Specifications include, but are not limited to: Through this Request for Proposal (RFP) the Department of Mental Health (DMH, hereinafter the “State”) is seeking to establish contracts with one or more companies that can provide Home and Community-Based Mental Health Urgent Care Services. The purpose of the RFP is to solicit proposals from qualified Medicaid providers to support start-up and program implementation costs to provide alternatives to hospital Emergency Department (ED) utilization for mental health crisis care. This opportunity will focus on crisis care that could be covered under the rehabilitative services benefit and are intended to be less than 24-hour stays. 2.1.1. Emergency Psychiatric Assessment, Treatment & Healing (EmPATH) 2.1.1.1. “These are hospital-based outpatient programs which can promptly accept all medically appropriate patients in a psychiatric crisis, even those on involuntary psychiatric detention. Rather than being an alternative-to inpatient destination for ED mental health patients, the EmPATH unit is the destination for all the ED's acute mental health patients, a place where disposition decisions are typically not made until after a thorough psychiatric evaluation, treatment, and an observation period in the recuperative unit setting.” (Zeller, 2017) 2.1.1.2. Programs feature large central room instead of individual beds or rooms. 2.1.1.3. All staff are intermingled with the patients on the milieu, not behind glass or closed doors. 2.1.1.4. All patients see a psychiatrist as quickly as possible. 2.1.2. Living Room Model 2.1.2.1. “While a focus of The Living Room is to help those in crisis avoid using the ED, the service philosophy also embraces the Recovery Model…including autonomy, respect, hope, empowerment, and social inclusion.” (Heyland et. al., 2013) 2.1.2.2. The space is designed to be much like the familiar living room that is warm and welcoming, where guests feel safe and not overwhelmed. 2.1.2.3. This model also has an integral peer support counselors to help de-escalate and work on safety planning. 2.1.3. Psychiatric Urgent Care (PUC) or Psychiatric Urgent Care for Kids (PUCK) 2.1.3.1. In the PUC(K) model, Vermonters and their family members who need an urgent level of response meet with mental health clinical staff on site at their urgent care location, where they can receive crisis de-escalation, safety planning, clinical assessment, psychiatric consultation, and sensory tools as well as potentially peer and respite supports. Vermonters stay onsite as long as they need to during weekday daytime hours, and even return the following day(s) if they can be safe at home overnight.
