Request for Services: Residential Services-Complex Needs
Partners Health Management (Partners) is seeking to identify organizations interested in and qualified to become enrolled/are enrolled as approved network providers through Partners credentialing process to offer residential services for patients with complex needs.
Residential Services–Complex Needs is a short-term residential treatment service focused on members with primary intellectual disabilities/developmental disabilities (I/DD) with co-occurring mental health diagnoses or significant behavioral challenges. The members being served through Residential Services – Complex Needs will benefit most by a multi-disciplinary approach with staff who are trained to treat I/DD, mental health and severe behaviors.
This service is available to children and adults, ages 10 and older diagnosed with I/DD and co-occurring mental health diagnosis(es).
Residential Services – Complex Needs will be delivered by practitioners employed by mental health or substance abuse provider organizations that:
- Meet the provider qualification policies, procedures, and standards established by NC Medicaid;
- Meet the provider qualification policies, procedures, and standards established by the Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMHDDSAS); and
- Fulfill the requirements of 10A NCAC 27G.
At a minimum, providers are required to have access to qualified professionals, licensed clinical staff, psychologists and medication prescribers within their own agencies. Based on the member’s individual needs, other services (such as Nursing Services, Occupational Therapy and Physical Therapy) also may be utilized as adjuncts to treatment.
Please refer to the Partners Residential Complex Needs In Lieu of Service Definition, available at https://providers.partnersbhm.org/service-definitions/ for all treatment elements, core concepts, criteria and requirements that are to be met.
If your agency is currently contracted with Partners and would like to be considered for provision of this service, please complete the Provider Change Form located at https://providers.partnersbhm.org/provider-enrollment-credentialing/ and submit to your account specialist, or firstname.lastname@example.org.
Providers Needed: Rapid Response Bed Therapeutic Foster Care (S5145U5) for Children and Youth
Partners Health Management (Partners) is seeking to identify organizations interested in and qualified to become enrolled or are enrolled as approved network providers through Partners credentialing process to offer Rapid Response Bed Therapeutic Foster Care (S5145U5) for eligible children and youth program enrollees.
Our goal is to identify providers able to strengthen and increase the availability of behavioral health services in Partners service area. The organization providing services must have the capability and capacity to provide the needed services as well as demonstrate use of evidenced based practices and a strong system for outcomes measurement.
Partners seeks to increase the network availability of Rapid Response Bed Therapeutic Foster Care. Rapid Response Bed Therapeutic Foster Care (RR) services are provided through 131D Licensed Therapeutic Foster Homes with a North Carolina Licensed Child Placing Agency that provides emergency treatment, structure, stabilization, and supervision to children and youth who are experiencing a behavioral health crisis and who have Medicaid originating from the designated LME/MCO catchment area. This crisis response and stabilization service is treatment focused and intended to support family stability, prevent abuse and neglect, be of short term duration, return children to the home and prevent or minimize the need for out-of-home placements.
Providers of this service must be able to respond to referrals within two hours and notify Partners’ Access to Care department of bed availability daily. This treatment service is designed to maintain family stability, decrease lengths of stay and return the child or youth to the home. Because this service is designed to meet the needs of individuals and families who need crisis stabilization within or near their community and at the same time reducing unnecessary costs of higher levels of care, providers will also be required to demonstrate effective outcomes by reducing use of higher levels of care and returning the majority of children back to their home community within 10 days.
A standard outcomes report will need to be submitted to Partners monthly. Following six months of implementation, Partners’ and the provider(s) will evaluate the effectiveness and cost benefit analysis to determine the need, if any, for modifications or potential discontinuation of the service. This In Lieu Of Medicaid service was approved by the Division of Health Benefits on the condition that the cost of care for these children does not increase as a result of this new service. This budget neutrality is based on reducing use of acute care and restrictive services, like emergency departments, inpatient and Psychosocial Residential Treatment Facility (PRTF). We are seeking providers that have at least two years of provision and expertise in Therapeutic Foster Care services, management of crisis situations and engagement of family members/caregivers in services.
Please refer to the Rapid Response Bed Therapeutic Foster Care Service Description (located at https://providers.partnersbhm.org/request-for-services/ for all treatment elements, core concepts, criteria and requirements that are to be met.
If you would like to be considered for provision of this service and are:
- Currently contracted with Partners, please complete the PROVIDER CHANGE FORM located at https://providers.partnersbhm.org/provider-enrollment-credentialing/ and submit to your account specialist, or email@example.com.
- NOT currently contracted with Partners, please complete the REQUEST FOR CONSIDERATION FORM located at https://providers.partnersbhm.org/provider-enrollment-credentialing/ and submit to firstname.lastname@example.org.
Registration of Interest #1020-001: NC Medicaid Children and Youth Services, Burke and Rutherford Counties
This Registration of Interest will be used to identify appropriately qualified organizations providing will be used to identify any MH/SU Providers interested in and qualified to participate in trauma initiatives in Burke and Rutherford counties. Partners is specifically seeking mental health provider agencies and/or Department of Social Services agencies with clinical teams willing to have their clinical staff (up to five clinicians and one clinical team lead) trained and certified, as well as, maintain certification in order to participate in the project. Certification is awarded by Benchmarks after the designated clinical team leader and clinical team complete the required three-day training and demonstrate competence in the required modalities. Each clinical team will be trained in the use of the assessment, the impact of trauma, how to utilize the standardized measures and the Trauma-intensive Comprehensive Clinical Assessment (TiCCA) template. Clinicians that demonstrate proficiency through North Carolina’s Child Treatment Program (NC CTP) rostering or through their professional license will be exempt from some aspects of clinical training. Clinical team leaders will receive additional training in facilitative administration including operational components. Completion of the training, in addition to ongoing fidelity monitoring, will deem a clinician as certified.
Please refer to the Submission Information for the complete ROI and associated forms.
Responses to Registration of Interest #1020-001 Due December 31, 2020 by 5:00 PM
Please note that issuance of an ROI, RFI or RFP does not guarantee a financial award, nor does it indicate a commitment on the part of the issuer to pursue further contractual relationship.
Please follow the directions below in order to successfully submit your ROI:
- Review the ROI Informational PDF
- Complete and sign the ROI #1020-001 Response Form. (docx.)
- The organization’s clinical director/supervisor/lead must complete the Agency Assessment Tool for ROI #1020-001 (docx.)
- Submit both completed forms by email to Lisa Jordan at email@example.com by 5 p.m. on December 31, 2020.
Request for Proposals #1120-001: NC Medicaid Residential Service for Children (ages 9-12) with Complex Needs
Partners is initiating a Request for Proposals (RFP) to identify current network providers interested in and qualified to provide NC Medicaid Residential Services for Children (Ages 9-21) with Complex Needs in accordance with the guidelines below:
A. One (4 bed) .5600 B Licensed Group Home:
- This group home would be co-ed and serve children, ages 9-21, with dual diagnoses of intellectual/developmental disabilities (I/DD) and mental health (MH) or substance use disorder (SUD). Diagnosis can include Autism Spectrum Disorder (ASD). Clinical Coverage Policy 8-D2 would be followed. Funding sources include regular Medicaid B under an In-Lieu-Of Service Definition. The location must be within Partners’ catchment area and the home must be open for services on or before January 4, 2021. There may be potential for more than one home for which this RFP will be used at a later date.
- This service includes provision to children eligible under the criteria for Children with Complex Needs. Eligibility criteria includes the following:
a. Medicaid eligible children ages 9 and under 21; and
b. Who have been diagnosed with a developmental disability (including I/DD and/or ASD) and a mental health disorder; and
c. Who are at risk of not being able to return to or maintain placement in a community setting; and
d. Has a history of mental health and intellectual and/or developmental disabilities diagnoses or treatment AND one or more of the following risk factors will include the following:
- The child is exhibiting behaviors that are a danger to self or others at this time; and/or
- Has been expelled or is at risk of expulsion from school due to disruptive or dangerous behaviors; and/or
- Has experienced incidents for crisis such as frequent emergency department visits, out of home placements, involvement with criminal justice system, or involuntary commitments.
If you are interested in being considered for provision of these services with Partners, you or a representative from your agency must register and attend the virtual Mandatory Provider Meeting to be held on Friday, October 30, 2020, from 2:00-3:30 PM via Zoom.
Click here to register for the Mandatory Provider Meeting (Bidders’ Roundtable Discussion). Registration will close on Thursday, October 29, 2020 at 5:00 p.m.
RFP #1120-001 Timeline:
- Mandatory Provider Meeting, Bidders’ Roundtable Discussion: October 30, 2020, 2-3:30 p.m. (Click here to register)
- RFP #1120-001 Release Date: November 6, 2020
- RFP #1120-001 Submission Deadline: November 30, 2020
Please direct all questions to Lisa Jordan, firstname.lastname@example.org
Files associated with this RFP:
- RFP #1120-001: NC Medicaid Residential Service for Children (Ages 18-21) With Complex Needs (PDF)
- RFP #1120-001: Provider Narrative Template (docx.)
- RFP #1120-001: Budget Form (xlsx.)
Submission Process: Electronically submit the Provider Narrative with Attestation, the Budget Form and any additional documentation to Lisa Jordan, email@example.com, by 5 p.m., Nov. 30, 2020.
Questions: Email Lisa Jordan at firstname.lastname@example.org