Specifications include, but are not limited to: At minimum, Contractor shall provide the services and related standards described in the subsequent categories below for Member services as well as for Entity services. A. Services for Members 1. Access to Care. Contractor shall: a. Be able to provide referrals to counselors within two business days and provide access to licensed therapists and other types of providers with confirmed availability within five business days. b. Offer easy access to care in various modalities including in-person, virtual, and selfdirected digital care. c. Provide a staffed 24/7 crisis line for in the moment support. d. Provide guided assistance and scheduling support, including scheduling of first appointment and provider alignment with health plan. e. Provide critical incident support within 24-36 hours of request. 2. Network Quality and Management. Contractor shall: a. Provide access to a broad network of evaluated behavioral health providers to meet the diverse needs of the OEBB population. b. Make available a provider network that includes licensed clinicians providing services to children and adolescents. c. Have or implement a process to search and match Members with a provider by race, ethnicity and language, LGBTQ+, and religious preference as well as clinical competencies to ensure the best patient to provider match. d. Have a rigorous process in place for credentialing providers and accepting new providers into the network, including a process for single case agreements. e. Proactively identify and fill network gaps, including having a process for monitoring capacity and availability of providers. 3. Clinical Processes and Support. Contractor shall: a. Have clear and concise crisis protocols in place to ensure high acuity cases are identified and connected with needed care and resources, with documented follow up to ensure care and resources were received. b. Monitor quality of care oversight and have quality assurance and quality improvement processes in place to address quality or care issues. c. Ensure evidence-based therapies are offered and utilized. 4. Member Experience. Contractor shall: a. Provide a Member experience aligned with OEBB's culture. b. Make available concierge service to OEBB members in life’s most difficult times. c. Offer customer service support at appropriate times for Pacific Time Zones. d. Provide easy to navigate web-based platform and applications. e. Provide modern resources and tools that are easy to find, relatable to the OEBB population, and engages the entire family. 5. Equity and Inclusion. Contractor shall: a. Have or implement capabilities to provide concordant services for Members based on race, ethnicity, language, sexual orientation and gender preference. b. Make available a diverse network of providers that provide culturally and linguistically appropriate services. c. Demonstrate equity strategies that ensure inclusiveness and accessibility through culturally and linguistically appropriate services (WCAG 2.1, language services offered, language level on all communications).
