Invitation to Negotiate ITN # 1-AMI-VA-0517 Multisystemic Therapy Program June 28, 2017 Virginia Department of Juvenile Justice 600 E. Main St. Richmond, VA AMIkids Virginia 5900 E. Virginia Beach Blvd Ste 310 Norfolk, VA 23502
OVERVIEW On behalf of the Virginia Department of Juvenile Justice (VDJJ), AMIkids Virginia is seeking one or more dedicated, community-based provider agencies that provide clinical services to children, youth and families that would be interested in being trained to deliver and provide Multisystemic Therapy (MST) for system-involved youth in one or more Court Service Units (CSUs) in the Eastern Region of the Commonwealth. Beginning in October 2016, VDJJ contracted with AMIkids Virginia to implement and provide third party management of a Regional Service Coordination (RSC) model of service delivery. Due to a desire to implement a home-based intervention with a proven track record of serving high-risk juvenile offenders, this ITN as administered by AMIkids Virginia is to implement MST, a family-focused, intensive, home-based and evidence-based program. Among the goals of VDJJ s service coordination model are to a) use evidence-based models that have been shown to reduce juvenile recidivism; and b) achieve a reduction in the rate of commitments to DJJ. ABOUT MST: MST addresses the multiple factors known to be related to delinquency across the key settings, or systems, within which youth are embedded. MST strives to promote behavior change in the youth s natural environment, using the strengths of each system (e.g., family, peers, school, neighborhood, indigenous support network) to facilitate change. The major goal of MST is to empower parents with the skills and resources needed to independently address the difficulties that arise in raising teenagers and to empower youth to cope with family, peer, school, and neighborhood problems. Within a context of support and skill building, the therapist places developmentally appropriate demands on the adolescent and family for responsible behavior. Intervention strategies are integrated into a social ecological context and include strategic family therapy, structural family therapy, behavioral parent training, and cognitive behavior therapies. MST is provided using a home-based model of services delivery. This model helps to overcome barriers to service access, increases family retention in treatment, allows for the provision of intensive services (i.e., therapists have low caseloads), and enhances the maintenance of treatment gains. The average duration of MST treatment is approximately 4 months. MST s target population includes system-involved (Probation, Parole, or Reentry) Youth who: - live at home or will be returning to a home-like setting with family, broadly defined 2
- are scored Moderate or High Risk to recidivate on the YASI; - are under 18 years old - Have intellectual capacity to benefit from therapy For questions related to the provision of Multisystemic Therapy (MST), please visit http://mstservices.com. SUBMITTAL INSTRUCTIONS: Electronic submissions are due to virginiaservices@amikids.org by 5 pm EST on 7/31/2017. Responses must be received by the stated deadline to be eligible for consideration. The proposals received by the above date and time will be opened simultaneously. The schedule for review and selection is attached as Appendix B. Questions regarding this ITN should be directed to the above email address. The deadline for questions is by 5pm EST on 7/10/17. All questions must be in writing to ensure all information is available to all bidders. All questions will receive a written e-mail response with a copy to all prospective bidders by 5pm EST on 7/17/17. ELIGIBILITY: Private not-for-profit, public, and private for-profit youth-serving agencies may respond to this ITN. The Commonwealth of Virginia wishes to support the development and expansion of programs using an MST approach implemented with a high degree of clinical fidelity by investing in training and program design; therefore, though experience is not required to make application, preference may be given to those agencies with experience and a track record of success in providing MST to the juvenile offender population either within the Commonwealth or in other jurisdictions. Providers are strongly encouraged to review service provision guidelines at http://mstservices.com. SELECTION PROCESS: Proposals will be selected for contract negotiation based on clearly stated criteria (See Appendix A for list of Rating Criteria): - ability to meet the needs of AMIkids and VDJJ within the timeframes required; 3
- ability to attract and retain three (3) MST therapists and one highly-qualified, highlyskilled MST supervisor (with hiring support from AMIkids and MST Services); - knowledge and history of serving at-risk youth using family-centered, home-based, and evidence-based treatment approaches, and community-based services; - potential to stabilize families at-risk of continued involvement in the juvenile justice system; - ability to manage and support a top-tier, evidence-based intervention; - cost-effectiveness of budget proposal; - experience with and/or knowledge of MST; - willingness to support the evaluation of this project; - quality of the proposal; - current team(s)s in good standing with MST Services, Inc., if applicable. (For a list of licensed MST programs globally, see http://mstservices.com/teams/team-locations.) The award for this ITN is subject to review by MST Services to determine the nominated applicant s ability to achieve and sustain an adherent and competent team. Please note all decisions are final and not subject to challenge. The final award will be dependent on the availability of funding. Payment terms will be monthly. FUNDING/TIME FRAMES: Goal for anticipated initial training date is 10/23/17. A one year contract (with options for renewal) will be negotiated as a result of this ITN process. Continued funding is contingent upon 1) effectively managing contract funds and 2) compliance with MST clinical requirements and AMIkids Virginia s administrative requirements, as well as upon 3) accurate and prompt submission of required program and financial data and reports. Continued funding is also contingent upon positive performance history with achievement of program goals and objectives. Regarding resource allocation and budget proposals, note that all MST-specific training costs and related travel associated with MST licensed training and fidelity will be borne by AMIkids Virginia. SCOPE OF SERVICES: 1. Hire and support a standard MST Team, usually comprised of three full-time therapists and one full-time case carrying Supervisor (and allocation of program administration 4
staff) to provide Multisystemic Therapy to youth and families identified by VDJJ Court Service Unit personnel while adhering to the program model provided by MST Services. - Therapists shall have a master s degree in psychology, counseling, marriage and family therapy, social work, or a related area, or a bachelor s degree with at least five years of related experience (e.g., family therapy and/or intensive in-home counseling). - Therapists will be full-time and must not be engaged in other professional work outside the MST working/training group (i.e., doing contract work at their agency). 2. Meet all training, clinical supervision, and reporting requirements outlined by MST Services and their representatives. MST therapists and the supervisor shall participate in all training required by VDJJ, AMIkids Virginia, and MST Services. Training requirements include: - initial 5-day training for therapists and supervisor orientation training October 23-27, 2017, in or near Norfolk, VA (this can be re-negotiated with MST Services) - a supervisor jump-start training for the supervisor; and - quarterly boosters on selected topics by the MST expert. Note: MST-Specific Training costs including travel will be paid for directly by AMIkids. MST-Specific training and travel costs need not be included in attached budget. 3. Fully support all administrative and programs requirements for MST programs and staff as outlined in Attachment C 4. Agency shall provide therapists with, or ensure that therapists have access to, required equipment including: laptop computers and cellular telephones. 5. Agency must be able to locate appropriate community-based resources to meet any additional needs identified by the family which may include basic needs including enrollment in Medicaid, mental health services such as counseling, individual and/or family therapy, drug and alcohol evaluation and treatment, informal parenting support, mediation, safety planning, etc. 6. Serve 40-45 youth per year, with service commencing on or before November 1, 2017. Referrals are made by DJJ Probation officers and approved by DJJ supervisors within each CSU. 7. The Direct Service Provider (DSP) agency that houses an MST Program shall prepare monthly client summaries to the CSU and AMIkids which describe family s progress 5
toward meeting treatment goals as well as specific court obligations. As part of providing MST, the DSP may be required to appear in Court as necessary. 8. The DSP must track and report client outcomes on a quarterly and as-needed basis, including but not limited to: Required Process Goals (tracked via the MSTI web-based data collection system): Length of treatment - Target range: 90 150 days (3-5 months); Target average: 120 days (4 months) Percent of youth completing treatment - Target: 85% Percent of youth discharged due to lack of engagement Target: <5% Percent of youth discharged due to placement - Target: <10% Average caseloads range within 4 6 per therapist. Therapist Adherence Measure (TAM-R) collection rate Target: > 70% Overall average adherence score - Target:.61 Percent of youth reporting adherence above threshold (>.61) Target: 80% Percent of youth with at least one TAM-R interview Target = 100% Youth at home MSTI Definition: Youth is living at home. Home is defined as a private residence that is approved by the youth s guardian. This could include a parent s home, the home of an approved relative or friend of the family. Foster homes or other types of placement would not be included in the definition of home. Youth who are on runaway status would not be at home. Educational/vocational involvement MSTI Definition: Youth is attending school (is not truant) or vocational training or, if of the legally appropriate age to not attend school, has a paying job (at least half time). Out of trouble with the law MSTI Definition: Youth has not been arrested since the beginning of MST treatment, for an offense committed during MST treatment. (Many MST programs have defined arrests as involvement with police that results in a charge for a new criminal behavior (i.e., not a violation of probation)). 9. Participate in regular meetings with the AMIkids staff to exchange program and evaluation information. LOCALITIES: 6
MST is best delivered with teams that are highly involved in the community. Providers should be familiar and engaged in community agencies including schools and Court Service Units. Therefore, DSP s are encouraged to identify 1-3 localities they will be able to serve. Identified geographic areas in need of MST in order of priority: CSU 4 / Norfolk CSU 2 / Virginia Beach CSU 7 / Newport News CSU 1 / Chesapeake CSU 8 / Hampton CSU 3 / Portsmouth CSU 5 / Suffolk, Isle of Wright, Southampton CSU 2A / Northampton, Accomack For example, a desirable set up would be one team in Newport News / Hampton area and one team in Norfolk / Virginia Beach area. APPLICATION PROCESS: Your written response, utilizing the proposal outline indicated below, should have a minimum of one-inch margins, be prepared in a minimum of 12pt font size, and should not exceed eight (8) single-spaced, single-sided, type-written pages. The narrative response and required attachments should be submitted together in one (1) PDF file. Attachments do not count against the page limit for the narrative. In addition to your narrative response, please provide: Attachment A - Detailed Budget Outline. (use the attached cost estimator) Provide a budget that: outlines specific expenditure(s) of contract funds; outlines 12-month costs for, at minimum, 3 FTE Therapists, 1 FTE Supervisor and.2 Program Manager; a.2 FTE administrative assistant is optional justifies each budget category with a brief statement of calculation or explanation; Attachment B Organization Chart with Identification of where the MST program fits Attachment C - Signed MST Requirements for Agencies 7
Attachment D (If Applicable) -- Most recent Periodic Implementation Review (PIR) report for active MST team(s) PROPOSAL OUTLINE (Your response must be structured in this format in order to be considered for contract funding. Proposals not submitted in this format may be subject to significant deductions in point values assigned by the review committee.) 1. Introduction/Management Capability A. Describe your agency and agency s history. B. Provide an organization chart, identifying key personnel/positions and their qualifications that will have management and oversight of MST. C. Describe your agency s ability to serve multiple CSUs in the Eastern Region of the Commonwealth. Please provide your strategy for ensuring services can be provided in the home community of the youth. 2. Experience with status offender/at-risk youth population and treatment model A. Describe your agency s experience serving at-risk youth and youth at a moderate to high risk to re-offend involved in the juvenile justice and/or mental health systems. B. Describe your agency s experience with and/or knowledge of MST or other community-based, family-centered treatment models. If your agency has never provided MST, please describe your efforts to research and familiarize your agency with the service requirements. C. If currently providing MST services, please share your success with the model and the obstacles encountered and how those obstacles are being handled. Most recent PIR should be included for active teams. 8
3. Ability to meet AMIkids, VDJJ and MST Services requirements, deadlines and timeframes A. Provide detailed plan for your operational approach to the recruitment, training supervision and retention of therapists to provide management and MST therapists. B. Provide detailed plans for how your agency will meet the obligations of AMIkids and VDJJ to ensure that services commence by November 1st at the latest. Include a detailed description of proposed contract initiation operations including all start up activities. Provide a timeline with days and steps detailed beginning with the day the contract is awarded and ending with the day the team is fully staffed. C. Confirm your agency s ability and willingness to participate in the evaluation of this project. 9
APPENDIX A AMIkids Score Form 2017 Multisystemic Therapy (MST) Program Virginia DJJ Agency Name: Program Title: Multisystemic Therapy (MST) Application #: ITN # 1-AMI-VA-0517 Reviewer Name: Review Date: Total Score: Definitions of Rating Categories Exceptional - The proposal exceeds all technical specifications and requirements for all program components. The proposal is innovative, comprehensive, and complete in every detail. Good - The proposal meets all technical specifications and requirements for all program components. The proposal is comprehensive and complete in every detail. Adequate - The proposal generally meets all technical specifications and requirements for all program components, but it is not complete in every detail. Poor - The proposal does not meet all technical specifications and requirements for all program components, or it does not provide essential information to substantiate the grant applicant's ability to provide the service. Comments Are discretionary, but may offer guidance to AMIkids, current or future provider and/or members. If you score exceptional or poor you must add comments. Please circle the appropriate points for each category. 10
SECTION A: Capability Management Exception al Good Adequate Poor The organization clearly describes the history of an organization that can support implementation and oversight of the MST model The organization clearly demonstrated management/organizational structure capability for monitoring the program and Adhering to the MST Model to include strategies for addressing Non-Adherence Practice. Maximum Points = 10 Total Points = Comments: SECTION B: Experience Knowledge & The organization demonstrated knowledge of evidence based treatment modalities such as MST The organization demonstrated knowledge of or experience with evidence-based treatment modalities other than MST The organization demonstrated knowledge of and experience with the target population The organization demonstrated a commitment to evidence based programming. Exception al Good Adequate Poor The organization s most recent PIR report demonstrates adherence to the model and predominately green or met scoring Maximum Points = 25 Total Points = 11
Comments: SECTION C: Services/Staff Exceptiona l Good Adequate Poor The organization demonstrated the ability to recruit and retain home-based clinical staff. The organization has demonstrated the ability to recruit and retain therapists and supervisors The organization s Plan for Recruitment & Retention of MST Therapists meets the needs of AMIkids and VDJJ The organization s policies provide ongoing support to the clinical staff that encourage growth and support the home based clinical staff non -traditional hours & working conditions Maximum Points = 20 Total Points = Comments: 12
SECTION D: Start Up Exception al Good Adequate Poor The organization s start up plan meets the scope of services required by MST with sufficient detail on task, person responsible The organization s plan meets the needs of AMIkids and the DJJ within given time frames Maximum Points = 10 Total Points = Comments: SECTION E: Budget Summary Exception al Good Adequate Poor The organization s budget demonstrates realistic appraisal of operating costs associated with operating MST given the assigned case rate (e.g. salaries, travel, start-up, etc.). Maximum Points = 5 Total Points = Comments: 13
SECTION F: Proposal Overall Quality of Exception al Good Adequate Poor The organization clearly describes implementation and oversight of the MST modality The organization demonstrated professionalism and attention to detail. Maximum Points =10 Total Points = Comments: Total Grant Scoring Points (maximum points 80) Reviewer Signature: 14
APPENDIX B SCHEDULE OF REVIEW AND SELECTION June 28 th -- July 10 th -- July 17 th -- July 31 st -- August 7 th -- August 9 th -- Distribution of the ITN Deadline for Submitting Questions Answers Posted Responses Due Rater Responses Due Finalists Selected August 14 th -- Award Recipients Announced August 23 rd Contract Commences and Recruitment/Hiring Begins September/ October Recruitment and Hiring of MST staff October 23 rd -27 th MST Training (Tentative) November 1, 2017 MST Services Begin 15
Appendix C MST Acknowledgement of Requirements MST Program Requirement 1 MST Therapists are full-time employees assigned solely to the MST program. 2 MST Therapists do not have any non-mst program responsibilities in the agency, do not carry any additional non-mst cases, and do not have other part-time jobs outside of the agency. 3 MST staff are allowed to work a flexible schedule as needed to meet the needs of the families they are serving. 4 MST staff are allowed to use their personal vehicles to transport clients. 5 MST staff have use of either cellular phones or pagers so that clients can contact them quickly and conveniently. 6 MST Therapists operate in teams of no fewer than 2 and no more than 4 therapists (plus the Clinical Supervisor) and use a home-based model of service delivery. 7 MST Clinical Supervisor is assigned to the MST program a minimum of 50% time per MST Team. 8 MST Clinical Supervisor conducts weekly team clinical supervision, facilitates the weekly MST telephone consultation and is available for individual clinical supervision for crisis cases. 9 MST caseloads do not exceed 6 families per therapist and the normal range is 4 to 6 families per therapist.. 10 Overall average duration of treatment is 3 to 5 months. 11 Each MST Therapist tracks progress and outcomes on each case by completing MST case paperwork and participating in team clinical supervision and MST consultation weekly. 12 The MST program has a 24 hour/day, 7-day/week on-call system to provide coverage when MST Therapists are on vacation or taking personal time. This system is staffed by members of the MST team. 13 With the buy-in of other organizations and agencies, MST is able to take the lead for clinical decision-making on each case. Stakeholders in the overall MST program have responsibility for initiating these collaborative relationships with other organizations and agencies while MST staff sustain them through ongoing, case-specific collaboration. 14 Referrals to non-mst compatible programs (e.g., any form of mandated group treatment, day treatment programs, etc.) are not made while youth are in MST, especially on a standard or routine basis. 15 MST program discharge criteria are outcome-based rather than duration-focused. 16 Referrals for additional services after clients are discharged from the MST program are carefully planned and limited to those that can accomplish specific, well-defined goals. The assumption is that most MST cases should need minimal formal after-care services. 17 All MST staff, who have been working for more than 2 months, participate in a 5-day orientation training. 18 MST Supervisor and Therapists are Masters-prepared (clinical-degreed) professionals. I have reviewed the above requirements and on behalf of my agency attest that the agency will comply with all the requirements. Signature Title Agency Date
APPENDIX D Program Goals for Target Population I. Required Process Goals (tracked via the MSTI web-based data collection system): Length of treatment - Target range: 90 150 days (3-5 months); Target average: 120 days (4 months) Percent of youth completing treatment - Target: 85% Percent of youth discharged due to lack of engagement Target: <5% Percent of youth discharged due to placement - Target: <10% Average caseloads range within 4 6 per therapist. Therapist Adherence Measure (TAM-R) collection rate Target: > 70% Overall average adherence score - Target:.61 Percent of youth reporting adherence above threshold (>.61) Target: 80% Percent of youth with at least one TAM-R interview Target = 100% II. Required Outcome Goals (tracked via the MSTI web-based data collection system): Youth is living at home (or a parent approved caregiver) at time of discharge Youth is attending school, receiving vocational training, or (if of the legally appropriate age to not attend school) has a paying job at time of discharge Youth has not been arrested since the beginning of MST treatment, for an offense committed during MST treatment. (Many MST programs have defined arrests as involvement with police that results in a charge for a new criminal behavior (i.e., not a violation of probation). 17
APPENDIX E REGIONAL MAP WITH CSU s 18