Request for Qualifications (RFQ)
Skagit County Crisis Center and Mobile Outreach Team
A. Summary
Skagit County Community Services and the North Sound Mental Health Administration
(County/NSMHA) are requesting proposals from qualified organizations to:
Manage the Skagit County Crisis Center (Crisis Center) to provide sub-acute
detoxification and mental health crisis stabilization services for up to 11 people at
any given time, and
Provide a Mobile Outreach Team.
The Crisis Center facility is owned by the County and located in Burlington, WA. The goal
of this program is to stabilize individuals in crisis, encourage their involvement in
treatment, and prevent unnecessary hospitalization. The operation of this facility also
includes the provision of room and board and related supports. Maximum stay for clients is
5 days with the possibility of extensions as warranted.
The Mobile Outreach Team (MOT) will be housed at the Crisis Center and will provide
outreach to community settings. Services will be aimed at preventing or mitigating mental
health crises. MOT will consist of two people, a master’s level mental health professional
and a peer counselor, and will provide early intervention and stabilization services. MOT
will provide voluntary services only and will operate Monday through Friday from 1pm to
9pm.
Funding for these services is expected to be available through the term of any agreement
resulting from this request, subject to continued appropriation in the State, County, and
NSMHA budgets. It is the intent to award a contract for services for a two-year term, with
an option to extend the agreement subject to the continued availability of funding.
County/NSMHA may contract with service providers who meet federal, state, and local
requirements as specified throughout this RFQ.
Funding not to exceed $883,500 per year is available for these services. The total
includes annual funds of $365,000 (NSMHA) and $365,000 (County) for Crisis Center and
$153,500 (NSMHA) for Mobile Outreach Team.
Further submission criteria, funding, service provisions and contractual expectations are
described below.
B. Schedule
RFQ Release Date 12/8/2010
Non-mandatory Bidders’ Conference 10-11:30am 12/15/2010
Target date for release of Response to Questions 12/23/2010
Letter of Interest 12/17/2010
RFQ Applications due by 4:30pm 1/7/2011
Interviews TBD 1/14/2011
Award Notification 1/19/2011
Begin Services 3/1/2011
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C. Minimum Qualifications
The County/NSMHA requires that all applicants meet the following minimum qualifications.
Failure to meet each of these minimum standards will result in disqualification. The
applicant shall:
1. Be legally organized according to WAC 388-805, RCW 70.96A, WAC 247, and WAC
246-337 to provide the requested services, and possess a current business license.
2. Be licensed with Department of Health as a Residential Treatment Facility. If the
applicant is in the process of obtaining certification, certification shall be in place by the
commencement date of the contract.
3. Be a Licensed Mental Health Agency (CMHA), per RCW 71.24. If the applicant is in the
process of obtaining licensure, licensure shall be in place by the commencement date
of the contract.
4. Be certified or be in the process of securing certification by the State of Washington
(DBHR), per WAC 388-865, to provide Emergency Crisis Intervention Services, Peer
Support Services and Crisis Stabilization Services.
5. Be certified or be in the process of securing certification by the State of Washington
(DBHR) to provide detoxification services. If the applicant is in the process of obtaining
certification, certification shall be in place by the commencement date of the contract.
6. Provide social detox services, which shall include a Chemical Dependency
Professional (CDP) or trainee under the supervision of a CDP.
7. Carry professional liability insurance in a minimum amount of $1,000,000 per
occurrence and $2,000,000 aggregate.
8. Demonstrate knowledge of substance dependent clientele and of people with other
cognitive disorders in crisis, individuals with mental illness in crisis, and individuals with
co-occurring mental illness and substance abuse disorders in crisis. The successful
applicant will also have documented successful experience with techniques for
engaging people in crisis due to substance abuse, mental illness or co-occurring
disorders, and for facilitating referrals into necessary treatment.
9. Demonstrate experience and quality of services offered.
10. Assure sufficient financial resources to perform the contracted services.
D. Mandatory Requirements
In addition to the service requirements established in this RFQ, applicants must agree to
the following:
1. Meetings and Oversight- Selected service provider will be expected to attend meetings:
a) To provide oversight and to collaborate with treatment providers in order to assist
clients in accessing services. To develop and implement performance outcome
measures.
b) To provide summary presentations as necessary.
c) To provide outreach and education to the community, including law enforcement
and hospitals to assure public awareness and a level of utilization of these
programs.
2. Confidentiality - All client records and information are protected by Federal and State
privacy regulations. No information, which identifies an individual client, will be shared
with any other agency unless the client specifically approves the request in writing or
the release is approved by the County/NSMHA.
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3. Reporting - Successful Applicant will be required to submit monthly reports on project
activity in a County/NSMHA approved format. Reporting will include:
a) TARGET data entry
b) County/NSMHA MHCIS Encounter reporting and monthly and annual reports
A mandatory letter of interest is due on December 17, 2010. This should be faxed to
Skagit County Community Services 360.419.3304. The purpose of the letter of intent
allows the funders to contact the potential bidders if changes or clarifications are made to
the RFQ. A bidder may submit a letter of intent and then choose not to submit a bid.
Letter of interest is attachment 1.
E. Description, Objectives, and Specifications
1. Skagit County Crisis Center
a) The Crisis Center provides an 11 bed blended mental health crisis stabilization and
sub-acute detox residential unit.
i. Client Eligibility and Referral
Individuals considered for admission to the residential unit are at least 18 years
old, are in mental health crisis, or are intoxicated or in withdrawal from alcohol or
drugs, and/or are transferring to or from inpatient treatment. Individuals may
self-refer or be referred by family members. Advocates and community
professionals (including case managers, mental health or substance abuse
professionals, and law enforcement) can make direct referrals.
ii. Crisis Center Services
a. Provide sufficient staffing to operate an adult, voluntary, 11 bed, integrated
mental health crisis stabilization and state certified, sub acute detoxification
program that is staffed 24 hours per day/7 days per week with minimum of
two staff at all times.
b. Promote a recovery philosophy and support people living as independently
as possible in the community.
c. Employ at least 1 FTE of staff who are Certified Peer Counselors and in
recovery from mental illness to promote and support recovery and facilitate
stabilization. Hiring a portion of staff that is in recovery from
alcohol/substance abuse is also encouraged.
d. Be accessible to the community 24 hours per day/7 days per week to accept:
1) Direct admits from the police and other emergency services.
2) Direct admits from MOT, Designated Crisis Responders (DCR), and
outpatient staff with telephone screening.
3) Admissions from hospital Emergency Departments (EDs).
4) Transfers to/from inpatient treatment for up to 10 days.
5) Self and family referrals with telephone screening.
e. Provide for client safety through the monitoring of vital signs, safety checks,
safety contracting, and the implementation of detoxification and crisis
stabilization protocols.
f. Utilize County-funded on call medical consultation 24 hours per day/7 days
per week to assist with screening of potential admits and symptoms of
concern during a client’s stay at the facility.
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g. Implement a screening and admission protocol which is friendly for client
self-referral, agency referral, community referral, law enforcement, and
family referral of clients.
h. Develop discharge plans with clients which link them to the appropriate
resources in the mental health and substance abuse treatment community.
i. Develop relationships in the chemical dependency and mental health
treatment communities to facilitate the transfer of clients to different levels of
care as indicated.
j. Provide for client self administration of psychiatric, detoxification, and other
prescribed medications.
k. Facilitate programming in the facility which nurtures stability and health of all
clients.
l. Provide three meals a day and a minimum of two snack services for all
clients.
m. Facilitate transportation (taxi, bus) for clients for appointments, transportation
from EDs, etc.
n. Provide adequate custodial services and supplies for the facility.
o. Provide room and board for up to five days with extensions as needed.
p. Provide temporary residence for individuals transferring to or from inpatient
treatment.
q. Have close coordination with MOT and DCR staff.
r. Provide capability of reporting mental health services into NSMHA’s Client
Information System (CIS) and TARGET.
b) Objectives of the Skagit County Crisis Center
i. Provide rapid and simple admission access to crisis stabilization and social
detox services to assure patient safety without unnecessary utilization of
Emergency Departments. The programs access needs to be closely
coordinated with community, especially hospital emergency departments and
law enforcement.
ii. Improve the delivery of service by integrating social detox and mental health
crisis stabilization services.
iii. Increase public safety by providing short-term mental health crisis stabilization
and social detoxification services, which comply with federal, state, and county
requirements.
iv. Prevent unnecessary psychiatric hospitalizations.
v. Provide services which improve client outcomes.
vi. Develop effective linkages to treatment services and partnerships with other
community organizations.
c) Specifications of the Crisis Center
i. Operations of the Crisis Center include the following:
a. Management of the Crisis Center facility at 201 Lila Lane, including day-to-
day activities of the center 24 hours per day/7 days per week. The County
will provide use of the facility rent-free;
b. Single point of contact regarding program and facility issues;
c. Memoranda of Understanding (MOUs) will be reached with other service
providers as necessary to provide necessary integrated services.
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d. Responsibility for janitorial services and necessary supplies, and the utilities
at the building.
1) Cleanliness and housekeeping of the interior of the building will follow
standards established by the County.
2) The County will be responsible for exterior building maintenance and the
maintenance of HVAC, electrical, and plumbing systems.
e. Minimum Utilization of 80% after three months. If minimum utilization is not
met beds will be paid for on a daily bed rate basis to be determined in the
contract.
f. Miscellaneous provisions:
1) Employ policies and procedures to screen all potential clients for possible
Title XIX eligibility and when applicable, refer eligible clients to the DSHS
Community Services Office to apply for financial assistance.
2) Be prepared to make rapid decisions about acuity and be able to
transition people to services in the community. The applicant will be fully
trained and qualified to make placement decisions along a complete
continuum of care.
3) Integrate the substance abuse and mental health services included in this
RFQ to the extent possible. To that end, establish MOUs with the Crisis
Response Mental Health provider, the local hospitals, and outreach
providers within 60 days of the contract start date. Each MOU should
address integration of services.
4) Coordinate services with other providers and allow service delivery in the
Center to the extent possible.
2. Mobile Outreach Team
a) The Contractor will develop and operate a mental health mobile outreach team
which will:
i. Be comprised of two members, a master’s level mental health professional and
a peer counselor.
ii. Offer a voluntary service (will not read people their rights or conduct involuntary
treatment investigations.)
iii. Provide a majority of its services (>75 %) in homes and community settings and
not in provider offices and emergency departments.
iv. Be fully integrated with the existing Emergency Services system.
v. Be available 5 days a week, between the hours of 1pm to 9pm. Referrals will
come from calls to Volunteers of America (VOA) Care Crisis Line.
vi. Respond to VOA’s telephone calls and pages within 10 minutes.
vii. Provide community outreach as rapidly as possible and within a maximum of 2
hours.
viii. Utilize family, community and other natural supports.
ix. Provide face to face stabilization services that can last up to 4 hours.
x. Develop a recovery oriented stabilization plan with the individual and family.
xi. Report the stabilization plan to VOA Care Crisis upon completion of the
outreach.
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b) Objectives of the Mobile Outreach Team
i. Provide situational assessments which include continuing safety, strength, and
risk assessments, diversion and stabilization options.
ii. Divert people from being hospitalized, unless it is the least restrictive option that
is viable.
iii. Provide support to individuals at risk of experiencing mental health crises.
iv. Promote Recovery and Hope.
v. Encourage stable community living and problem solving.
vi. Refer individuals to the most appropriate resources including:
a. Outpatient and Community Services
b. Crisis Center
c. Urgent Appointments
d. Coordination with existing CMHA and other service providers.
1) Provide consultation to care providers.
2) Provide follow-up to families including phone calls and outreach for up to
7 days.
3) Assist with coordination of emergency medication services.
e. Voluntary inpatient services if no less restrictive plan can be developed
c) Specifications of the Mobile Outreach Team
i. The Team will consist of 2 FTEs
a. The master’s level Mental Health Professional will:
1) Have a minimum of 2 years of experience;
2) Have knowledge and experience with resolving crises;
3) Have a willingness to provide outreach to homes and community settings;
4) Be knowledgeable and experienced with recovery philosophy and
providing recovery-oriented services;
5) Have knowledge and experience in working with children, youth, and
adults;
6) Have knowledge of Wellness Recovery Action Plan (WRAP)
development;
7) Have knowledge of target symptoms for psychiatric medications.
b. The Peer Counselor will:
1) Be certified as a peer counselor;
2) Have knowledge and experience in resolving crises;
3) Have a willingness to provide outreach to home and community settings;
4) Have knowledge and experience in working with children, youth, and
adults;
5) Have knowledge of Wellness Recovery Action Plan (WRAP)
development;
6) Have the ability and willingness to work a minimum of .5 FTE;
7) Have knowledge and experience in recovery philosophy and providing
recovery-oriented services.
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F. Submittal Instructions
1. Each Minimum Qualification, Mandatory Requirement, and item in the Proposal
Evaluation Criteria will be addressed. Organize responses in the same order as the
items are shown in the RFQ.
2. Responses will be prepared simply and economically, providing a straightforward and
concise but complete and detailed description of your ability to meet the requirements
outlined in this document. Emphasis will be on the completeness of content. Single
spacing is allowed. Fancy bindings, colored displays, and promotional materials are not
desired.
3. The response must use standard size type (a font of no less than 12 points) and must
be submitted both on 8.5 x 11 inch white paper and electronically in an MS Word or
PDF format.
4. The complete narrative response must be no longer than 15 pages, not including
budget detail and narrative or attachments.
5. One (1) hard copy of the completed and signed Application Form and one (1) emailed
copy must by received by Skagit County Community Services no later than 4:30 PM,
January 7, 2011. Postmarks are not acceptable. Hard copies may be delivered or
mailed to Skagit County Community Services, 309 S. 3rd St., Mount Vernon, WA
98273. Emailed copies must be sent to Bob Hicks, Resource Manager, Skagit County
Community Services at bobhicks@co.skagit.wa.us; in MS Word or PDF format.
G. Proposal Evaluation Criteria
Applicant contractors will be evaluated by an Evaluation Team that will score the
applications. The County/NSMHA will make recommendations to the Board of County
Commissioners and the NSMHA Planning Committee and Board of Directors based on the
Evaluation Team’s findings. Provider selected must be prepared to provide services
beginning March 1, 2011.
1. Proposal Narrative: A total of 100 points will be awarded for the written response not to
exceed 15 pages in the following categories:
a) Organizational Philosophy (20 points) - Describe your organization’s:
i. Understanding of social detox and mental health crisis stabilization services
including the importance of rapid decision making and transitioning people to
services.
ii. Philosophy regarding treatment of people who are intoxicated, people in crisis,
and people with severe chemical dependence
iii. Philosophy regarding treatment of individuals with mental illness in crisis
iv. Philosophy regarding treatment of individuals with co-occurring substance
abuse and mental illness in crisis.
v. Understanding of any barriers faced by the populations identified in i)-iv) above,
particularly concerning access and retention.
vi. History in mitigating barriers, including agency strengths and limitations.
vii. Policies and overall approach when working with individuals who may be acting
out verbally and/or physically due to intoxication or psychiatric symptomology;
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viii. Admission policies and overall approach when working with individuals who may
be medically compromised due to their mental illness and/or chemical
dependency.
b) Relevant Experience and Ability (20 points) - Describe your organization’s
experience providing services included in this RFQ including the following:
i. Length of time providing similar services.
ii. Working with individuals with mental illness, and behavioral and/or cognitive
disorders.
iii. Working with individuals with substance use disorders.
iv. Working with individuals with co-occurring mental health and substance abuse
disorders.
v. Working with people who are homeless and people involved with the criminal
justice system.
vi. Collaborating with mental health and substance abuse treatment providers.
vii. Providing social detoxification services.
viii. Providing mental health crisis stabilization services.
ix. Making rapid, acuity-based decisions regarding client care.
x. Making placement decisions along a complete continuum of care.
xi. Motivating severely compromised individuals to the next level of care and
promoting hope and recovery.
xii. Conducting discharge planning and transitioning people back into the
community.
xiii. Detoxification procedures which address inclusion of clients receiving
medication to treat substance dependence or for mental health disorders
xiv. Clinical expertise and staffing
a. Summarize the proposed staff including:
1) Staff education and experience
2) Ability to orient and train staff to the standards in this RFQ
3) Number of full time equivalent staff expected in the Center
xv. Describe any challenges your organization may have with providing these
services.
xvi. Licensure or Certification-Respond either Yes or No to the following questions. If
you respond “yes” to either question include an explanation in your response.
a. Has your organization ever had a license or certification to practice
substance abuse or mental health services revoked or suspended by a
licensing or certifying entity?
b. Has your organization ever had a license or certification to practice
substance abuse or mental health services placed on probation by a
licensing or certifying entity?
c) Plan of Operations (20 points)
i. Include in the narrative a summarized plan of operations for the Center that
addresses at a minimum:
a. Behavioral management and de-escalation.
b. Describe your ability to start up services within the required time frame.
c. Transportation between Crisis Center and treatment facilities, EDs, and
DSHS.
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d. Medication storage and administration.
e. Planned recreational and/or educational activities.
f. Safety and Security.
g. Admission policies and procedures, especially around coordination with law
enforcement and emergency departments.
h. Meal and laundry service.
i. Any other operational issues deemed relevant.
ii. Include in the narrative a summarized plan of operations for the Mobile
Outreach Team that addresses at a minimum:
a. Staffing.
b. Philosophy and procedure regarding outreach and engagement as well as
diversion from hospitalization when appropriate.
c. Behavioral management and de-escalation.
d. Promoting Recovery and Hope.
e. Any other operational issues deemed relevant.
2. Budget Detail and Narrative is not to exceed 4 pages (20 points) (See attachment 2)
a) Provide a project budget on the budget form included in the RFQ with a detailed
description of each budget item.
b) Provide names and roles of staff participating in this project, if known.
c) Describe how the budget sufficiently supports the proposed response to the
requirements of this RFQ.
3. Organizational Profile and Capacity (20 points)
a) By responding to this RFQ, your organization is presumed to meet all federal, state,
and local requirements as described throughout this RFQ.
i. Status-Describe your agency’s organizational status (private for profit, not-for-
profit, other).
ii. Attach a copy of your business license, DSHS/DBHR certification to provide
Detox services.
iii. Attach proof of your 501(c)3 status if applicable.
iv. Attach a copy of your Community Mental Health Agency licensure.
v. Attach a transmittal letter signed by an individual authorized to legally bind the
organization to fulfill the RFQ requirements. The letter will include a statement
indicating the legal entity, licensure, and tax status of the organization.
vi. Attach an organizational chart and explain any relationship of your agency to
any parent or sponsoring agency.
vii. Include the names of the members and officers of the Board of Directors (if
applicable) as an attachment.
viii. Attach job descriptions of positions which will provide direct services. If you will
be hiring new staff to perform these services, submit a timeline for hiring.
ix. Attach copies of audited financial statements for the previous 2 years.
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H. Additional Information
1. Exceptions/Deviations-Exceptions or deviations from this RFQ may be negotiated prior
to development of the contract for services, depending on type of exception. Failure to
disclose at the time of proposal submission could result in automatic elimination from
the RFQ process. Any deviation from the description of services and requirements
herein should be declared in the context of your organization’s proposal.
a) Describe exceptions or deviations from the proposed services as described above.
b) Describe any exceptions your organization will request with regard to reporting or
auditing requirements.
c) Describe any exceptions or waivers of certification sought by your agency.
2. Appeals - Applicants may appeal only deviations from laws, rules, regulations, or
procedures. Disagreement with the scoring by evaluators may not be appealed. The
following procedure applies to Applicants who wish to appeal a disqualification of
Application or award of contract:
a) All appeals must be in writing and physically received by the NSMHA Executive
Director no later that 4:00 pm on the fifth (5th) working day after the postmarked
notice of intent to award or disqualification. Address appeals to: Charles R.
Benjamin, Executive Director, North Sound Mental Health Administration, 117 N. 1 st
Street, Suite 8, Mt. Vernon, WA 98273-2858.
b) Appeals must specify the grounds for the appeal including the specific citation of
law, rule, regulation, or procedure upon which the protest is based. The judgment
used in scoring by individual evaluators is not grounds for appeal.
c) Appeals not filed within the time specified above, or which fail to cite the specific
law, rule, regulation, or procedure upon which the appeal is based shall be
dismissed.
3. Questions about this RFQ will be answered at the non-mandatory Applicants’
Conference to be held on December 15, 2010. Questions may also be e-mailed to Bob
Hicks at Skagit County (bobhicks@co.skagit.wa.us) prior to the December 15, 2010
Applicants’ Conference; this is the preferred option. All questions from the Applicants’
Conference will be answered in writing by close of business on December 23, 2010.
4. The County/NSMHA reserves the right to: reject any and all Applications, extend the
Application submission date, amend the RFQ, and waive any irregularities or
informalities in any Applications. The County/NSMHA shall be the sole judges of the
merits of each application.
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Attachment 1
LETTER OF INTEREST FORM
Please type or print all information. Return the completed and signed form to Skagit
County Community Services at 309 So. 3rd Street, Mount Vernon, WA 98273. Forms may
also be emailed to Bob Hicks at bobhicks@co.skagit.wa.us. Letter of Interest Form must
be received by Skagit County Community Services on December 17, 2010. Late or
incomplete forms will not be accepted.
IDENTIFYING INFORMATION
Contractor’s Name ___________________________________________________
Organization’s Name __________________________________________________
Address ___________________________________________________
Street or Box #___________________________________________________
City_________________________ State _______ Zip _________
Phone ______________________ Fax _________________________
Email Address___________________________________________________
Signature below indicates an interest in becoming a contractor for the North Sound Mental
Health Administration and Skagit County and providing the aforementioned consultation
and report. I understand that signing this letter does not bind me to submission of a full
application. All information submitted in this letter of intent is true to the best of my
knowledge and belief. I fully understand that any significant misstatement in or omission
from this application may constitute cause for denial of participation.
_____________________________________________________________________
Name and Title (print or type)
______________________________________________________________________
Signature Date
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