PBH Request for Intent - Cardinal Innovations Healthcare Solutions

Request for Proposal (RFP) AnnouncementSpecialized Residential Treatment - Level IICardinal Innovations Catchment AreaNovember 29, 2012Introduction of Cardinal Innovations Healthcare Solutions (Cardinal Innovations):Cardinal Innovations is a Managed Care Organization (MCO) and is the entityresponsible for managing Mental Health, Developmental Disability, and SubstanceAbuse services for residents of 15 Counties in the State of North Carolina. As such, theCardinal Innovations Catchment area is comprised of the following regions andrespective counties:Piedmont RegionAlamance Caswell RegionFive County RegionOPC RegionCabarrus, Davidson, Rowan, Stanly, UnionAlamance, CaswellFranklin, Granville, Halifax, Vance, WarrenOrange, Person, ChathamCardinal Innovations serves a geographical area that is both rural and urban/suburban,which also has a rapid population growth. Cardinal Innovations was the pilot programfor the implementation of the 1915 b/c waiver in the state of North Carolina, which hasbeen expanded across the state.Cardinal Innovations’ role is to manage financial resources and direct services to peoplein need of mental health, developmental disability and substance abuse care. Theseservices are provided through a Network of Provider Agencies and Licensed IndependentPractitioners that are located across the catchment and are under contract with CardinalInnovations. Our goal is to develop a consumer and family driven system that is capableof making continual adjustments to meet the changing needs and choices of our citizensin need of services and supports. The values of Recovery, Empowerment, Self-Determination, Person Centered Planning and Consumer and Family driven services arethe foundation of the system that is being re-engineered at Cardinal Innovations, as partof North Carolina’s Mental Health System Reform Initiative.Announcement / Background of RFPCardinal Innovations has identified the need at this time for Specialized ResidentialTreatment (Level II) homes to serve consumers diagnosed with a Mental Health disorderAND a development disability as a pilot program. The service will be billed under the

existing service code of S5145, but with an enhanced rate of $125.00, as opposed to thecurrent rate of $95.40. The service will be targeted to consumers under age 21 that areeither transitioning down from higher levels of care, or in an effort to prevent a need for ahigher level of Care. Level II services are found to be most effective when the treatmentneeds of the recipient are individualized, consistent, and transition planning occurs at thestart of admission. Level II providers are expected to coordinate with all other involvedproviders, including medical homes, stakeholders, and natural supports.This service is responsive to the need for active therapeutic intervention, by individualstrained in interventions for both the mental health and developmental disabilitypopulation. This service is to support the youth in gaining the skills necessary to stepdown to a lower level of care. The expectation of this service would be to utilize theexisting requirement of the standard Level II clinical coverage policies, with an agencywho identifies how additional training and supervision specific to serving duallydiagnosed consumers will be incorporated into the identified sites. Due to many of thetargeted consumers having been in prior residential treatment services or multipleplacements, the intent of this service is to have a provider who is able to effectively workwith this population and have strategies in place to maintain the consumer in the Level IIservices without having to move consumers suddenly to alternative treatment services.‣ Prospective Provider Requirements:Level II services shall be performed in accordance with existing clinical guidelines. Theprospective provider will also adhere to all existing contractual requirements. To beconsidered for the Cardinal Innovations RFP, the applicant must be currently enrolled ingood standing with Cardinal Innovations and have a demonstrated history with deliveringLevel II residential treatment services. The prospective provider must also meet allrequirements of the RFP and be willing to accept referrals from any consumers within the15 county catchment area.‣ Reporting:To evaluate the effectiveness of this pilot program, participating providers will beexpected to collect and submit to Cardinal Innovations clinical data to be used to evaluatethe effectiveness of the program on a quarterly basis in line with the fiscal year. CardinalInnovations reserves the right to modify the reporting format as deemed necessary.‣ Collaboration with Stakeholders:The provider shall work collaboratively and have positive relationships with CardinalInnovations and community agencies such as the Department of Social Services,Department of Juvenile Justice and schools in order to optimize services for consumers.Level II providers are expected to actively convene routine child and family teammeetings and coordinate with all other involved providers, including medical homes,stakeholders, and natural supports to support a comprehensive System of Careframework.‣ Implementation:Service implementation for the Specialized Residential Treatment- Level II programmingmust be in place by March 1, 2013.Cardinal Innovations Request for Proposal Announcement 1212-1Page 2 - Specialized Residential Treatment Level II

Timeline1. Prospective Providers must submit in writing a Letter of Intent to file includingtheir ability to meet all requirements in the RFP announcement by no later thanthe close of business (5:00 P.M. ) on December 10, 2012. The CardinalInnovations Provider must submit it in writing to:Cardinal Innovations Network Operations DepartmentAttn: Nicole P. McKinney – Network Operations Director4855 Milestone AvenueKannapolis, North Carolina 280812. Mandatory Bidders Conference will be held on:December 17, 201210:00 am – 12:00 pmCardinal Innovations Healthcare SolutionsCorporate office4855 Milestone AvenueKannapolis, NC 280813. The RFP application shall be emailed to attendees of the Bidders Conference onDecember 18, 2012.4. RFP Applications shall be due to Cardinal Innovations by no later than the close ofbusiness (5:00 PM) on January 4, 2013. Late applications shall not be accepted.Prospective Providers must submit hard copies (printed) of their RFP applications,applications submitted electronically will not be accepted. Three copies of theproposal shall be submitted to:Cardinal Innovations Network Operations DepartmentAttn: Nicole P. McKinney – Network Operations Director4855 Milestone AvenueKannapolis, North Carolina 280815. The Network Operations and Quality Management Departments will begin the reviewof applications on January 9, 2013 and notify the five candidates with the highestreview scores of their selection for the stakeholder interview process. All ProspectiveProviders should provide a phone number they can be contacted at for the purpose ofnotification of their selection for the interview process.Cardinal Innovations Request for Proposal Announcement 1212-1Page 3 - Specialized Residential Treatment Level II

6. Stakeholder Interviews (Community Review Team) for the finalists will be conductedon January 15, 2013.Cardinal Innovations Healthcare SolutionsCorporate office4855 Milestone AvenueKannapolis, NC 28081** specific time to be determined**7. All finalists will be asked to provide a phone number they can be contacted at no laterthan 5:00 pm on January 28, 2013 for the purpose of notification of the award of thisRFP.8. Implementation of the Specialized Residential Treatment – Level II programmingmust in place by March 1, 2013.Please remember the Bidders Conference onDecember 17, 2012 from 10 am until 12 pm ismandatory. Providers that do not attend theBidders Conference will not be eligible toparticipate in the RFP.Cardinal Innovations Request for Proposal Announcement 1212-1Page 4 - Specialized Residential Treatment Level II