Pierce County

Questionnaire

Veteran and Veteran Families' Outpatient Behavioral Health Services

26-001-Vet-VOPBS

Project Questions

1

Proposer Confirmation

Type: confirmation

As an authorized representative of the proposer, having carefully examined the Request for Proposals, propose to furnish services in accordance therewith as set forth in the attached proposal.I further agree that this proposal will remain in effect for not less than sixty (60) calendar days from the date that proposals are due, and that this proposal may not be withdrawn or modified during that time.I hereby certify that this proposal is genuine and not a false or collusive proposal, or made in the interests or on behalf of any person not therein named; and I have not directly or indirectly induced or solicited any Contractor or supplier on the above work to put in a false proposal or any person or corporation to refrain from submitting a proposal; and that I have not in any manner sought by collusion to secure to myself an advantage over any other contractor(s) or person(s).In order to induce the County to consider this proposal, the proposer irrevocably waives any existing rights which it may have, by contract or otherwise, to require another person or corporation to refrain from submitting a proposal to or performing work or providing supplies to Pierce County, and proposer further promises that it will not in the future directly or indirectly induce or solicit any person or corporation to refrain from submitting a response or proposal to or from performing work or providing supplies to Pierce County.
2

Proposer Eligibility

Type: confirmation

Proposers who do not meet these minimum qualifications will be considered non-responsive and their proposal will not be evaluated. Proposers must be either a Behavioral Health Agency (BHA) licensed under WAC 246-341, a faith-based outpatient clinic, or a community agency that employs or contracts with licensed behavioral health providers. In accordance with WAC 246-341-0515, all staff providing clinical services must be appropriately credentialed for the services they deliver and must receive clinical supervision. Unlicensed staff may provide services only under the supervision of licensed clinical professionals, as defined by Washington State Department of Health regulations.Proposers that are BHAs must provide a copy of their license issued by the Department of Health. Proposers that are operating a faith-based outpatient clinic must provide certification that the agency is compliant with WAC 246-341. All other community agencies (defined as organizations that are not licensed Behavioral Health Agencies but provide behavioral health services through employed or contracted licensed professionals) must provide documentation demonstrating that staff administering eligible services are licensed behavioral health providers. In accordance with WAC 246-341-0515 and WAC 246-341-0520, any unlicensed staff must be supervised by a licensed clinician appropriate to the services being delivered, and supervision must meet the standards set forth by the Washington State Department of Health.Proposers must be legally authorized to conduct business in the State of Washington, as demonstrated by:Providing a valid Unified Business Identifier (UBI) number.By checking 'Confirm', I agree that the organization meets all eligibility requirements as stated under this section. If you have questions regarding eligibility requirements, please submit a question through the "Question & Answer" section of this RFP.
3

Ownership and Copyright of Submitted Materials

Type: confirmation

By submitting a proposal, I agree that all documents, reports, proposals, submittals, working papers, or other materials prepared by the applicant pursuant to this proposal shall become the sole and exclusive property of the County, and the public domain, and not property of the applicant. The applicant shall not copyright, or cause to be copyrighted, any portion of said items submitted to the County because of this solicitation.
4

Supplemental Attachment Confirmations

Type: confirmation

I confirm I have reviewed the content of the following attachments included under this RFP: Sample Agreement and any other documents as identified as "sample" in the Attachments section and acknowledge I understand and agree to these requirements should my organization receive a contract as a result of this proposal.
5

Insurance Requirements

Type: confirmation

By submitting a proposal, I understand and agree that if awarded funding from this RFP, the organization must be able to meet all insurance requirements based on services being purchased, prior to contract execution, and types of insurances may include, but are not limited to:Commercial General Liability Insurance: Required on all contracts. Standard levels are $1M occurrence/$2M aggregate (may be higher/lower, depending on value of contract and type of service).Commercial Automobile Liability Insurance: Required when the Contractor uses owned, rented, or leased automobiles to complete the services as required per the contract. Higher coverages may be required for fleet/large passenger vehicles. Workers Compensation Insurance: As required by Washington State. Professional Liability or Errors and Omissions Insurance: If the Contractor provides services such as analysis, consulting, counseling, daycare, legal, medical, nursing, pastoral, medical, or other services that require professional licensing.Abuse and Molestation: If the Contractor will be working directly with youth under the age of 18, elderly, disabled or other vulnerable populations.Cyber/Privacy and Security Insurance: If the Contractor is doing work that could give the Contractor access to personal or sensitive information from within the County's network or on the Contractor's personal computer, or lead to breaches of security, leading to a loss of privacy or identity theft. Crime/Employee Dishonesty Insurance: If the Contractor is in the custody or control of Pierce County funds such as cash, credit cards, checks or physical property.Other insurance(s) applicable to services being purchased: Such as Excess or Umbrella Liability Insurance if the contract is in excess of $500,000.In addition, Pierce County shall be named as an "Additional Insured,” which must be provided in the insurance endorsement. Insurance requirements also apply to any subcontractors hired by the main Contractor to deliver services, where applicable.Please see "Exhibit D" in the SAMPLE AGREEMENT under attachments to see full insurance requirements. If you have questions regarding insurance requirements, please submit them through the “Question & Answer” section of the RFP.
6

Debarment Certification

Type: confirmation

As an authorized representative of the proposer, I certify to the best of my knowledge and belief that the organization and its principals:Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency;Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;Are not presently indicted for or otherwise criminally or civilly charged by a government entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; andHave not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State, or local) terminated for cause or default.Does not employ any person nor contracts with any person or agency excluded from participation in federal health care programs under either 42 U.S.C. 1320a-7 (§§1128 or 1128A Social Security Act) or debarred or suspended.By checking the confirmation, I understand that a false statement on this certification may be grounds for rejection of this proposal or termination of any award. In addition, under 18 USC Sec. 1001, a false statement may result in a fine of up to $10,000 or imprisonment for up to 5 years, or both.
7

Financial Risk Assessment

Type: confirmation

I understand that all potentially successful Proposers will be required to complete a financial risk assessment prior to a formal contract offer. This audit requires the organization to submit detailed financial information about the organization’s financial history, current status, and details regarding boards, internal processes, and controls. The results of the risk assessment shall be utilized to determine the potential financial risk and stability of the organization. The County reserves the right to take all content of the Risk Assessment into consideration when making contracting, funding, and monitoring decisions. If you have questions regarding risk assessments, please submit a question through the "Question & Answer" section of this RFP.
8

Minimum Requirements

Type: sectionHeader

9

UBI Number

Type: shortAnswer

Please provide the organization's Washington State Unified Business Identifier (UBI) number.WARNING: Failure to provide a UBI number may be cause for the application to be disqualified from competition.
10

Organization Tax ID Number

Type: shortAnswer

Please provide the organization's Federal Tax Number (EIN).
11

Entity Type

Type: multipleChoice

12

Eligible Entity Documentation

Type: fileUpload

Behavioral Health Agencies: Upload a copy of your current license issued by the Washington State Department of Health.Faith-Based Outpatient clinics: Upload documentation that your agency is in compliance with WAC 246-341. Other Community-Based Organizations: Upload documentation demonstrating that staff responsible for delivering the proposed services are qualified through appropriate licensure, certification, and/or relevant experience.
13

Organization Information

Type: sectionHeader

14

Authorized Individual

Type: shortAnswer

Please provide the name and title of the individual authorized to execute a contract on behalf of the organization.
15

Organization Information

Type: longAnswer

Please provide the legal name, any d/b/a names, years in business, local address, billing address if different, email address, and phone number of the organization making the proposal.
16

UEI Number

Type: shortAnswer

An organization must have, at the time of submission, an active UEI number when the funding is identified as federal. Please list your UEI as issued by SAM.gov. Funding may or may not create a subrecipient relationship between the organization and the County. WARNING: Failure to provide a number OR if the UEI number is NOT ACTIVE may be cause for the application to be disqualified from competition.
17

Organization Contacts

Type: longAnswer

Please provide the name, phone, and email for:Executive Director/CEO/PresidentFinancial Manager/CFOContract Manager
18

Project Description (150 Points)

Type: sectionHeader

This section should clearly demonstrate how your project meets the requirements in the Scope of Work; address all applicable factors noted from the Scope of Work.
19

Project Design & Alignment (25 points)

Type: longAnswer

Describe your proposed project. Include how it will serve diverse populations, provide outpatient counseling for veterans and their families, ancillary services and supports, your hours of operation, service locations, and the full scope of services to be delivered.
20

Target Populations (25 points)

Type: longAnswer

Describe the specific subpopulations of indigent veterans and their families your proposed project will serve, including any target populations identified in Section 4.2 of this RFP.
21

Service Delivery (25 points)

Type: longAnswer

Explain how your program will reduce social isolation and suicide risk and address ongoing and emerging behavioral health needs to include reduction in reliance on crisis and inpatient care and promote stability and recovery.
22

Access to Care & Coverage Gap Mitigation (25 points)

Type: longAnswer

Explain how your program addresses gaps in Medicaid and private insurance coverage for veterans and their families, including those who are underinsured, uninsured, or ineligible for Access to Care standards. Please describe how your services reduce duplication across systems, decrease wait times to care, and provide low barrier entry, particularly for individuals awaiting VA Community Care appointments or needing services that are not billable under traditional insurance.
23

Health Outcomes, Community Connection, & Social Support (25 Points)

Type: longAnswer

Describe how your project shows sustainable improvements in the health, daily function, and community connection for veterans and their families.
24

Participant Eligibility & Recruitment/Retention (25 points)

Type: longAnswer

Describe in detail your organization’s process for screening and verifying participant eligibility in accordance with RCW 73.08 and the requirements of this funding opportunity. Your response must explain how you will determine and document eligibility for indigent veterans and their families, including:Verification of Indigent StatusExplain how you will assess and document that an applicant meets at least one of the following criteria:Receipt of qualifying public assistance benefits (e.g., TANF, ABD, PWA, poverty-related veterans’ benefits, SNAP, refugee resettlement benefits, Medicaid, medical care services, or SSI);Annual after-tax income at or below 210% of the federally established poverty level, or Demonstrated inability to pay reasonable costs for shelter, food, utilities, and transportation due to insufficient available funds.Include the documentation standards, self-attestation policies (if applicable), and procedures for resolving incomplete or conflicting information.Verification of Veteran StatusDescribe how you will confirm that an individual meets the statutory definition of a veteran under RCW 73.04.005, including verification of qualifying service, discharge status, activation status (for Reserve/National Guard members), disability rating (if applicable), and other qualifying categories outlined in the funding announcement. Specify acceptable documentation (e.g., DD-214, VA documentation, activation orders) and procedures for applicants who lack immediate access to records.Prioritization of Target PopulationsDescribe how you’re screening and intake process will identify and prioritize:Veteran households experiencing ongoing or emerging behavioral health needs;Households awaiting a Department of Veterans Affairs, Community Care, or similar provider appointment scheduled more than 30 days from referral who seek more immediate behavioral health services;Households that are underinsured, uninsured, or do not meet Medicaid Access to Care standards for outpatient behavioral health services.Equity, Timeliness, and AccessibilityExplain how your eligibility screening process will ensure timely access to services, reduce administrative barriers, maintain confidentiality, and promote equitable access for eligible veterans and their families.
25

SMART Objective (Not Scored)

Type: longAnswer

Please provide the additional required performance metric (SMART Objective) per Section 4.5 of this RFP.
26

Organizational Experience (45 Points)

Type: sectionHeader

27

Partnerships (15 Points)

Type: longAnswer

Explain the partnerships you currently have developed or plan to develop to coordinate with the VA and Community Care, veteran non-profits, and any other organizations that will assist you in reaching the goals of this RFP.
28

Experience and Capacity (15 Points)

Type: longAnswer

Describe your organization’s experience delivering behavioral health services to veterans and/or their families and capacity to provide services.
29

Staffing, Training, & Retention (15 points)

Type: longAnswer

Indicate the number of full-time equivalent (FTE) positions required to implement the proposed project and describe the credentials, qualifications, and relevant experience of the staff who will carry out these services. Include your approach to staff training, professional development, and retention strategies, and how you ensure staff are equipped to deliver high-quality, evidence-based care.
30

Budget (60 Points)

Type: sectionHeader

31

Budget Worksheet (Pass/Fail)

Type: download

Please download the below documents, complete, and upload.
32

Budget Impact (15 points)

Type: longAnswer

Based on your detailed budget submission, describe how the requested funding will be used to implement or support your program. In your response, explain how each major cost is necessary, reasonable, and directly aligned with your program goals, activities, and expected outcomes.
33

Operating Budget (15 Points)

Type: longAnswer

What percentage increase would this funding represent compared to your current annual operating budget?
34

Budget Flexibility (15 Points)

Type: longAnswer

If full funding is not awarded, how will the project scope or activities be adjusted?
35

Project Sustainability & Funding (15 points)

Type: longAnswer

What is your plan to ensure the proposed project is sustainable beyond the initial funding period? Will any portion of this project be billed to another grant, Medicaid, or insurance? If so, please describe.
36

Payment Structure (Informational Only)

Type: longAnswer

Identify the proposed payment structure (cost reimbursement, fee for service, or case rate); all rates are subject to negotiation. Include:Why this payment structure was chosen, How the payment structure will demonstrate an efficient use of funds, and The rate requested (for fee for service & case rate only). Cost Reimbursement: The awarded contractor will invoice Pierce County for approved costs (e.g. employee costs for those staff described in the service delivery). The contractor will need to demonstrate on an ongoing basis and during audits that any staff time charged to the BH Tax was specifically for work done through this grant. The contractor will also need to demonstrate that staff output (e.g. numbers served, hours of service) justifies the funding for the position.Fee for Service: The awarded contractor invoices Pierce County at an agreed-upon rate for specific services provided. The rate includes all direct, indirect, and other associated costs and is considered full payment for the service provided.Case Rate: The awarded contractor invoices Pierce County at an agreed-upon monthly rate for services provided per participant. The rate includes direct, indirect, and other associated costs and is considered full payment for all services provided during the month. Pierce County will monitor whether the services provided under the case rate approach result in an efficient cost of service. If not, the contract may be amended to a more efficient payment model.Milestone: Milestone payments are a structured payment method used in contracts or projects, where funds are released upon the completion of specific stages or predefined goals. Instead of paying the full amount upfront, the payer makes payments incrementally, tied to agreed-upon deliverables or performance benchmarks. This approach helps manage risk, ensures progress, and aligns incentives for both parties throughout the project.
37

Pre-Award Risk Assessment

Type: sectionHeader

38

Pre-Award Risk Assessment Upload

Type: download

Please download the below documents, complete, and upload the Pre-Award Risk Assessment and all required supplemental materials as listed in the attachment.