ASSESSMENT SERVICES

Procurement 530-13-0013A

CONTRACTING WITH DFPS

THE ROAD TO A SUCCESSFUL CONTRACT

Meets Client Needs Meets DFPS DFPS Needs Needs Meets

Fulfills Contract Terms

Contract Purpose Technology DFPS Internet Site Referrals Withdrawals Administrative Functions Service Expectations Deliverables Timeframes

Staff/Subcontractors Required Record Keeping Complaints Contract Evaluation Performance Measures Compensation Invoicing Contract Changes

CPS Program 1
CPS Program 2 CPS Program 3 CPS Program 4

Time Frames Recap

Handouts DFPS Contacts
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GENERAL INFORMATION
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Contracting with DFPS

CONTRACT PURPOSE

To obtain the expertise of a Contractor that will:

Provide a work product that is of the quality and within the timeframes to enable CPS to make the best permanency decision for the child.
Provide thorough FAD Screenings, HSEGH Reports and Kinship Home Assessments. Offer flexible hours to accommodate the applicants schedules Be available to receive referrals. Adequately screen, select, develop, supervise and manage qualified, trained service providers (if using subcontractors).

TECHNOLOGY

Requirements

Broadband Internet Connection Internet Explorer 6.0 or Higher Microsoft Word Email Address Anti-Virus Program (Active and Up-to-Date)
Select Contracting with DFPS from the DFPS Internet Homepage

DFPS Internet Site

DFPS Internet Homepage

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

Purchased Client Services (PCS) Homepage

Regional CPS Contracts Homepage Regional CPS Contracting Forms Client Services Contractor Reference Guide ABCS Registration ABCS User Login

DFPS INTERNET SITE

PURCHASED CLIENT SERVICES (PCS) HOMEPAGE
http://www.dfps.state.tx.us/PCS/About_PCS/

Select to Access the Regional CPS Contracts Homepage

Quick Links: Select Contracting and Procurement Forms to Obtain the 2970C and 2971C

Scroll down to Log-in to ABCS

DFPS INTERNET SITE

REGIONAL CPS CONTRACTS HOMEPAGE
http://www.dfps.state.tx.us/PCS/Regional_Contracts/

Select to Access Forms

DFPS INTERNET SITE

REGIONAL CPS CONTRACTING FORMS

Forms Grouped by Category Click on Category to Auto-Scroll to Applicable Forms

RECEIVING REFERRALS & DELIVERING SERVICES

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Assessment Services

REFERRALS
VALID REFERRAL PACKET CONTENTS (MINIMUM)
Foster/Adopt (FAD) Home Screening

Form 2054 (Service Authorization) Form 2700FAD (Routing and Approval) Form 2178FAD (Home Screening Referral)

Foster/Adopt (FAD) Home Screening with Kinship

Form 2054 (Service Authorization) Form 2700FAD (Routing and Approval) Form 2178FAD (Home Screening Referral) Most Recent Kinship Caregiver Assessment

Health, Social, Educational and Genetic History (HSEGH) Report

Form 2054 (Service Authorization) Form 2700HSEGH (Routing and Approval) Form 2644 (Referral for HSEGH Report)

Kinship Caregiver Home Assessment (KCHA)

Form 2054 (Service Authorization) Form 2700KIN (Routing and Approval) Form 6581 (Kinship Request for Assessment) or ICPC Referral (ICPC Regulation 2 Case Manager Statement)

Court Related Services

Form 2054 (Service Authorization)

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REFERRALS
INITIAL CONTACT - TIMEFRAME
Within Two (2) Business Days from the Receipt of the Complete Referral (Form 2054 and Referral Packet)

Acknowledge Receipt of Referral Make Initial Contact with Client Validate Household Composition

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WITHDRAWALS
Face-to-Face Contact
(Refer to Fee Schedule)

No Face-to-Face Contact
(Refer to Fee Schedule)

Acceptable Withdrawals of a Referral*

The household desires to be removed from consideration for placement of a Child DFPS notifies the Contractor that the Assessment is no longer needed The Contractor notifies DFPS of information that may result in the immediate rejection of the Client for placement of a Child The household is uncooperative Notify DFPS person making the referral via email within 1 business day of Contractors knowledge of the households withdrawal Complete and submit Form 5520 (Withdrawal Report) within 5 calendar days of the withdrawal *All Withdrawals subject to DFPS approval

The Contractor must:

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ADMINISTRATIVE FUNCTIONS

Maintain sufficient funds to support the contracted services. Have an operational system for managing referrals, assignments, and obtaining work product approval that is complimentary with DFPS internal processes. Ensure CPM Staff and Service Providers meet minimum qualifications for License, Education and Experience. (Submit to Contract Manager-PCS-102 & Form 551 & resume attached * form must be approved by Contract Specialist before staff can work with DFPS clients) Develop, manage, and maintain a Quality Assurance process and satisfy the requirements of the contract. Successfully administer a performance-based contract. Secure translation and interpreter assistance as needed. Meet all submission and documentation requirements. Complete all contracting actions.
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SERVICE EXPECTATIONS
FOSTER/ADOPT (FAD) HOME SCREENING
Collect Case Information

Read All Referral Packet Information Examine & Understand All Other Information Provided by CPS Staff Conduct face-to-face interviews with all household members at least 3 years of age or older according to Section 2.17 of the Statement of Work. Conduct interviews in an effective and appropriate manner. Obtain signed Form 2163 (Agreement to Give Information) from all adult household members.

Conduct Interview

Compile Assessment

Consider all information provided by DFPS and disclosed during the interview when developing the final product. Use prescribed format. Adoptive Only: Form 2190 (Adoptive Home Screening) and Form 2190ins (Instructions) Foster /Adoptive: Form 2191 (Foster/Adoptive Home Screening ) and Form 2191ins (Instructions) Foster Only: Form 2192 (Foster Care Home Screening) and Form 2192ins (Instructions) Microsoft Word (Font: Arial 10 point)
Compose and submit completed assessments according to the requirements in Sections 2.17, 2.18 and 2.19 of the Statement of Work.

Timeframes

Standard: 20 Calendar Days* Expedited: 15 Calendar Days*

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* The day count begins the calendar day following the date of the email acknowledging the referral or two (2) business days after the receipt of the referral and the Form 2054 whichever is earlier.

SERVICE EXPECTATIONS
FOSTER/ADOPT (FAD) HOME SCREENING W/KINSHIP
Collect Case Information

Read All Referral Packet Information Use the previously completed (within the past 2 years) Kinship Caregiver Home Assessment Examine & Understand All Other Information Provided by CPS Staff

Conduct Interview

Conduct all interviews and other contacts as required in the Minimum Standards and Section 2.17 of the Statement of Work. Conduct interviews in an effective and appropriate manner. Obtain signed Form 2163 (Agreement to Give Information) from all applicable adult household members.

Compile Assessment

Consider all information using the information provided by DFPS, included in the previously completed Kinship Caregiver Home Assessment and disclosed during the interview when developing the final product. Use prescribed format.

Foster/Adoptive with Kinship: Form 2193 (Foster and Adoptive Home Screening with Kinship Guide) Foster /Adoptive: Form 2191 (Foster/Adoptive Home Screening ) and Form 2191ins (Instructions) Microsoft Word (Font: Arial 10 point)

Compose and submit completed assessments according to the requirements in Sections 2.17, 2.18 and 2.19 of the Statement of Work.

Timeframes

Standard: 20 Calendar Days* Expedited: 15 Calendar Days*

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* The day count begins the calendar day following the date of the email acknowledging the referral or two (2) business days after the receipt of the referral and the Form 2054 whichever is earlier.

SERVICE EXPECTATIONS
HEALTH, SOCIAL, EDUCATIONAL & GENETIC HISTORY (HSEGH) REPORT
Collect Case Information

Read All Referral Packet Information

Examine All Other Data Provided by CPS Staff including the DFPS Official Case Records according to requirements in Form 2649ins (HSEGH Report Instructions for Contractors)
Contact individuals identified in Form 2644 (HSEGH Referral Form) as applicable

Conduct Interview

Only at DFPS request

With Child or Biological Family

Compile Report

Consider all information provided by DFPS when developing the final product. Use prescribed format. Health, Social, Educational and Genetic History (Form 2649) HSEGH Report Instructions for Contractors (Form 2649ins) Microsoft Word (Font: Arial 10 point) Compose and submit completed assessments according to the requirements in Sections 2.17, 2.18 and 2.19 of the Statement of Work.

Timeframes

Standard: 20 Calendar Days* Expedited: 15 Calendar Days*

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* The day count begins the calendar day following the date of the email acknowledging the referral or two (2) business days after the receipt of the referral and the Form 2054 whichever is earlier.

SERVICE EXPECTATIONS
KINSHIP CAREGIVER HOME ASSESSMENT (KCHA)
Collect Case Information

Read All Referral Packet Information Examine & Understand All Other Information Provided by CPS Staff Hold at least one (1) face-to-face interview with all household members. Conduct interviews in an effective and appropriate manner. Provide a Kinship Manual and Kinship Profile Questionnaire to the family. Obtain All Applicable Forms 0399 (Kinship Release of Information and Acknowledgement).

Conduct Interview

Compile Assessment

Consider all information provided by DFPS and disclosed during the interview when developing the final product. Use prescribed format. Kinship Caregiver Home Assessment Template (Form 6588) Kinship Caregiver Home Assessment Instruction Guide (Form 6588ins) Microsoft Word (Font: Arial 10 point)
Compose and submit completed assessments according to the requirements in Sections 2.17, 2.18 and 2.19 of the Statement of Work.

Timeframes

Standard: 15 Calendar Days* Expedited: 5 or 10 Calendar Days*

* The day count begins the calendar day following the date of the email acknowledging the referral or two (2) business days after the receipt of the referral and the Form 2054 whichever is earlier.

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SERVICE EXPECTATIONS
COURT RELATED SERVICES

Court Related Services allowed under this Contract:

ONLY when DFPS requests the service via a valid Form 2054 (Service Authorization).

Contractor must:

Receive a 2054 (Service Authorization) Print and Complete Form 2057 (Court Related Services Case Note)

Take to the Deposition or Court Hearing Complete and Sign Obtain DFPS Authorized Signature

Submit Form 2057 with the Invoice File Copy of Form 2057 as Case Note in the Assessment file.

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DELIVERABLES
TIMEFRAMES
STANDARD
Kinship 15 Calendar Days

EXPEDITED
5 Calendar Days or 10 Calendar Days

FAD FAD with Kinship

20 Calendar Days

15 Calendar Days

HSEGH

20 Calendar Days

15 Calendar Days

Timeframe Begins the Earlier of:

o o

Timeframe Ends:
o o

One (1) Calendar Day after Acknowledgement OR Two (2) Business Days after Receipt of 2054

DFPS Receipt of Complete Assessment AND Hard Copy of Signed Signature Page

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CONTRACT MANAGEMENT
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Region 8

MINIMUM INSURANCE REQUIREMENTS

Commercial General Liability Insurance or equivalent insurance coverage including, but not limited to, liability with a minimum combines bodily injury (including death) and property damage limits of $300,000 per occurrence , and $600,000 aggregate. Commercial Crime Insurance or equivalent insurance coverage to cover losses from fraudulent and dishonest acts with a minimum limit of $25,000. The Commercial Crime Insurance or equivalent insurance coverage must include a third party endorsement and an employee dishonesty endorsement or equivalent endorsements.

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STAFF/SUBCONTRACTORS
Background Check

Applies to All Contractors Employees, Volunteers & Subcontractors

Involved in Direct Delivery of Services to Clients Who 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.

List of Staff, Subcontractors and Volunteers

Applies to All Persons Providing Services or Having Access to Client Information

Submit Form PCS-102 within three (3) months of Contract execution Submit Form PCS-102 annually thereafter on the first business day of each July during the Contract Period of Performance Submit Form 5519 for new persons identified as CPM Staff or Key Personnel

Report All New Persons Associated with this Contract Using PCS-102

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STAFF/SUBCONTRACTORS
Staff

Supervisory Staff Must Be Employees Staff Record Must Be Maintained

Subcontractors

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:

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

All Required Records

Must be made accessible to DFPS staff upon request.

Required Personnel Records

Must support all Contractor Minimum Qualification requirements for Employees, Subcontractors, and Volunteers.

Performance Compliance Review Meeting (PCR) Records

Must maintain records of each PCR meeting Refer to Section 2.25.B of the Statement of Work for a List of PCR Record Requirements

Performance Measure Records

Must maintain documentation to support validity of performance measure results

Required Contractor Case Records*

Must include Complaint Investigation and Outcome Reports

Must contain the individual (hard copy) of the individual Assessment documents.
Case records must be housed or maintained in a central location. Refer to Section 2.25.D of the Statement of Work for a List of the Minimum Assessment Client Record Requirements
*Note: DFPS reserves the right to require additional records from the Contractor as needed.

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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

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DFPS Notifies Contractor of Determination and Findings

CONTRACT EVALUATION

Monitoring

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

Contractor Satisfaction Survey Distributed

Desk Review Billing Review 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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PERFORMANCE MEASURES
Output #1
Contractors submissions of completed Assessments occur within the required timeframes.

Target
Percent of Assessments that were completed within required timeframes: 85%

Quarterly Performance Periods

September 1 November 30 December 1 February 28/29

March 1 May 31 June 1 August 31

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PERFORMANCE MEASURES
Methodology
How Will Performance Be Calculated?
Performance will be calculated for each performance period, wholly or partially, depending on the contract start and end dates.

The total number of Assessments completed within the required timeframe during the performance period
The total number of completed Assessments that were due during the performance period

= % of Assessments completed within required timeframes

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PERFORMANCE MEASURES
Outcome #1
Applicants perceive Contractor delivery of authorized services as professional and respectful.

Target
Percent of aggregated favorable responses made to items on the Applicant Satisfaction Survey Questionnaires: 86%

Quarterly Performance Periods

September 1 November 30 December 1 February 28/29

March 1 May 31 June 1 August 31

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PERFORMANCE MEASURES
Methodology
How Will Performance Be Calculated?
Performance will be calculated for each performance period, wholly or partially, depending on the contract start and end dates.

The aggregate number of favorable responses from Applicant Satisfaction Survey Questionnaire returned during the performance period
The aggregate number of all responses from Applicant Satisfaction Survey Questionnaires returned during the performance period

= % of aggregated favorable responses made to items on the Applicant Satisfaction Survey Questionnaires

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PERFORMANCE MEASURES
Output/Outcome #2
Contractors assessment contain all required documentation in a clear, concise narrative format.

Target
Percent of Assessments that contain all required documentation: 85%

Quarterly Performance Periods

September 1 November 30 December 1 February 28/29

March 1 May 31 June 1 August 31

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PERFORMANCE MEASURES
Methodology
Performance will be calculated for each performance period, wholly or partially, depending on the contract start and end dates as Contractor reviews completed Assessments

The aggregate number of Assessment categories with completed required categories from Assessments during the performance period
The aggregate number of all responses from Assessment categories reviewed during the performance period

= % of aggregated completed reviewed items completed Assessments

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COMPENSATION
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Assessment Services

COMPENSATION
Assessment Services
Fee Schedule SERVICE Foster/Adoptive (FAD) Home Screening Assessment Foster/Adoptive (FAD) Home Screening Assessment with Kinship 88B Kinship Caregiver Home Assessment HSEGH Report Disposition

88A

Paid per Unit of Service Financial Remedies

Service Codes 88B, 88C, 88E, 88Y or 88Z STANDARD One (1) Unit = One (1) Complete Assessment ADDITIONAL CHILD Additional Payment for a Completed Report per child in a sibling group EXPEDITED - 5-Day Received Timely and Complete Additional 20% of STANDARD Unit Rate EXPEDITED - 10-Day Received Timely and Complete Additional 6% of STANDARD Unit Rate EXPEDITED - 15-Day Received Timely and Complete Additional 6% of STANDARD Unit Rate WITHDRAWN NO Face to Face conducted 15% of STANDARD Unit Rate WITHDRAWN Face to Face 25% of STANDARD Unit Rate LATE Still Useful 80% of STANDARD Unit Rate NO LONGER USEFUL

68A or 81D

$525.00

$262.50

$525.00

$525.00

$50.00

Timeframes not met Product submitted is not acceptable Acceptable product received after it is no longer useful

$630.00

Unit of Service Includes

Contractor Costs for:

$556.50

$556.50

$278.25

$556.50

Travel Translators Interpreters Reports Long Distance Calls

$78.75

$39.38

$78.75

$131.25

$65.63

$131.25

Time spent preparing for or documenting Court Related Services

$420.00

$210.00

$420.00

$420.00

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$0.00

INVOICING
DFPS
Create 2054 Send Send Pre-Bill 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

Billing Invoice (Pre-Bill), signed Form 2016, if applicable Form 4116-Xe, signed

Form 2700 for Each Assessment Billed Form 2057 for Each Court Ordered Service Billed, signed Form 5520 for each Withdrawn Assessment

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CONTRACT CHANGES

DFPS and Contractor may make modifications to this Contract according to the requirements in Section 8 of the Uniform Terms and Conditions (2282UTC).
8.1.1 Bilateral Amendment 8.1.2 Unilateral Amendment 8.1.3 Contract Renewal

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TIMEFRAMES RECAP
Acknowledgement

Withdrawals

Within 2 Business Days of Complete Referral

Within 1 Business Day

Email DFPS of receipt of 2054 and Referral Packet Make initial contact with Client Verify household composition

Submit written notification of household withdrawal

Submit Withdrawal Report (Form 5520)

Within 5 Calendar Days

Deliverables*

Complaints

FAD Home Screening

Standard: 20 Calendar Days Expedited: 15 Calendar Days

Within 5 Business Days from Notification

Submit preliminary report

FAD Home Screening with Kinship

Invoice

Standard: 20 Calendar Days Expedited: 15 Calendar Days Standard: 20 Calendar Days Expedited: 15 Calendar Days Standard: 15 Calendar Days Expedited: 5 or 10 Calendar Days
*Timeframe Begins the Earlier of:
o

15th Day of the Month

HSEGH Report

Submit Invoice Court Related Services Include 2057 with Invoice

Kinship Assessment

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One (1) Calendar Day after Acknowledgement OR Two (2) Business Days after Receipt of 2054

*Timeframe Ends Upon DFPS Receipt of: o Complete Assessment AND Hard Copy of signed Assessment Signature Page

DFPS CONTACTS
ASSESSMENT SERVICES

DFPS CPS/PCS Regional Contracts Region 08 Contacts

Contract Manager
Shelly Grunewald Tel# 210-337-3573 Email: Shelly.Grunewald@dfps.state.tx.us Victoria Navarette Tel# 210-337-3132 Email: Victoria.Navarette@dfps.state.tx.us Samuel Garcia Tel# 210-337-3400 Email: Samuel.Garcia@dfps.state.tx.us

Contract Technician
Linda Bernal Tel# 210-337-3597 Email: Linda.Bernal@dfps.state.tx.us Sandra Levrie Tel# 210-304-3887 Email: Sandra.Levrie@dfps.state.tx.us

Contract Director Linda Tavel

Phone (210) 337-3362

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