Substance Use Disorder (SUD) Services

Procurement: 530-13-0005

Contracting with DFPS

The Road to a Successful Contract
Meets Client Needs

Meets DFPS Needs

Fulfills Contract Terms

Contract Model Technology DFPS Internet Site PCS Homepage Regional CPS Contracts Homepage Regional CPS Contracting Forms Contractor Expectations Referrals Service Description CPS Program

Insurance Staff/Subcontractors Required Record Keeping Contract Evaluation Performance Measures Compensation Invoicing Contract Changes Complaints Time Frames Recap Handouts Questions

Contract Model: A-3

Contract Model: A-3

Sign Here

DFPS will insert Contract Effective Date

Technology

Requirements

Broadband Internet Connection Internet Explorer 6.0 or Higher Microsoft Word Email Address Anti-Virus Program (Active and Up-to-Date)

DFPS Internet Site

DFPS Internet Homepage

http://www.dfps.state.tx.us/ Regional CPS Contracts Homepage

Contracting with DFPS Homepage

Regional CPS Contracting Forms 2970C Disclosure & Consent to Release of Information Form (Criminal or Abuse/Neglect History) 2971C Request for Criminal History & DFPS History Check Form

Contracting and Procurement Forms

Client Services Contractor Reference Guide

DFPS Internet Site

DFPS Internet Homepage
http://www.dfps.state.tx.us

Select Contracting with DFPS

DFPS Internet Site

http://www.dfps.state.tx.us/PCS/

Contracting with DFPS Homepage

Select to access Regional CPS Contracts

Select Contracting and Procurement Forms to Obtain the 2970c and 2971c

Select to Open the Client Services Contractor Reference Guide

DFPS Internet Site

Regional CPS Contracts Homepage

http://www.dfps.state.tx.us/PCS/Regional_Contracts/default.asp

Select Regional CPS Contracting Forms to obtain Servicespecific documents

DFPS Internet Site

Regional CPS Contracting Forms Homepage

http://www.dfps.state.tx.us/PCS/Regional_Contracts/forms.asp

Contractor Expectations

Provide a work product that satisfies the quality and timeframe requirements of the contract and ensure continuity of care

Provide services within the entire contracted service delivery area selected in Attachment A-4 Service Delivery Areas when authorized and requested by DFPS
Offer flexible hours to accommodate client schedules and that do not interfere with a childs school attendance and participation in school activities Provide services in the Contractors office unless out-of-office services are requested in writing by the CPS caseworker Be available at the office location shown in Attachment A-3 and all satellite locations listed on Attachment A-4 Adequately screen, select, develop, supervise and manage qualified, trained service providers

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Referrals
Substance Use Disorder (SUD) Services

A Valid Referral Consists of: Form 2054 (Service Authorization) Form 2062 (Referral for Substance Abuse) Form 2063 (Release of Confidential Information) with Section 1 Completed by DFPS Contractor must contact Client within 3 business days of receipt of valid referral to schedule initial appointment. Contractor must begin authorized service(s) within 10 business days of receipt of valid referral. Document all attempts to contact Client and method of attempt Notify CPS Caseworker if time frame cannot be met

Referral Timeframe

Document reason in clients record

Emergency Situations

Work closely with DFPS to expedite service delivery as requested

Services Missed by Client*

1 Missed Appointment Contact CPS Caseworker by 5:00 p.m. on the business day following missed appointment 2 Consecutive Missed Appointments Notify CPS Caseworker Obtain instructions from CPS Caseworker on how to proceed Do not schedule further appointments unless instructed by DFPS Contractor must notify all Clients 24 hours prior to scheduled session.
Contractor must not bill Clients for

Group Session Cancelled by Contractor*

*Contractor must note all missed appointments and cancellations in the Client case file.
missed appointments.

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Service Description
Direct Client Services

Indirect Client Services

Assessment Substance Use Disorder Treatment

Court Related Services Case Specific Diagnostic Consultation

Counseling

Individual Group

Service Provider Qualifications

Medicaid Provider Managed Care Organization (MCO) Must Meet Texas CDTF License Requirements (obtain Facility License from DSHS)
QCC: Qualified Credentialed Counselors

Additional Requirements for All Service Providers

Cleared Criminal History and DFPS History Check Written Acceptance of Subcontract by DFPS Contract Manager (if subcontracting) Written DFPS Contract Manager Approval of All Individuals Working under this Contract

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Service Description
Administrative Functions

Maintain sufficient funds to support the contracted services.

Employ or contract with qualified service providers. Have an operational process to submit background and criminal checks and obtaining DFPS approval of all service providers prior to the delivery of services. Ensure delivery and quality of services. Secure translation and interpreter assistance as needed. Maintain accurate and complete documentation to support contract activities. Implement and maintain a process to ensure reports are acceptable and submission is timely. Submit accurate and timely billing. Complete all contract requirements.

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Insurance*

Commercial General Liability Insurance

Limits of $1,000,000 per occurrence $2,000,000 aggregate

Commercial Crime Insurance

Minimum of $25,000 Must include a third party endorsement and an employee dishonesty endorsement or equivalent

Professional Liability Insurance

Minimum Limit of $1,000,000 per occurrence $2,000,000 aggregate

Form 4736 Certificate of Insurance

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*Contractor must immediately provide written notice to DFPS of any material changes/cancellation of coverage before the expiration date (i.e., end of policy period)

Staff/Subcontractors
Background Check

Applies to All Contractors Employees, Volunteers & Subcontractors

Involved in Direct Delivery of Services to Clients Will Have Access to Personal Client Information

Contractor Must Submit Requests Electronically through the DFPS Automated Background Check System (ABCS) Required Every 2 Years Forms 2970c and 2971c

Employee/volunteer/subcontractor information requested on these forms is collected in order to run the background check. Contractor must file the completed 2970c and 2971c with cleared disposition in the employee/volunteer/subcontractor personnel record.

Staff

Supervisory Staff Must Be Employees Staff Record Must Be Maintained All subcontractors providing services under this Contract must meet the same requirements as specified in the contract. Prior to the commencement of any services by any subcontractor:

Subcontractors

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Contractor must provide DFPS with a copy of the subcontract Contractor must have received written DFPS approval on Form PCS-102 of the use of the subcontractor

Staff/Subcontractors
Credentialing

Form PCS-102SUD Contracting Entity & List of Staff, Subcontractors & Volunteers

Background Check License Type Traditional Medicaid # Managed Care Plan(s) Enrolled In

Form PCS-107

Documents DFPS Review & Acceptance of the Contractors Subcontracting Policy and Procedures Verifies Inclusion of Required Items in the Subcontract Template

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Required Record Keeping

All Required Records

Must be made accessible to DFPS staff upon request. Must support all Contractor Minimum Qualification requirements for Employees, Subcontractors, and Volunteers Refer to Section 2.16.2 of the Statement of Work for a List of the Minimum Record Keeping Requirements Refer to the Statement of Work

Required Personnel Records

Required Contractor Records*

Individual Client Service Case Record: Section 2.16.1 Personnel Records: Section 2.16.2 Billing Records: Section 2.16.3

Must include Complaint Investigation and Outcome Reports

Contractor must house or maintain Case records in a central location.
*Note: DFPS reserves the right to require additional records from the Contractor as needed.

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Contract Evaluation

Monitoring Methods

On-Site Monitoring

Planned

Notice of Monitoring Activity Inform of Goals and Objectives

Conducted with Least Disruption to Day-to-Day Operations as Possible Results Communicated During Exit Conference

Desk Review Administrative Programmatic Fiscal

Monitoring Scope

Monitoring Results A Formal Monitoring Report Provided to Contractor Performance Measures

Pursuant to Texas Human Resources Code 40.058(b) all Contracts for client services must include clearly defined goals and outcomes that can be measured to determine whether the objectives of the program are being achieved.
Performance Measure results will be provided to the Contractor in order to assist the Contractors compliance with the terms of the contract, DFPS policies, and applicable state and federal regulations.

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Contract Evaluation
Administrative Monitoring

Documentation of subcontractor compliance with DFPS Policies and Procedures

Insurance, License, Background Checks, Clearance Emails

Programmatic Monitoring

Documentation of a Psychosocial Assessment that has been appropriately completed and is unique to the Client Documentation of an initial and revised Treatment Plan that is unique to the Client and representative of the specific needs of the Client Documentation of clear and complete Monthly Progress Reports Documentation exists for Diagnostic Consultation, Court Related Services, closure summaries, missed appointment, and cancellation of group counseling sessions Interpreter and Translation Services were provided when needed The caseworker special instructions as noted in the Comments section of Form 2054 were followed, or justification for not doing so is documented Documentation of timely submission and the manner of submission of applicable items to the caseworker or contract manager

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Contract Evaluation
Fiscal Monitoring
Valid Service Authorization Form 2054 Received prior to providing services Receipt of the 2054 is easily identified Services within the number of units authorized Services delivered within the time frames authorized Appropriate Claims If family, billed under one family member only Travel time is not included in any claim Documentation time is not included in any claim Group claims are appropriate to location of service or makeup of attendees Services delivered in appropriate time of the day Home-based services provided only when authorized and the type of service was identified Amount of services delivered by any one clinician is reasonable Services delivered by any one clinician do not overlap times or Clients being served at any one location Interpreter or Translation services not provided by a staff, volunteer, or child victim.

Court Related Services were at the request of DFPS, not the defense attorney

Documentation to Support the Unit of Service Billed Service provided by approved staff or approved subcontractor Service begin and end time

Location of service
Type of service delivered was authorized Medicaid denial *not based on error reports*.

Contract Manager Approvals Prior approval for Interpreter and Translator Services Service provider NOTE: Contractor is to ensure service providers are aware of the contract requirement to cooperate with any audit or monitoring. This includes making records available or being available for interviews.

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Contract Evaluation
Monitoring Results

All material errors or questionable items found in fiscal and/or programmatic monitoring or the Administrative Review will be addressed in a written Monitoring Report. The written Monitoring Report will be provided within 30 days of the conclusion of the monitoring. The Contractor will be asked to respond

Agreement or disagreement

Actions to be taken to remedy

Time frames for correction Reimbursement of disallowed costs

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Performance Measures
Substance Use Disorder (SUD) Services

Outcome #1
Authorized services provided by the Contractor meet Caseworkers expectations.

Target
At least 90%.

Performance Periods

September 1 February 28/29

March 1 August 31

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Performance Measures
Substance Use Disorder (SUD) Services

Methodology
How Will Performance Be Calculated?
Data will be obtained by DFPS from CPS Caseworker Satisfaction Survey Questionnaires. Performance will be calculated for each performance period, wholly or partially, depending on the contract start and end dates.

The aggregated number of favorable responses to the Caseworker Satisfaction Survey Questionnaires obtained from Caseworkers for the Outcome Performance Period. The aggregated number of all responses, excluding Not Applicable (NA) responses, to the Caseworker Satisfaction Survey Questionnaires obtained from Caseworkers for the Outcome Performance Period.
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X 100 = %

Performance Measures
Substance Use Disorder (SUD) Services
Caseworker Satisfaction Questionnaire
Question 1. I was satisfied with the efforts the Contractor made to schedule appointment(s). The Contractor was flexible in scheduling to accommodate clients' school/work/personal commitments. 2. Contractor initiated services within 10 business days of DFPS providing the 2054 and referral or within the requested timeframe if an emergency situation. 3. Contractor notified CPS worker within 24 hours of any exceptional events (i.e., missed appointment, relapse, positive drug test, or other events) that could affect the safety of the children. 4. The initial assessment addressed issues identified in the referral and was individualized, complete, and useful in the development of the family service plan, for making case decisions and/or for use in court. 5. If treatment was recommended, the initial treatment plan addressed issues identified in the referral and was individualized, with treatment goals that included child safety issues. 6. If client was referred for SUD treatment, quarterly summary notes were submitted following 90 days of SUD treatment. 7. If client was referred for ongoing SUD treatment, quarterly summary notes were individualized, with sufficient detail to support progress, or lack thereof, in meeting goals identified in the Treatment Plan and were useful in making decisions and/or for use in court. 8. If client was referred for ongoing SUD treatment, the treatment plan was reviewed and updated every 90 days. 9. Contractor provided clients with at least 24 hour notification when a group session was canceled. 10. Contractor took into consideration the needs, abilities, cultures, and communication preferences of clients. (i.e., considered intellectual functioning, literacy, level of education, comprehension ability. Respected the cultures of clients and offered appropriate translation or interpreter services, if needed.) 11. Contractor was prepared and willing to appear in court; and testimony was consistent with information reported to DFPS.
Strongly Agree Agree Disagree Strongly Disagree N/A

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12. I would recommend this service and this Contractor to other DFPS Caseworkers. Comments

Performance Measures
Substance Use Disorder (SUD) Services

Outcome #2
Contractor facilitates the development of a therapeutic relationship and effective treatment intervention by ensuring that client progress is not impacted by a change in treatment service provider during an entire course of treatment.

Target
At least 80%

Performance Periods

September 1 February 28/29

March 1 August 31

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Performance Measures
Substance Use Disorder (SUD) Services

Methodology
How Will Performance Be Calculated?
Data will be self-reported by Contractor in PMET. Performance will be calculated for each performance period, wholly or partially, depending on the contract start and end dates.

The total number of unduplicated clients who received Substance Abuse Treatment services anytime during the Performance Period who have had only one treatment service provider during their course of treatment as of the Performance Period end date.
The total number of unduplicated clients who received Substance Abuse Treatment services anytime during the Performance Period.
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X 100 = %

Compensation
Direct Client Services
Category Service Service Code
CDTF Assessment performed by a qualified credentialed counselor (QCC) (as defined by the DSHS licensure standard) to determine the severity of an individual's SUD and identify treatment needs. DFPS Service Code: 83F Medicaid Code: H0001-HF CDTF Group Counseling performed by a qualified credentialed counselor (QCC) (as defined by the DSHS licensure standard) to equip clients with skills needed to understand the disease concept and maintain sobriety. DFPS Service Code: 83H Medicaid Code: H0005 HF CDTF Individual Counseling performed by a qualified credentialed counselor (QCC) (as defined by the DSHS licensure standard) to equip clients with skills needed to understand the disease concept and maintain sobriety. DFPS Service Code: 83G Medicaid Code: H0004 HF Unit Rate Limitations

Assessment

$41.35

Once per episode of care

Group Counseling

$16.00 per hour

Provided in one (1) hour increments Maximum: 135 hours per calendar year

Individual Counseling

$47.00 per hour

Provided in fifteen (15) minute increments Maximum: 26 hours per calendar year

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Missed appointments are not billable to DFPS.

Compensation
Indirect Client Services
Category Service Service Code
Unit Rate Limitations Only billable when specifically requested and authorized by DFPS. Court Related Services When legally necessary and appropriate for the wellbeing, safety, or permanency of the child. $47.00 per hour Maximum: Controlled by authoring F2054 2.12.9 Court Related Services for more specific limits and requirements Only billable when specifically requested and authorized by DFPS.

DFPS Service Code: 86H

Case Specific Diagnostic Consultation

To obtain professional recommendations and opinions about a specific client.

DFPS Service Code: 81H

$47.00 per hour

Maximum: Controlled by authoring F2054

2.12.10 Case Specific Diagnostic Consultation for more specific limits and requirements

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Invoicing
DFPS
Create 2054 Send Pre-Bill

Receive 2054

Provide Service

Review Pre-Bill

Contractor
Send Billing Invoice Complete Billing Invoice Determine Billable Amount

Send Billing Invoice & Forms to DFPS

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Billing Invoice (Pre-Bill), signed Form 2016, if applicable

Form 4116-X, signed

Invoicing
Required Billing Forms and Supporting Documentation

State of Texas Purchase Voucher, Form 4116 Billing Invoice (DFPS Pre-Bill) Delivered Services Input, Form 2016 For anyone served but not listed on the Pre-Bill Referred to as Supplemental Billing Service Authorization, Form 2054 Only required for Supplemental Billing, Home-Based or Out-of-Office Court Related Services Court Related Services Case Note, Form 2057 Medicaid Denials Other supporting documents as requested

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Contract Changes

DFPS and Contractor may make changes to this Contract according to Section 4.37 of the Contract.

Section 4.37.1 Bilateral Amendment

Incorporates a substantive change into the existing contractual agreement.

May be initiated by either party. Requires mutual agreement. Requires signatures of BOTH parties.

Section 4.37.2 Unilateral Amendment

Only for circumstances listed in Section 4.37.2 of the Contract

Signed by DFPS Contract Manager. Provided to the Contractor with ten (10) days notice prior to execution of the amendment.

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Complaints

Process

DFPS Receives a Complaint

DFPS Notifies the Contractor

DFPS Determines Who Investigates

DFPS Investigates Contractor Investigates

Report Preliminary Information to DFPS within 5 Business Days of Receiving the Complaint

Investigation Completed Determination Reached

Complaint Not Validated Complaint Validated

Contractor Notified of Determination and Findings

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Timeframes Recap
Initial Contact

Assessment

By 3rd BD* after Referral

Initial Assessment

Receipt of 2054 & Referral Information

Due by 10th BD* after face-to-face meeting

Initiate Service

Treatment

By 10th BD* after Referral

Initial Treatment Plan

Receipt of 2054 & Referral Information

Due by 21st BD* after referral Updated every 90 days & at 1 year intervals Due by 10th day after update Due within 24 hours following any event listed on the form Due every 90 days after Initial Assessment Due by 30th day after service ends

Respond to Complaint

Updated Treatment Plan

By 5th BD* after Notification

Submit Preliminary Report

Submit Invoice

Treatment Exceptions Form 2040

By 15th Day of the Month Following the Month of Service

Send Invoice

Quarterly Summary Notes

Register in PMET

By 30th Day after Initial Service

Discharge Plan

Court Related Services

*BD = Business Day 33

Case Note Form 2057

Due with Invoice by 30th day of the month following the month of service

Contacts
DFPS CPS/PCS Regional Contracts Region 8 Contacts
Contract Managers

Contract Technicians

Victoria Navarrette Phone: 210-337-3132 Email: Victoria.Navarrette@dfps.state.tx.us

Linda Bernal Phone: 210-337-3597 Email: Linda.Bernal@dfps.state.tx.us Sandra Levrie Phone: 210-304-3887 Email: Sandra.Levrie@dfps.state.tx.us

Shelly Grunewald Phone: 210-337-3573 Email: Shelly.Grunewald@dfps.state.tx.us Samuel Garcia Phone: 210-337-3400 Email: Samuel.Garcia@dfps.state.tx.us Contract Program Director Linda Tavel

Phone 210-337-3362

Email Linda.Tavelt@dfps.state.tx.us

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