Project Title: Problem Gambling Prevention and Treatment Services
Project #: RFPQ-176-2019
Issued by: Multnomah County view agency website
Publish Date: 3/1/2019
Due Date: 4/1/2019

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Description

PRE-PROPOSAL CONFERENCEThere will be a optional pre-proposal conference for this sourcing event on March 13, 2019 at 1:30 P.M. at the Multnomah Building, Room 126 at 501 S.E. Hawthorne Blvd., Portland, Oregon 97214.Attendance is: OptionalINTRODUCTION AND PROGRAM HISTORYProblem Gambling (PG) is a serious public health issue, characterized by high rates of suicide, domestic violence, bankruptcy, divorce, property crime, poor health  and other illnesses. Research suggests that the damage and disruption PG causes to the lives of individuals who suffer from it is comparable to the destruction caused by substance use to individuals who suffer from substance use disorders. Legal gambling, which was severely limited during most of the 20th century in the U.S began to explode in the 1980s and 1990s. This was a result of the introduction of electronic gambling machines that contain random number generators, and legislators creating state lotteries in lieu of increasing taxes. Gambling has become a leading form of entertainment in the U.S., with Americans losing more than $117 billion a year, about three times more than they spend going to movies. While a very small percentage of people who gamble have a gambling disorder prevalence rates are similar to other conditions that receive important public health attention. Major Service Components Include:PreventionThe purpose of the prevention portion of this RFPQ is to qualify one or more prevention providers who can use evidence-based prevention strategies to increase awareness of problem gambling (PG) and work to reduce PG rates within Multnomah County. Strategies could include (but are not limited to): expanding community awareness of problem gambling issues; infusing problem gambling prevention messages into prevention education; providing alternative activities; utilizing community-based processes; and/or advocating for policy change. If the providers offers other services in addition to PG prevention, PG awareness will be incorporated into those services.TreatmentThe purpose of the treatment portion of this RFPQ is to qualify treatment providers who can integrate problem gambling awareness and early intervention into their behavioral health programs and also provide assistance to individuals in the community who have disordered gambling, and to their significant others. Individuals who have PG are an underserved and stigmatized population. It is challenging to engage them in services. This RFPQ will qualify suppliers to provide both outpatient treatment services and client-finding outreach services to: a) individuals assessed as needing treatment for problem gambling and; b) significant others who are experiencing relational problems due to the gambling behavior of someone close to them. There will be no fees charged to individuals for any treatment services provided under this procurement.GOALS, VALUES AND OTHER IMPORTANT CONSIDERATIONSMultnomah County has a long history of providing help to individuals and families impacted by problem gambling, as early as 1992 becoming the site of one the earliest Oregon treatment programs, even before a statewide system was developed. Multnomah County Mental Health and Addiction Services Division (MHASD) is currently seeking to qualify providers to provide problem gambling prevention services and outpatient treatment and client-finding services for the County. Approximately 16,000 Multnomah County residents have a gambling problem. For each individual who suffers from the disorder, it’s estimated that six others are negatively impacted. Individuals who have gambling disorder are high consumers of behavioral health services but rarely seek help for their gambling problems. They are more likely to present to behavioral health services with complaints of anxiety, depression, substance use disorders or relationship problems. Among individuals who are in treatment for substance use disorders problem gambling rates are high. This is particularly true for opioid-dependent people. Between 17% and 46.2% of methadone maintenance patients have Gambling Disorder. These individuals are more likely to have positive urine samples and drop out early from treatment. Gambling activity also puts individuals who are in recovery from substance use disorders at high risk of relapse, as alcohol and other drugs are widely available at both legal and illegal gambling venues. Clearly, addressing problem gambling is a component of a comprehensive approach to combating the opioid epidemic. As with other addictive disorders ambivalence about change is a major factor that prevents individuals from seeking problem gambling help. But there are other societal factors that are also critical. One major reason is the stigma identified with having a gambling problem. In a 2015 U.S. survey only 6% of the general population identified gambling addiction as a medical problem, while 49% identified it as a “personal or moral weakness.” (6) Another reason individuals rarely seek help for their gambling problems is due to the marginalization of problem gambling within the healthcare system and relative lack of funding and accessibility. In the U.S. it is four times more likely that someone will have a substance use disorder than a gambling disorder. Yet public funding to treat substance use disorders is 338 times larger than funding to treat gambling disorders. All public funding for problem gambling prevention and treatment is local. The Federal government does not spend a single dollar on problem gambling research, prevention or treatment. Behavioral health and other health clinicians rarely receive training in this area, and Medicare and almost all Medicaid and third-party private insurance plans do not reimburse counseling for Gambling Disorder. (7) Given these characteristics of problem gambling, the overall goals of MHASD Problem Gambling Treatment and Prevention Program are to reduce the negative impact of problem gambling on public health by: 1. Working to reduce the stigma associated with problem gambling.2. Better integrating help for problem gambling into the behavioral health and medical systems.3. Employing prevention and early intervention strategies to reduce the number of individuals who will develop a gambling problem.4. Actively working to identify and engage in services individuals who suffer from disordered gambling.5. Providing direct outpatient treatment services to those who have a gambling problem and to their significant others.TARGET POPULATION SERVEDThe prevention program will develop and offer activities involving participants across the age spectrum, with the goal of integrating culturally-specific programming into the work across the county. The statistics in the following sections are broken down to show current trends among specific community subpopulations, but are not intended to be the only focus of this funding.The treatment and targeted outreach program must serve individuals of all cultures and have culturally responsive means to address these populations to produce positive outcomes. Another goal is to increase access to treatment for underserved geographical areas of the county. For example, currently no services are available in North Portland or Gresham, where there are very high rates of video lottery gambling. An important aim is to enroll in services more of those individuals who experience distress due to the gambling behavior of a significant other, whether or not the significant other is enrolled.Problem Gambling Prevention StatisticsAccording to results from the 2016 Oregon Adolescent Prevalence study, 55% of Oregon adolescents have gambled in their lifetime, with 39.7% having gambled in the past year. Preferred games in the past year included: gambling on the internet (without money) 15.1%, sports betting 14.%, charitable gambling 13.6%, and gambling on personal skill 13.1%.Over half (54%) of youth surveyed believe that gambling can become a problem for young people, and 94% believe that gambling problems can be prevented through education and awareness (Moore 2017). The 2018 “past 30 day” surveys of Multnomah County students in 6th, 8th, and 11th grades show that forms of gambling activity appear as early as sixth grade. In the 2018 Student Wellness Survey, gambling is defined as betting something of value (money, a watch, soda, etc.) on a game or event. Most notably, the two most reported types of gambling included betting on games of personal skill and betting on a sports team.  The table below has additional data relevant to current gambling trends among adolescents in Multnomah County.  2018 Student Wellness Survey - Multnomah County 6th Grade 8th Grade 11th Grade % who gambled in the last 30 days 26.5 28.0 25.5 % whose parents have talked to them about the risks of betting/gambling 47.8 47.7 35.3 % whose teachers have talked to them about the risks of betting/gambling   17.6 16.8 14.4 Among most adult Oregonians, gambling is a form of entertainment and recreation. A recent study of Adult Gambling behavior in Oregon showed that 56.6 % of adults have gambled in the past year, with nearly 86% of adults gambling in their lifetime. Knowing the prevalence of gambling, it is necessary to address stigma and concern for any and all Oregonians who are at risk of developing a gambling problem and/or are negatively impacted by gambling.A recent statewide study was conducted by the Center for Health & Safety Culture in order to better understand engagement with the Oregon Problem Gambling Resource (OPGR). This study found that 46% of people are moderately (or more) concerned about problem gambling in Oregon. While asking those respondents about OPGR as a resource, 40% felt it would be scary to contact OPGR if they were concerned about some else’s gambling behaviors. This leaves our state and county with opportunity to address stigma and fear around problem gambling behaviors as well as bolster messaging around OPGR as a helpful resource for anyone concerned about problem gambling in Oregon.Sources:  2018 Oregon Student Wellness Survey https://oregon.pridesurveys.com/dl.php?pdf=Multnomah_Co_2018.pdf&type=county2018 Oregon Problem Gambling Survey Key Findings Report - Montana State University Center for Health and Safety Culture.  Oregon Adult Gambling Behavior Study, 2016, Oregon Council on Problem Gambling in Multnomah County.  Adult Problem Gambling Statistics The table shown below is a snapshot of the gambling treatment clients in Multnomah County in Fiscal Year 2017-2018. See below. Estimated adult population:(18 years and above) 600,000 Number of gamblers enrolled in treatment: 180 Gender of gamblers seeking treatment: Male    56%Female  44.4% Ethnicity of gamblers seeking treatment: White  76.1%Asian American  8.3%Black   7.8%Hispanic  5.0% Primary gambling activity: Line Games 51.1%Video Poker  28.3%Cards  7.2%All Others  4.5% Source of referral to the treatment program: Gambling Helpline  32%Previous/Current Client 10.6%Web/Internet  11.1%Community based MH/SUD 10.6%Family/Friend 6.7%All other 29% Number of family members enrolled in treatment: 46 Source: Thomas Moore, Herbert & Louis, 2018 SCOPE OF SERVICES Problem Gambling Prevention Services Description MHASD is seeking a provider to increase awareness and provide education to prevent problem gambling issues across the entire county. Prevention services are an integrated combination of strategies designed to prevent problem gambling issues. Multnomah County uses the Institute of Medicine (IOM) Continuum of Health Care Model to provide a strategic framework for defining target populations and activities addressed by various addictions prevention efforts. Services must be classified as Promotion, Universal, Selective, or Indicated according to the IOM Model, and should be implemented through one or more of the Center for Substance Abuse Prevention (CSAP) strategies. Prevention contractor(s) will be required to meet with the MHASD Addictions Prevention Coordinator for the purpose of identifying these unique problem gambling prevention strategies and write a plan to be submitted for approval by State of Oregon Addictions and Mental Health (AMH) Division as part of the State Biennial Implementation Plan or other planning process(es). Currently, MHASD and contractors are working with Oregon Health Authority (OHA) to conduct a community readiness assessment that will identify the level of awareness of current prevention messaging and programing.  MHASD will be using the assessment in the development of its Biennial Implementation Plan. In addition to collaborating on the Biennial Implementation Plan, providers will be asked to evaluate and reassess the community as needed and/or requested by the County. Any changes/revisions to the strategies submitted under the indicated prevention funding plan will be reduced to writing and incorporated into the agreement by reference herein after approval by State OHA. Prevention contractors will be responsible for reporting Problem Gambling program outcomes on at least a quarterly basis, as required by County contract and described below in the Performance Measures/Performance Contracting section. Future funding of this project will depend, in part, on State AMH’s assessment of the project’s success in meeting goals and outcomes identified in the indicated Multnomah County Problem Gambling Prevention Implementation Plan. MHASD will require prevention provider staff to complete the Problem Gambling Prevention Coordinator Training series within two years of hire. More information on this requirement can be found at: https://www.oregonpgs.org/prevention/new-coordinator-training/. In addition, any prevention program staff providing more than .5 FTE will be required to attend a minimum of 15 hours of OHA Problem Gambling approved trainings per biennium.   Outpatient Problem Gambling Treatment & Targeted Outreach Services Description Outpatient problem gambling treatment services include: problem gambling targeted outreach; assessment, treatment and rehabilitation services delivered on an outpatient basis or intensive outpatient basis to individuals who exhibit one or more Diagnostic and Statistical Manual (DSM)-5 symptoms of Gambling Disorder and who are not in need of 24-hour supervision in order to make progress in recovery; family therapy for families negatively impacted by a member who engages in disordered gambling; counseling for individuals who have a significant other who is gambling problematically and, as a result, are experiencing relational or behavioral health problems. Specific services allowed are currently defined in Oregon Administrative Rules  (OAR) 309-019-0170, and by the 2019 Oregon Health Authority Problem Gambling Services Billing Codes.   Developing and Implementing a Targeted Client-Finding Outreach Plan Because individuals impacted by problem gambling are reluctant to access problem gambling services and are rarely mandated to treatment by the criminal justice system or employers, it falls on the shoulders of treatment providers to actively solicit referrals to the county problem gambling treatment system. Targeted outreach efforts are an essential activity for every problem gambling treatment provider and the time spent on this activity is reimbursed. Targeted outreach is defined as either outreach to high-risk populations -- for example making a presentation to individuals who are receiving substance abuse treatment services -- or as meeting with other professionals who by the nature of their work are likely to come in contact with individuals who qualify for services and may refer them for treatment -- for example attorneys, clergy, physicians or behavioral health professionals. Treatment advertising and exhibiting at professional conferences are also reimbursed as client-finding outreach. Every proposing organization that provides other behavioral health services in addition to problem gambling treatment will implement Gambling Brief Intervention and Referral to Treatment (GBIRT) in their organization. GBIRT is the current best practice model for screening and early intervention and is strongly recommended by the Oregon Health Authority Problem Gambling Services for all providers. Accessing Services Provider will maintain a referral and intake process that facilitates client access and engagement in treatment. This process will be culturally sensitive and target the unique barriers experienced by individuals who have gambling problems. Emphasis will be paid to engaging significant others throughout the course of treatment. Assessment For the individual with disordered gambling the assessment process begins with the first contact, initially focusing on making a diagnosis(es), if/when appropriate, increasing motivation for change and motivation for treatment. and developing an initial treatment plan. Part of the initial process is a financial assessment and suggested level of care referenced by the American Society of Addiction Medicine (ASAM) Patient Placement Criteria. Over time, a more complete biopsychosocial assessment will further guide treatment planning. For significant others the assessment can be more limited to relational issues and family structure unless a diagnosis of a disorder related to the gambling is a treatment target.  Treatment Planning  Each plan can include -- as appropriate -- individual, couples, family, financial and group counseling; psychiatric assessment and medication management; case management; recovery mentor services; physical health services; and using flex funds to support building a stronger recovery environment. Treatment service effectiveness should be monitored by the provider and individual or family receiving services, including obtaining frequent written feedback from those who are receiving services, which can help guide any adjustments to their service plans. Family services: The program shall actively work to engage in services family members of individuals who have a gambling problem. Treatment staff will have capability to provide couples counseling and family therapy using a systemic approach. Discharge Planning Program shall comprehensively address the transition and discharge planning process and include a written wellness plan. The discharge process must begin to be addressed early in treatment to ensure a smooth transition. The wellness plan must feature natural and community–based support systems. Variances for extended services are requested when appropriate. Continued Care Services Continued care services must be designed to help prevent relapse and address relapse intervention, PG providers will connect clients with recovery supports, and collaborate with recovery-oriented organizations to provide spaces and ongoing services for individuals engaged in, and exiting from treatment. Examples include (but are not limited to): partnering with Voices of Problem Gambling Recovery (VPGR) certified gambling recovery mentors (CGRM); hiring CGRMs; connecting clients to Gamblers Anonymous or other self-help groups; and collaborating with recovery centers to provide space for gambling-specific recovery support.    Trauma-Informed and Trauma-Based Practices Research suggests a substantial majority of Oregonians who seek problem gambling treatment experienced significant life trauma prior to the initiation of their problematic gambling. According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) concept of a trauma-informed approach, a program, organization, or system that is trauma-informed: realizes the widespread impact of trauma and understands potential paths for recovery; recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system; responds by fully integrating knowledge about trauma into policies, procedures, and practices; and seeks to actively resist re-traumatization. Additionally, programs must demonstrate capability to treat trauma-based symptoms based on a research-supported strategy(s) for treating comorbid Post-Traumatic Stress Disorder and addiction, and to deliver services in a manner that demonstrates respect and promotes safety and resiliency. Culturally Responsive Practices Culturally responsive services are general services that have been adapted to honor and align with the beliefs, practices, culture and linguistic needs of diverse consumer / client populations and communities whose members identify as having particular cultural or linguistic affiliations by virtue of their place of birth, ancestry or ethnic origin, religion, preferred language or language spoken at home. Culturally responsive services also refer to services provided in a way that is culturally responsive to the varied and intersecting “biological, social and cultural categories such as gender identity, class, ability, sexual orientation, religion, caste, and other axes of identity.” Culturally responsive organizations typically refer to organizations that possess the knowledge and capacity to respond to the issues of diverse, multicultural communities at multiple intervention points. Culturally responsive organizations affirmatively adopt and integrate the cultural and social norms and practices of the communities they serve. These agencies seek to comprehensively address internal power and privilege dynamics throughout their service delivery, personnel practices and leadership structure. A culturally responsive organization is one that reflects the following characteristics: ●      Prioritizes responsivity to the interests of communities experiencing inequities/racism and provides culturally grounded interventions that have been designed and developed starting from the values, behaviors, norms, and worldviews of the populations they are intended to serve, and therefore most closely connected to the lived experiences and core cultural constructs of the targeted populations and communities; ●      Affirmatively adopts and integrates the cultural and social norms and practices of the communities they serve; ●      Addresses power relationships comprehensively throughout its own organization, through both the types of services provided and its human resources practices. A key way of doing this is engaging in critical analysis of the organization’s cultural norms, relationships, and structures, and promoting those that support democratic engagement, healing relationships and environments; ●      Values and prioritizes relationships with people and communities experiencing inequities universally, paying particular attention to communities experiencing racism and discrimination; ●      Commits to continuous quality improvement by tracking and regularly reporting progress, and being deeply responsive to community needs; and ●      Strives to eliminate barriers and enhance what is working. PG Providers must have reasonable and effective strategies in place to operate culturally responsive and trauma informed services. As detailed in the Trauma-informed and Trauma-based Services section, the majority of problem gamblers seeking services in Oregon have a significant history of trauma. They also live with stigma and a cultural misunderstanding of the nature of their addiction. As such, problem gamblers have unique needs that may not be reflected in typical behavioral health settings, and may pose barriers to treatment engagement and retention. PG providers must have awareness of the culture of problem gambling, and tailor outreach, treatment, and recovery support to be responsive to this population. PG providers must also be responsive to the role of family members in treatment approaches. Furthermore, people who are members of minority and/or marginalized populations face additional barriers to engaging in PG treatment. Cultural norms surrounding both gambling and accessing behavioral healthcare can impact treatment engagement, requiring culturally-responsive outreach strategies. Dominant culture behavioral health facilities are not always conducive environments to effectively treat all members of the population, especially when there are additional language barriers. There have been challenges to successfully engage individuals from African American, some Asian, Pacific Islander, or Eastern European communities in PG treatment in Multnomah County, despite outreach efforts by PG providers and County staff. There is also a lack of local data to gauge the efficacy of current treatment models for other marginalized populations, such as LGBTQ+ individuals. On the other hand, culturally-specific Latino problem gambling programs have been successful and Lewis & Clark Problem Gambling Services currently operates a vibrant Portland-area tri-county Latino problem gambling program funded directly by OHA. Culturally specific services are services provided for specific populations based on their particular needs, where the majority of members/clients are reflective of that community, and use language, structures and settings familiar to the culture of the target population to create an environment of belonging and safety in which services are delivered. While it is not a requirement to provide culturally specific service to qualify under this procurement, culturally-specific organizations are encouraged to qualify, and dominant-culture organizations will be expected to collaborate with MHASD, OHA and/or culturally-specific providers to improve outreach strategies and reduce barriers to treatment.    Collaborative Services PG providers works to maintain close, collaborative working relationships with referral sources, self-help groups and other service agencies involved with individuals and families who are negatively affected by problem gambling. Collaborative relationships expand the range of services available, and exist throughout the continuum of care. Successful outreach relies on a network of behavioral health providers, recovery services, culturally-specific organizations, and other community partners to raise awareness, reduce stigma, and engage individuals who are impacted by problem gambling in treatment. During treatment clients may need resources such as: financial/bankruptcy counseling; housing support; domestic violence advocacy; as well as behavioral health counseling outside the scope of the provider’s clinical practice (i.e. medication assisted treatment, psychiatric counseling and medication management,  etc.).  Staff Requirements Except for clinical Interns, Proposer staff members who deliver treatment services funded through this RFPQ must meet requirements of OAR 309-019-0125. Experienced supervision is adequate to support treatment staff who are working with a challenging, high-risk population. GEOGRAPHIC BORDERS/LIMITATIONS & SERVICE AREAS Problem gambling prevention and treatment services will be sited and provided in Multnomah County. Treatment providers will serve any individual  who needs treatment for problem gambling and/or their significant others. Services are not limited to Multnomah County residents. Any Oregon resident or resident of another state whose primary gambling problem is connected to an Oregon Lottery product may receive services in Multnomah County. FUNDING Projected funding for this procurement is estimated at approximately $770,000 annually, or $3,850,000 over the five-year procurement period. Funding for problem gambling treatment services is estimated to be approximately $700,000 annually for five years, or $3,500,000 total for the procurement period. Funding for problem gambling prevention services is estimated to be approximately $70,000 annually for five years, or $350,000 total for the procurement period. Funding for the work described in this RFPQ is not guaranteed. Fluctuations in funding year to year should be expected. The County cannot ensure that any particular level of work will be provided and the contract will permit the County to add or remove work as necessary depending on availability of funding. If, during the term of any Contract subsequent to this RFPQ, Contractor delivers less than the anticipated level of service upon which payments were calculated, the County may unilaterally reduce the amount of the remaining payments for that service. MATCH REQUIREMENTS Not applicable to this sourcing event.  FISCAL REQUIREMENTS AND REPORTING Proposed Problem Gambling Prevention 12 Month Budget Proposers must provide a 12-month annual budget and budget narrative for the proposed first 12 months of providing services. The Problem Gambling Prevention Proposal Packet provides a sample budget form; however, proposers are welcome to use their own formats. Budget should be based on Proposer’s best estimates of prevention services provided. This documentation will be used during the allocation process.  Attach Packet to Supplier Attachments. Proposed Problem Gambling Treatment Service Funding Plan Proposer must provide an annual 12-month Service Funding Plan. The Problem Gambling Treatment Service Proposal Packet provides a sample budget form; proposers must use this format. For each Procedure Code, provide the projected units of service to be provided, the estimated number of clients to be served, and the projected annual cost. This documentation will be used during the allocation process.  Attach Packet to Supplier Attachments. Service Encounters The Oregon Health Authority (OHA) bases county problem gambling funding allocations primarily on client encounter performance data collected by the State of Oregon’s external evaluator, Herbert & Louis LLC, from providers. Proposer must have a system and staff training in place to assure that all reimbursable services, including targeted client-finding outreach, are accurately and completely transmitted to Herbert & Louis LLC on time each month. PERFORMANCE MEASURES/PERFORMANCE CONTRACTING Service providers are required to participate in MHASD’s monitoring and evaluation activities. Programs will be evaluated by a number of means that could include: provider self-assessment and peer reviews; monitoring and site visits; compliance with State reporting requirements; compliance with contract standards and performance criteria; tracking client outcomes; client satisfaction surveys and complaint resolution processes; and other quality assurance and evaluation processes as developed between the parties. MHASD may require its contracted service providers to develop and maintain internal quality assurance and evaluation practices to determine the quality of their services, compliance with regulations, stability of operations, consumer satisfaction, and appropriateness of the services. These practices may include problem identification, problem resolution, and follow-up to assure that program improvements are sustained over time. Each biennium the county shall require a final Trauma-Informed Care report from all providers. Problem Gambling Prevention Performance Measurement/Reporting Problem gambling prevention activities will be required to be entered on a quarterly basis in the State Addictions and Mental Health Division (AMH) Minimum Data Set web based database (or other database that may be required by OHA in the future). The Contractor(s) will be required to provide written or phone updates to the County Addictions Prevention Program Coordinator. Contractor(s) will also be required to submit an Annual Report summarizing problem gambling prevention events and activities for the fiscal year and the Provider’s success in meeting output and outcome goals. Provider will also meet with the County Addictions Prevention Coordinator to assist in developing Annual or Biennial Implementation Plans, according to State OHA requirements, as described in Scope of Services. In compliance with State of Oregon mandatory contract language, at the time of contract negotiation, the prevention provider will have a comprehensive written policy on gambling in the workplace by program participants and staff. In addition, providers will need to be in compliance with OHA’s Trauma Informed Care (TIC) Policy which includes having: a TIC plan; TIC as a core principle in agency's policies, mission statement, and written program/service information, have initiated and completed an agency self-assessment, and have a quality assurance structure/process to further develop and sustain TIC. Proposers can find more information on all State requirements in the .PDF labeled as Problem Gambling Prevention Services located in the buyer attachments of the sourcing event.  Problem Gambling Treatment Performance Measurement/Reporting Providers of Problem Gambling Treatment Services must maintain a State Certification for Outpatient Behavioral Health Services as a Mental Health Service Agency or a Letter of Approval as an Alcohol and Drug Treatment Agency for all levels of outpatient treatment, as well as the endorsement for Outpatient Problem Gambling Treatment and Recovery Services in accordance with OAR.  Problem Gambling Treatment Services must also follow governance set forth in OHA’s Service Element A&D 81. Proposers can find more information on relevant service elements and OARs are labeled as Outpatient Gambling Services located in the buyer attachment of the sourcing event. Rules and weblinks may be revised from time to time. It is the responsibility of providers to maintain certification and compliance with regulations. Problem Gambling Treatment providers will be required to participate in the State’s Gambling Participant Monitoring System (GPMS) and Gambling Treatment Encounter Data System. Providers must agree to maintain accurate fiscal records that conform to generally accepted accounting principles and to be in compliance with all State audit accounting procedures and requirements. Treatment Contractor(s) must create and maintain significant documentation according to the current user manual located in the buyer attachments labelled as Gambling Participant Monitoring System. Providers of Problem Gambling Treatment Services paid through this Contract must also comply with Oregon Administrative Rules governing Certification Onsite Reviews, and meet the performance standards below. If MHASD or OHA determines that a Provider of Services fails to comply with any of the specified performance standards, the specific areas out of contract compliance would then be reviewed at the next scheduled site review or a discretionary site review could be scheduled specifically to review these areas. Current performance standards are: Access The amount of time between an individual’s request for services and the first offered service appointment must be five (5) business days or less for at least 90% of all individuals receiving Services. Retention The percent of problem gambling affected individuals receiving Services who actively engage in the Services for at least ten (10) clinical contact sessions must not be less than 40%. Successful Completion The percent of all individuals receiving services who successfully complete treatment must not be less than 30%. A successful problem gambling treatment completion is defined as the individual: (1) meeting at least 75% of their treatment plan’s measurable objectives; (2) completing a written wellness plan; and (3) no evidence of problem gambling behaviors for at least 30 days prior to completion of services. Client Satisfaction Client satisfaction surveys must be collected from not less than 50% of total enrollments and at least 85% of those surveyed would positively recommend the provider. Long-Term Outcome Minimum of 85% of enrollees sign consent to long-term follow-up. GPMS Intake and Completion Data For at least 90% of enrollees, the GPMS enrollment record abstracting form and the gambling client survey must be collected and submitted within 14 calendar days of the first face-to-face treatment contact. All completions must be submitted within 90 calendar days of the last service. Encounter Data Reporting Requirements All service encounters must be submitted within 30 calendar days following the end of each month. Encounter data must be submitted in a format approved by OHA’s evaluator, Herbert & Louis LLC in accordance with OHA’s GPMS Manual located within the buyer attachments of the sourcing event. Prior to submitting data, each encounter claim must be documented in the clinical record and must include the date of the encounter Service, type of Service delivered, length of Service, clinician identification, and a clinical note that includes a description of the session, the clinician’s signature, and date the clinical note was completed. Length of stay: No clients to be open for longer than 365 days without a variance from OHA. CONTRACT NEGOTIATION Once selected in the allocation process, The County will initiate contract negotiations with the Proposer. Multnomah County may, at its option, elect to negotiate general contract terms and conditions, services, pricing, implementation schedules, and such other terms as the County determines are in the County’s best interest. If negotiations fail to result in a contract, the County reserves the right to terminate the negotiations and initiate contract negotiations with another qualified Proposer(s). This process may continue until a contract agreement is reached. CONTRACT AWARD AND ALLOCATION PROCESS This is a formal, competitive, Request For Programmatic Qualifications (RFPQ) process as provided for under the authority of PUR-1. No contracts will be issued as a result of this RFPQ process. Our intent is to establish pools of qualified vendors who will be eligible for potential contract awards. There is no limit on the number of vendors that may be qualified under this RFPQ process. Supplier must verify the requirements are met as a treatment agency identified in Attachment X located within the buyer attachment. (Suppliers are not required to submit this document.  This document is for informational purposes only.) Multnomah County strongly encourages the participation of Minority-Owned, Women-Owned, and Emerging Small Businesses and Organizations in providing these services. Allocation Process Entirely separate from this qualification process, MHASD will initiate and award contracts to those qualified providers who demonstrate the desired experience, skills, proficiency, certifications (e.g., see OAR 309-008--0100 through 309-008--1600), and area of specialty that will best meet and match the needs of Problem Gambling Prevention and Treatment services. MHASD will conduct a rigorous funds allocation process to distribute available funds according to known system requirements and priorities. Allocations will only be made to providers who previously qualified under this RFPQ. The funding allocation process will be a formal one, requiring MHASD to document their findings and determinations in writing that lead to specific funding allocations or to the continuation of funding allocations. Vendors may not protest funding allocation decisions. Funding allocation decisions will be made from an overall County system of care perspective. Allocation priorities and selection criteria may include: ●      County and Department strategic priorities; ●      Overall system of care needs and deficiencies; ●      RFPQ proposal information and evaluation input from the RFPQ Raters; ●      Provider/system stability; ●      Provider experience; ●      Funder-imposed requirements or restrictions (i.e. non-profit, etc.); ●      Specific population coverage; ●      Geographic service coverage; ●      Coverage of specific modalities; ●      Client needs and trends; ●      Provider economy of scale; ●      Past performance;                                    ●      Certification status; and ●      Other factors as deemed appropriate by the funding allocation team. Since the allocation process considers a variety of factors, funding may go to qualified Proposers who did not earn the highest overall RFPQ qualification score. Therefore, it will be possible to qualify under this RFPQ process and not receive a funding allocation due to resource limitations and other factors. MHASD does not guarantee any particular funding allocation will be offered to any applicant who qualifies to provide services. After Purchasing provides written solicitation results to all Proposers and with the completion of the separate allocation process by MHASD, MHASD staff will contact the successful and qualified Proposer(s) who will receive an allocation for contract negotiations. The County does not guarantee any level of funding and funding levels may change from year to year. The successful Proposer shall be able to provide services immediately, upon contract award. Any exceptions must be County-approved and include a mutually agreed upon start-up time period. All Proposers seeking to provide services must submit a proposal and receive a minimum 70% of the total points possible in order to qualify.  The County reserves the right to qualify additional suppliers for these services as it deems necessary. All qualified suppliers will be added to one vendor pool, from which contracts will be awarded through the allocation process. CONTRACT TERM Fixed term The contract term shall be five (5) years. The effective date of any resulting contracts shall be approximately July 1, 2019, or later if other contractors are qualified after the initial allocation process. The end date shall be June 30, 2024. COMPENSATION AND METHOD OF PAYMENT Problem Gambling Services Payment Structure Problem Gambling services and compensation/method(s) of payment will be negotiated with Proposer at time of contracting. Contractors are typically reimbursed under a Cost Reimbursement payment structure. Payment made on a Cost Reimbursement basis means that payment is made for exact costs incurred. An annual budget is required to validate the maximum reimbursement amount awarded by the County. Contract Settlement The County may reconcile any contract settlement on discrepancies that may have occurred during the term of this Contract between actual County payments for services and amounts due for such services provided by Contractor. For purposes of this section, “amounts due” to Contractor is determined by the actual amount of services delivered during the period, as properly reported. COOPERATIVE PURCHASING   Not applicable to this sourcing event. INSURANCE REQUIREMENTS Sample Exhibit 2, in the Buyer Attachments, reflects the minimum insurance required of a Contractor to provide this service. Additional insurance coverage may be required depending on the key features of service delivery chosen by the Contractor. Final insurance requirements will be subject to negotiation between, and mutual agreement of, the parties prior to contract execution. In addition to the Sample Exhibit 2, the State may require additional insurance, depending on the contract amounts, as shown below. This contract is currently additionally funded under the 2017-2019 Intergovernmental Agreement for the Financing of Community Mental Health, Substance Use Disorders, and Problem Gambling Services Addictions and Mental Health Services, State Agreement # 153134134327. This document can be found on the Multnomah County Addictions page under “Documents” at https://multco.us/mhas/addiction-provider-resources. In addition to the County minimums, this contract requires the following insurance coverage, based upon the contract total. These are all per occurrence for all claimants arising out of a single accident or occurrence. MINIMUM REQUIREMENTS At the time of proposal submission, Proposers must meet the following minimum requirements. Failure to provide any of the required documents or meet any of the below requirements shall result in rejection of the proposal. The Proposal response must be received by Multnomah County Purchasing no later than 4:00 P.M. local Portland time on the proposal submission deadline. Proposer Representations and Certifications  The Proposer must certify that they agree to the Proposers Representation and Certification terms in the Pre-requisite page of the Sourcing Event. At the time of Contracting, Proposers must meet the following minimum requirements. Failure to provide any of the required documents or meet any of the below requirements shall result in cancellation of the contract Proposers must be legal entities, currently registered to do business in the State of Oregon (per ORS 60.701). Proposers must submit verification that all insurance requirements are met. Proposers must have a completed Pre-Award Risk Assessment if federal funds are used for this Sourcing Event. (See Procedural Instructions in the Buyer Attachments page of this Sourcing Event)

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About Multnomah County

Multnomah County cares about equity in purchasing and contracting. We are committed to working with State Certified Firms and encourages Minority, Women and Emerging Small Business (MWESB), Service Disabled Veteran (SDV) firms and Disadvantaged Business Enterprises (DBE) to compete for our contracting opportunities.

If you'd like to know more about our MWESB outreach programs, please visit https://multco.us/purchasing/minority-women-and-emerging-small-business.

You can find the authoritative listing for procurement opportunities on our Bids and Opportunities webpage, https://multco.us/purchasing/bids-proposal-opportunities.

If your firm is interested in an opportunity posted on our webpage, we'd love to hear from you. Here's how:

  1. First, read over the opportunity description.
  2. Next, go to the Multnomah County Bids and Opportunities page for this specific solicitation: https://solutions.sciquest.com/apps/Router/ViewSourcingEvent?AuthToken=0%3AAES2%23CKiit6DUQlVhbaDlTQqAdMrj9I4hsseka9xVmA4QR3l4rI82siXFmebEgbtQpVyZXrLtImVw6LBfHMpIlLQAtPkd2agaR7CejID5QO4NRi9XVtd5KFXLC3clTX6sf8B0oUkWM%2Bk69uT%2FIhM0RiC8Svqi0Dx%2BBgmWcA%3D%3D&tmstmp=1553289757751
  3. Please review all of our solicitation documents carefully, to ensure that the opportunity is is a good fit for your firm!
  4. Register for the solicitation here. This will ensure you receive any addenda or updates that we may post from time to time.
  5. That's it! You'll receive an email confirming your interest. If you have questions, please contact the Purchasing Contact assigned to the project, or visit our Contact Us page.

Multnomah County competitively procures materials and services, taking into consideration the best combination of price, quality and service. We look forward to hearing from you. Whether this is your first bid proposal, or you've worked with us before, we look forward to doing business with you.