Request for Proposal
To Provide Residential Treatment Facility Services for Adults
Within the Mayview Regional Service Area
Statement of Purpose
The counties of Beaver, Greene, Lawrence, and Washington are seeking a qualified
provider to develop and implement a Residential Treatment Facility for Adults (RTFA)
within their four-county region. These counties, along with Allegheny County, are
involved in the current Mayview Regional Service Area Plan (MRSAP) initiative which
will result in the closure of the Mayview State Hospital (MSH). Allegheny
HealthChoices, Inc. (AHCI), on behalf of the MRSAP counties, is issuing this Request
for Proposals (RFP).
The desired RTFA will be a 12-14 bed facility providing highly structured therapeutic
residential mental heath treatment services for individuals 18 years and older. It will
accept individuals on a voluntary and involuntary basis, and serve as an inpatient
diversion and acute stabilization option for adults who are being considered for referral to
the state hospital system or are at imminent risk of community hospitalization. It is
preferred that this is a non-hospital based facility.
Qualified providers shall be licensed as an RTFA in accordance with the requirements
within the attached Pennsylvania Department of Public Welfare’s License Application
Package for Residential Treatment Facilities for Adults and the Residential Treatment
Facilities for Adults On-Site Survey Report. Qualified providers shall also meet the
accreditation standards set forth by The Joint Commission (formerly the Joint
Commission on Accreditation of Healthcare Organizations - JCAHO) – please refer to
their web site for additional information - http://www.jointcommission.org/.
Background
Over the past two years, the MRSAP counties have been working in collaboration with
numerous stakeholders on the development of a plan to enhance community services and
supports. These enhanced community services and supports will enable residents of
MSH to permanently return to their home communities, as well as help other individuals
avoid admission to the state hospital. This planning and service development effort is
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MRSAP Request for Proposal - Residential Treatment Facility for Adults
being enhanced as a result of the Department of Public Welfare’s (DPW) announcement
of the closure of MSH effective December 31, 2008. (Please see the MRSAP website –
www.mayview-sap.org for additional information.)
Residents of the hospital are participating in an individualized assessment and discharge
planning process, known as the Community Support Plan Process (CSP). To date, over
110 individuals have been discharged and beds have closed following their discharge. As
these individuals have been discharged, all counties have aggressively been developing
new services and supports to facilitate individuals returning to the community and to
facilitate the diversion of individuals who might otherwise have been admitted to MSH.
New service development across the region and within individual counties includes
community treatment teams or assertive community treatment approaches; peer support
programs; enhanced crisis systems; small, comprehensive personal care homes;
permanent, supported housing; mobile medication, drop-in centers; one-to-one in-home
support and numerous other services and supports.
The closure plan calls for 150 individuals to be discharged and 150 beds closed by June
30, 2008; the remaining 75 individuals will be discharged and the hospital closed by
December 31, 2008.
The MRSAP counties intend to develop sufficient treatment-based structured residential
capacity in order to best serve the individuals discharged from MSH, as well as those
individuals who might have otherwise been referred for admission to the state hospital.
Recovery Orientation
The provider of the RTFA will be expected to provide services in a recovery-oriented
environment with a focus on strong integration with community service providers,
involvement of peers in the program milieu, and strong collaboration with the natural
support systems of consumers - especially their families. In accordance with the
philosophy of the DPW and the MRSAP counties, the RTFA must be guided by
Community Support Program and Recovery Principles as follows:



Consumer Centered/Consumer Empowered
Culturally Competent
Meet Special Needs
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MRSAP Request for Proposal - Residential Treatment Facility for Adults






Utilize Community-Based Natural Supports
Flexible
Coordinated
Accountable
Strengths-based
Home-like, and not institutional
Program Requirements/Goals
This program will assist individuals by providing needed acute stabilization services in a
safe and secure residential placement, and will serve as an appropriate alternative to state
or extended community-based inpatient hospitalization. Another goal of the program is
to reduce inpatient days and inpatient recidivism by diverting individuals from an acute
or extended hospitalization.
In collaboration with the individuals and their professional and informal supports, the
program will facilitate a timely discharge and transition into other services or appropriate
home setting as quickly as possible. The program will assist in the development of a
coordinated recovery plan supporting the individual in the least restrictive environment
with the least amount of stress and the appropriate level of support. The RTFA is also
expected to provide behavioral health interventions that are evidence-based in order to
enhance progress in treatment and recovery.
Additional core services of the selected RTFA program will include the following:


Immediate admission to the program upon receipt of an appropriate referral
A complete initial screening and comprehensive assessment within 24 hours of
admission

Development of a comprehensive treatment plan with the member and his or her
family, within 72 hours of admission
Daily assessment of mental, physical and functional status and a determination of
the level of staffing/support necessary to further progress toward goals
Collaboration with the member’s entire support team and with crisis service
providers within the County
Response to immediate case management needs as well as linkage to ongoing
case management services



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MRSAP Request for Proposal - Residential Treatment Facility for Adults







Daily availability of treatment services, including individual and group therapy, as
well as pharmacological treatment
Family meetings available at least twice weekly
One-on-one staffing available
Emergency evaluation services by medical personnel
Supervision of activities of daily living available 24 hours a day
Outreach stabilization assistance to members for at least 30 days after discharge.
Linkage and coordination with other community providers
The RFP Process
Proposals will be evaluated and selected through a competitive bid process. The MRSAP
counties, Community Care, Value Behavioral Health-PA (VBH-PA), and AHCI will
establish a proposal evaluation committee whose members shall have no conflict of
interest with any respondents to this RFP.
Timeline/Key Dates

March 31, 2008
RFP is released
April 7, 2008
Bidder’s Conference held at AHCI
April 16, 2008
Letters of Intent to Respond to RFP due
May 2, 2008
Proposals Due
May 5, 2008 (week of)
Proposals Reviewed by Evaluation Committee
May 12, 2008 (week of)
Interviews with Applicants if necessary
May 19, 2008 (week of)
Notification to successful provider
August 8, 2008
Program will start accepting referrals
Dates are subject to change
Bidders’ Conference
AHCI will hold a bidders’ conference on behalf of the counties, Community Care, and
VBH-PA. The bidders’ conference will be held on Monday, April 7, 2008 from 1:00 PM
– 3:00 PM at the Pittsburgh Airport Marriott located at 777 Aten Road, Coraopolis, PA
15108.
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MRSAP Request for Proposal - Residential Treatment Facility for Adults
Interested parties are asked to RSVP to the RFP Project Manager with the name(s) of the
people planning to attend by noon on Friday, April 4, 2008. We ask for a maximum of
two representatives from each organization.
It is requested that questions be submitted to the RFP Project Manager in advance of the
bidder’s conference. The Project Manager will accept additional questions after the
bidders’ conference until Wednesday April 16, 2008 - the due date to submit letters of
intent. To ensure all applicants receive the same information, the Project Manager will
collect all questions and disseminate responses to all prospective bidders that submit
letters of intent.
Contact with any staff of the MRSAP counties, AHCI, Community Care, or VBH-PA
concerning this RFP, unless occurring at the bidders’ conference or through the RFP
Project Manager is grounds for disqualification.
Letter of Intent to Submit Proposal
All candidates interested in submitting a response to this RFP are required to mail or
deliver a letter of intent to the RFP Project Manager by 4:00 pm on Wednesday April 16,
2008. Only responses from applicants that have submitted a letter of intent will be
considered for evaluation. The letter of intent should include the following:



Name of the organization(s) involved in the submission.
A statement that the organization(s) intend(s) to submit a response to this Request
for Proposal
Name, title, address, telephone number and e-mail address of the contact person
for this proposal
Submission Deadline
All submissions must be received by 4:00 PM on May 2, 2008. The original and 15
(unbound) copies of the response to the RFP must be submitted. Please include an
electronic file (in Microsoft Word) on diskette with the submission.
Please note that late submissions will not be considered.
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MRSAP Request for Proposal - Residential Treatment Facility for Adults
RFP Project Manager Contact Information:
Matt Koren
Allegheny HealthChoices, Inc.
444 Liberty Ave., Suite 240
Pittsburgh, PA 15222
412-325-1100, ext 7774
mkoren@ahci.org
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MRSAP Request for Proposal - Residential Treatment Facility for Adults
Request for Proposal
To Provide Residential Treatment Facility Services for Adults
Within the Mayview Regional Service Area
Submission Requirements
Applicants are required to submit the following information:
I.
Experience and Skills of the Applicant and/or Partners
A. Skills and Experience of the Applicant
B. Staff Competencies
C. Proposed Partners/Subcontractors
D. Resumes of Key Staff
II.
Program Design
A. Staffing Plan
B. Physical Plan
C. Program Integration
D. Coordination with Physical Health Care
E.
F.
G.
H.
Peer Supports
Clinical Services
Discharge Planning and After Care
Case Studies
III.
Program Implementation
A. Implementation Timetable
IV.
Outcome/Quality Monitoring Plan
V.
Program Budget
In order to be considered responsive to this RFP, the applicant must address the specific
areas in each of the topic areas below. Applicants are encouraged to respond to these
specific qualifications and questions. Responses may be provided in outline or bullet
form as long as they address the points below.
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MRSAP Request for Proposal - Residential Treatment Facility for Adults
I.
Experience and Skills of the Applicant and/or Partners (30 Points)
A. Skills and Experience of the Applicant: Describe your agency’s specific
skills and experience that make your organization a good candidate for
managing the operations of the RTFA. Also describe how your agency will use
these skills in the management and operation of the RTFA. At a minimum,
your response should address the following areas:
1. Your organization’s understanding of the needs of the target
population;
2. Your organization’s relationship(s) to VBH-PA and Community Care
as the behavioral health managed care organizations in the area;
3. Your organization’s experience with hospital diversion and hospital
step-down services.
B. Staff Competencies: Describe what types of skills/competencies the staff of
the program need to possess in order to effectively operate the RTFA.
C. Proposed Partners/Subcontractors: Identify and describe the role of
proposed partner(s)/subcontractor(s) will play in the management and
operations of the RTFA. In this discussion, clearly describe what skills and
experience that the partner(s) will bring to the program in order to strengthen
your overall ability to manage the program. Describe in detail how your
agencies will manage the relationship with the partner(s) (i.e. development of a
MOU, quarterly operational meetings, performance standards/measures) to
ensure the provision of services and the effective coordination of program
activities.
D. Resumes of Key Staff: Please provide the professional resumes of key staff
members
that
will
be
assigned
the
responsibility for
the
implementation/operations of the RTFA.
II.
Program Design (35 Points)
Understanding of the Program: To assess your understanding of the program and
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MRSAP Request for Proposal - Residential Treatment Facility for Adults
how you will coordinate services and resources, please respond to the following
scenarios:
A. Staffing Plan: Describe your organization’s staffing plan for the RTFA.
Include: a table of organization for the RTFA that also reflects the reporting
responsibilities within your larger organization, staff positions and
qualifications for each position, staffing plan/pattern, staff initial and ongoing
training plan, and staff supervision requirements.
B. Physical Plan:
Describe the physical space/floor plan to be used for this
program, as well as how the location of the program will facilitate community
integration and people’s access to the community. Include pictures of the site or
properties under consideration. (Note, the counties prefer single room
occupancy for this program.)
C. Program Integration: In order for the RTFA services to be effective, the
counties expect the RTFA provider to coordinate its services internally as well
as collaborate with each person’s family, natural supports, and existing clinical
team. Describe the strategies and systems that you would establish as the RTFA
provider to foster and strengthen integration and coordination both internally
and externally.
D. Coordination with Physical Health Care: Describe how the RTFA program
will address people’s physical health needs as well as mental health and
substance abuse issues.
E. Peer Supports: Describe how your organization envisions utilizing peer
supports and recovery principles in the RTFA.
F. Clinical Services: Describe strategies that the RTFA program will employ to
engage people receiving services.
Include a description of daily
activities/treatment.
G. Discharge Planning and After Care: Describe your organization’s philosophy
on discharging planning and after care and how you will operationalize this
within the RTFA.
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MRSAP Request for Proposal - Residential Treatment Facility for Adults
H. Case Studies: Using the two case summaries below, please provide a short (no
more than two pages per case study) summary of how you would envision
serving these individuals in the RTFA.
1. Case Study #1
Janet is a 60 year old single, African American female; with a diagnosis
of chronic paranoid schizophrenia; a history of addictions and IV drug
use; history of repeated inpatient hospitalizations and outpatient service
use. She has a lengthy history of involvement with the mental health
system with previous community inpatient and Mayview admissions.
She had been at Mayview for 11 months and was discharged in early
2006, although she has not been engaged in community-based treatment.
She has multiple medical problems: hypertension; GERD; irritable
bowel syndrome; history of seizures.
Janet was admitted from a CRR where she had resided for approx six
months. During that month she eloped three times; she has been
irritable, reclusive, verbally aggressive, and has had one-on-one support
at times. She left the CRR four days before this psychiatric admission to
live with an old boyfriend with whom she had been out of touch for
several years. He called the police who took her to the hospital.
She has been on the acute care unit for 55 days and is being referred to
an RTFA for intensive treatment within a structured residential
placement. Upon the current admission, she was generally not
cooperative and provided very little information. Subsequently daily
progress notes indicate an ongoing high level of delusions and she
continues to be extremely symptomatic. She seems to suffer from both
auditory and visual hallucinations in the context of her delusions. She
has been accepting of Zyprexa with out any side effects.
2. Case Study #2
Becky is a 43 year old, single Caucasian female who was admitted to
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MRSAP Request for Proposal - Residential Treatment Facility for Adults
acute care approximately 30 days ago. She has a diagnosis of Paranoid
Schizophrenia and alcohol abuse. She has an 18 year old daughter who
brought her to ER when a bartender called to say she was threatening,
bizarre, etc. The daughter provided most of the information upon
admission and continues to have contact with Becky.
At the time of admission, Becky was homeless and probably surviving
through prostitution. The most recent progress notes indicate she does
not plan to remain sober after discharge. The progress notes indicate
that Becky is isolative; disheveled in appearance, disorganized in
thought; polite and cooperative with no dangerous behaviors; ongoing
delusions of persecutory and/or grandiose nature; episodic auditory
hallucinations receives commands from God and TV; history of poor
treatment compliance. Becky has been referred to an RTFA because the
inpatient unit is reluctant to discharge her since she will not commit to
remaining sober.
III.
Program Implementation (15 Points)
A. Implementation Timetable:
Describe your organization’s strategy for
seamlessly implementing the RTFA. Provide a detailed implementation plan
that includes activities, staff responsible, and timeframes for the
implementation. In your response, please address how your agency intends to
phase the start-up activities.
IV.
Outcome/Quality Monitoring Plan (10 points)
Please describe your quality management approach and how findings will be used
to enhance or improve the quality of services, including the use of consumer
satisfaction surveys. Please describe how you will measure the outcomes of the
program.
V.
Program Budget (10 points)
Please provide a detailed budget for this program, including start-up and annual
operating costs on the budget sheet included with this RFP. A narrative that
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MRSAP Request for Proposal - Residential Treatment Facility for Adults
explains budget assumptions should accompany the budget sheet. Candidates that
do not use this budget sheet will be disqualified.
It will be the intent to enroll this program in the HealthChoices program; please
indicate your estimate of revenue based on HealthChoices participation as a
percentage of utilization. Non HealthChoices clients will be paid for by the
counties. Community Care and VBH-PA will serve as the gatekeeper for this
program based on current planning, although this is subject to change.
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