TEXAS HEALTH AND HUMAN SERVICES COMMISSION



Texas Health and Human Services CommissionProcurement and Contracting Services Division(PCS)Community Based Care- Bexar CountyRFA HHS0000607Questions and ResponsesJanuary 4, 2017May applicants get a list of all the current contractors in Bexar County regarding all the required RFA SSCC responsibilities of Service?Response: An applicant would have to request this information via an Open Records request. When DFPS awards the SSCC contract, the SSCC will be provided this information.The Exceptional Foster Care numbers is the usage currently provided?Response: The exceptional foster care rate is only used in active SSCC catchment areas (ie. Region 3b). The exceptional foster care rate does not exist in the legacy system. See Section 3.02 Foster Care Rates, C, Exceptional Foster Care Rate for more information.How many days per year? (follow up question for #2)Response: The exceptional foster care rate is only used in active SSCC catchment areas (ie. Region 3b). There is no set number of exceptional care days allotted to each SSCC. See Section 3.02 Foster Care Rates, C, Exceptional Foster Care Rate, #1: DFPS will authorize use of exceptional days of care using a validation process in instances when (1) there is a Court Order that dictates a child specific placement or payment that exceeds the contemplated rate structure of the blended rate, (2) the child has extraordinary service needs that far exceed the traditional residential child care settings (example: major eating disorders, severe medical/psychiatric needs); or (3) the SSCC has performed an exhaustive search and placement cannot be located without the use of a child-specific contract whose rate exceeds the contemplated rate structure of the blended rate. In order to use exceptional days of care in these instances, the SSCC must submit sufficient documentation detailing the circumstances surrounding the request and justification for utilization of exceptional care days to the CPS Director of Placement (or her designee). The CPS Director of Placement (or designee) must approve the utilization request prior to the SSCC using exceptional care days.CPS staff whom come to work for the SSCC, does their trainings count as required SSCC trainings?Response: This will be up to the SSCC to determine. Has DFPS considered a preferred or estimated length of time for transition from contract start (stage 1) into Stage 2?Response: See Section 2.03 Staged Implementation. Progression from Stage I to Stage II will depend upon the SSCC’s demonstrated readiness. Progression from Stage II to Stage III will depend upon demonstrated readiness, but will occur no earlier than 18 months from the date DFPS makes the first referral for case management services to the SSCC as a part of implementation Stage II. All three stages are included as a part of this procurement. Is there a prescribed amount of cases per case manager (ratio of CM to child)?Response: No, see Section 3.05 Case Management Funding (Stages II-III). Is there data reflecting the number of courtesy case manager/supervisor kids in the county?Response: The “Foster Care” tab on the Regional statistical data posted here: ” shows the number of children from each region placed into Bexar County at a point in time. The count is not synonymous with the number of children from out of area in Bexar county receiving courtesy supervision, but will give you an idea. Is there any significant difference, or difference at all, in the expectation or transfer of case management duties to the Bexar County SSCC from R3b (OCOK) or R2 (providence)?Response: Case management services have not to date been transferred in either the previous SSCC contract in Region 2/9 or the current SSCC contract in Region 3b. See Section 2.05 Stage II Case Management for more information.Stage II services and funding will be negotiated prior to implementation of Stage II with each SSCC. The SSCC’s proposal, along with information obtained through assessment and evaluation of case management services in other catchment areas and parts of the state and recommendations of the Public Private Partnership and other stakeholders, as well as other information, will be used to further define Stage II services and performance measures.In regards to kinship, will investigations seek or find a family member before turning the child over to the SSCC or will the SSCC be responsible for finding a family member?Response: Both the CPS removal worker and SSCC are responsible for seeking the least restrictive placement for a child who has been removed and placed into DFPS legal conservatorship. See Section 2.32 Kinship Services (Stages II-III); Roles, Responsibilities and Documentation Requirements (See Chart 12).DFPS, upon removal, will notify the SSCC of the need for kinship caregiver services when known. The SSCC must promote the placement of children with relative or kinship caregivers and continue to search for appropriate kinship placement throughout the life of the case.Section 2.16- Negotiate for outside placement exclusivity- Does this apply to kinship and relative placements?Response: If this question is related to preserving placement capacity within a catchment area, then no, non-verified kinship and relative placements do not apply. Also, see Section 2.16 Placement Capacity. Section 2.19- What is the proposed administrative structure above cw. and supv? Response: The SSCC’s proposed model is not dictated by DFPS. See Section 2.19 Major Deliverable #4 - Placement Services and Services to Children The SSCC must coordinate and manage services to the child or youth in a manner that, at a minimum, conforms to and complies with the service and contract requirements stated, defined, and described in this contract.Also see Section 5.02 Assurance of System and Operational Readiness. Follow up for question number 11- Any idea who will fill those experienced slots?Response: The SSCC’s proposed model and staffing structure is not dictated by DFPS. See Section 2.11 Staffing Qualifications.The SSCC is required to give employment preference to an employee of DFPS whose position is being impacted by the implementation of community based care and who is considered to be employee in good standing.See also Section 5.02 Assurance of System and Operational Readiness. In addition to successfully providing the Deliverables described in Section 4.03 (“Startup Period Schedule and Tasks”), the SSCC must assure DFPS that all processes, MIS systems, and staffed functions are ready and able to successfully assume responsibilities for operations prior to the Operational Start Date. In particular, the SSCC must assure that Key SSCC Personnel, and network Provider staff are hired and trained, MIS systems and interfaces are in place and functioning properly, communications procedures are in place, Provider Manuals have been distributed, and that Provider training sessions have occurred according to the schedule approved by DFPS. Section 2.32- How are disagreements between CPS oversight and SSCC handled?Response: Disagreements between CPS oversight and the SSCC that cannot be resolved through normal communication between each entity will be handled, when necessary, through a formal dispute resolution process. What is the difference between startup funds and resource transfer?Response: See Section 3.01One Time Start-up Funds (Stages I-II). DFPS will provide the SSCC with an upfront, one-time payment for Stage I and II for the purposes of building a provider network to manage DFPS referrals in the catchment area. Prior to the payment of $907,000 for each stage, the SSCC must provide a Budget detail report to DFPS outlining how the SSCC will expend the one-time start-up funds. The SSCC may not use start-up funds to purchase equipment. Start-up funds may be used to lease equipment. Additionally, the SSCC must submit a final expenditure report to DFPS of these funds as requested by DFPS. Any unexpended funds must be returned to DFPS as requested. See Section 3.04 Resource Transfer. As DFPS and the SSCC move through the Stages of Implementation, some of the functions traditionally performed by DFPS will shift to the SSCC. In Stage I, these functions include contract management, child placement and services and adoption services. Transfer of resources will be commensurate with the transfer of functions from DFPS to the SSCC according to the stage of implementation and children served under the SSCC continuum of care. The resource transfer for each stage will be paid to the SSCC each quarter via invoicing prepared by DFPS staff. See also Exhibit C. Resource transfer is ongoing and paid to the SSCC on a quarterly basis. In Stage I the resource transfer will include; placement staff, conservatorship staff and contract management staff. The resource transfers for placement and conservatorship staff discontinue in Stage II and III.Do we have Exception Care rates kids in Bexar County? If yes, can we get historical information on the numbers?Response: Yes, see Exhibit C, estimated exceptional care rate is $465.13 for Bexar County; however the exceptional care rate is reserved for use in active SSCC catchment areas. Since Bexar County has never been an active SSCC catchment area, there is no historical information to be shared at this time. See Exhibit A. Section 3.02 D. for more information on exceptional care rates, the authorization process for the use of these rates and the Stop Loss process.Provider Manual- Exhibit A 63/.3.02(c) - Is this required for RFA or during start-up period?Response: During start-up, see Section 2.14 Major Deliverable #2 - Development and Management of a Continuum of Care and Service Delivery Model. (F) SSCC Provider Manual. Is section 6.4 missing in RFA? This section goes from 6.3 to 6.5 – we wanted to confirm this was an error & content wasn’t missing? Response: Yes, this was a numbering error there is no Section 6.4.We would like to confirm a case is defined by child and not per sibling group?Response: Yes, a case is defined by child.Will DFPS foster homes transfer to SSCC or remain with DFPS? If yes, what is the expected timing for transition?Response: See Section 2.14 Major Deliverable #2 - Development and Management of a Continuum of Care and Service Delivery Model. (C) SSCC Management Plan. b. The schedule, processes and procedures for transition of legacy cases and foster homes from DFPS to the SSCC. Include plan for communicating with providers, foster parents, judiciary and the community. DFPS anticipates a full transition of paid foster care placements between systems within 12 months of contract effective date. The transition of DFPS foster homes to the SSCC will be included in the transition plan as noted, at which time all children entering CPS care from the catchment area will be referred to the SSCC for placement within their SSCC network. Exhibit H- Do we need to specify amount for each purchased services individually? If yes, can DFPS provide the current amount being appropriated?Response: See Section 3.12 Coordination and Delivery of Family Services (Stages II – III) and Exhibit C for methodology. The SSCC must identify its own unmet service needs and either deliver the services directly, identify available community resources, or purchase the needed services. Processes and parameters established in this subsection are only applicable to those services offered by the SSCC through the use of the DFPS purchased client services (PCS) negotiated allocation and do not apply to any services offered by the SSCC through the use of community resources or additional funding methods. DFPS and the SSCC will negotiate the projected amount of purchased client services funds available to the SSCC on an annual basis starting with Stage II. The negotiated amount will be determined, no later than 60 days before Stage II and annually thereafter. Can we get historical data on the purchased services since it varies by youth? In responders conference DFPS indicated it was in Procurement Library. I could not locate, may we have the report name.Response: Yes, see “Paid Services Provided to Families* in Bexar County” posted in the procurement library. Procurement Library- Can we get service code definitions for the Paid Services provided to families? Please refer to actual report – Service code numbers are in left column, but we cannot identify what the codes represent.Response: See Section 2.31 Sample Array of Family Services and Chart 11 Sample Service Array, a description of the broad service categories is provided. See service code categories below.79ADrug Testing-Urine Analysis79BDrug Testing-Oral Fluids79CDrug Testing-Hair Testing81HDiagnostic Consultation82CConcrete Services83FSub Abuse- Assessment83GSub Abuse- Individual Couns/Therapy83HSub Abuse- Group Couns/Therapy86APsylogical/Dev Eval/Test86BPsychiatric Eval86CCouns/Therapy- Individual86ECouns/Therapy- Group86FCouns/Therapy- Family86HCourt-Related Services86UPsycho-Social Assessments87Bno expenditures88KHome-based Therapy92LCourt Ordr Sup Visitation98LTranslator Services Procurement Library- Reports reflects “at the end of October”. Is this a monthly report? If no, what period does it represent?Response: These reports can be produced monthly and show point in time data as of the last day of the month. Therefore, the reports reflect data on October 31, 2017. For example, PP_01r reports the demographics of children in open conservatorship on October 31.Procurement Library- The numbers appear to be the same for both the regional and Statewide report. Is this accurate?Response: Although these reports have “regional” or “statewide” in the title, report parameters allow for data to be produced at the county level. Both reports have the statement “For selected counties only” at the bottom with Bexar county noted as a subheading to the report or in the data line.Data Use Agreement, Exhibit D- References Travis County, should this be Bexar County?Response: The Data Use Agreement references Travis since that is where HHSC and DFPS are located. All issues would be resolved in Travis County. Exhibit A Statement of Work- Authorized Service Level Definition. Will Youth For Tomorrow still provide service level determinations as a third party contractor? Data Use Agreement, Exhibit D- References Travis County, should this be Bexar County?Response: DFPS will pay the SSCC the established blended foster care rate for each calendar day of placement in paid foster care provided under the SSCC's contract, mitigating risk associated with increased entries into paid foster care. Therefore a child placed with the SSCC will not receive a service level through DFPS or its third party contractor, YFT.DFPS does not dictate who the SSCC uses as a third party contractor for service level determinations. See Section 2.14 Major Deliverable #2 Development and Management of a Continuum of Care and Service Delivery Model and related quality assurance and utilization management (QA and UM) requirements. Exhibit A Statement of Work- Is there a cost associated with completing the CANS?Response: The administration of the CANS assessment for a child will be conducted and billed to an approved Star Health/Medicaid provider. Exhibit A Statement of Work- Is there a cost associated with utilizing the eCANS?Response: There is no cost for a CANS Certified provider to enter CANS results for a DFPS child or youth into eCANS.Exhibit A Statement of Work Section 2.08- Will the SSCC input information into CLASS and/or TARE? Response: Not in CLASS, based on demonstrated business need and job function justification, “read only” access will be provided for a limited number of SSCC employees. However, based on demonstrated business need and job function justification, access to input information into TARE will be available to the SSCC.Exhibit A Statement of Work Section 2.08- Please define what information would be “retrieved”.Response: “Retrieved” in this context is referring to the ability for SSCC staff to run reports from the CLASS and TARE systems. Exhibit A Statement of Work 2.10 - How many children and youth in Bexar on average need courtesy supervision?Response: See Response to Question #7Exhibit A Statement of Work 2.10 - What are the functions/expectations of courtesy supervision?Response: In Stage II implementation of Community Based Care, SSCC’s will be responsible for providing courtesy supervision to children, parents and caregivers who reside outside the child’s legal region. See CPS Policy Handbook, section HYPERLINK "" \l "CPS_6314" 6314 Services to Children and Parents across Regional Lines for general guidance on the functions and expectations of courtesy supervision.Exhibit A Statement of Work 2.10 - How will partnering/making referrals to the Integrated Care Coordination contractor work with this contract?Response: The Integrated Care Coordination contract is currently on hold and is not anticipated to rollout in Bexar County.Exhibit A Statement of Work 2.14 Are any staff members required to be a Licensed Child Placing Agency Administrator (LCPAA) or Licensed Child Care Administrator (LCCA)?Response: Community Based Care does not impact or in any way change HHSC Licensing requirements. Job functions that require LCCPAA and LCCA are not changed. Exhibit A Statement of Work 2.14 – Knowing Who You Are training delivered by DFPS is encouraged - Is there a cost associated with utilizing this training?Response: No, DFPS will coordinate with the SSCC to provide this training free of charge.Exhibit A Statement of Work 2.15 Does the SSCC still receive payment on children once they return home and are still in DFPS conservatorship?Response: When a child is returned home, payment to the out of home placement/SSCC ceases. However, the SSCC will continue to receive a case management rate for each child who is reunified with his/her parents until legal permanency is achieved. Exhibit A Statement of Work 2.17- Can client records and service delivery documentation be made available electronically?Response: Response: See Charts in Exhibit A Statement of Work and the SSCC Documentation Requirements. Most client data is entered into the IMPACT, however should DFPS request supporting documentation such as client specific records, service delivery documentation or any other information, the SSCC must provide the information. In most cases a scanned electronic version of the information will be accepted.Exhibit A Statement of Work Chart 6 - Is there an average timeframe that post adoption services are provided?Response: No, the timeframe will vary from child to child and the agency does not collect the data in this way. Exhibit A Statement of Work 2.27 - Are there additional funds to support these family services? Is there data noting how many of these services are covered each year?Response: See Response to Q#20 and Q#21. See also Exhibit C Funding Matrix methodology.Exhibit A Statement of Work 2.27 - How many kinship caregivers receive services that are financially covered by DFPS?Response: DFPS tracks the number of children in kinship placements and verified kinship foster homes. Historical data can be found on the following page of the online interactive data book: . Data can be filtered for relative placement and by foster care or other substitute care. “Demographics of Children age 0-17 in Kinship Placements by Region” reports data for Bexar County as of October 31, 2017. Exhibit A Statement of Work 2.28- Is there a cap on the distance that families outside of the catchment area may reside? Response: No, beginning in Stage II and throughout the life of the contract, the SSCC must serve all families referred by DFPS, including families who reside outside of the catchment area. Exhibit A Statement of Work 2.28- What do services provided to these families look like? Are monthly face to face visits expected?Response: Case management services to families are defined in Section 2.27 Major Deliverable #5 – Case Management (Stages II-III). The SSCC is allowed flexibility in developing their model of how case management services are delivered to children and families within state and federal requirements. Yes, monthly face to face visits with a child, family and caregivers are required and is outlined in Section 2.29 Conducting visits with the Child and the Family (See Chart 9). Exhibit A Statement of Work 2.30 - Please provide a copy of form 2054, including any current rates associated with the services outlined on the form.Response: See response to Q21 and Q 22 above – the 2054 is an automated form that guides data entry in IMPACT, it is not a hardcopy form. Exhibit A Statement of Work Chart 12 - Is the SSCC responsible for providing Permanency Care Assistance?Response: In Stage I implementation of Community Based Care, the SSCC will have a role in verifying kinship caregivers as foster parents within the SSCC provider network; facilitating placements of children with the verified kinship caregivers; and in collaboration with the primary CPS caseworker, assisting caregivers with applying for Permanency Care Assistance. In Stage II implementation of Community Based Care, the SSCC will assume all responsibilities related to Permanency Care Assistance for eligible kinship or relative placements.Exhibit A Statement of Work Chart 13 - Do family reunification services end when DFPS conservatorship ends?Response: Yes Exhibit A Statement of Work Chart 13 - What is the average timeframe from reunification to the end of DFPS conservatorship? How many kids on average reunify each month?Response: DFPS tracks the number of children exiting to reunification and average months in care. Historical data is available by county on the following page of the online interactive data book: . Exhibit A Statement of Work 2.36 - What was Community Based Care logic model for Bexar?Response: A logic model for Community Based Care in Bexar County specifically has not been created. A logic model has been developed for the Community Based Care model in Texas. RFA - Is the SSCC required to acquire an agency accreditation?Response: NoRFA 4.3.1 - Has a competitive range been established, and if so, what is that range?Response: If this question is referring to a “competitive range” for Community Based Care, then the answer is No. RFA 5.1.3 - Please provide an example of who/what a legacy case is.Response: “Legacy” means the child welfare system outside of Community Based Care catchment areas. Therefore, a legacy case is a child welfare case that is not being served under the SSCC continuum of care.RFA 6.1 History and Experience section - Should this section be added to the checklist as items for submission?Response: Yes, See revised Submission Checklist 6.1. History and Experience has been added.RFA 7.1 Fiscal Capacity and Fiscal Controls - Should this section be added to the checklist as items for submission?Response: Yes, See revised Submission Checklist 7 .1 Fiscal Capacity and Fiscal Controls has been added.Exhibit C Purchased Client Services - Does the PAL Life Skills begin in stage 1?Response: YesExhibit C Purchased Client Services - What is the anticipated budget for the PAL Life Skills PAL After Care and ETV?Response: See Section 3.01 Chafee Funds: Methodology and Exhibit C Funding MatrixExhibit C Purchased Client - What are the post adoption historical expenditures for Bexar?Response: That data has not been provided as part of this RFA, but once a contract is awarded to a SSCC, this information will be provided. In the original design of community based foster care, the daily rate to provide services to children was described as being unique to each catchment area, and was to be based on the total DFPS spending for children in that area.? The daily rate was identical in the two proposals recently released.? Does the rate of $79.83 in the RFP equate to the total cost of care anticipated for children in Bexar County?Response: The rate of $79.83 was the rate determined by the Legislative Budget Board and noted in the Senate Bill 1 Rider 42. See Exhibit A. Section 3.02 B. for more information on the blended foster care rates for the catchment area and Section 3.02 D. for information on the midyear rate adjustment process that incorporates the actual case mix experience of the SSCC in order to re-calculate the blended and exceptional care rates. Is the same strategy to transfer the full amount of projected funding for children in the catchment area to the SSCC still being used?Response: See Exhibit C for the resource transfer methodologies for each component and stage. What assumptions and calculations were used to estimate the funding to be included in the daily rate for treatment foster care?? Were these assumptions for services based on children age 10 and under?Response: The Blended Rate is based on projected paid Days of care for each of the four stratas (Infants-Age <1; Ages 1-13, in Care <2 Years; Ages 1-13, in Care 2+ Years; Ages 14-17). The Treatment Foster Care (TFC) Assumptions only adjusted stratas A, B and C, as those stratas include children that first entered care prior to age 13. Strata D includes children that first entered at age 13 and older and therefore were not included. The Impact on stratas A, B and C were assumed to mirror the existing projected splits for those 3 Strata, meaning that if Strata A is projected to represent 20% of the total of A, B, C; then 20% of the total TFC Paid Days is assumed to come from strata A.The impact on the Blended Rate for Treatment Foster Care is strictly based on the projected impact on the Legacy Case-Mix (Overall Average Cost per Day). It does not take into account any differences between an SSCC Catchment Area TFC program and the Statewide Program.The Blended Rate and Exceptional Rate is only based on the anticipated cost it would have cost the State had the children not been in Community Based Foster Care.The current assumptions included a Start Date of October 2017 with capacity of 25, and capacity ramping up by 25 for each month until total capacity reaches 500.Exits are assumed to occur after 6 months, after which 75% are assumed to enter a Moderate Foster Home and the other 25% are expected to exit.These assumptions will be re-evaluated and re-adjusted for the mid-year rate review that will occur in FY18.Does DFPS have standard forms for us to use to provide Budget for SSCC?Response: No specific budget forms are required. The SSCC must provide a 12 – 24 month budget by month and by line item detail. ................
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