during these difficult times. a. Clients who do not complete a first visit with the Clinician and Family Partner/Therapeutic Mentor/Community Support Person, or clients whom the Clinician and Family Partner/Therapeutic Mentor/Community Support Person are unable to contact due to change of number, disconnected number, etc. and whom are patients of the Healthcare Providing agency, will have a note placed in their EMR to ensure follow-up at their next visit. 20. The Clinician and Family Partner/Therapeutic Mentor/Community Support Person will facilitate community healing or psycho-educational sessions both in the short-term after an event, and ongoing, if needed and requested by the community. 21. The Clinician and/or the Family Partner/Therapeutic Mentor/Community Support Person will attend community meetings when appropriate, to be available as a compassionate presence and to share information about available clinical trauma services. 22. Hold or participate in a briefing call with NTTs and identified partners, within the required time for qualified incidents to coordinate support services for immediate family and friends of affected individuals, as well as the community as a whole. Level 2 and level 3 incidents will require NTT s to assess for impact and to help facilitate identification of other community partners to support community engagement efforts. a. Participate in the development of communication and collaboration protocols with BPHC, Boston Trauma Response Team, other city agencies supporting individuals and families impacted by community violence and service providers; to ensure coordinated trauma services. Provide services to family, close friends and the community impacted by a traumatic event (to be offered within 0-72 hours or 72 hours-1 week depending on the incident classification and expectations assigned to the incident). 23. The Clinician and Family Partner/Therapeutic Mentor/Community Support Person will collaborate throughout all time-points with other NTT staff, BPHC and City partners. Page 20 of 30