Children’s Services Council of Palm Beach County
Request for Proposals 17-002
Page 9 of 9
RFP FORMS
REMINDER
DEADLINE FOR SUBMISSION IS
3/21/2017
Subject: RFP # 17-002
REPLIES ARRIVING AFTER 2:00 PM
ON 3/21/2017
WILL NOT BE CONSIDERED
SECTION 6: SUBMITTAL DOCUMENTS
The following documents can be downloaded from CSC’s website at:
www.cscpbc.org/openprop
Reference file name: RFP #17-002Forms
Responses should be in Arial or Calibri minimum size 11 font and should be assembled in the following manner:
¨ Cover Page – Complete this entire document, sign, scan and include with response. Must be signed.
¨ Questionnaire – Complete this entire document and include with response.
¨ Proposer Qualifications – This section must contain all pertinent data related to the Proposer (including Proposer’s organization, if applicable) and education and experience that would substantiate Proposer’s qualifications and capabilities to perform the services requested.
¨ Professional References - List three professional references, other than Children’s Services Council of Palm Beach County’s staff, associated with similar work previously performed by the Proposer preferably within the past 5 years. For each reference, please specify:
a. Name, address, telephone number, email
b. Project start date and duration
c. Scope and cost of project
d. Role in project
e. Outcome of project
¨ Conflict of Interest Disclosure Form – Complete this document, sign, scan and include with response. This document must include a signature.
COVER PAGESubmit this RFP response to:
Subject: RFP #17-002 /
RFP Title: Counseling for Parents and Young Children / RFP #: 17-002
NAME OF FIRM, ENTITY, ORGANIZATION:
NAME OF CONTACT PERSON: / TITLE:
PHONE NUMBER: / FAX NUMBER: / EMAIL:
MAILING ADDRESS:
CITY: / STATE: / ZIP CODE:
HEADQUARTERS ADDRESS (If different than mailing address):
FEDERAL EMPLOYER IDENTIFICATION NUMBER (EIN): / STATE OF FLORIDA BUSINESS LICENSE NUMBER (If Applicable):
DO NOT include Social Security number with this application; CSC will obtain if/when contracted.
ORGANIZATION STRUCTURE (Please check one):
Corporation ☐ LLC ☐ Partnership ☐ Proprietorship ☐ Joint Venture ☐ Other ☐
If Corporation or LLC, please provide the following:
(A) Date of incorporation/Formation (B) State or Country of incorporation/Formation:
I certify that this Proposal is made without prior understanding, agreement, or connection with any corporation, firm, or person submitting a proposal for the same materials, supplies, or equipment, and is in all respects fair and without collusion or fraud. I agree to abide by all terms and conditions of this RFP and certify that I am authorized to sign this Proposal and that this Proposal is in compliance with all requirements of the Request for Qualifications, including but not limited to, certification requirements.
REQUIRED SIGNATURE
______
Authorized Signature (Manual) (Authorized Signature (Print or Type) Title (Print or Type)
COMPLETE & PRINT FORMS; SIGN THE COVER PAGE; SCAN INTO PDF FORMAT AND EMAIL TO CSC BY 2:00 PM ON DUE DATE
QUESTIONNAIRE
The following Questionnaire shall be completed and submitted with the Request for Proposal. Proposer guarantees the truth and accuracy of all statements and answers herein contained.
Page Limit – 25 pages, excluding Budget Chart and supporting documents (single space and 11 font size)
1. Proposer Agency Experience and Capacity
a. Describe how your agency’s mission supports promoting social-emotional well-being and mental health for children and families, targeting the prenatal period through early childhood years.
b. Describe your agency’s experience in serving children through the age of 5, expectant parents/caregivers and parents/caregivers with children through the age of 5 in the past five years. Include both therapy and other prevention/intervention programs as well as numbers and percentages of children under the age of 5 and adults served by your agency.
c. Describe your agency’s specific experience providing mental health therapy services to vulnerable, high-risk, and potentially hard-to-reach children and families. Please address your agency’s experience and capacity to serve families from diverse cultural and linguistic backgrounds and any efforts made to reduce racial and ethnic disparities.
d. Describe how your agency has provided therapeutic services in the home to any population. Indicate programs, as applicable.
e. List specific areas of the county you propose to serve.
2. Proposer Agency Ability to Function as a System Partner
a. Describe in detail a plan for how your agency proposes to work with the Healthy Beginnings Entry Agencies and other HB Providers to ensure a timely, smooth, warm transfer from referral to services.
b. Describe your agency’s process for collaborating internally and with other agencies involved in clinical work with children and families you are serving, especially pediatric primary care, early care and education, and child welfare. Include your protocol for cross-agency case conferencing on behalf of individual clients and families.
3. Proposer Agency Capacity to Engage, Assess, and Triage Clients
a. Describe your client engagement process, with timelines, from the point of an initial referral to full engagement, including assessments, treatment plans and start of therapy. Include the individuals responsible for each step and your process for triaging adult and child referrals.
b. What are challenges that you would expect to face related to client engagement in therapy and how will you address these?
4. Proposer Agency Ability to Deliver Evidence-Based Treatment
a. Describe your experience replicating evidence-based therapy models.
b. How is fidelity to the therapy model ensured on an ongoing basis?
c. Describe your agency’s experience and capacity to implement the following, include the number of therapists and supervisors trained in each model and their years of experience implementing each model:
1) Manualized Cognitive Behavioral Therapy for Maternal/Caregiver Depression
2) Manualized Interpersonal Therapy for Maternal/Caregiver Depression
3) Play Therapy
4) Filial Play Therapy for Birth to 5
5) Trauma-Focused Cognitive Behavioral Therapy for Preschoolers
6) Child-Parent Psychotherapy
7) Any other evidence-based therapy models.
- Describe your agency’s philosophy regarding ongoing learning and evolving as research identifies best practices.
5. Proposer Agency Staffing, Qualifications, and Supervision
a. Describe the composition of your current therapists who will be providing mental health therapy under this contract, and the number of staff you anticipate needing to recruit to support this program. Please include information regarding: language, cultural diversity, level of education, tenure with the agency and tenure in the field of work.
b. Describe how you will recruit qualified therapists. How will you ensure staff are diverse, culturally competent, and multi-lingual and reflect the communities that will be served by the Counseling for Parents and Young Children program? What practitioner skills and competencies, beyond academic qualifications or experience do you use to select individuals who will implement this program?
c. Please summarize your current method for supporting training of staff in the following areas:
1) Cognitive Behavioral Therapy and/or Interpersonal Therapy for Depression
2) Play Therapy/Filial Play Therapy
3) Trauma-Focused Cognitive-Behavioral Therapy
4) Child-Parent Psychotherapy
d. How does your pay scale for therapists compare to other similar agencies? Be specific.
e. What is the rate of staff turnover in your agency, specifically your clinical staff? How do you promote a positive staff climate?
f. What is your agency’s current policy/procedure on reflective supervision, and how will your agency demonstrate its ongoing commitment to reflective supervision? What types of supervision are provided to clinicians, by whom and with what frequency?
6. Evaluation and Accountability
- How does your agency currently evaluate client progress throughout services, and determine when a client has completed services?
b. Describe how you analyze and group data to guide decisions in your agency’s daily operations.
c. How will your agency ensure the collection of accurate data?
7. Funding
a. Create your budget using the Budget Chart provided.
In preparing your budget, understand that the program is a fee for service (unit cost) model. As such, the proposed unit rates, in total, listed in the Budget Chart should cover all costs related to the program (i.e.: rent, phone, utilities, mileage, support staff, etc.) for the number of clients that you estimate you will serve, and the number of staff needed to serve the anticipated number of clients. Include additional lines for any other activities that you would expect to be part of the program and the associated rate on the Budget Chart.
Submit the Budget Chart along with all supporting documents used to determine the information provided in the Budget Chart with your proposal. Describe in detail how you arrived at the unit rates, and your logic in estimating the number of clients, number of staff and therapists, number of activities per client, etc.
Ensure that the total costs entered in the Budget Chart align with the total dollars needed to operate and deliver the program as reflected in this RFP, including what you anticipate earning from Medicaid.
As CSC is the payor of last resort, you will need to estimate what you will earn from Medicaid. Include this amount in the Budget Chart on the “Less Medicaid/Other Payor Sources” line.
b. How many years have you provided mental health services?
c. Which Medicaid managed care plans does your agency participate in? In addition to Medicaid, how many payor sources do you contract with? Provide the types and percentage of income associated with each payor/funding source.
d. What is your fund balance or retained earnings balance as of your most recently ended fiscal year?
e. What are your total revenues as of your most recent ended fiscal year?
PROPOSER QUALIFICATIONSThis section must contain all pertinent data related to the Proposer’s experience that would substantiate their qualifications and capabilities to perform the services requested.
1. Provide details on the qualification(s) of the organization(s) who will perform the work outlined in Section 3.4 Project Goals; including relevant education and experience with similar work.
2. Describe the Proposer’s experience in performing similar work as outlined in Section 3.4 Project Goals.
PROFESSIONAL REFERENCESList three clients, current or past that can serve as a reference on the development of similar work performed by the Proposer in the past five years. For each reference, please specify:
a. Name, address, telephone number
b. Project start date and duration
c. Scope and cost of project
d. Role in project
e. Outcome of project
Reference #1:Reference #2:
Reference #3:
CONFLICT OF INTEREST DISCLOSURE
The Proposer certifies that this price is made independently and free from collusion. Proposer shall disclose below, to the best of its knowledge, any CSC Council member, employee, or any spouse, son, daughter, stepson, stepdaughter, or parent of any such Council member or CSC employee, who is an officer or director of, or has a material interest in, the Proposer’s business. For purposes hereof, a person has a material interest if he or she directly or indirectly owns more than five percent (5%) of the total assets or capital stock of any business entity, or if he or she otherwise stands to personally gain if the contract is awarded to this vendor.
Failure of a vendor to disclose any relationship described herein shall be reason for debarment.
LIST NAME(S) AND RELATIONSHIPS (IF APPLICABLE)
NAME RELATIONSHIPS
______
(Print Name)
______
(Print Name)
REQUIRED SIGNATURE
______
(Proposer’s Signature)
Document Name: RFP 17-002: Counseling for Parents and Young Children
1/31/2017