Q. In reviewing the RFI, I noticed that Forensic and Jail Based Services are listed on p.6, but not elaborated on in Section 1.4. Could you possibly clarify if that was intentional or an oversight, and if it was an oversight, in what manner will be corrected? Thank you.
A. The Jail Based services are currently provided by employees within the outpatient mental health clinic in accordance with the Department of Corrections regulations and requirements. There is no state funding or OMH oversight of this program and it is funded through a separate contract between the Mental Health Clinic and the Sheriff's Department. The expectation is that the agency that is awarded the outpatient clinic services will also be able to meet the needs of the county jail and negotiate an appropriate contract with the county for the provision of those services.
Additional Forensic Services include the completion of court ordered examinations that require qualified psychiatric examiners as defined in the Assisted Outpatient Treatment statute, applicable Criminal Procedure Law, and Family Court Law. The successful applicant will be required to demonstrate that they are able to provide the qualified professionals necessary to conduct all forms of forensic assessments within the legally defined time frame.
Q. How would the new agency deal with union/civil service employees
including retirement benefits, etc?
A. As long as the new entity is a non-governmental entity (i.e. a not-for-profit or for profit corporation, etc.), there is no carry over as far as those obligations are concerned. The civil service law only applies to governmental entities. Any union contracts in existence at the time of the transition are between the union and the County, and therefore would not apply once the new entity assumed operation. Similarly, with the NYS Retirement System, a non-governmental agency is precluded from participating and therefore there would be no obligation in that regard. The new entity is free to make its own decisions as to what retirement benefits may be available for its employees.
Q. Is the Children's Intensive Case management program composed of both
Lewis County and state employees?
A. No. There is one Children's Intensive Case Manager providing services for Lewis County and this employee is employed by the county. There are no state employees providing Children's Intensive Case Management services.
Q. Does the amount of state aid quoted include the flex dollars assigned to each case management slots?
A. No.
Q. How many cases managers do you have?
A. One adult intensive case manager. One adult supportive case manager.
These programs are blended. One children's intensive case manager.
Q. What impact if any will Medicaid managed care have on the children's programs specifically.
A. Currently our Medicaid program is fee for service. It is not known what the effects of the transition to Medicaid managed care will have on the children's programs.
Q. What is the current number of all existing staff in community based services and clinic? (also clinic only)
A. The Community Support Programs and Outpatient Clinic employ a total FTE of 33.12 individuals. The Outpatient Clinic employs a total FTE of 30.18 individuals.
Q. What are the titles of the current staff, current salaries, credentials, and case loads?
A. Information about existing staff and credentials is listed on the website. http://lewismh.org/content/Generic/View/1
Salaries vary significantly depending on job title, experience, civil service, degree, and employment status (part time versus full time). Salaries are competitive and consistent with the industry standards.
Case loads assigned to individual clinicians vary depending on staff credentials, specialty, location of secondary offices, and number of hours the clinician is employed. Individual case loads are consistent with industry standards. The average therapist carries a case load of 60 individuals.
Q. What is the number of face-to-face hours per therapist and their case loads? What is the expectation?
A. The number of face to face hours per therapist and their case loads varies significantly depending on other responsibilities assigned to the therapist, such as supervision. Individual productivity targets are established based on staff responsibilities, staff credentials, areas of specialty, severity and complexity of the individual caseloads, number of groups provided, and number of hours worked per week.
Q. How many separate individual clients are registered in the clinic?
A. Client census changes daily. It has ranged from 568 - 1071 in the last five years.
Q. How many people ages 5-17 are seen?
A. Please refer to the information provided on the New York State Office of Mental Health County Mental Health Profile dashboard website: http://bi.omh.ny.gov/cmhp/dashboard
Q. How many are 18-65 years old?
A. Please refer to the information provided on the New York State Office of Mental Health County Mental Health Profile dashboard website: http://bi.omh.ny.gov/cmhp/dashboard
Q. How many are older than 65?
A. Please refer to the information provided on the New York State Office of Mental Health County Mental Health Profile dashboard website: http://bi.omh.ny.gov/cmhp/dashboard
Q. How many clients are given IM meds per month?
A. 10-12
Q. Do any clients undergo a full psychological battery? How many per year?
A. No
Q. What is the average rate per month for a unique client? 1x/wk, 2x/month, 1x/month, etc.?
A. The frequency with which a client is seen is based on clinical need and varies significantly. The establishment of practice is up to any new agency to determine going forward.
Q. Do any clients walk to the clinic? What percentage of the total?
A. Yes. The percentage is not currently tracked.
Q. What is the average hospitalization rate per month?
A. Please refer to the information provided on the New York State Office of Mental Health County Mental Health Profile dashboard website: http://bi.omh.ny.gov/cmhp/dashboard
Q. What is the number of scheduled appointments PER CLINICIAN? Per week?
A. The number of appointments scheduled per clinician varies significantly depending on other responsibilities assigned to the staff, type of service provided, their credentials, areas of specialty, complexity and severity of cases, number of groups provided, location of service (e.g. off site or at schools) and number of hours worked per week. Current operations and existing practice is consistent with industry standards.
Q. What is the number of no shows PER CLINICIAN? Per week? Per year?
A. The number of no shows per clinician, per week, and per year fluctuates due to individual differences in clinician case load, hours worked each week, vacation, holidays, weather, and includes seasonal fluctuations. No show rates can rage from 4-30% depending on the tracking methodology.
Q. What is the payer mix for clinical programs? Medicaid? Medicare? Tricare? Private Insur? Etc?
A. 2011 records indicate that 46-50% of recipients were currently enrolled with Medicaid. 14-16% of recipients were enrolled in Medicare. 26-31% had a Third Party Insurance, 0-5% were self-pay.
Q. Which programs of the following ended 2010 in a deficit?
SPOA; Family Support; Advocacy; Transition Management Services; MICA Network; Outpatient Clinic; Psychosocial Club; Crisis Intervention; Client Transportation; Supported Housing & Rental Assistance; Case Management; Case Management Non-Medicaid Care Coordination; Adult Blended Intensive/Supportive, Case Management; Children's Intensive Case Management
A. At the end of 2010 all programs were fully funded either through State Aid or through County contributions, as a result no programs ended in a deficit.
Q. Please supply copies of the CFR for 2009 and 2010
A. The CFRs will be mailed separately upon request.
Q. Do you currently have electronic case files, and if so, who is the vendor?
A. The Outpatient Clinic (only) utilizes Electronic Medical Records. The vendor is Docu track.
Q. Until what date is the clinic certified?
A. The Outpatient Clinic is not certified. The Outpatient Clinic is, however, licensed through the New York State Office of Mental Health to provide clinical services until April 2012.
Q. Please supply a current organization chart.
A. Organizational Charts will be provided through the mail upon request.
Q. Is the clinic currently following the 599 regs and using the new billing codes?
A. Yes
Q. What is the current rent and utilities for the space occupied by the community services and mental health clinic?
A. $89,172 Rent ; $24,950 Utilities (not including telephone)
