Supported Recovery Housing Services – RFP Questions with DMHAS Reponses

What provisions in this award are being made for the required on-site staff for case management services available a minimum of 8 hours per day and 5 days per week and on call staff availability 24 hours a day 7 days per week?

Reimbursement for these services will be made on a bundled case rate basis in the amount of $500 per person per month to include housing and case management. To receive reimbursement, recipients must be eligible for the General Assistance Recovery Supports Program (GA RSP) or Access to Recovery (ATR).

Is case management included in the $500 per bed per month for a maximum of 2 months?

Yes.

I don’t see mention that DMHAS is requesting proposals from faith-based organizations, the RFP states “DMHAS in its effort to successfully implement a person-centered, recovery-oriented, and value-driven system of care requests proposals from qualified community and peer-based organizations capable of providing short-term Supported Recovery Housing Services.” Is DMHAS requesting proposals from faith-based organizations also?

Yes.

Clients such as clients with felony convictions or sex offenders have a much more difficult time securing employment and permanent housing, What provisions will be made for these clients after 2 months if they still have not secured employment and permanent housing?

GA RSP and/or ATR will provide reimbursement for Supported Recovery Housing Services for a maximum of 2 months. During these 2 months, service recipients shall work on an individualized recovery plan with the support of case management in an effort to secure additional recovery supports and formulate an appropriate discharge plan based on their needs. Further reimbursement beyond 2 months will not be available.

If the CT HUD Fair Market Rate (FMR) is higher than the $500 per bed per month rate, will you pay for the higher FMR?

No.

(page 5) “Through GA RSP and ATR II, the maximum length of stay for this service will be 60 days.” In a sober housing environment, particularly with individuals who seek and obtain employment, some will obtain employment and wish to remain in the sober housing environment on a self-pay basis. Is that acceptable under this program, or is the length of stay at the facility limited to 60 days regardless of payment source?

It is the Department’s expectation that beds contracted as Supported Recovery Housing Services beds will be available as such. Thus, the length of stay is limited to 60 days. Facilities that have additional beds available may choose to allow residents to remain for a longer period of time on a self-pay basis.

(page 4) “No more than 30% of individuals… will have left due to reasons of non-compliance, against staff advice, and/or administrative reasons.” What is the time period used for measuring this? Is it the period the client is at the facility and being paid for under this program (maximum 60 days) or is it the clients entire time at the facility?

This outcome will be based on the type of discharge from Supported Recovery Housing Services (maximum 60 days) entered into the DMHAS data system.

The staffing requirements indicated a case manager must be available a minimum of 8 hours per day, 5 days a week and on- call staff availability 24-hours a day, 7 days a week. Is the concept individuals will live within a boarding home environment without the availability of staff on an evening/overnight basis? Please clarify.

It is the Department’s expectation that staff will be available on-site a minimum of 8 hours per day, 5 days per week to provide case management services. DMHAS encourages providers to base staff schedules on resident availability and need. On-call staff shall be available 24 hours a day, 7 days a week, so staff shall be available (not necessarily on site) at all times.

How are room & board payments collected from the individuals Residents shall not be charged for Supported Recovery Housing

THOMAS A. KIRK, JR., PH.D.

M. JODI RELL GOVERNOR

STATE OF CONNECTICUT DEPARTMENT OF MENTAL HEALTH AND ADDICTION SERVICES

A Healthcare Service Agency

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who will be living at this residence? Services. The Department and/or its contracted Administrative Services Organization shall make payments to contracted providers for residents authorized as eligible for GA RSP and/or ATR.

Is there any statewide zoning regulation which allows this residence to be located in a residential neighborhood?

There are no statewide zoning regulations which pertain to Supported Recovery Housing Services. Providers must adhere to their local municipality’s zoning regulations.

Is there any funding available to furnish this residence? No. The request for services indicated in the RFP is significant. Why is the reimbursement established $500 per bed, per month for a maximum of two months?

DMHAS utilized feedback from community providers to develop the rate. The 2 month maximum was implemented based on average lengths of stay for GA RSP and ATR housing recipients and the total available funding.

What are the source of referrals? Referrals may come from multiple sources, but in general: GARSP recipients are referred from a behavioral health treatment provider, and ATR recipients are referred from one of the ATR portal agencies (e.g. Department of Correction, Court Support Services Division, Department of Children and Families, etc.) More information on both programs can be found on the DMHAS website (www.ct.gov/DMHAS).

Is there a minimum/maximum capacity per residence? Total residence capacity shall not exceed that which is set by local zoning regulations.

In regards to the case manager, is 8 hours a day 5 days a week all on-site or can it be a combination of on and off-site availability?

It is the Department’s expectation that case management staff will be available on-site 8 hours a day, 5 days per week. However, it is understood that staff may also perform work duties that are outside of the residence (e.g. transportation to appointments).

Are clients expected to have a job and/or housing within 60 days and what happens if they don’t?

While at the residence, service recipients shall work on an individualized recovery plan with the support of case management in an effort to secure additional recovery support services and formulate an appropriate discharge plan. Both the recovery and discharge plan shall be tailored to the resident’s specific skills, needs, and goals. It may not be feasible for all residents to secure employment prior to discharge, perhaps they want a referral to a vocation/educational program instead. Upon discharge, it is expected that all residents will have secured or have been referred to appropriate housing and other recovery support services as needed.

With the max length of stay being 60 days, does this mean that the required components (i.e. reporting, transportation etc.) only last 60 days?

Yes.

How do you want the performance measures reported? Data will be collected using multiple methods. Expectations will be clearly delineated within the Supported Recovery Housing Services contract with DMHAS.

Does the reporting have to be in the new DDAP system? Yes, it is the Department’s expectation that data will be entered into DPAS or the new DDAP application (when available).

Is there any supplemental funding beyond the $500 a month per client?

No.

After the 60 day resident length of stay is the expectation that the resident will be discharged and a new client will be admitted?

Yes, after 60 days, the resident should be discharged from a DMHAS funded bed, but not necessarily from the house. Facilities that have additional beds available may choose to allow residents to remain for a longer period of time on a self-pay basis.

If the service is provided in a leased space, do we need to provide a letter from the owner stating that he has knowledge of the intended use? Can we get a waiver on this requirement? If so, how?

Yes, this is clearly stated in the Supported Recovery Housing Services Certification Application (page 19 of the RFP). No waivers will be granted.

Do we need to provide a copy of the assessor's card? What if the information contained on the assessor's card is incorrect?

Yes, this is clearly stated in the Supported Recovery Housing Services Certification Application (page 19 of the RFP). If necessary, provide additional documentation which clarifies any

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irregularities on the Tax Assessor’s Field Card. In Section 3 of the certification application there is a question about litigation (page 19). Does that refer to litigation around the proposed site of operations or to the proposed applicant?

The question refers to both the provider organization and proposed site.

May we propose multiple addresses for sleeping quarters while utilizing a single address for program services? If this is allowed, are there any considerations we need to be aware of when preparing and presenting the proposed budget?

This was not the intention of the RFP.

I am curious as to how the RFP is going to affect ATR case Management Services. Under my current arrangement I provide case management and housing through ATR and GA RSP. It looks like the two are being folded together. If I have a woman I am providing housing for under the new agreement will I be able to bill for Case Management Services as well?

Yes. Providers who are contracted to provide ATR case management (or faith- or peer-based) services may continue to bill for these services. It is the Department’s expectation that these additional case management (or faith- or peer-based) services will allow providers to work more intensively with some residents as appropriate. All services must be documented and are subject to DMHAS review.

In Section VII : B Award and Funding it states that "residents shall not be charged any additional fees by the provider". We currently charge a processing fee of $260.00 - and many houses charge sober deposits. Are we not able to collect these monies, based on the agreement?

That is correct.

In Section V. Required Components, #3, can you provide more specificity around the supervision? What is the form and manner defined by DMHAS?

Please see RFP Section VIII.1.II.2 Roles and Responsibilities (page 11), in which the RFP requests the proposer to “identify qualified administrative/leadership personnel to provide oversight and supervision of the case management staff” and RSP Section VIII.1.I.3.ix (page 11), in which the RFP requests the proposer to provide policies and procedures for staff supervision. Per RFP Section V.3 (page 5), “supervision will be provided to each direct care staff person at a minimum of twice monthly.” Other supervision expectations will be clearly delineated within the Supported Recovery Housing Services contract with DMHAS.

In Section V. Required Components, #6, what are DMHAS’ requirements for the Case Manager position? Are there required qualifications that DMHAS has established?

DMHAS is requesting that this information be provided by the proposer as part of the RFP. Please see RFP Section VIII.3. Appendix 2 (page 12). Per RFP Section V.2 (page 5), staff should “have an understanding of substance use disorders and substance use and co-occurring mental health disorders, along with the principles of recovery. Staff should understand addiction as a disease and should reflect the ethnic, racial, gender, and linguistic composition of the individuals requiring services.”

In Section V. Required Components, #8, are test cups all that is needed or is a relationship with a lab necessary?

A relationship with a lab is not necessary if the provider can collect and process urine samples on-site.

In Section VIII. Instructions for Completion of Proposal, Proposal Evaluation Criteria, and Scoring, section 2. Program Budget, #1, does this apply to the entire program or just the part of the program that pertains to this RFP?

#1 applies specifically to Supported Recovery Housing Services.

In attachment A, section 5B, Workers’ Compensation Insurance, if the applicant is a sole proprietor, do you require that they have workers compensation insurance?

Workers’ Compensation Insurance will be required for any provider who has employees. If a sole proprietor proposes to perform all work duties independently, then no worker’s compensation insurance will be required.

Do you anticipate this being an online application similar to what is being used for ATR today?

GA RSP and ATR application procedures will remain the same. More information on both programs can be found on the DMHAS website (www.ct.gov/DMHAS).

Are peer-to-peer and case manager recovery support services going to continue to be paid through ATR?

Yes. Providers who are contracted to provide ATR case management, peer-based, or faith-based services may continue to bill for these services. It is the Department’s expectation that these additional case management, peer-based, or faith-based services will allow providers to work more intensively with some

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residents as appropriate. All services must be documented and are subject to DMHAS review.

Please clarify expectations for length of stay in program. Client eligibility for funding under GA RSP and ATR II is limited to two months, during which time provider may not charge any additional fees. Is it DMHAS’ expectation that residents are discharged after two months, or that they remain in the program for whatever period is appropriate until they are ready for transition to community?

It is the Department’s expectation that beds contracted as Supported Recovery Housing Services beds will be available as such. Thus, the length of stay is limited to 60 days. Facilities that have additional beds available may choose to allow residents to remain for a longer period of time on a self-pay basis.

If they can remain in residence longer than two months, can the provider charge fees after the two month period?

If residents transition to a self-pay bed that is not funded by DMHAS, then the Supported Recovery Housing Services rules do not apply. Thus, providers may charge additional fees; however, it is the Department’s expectation that residents are informed of these fees (or other rule changes) prior to admission to a self-pay bed so they may make an informed decision.

What is the linkage between achieving or not achieving the performance measures and continued funding? (Relating to the previous question about funding, clearly the longer the length of stay in residence, the greater the chances of outcomes that achieve the performance measures.)

All performance measures will be based on the discharge from Supported Recovery Housing Services (maximum 60 days). Providers will not be expected to report outcomes on residents that move into a self-pay bed. The linkage between achieving performance measures and continued funding will be clearly delineated within the Supported Recovery Housing Services contract with DMHAS.

Does the transportation requirement (RFP section V.7) mean that the provider must pay for all transportation to appointments, whether offered directly or through public transportation?

No, referrals can be made to other appropriate transportation services/programs.

Does the drug screening requirement (RFP section V.8) mean that the provider must pay lab fees for all necessary drug screening?

No, many public and private health insurance policies also reimburse for laboratory services.

Can residents funded through this RFP be mixed in the sober living environment with residents needing supported recovery housing who are supported by other funding streams?

Yes.

Are there any requirements for case manager/client ratio? No. Is the reimbursement expected to cover both room and board and case management?

Yes.

Can case management services be billed elsewhere? Yes. Providers who are contracted to provide ATR case management (or faith- or peer-based) services may continue to bill for these services. It is the Department’s expectation that these additional case management (or faith- or peer-based) services will allow providers to work more intensively with some residents as appropriate. All services must be documented and are subject to DMHAS review.

Do residents have access to other funding for necessities such as medication, clothing, personal hygiene items, etc.?

Not through this RFP; however, case management staff should work with residents to secure additional recovery supports as needed per the resident’s individualized recovery plan.

Are we required to have a peer advisory group established? No, but RFP Section VIII.1.I.1 (page 10) requests information on recovery community involvement.

As a faith-based program, we’ve established admission criteria, would DMHAS expect to alter those criteria?

No, in Section VIII.1.I.2.vii (page 10), DMHAS requests that admission procedures are detailed in the proposal that is submitted.

Spirituality curriculum is part of programming, in transitioning individuals into the community and helping to connect with an integral spiritual support base. Would this present an issue in receiving funding?

No.

As part of our strategic plan, we are committed to admitting 3 residents per year for the first two years. Would DMHAS expect a different rate of utilization?

Once Supported Recovery Housing Services contracts are awarded, DMHAS would expect a utilization rate of at least 90% for the contracted services per the performance measures.

Has this funding been awarded to faith based programs in the This is a new service. However, GA RSP and ATR have paid for

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past? faith-based services/providers in the past. Will the case management services be billable services under ATR as is the current practice? (It is currently billed separately from the housing).

Yes. Providers who are contracted to provide ATR case management (or faith- or peer-based) services may continue to bill for these services. It is the Department’s expectation that these additional case management (or faith- or peer-based) services will allow providers to work more intensively with some residents as appropriate. All services must be documented and are subject to DMHAS review.

Is there a prescribed manner in which case management documentation must be done?

No. Please see RFP Section VIII.1.I.3 (page 10-11). Other documentation expectations will be clearly delineated within the Supported Recovery Housing Services contract with DMHAS.

Why did the Department choose not to have a bidders conference for this RFP?

The Department feels that all questions can be answered in this format.

Is the 200 bed maximum per applicant, or an aggregate number statewide? If the answer is statewide, is the 200 maximum an aggregate of RSP and ATR II beds?

DMHAS will contract a maximum of 200 beds statewide to include an aggregate of GA RSP and ATR beds.

For applicants with multiple housing sites, may the descriptions of the individual houses be attached as an appendix and incorporated into the narrative by referring to the appendix? Is it correct that one (1) RFP response should be submitted for a provider with multiple service sites? Is it correct that the RFP response should include a separate GA RSP certification application for each site proposed? In other words, if an applicant proposes to provide housing at twelve (12) sites, the RFP response should include twelve (12) attachment A’s, one for each site?

Yes, multiple sites may be included in the RFP response. Site specific information must be contained in RFP Section VIII.I.1.2 (page 10). Please note that the Program Narrative must not exceed 10 single-spaced pages in length. Also, (1) Appendix 1 (GA RSP Certification Application) must be completed per proposed site.

Please clarify or expand on the “on-site” case management requirement. For a provider with twelve (12) housing locations, with multiple case managers on staff, who meet with clients in the individual houses and in a centralized office, is that acceptable, or is DMHAS requiring that the provider retain twelve (12) full time case managers and locate a full time case manager in each individual house?

The intention of the RFP was to have case management staff present on-site at the proposed Supported Recovery Housing Services location 8 hours a day, 5 days a week.

Must the number of beds each applicant proposes to provide services for be site specific, or may the number of beds be spread across multiple houses operated by the provider?

The intention of the RFP is to contract site specific beds for Supported Recovery Housing Services.

Is this RFP taking the place of how DMHAS currently pays for sober housing services via GA RSP and ATR?

Yes.

Is this RFP in addition to housing services already being paid for by DMHAS?

Supported Recovery Housing Services will take the place of Sober Housing Services previously paid for by DMHAS via GA RSP and ATR. DMHAS will no longer pay for Sober Housing Services via GA RSP and ATR effective October 1, 2009. DMHAS will continue to reimburse GA RSP and ATR certified and contracted shelters.

Do existing GA RSP and ATR sober house provider have to apply to continue to be a provider?

Yes. Supported Recovery Housing is a new service, thus all interested providers must apply.

Required Components-Pg. 5, #1- In-house case management 8 hrs. per day & 5 days per week. If case management services are offered off-site, will we have staff our houses based on the above case management schedule?

Yes.

Statement of Intent- End of last paragraph. Our clients are not allowed to work while in treatment. Can this be waived?

No. All residents shall create an individualized treatment plan with the aid of their case manager based on their specific needs and goals. It may not be feasible for all residents to secure employment prior to discharge, perhaps they want a referral to a vocation/educational program instead. Upon discharge, it is expected that all residents will have secured or have been referred to appropriate housing and other recovery support services as needed.

Required Components- Pg. 5, # 2- "Staff who have an Knowledge may be based on both educational credentials and

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understanding of substance abuse disorders and substance abuse and co-occurring mental health disorders". What standards are DMHAS using to meet this requirement?

experience.

Our clients have to be engaged in treatment with our agency to live in our housing. Will DMHAS allow for increased lengths of stay for clients who need more time to engage in work, find housing etc.

It is the Department’s expectation that beds contracted as Supported Recovery Housing Services beds will be available as such. Thus, the length of stay is limited to 60 days. Facilities that have additional beds available may choose to allow residents to remain for a longer period of time on a self-pay basis.

How does the Supported Recovery Housing Services RFP relate to the current GA RSP and/or ATR II housing assistance programs?

Supported Recovery Housing Services will take the place of Sober Housing Services previously paid for by DMHAS via GA RSP and ATR. DMHAS will no longer pay for Sober Housing Services via GA RSP and ATR effective October 1, 2009. DMHAS will continue to reimburse GA RSP and ATR certified and contracted shelters.

Are grants for Case Management Services and other things affected in any way by this RFP?

This will have to be reviewed on a case-by-case basis.

STATEWIDE REQUEST FOR PROPOSALS (RFP)

THOMAS A. KIRK, JR., PH.D. COMMISSIONER

STATE OF CONNECTICUT DEPARTMENT OF MENTAL HEALTH AND ADDICTION SERVICES

A Healthcare Service Agency

M. JODI RELL GOVERNOR

Supported Recovery Housing Services

The Connecticut Department of Mental Health and Addiction Services (DMHAS) in its effort to successfully implement a person-centered, recovery-oriented, and value-driven system of care requests proposals from qualified community- and peer-based organizations capable of providing short-term Supported Recovery Housing Services to male and female adults with substance use disorders or with co-occurring substance use and mental health disorders who are eligible for the State-Administered General Assistance Recovery Supports Program (GA RSP) or Access to Recovery II (ATR II) Program. In addition to safe, sober housing, Supported Recovery Housing Services will provide case management to support residents in securing substance abuse treatment or community-based and other recovery services, including employment, long-term housing, etc., necessary for sustained recovery. Supported Recovery Housing Services providers will collaborate with substance abuse treatment service providers and other community-based organizations to assist residents in identifying and securing these additional supports which are conducive to recovery. Written responses to this RFP must be received by the DMHAS contact person (listed below) no later than 2:00 PM local time on Tuesday, August 18, 2009. Any response(s) received after that date and time shall be returned, unopened to the applicant. Postmarks will not be considered. The original and nine (9) exact legible copies (for total of 10) of the proposal must be submitted by the deadline to:

Betty McCants

Department of Mental Health and Addiction Services P.O. Box 341431

410 Capitol Avenue Hartford, Connecticut 06134

(860) 418-6890 phone; (860) 418-6698 fax betty.mccants@po.state.ct.us.

Re: Supported Recovery Housing Services RFP (must appear on the outside of the envelope)

QUESTIONS: To avoid giving one applicant advantage over others, all questions regarding this RFP must be emailed no later than 3:00 PM Local Time on July 10, 2009, to the agency contact listed above. Responses to all questions will be posted on the DMHAS website, http://www.ct.gov/dmhas/rfp no later than July 24, 2009. This RFP also is available on the DMHAS Web Site at: http://www.ct.gov/dmhas/RFP

1 (AC 860) 418-7000

410 Capitol Avenue, P.O. Box 341431 Hartford, Connecticut 06134 www.ct.gov/dmhas

An Equal Opportunity Employer

TABLE OF CONTENTS

I. Introduction II. Statement of Intent III. Program Goals and Objectives IV. Performance Measures V. Required Components VI. Other System Expectations VII. Award and Eligibility VIII. Instructions for Completion of Purpose, Proposal Evaluation Criteria, and

Scoring IX. Evaluation Criteria/Selection Committee X. General Proposal Requirements XI. Attachments:

RFP Proposal Face Sheet (Must be page 1 of all proposals) Attachment A: General Assistance Recovery Supports Program Certification Application Attachment B: Notice to Executive Branch State Contractors and Prospective State Contractors of Campaign Contribution and Solicitation Ban Attachment C: Consulting Agreement Affidavit Attachment D: Affirmation of Receipt of Summary of State Ethics Law Attachment E: GIFT AND CAMPAIGN CONTRIBUTION CERTIFICATION Attachment F: SCORING GRID

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I. Introduction The Department of Mental Health and Addiction Services (DMHAS) is the state healthcare service agency responsible for health promotion, and the prevention and treatment of mental health and substance use disorders in Connecticut. The DMHAS mission is “to improve the quality of life of the people of Connecticut by providing an integrated network of comprehensive, effective and efficient behavioral health services that foster self-sufficiency, dignity and respect.” To that end, DMHAS is focused on promoting and achieving a quality-focused, culturally responsive and recovery-oriented system of care. DMHAS has, therefore concentrated its efforts on greater involvement of persons in recovery in the planning and development of services, expanding system capacity through better care management of persons in treatment, promoting age, gender, sexual rientation and culturally responsive services, and strengthening supportive community-based services. o

DMHAS strives to enhance its recovery-oriented system of behavioral health care that offers Connecticut’s citizens an array of accessible services and recovery supports from which they are able to choose those that are effective in addressing their particular behavioral health condition or combination of conditions. These services and supports are culturally, age, and gender-responsive, build on personal, family, and community strengths, and have as their primary and explicit aim, the promotion of the person/family’s resilience, recovery, and inclusion in community life. Finally, services and supports are provided in an integrated and coordinated fashion in collaboration with the surrounding community, thereby ensuring continuity of care both over time and across agency boundaries and maximizing the person’s opportunities for establishing, or reestablishing, a safe, dignified, and meaningful life in the community of his or her choice. Connecticut’s vision is based on the following underlying values: The shared belief that recovery from behavioral health disorders is possible and expected; An emphasis on the role of positive relationships, family supports, and parenting in maintaining recovery,

achieving sobriety, and promoting personal growth and development; The priority of an individual’s or family’s goals in determining their pathway to recovery, stability, and self-

sufficiency; The importance of cultural capacity, cultural competence and age and gender-responsiveness in designing

and delivering behavioral health services and recovery supports. Cultural competence is defined as respectful and sensitive services that employ racial, cultural, age, gender, and sexual orientation consideration;

The central role of hope and empowerment in changing the course of individuals’ lives; and The necessity of state agencies, community providers, and individuals in recovery, and recovery

communities coming together to develop and implement a comprehensive continuum of behavioral health promotion, prevention, early intervention, treatment, and rehabilitative services.

II. Statement of Intent The purpose of this Request for Proposals (RFP) is to establish Supported Recovery Housing Services throughout the state of Connecticut that are responsive to the needs of persons with substance use disorders or substance use and co-occurring mental health disorders. As part of the evaluation process, DMHAS will place considerable emphasis on geographic, gender-specific, and other perceived needs pertaining to the Supported Recovery Housing Services Network (e.g. methadone friendly, smoke-free environment, etc). This network is an integral component of the DMHAS continuum of behavioral healthcare services which provides a transitional, sober living environment for male and female adults who are eligible for the DMHAS General Assistance Recovery Supports Program (GA RSP) or Access to Recovery II (ATR II). The proposed service is not treatment, but rather a transitional recovery housing environment that provides a platform where residents

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live and work with in-house case management staff to secure treatment and supports that are necessary to maintain recovery. Case management staff will also assist residents to identify and secure employment and permanent housing so they may ultimately transition into the community. Services must be recovery oriented and person-centered to ensure that individual recovery supports and skills are enhanced as people transition into the community while maintaining recovery. III. Program Goals and Objectives DMHAS will use this RFP to accomplish the following program goals and objectives:

1. Enhance recovery success by providing transitional recovery housing for individuals while they secure

permanent housing and employment. 2. Reduce substance abuse treatment recidivism by providing a supportive, drug and alcohol free living

environment as individuals transition from treatment, secure permanent housing and employment, and maintain their recovery in the community.

3. Case management services will utilize a person-centered, strengths-based approach and promote the active participation of the individual in stating preferences and making decisions that support recovery skills, foster independent living, promote community integration and increase the length of overall health and recovery while decreasing the risk for relapse.

4. Provide a culturally competent, gender responsive, and respectful transitional recovery housing environment.

IV. Performance Measures It is expected that all DMHAS General Assistance provider agreement requirements will apply. Also, DMHAS will conduct site visits to monitor the program’s performance. All performance outcomes identified below will be expected as well:

1. The contractor will ensure a utilization rate of at least 90% for the contracted services. 2. At least 70% of participants served will be living in stable or permanent housing at the time of

discharge, as measured by the living arrangements reported to DMHAS at discharge. 3. At least 75% of respondents to the DMHAS consumer survey will rate services positively in the

domains of access to services, quality of services, outcomes, participation in recovery planning, and overall satisfaction with services.

4. No more than 30% of individuals who have been discharged from Supported Recovery Housing Services will have left due to reasons of non-compliance, against staff advice, and/or administrative reasons.

5. At least 75% of participants will be connected to appropriate treatment services within 30 days of discharge and will have participated in at least one (1) community recovery support such as employment services, peer or faith based services, etc.

6. No more than 30% of individuals who have been discharged from the residence will be readmitted to acute care within thirty (30) days.

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V. Required Components The following are mandatory components of Supported Recovery Housing Services:

1. A clean, safe, drug and alcohol-free living environment in which on-site case management services are available a minimum of 8 hours per day and 5 days per week, and on call staff availability 24 hours a day 7 days per week. Priority admission will be granted to individuals who are eligible for the DMHAS General Assistance Recovery Supports Program or Access to Recovery II. Through GA RSP and ATR II, the maximum length of stay for this service will be 60 days.

2. Staff who have an understanding of substance use disorders and substance use and co-occurring mental

health disorders, along with the principles of recovery. Staff should understand addiction as a disease and should reflect the ethnic, racial, gender, and linguistic composition of the individuals requiring services.

3. Supervision will be provided to each direct care staff person at a minimum of twice monthly in the form

and manner defined by DMHAS. 4. Availability of and/or referral to on-site or off-site recovery support groups such as those based on a 12-

step model. 5. A detailed orientation for the residents to services available through the program and to their rights and

responsibilities as program residents that is sensitive to individuals’ culture, gender, and language. 6. Case management assistance to support residents in securing basic needs (e.g. clothing, food), permanent

housing, employment, entitlements, transportation, and treatment services. On-site services should include referrals to DSS entitlements, the DMHAS GA Recovery Supports Program or Access to Recovery II, vocational/educational opportunities, Section 8 and other housing subsidies, medical or other treatment appointments, energy assistance, food stamps, and other potential sources of income and community recovery supports.

7. Transportation (or linkage to transportation services) for resident appointments or meetings at medical,

clinical, or other community services. 8. The capacity to collect and process urine samples or access drug screening results via an agreement with

another provider, when indicated. 9. Collaboration with other community service providers as demonstrated in letters of support and

memoranda of agreement with other community-based organizations. Evidence of these collaborations must be submitted with the applicant’s proposal.

10. Description of procedures for collaborating in the development and implementation of recovery plans

with the residents, treatment provider(s), and other agencies and family members as appropriate. 11. Evidence that the Supported Recovery Housing Services program is designed and will be operated as an

integral part of a regional and/or statewide system of care, including identification and listing of local recovery and community resources.

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12. A mechanism and detailed procedure specifying discharge planning and resident transition to a

permanent living arrangement. 13. Compliance with all state and federal regulatory requirements as well as local zoning, fire, and safety

laws. 14. Successful completion of the General Assistance Recovery Supports Program certification

application/materials for this service. 15. Consultation with recovery community advocacy organizations, cultural organizations, and other

community stakeholder groups with expertise in such services. The applicant must demonstrate mechanisms, frequency, quantity, and outcomes of its efforts to gather input from individuals in recovery and family members in the preparation of this application and in the planning, implementation, evaluation, and ongoing quality improvement of the service. Mechanisms for involvement of individuals in recovery and family members include, but are not limited to:

• Voting members on agency planning committees, boards, advisory groups, etc. • Focus groups • Surveys • Facilitated discussions • Solicitation of written suggestions

16. The ability to offer these services by October 1, 2009.

VI. Other System Expectations Services implemented through this RFP, which are aimed at improving quality of care, must build upon and compliment DMHAS’ focus on enhancing its recovery-oriented system of care that is responsive to the needs of persons served. All applicants must specify how they will address the following system expectations within their response. Please refer to the websites listed below for guidance regarding implementation of these systems expectations.

• Cultural Competence (See Commissioner’s Policy Statement #76: Policy on Cultural Competence http://www.ct.gov/dmhas/cwp/view.asp?a=2907&q=334668 Research and experience have shown that culture and society play pivotal roles in behavioral health, behavioral disorders, and the utilization and effectiveness of treatment services. Understanding the wide-ranging roles of culture and society enables the behavioral health field to design and deliver services that are more responsive to the needs of diverse racial and cultural groups. Currently, the DMHAS system serves many different populations and recognizes the significance culture as a factor affecting individual outcomes. In the coming decades, as Connecticut’s demography continues to change, it will become increasingly important that we strengthen the cultural competence of our service system. In order to address this issue in the present RFP, the following requirements have been set:

o The successful applicant must have a Cultural Competency Plan approved by the DMHAS Office of Multicultural

Affairs. o The applicant must demonstrate an understanding of the demographic, racial, ethnic, socioeconomic, and religious

haracteristics of the population in its targeted service area. c

• Recovery-Oriented Service System (See Commissioner’s Policy Statement #83 Promoting a Recovery-Oriented Service System

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http://www.ct.gov/dmhas/cwp/view.asp?a=2907&q=334672 The purpose of this policy is to formally designate the concept of “recovery” as the overarching goal of the service system operated and funded by DMHAS. This action is consistent with the fact that DMHAS is a healthcare service agency. Thus, it is most appropriate that one should hope and expect that, as a result of active involvement with this healthcare system, they will be better able to manage their illness and improve the quality of their life.

• Co-Occurring Capability (See Commissioner’s Policy Statement #84

http://ct.gov/dmhas/LIB/dmhas/CommissionersPolicies/policy84.pdf An overarching goal of DMHAS, as a healthcare service agency, is promoting and achieving a quality-focused, culturally responsive, and recovery-oriented system of care. The full attainment of this goal is not possible if the service system design, delivery, and evaluation are not fully responsive to people with co-occurring mental health and substance use disorders. Given the high prevalence of co-occurring disorders, the high number of critical incidents involving individuals with these conditions, and the often poor outcomes associated with co-occurring disorders in the absence of integrated care, it is extremely important that we collectively improve our system in this area. There have been advances in research and practice related to co-occurring disorders and it is important that the system close the science to service gap. Through these and other related improvements, the citizens of the state can expect better processes of care and better outcomes for people with co-occurring disorders.

• Gender Responsive Care

DMHAS’ initiative for Gender Responsive Care is designed to enhance our current behavioral health service system for women in a way that is trauma-informed, gender-specific, and promotes self-determination. A best practice system of care for women, supported by system-level policies and standards and program-level practices is currently under development. The goal is to improve treatment outcomes and the quality of services for women receiving substance abuse treatment in Connecticut through participation in a recovery-oriented treatment system of care that incorporates current best practices in gender responsive and trauma-informed programming.

• Trauma Informed Care

The primary goal of DMHAS’ Trauma Informed Care initiative is to deliver behavioral health care that is sensitive and responsive to the needs of men and women who have experienced trauma. Trauma services are being developed based on the guiding principle that treatment must be informed by a sound scientific, clinical, culturally relevant, and humanistic understanding of the impact and impairment caused by traumatic stress.

• Person-Centered Care (See CT Implementation of Person-Centered Care

http://www.ct.gov/dmhas/LIB/dmhas/Recovery/personcentered.pdf Commissioner’s Policy Statement #83 formally designates the concept of “recovery” as the overarching goal of the service system operated and funded by DMHAS. DMHAS’ mission to provide recovery-oriented care requires that services be maximally responsive to each individual’s unique needs, values, and preferences. Emphasis on person-centered care is consistent with major advances that have already occurred throughout the DMHAS system, such as greater collaboration with advocacy and recovery groups and increased recognition of, and funding for, peer-based services.

• Concurrent Medication-Assisted Treatment (MAT)

Each program must have access to, or coordinate with other providers, services that address the needs of individuals they serve, including individuals whose recovery is supported and enhanced through the use of clinically appropriate medications. These include, but are not limited to, medications to address symptoms directly related to substance use disorders (e.g., methadone, buprenorphine/naloxone, naltrexone, disulfuram, etc.), psychiatric conditions (e.g., antidepressants, antianxiolytics, antipsychotics, etc.), physical conditions (e.g., insulin, analgesics for chronic pain management, medications for TB, HIV/STD, Hepatitis, antihypertensives, anti-cholesterol, etc.), and smoking cessation medications (e.g., varenicline, wellbutrin, over-the-counter (OTC) products, etc.). Programs are encouraged to facilitate and support general wellness through the use of effective medications.

• DMHAS’ Recovery Practice Guidelines (See Practice Guidelines for Recovery-Oriented Behavioral Health

Care http://www.ct.gov/dmhas/lib/dmhas/publications/practiceguidelines.pdf Wherever possible, programs must be guided by innovative, recovery-oriented, community-focused practice principles and guidelines, such as those outlined in the DMHAS’ Practice Guidelines for Recovery-Oriented

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Behavioral Health Care. DMHAS’ Guidelines emphasize the following principles: Participation, Promoting Access and Engagement, Continuity of Care, Strengths-Based Assessment, Individualized Recovery Planning, Functioning as a Recovery Guide, Community Mapping, Development, and Inclusion, and Identifying and Addressing Barriers to Recovery.

Integration of Primary Health and Wellness Behavioral health disorders frequently co-occur along with a medical illness, such as heart disease, cancer, diabetes, and neurological illnesses (Institute of Medicine, 2005). Even more disturbing are findings that suggest that those with serious behavioral health disorders experience earlier death as a result of under-treated medical conditions (Surgeon

eneral’s Report, 1999). G Integration of and/or more effective coordination of care and collaboration between behavioral and primary health and wellness approaches must be addressed to improve health and quality of life and to enhance life expectancy for individuals served throughout the DMHAS service system.

Institute of Medicine (IOM) The Institute of Medicine (IOM) issued two seminal reports—Crossing the Quality Chasm (2001) and Improving the Quality of Health Care for Mental and Substance Use Conditions (2006)—that inform the foundational qualities of recovery-oriented systems of care. IOM proposed six (6) goals to improving the ealth care system (2006). Health care should be:

1. Person-Centered—A highly individualized comprehensive approach to assessment and services used to understand each individual’s and family’s history, strengths, needs and vision of their own recovery including attention to the issues of culture, spirituality, trauma, and other factors. Service plans and outcomes are built upon respect for the unique preferences, strengths and dignity of each person.

2. Timely and Responsive—Goal-directed services are promptly provided in order to restore and sustain consumers/individuals in recovery and families integration into the community. 3. Effective—Up-to-date evidence-based services are provided in response to and respectful of individual/family choice and preference. 4. Efficient—Human and physical resources are managed in ways that minimize waste and optimize access to appropriate treatment. 5. Equitable—Assess and quality of care do not vary because of consumer/individual in recovery characteristics such as: race, ethnicity, age, gender, religion, sexual orientation, disability, diagnosis, geographic location, socioeconomic status or legal status.

6. Safe—Services are provided in an emotionally and physically safe, compassionate, trusting and caring treatment/working environment for all consumers/individuals in recovery, family members and staff.

DMHAS is currently working towards incorporating the above six goals within its existing performance and outcome indicators in order to more effectively measure successes in achieving a recovery-oriented system of care. Additional information will be forthcoming. VII. Award and Eligibility

A. ELIGIBLE APPLICANTS Proposals may be submitted from organizations that can demonstrate experience with and capacity to develop and implement services defined through this RFP within timeframes set forth by DMHAS.

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Additionally, the applicant must successfully complete the DMHAS General Assistance Recovery Supports Program certification process for this housing service which will include a site visit to be conducted by DMHAS staff. B. AWARD AND FUNDING DMHAS anticipates making multiple awards up to 200 beds maximum based on this RFP. Awards will be based on the content of the proposal as well as the geographical, gender-specific, and other needs of the Department. Reimbursement for each award will be $500 per bed per month, for a maximum of 2 months, paid retrospectively on a fee-for-service basis. This level of reimbursement is intended to cover services delivered to individuals who are eligible for the General Assistance Recovery Supports Program or Access to Recovery II. In accepting this GA RSP and ATR II-funding, residents shall not be charged any additional fees by the provider. Services will be authorized via the Department’s Administrative Services Organization (ASO), and providers shall submit an invoice to the ASO for payment following the delivery of services. Payment will be pro-rated based on the actual number of days that services were provided if less than a month. Applicants must provide a copy of the provider’s most recent annual financial audit, if available. Such audit shall include management letters and audit recommendations. Continued funding is contingent upon the ongoing availability of funds, satisfactory program performance, and demonstrated need for these services. Applicants should note that any contracts developed as a result of this RFP are subject to the Department’s contracting procedures that include approval by the Office of the Attorney General, as well as, compliance with OPM Cost Standards, and State Contracting Board and State Election Enforcement Commission (SEEC) requirements. C. SCHEDULE

EVENT DATE Release of RFP 6/30/09 Bid Deadline 8/18/09 Notice of Award (Begin Contract Negotiations) 8/09 – 9/09 Begin Implementation (Contracts fully executed) 9/09 Fully operational 10/1/09

D. EX PARTE CONTACT PROHIBITED Any form of ex parte contact regarding this RFP or any proposal being prepared or being considered under this RFP, whether directly or indirectly, is hereby strictly prohibited. This includes, but is not limited to, any contact with elected officials or other state employees asking them for advice, information, or support at any time when actual notification of results is made. Violations will result in outright rejection of any and all proposals submitted under this RFP by the respondent. Any inquiries or requests regarding the RFP must be submitted to the Program Contact (Reference RFP Cover). E. EVALUATION AND SELECTION DMHAS will conduct a comprehensive, fair and impartial evaluation of proposals received in response to this procurement. Only proposals found to be responsive to the RFP will be evaluated and scored. A responsive proposal must comply with all instructions listed in this RFP. The original and nine exact, legible copies (total of 10) of the proposal must be submitted in a properly addressed package by the deadline. F. CONTRACT EXECUTION The pursuant contract developed, as a result of this RFP, is subject to Department contracting procedures, which includes approval by the Office of the Attorney General. Please note that contracts are executory and that no financial commitments can be made until, and unless, the contracts are approved by the Office of the Attorney General. G. APPLICANT DEBRIEFING

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DMHAS will notify all applicants of any award issued by it as a result of this RFP. Unsuccessful applicants may, within thirty (30) days of the signing of the resultant contract, request a meeting for debriefing and discussion of their proposal by making a written request to the DMHAS contact person identified on the cover page of is RFP. Debriefing will not include any comparisons of unsuccessful proposals with other proposals.

VIII. Instructions for Completion of Proposal, Proposal Evaluation Criteria, and Scoring Responses to this RFP shall include the following sections IN THE ORDER SPECIFIED BELOW. Please refer to the description of each section and its subcomponents, also shown below. The content of each section and the number of points used to evaluate the section (and its subcomponents) are provided. The maximum evaluation score is 200 points. 1. PROGRAM NARRATIVE (Up to 135 Points)

The Program Narrative must be clear, concise, and paginated and must not exceed 10 single-spaced pages in length. The Proposal Narrative shall contain the following subcomponents:

I. PROGRAM DESIGN AND SERVICE OBJECTIVES (100 POINTS)

This Section should provide the reader a clear and specific description of the service required through this RFP.

1. Recovery Community Involvement: Describe how individuals in recovery and family members were

involved in the preparation of the application, and how they will be involved in the planning, implementation, and evaluation of the project.

2. Description of Housing and Case Management Services: Describe the services that will be offered to residents including responses to the following:

i. Location of services and target population served (e.g. age range, gender). Please also include any exclusionary criteria that will be applied to the target population (e.g. will not accept people on chemical maintenance, sexual offenders, etc).

ii. Accessibility of services (e.g. housing proximity to public transportation, community services and other community resources).

iii. Physical plant description of the residence including zoning information (e.g. type of structure, capacity of the residence, proof of compliance with town zoning laws, reasonable accommodations requests, rooming house license, etc.), safety features, fire code compliance, and public health and safety code compliance. Please also include pictures of the residence including the exterior and interior rooms such as the kitchen, bathroom, staff office, dining area, living area, and sample bedroom.

iv. Hours of operation including staff coverage schedules. v. Availability of staff 24 hours a day, 7 days per week, on an on-call basis.

vi. Detail relationships with other community providers including treatment programs, employment/education services, transportation services, etc. (Include letters of support and/or memoranda of agreement where applicable.)

vii. Detail admission procedures (e.g. referrals, paperwork to be completed, orientation guidelines, etc.)

viii. Include information on how individualized recovery plans will be developed and maintained. 3. DMHAS expects that a chart will be kept detailing each resident’s housing and case management

services. Please submit the following in addition to the narrative (not to be included in the 10 page maximum noted above):

i. Sample intake assessment template or form ii. Admission documentation including resident rights and responsibilities, policy manual,

grievance procedures, etc. iii. Sample recovery plan template or form

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iv. Risk assessment policy/procedure and any additional measures and tools used for risk assessment.

v. Procedures used to assertively link individuals with 12 step groups in the community. vi. Sample discharge plan template or form.

vii. Progress note template or form. viii. Sample release of information.

ix. Policy and procedures for staff supervision. x. Written annual training plan for staff in program, which includes focus on housing-based case

management and education on substance use and mental health disorders. xi. Evidence that individuals will have access to the following services in the program, other parts

of the agency, or through assertive linkage and collaboration with affiliate programs: 1. Treatment Services 2. Case Management 3. Employment/Education Services 4. Peer Services 5. Transportation 6. Long-term or Permanent Housing

II. AGENCY/OUSING PROVIDER DESCRIPTION, EXPERIENCE, AND MANAGEMENT PLAN (25

POINTS)

This section should clearly and specifically describe the organizational and personnel capacity of the applicant in relation to service delivery, cultural capacity, and fiscal and program management. The section should also describe personnel from the applicant organization who will be responsible for the program’s oversight and the experience and expertise of individuals who will play a key role in the program.

1. Organizational Structure: Provide an organizational chart that depicts the total organizational structure and where this program would reside within that structure. Provide a clear, detailed summary of the agency’s experience and expertise relevant to successful services offered to a similar target population.

2. Roles and Responsibilities: Describe the roles, responsibilities and reporting relationships of key staff, service providers and any partners. Identify qualified administrative/leadership personnel to provide oversight and supervision of the case management staff.

3. Integration of Funding and Resources: Provide a clear understanding of how funds will be spent and how they support the implementation of a program consistent with the vision, goals and objectives detailed in this RFP. Describe clearly the agency’s capacity for fiscal and program management of the proposed service. 4. Agency Cultural Capacity: Provide evidence of the agency’s cultural capacity and its experience and expertise in addressing the needs of individuals of different races, cultures, ages, genders, and sexual identities and languages.

5. Realistic Implementation Timeline. Are Supported Recovery Housing Services currently operational? If not, provide a detailed implementation plan which lists key dates such as acquisition of property, hiring and training of staff, etc.

III. DATA COLLECTION AND EVALUATION PLAN (10 POINTS)

This section should clearly and specifically describe the kinds of data that will be collected, how and when it will be collected, how it will be stored and managed, how it will be used by program staff and how it will be reported to DMHAS.

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1. Data Collection and Management Plan: Provide a specific, clear description of how the program will collect and manage data (e.g. admission date, discharge date, discharge disposition, etc.). Describe specific instruments that will be used. Provide examples of successful prior history in collecting, managing and reporting program/participant data.

2. Utilization of Data: Describe how program staff will utilize data to monitor and inform program management (including monitoring productivity) and quality management and improvement.

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. PROGRAM BUDGET (Up to 20 Points)

The Program Budget should clearly identify how funds will be used and how costs for expenditures were determined. It should be clear to the reviewer that the budget is sufficient, realistic and appropriate to the program.

1. Submit an annual budget which details all income and expenses (e.g. staff salary, rent, utilities, etc.). 2. Provide a copy of the agency’s most recent annual financial audit, if available. Such audit shall include

management letters and audit recommendations. 3. Describe how applicant intends to maximize use of existing community resources and services, including utilizing

Medicare, Medicaid, and/or other subsidized programs. 4. Describe the extent of "in-kind" services the applicant will provide to this program.

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. APPENDICES (Up to 45 Points). All are required.

Only the following appendices may be included in the application. These appendices must not be used to extend or replace sections of the Program Narrative. All appendices must be completed. 1. Appendix 1: General Assistance Recovery Supports Program Certification Application (see Attachment A).

Applicants must successfully complete the General Assistance Recovery Supports Program certification application/materials for this service.

2. Appendix 2: Biographical Sketches/Resumes for Existing Staff and/or Job Descriptions for New Positions 3. Appendix 3: Letters of Support/Coordination 4. Appendix 4: Organizational Structure (Table of Organization) 5. Appendix 5: Notice To Executive Branch State Contractors and Prospective State Contractors of Campaign

Contribution and Solicitation Ban (see Attachment B) 6. Appendix 6: Consulting Agreement Affidavit (see Attachment C) 7. Appendix 7: Affirmation of Receipt of Summary of State Ethics Law (See Attachment D) 8. Appendix 8: Gift and Campaign Contribution Certification (See Attachment E)

IX. Evaluation Criteria/Selection Committee A Selection Committee (SC), including but not limited to DMHAS staff, one or more people in recovery from mental health, substance use, or co-occurring mental health and substance use disorders, and other parties with expertise or relevant experience in the RFP focus, will evaluate all proposals that meet qualification requirements set forth in this RFP. The SC will score proposals in accordance with the evaluation criteria set forth in this RFP. The evaluation of proposals shall be within the sole judgment and discretion of the SC. This will result in a recommendation to the Commissioner or his designee. The applicant shall neither contact nor lobby DMHAS administration, staff, or evaluators during the evaluation process. Attempts by an applicant to contact and/or influence DMHAS administration, staff, or members of the SC may result in disqualification of the applicant. The SC will evaluate each proposal to determine the extent to which it has met qualification requirements set forth in this RFP. The applicant should bear in mind that any proposal deemed by the SC to be unrealistic in terms of the technical or

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schedule commitments, or unrealistically high or low in cost, will be deemed reflective of a lack of technical competence or of a failure to comprehend the complexity and risk of the requirements as set forth in this RFP. As a result of this RFP, DMHAS intends to enter into contract negotiations with parties selected using this RFP. Applicants whose responses conform to the RFP requirements and whose bids present the greatest value to people served by DMHAS, when all evaluation criteria are considered will be selected for final contract negotiations. The goal is to recommend proposals for award based on the cumulative points scored using the evaluation criteria. Specifications contained in this RFP should be considered as minimum requirements. Much of the material needed to present a comprehensive proposal can be placed into one of the sections listed. Proposals will be rated using a point scoring system that assesses how well the applicant addressed requirements set forth in this RFP. The maximum score across all evaluation criteria is 200 points.

Program Narrative (135 Points), includes:

• PROGRAM DESIGN AND SERVICE OBJECTIVES (100 Points) • AGENCY DESCRIPTION, EXPERIENCE, AND MANAGEMENT PLAN (25 POINTS) • DATA COLLECTION AND EVALUATION PLAN (10 POINTS)

Program Budget (20 Points) Appendices (45 Points)

X. General Proposal Requirements A. DISPOSITION OF PROPOSALS The Department reserves the right to reject any and all proposals, or portions thereof, received as a result of this request or to negotiate separately any service in any manner necessary to serve the best interest of the Department. The Department also reserves the right to contract for all or any portion of the scope of work contained within this RFP if it is determined that contracting for a portion of the work will best meet the needs of the Department. Finally, the Department reserves the right to terminate this competitive procurement process at any time based on funding limitations and/or statutory changes.

B. CONDITIONS Any prospective applicants must be willing to adhere to the following conditions and must positively state them in the proposals: 1. Conformance with Statutes. Any contract awarded as a result of this RFP must be in full conformance with statutory

requirements of State of Connecticut and the Federal Government. 2. Ownership of Subsequent Products. Any product, whether acceptable or unacceptable, developed under a contract

awarded, as a result of this RFP is to be sole property of the Department unless stated otherwise in the RFP or contract.

3. Timing and Sequence. Timing and sequence of events resulting from this RFP will ultimately be determined by DMHAS.

4. Oral Agreement. Any alleged oral agreement or arrangement made by an applicant with any agency or employee will be superseded by a written agreement.

5. Amending or Canceling Requests. DMHAS reserves the right to amend or cancel this RFP, prior to the due date and time, if it is in the best interest of DMHAS and the State.

6. Rejection for Default or Misrepresentation. DMHAS reserves the right to reject the proposal of any applicant that is in the default of any prior contract or for misrepresentation.

7. Department's Clerical Errors in Awards. DMHAS reserves the right to correct inaccurate awards resulting from its clerical errors.

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8. Rejection of Qualified Proposals. Proposals are subject to rejection in whole or in part if they limit or modify any of the terms and conditions and/or specifications of the RFP.

9. Applicant Presentation of Supporting Evidence. An applicant, if requested, must be prepared to present evidence of experience, ability, service facilities, data reporting capabilities, and financial standing necessary to satisfactorily meet the requirements set forth or implied in the proposal.

10. Changes to Proposal. No additions or changes to the original proposal will be allowed after submittal. While changes are not permitted, clarification at the request of DMHAS may be required at the applicant's expense.

11. Collusion. By responding, the applicant implicitly states that they are submitting a response to this RFP that in all respects is fair and without collusion or fraud. It is further implied that the applicant did not participate in the RFP development process, had no knowledge of the specific contents of the RFP prior to its issuance, and that no employee of DMHAS participated directly or indirectly in the applicant’s proposal preparation.

C. PROPOSAL PREPARATION EXPENSE The State of Connecticut and DMHAS assume no liability for payment of expenses incurred by applicants in preparing and submitting proposals in response to this solicitation. D. RESPONSE DATE AND TIME In order to be considered for selection, the Department must receive proposals by 2:00 P.M. Local Time, on August 18, 2009. Postmark date will not be considered the basis for meeting any submission deadline. Any applicant's response, which is received after the deadline, will not be accepted. Receipt of a proposal after the closing date and time as stated herein shall not be construed as acceptance of the proposal. If delivery of the proposal is not made by courier or in person, the use of Certified or Registered mail is suggested. All RFP communications, including proposals, should be addressed to the RFP Program Contact (Reference RFP page 1). Please confirm receipt of your submission by email or phone with the RFP Program Contact. E. INCURRING COSTS DMHAS is not liable for any costs incurred by the applicant prior to the effective date of a contract. F. FREEDOM OF INFORMATION Due regard will be given to the protection of proprietary information contained in all proposals received. However, applicants should be aware that all materials associated with this RFP are subject to the terms of the Freedom of Information Act, the Privacy Act, and all rules, regulations and interpretations resulting there from. It will not be sufficient for applicants to merely state generally that the proposal is proprietary in nature and not therefore subject to release to third parties. Those particular pages or sections, which an applicant believes to be proprietary, must be specifically identified as such. Convincing explanation and rationale sufficient to justify each exception from release consistent with Section 1-210 of the Connecticut General Statues must accompany the proposal. The rationale and explanation must be stated in terms of the prospective harm to the competitive position of the Applicant that would result if the identified material were to be released and the reasons why the materials are legally exempt from release pursuant to the above-cited Statute. In any case, the narrative portion of the proposal may not be exempt from release. Between the applicant and DMHAS, the final administrative authority to release or exempt any or all material so identified rests with DMHAS. H. CONFIDENTIALITY The successful applicant shall comply with all applicable state and federal laws and regulations pertaining to the confidentiality of proprietary information, data and other confidential or personal information concerning the medical, personal or business affairs of program participants acquired in the course of providing services under this RFP. The successful applicant shall keep confidential all financial, operating, proprietary or business information of DMHAS relating to the provision of services under this RFP which is not otherwise public information, along with all information, not described above, but specified in writing by DMHAS as confidential information. The successful applicant shall also cause each of its agents, employees, or subcontractors and other persons and organizations involved in doing business with or controlled by it from disclosing or transmitting to any person or legal entity any of the described information. The successful applicant shall ensure that the appropriate qualified service organization agreements are in place pursuant to federal confidentiality regulations.

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I. AFFIRMATIVE ACTION Regulations of Connecticut State Agencies Section 46a68j-3(10) requires agencies to consider the following factors when awarding a contract that is subject to contract compliance requirements: i. the applicant's success in implementing an affirmative action plan; ii. the applicant's success in developing an apprenticeship program complying with Section 46a-68-1 to 46a-68-17 of the Connecticut General Statutes, inclusive; iii. the applicant's promise to develop and implement a successful affirmative action plan; iv. the applicant's submission of EEO-1 data indicating that the composition of its work force is at or near parity when compared to the racial and sexual composition of the work force in the relevant labor market area; and v. the applicant's promise to set aside a portion of the contract for legitimate small contractors and minority business enterprises. (See CGS 4a-60).

J. OFFER OF GRATUITIES

By submission of a proposal, the applicant certifies that no elected or appointed official or employee of the State of Connecticut has or will benefit financially or materially from this procurement. Any contract arising from this procurement may be terminated by the Department if it is determined that gratuities of any kind were either offered to or received by any of the aforementioned officials or employees from the applicant, the applicant's agent or the applicant's employee(s). The gift affidavit, provided as Attachment E, must be completed by all bidders on all large state contracts in compliance with Public Act 04-245.

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PROPOSAL FACE SHEET

REQUEST FOR PROPOSAL (RFP) – Supported Recovery Housing Services

RESPONDING AGENCY (Legal name and address of organization as filed with the Secretary of State): SERVICES TO BE PROVIDED

(Check applicable box[es]) 1 LEGAL NAME: _ STREET ADDRESS: _ Mental Health Services NA TOWN/CITY/STATE/ZIP: _ Addiction Services NA FEIN: _ AGENCY DIRECTOR/CEO TELEPHONE NO: FAX NO:

2 NAME:

TITLE: E-MAIL: CONTACT PERSON TELEPHONE NO: FAX NO:

3 NAME:

TITLE: E-MAIL: AREA(s) TO Be SERVED: STATEWIDE CATCHMENT AREAS (List) TOWNS (List) REGIONS (List) 7

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ATTACHMENT A: GENERAL ASSISTANCE RECOVERY SUPPORTS PROGRAM (GA RSP) CERTIFICATION APPLICATION: SUPPORTED RECOVERY HOUSING SERVICES

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STATE OF CONNECTICUT

DEPARTMENT OF MENTAL HEALTH AND ADDICTION SERVICES A Healthcare Service Agency

M. Jodi Rell Thomas A. Kirk, Jr., Ph.D Governor Commissioner

GENERAL ASSISTANCE RECOVERY SUPPORTS PROGRAM (GA RSP) Certification Application

Supported Recovery Housing Services Section 1: Identifying Information A. Provider Information: Provider Name (as registered with the IRS): _____________________________________________ Provider Administrative Address: _____________________________________________________

City: __________________________________________State: _____________Zip: ______________

President/CEO/Executive Director Name: ________________________ Title: _________________

Phone: ___________________________ Fax: ____________________________

Email: ______________________________________________________________

B. Program Information: Program Name:_____________________________________________________________________

Program Address: ___________________________________________________________________

City: __________________________________________State: _____________Zip: ______________

Program Phone: ___________________________ Program Fax: ___________________________

Program Contact Person: ________________________________ Title: _______________________ Email: ______________________________________________________________

C. Tax Information: Federal Tax ID (TIN): _____________________

Please attach a copy of IRS Form W-9 (http://www.irs.gov/pub/irs-pdf/fw9.pdf?portlet=3), which is required for payment.

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If listed as a Corporation, Partnership, or other business designation on IRS form W-9, please attach an Organizational Chart or a Partnership Agreement.

Tax Exempt Agencies: 501 (c)(3) ID Number: ______________________________ Please attach a copy of the IRS determination letter D. Site Staffing: What hours are staff available on site? __________________________________________________ Can residents reach staff when they are not on site? If so, how? _____________________________ Section 2: General Site Information A. Please attach a copy of this site’s most recent Tax Assessor’s Field Card. Per the most recent Tax

Assessor’s Field Card:

Who is the listed owner of this dwelling site: ______________________________________________

What is the owner’s relationship to the Provider: ___________________________________________ B. If this dwelling site is not owned by the Provider, please provide a lease agreement and a letter

signed by the dwelling owner stating that the dwelling owner has full knowledge of the intended use of the dwelling site. This letter must have the exact dwelling address as listed on Page 1 of this application.

C. Zoning Information: Please provide a copy of the local zoning laws that pertain to this dwelling

site. Also include ALL other documentation that relates to zoning such as: rooming house licensure, variance approval, reasonable accommodation request and/or approval, etc. DMHAS shall contact local zoning departments to confirm information as needed.

What is the maximum number of unrelated individuals that may reside together in this dwelling site per

the local zoning laws: ________________ What is the actual number of unrelated individuals that reside in this dwelling site: ___________ Section 3: Pending Investigation/Litigation A. Is the Provider and/or this dwelling site currently in the midst of any legal actions (e.g. litigation,

investigation, cease and desist orders, etc.): Yes ________ No ___________ B. If yes, please explain in detail and attach copies of any current documentation. Please note, per

DMHAS Cease and Desist Policy, GA RSP will not certify a new site if the site is under an active cease and desist order for a zoning violation until such a time that the zoning issue has been resolved.

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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____________________________________________________________________________________________________________________________________________________________________________________ C. In the past, has DMHAS, or any other State Agency, terminated a contract with the Provider and/or this dwelling site prior to the contract end date: Yes ________ No ___________ D. If yes, please explain in detail and attach copies of any documentation. _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Section 4: Resident Information A. Please answer the following questions as they pertain to Supported Recovery Housing Services. Gender(s) and age groups served: ________________________________________________________ Individuals on methadone/buprenorphine: Accepted ________ Not Accepted ________ Individuals on psychotropic meds: Accepted ________ Not Accepted _________ Smoking allowed inside the residence: Yes ________ No __________ Faith-based program: Yes ________ No _________ If yes, are residents required to attend religious services: Yes _________ No __________ Section 5: Insurance Coverage Please attach the appropriate certificate of insurance. If current insurance does not meet the specifications below, please submit a copy of the quote/binder from your insurance agent or a plan/timetable to secure insurance. Supported Recovery House Service providers are required to submit proof insurance prior to contract execution. A. Commercial General Liability Insurance:

• $1M combined single limit per occurrence for bodily injury, personal injury, and property damage. If a general aggregate is used, it shall be twice the occurrence limit.

• The State of Connecticut Department of Mental Health and Addiction Services shall be listed as Additional Insured.

B. Workers’ Compensation Insurance:

• Statutory coverage in compliance with the Compensation Laws of the State of Connecticut. • Coverage shall include Employer’s Liability with minimum limits of $100,000 each accident,

$500,000 Disease – Policy limit, $100,000 each employee.

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Section 6: Physical Environment/Site Visit Standards A. The Supported Recovery House shall have a homelike, residential appearance and shall be clean and well maintained. DMHAS will conduct site visits using an inspection tool similar to the U.S. Department of Housing and Urban Development’s Housing Quality Standards (HQS) Inspection Form (http://www.hud.gov/offices/cpd/affordablehousing/library/forms/hqschecklist.pdf). Dwellings must pass this inspection as part of the certification process. B. During the site visit, DMHAS will also look for standards such as, but not limited to:

• Adequate living space for daily activities and support services • Appropriate and separate locked storage for support service records and files • Adequate storage space for resident belongings • Furniture is clean and in good repair • All living space is finished – there is no one living in the attic or basement • Appropriate fire/smoke detection

For DMHAS Use Only: DMHAS Site Visit Date: ________ Inspection Passed: _____ Yes _____ No DMHAS Staff Initials: ___________ Comments:

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Section 8: Attestation My signature below indicates that: 1. All of the information provided on this application and attachments are true and correct. 2. The listed dwelling on this application is, and shall remain, in full compliance with all zoning, ordinances, and fire and safety requirements. 3. I understand that if this dwelling is found to be non-compliant with zoning, ordinances, and/or fire & safety requirements this shall result in discontinuation or suspension of payment until such a time that a final determination is made that the dwelling is compliant with zoning, ordinances and/or fire & safety requirements. 4. Any misrepresentation on this application and attachments may result in the immediate termination of the application process. 5. If a contract has been signed based on the misrepresentation of information contained within this application and attachments, the contract may be terminated immediately. 6. Any changes made to this dwelling and/or its policies and procedures that affects the information contained in this application, attachments, must be brought to the attention of DMHAS, or its designated agent, immediately, or the applicant may risk termination of the contract. ________________________ (Printed Name and Title)

________________________ (Signature) STATE OF CONNECTICUT) ) ss. ______________________ COUNTY OF ____________ ) Subscribed and sworn to before me on this _______day of _____________, 20__.

___________________________ Notary Public/Commissioner

of the Superior Court

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ATTACHMENT B: NOTICE TO EXECUTIVE BRANCH STATE CONTRACTORS AND PROSPECTIVE STATE CONTRACTORS OF CAMPAIGN CONTRIBUTION AND SOLICITATION BAN

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NOTICE TO EXECUTIVE BRANCH STATE CONTRACTORS AND PROSPECTIVE STATE CONTRACTORS OF CAMPAIGN CONTRIBUTION AND SOLICITATION BAN

This notice is provided under the authority of Connecticut General Statutes 9-612(g)(2), as amended by P.A. 07-1, and is for the purpose of informing state contractors and prospective state contractors of the following law (italicized words are defined on page 2): Campaign Contribution and Solicitation Ban No state contractor, prospective state contractor, principal of a state contractor or principal of a prospective state contractor, with regard to a state contract or state contract solicitation with or from a state agency in the executive branch or a quasi-public agency or a holder, or principal of a holder of a valid pre-qualification certificate, shall make a contribution to, or solicit contributions on behalf of (i) an exploratory committee or candidate committee established by a candidate for nomination or election to the office of Governor, Lieutenant Governor, Attorney General, State Comptroller, Secretary of the State or State Treasurer, (ii) a political committee authorized to make contributions or expenditures to or for the benefit of such candidates, or (iii) a party committee; In addition, no holder or principal of a holder of a valid pre-qualification certificate, shall make a contribution to, or solicit contributions on behalf of (i) an exploratory committee or candidate committee established by a candidate for nomination or election to the office of State senator or State representative, (ii) a political committee authorized to make contributions or expenditures to or for the benefit of such candidates, or (iii) a party committee.

Duty to Inform State contractors and prospective state contractors are required to inform their principals of the above prohibitions, as applicable, and the possible penalties and other consequences of any violation thereof.

Penalties for Violations

Contributions or solicitations of contributions made in violation of the above prohibitions may result in the following civil and criminal penalties: Civil penalties--$2000 or twice the amount of the prohibited contribution, whichever is greater, against a principal or a contractor. Any state contractor or prospective state contractor which fails to make reasonable efforts to comply with the provisions requiring notice to its principals of these prohibitions and the possible consequences of their violations may also be subject to civil penalties of $2000 or twice the amount of the prohibited contributions made by their principals. Criminal penalties—Any knowing and willful violation of the prohibition is a Class D felony, which may subject the violator to imprisonment of not more than 5 years, or $5000 in fines, or both.

Contract Consequences

Contributions made or solicited in violation of the above prohibitions may result, in the case of a state contractor, in the contract being voided. Contributions made or solicited in violation of the above prohibitions, in the case of a prospective state contractor, shall result in the contract described in the state contract solicitation not being awarded to the prospective state contractor, unless the State Elections Enforcement Commission determines that mitigating circumstances exist concerning such violation. The state will not award any other state contract to anyone found in violation of the above prohibitions for a period of one year after the election for which such contribution is made or solicited, unless the State Elections Enforcement Commission determines that mitigating circumstances exist concerning such violation.

Receipt acknowledged:_______________________________________ ______________ (signature) (date)

Print name:_________________________________________________ Title:______________________________

Company Name:_____________________________________________

Additional information and the entire text of P.A 07-1 may be found on the website of the State Elections Enforcement Commission, www.ct.gov/seec. Click on the link to “State Contractor Contribution Ban”

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Definitions:

"State contractor" means a person, business entity or nonprofit organization that enters into a state contract. Such person, business entity or nonprofit organization shall be deemed to be a state contractor until December thirty-first of the year in which such contract terminates. "State contractor" does not include a municipality or any other political subdivision of the state, including any entities or associations duly created by the municipality or political subdivision exclusively amongst themselves to further any purpose authorized by statute or charter, or an employee in the executive or legislative branch of state government or a quasi-public agency, whether in the classified or unclassified service and full or part-time, and only in such person's capacity as a state or quasi-public agency employee. "Prospective state contractor" means a person, business entity or nonprofit organization that (i) submits a response to a state contract solicitation by the state, a state agency or a quasi-public agency, or a proposal in response to a request for proposals by the state, a state agency or a quasi-public agency, until the contract has been entered into, or (ii) holds a valid pre-qualification certificate issued by the Commissioner of Administrative Services under section 4a-100. "Prospective state contractor" does not include a municipality or any other political subdivision of the state, including any entities or associations duly created by the municipality or political subdivision exclusively amongst themselves to further any purpose authorized by statute or charter, or an employee in the executive or legislative branch of state government or a quasi-public agency, whether in the classified or unclassified service and full or part-time, and only in such person's capacity as a state or quasi-public agency employee. "Principal of a state contractor or prospective state contractor" means (i) any individual who is a member of the board of directors of, or has an ownership interest of five per cent or more in, a state contractor or prospective state contractor, which is a business entity, except for an individual who is a member of the board of directors of a nonprofit organization, (ii) an individual who is employed by a state contractor or prospective state contractor, which is a business entity, as president, treasurer or executive vice president, (iii) an individual who is the chief executive officer of a state contractor or prospective state contractor, which is not a business entity, or if a state contractor or prospective state contractor has no such officer, then the officer who duly possesses comparable powers and duties, (iv) an officer or an employee of any state contractor or prospective state contractor who has managerial or discretionary responsibilities with respect to a state contract, (v) the spouse or a dependent child who is eighteen years of age or older of an individual described in this subparagraph, or (vi) a political committee established or controlled by an individual described in this subparagraph or the business entity or nonprofit organization that is the state contractor or prospective state contractor. "State contract" means an agreement or contract with the state or any state agency or any quasi-public agency, let through a procurement process or otherwise, having a value of fifty thousand dollars or more, or a combination or series of such agreements or contracts having a value of one hundred thousand dollars or more in a calendar year, for (i) the rendition of services, (ii) the furnishing of any goods, material, supplies, equipment or any items of any kind, (iii) the construction, alteration or repair of any public building or public work, (iv) the acquisition, sale or lease of any land or building, (v) a licensing arrangement, or (vi) a grant, loan or loan guarantee. "State contract" does not include any agreement or contract with the state, any state agency or any quasi-public agency that is exclusively federally funded, an education loan or a loan to an individual for other than commercial purposes. "State contract solicitation" means a request by a state agency or quasi-public agency, in whatever form issued, including, but not limited to, an invitation to bid, request for proposals, request for information or request for quotes, inviting bids, quotes or other types of submittals, through a competitive procurement process or another process authorized by law waiving competitive procurement. “Managerial or discretionary responsibilities with respect to a state contract” means having direct, extensive and substantive responsibilities with respect to the negotiation of the state contract and not peripheral, clerical or ministerial responsibilities. “Dependent child” means a child residing in an individual’s household who may legally be claimed as a dependent on the federal income tax of such individual. “Solicit” means (A) requesting that a contribution be made, (B) participating in any fund-raising activities for a candidate committee, exploratory committee, political committee or party committee, including, but not limited to, forwarding tickets to potential contributors, receiving contributions for transmission to any such committee or bundling contributions, (C) serving as chairperson, treasurer or deputy treasurer of any such committee, or (D) establishing a political committee for the sole purpose of soliciting or receiving contributions for any committee. Solicit does not include: (i) making a contribution that is otherwise permitted by Chapter 155 of the Connecticut General Statutes; (ii) informing any person of a position taken by a candidate for public office or a public official, (iii) notifying the person of any activities of, or contact information for, any candidate for public office; or (IV) serving as a member in any party committee or as an officer of such committee that is not otherwise prohibited in this section.

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ATTACHMENT C: CONSULTING AGREEMENT AFFADAVIT

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STATE OF CONNECTICUT CONSULTING AGREEMENT AFFIDAVIT

Affidavit to accompany a State contract for the purchase of goods and services with a value of $50,000 or more in a calendar

or fiscal year, pursuant to Connecticut General Statutes §§ 4a-81(a) and 4a-81(b)

INSTRUCTIONS:

If the bidder or vendor has entered into a consulting agreement, as defined by Connecticut General Statutes § 4a-81(b)(1): Complete all sections of the form. If the bidder or vendor has entered into more than one such consulting agreement, use a separate form for each agreement. Sign and date the form in the presence of a Commissioner of the Superior Court or Notary Public. If the bidder or vendor has not entered into a consulting agreement, as defined by Connecticut General Statutes § 4a-81(b)(1): Complete only the shaded section of the form. Sign and date the form in the presence of a Commissioner of the Superior Court or Notary Public.

Submit completed form to the awarding State agency with bid or proposal. For a sole source award, submit completed form to the awarding State agency at the time of contract execution.

This affidavit must be amended if the contractor enters into any new consulting agreement(s) during the term of the State contract.

AFFIDAVIT: [ Number of Affidavits Sworn and Subscribed On This Day: _____ ]

I, the undersigned, hereby swear that I am the chief official of the bidder or vendor awarded a contract, as described in Connecticut General Statutes § 4a-81(a), or that I am the individual awarded such a contract who is authorized to execute such contract. I further swear that I have not entered into any consulting agreement in connection with such contract, except for the agreement listed below: ________________________________________ _____________________________________ Consultant’s Name and Title Name of Firm (if applicable) __________________ ___________________ ___________________ Start Date End Date Cost Description of Services Provided: _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ Is the consultant a former State employee or former public official? YES NO If YES: ___________________________________ __________________________ Name of Former State Agency Termination Date of Employment Sworn as true to the best of my knowledge and belief, subject to the penalties of false statement. ___________________________ ___________________________________ __________ Printed Name of Bidder or Vendor Signature of Chief Official or Individual Date _________________________________ ___________________ Printed Name (of above) Awarding State Agency

Sworn and subscribed before me on this _______ day of ____________, 200__.

___________________________________ Commissioner of the Superior Court or Notary Public

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ATTACHMENT D: AFFIRMATION OF RECEIPT OF STATE ETHICS LAWS SUMMARY

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STATE OF CONNECTICUT AFFIRMATION OF RECEIPT OF STATE ETHICS LAWS SUMMARY

Affirmation to accompany a large State construction or procurement contract, having a cost of more than $500,000, pursuant

to Connecticut General Statutes §§ 1-101mm and 1-101qq

INSTRUCTIONS:

Complete all sections of the form. Submit completed form to the awarding State agency or contractor, as directed below.

CHECK ONE:

I am a person seeking a large State construction or procurement contract. I am submitting this affirmation to the awarding State agency with my bid or proposal. [Check this box if the contract will be awarded through a competitive process.]

I am a contractor who has been awarded a large State construction or procurement contract. I am submitting this affirmation

to the awarding State agency at the time of contract execution. [Check this box if the contract was a sole source award.]

I am a subcontractor or consultant of a contractor who has been awarded a large State construction or procurement contract. I am submitting this affirmation to the contractor.

IMPORTANT NOTE:

Contractors shall submit the affirmations of their subcontractors and consultants to the awarding State agency. Failure to submit such affirmations in a timely manner shall be cause for termination of the large State construction or procurement contract.

AFFIRMATION:

I, the undersigned person, contractor, subcontractor, consultant, or the duly authorized representative thereof, affirm (1) receipt of the summary of State ethics laws* developed by the Office of State Ethics pursuant to Connecticut General Statutes § 1-81b and (2) that key employees of such person, contractor, subcontractor, or consultant have read and understand the summary and agree to comply with its provisions.

* The summary of State ethics laws is available on the State of Connecticut’s Office of State Ethics website at http://www.ct.gov/ethics/lib/ethics/contractors_guide_final2.pdf

___________________________________________ ____________________ Signature Date __________________________________ __________________________________ Printed Name Title ________________________________________________ Firm or Corporation (if applicable)

________________________________________________ Street Address _________________ ____ ______ City State Zip Code

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ATTACHMENT E: GIFT AND CAMPAIGN CONTRIBUTION CERTIFICATION

30

STATE OF CONNECTICUT GIFT AND CAMPAIGN CONTRIBUTION CERTIFICATION

Certification to accompany a State contract with a value of $50,000 or more in a calendar or fiscal year, pursuant to C.G.S.

§§ 4-250 and 4-252(c); Governor M. Jodi Rell’s Executive Orders No. 1, Para. 8, and No. 7C, Para. 10; and C.G.S. §9-

612(g)(2), as amended by Public Act 07-1

INSTRUCTIONS:

Complete all sections of the form. Attach additional copies of this certification, if necessary, to provide full disclosure about any gifts made to any public official or employee of the awarding State agency. Sign and date form in the presence of a Commissioner of the Superior Court or Notary Public. Submit completed form to the awarding State agency at the time of contract execution. CHECK ONE:

Initial gift and campaign contribution certification. Annual update of initial gift and campaign contribution certification. (Multi-year contracts only.)

CERTIFICATION: [ Number of Certifications Sworn and Subscribed On This Day: _____ ] I, the undersigned, am the official authorized to execute the attached contract on behalf of the contractor (named below). I hereby certify that no gifts were made, as defined and described in C.G.S. §§ 4-250(1) and 4-252(c)(1), between the date (indicated below) that the awarding State agency began planning the project, services, procurement, lease or licensing arrangement covered by this contract and the execution date of this contract, except for the gift(s) listed below:

Date of Gift Name of Gift Giver Name of Recipient Value Gift Description

______________________________________________________________________________________

______________________________________________________________________________________ I further certify that neither I, nor any principals or key personnel of the contractor, nor any principals or key personnel of the agents of such contractor, know of any action by such contractor to circumvent the above prohibition on gifts by providing for any other principals, key personnel, officials, employees or agents of such contractor to provide a gift to any public official or employee, as described in C.G.S. § 4-250(c). I further certify that, on or after December 31, 2006, neither I, nor any principals or key personnel of the contractor, nor any principals or key personnel of the agents of such contractor, made a contribution to, or solicited a contribution on behalf of, any campaigns of candidates for statewide public office or the General Assembly. I further certify that the contractor made the bid or proposal without fraud or collusion with any person. Sworn as true to the best of my knowledge and belief, subject to the penalties of false statement. _______________________________ ____________________________ ___________________ Printed Contractor Name Signature of Authorized Official Date _______________________________ ____________________________ Federal Employer ID Number (FEIN) or Printed Name of Authorized Official Social Security Number (SSN) _______________________________ ____________________________ ___________________ Awarding State Agency Start Date of Agency Planning Contract Execution Date

Sworn and subscribed before me on this _______ day of ____________, 200__.

___________________________________ Commissioner of the Superior Court or Notary Public

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ATTACHMENT F: SCORING GRID

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SUPPORTED RECOVERY HOUSING SERVICES RFP APPLICANT: _____________________________________

PROGRAM NARRATIVE

I. PROGRAM DESIGN AND SERVICE OBJECTIVES (100 points) I.1. Recovery Community Involvement:

Point Value

Not Addressed

Poor Fair Average Good Excellent

Describe how individuals in recovery and family members were involved in the preparation of the application, and how they will be involved in the planning, implementation, and evaluation of the project.

5 0 1 2 3 4 5

I.2. Description of Housing and Case Management Services: Describe the services that will be offered to residents including responses to the following:

Point Value

Not Addressed

Poor Fair Average Good Excellent

I.2.i Location of services and target population served (e.g. age range, gender). Please also include any exclusionary criteria that will be applied to the target population (e.g. will not accept people on chemical maintenance, sexual offenders, etc).

10 0 2 4 6 8 10

I.2.ii Accessibility of services (e.g. housing proximity to public transportation, community services and other community resources).

10 0 2 4 6 8 10

I.2.iii Physical plant description of the residence including zoning information (e.g. type of structure, capacity of the residence, proof of compliance with town zoning laws, reasonable accommodations requests, rooming house license, etc.), safety features, fire code compliance, and public health and safety code compliance. Please also include pictures of the residence including the exterior and interior rooms such as the kitchen, bathroom, staff office, dining area, living area, and sample bedroom.

15 0 3 6 9 12 15

I.2.iv Hours of operation including staff coverage schedules 7 0 1.4 2.8 4.2 5.6 7

I.2.v Availability of staff 24 hours a day, 7 days per week, on an on-call basis. 5 0 1 2 3 4 5

I.2.vi Detail relationships with other community providers including treatment programs, employment/education services, transportation services, etc. (Include letters of support and/or memoranda of agreement where applicable.)

5 0 1 2 3 4 5

I.2.vii Detail admission procedures (e.g. referrals, paperwork to be completed, orientation guidelines, etc.)

5 0 1 2 3 4 5

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1.2.viii Include information on how individualized recovery plans will be developed and maintained.

5 0 1 2 3 4 5

I.3.DMHAS expects that a chart will be kept detailing each resident’s housing and case management services. Please submit the following in addition to the narrative :

Point Value

Not Addressed

Poor Fair Average Good Excellent

I.3.i Sample intake assessment template or form 3 0 0.6 1.2 1.8 2.4 3

I.3.ii Admission documentation including resident rights and responsibilities, policy manual, grievance procedures, etc.

3 0 0.6 1.2 1.8 2.4 3

I.3.iii Sample recovery plan template or form 3 0 0.6 1.2 1.8 2.4 3

1.3.iv Risk assessment policy/procedure and any additional measures and tools used for risk assessment.

3 0 0.6 1.2 1.8 2.4 3

1.3.v Procedures used to assertively link individuals with 12 step groups in the community.

3 0 0.6 1.2 1.8 2.4 3

1.3.vi Sample discharge plan template or form 3 0 0.6 1.2 1.8 2.4 3

1.3.vii Progress note template or form 3 0 0.6 1.2 1.8 2.4 3 1.3.viii Sample release of information 3 0 0.6 1.2 1.8 2.4 3 1.3.ix Policy and procedures for staff supervision 3 0 0.6 1.2 1.8 2.4 3

1.3.x Written annual training plan for staff in program, which includes focus on housing-based case management and education on substance use and mental health disorders

3 0 0.6 1.2 1.8 2.4 3

1.3.xi Evidence that individuals will have access to the following services in the program, other parts of the agency, or through assertive linkage and collaboration with affiliate programs: Treatment Services, Case Management, Employment/Education Services, Peer Services, Transportation, Long-Term Housing

3 0 0.6 1.2 1.8 2.4 3

II. AGENCY DESCRIPTION AND EXPERIENCE (25 Points)

Point Value

Not Addressed

Poor Fair Average Good Excellent

II.1. Organizational Structure: Provide an organizational chart that depicts the total organizational structure and where this program would reside within that structure. Provide a clear, detailed summary of the agency's experience and expertise relevant to successful services offered to a similar target population.

5 0 1 2 3 4 5

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II. 2. Roles and Responsibilities: Describe the roles, responsibilities and reporting relationships of key staff, service providers and any partners. Identify qualified administrative/leadership personnel to provide oversight and supervision of the case management staff.

5 0 1 2 3 4 5

II.3. Integration of Funding and Resources: Provide a clear understanding of how funds will be spent and how they support the implementation of a program consistent with the vision, goals and objectives detailed in this RFP. Describe clearly the agency's capacity for fiscal and program management of the proposed service.

5 0 1 2 3 4 5

II.4. Agency Cultural Capacity: Provide evidence of the agency's cultural capacity and its experience and expertise in addressing the needs of individuals of different races, cultures, ages, genders, and sexual identities and languages.

5 0 1 2 3 4 5

II.5. Realistic Implementation Timeline: Are Supported Recovery Housing Services currently operational? If not, provide a detailed implementation plan which lists key dates such as acquisition of property, hiring and training of staff, etc.

5 0 1 2 3 4 5

III. DATA COLLECTION AND MANAGEMENT PLAN (10 Points)

Point Value

Not Addressed

Poor Fair Average Good Excellent

III.1. Data Collection and Management Plan: Provide a specific, clear description of how the program will collect and manage data (e.g. admission date, discharge date, discharge disposition, etc.). Describe specific instruments that will be used. Provide examples of successful prior history in collecting, managing and reporting program/participant data.

5 0 1 2 3 4 5

III.2. Utilization of Data: Describe how program staff will utilize data to monitor and inform program management (including monitoring productivity) and quality management and improvement.

5 0 1 2 3 4 5

2. PROGRAM BUDGET (20 Points)The Program Budget should clearly identify how funds will be used and how costs for expenditures were determined. It should be clear to the reviewer that the budget is sufficient, realistic and appropriate to the program.

Point Value

Not Addressed

Poor Fair Average Good Excellent

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2.1.Submit an annual budget which details all income and expenses (e.g. staff salary, rent, utilities, etc.).

10 0 2 4 6 8 10

2.2. Provide a copy of the agency’s most recent annual financial audit. Such audit shall include management letters and audit recommendations.

5 0 1 2 3 4 5

2.3. Describe how applicant intends to maximize use of existing community resources and services, including utilizing Medicare, Medicaid, and/or other subsidized programs.

3 0 0.6 1.2 1.8 2.4 3

2.4. Describe the extent of "in-kind" services the applicant will provide to this program.

2 0 0.4 0.8 1.2 1.6 2

3. APPENDICES (45 Points)

Point Value

Not Addressed

Poor Fair Average Good Excellent

3.1. Appendix 1: General Assistance Recovery Supports Program Certification Application. Applicants must successfully complete the General Assistance Recovery Supports Program certification application/materials for this service.

26 0 5.2 10.4 15.6 20.8 26

3.2. Appendix 2: Biographical Sketches/Resumes for Existing Staff and/or Job Descriptions for New Positions.

5 0 1 2 3 4 5

3.3. Appendix 3: Letters of Support/Coordination 5 0 1 2 3 4 5

3.4. Appendix 4: Organizational Structure (Table of Organization) 5 0 1 2 3 4 5

3.5. Appendix 5: Notice To Executive Branch State Contractors and Prospective State Contractors of Campaign Contribution and Solicitation Ban

1 0 0.2 0.4 0.6 0.8 1

3.6. Appendix 6: Consulting Agreement Affidavit 1 0 0.2 0.4 0.6 0.8 1

3.7. Appendix 7: Affirmation of Receipt of Summary of State Ethics Law

1 0 0.2 0.4 0.6 0.8 1

3.8. Appendix 8: Gift and Campaign Contribution Certification 1 0 0.2 0.4 0.6 0.8 1

TOTAL SCORE 200

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