request for qualificationscdn.trustedpartner.com/docs/library...8/4/2015 6:27:06 pm florida licensed...

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Document Number: 165499 Document Name: RFQ 15-012: Mental Health Counseling Quality Assurance Specialist - General Services/Consulting 8/4/2015 6:27:06 PM

Request for Qualifications

Mental Health Counseling Quality Assurance Specialist

RFQ #: 15-012

Deadline for Responses: 2 PM – September 24, 2015

2300 High Ridge Road Boynton Beach, FL 33426

(561) 740-7000 www.cscpbc.org

http://www.cscpbc.org/

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Table of Contents

SECTION 1: INTRODUCTION .................................................................................................. 3

1.1 WHAT WE ARE SEEKING ........................................................................................................ 3

1.2 THE COUNCIL ......................................................................................................................... 3

1.3 OVERVIEW OF THE CHILDREN’S SERVICES COUNCIL ............................................................. 3

SECTION 2: Mental Health Counseling Quality Assurance Specialist ....................................... 4

2.1 BACKGROUND ........................................................................................................................ 4

2.2 PROJECT GOALS ..................................................................................................................... 4

2.3 SCOPE OF WORK .................................................................................................................... 4

2.4 MINIMUM REQUIREMENTS ................................................................................................... 5

SECTION 3: RFQ PROCESS ...................................................................................................... 7

3.1 LIMITATIONS ON CONTACTING CSC PERSONNEL .................................................................. 7

3.2 PROPOSER DISQUALIFICATION .............................................................................................. 7

3.3 RFQ TIMETABLE ..................................................................................................................... 8

3.4 INQUIRIES .............................................................................................................................. 9

3.5 ACCEPTANCE OF APPLICATIONS ............................................................................................ 9

3.6 NOTICE OF INTERVIEWS ........................................................................................................ 9

3.7 PROCEDURE FOR CONDUCTING INTERVIEWS ....................................................................... 9

3.8 NOTICE OF QUALIFIED PROPOSERS FOR CONTRACT DISCUSSIONS .................................... 10

SECTION 4: RFQ RESPONSE .................................................................................................. 10

4.1 INSTRUCTIONS FOR SUBMITTING RESPONSE TO RFQ ........................................................ 10

4.2 INCOMPLETE RESPONSES .................................................................................................... 10

4.3 RESPONSE FORMAT ............................................................................................................. 10

4.4 RESPONSE REVIEW AND SELECTION CRITERIA .................................................................... 11

4.5 INSURANCE REQUIREMENTS ............................................................................................... 12

4.6 COMPLIANCE WITH SECTION 287.133, FLORIDA STATUTES ............................................... 12

SECTION 5: SUBMITTAL DOCUMENTS .................................................................................. 13

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SECTION 1: INTRODUCTION

1.1 WHAT WE ARE SEEKING

Children’s Services Council of Palm Beach County (CSC) is seeking one or more qualified individuals, firms, organizations, colleges or universities to assist in the development and implementation of a treatment fidelity protocol for mental health counseling contracts funded by CSC

1.2 THE COUNCIL

CSC, an independent special district created by Palm Beach County voters in 1986, and reauthorized in 2014, provides leadership, funding, services and research on behalf of the county’s children so they grow up healthy, safe and strong.

1.3 OVERVIEW OF THE CHILDREN’S SERVICES COUNCIL

The Council invests resources in programs and services that support the physical, social-emotional and psychological development of children. In order to have an impact in those areas, the Council has four goals: children are born healthy, are safe from neglect and abuse, are ready for kindergarten, and have access to quality afterschool and summer programs.

Supported by a blend of federal, state and local funding, our programs and systems are designed to achieve our goals by providing seamless, efficient, and accountable prevention and early intervention services to Palm Beach County’s children and families. These systems include:

Healthy Beginnings, which provides comprehensive, integrated direct services to pregnant women, infants, and young children.

Strong Minds, which provides services to increase the quality of child care and afterschool providers.

Bridges, which is a neighborhood-based strategy to achieve CSC’s goals at a population level. Bridges address such issues as adult literacy, father involvement, maternal depression, teen pregnancy prevention, cyclical poverty and child development.

The Council believes that by offering families the right approach – and combinations of programs and services – at the right time, in the right place, we will achieve our goals. By strengthening the system of care, which is built upon sound research and strong data, we can achieve our child outcomes.

For additional information regarding CSC, please visit www.cscpbc.org/openprop

http://www.cscpbc.org/open

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SECTION 2: Mental Health Counseling Quality Assurance Specialist

2.1 BACKGROUND

In 2014, CSC released a Request for Proposals (RFP) for mental health therapy that included a re-design of prior mental health therapy models/contracts. New requirements included an increased focus on the use of evidence-based counseling models to target the needs of the child through age five, child-parent dyad, or parent/caregiver. In order to ensure quality therapy services, contracts for mental health providers include an independent review of treatment fidelity, treatment quality and client progress. A federal report that identified quality as one of the most pressing issues in mental health services referred to quality assurance as one of the most promising means for improving care (Institute of Medicine, 2006).

2.2 PROJECT GOALS

The goal of this Request for Qualifications (RFQ) is to enter into a contract with one or more qualified individuals, firms, organizations, colleges or universities to assist in the development and implementation of a quality assurance and treatment fidelity protocol for mental health counseling contracts funded by CSC.

2.3 SCOPE OF WORK

CSC is seeking a Quality Assurance Specialist to develop and then implement treatment fidelity chart review protocols for contracts funded to provide counseling for parents and young children. Qualifications should be submitted in response to one of the following categories: A. Development of the fidelity protocol AND ongoing provision of quality assurance at funded sites for

counseling (Preferred Category) B. Development of the fidelity protocol ONLY C. Ongoing provision of quality assurance ONLY Development of the Fidelity Protocol The first body of work involves developing the Quality Assurance (QA)/treatment fidelity protocol that fits the CSC funded model for mental health counseling. It is expected that the body of work to develop the comprehensive fidelity protocol will not exceed 20 hours per week for approximately two months. CSC may contract with more than one entity or individual for the development component to ensure expertise with all models/practices that are core components of the mental health counseling contracts. The funded individual(s) or entity(ies) will develop treatment fidelity chart review protocols and fidelity forms for the following therapy models, assessment tools and systems:

A. Cognitive Behavioral Therapy with a focus on treating mothers and caregivers with depression B. Interpersonal Therapy with a focus on treating mothers and caregivers with depression C. Play Therapy for children through age 5 D. Filial Play Therapy for children through age 5 E. Trauma-Focused Cognitive Behavioral Therapy F. Child Parent Psychotherapy

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G. The Partners for Change Outcome Management System (PCOMS), The Outcome Rating Scale (ORS), and The Session Rating Scale (SRS)

H. Child and Adolescent Needs and Strengths (CANS) Comprehensive Multisystem Assessment, specifically the CANS Birth to Five

Ongoing Quality Assurance CSC may negotiate with a proposer submitting under Category A or C to provide quality assurance at funded sites. For ongoing work, CSC will fund one entity or individual not to exceed 35 hours monthly to conduct fidelity reviews for a sample of mental health counseling cases. Travel to sites in Palm Beach County will be required approximately one day per month. Monthly hours may be reduced over time as newly established mental health contracts reach full implementation. CSC intends to enter into an agreement for up to two years for ongoing provision of quality assurance. The contract may be renewed for an additional two-year period based upon performance. The QA Specialist will evaluate the following: treatment fidelity and quality, client progress, adherence to procedures, efforts to engage clients and client-therapist match. The QA specialist will be expected to engage in the following activities:* 1. Conduct a monthly in-depth file review at a funded mental health agency to assess treatment fidelity. 2. Examine therapist academic transcripts and training records to ensure they have been adequately

trained to deliver treatments as specified in mental health contracts. 3. Examine the frequency and general content of reflective supervision sessions, as described and logged

by supervisors and therapists. 4. Submit fidelity findings to the CSC Program Officer assigned to the contract. 5. Keep the assigned CSC Program Officer apprised of contracted agencies’ status in meeting fidelity

measures. 6. Consult with the assigned CSC Program Officer regarding clinical-related issues that impact contract

management, to include the appropriateness of alternative treatment modalities, making recommendations regarding the training needs of providers, and treatment/billing-related questions.

7. Follow appropriate protocols regarding client consent, privacy and confidentiality. *Please note that these responsibilities may shift as the newly funded contracts work with CSC to refine services. CSC may negotiate with a proposer submitting under Category A for development of the fidelity protocol only or ongoing provision of quality assurance at funded sites for counseling, only. CSC may negotiate with a proposer submitting under Category A or B to develop fidelity protocols for specific models only.

2.4 MINIMUM REQUIREMENTS

In order to ensure Proposers possess the minimum qualifications and/or experience needed to support CSC’s needs, applicants must meet the following requirements:

Master’s degree with demonstrated continued education, professional training, and clinical experience in the therapy models listed in Section 2.3

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Florida Licensed therapist or psychiatrist: Licensed Clinical Social Worker (LCSW), Licensed Mental Health Counselor (LMHC), Licensed Marriage and Family Therapist (LMFT), Clinical Psychologist (PhD or PSY.D), or Psychiatrist with at least 5 years of clinical experience

Experience with quality assurance and/or evaluation of treatment fidelity

Maintains independence from and receives no financial compensation, through employment or contractual agreements, from agencies or organizations funded by CSC to provide behavioral health services. CSC currently works with the following agencies that provide mental/behavioral health services: Center for Child Counseling, Inc.; Center for Family Services of PBC; Families First of Palm Beach County; Father Flanagan’s Boys Town Florida, Inc.; The Institute for Child and Family Health, Inc.; Jerome Golden Center for Behavioral Health, and Parent-Child Center, Inc.

Complete all required submission documents and sign, as required

Submit a current resume or vitae for each individual who will be involved in the scope of work. The resume/vitae must include academic work and degrees, training, work experience and dates, and any relevant publications, reports, and presentations.

Participate in an interview process, upon request

Provide three professional references specifically relating to assignments completed within the past five years

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SECTION 3: RFQ PROCESS

3.1 LIMITATIONS ON CONTACTING CSC PERSONNEL

This Request for Qualifications is issued by the Children’s Services Council of Palm Beach County. The

contact person listed below is the sole point of contact for this RFQ:

Jennifer Hardy, Administrative Assistant III

[email protected]

All contact shall be by email only

Proposers are prohibited from contacting CSC personnel or board members regarding this solicitation

other than the person identified above. Any occurrence of a violation may result in the disqualification of

the proposer.

3.2 PROPOSER DISQUALIFICATION

Failure to have performed any contractual obligations with CSC in a manner satisfactory to CSC will be

sufficient cause for disqualification. To be disqualified as a proposer under this provision, the proposer

must have:

1. Previously failed to satisfactorily perform in a contract with CSC, been notified by CSC of

unsatisfactory performance, and failed to correct the unsatisfactory performance to the

satisfaction of CSC; or

2. Had a contract terminated by CSC, by any other county or state agency, or by any Children’s

Services Council, or like organization, for cause.

mailto:[email protected]

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3.3 RFQ TIMETABLE

8/10/2015 RFQ packets are available on the CSC website (www.cscpbc.org/openprop)

9/8/2015 Deadline for submission of questions regarding clarification of RFQ

9/15/2015 Final posting of questions and answers and/or clarification or addenda to RFQ (if

any) on CSC website (www.cscpbc.org/openprop)

9/24/2015 RESPONSE DEADLINE - All RFQ responses are due by 2 PM at:

[email protected]

Subject: RFQ #15-012

Responses will be opened publicly at 2:01 PM

Note: CSC email server date and time stamps all email

9/24/2015 - Evaluation of responses by RFQ Selection Team

10/8/2015

10/8/2015 Notification by email to proposers selected for interviews and list of those

selected for interviews posted on CSC website (www.cscpbc.org/openprop)

10/27/2015 – Interviews at CSC offices, if needed

10/28/2015

11/3/2015 Notice of Award posted on CSC website at:

https://www.cscpbc.org/proposal-outcomes

Notification by email of proposers not selected for further contract discussions;

notification by email to Proposers selected for contract discussions

11/24/2015 Discuss and Finalize Contract

12/3/15 Approval of Contract by Council, if needed.

NOTE: CSC reserves the right to adjust the timetable and any adjustments will be made available on the

CSC website.

http://www.cscpbc.org/openprop




https://www.cscpbc.org/proposal-outcomes

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3.4 INQUIRIES

All inquiries requesting clarification regarding this RFQ must be made in writing and emailed to the

identified contact person by September 8, 2015. During the RFQ period, Proposers must not submit any

forms of marketing or promotional materials that would raise the Proposer’s profile or give the Proposer

an advantage or benefit not enjoyed by other perspective proposers. Copies of responses to all inquiries

that require clarifications and/or addenda to the RFQ will be made available no later than 5 PM

September 15, 2015 on CSC’s website.

3.5 ACCEPTANCE OF APPLICATIONS

All responses must be received by CSC no later than September 24, 2015 by 2 PM. Sign, scan and attach

document in PDF format to email and send to:

[email protected]


No changes, modifications or additions to the responses submitted will be accepted by, or binding on, CSC

after the deadline for submissions has passed.

CSC reserves the right to reject any and all responses or to waive minor irregularities when doing so would

be in the best interest of CSC. A minor irregularity is defined as a variation from the RFP terms and

conditions that do not affect the price of the application, or do not give the proposer an advantage or

benefit not enjoyed by other prospective proposers, or do not adversely impact the interest of CSC.

3.6 NOTICE OF INTERVIEWS

CSC will post a list of qualified proposers for interviews, if needed, on October 8, 2015 by 5 PM on the CSC

website.

3.7 PROCEDURE FOR CONDUCTING INTERVIEWS

After completion of the scoring process based on the review criteria, CSC will determine which, if

any, proposers meet the minimum requirements deemed necessary by CSC for interviews.

ALL EMAIL COMMUNICATIONS ARE DATE AND TIME STAMPED BY CSC’S EMAIL SERVER. BIDS RECEIVED AFTER THE DEADLINE WILL BE REJECTED

AND RETURNED TO THE PROPOSER BY THE CSC.


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Assuming that such minimum requirements have been met, CSC will require face-to-face

interviews with one or more proposers.

3.8 NOTICE OF QUALIFIED PROPOSERS FOR CONTRACT DISCUSSIONS

CSC will post a list of qualified Proposer(s) for contract discussions after 5 PM on November 3, 2015 on CSC’s website: http://www.cscpbc.org/proposal-outcomes

SECTION 4: RFQ RESPONSE

4.1 INSTRUCTIONS FOR SUBMITTING RESPONSE TO RFQ

All responses must be submitted on the forms included in this package (forms available on CSC website

(www.cscpbc.org/openprop). All responses are to be signed by a person/official who is legally authorized

to bind the Proposer to the proposed activity.

IMPORTANT: All responses must be received via email no later than September 24, 2015 at 2 PM per the

deadline in the RFQ. Proposers will receive an auto-generated confirmation email acknowledging receipt

of the proposal. Do not respond to this email. This receipt does not verify that CSC has received a

complete proposal – that will be determined after opening all proposals at the time set forth in this RFQ.

CSC is not responsible for the email reputation of the Proposer’s email account which may cause delays or

undeliverable messages if your server has been blacklisted. To check your sender score, please utilize an

email reputation service or use a service such as http://www.senderbase.org/ to confirm that you have a

good email reputation. CSC’s email server has the capacity to accept large files but, in some cases, the

Proposer’s email server may delay sending email based on the size of attachments. Please ensure you

allow ample time for transmission of files. CSC will not be responsible for emails received after the

deadline. Proposals received after the deadline will not be considered.

4.2 INCOMPLETE RESPONSES

Failure to respond to any item, including providing any requested information, or failure to

follow these instructions shall be considered submission of an incomplete response and may

result in disqualification from further consideration.

4.3 RESPONSE FORMAT

The typewritten portion of your response is to be submitted on the RFQ forms included in Section

5. The forms are available for download on CSC’s website: www.cscpbc.org/openprop

http://www.cscpbc.org/proposal-outcomes


http://www.senderbase.org/


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4.4 RESPONSE REVIEW AND SELECTION CRITERIA

Submissions must indicate to which category they are responding. Proposer selection will be

based upon the following criteria:

Category A (Preferred):

For responses addressing the development of the fidelity protocol AND ongoing provision of

quality assurance at funded sites for counseling, proposer selection will be based upon the

following criteria:

1. Education and Experience with Treatment Models 30 points

2. Experience with QA and/or Fidelity Monitoring 20 points

3. Ability to Develop Treatment Fidelity Protocols 20 points

4. Demonstrated Understanding of Task 5 points

5. Availability to Perform Requested Services 10 points

6. Cost 10 points

7. References 5 points

Category B:

For responses addressing development of the fidelity protocol ONLY, proposer selection will be



2. Ability to Develop Treatment Fidelity Protocols 20 points



5. Cost 10 points


Category C:

For responses addressing ongoing provision of quality assurance ONLY, proposer selection will be



2. Experience with QA and/or Fidelity Monitoring 20 points



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5. Cost 10 points


4.5 INSURANCE REQUIREMENTS

Proposer must provide, upon award of contract, proof of insurance meeting or exceeding the following requirements:

Professional Liability Insurance – Coverage of at least $1,000,000 per occurrence

General Liability Insurance - $500,000 general aggregate, $500,000 per person, $500,000 each occurrence, and $500,000 per accident for bodily injury. Proof will be required for those providing ongoing QA.

Automobile Liability Insurance – for owned vehicles, non-owned vehicles and hired vehicles, coverage shall provide minimum limits of liability of $300,000 per accident Combined Single Limit for Bodily Injury and Property Damage. Proof of automobile liability insurance will be required for those providing ongoing QA.

A certificate of insurance naming Children’s Services Council of Palm Beach County as additional insured for General Liability must be submitted no later than ten (10) days after award and prior to execution of Statement of Work.

4.6 COMPLIANCE WITH SECTION 287.133, FLORIDA STATUTES

In accordance with Section 287.133, Florida Statutes, persons and affiliates who have been placed on the convicted vendor list may not submit responses, contract with, or perform work (as a contractor, supplier, subcontractor or consultant) with CSC in excess of the threshold amount provided in Section 287.017, Florida Statutes, for Category Two for a period of thirty-six (36) months from the date of being placed on the convicted vendor list. Any response received from a person, entity or affiliate who has been placed on the convicted vendor list shall be rejected by CSC as unresponsive and shall not be further evaluated.

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SECTION 5: SUBMITTAL DOCUMENTS The following documents can be downloaded from CSC’s website at:

www.cscpbc.org/openprop

Reference file name: RFQ #15-012 Forms

Responses should be assembled in the following manner:

Cover Page – Complete this entire document, sign, scan and include with response. Must be

signed.

Questionnaire – Complete this entire document and include with response.

Proposer Qualifications – This section must contain all pertinent data related to the Proposer

(including proposer’s organization, if applicable) and experience that would substantiate

Proposer’s qualifications and capabilities to perform the services requested. Include

documentation/verification of training in the 8 therapy models, assessment tools, and

systems listed as A through H in Section 2.3 and in Question 7, Section C of the

Questionnaire.

Resume or curriculum vitae as described in Section 2.4

Copy of Professional License

Professional References - List three professional references, other than CSC’s staff, associated

with similar work previously performed by the Proposer preferably within the past 5 years. For

each reference, please specify:

a. Name, address, telephone number, email b. Project start date and duration c. Scope and cost of project d. Role in project e. Outcome of project

Fee Schedule – Provide a schedule of fees (Include hourly, per unit, project, etc.)

Conflict of Interest Disclosure Form – Complete this document, sign, scan and include with

response. This document must include a signature.

http://www.cscpbc.org/

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REMINDER

DEADLINE FOR SUBMISSION IS September 24, 2015

[email protected]


REPLIES ARRIVING AFTER 2 PM ON SEPTEMBER 24, 2015 WILL BE REJECTED AND

RETURNED TO PROPOSER


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COVER PAGE Submit this RFQ response to:

[email protected] Subject: RFQ #15-012

RFQ Title: Mental Health Counseling Quality Assurance Specialist

RFQ #: 15-012

NAME OF INDIVIDUAL, FIRM, ENTITY, ORGANIZATION, COLLEGE, or UNIVERSITY:

NAME OF CONTACT PERSON:

TITLE:

PHONE NUMBER:

FAX NUMBER:

EMAIL:

MAILING ADDRESS:

CITY:

STATE:

ZIP CODE:

HEADQUARTERS ADDRESS (If different than mailing address):

FEDERAL EMPLOYER IDENTIFICATION NUMBER (EIN):

STATE OF FLORIDA BUSINESS LICENSE NUMBER (If Applicable):

DO NOT include Social Security number with this application; CSC will obtain if/when contracted.

ORGANIZATION STRUCTURE (Please check one):

Corporation Partnership Proprietorship Joint Venture Other

If Corporation, please provide the following:

(A) Date of incorporation (B) State or Country of incorporation:

I certify that this Proposal is made without prior understanding, agreement, or connection with any corporation, firm, or person submitting a proposal for the same materials, supplies, or equipment, and is in all respects fair and without collusion or fraud. I agree to abide by all terms and conditions of this RFQ and certify that I am authorized to sign this Proposal and that this Proposal is in compliance with all requirements of the Request for Qualifications, including but not limited to, certification requirements.

_________________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________ Authorized Signature (Manual) (Authorized Signature (Print or Type) Title (Print or Type)

COMPLETE & PRINT FORMS; SIGN THE COVER PAGE; SCAN INTO PDF FORMAT AND EMAIL TO CSC BY 2 PM ON DUE DATE


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QUESTIONNAIRE The following Questionnaire shall be completed and submitted with the Request for Qualifications. Proposer guarantees the truth and accuracy of all statements and answers herein contained.

Page Limit – 20 pages (single space and 11 font size) In order to guide the review process, please answer the following questions regarding your response. A. Are you submitting your qualifications in response to Category A (Preferred), development of the

fidelity protocol AND ongoing provision of quality assurance at funded sites for counseling?

YES NO If yes, please respond completely to ALL questions. B. Are you submitting your qualifications in response to Category B, development of the fidelity protocol

ONLY?

YES NO If yes, please respond completely to ALL questions. C. Are you submitting your qualifications in response to Category C, ongoing provision of quality

assurance ONLY?

YES NO If yes, omit questions 12 and 13 from your response.

D. Are you willing to be considered for partial responsibilities outlined in this RFQ?

YES NO For example, CSC may negotiate with a proposer submitting under Category A for development of the fidelity protocol only or ongoing provision of quality assurance at funded sites for counseling only. CSC may also negotiate with a proposer submitting under Category A or B to develop fidelity protocols for specific models only.

1. How many years have you/your organization/company been in business? 2. What is the last project of this nature that you have completed?

3. Have you ever failed to complete work awarded to you? NO YES If so, where and why?

4. Availability to Perform the Requested Services – Given your current and anticipated workload, explain

how the proposer will meet any agreed upon project deadlines, which may, at times, require expedited timelines.

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5. Do you receive or anticipate receiving financial compensation, through employment or contractual

agreement, from agencies or organizations funded by CSC to provide behavioral health services? CSC currently works with the following agencies that provide mental/behavioral health services: Center for Child Counseling, Inc.; Center for Family Services of PBC; Families First of Palm Beach County; Father Flanagan’s Boys Town Florida, Inc.; The Institute for Child and Family Health, Inc.; Jerome Golden Center for Behavioral Health, and Parent-Child Center, Inc. If you have any relationships with local agencies, organizations, or individuals funded by CSC, please describe.

6. Please detail your academic background and professional credentials in the field of mental health.

Include the following: A. Academic degree(s) and training focus B. Professional licensure C. Specific training, including workshops, related to the following:

1) Cognitive Behavioral Therapy 2) Interpersonal Therapy 3) Play Therapy 4) Filial Play Therapy 5) Trauma-Focused Cognitive Behavioral Therapy 6) Child Parent Psychotherapy 7) The Partners for Change Outcome Management System (PCOMS), The Outcome Rating Scale

(ORS), and The Session Rating Scale (SRS) 8) Child and Adolescent Needs and Strengths (CANS) Comprehensive Multisystem Assessment,

noting experience with the CANS Birth to Five 7. Describe your professional experience in the field of mental health. Include the following:

A. Brief description of professional experience in the mental health field B. Professional experience with the following:

1) Cognitive Behavioral Therapy 2) Interpersonal Therapy 3) Play Therapy 4) Filial Play Therapy 5) Trauma-Focused Cognitive Behavioral Therapy 6) Child Parent Psychotherapy 7) The Partners for Change Outcome Management System (PCOMS), The Outcome Rating Scale

(ORS), and The Session Rating Scale (SRS) 8) Child and Adolescent Needs and Strengths (CANS) Comprehensive Multisystem Assessment,

noting experience with the CANS Birth to Five

8. Describe your experience monitoring the fidelity of implementation of evidence-based models and practices.

9. Describe your experience reviewing behavioral health charts/documentation for compliance as part of

a quality improvement, utilization review, or quality assurance process.

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10. What is the value of monitoring fidelity within community-based behavioral health services? 11. What are some of the challenges involved in monitoring fidelity of practice within community-based

behavioral health services? Describe possible solutions to these challenges. OMIT QUESTIONS 12 and 13 if responding for Category C. 12. Describe your experience creating fidelity tools, checklists, and rating forms. (Omit question 12 if

responding for Category C.) 13. Briefly describe the process you would use to create a protocol for monitoring treatment fidelity for

Cognitive Behavioral Therapy or Play Therapy. (Omit question 13 if responding for Category C.)

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REFERENCES List three professional references, current or past, who can provide input on the engagement in similar work performed by the Proposer in the past five years. For each reference, please specify:

a. Name, address, telephone number b. Project start date and duration c. Scope and cost of project d. Role in project e. Outcome of project

Reference #1:

Reference #2:

Reference #3:

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FEE SCHEDULE PURPOSE: The purpose and intent of this RFQ is to secure a fixed and firm fee schedule and establish a term-contract for professional services. Fees will be negotiated. CSC intends to award contract(s) to the lowest, responsive, responsible, qualified Proposer in response to this RFQ, taking into consideration experience, staffing, equipment, materials, references, and past performance. In the case of disputes in the award of contract(s), the decision by CSC shall be final and binding on both parties. CSC intends to enter into an agreement for up to two-years for ongoing provision of quality assurance. The contract may be renewed for an additional two-year period based upon performance. PRICES SHALL BE FIXED AND FIRM FOR TERM OF CONTRACT: If the Proposer is awarded a contract under this solicitation, the prices quoted by the Proposer shall remain fixed and firm during the term of the contract; however, when applicable, CSC may request a price quote from the pool of qualified contractors based on special projects or statements of work. INDIRECT COST LIMITS FOR UNIVERSITIES: When contracting with universities or other academic institutions, the indirect cost rate allowed by CSC will not exceed the then-current maximum indirect cost rate approved for other CSC providers, currently 15%. This would apply to all proposals. WORK AUTHORIZATION: Statements of Work will be authorized by the CSC Chief Executive Officer or designee. No work shall commence without written authorization. INVOICES AND PAYMENT: Detailed reports will be required with submittal of invoices. Payment will be made within 15 days of receipt of invoice and acceptance of the complete unit(s). No down or partial payments will be made.

FEE SCHEDULE Include costs associated with the RFQ components for which you are responding. 1. Include all relevant fees associated with professional services (i.e. hourly rate, travel expenditures, unit cost, etc.) for protocol development. Include an estimate of required time.

2. Include all relevant fees associated with professional services (i.e. hourly rate, travel expenditures, unit cost, etc.) for ongoing fidelity monitoring.

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CONFLICT OF INTEREST DISCLOSURE

The Proposer certifies that this price is made independently and free from collusion. Proposer shall disclose below, to the best of its knowledge, any CSC Council member, employee, or any spouse, son, daughter, stepson, stepdaughter, or parent of any such officer or employee, who is an officer or director of, or has a material interest in, the Proposer’s business. For purposes hereof, a person has a material interest if he or she directly or indirectly owns more than five percent (5%) of the total assets or capital stock of any business entity, or if he or she otherwise stands to personally gain if the contract is awarded to this vendor. Failure of a vendor to disclose any relationship described herein shall be reason for debarment.

LIST NAME(S) AND RELATIONSHIPS (IF APPLICABLE) NAME RELATIONSHIPS ________________________________________________________________________________________________________________ ____________________________________________________________________________________

(Print Name) ________________________________________________________________________________________________________________ ____________________________________________________________________________________

(Print Name)

REQUIRED SIGNATURE ________________________________________ (Proposer’s Signature)

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