HomeMy WebLinkAboutReg 2010-05-17 Item 7A - Crisis Diversion Facilities - Staff Report: Attachment DDREQUEST FOR
PROPOSAL
DATE ADVERTISED: March 11, 2009
Requesting Dept./ Div.:
RFP Number:
Due Date:
Buyer:
Pre-Proposal Conference:
A conference to discuss questions
related to this RFP shall be held at
1:30 p.m. on Thursday, March 18,
2010, in conference room 328 on
the 3rd Floor of The Chinook
Building, 401 Fifth Avenue, Seattle,
WA 98104
RFP Title:
king County
MIDD Crisis Diversion Services REBID
Department of Executive Services
Finance and Business Operations Division
Procurement and Contract Services Section
206-263-9400 TTY Relay: 711
King County Department of Community Human Services
MHCADSD
1056-10-RLD
May 6, 2010 no later than 2:00 P.M.
Roy L Dodman, roy dodman@kingcounty gov, 206-263-9293
Sealed Proposals are hereby solicited and will ONLY be received by
King County Procurement Services Section
The Chinook Building, 3' Floor
401 Fifth Avenue
Seattle, WA 98104-2333
Office Hours 8 00 a m 5:00 p m
Monday Friday
SUBMITTERS MUST COMPLETE AND SIGN THE FORM BELOW (TYPE OR PRINT)
Compafly Name
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This Request for Proposal will be provided in alternative formats such as Braille, large print, audio cassette
or computer disk for individuals with disabilities upon request.
Attachment DD
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RFP No. 1056 -10RLD
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Sealed proposals are hereby solicited and will be received only at the office of the King County Procurement
Services Section at 401 Fifth Avenue, 3rd Floor, Seattle, Washington, 98104 no later than 2 p.m. on the date
noted above regarding MIDD Community Diversion Services for the King County Department of Community
Human Services MHCADSD. This is a re- solicitation for these services. These services shall be
provided to King County in accordance with the following and the attached instructions, requirements, and
specifications.
Submittal: King County requires the Proposer to sign and return this entire Request for Proposal (RFP)
document. The Proposer shall provide one unbound original and ten (10) copies of the proposal response,
data or attachments offered, for eleven (11) items total. The original in both cases shall be noted or stamped
"Original In addition, provide one (1) CD -ROM, with either one (1) pdf version of the proposal, one (1)
Microsoft Word version of the proposal (2000 -2005 edition), or both.
Pre Proposal Conference: A conference to discuss questions related to this RFP shall be held at 1:30 p.m.
on Thursday, March 18, 2010, in Conference Room #328, 3rd Floor of The Chinook Building, 401 Fifth
Avenue, Seattle, WA 98104. See link for driving instructions http: /www.kingcounty.gov /procurement, go to
Contact Us menu and access Fund Us web page.
Questions: After the Pre Proposal Conference, Proposers will be required to submit any further questions in
writing prior to the close of business Thursday, April 1, 2010 in order for staff to prepare any response
required to be answered by Addendum. Questions are best received and most quickly responded to when
sent via e-mail directly to the following King County procurement personnel: Primary— Roy L. Dodman,
Senior Buyer roy.dodman @kingcounty.gov Secondary Cathy M. Betts, Buyer
cathy.betts @kingcounty.gov. Questions may also be sent via email to the address above.
SECTION I GENERAL INFORMATION
A. King County is an Equal Opportunity Employer and does not discriminate against individuals or firms
because of their race, color, creed, marital status, religion, age, sex, national origin, sexual orientation, or
the presence of any mental, physical or sensory handicap in an otherwise qualified handicapped person.
B. All submitted proposals and evaluation materials become public information and may be reviewed by
appointment by anyone requesting to do so at the conclusion of the evaluation, negotiation, and award
process. This process is concluded when a signed contract is completed between King County and the
selected Consultant. Please note that if an interested party requests copies of submitted documents or
evaluation materials, a standard King County copying charge per page must be received prior to
processing the copies. King County will not make available photocopies of pre printed brochures,
catalogs, tear sheets or audio visual materials that are submitted as support documents with a proposal.
Those materials will be available for review at King County Procurement.
C. No other distribution of proposals will be made by the Proposers prior to any public disclosure regarding
the RFP, the proposal or any subsequent awards without written approval by King County. For this RFP
all proposals received by King County shall remain valid for ninety (90) days from the date of submittal.
All proposals received in response to this RFP will be retained.
D. Proposals shall be prepared simply and economically, providing a straightforward and concise but
complete and detailed description of the Proposer's abilities to meet the requirements of this RFP. Fancy
bindings, colored displays and promotional materials are not desired. Emphasis shall be on
completeness of content.
E. King County reserves the right to reject any or all proposals that are deemed not responsive to its needs.
F. In the event it becomes necessary to revise any part of this RFP, addenda shall be created and posted at
the King County Procurement web site. Addenda will also be conveyed to those potential submitters
providing an accurate e-mail address. If desired, a hard copy of any addenda may be provided upon
request.
G. King County is not liable for any cost incurred by the Proposer prior to issuing the contract.
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H. A contract may be negotiated with the Proposer whose proposal would be most advantageous to King
County in the opinion of the King County Department of Community Human Services, all factors
considered. King County reserves the right to reject any or all proposals submitted.
It is proposed that if a selection is made as a result of this RFP, a contract with a fixed price /prices will be
negotiated. Negotiations may be undertaken with the Proposer who is considered to be the most suitable
for the work. This RFP is primarily designed to identify the most qualified firm. Price and schedule will be
negotiated with the "first choice" Proposer; negotiations may be instituted with the second choice and
subsequent Proposer until the project is canceled or an acceptable contract is executed.
J. This RFP shall be available for use by all King County Departments, Divisions and Agencies. If orders will
be placed by the County's Transit Division, the Contractor will be required to sign and comply with the
Federal Transit Administration's (FTA)'s required documentation. This RFP may also be used, as
appropriate and allowed, by other governmental agencies and political sub divisions within the State of
Washington.
K. The contents of the proposal of the selected Proposer shall become contractual obligations if a contract
ensues: Failure of the Proposer to accept these obligations may result in cancellation of their selection.
L. A contract between the Consultant and King County shall include all documents mutually entered into
specifically including the contract instrument, the original RFP as issued by King County, and the
response to the RFP. The contract must include, and be consistent with, the specifications and provisions
stated in the RFP.
M. News releases pertaining to this RFP, the services, or the project to which it relates, shall not be made
without prior approval by, and then only in coordination with, the King County Department of Executive
Services.
N. King County Code 4.16.025 prohibits the acceptance of any proposal after the time and date specified on
the Request for Proposal. There shall be no exceptions to this requirement.
0. King County agencies' staffs are prohibited from speaking with potential Proposers about the project
during the solicitation.
Please direct all questions to:
Roy L. Dodman Senior Buyer and Cathy M. Betts Buyer
206 263 -9293 206 263 -9291
roy.dodman @kingcounty.gov cathy.betts @kingcounty.gov
NOTE: Documents and other information is available in alternate formats for individuals with disabilities
upon advance request by calling the Procurement Receptionist at 206 263 -9400 or TTY711.
P. Protest Procedure King County has a process in place for receiving protests based upon either
proposals or contract awards. If you would like to receive or review a copy, please contact the Buyer
named on the front page of this document or call Procurement Services at 206 263 -9400.
Q. Term Service Requirement
If a contract is awarded based on this RFP, it may contain the following provision:
Contract Extension
The initial contract period will be for one (1) year from the start date of the contract. The term of the
contract may be extended in one (1) year increments for (5) additional one -year periods for a total
contract duration of six (6) years (2016), in accordance with the County's best interest and at the sole
option of the County. Prices shall remain firm for the duration of the contract period. Reasonable price
changes based on market conditions and price /cost analysis may be requested, if such escalations are
based on changes in the U.S. Department of Labor, Bureau of Labor Statistics Consumer Price Index for
All Urban Consumers "CPI -U for the Seattle- Tacoma Bremerton Statistical Metropolitan Area for the
preceding calendar year. You may obtain information about the CPI -U in general and the Seattle area in
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particular by visiting the United States Bureau of Labor Statistics web site at http: /www.bis.gov /cpi In
the event the CPI -U (or a successor or substitute index) is no longer published, a reliable government or
other non partisan index of inflation selected by the County shall be used to calculate any adjusted
amounts. Requests for any such changes are to be made in writing to the Department of Community
Human Services, and approved by the County Executive or his /her designee. Any agreed -to change shall
take effect at the time of the contract extension and shall remain in effect throughout the extension
period. The parties hereto recognize that such changes could be increases or decreases in the prices;
both parties are entitled to benefit from such price changes.
R. Electronic Commerce and Correspondence. King County is committed to reducing costs and facilitating
quicker communication to the community by using electronic means to convey information. As such,
most Invitations to Bid, Requests for Proposal, and Requests for Qualifications as well as related
exhibits, appendices, and issued addenda can be found on the King County Internet Web Site, located at
http: /www.kingcounty.gov /procurement. Current bidding opportunities and information are available by
accessing the "Solicitations" tab in the left hand column.
King County Procurement Services features an Online Vendor Registration (OVR) program that per-
mits vendors, consultants, contractors and other organizations to register their business with the County.
This OVR system allows interested parties to either directly register their firm by creating a unique User
ID, or to visit the website as a guest. Information regarding bid documents will be available to all users;
however, site visitors accessing the site as a guest will not be able to document their interest in a project
or add their name to the document holder's list. They will receive no automatic notification of issued ad-
denda. As such, the County encourages full registration in order to directly communicate with document
holders regarding any issued addenda or other important information concerning the solicitation.
After submittals have been opened in public, the County will post a listing of the businesses submitting
proposals, and any final award determination made.
Full information on vendor registration is available at the website. If you are viewing a paper version of
this RFP, you may download this document at http: /www.kingcounty.gov /procurement. Navigate to the
"Solicitation" web page. There you can view the web pages either as a guest or by logging -in as a regis-
tered vendor.
Search for 1056 -1 ORLD to access documents specifically for this solicitation (this is the location of the
required MS Excel budget forms, as well as two reference documents cited in Section II, Part 1, Item B)
and follow the resulting link to navigate to the "Solicitation Details" web page.
S. Unless otherwise requested, letters and other transmittals pertaining to this RFP will be issued to the e-
mail address noted in our files, and after submittal, noted on the first page of this document. If other
personnel should be contacted via e-mail in the evaluation of this proposal, or to be notified of evaluation
results, please complete the information in the table below.
Contact Name
I Title I Phone I E -mail address
1 1
I I
T. Washington State Public Records Act (RCW 42.56) requires public agencies in Washington to promptly
make public records available for inspection and copying unless they fall within the specified exemptions
contained in the Act, or are otherwise privileged.
U. Proposals submitted under this RFP shall be considered public documents and with limited exceptions
proposals that are recommended for contract award will be available for inspection and copying by the
public. King County may request an electronic copy of your proposal response at a later time for this
purpose. This copy may be requested in MS Word format, and delivered either by e -mail or directly
delivered on CD.
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If a Proposer considers any portion of his /her proposal to be protected under the law, the Proposer shall
clearly identify on the page(s) affected such words as "CONFIDENTIAL," PROPRIETARY" or
"BUSINESS SECRET." The Proposer shall also use the descriptions above in the following table to
identify the effected page number(s) and location(s) of any material to be considered as confidential
(attach additional sheets as necessary). If a request is made for disclosure of such portion, the County
will determine whether the material should be made available under the law. If the material is not exempt
from public disclosure taw, the County will notify the Proposer of the request and allow the Proposer ten
(10) days to take whatever action it deems necessary to protect its interests. If the Proposer fails or
neglects to take such action within said period, the County will release the portion of the Proposal
deemed subject to disclosure. By submitting a Proposal, the Proposer assents to the procedure outlined
in this paragraph and shall have no claim against the County on account of actions taken under such
procedure.
Type of exemption
Beginning Page Location
Ending Page Location
V. Proposers are urged to use recycled /recyclable products and both sides of paper for printed and
photocopied materials, whenever practicable, in preparing responses to this RFP.
W. During the solicitation process, King County strongly discourages the transmittal of Company information,
brochures, and other promotional materials, other than address, contact and e -mail information, prior to
the due date of proposals. Any pre packaged material received by a potential proposer prior to the
receipt of proposals shall not be reviewed by the County.
X. Bid Identification Label: Please see the Bid Identification Label on the last page of Section II.
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SECTION II PROJECT SPECIFICATIONS AND SCOPE OF WORK
PART 1 INFORMATION AND BACKGROUND
MHCADSD issues this RFP, through DCHS also referred to as "King County" or "the County."
This RFP aligns with the Mental Illness and Drug Dependency (MIDD) Plan and the Metropolitan King
County Council Ordinance 15949. The primary vision of the MIDD is to:
"Prevent and reduce chronic homelessness and unnecessary involvement in the criminal justice and
emergency medical systems and promote recovery for persons with disabling mental illness and
chemical dependency by implementing a full continuum of treatment, housing, and case management
services."
The Ordinance identified five policy goals:
1. A reduction in the number of mentally ill and chemically dependent people using costly interventions
Tike jail, emergency rooms, and hospitals;
2. A reduction in the number of people who recycle through the jail, returning repeatedly as a result of
their mental illness or chemical dependency;
3. A reduction of the incidence and severity of chemical dependency and mental and emotional
disorders in youth and adults;
4. Diversion of mentally ill and chemically dependent youth and adults from initial or further justice
system involvement; and
5. Explicit linkage with, and furthering the work of, other council directed efforts including, the Adult and
Juvenile Justice Operational Master plans, the Plan to End Homelessness, the Veterans and Human
Services Levy Service Improvement Plan and the King County Mental Health Recovery Plan.
In the MIDD Plan, the MHCADSD and its stakeholders identified 17 core strategies and corresponding sub
strategies for service improvement, enhancement and expansion to address these goals. This RFP aligns
with MIDD Strategy #10b: Crisis Diversion Center, Respite Beds and Mental Health Crisis Team. Further
information about the MIDD Plan and Ordinance is available on the MHCADSD web pages,
http://www.kingcounty.gov/healthservices/MHSA/MIDDPIan.aspx.
Capacity to provide diversion services to mentally ill or chemically dependent individuals in crisis is currently
limited in King County. MIDD Strategy 10b establishes a Crisis Diversion Facility (CDF) to which law
enforcement and other crisis first responders can refer adults who are in crisis. The facility will evaluate and
stabilize individuals in crisis and refer them to community -based services. Respite beds will also be created
to provide short-term housing for homeless individuals leaving the center. Respite beds will be within
proximity. Additionally, the strategy includes creation of a Mobile Crisis Team of mental health and chemical
dependency specialists who will provide increased access to crisis response for police as well as referrals
and linkage to the CDF and other community -based services.
The overarching vision of MIDD strategy 10b is to divert individuals from jails and hospitals. Based on the
National GAINS pre- booking diversion model and MIDD strategy 10b stakeholder planning, the county will
fund the creation of the Crisis Diversion Facility and the Mobile Crisis Team. The Crisis Diversion Interim
Services (Respite beds) funding was awarded under a separate solicitation.
The National GAINS Center within the Substance Abuse and Mental Health Services Administration acts as
a resource with a primary focus on expanding access to community -based services for adults diagnosed with
co- occurring mental illness and substance use disorders at all points of contact with the justice system
http: /gainscenter.samhsa.gov /html/). Pre booking jail diversion is when individuals with mental illness
and /or co- occurring disorders may be identified for diversion from jail by police, before formal charges are
filed. Pre booking diversion occurs at the point of contact with law enforcement officers and relies heavily on
effective interactions between police and community mental health and substance abuse services. Most pre
booking programs are characterized by specialized training for police officers and a 24 -hour crisis drop -off
center with a no- refusal policy for persons brought in by the police.
RFP No. 1056 -1ORLD
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MIDD Strategy 10b addresses hospital diversion in addition to pre- booking jail diversion. The CDF will
deliver more appropriate care at less cost by having an alternative to hospitals and emergency departments
for people who are in behavioral crisis due to mental health issues or substance abuse. This population
consists of individuals whose first contact with law enforcement and other first responders results from a
mental health or substance abuse crisis that puts either the person or others at risk. First responders are
trained to recognize signs of mental illness and substance abuse and deteriorating factors in the person's
condition. Their training and background proves extremely beneficial in quickly assessing the
decompensating nature of a person in crisis. However, options for first responders after field assessments
are made have been extremely limited. With a Crisis Diversion Facility, first responders will be able to
directly divert individuals in mental health or substance abuse crises based upon initial contact. In addition,
the CDF will provide law enforcement with the option to divert individuals who otherwise would have been
transported to the hospital. The Crisis Diversion Facility will provide a therapeutic alternative to simply
dropping off a person with a mental health or substance abuse crisis at a hospital emergency room.
A. Program Goal
This strategy seeks to improve the lives of those impacted by mental illness and substance abuse by
providing therapeutic alternatives in the community resulting in reduced admissions to jails, hospital
emergency departments and psychiatric hospital inpatient units.
B. Target Population
Adults (18 and older) in crisis in the community who might otherwise be brought to a hospital emergency
department or arrested for minor crimes and taken to jail will be targeted. Exclusionary criteria for
admission will include criminal charge /criminal history criteria and medical /behavioral criteria, as
recommended by target population workgroups. Please see two reference documents included on the
King County Procurement website as described in Section I, Item R of this RFP:
June 25, 2009 Memorandum from the King County Prosecuting Attorney's office
Hospital Diversion Medical Criteria
MHCADSD staff and the successful proposer(s) will develop and implement MIDD strategy 10b in King
County based upon the MIDD Plan Strategy 10b, the MIDD Evaluation Plan, the National GAIN model,
the MIDD 10b Population workgroup recommendations, and ongoing oversight of a MIDD Oversight
Committee subcommittee'.
MHCADSD will assure that training, technical assistance, coaching, fidelity monitoring, program
evaluation and capacity for system -wide quality improvement is available on an ongoing basis as funding
is available.
PART 2 INTENT
MHCADSD intends to contract with up to two (2) providers for the delivery of remaining services under MIDD
strategy 10b. Funding is available for two (2) components:
1. Crisis Diversion Facility and
2. Mobile Crisis Team.
MIDD strategy 10b services will be available county -wide; the strategy will serve 3,000 -5,000 individuals per
year.
Each successful proposer is expected to be at full staffing capacity, including location and licensure and
certification requirements met, no later than six (6) months from the date the contract is executed.
1 The MIDD Oversight Committee will create a subcommittee for MIDD strategy 10b in order to provide administrative oversight,
consultation and support on the implementation 'of services associated with 10b.
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A. Services
Specifically, the County is seeking proposals for the following services:
1. One (1) Crisis Diversion Facility (CDF): The CDF will have a capacity of 16 beds and be licensed by
the Department of Health as a Residential Treatment Facility (Chapter 246 -337 WAC). The mental
health and chemical dependence treatment services will be certified by the Department of Social and
Health Services, Mental Health Division as an Adult Residential Treatment Facility (RTF) (Chapter
388 -865 WAC). The RFT license is not required at the time of application, the bidder must
demonstrate that they have the capacity and infrastructure needed to successfully obtain a license by
the time the facility operations are expected to begin.
2. One (1) Mobile Crisis Team: A team of at least 2.0 FTE Licensed Mental Health Professionals (MHP)
on duty at all times to cover 24/7 operations with the capacity to conduct outreach visits to the
community to assist people in behavioral crisis. MHPs will also have professional certification in the
field of chemical dependency, or be willing to become certified within two years of employment and
provide evidence of working toward chemical dependency professional certification
3. All proposals will address provider capacity to meet diverse and /or special needs (e.g., culturally
specific needs; individuals who have been involved with the criminal justice system; immigrant and
refugee families; and /or medical needs).
A provider may submit proposals for one or two elements of this RFP. A partnership of any combination
of providers and /or subcontracting is encouraged.
B. Physical Plant
King County has not selected a physical plant for this strategy but will consider any location proposed by
a provider as long as it meets the following criteria:
1. Centralized location with easy access and at least 2 routes to the facility by freeway and /or major
arterials. Routes to access Eastside: 1 -405 I -90 1 -5; Seattle: Hwy 99, Hwy 509 1 -5; Northside:
Hwy 99, Hwy 509 1 -5; Southside: Hwy 167, East/West Valley Hwy.
2. Minimum of 7,200 sq /feet for the Crisis Diversion Facility (which will include office space for the
Mobile Crisis Team, police, Designated Mental Health Professionals and other professionals). The
space requirement of 7,200 sq /ft does not assume that the space is all contiguous. The applicant
shall explain the space configurations and accessibility to office spaces in adjacent parts of the
building.
3. Within proximity of the Crisis Diversion Interim Services (CDIS) to allow for easy transfer of
individuals between locations of the CDIS and CDF (which was awarded under RFP 1207- 09RLD).
4. Accessible to a Metro bus route.
5. Easy access for law enforcement and ambulance.
C. Values
All efforts will be made to make the Crisis Diversion Services welcoming and consistent with the following
values:
1. Recovery: A program model that is consistent with the King County Mental Health Recovery Plan
and the Chemical Dependency focus on Recovery Oriented Systems of Care. Recovery principles
include: services that are consumer centered and driven; assessment and treatment planning that is
strengths based; reduction or remission of symptoms; development or restoration of normative life
roles; active development and involvement of natural supports; and full community participation.
2 Reimbursement for Chemical Dependency Professional certification and training costs will be made available to the selected
agency through the King County MIDD Strategy #le through a separate contract with the King County MHCADSD.
RFP No. 1056 -10RLD
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2. Individualized: Emphasizing consumer's self- direction in treatment focusing on their particular
strengths, assets and needs.
3. Peer supported: Emphasizing a collaborative approach to resolving the challenges facing consumers.
4. Trauma informed: Trauma specific interventions are designed specifically to address the
consequences of trauma in the individual and to facilitate healing.
5. Strengths based: Treatment is built upon and enhances the capabilities, knowledge, skills, and
assets of the consumer, their community, and other team members.
6. Culturally competent: Demonstrates respect for and builds on the values, preferences, beliefs,
culture, and identity of the consumer and their community.
7. Evidence Based: Evidence based is defined as findings established through scientific research, such
as controlled clinical studies, but other methods of establishing evidence are considered valid as well.
Evidence -based practice stands in contrast to approaches that are based on tradition, convention,
belief, or anecdotal evidence.
PART 3 DESCRIPTION OF WORK
A. Crisis Diversion Facility (CDF)
The CDF will be a 16 bed facility to accept people age 18 and over in mental health and substance abuse
crisis to divert them from jails and hospitals. Individuals arriving at the facility will be evaluated within
three hours with some being linked directly to services and released while others are admitted to the
CDF. In this way, the capacity to assist people may be more than 16 as not everyone will need to be
admitted to a bed.
Individuals found by police and suspected of a crime may be brought to the CDF. Any person in mental
health or substance abuse crisis and suspected of a minor non violent crime and a limited and non-
violent criminal history may be considered for diversion from jail to the CDF Police officers may
suspend the arrest of a consumer favoring diversion to the CDF. A report and other proper paperwork
will accompany consumers sent to the CDF by police. CDF staff will follow up appropriately with police
on the status of consumers sent to the CDF. If a consumer admitted to the CDF in lieu of arrest
demands to leave before their crisis is stabilized or resolved, staff may contact police for disposition.
Individuals experiencing crisis in the community who are in good behavioral control and willing to
cooperate with CDF services may be diverted from hospital emergency departments to the CDF. A
telephone screening call with the facility from a professional in the community or concerned other will
precede a consumer coming to the CDF. Individuals may be diverted from hospital admission out of the
emergency department to the CDF. The CDF also needs the capacity to address the needs of walk -ins,
although the facility will not be advertised as having that capacity.
The CDF is not intended to be a substitute for detoxification or sobering services provided by other
facilities and consumers will be pre- screened to determine which facility is most appropriate. If a
consumer in crisis is admitted to the CDF and begins to shows signs of withdrawal, the consumer will be
referred to other resources as appropriate.
Submitted proposals for this RFP must address criminal justice and medical exclusionary criteria for
admission to the CDF as well as a plan to achieve restraint -free operation. Jail Diversion criteria are
included as Attachment C. Hospital Diversion criteria are included as Attachment B.
Restraint free facility: The County will give preference to proposals that use a recovery oriented model of
care system that is consistent with the principles of trauma- informed care, with policies and procedures
that maintain the safety of service recipients an staff as well as the dignity and self determination of
3 Refer to Attachment C, Jail Diversion Criteria for additional information.
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individuals who are in crisis. The following publication is provided as a reference: Roadmap to Seclusion
and Restraint Free Mental Health Services. DHHS Pub. No. (SMA) 05 -4055. Rockville, MD, Center for
Mental Health Services, Substance Abuse and Mental Health Services Administration, 2005.
Medical exclusionary (Hospital Diversion) criteria: Included in Attachment B, the medical exclusionary
criteria was developed in partnership with local hospitals and mental health care providers and are
designed to provide a broad overview of conditions /illnesses that would exclude an individual from
receiving services through the CDF. Specific medical exclusionary criteria may need to change once the
CDF has been in operation for enough time to evaluate how they are working. The county, in partnership
with the MIDD 10b subcommittee are willing to entertain suggestions for small modifications to the
exclusion criteria as long as the change would not result in a reduction in the effectiveness of the CDF as
a hospital or jail diversion resource.
The physical plant of the CDF must include:
At least 7,200 square feet.
Locking doors and security measures to assure that consumers do not leave the facility without the
awareness of staff members.
Interview rooms of which at least two (2) have security features that would allow for containment of
consumers who become behaviorally out of control.
Beds arranged in single cubicles allowing for some privacy but allowing for line of sight monitoring by
staff members.
Common areas that include a locking medical supply closet, a secure records room, medical exam
room, medication dispensary, intake /interview area, food storage and preparation areas, an eating
area, offices for police, DMHPs and other professionals.
Showers, some secure storage, laundry and a stocked clothes closet should also be incorporated.
The services offered at the CDF must include:
24 hour per day, 7 day per week operation.
Psychiatric evaluation, medication management, and stabilization services.
Peer support and other mental health counseling.
Chemical dependency evaluation.
Case management that focuses on specific linkage with needed services such as benefits, housing,
medical care, mental health and chemical dependency treatment.
Transportation arrangements for consumers leaving the CDF (vehicle costs are available as part of
start-up and within the annual budget).
Nursing services.
Three meals per day (arrangements may be made to have meals pre prepared and delivered or
prepared on -site) with snacks and produce available on -site.
Shower and laundry facilities.
Capacity for a maximum length of stay of 72 hours with an average length of stay less than 24 hours.
Submitted proposals must include staffing model for the CDF that contains a 4:1 consumer to staff
ratio, peer support staff, and access to medical and psychiatric staff.
The preferred staffing model includes:
1 CDF director (assigned full time to the CDF)
1 office support person
3 supervisors (1 per shift)
9 Mental Health Professionals (2 per shift)
4.5 Chemical Dependency Counselor (1 per shift)
4.5 Behavioral Health Specialists (1 per shift)
4.5 Registered Nurses /psychiatric ARNPs preferred (1 per shift)
4.5 Peer support specialists (1 per shift)
1 Psychiatric ARNP or Psychiatrist on -call after hours
Medical staff needed on -call 24/7
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B. Mobile Crisis Team
The mobile crisis team will be located at the CDF and will consist of 2.0 FTE Qualified Mental Health
Professionals (MHP) on duty at all times to cover 24/7 operations. MHPs will also have professional
certification in the field of chemical dependency, or be working towards chemical dependency
professional certification The team will operate 24 hours per day, seven days per week. They will
respond to police calls in the community to assist with people in mental health and chemical dependence
crisis. The team will help as staff members at the CDF when not responding to crises in the community.
They will also be called upon to transport consumers to and from the CDF.
The crisis team can be seen as another resource to help triage consumers into the CDF and assist with
stabilization and discharge planning. The team will have the ability to intervene with consumers in their
own communities, identify immediate resources on the scene and relieve the need for any further
intervention. They will also assist with discharge planning and transportation from the CDF to the
community.
The primary role of the mobile crisis team is to provide crisis outreach in the community by responding to
requests for crisis outreach. They may also assist with transportation to and from the CDF and /or CDIS
and assist at the CDF as long as they remain readily available to respond to calls from first responders.
Submitted proposals will include a staffing model for the Mobile Crisis Team that includes a minimum of
2.0 FTE coverage 24 hours /day, 7 days /week. Proposals will also include a detailed discussion of the
evidence based treatment approach to be used by the team consistent with the values expressed in
Section II C (Values) and Practice Guidelines: Core Elements for Responding to Mental Health Crisis
published by Substance Abuse Mental Health Services Administration (SAMHSA)
(http://download.ncadi.samhsa.gov/ken/pdf/SMA09-4427.pdf).
The preferred model includes:
One team of 2.0 FTE MHPs providing coverage 24 hours /day, 7 days /week located at CDF
Clinical Supervision on -site
Transportation resources (in order to conduct outreach across the county)
365 days /year and 24 hours per day coverage
C. Eligibility criteria
Any adult (at least age 18) experiencing an emotional and /or behavioral disturbance, including substance
use /abuse; who
Lives in King County;
Is in emotional or behavioral crisis that would benefit from crisis intervention services;
Agrees to participate in the services; and
Meets voluntary or involuntary eligibility criteria for jail or hospital diversion.
Voluntary Criteria Definition: the goal of the CDF is to engage people who present at the CDF into
voluntary treatment. The vast majority of individuals admitted to the facility will be voluntary at the time of
admission and remain voluntary. Some individuals will be persuaded to accept diversion in lieu of arrest
or involuntary civil commitment. We anticipate that some of these individuals may become involuntary
upon transfer to the facility or after admission. In these cases, individuals may be kept at the facility
under the following circumstances: 1) Individuals who, following admission to the facility, decide to leave
may be held for up to 72 hours on an alcohol commitment hold under 70.96A RCW (King County has an
4 Reimbursement for Chemical Dependency Professional certification and training costs will be made available to the selected
agency through the King County MIDD Strategy le through a separate contract with the King County MHCADSD.
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alcohol involuntary commitment specialist who has been designated by the King County Substance
Abuse Prevention and Treatment Coordinator with authority to place individuals on a alcohol commitment
hold.); 2) Individuals who may be a danger to self or others or gravely disabled due to a mental illness,
may be held a sufficient time in order to be referred to the Designated Mental Health Professional
(DMHP) for evaluation for detention under 71.05 RCW. If detained under 71.05 RCW, they will be
transferred to an evaluation and treatment facility; and 3) Individuals who are delivered to the facility by
police with a pending charge may be held up to 48 hours on a Police Hold. During this time CDF can de-
escalate the crisis and arrange for follow up services. Should a person on a police hold decline services
police can be called to arrange for an alternative disposition (potential booking).
D. Evaluation
King County Ordinance 16262 requires that the County conduct both process and outcome evaluations
for all strategies funded by MIDD revenue. An overall evaluation framework was developed as well as
proposed process and outcome measures for each of the MIDD strategies. Successful proposers will be
required to coordinate with the MIDD evaluation team in the implementation of the evaluation plan. The
goals of the MIDD crisis diversion strategy include diverting individuals with mental illness or chemical
dependency from initial or further justice system involvement, reducing the number of people with mental
illness and chemical dependency using costly interventions like jail, emergency rooms and hospitals,
reducing the number of people who cycle through the jail, returning repeatedly as a result of their mental
illness or chemical dependency, increased linkages of individuals admitted to needed community
treatment and housing, reduced admissions to emergency rooms, and reduced admissions to jails.
The evaluation criteria for MIDD strategy 10b will be created in partnership with the selected provider(s).
A preliminary evaluation plan for MIDD strategy 10b is included in Ordinance 16262 (available at the
following link http:// www .kingcounty.gov /healthservices /MHSA /MIDDPIan /MI DDThreePlans.aspx scroll
down to 'Evaluation Plan' and click on KC Ordinance 16262, page 57 in the document has the evaluation
plan for strategy 10b. This will be used as a starting point for finalizing the evaluation criteria for the
strategy.
Further information about the MIDD Oversight, Implementation and Evaluation Plans is available on the
MHCADSD web site, http:// www. kingcounty. gov/ healthservices /MHSA/MIDDPIan.aspx.
PART 4 PROPOSER QUALIFICATIONS
Each proposal must follow the outline and instructions as described in Section III, Proposal Requirements.
Each proposer must demonstrate how they will meet the following minimum qualifications in their responses
to the RFP:
1. Proposer must have the ability to contract with King County for service delivery. It is not necessary to
have a current or existing contract.
2. Proposer must agree to provide services in accordance with 45 CFR and HIPAA, parts 160 and 164,
and any applicable Revised Code of Washington (RCW) and Washington Administrative Code
(WAC).
3. Proposer must be able to submit data electronically to the MHCADSD Information System (IS) either
directly or under contract with another entity.
4. Proposer must have the ability to maintain records consistent with applicable RCWs, WACs, and the
King County Mental Health Plan Policies and Procedures Manual.
Proposals that do not meet the above requirements will not be reviewed.
PART 5 FUNDING
After the start up year, King County expects to award approximately $6,000,000 annually, (which does not
include the possibility of Medicaid match for Medicaid eligible individuals and services), for the
implementation of the CDF, CDIS and Mobile Crisis team components of MIDD strategy 10b. MIDD funding
RFP No. 1056 -1ORLD
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is made available through the King County one -tenth of one percent sales and use tax to fund the strategies
and programs outlined in King County's Mental Illness and Drug Dependency Plan, under King County
Ordinance 16261. Limited startup funding will be considered as a one -time amount if included in the
proposal. Successful proposals are eligible to receive continuation funding through the duration of the MIDD
sales tax, depending upon contract performance, alignment with King County goals and objectives, and
funding availability. King County renews contracts annually.
Contract amounts entered into as a result of this RFP will be negotiated with the successful proposers.
Proposers must demonstrate evidence of the ability to manage County allocated funds in a manner that
maximizes utilization of funds and provides services throughout the contract period.
A. Budget for a CDF
1. CDF services (including transportation): $4,034,791 (annualized)
2. CDF Facility Rent: $283,046 (annualized) (based on 7,200 square feet $38.9/sq ft)
3. Program /staff related start up costs:
Startup costs include hiring staff, staff training and vehicle.
Accessed through invoice to MHCADSD, on a cost reimbursement basis.
Not to exceed $230,000 over the first six (6) months of the contract.
4. One -time costs for building remodeling (including permit, fees, etc):
Accessed through invoice to MHCADSD, on a cost reimbursement basis.
Not to exceed $500,000 over the first six (6) months of the contract.
5. Budget forms (Appendix B available MS Excel spreadsheet) and budget narrative must be included.
B. Budget for Mobile Crisis Team
1. Mobile Crisis Team: $807,200 (annualized)
2. Program /staff Startup costs:
Startup costs include hiring staff, staff training and vehicle.
Accessed through invoice to MHCADSD, on a cost reimbursement basis.
Not to exceed $90,000 over the first six (6) months of the contract.
3. Mobile Crisis Team annual budget includes annualized staff rates utilized by MHCADSD for licensed
mental health professionals /chemical dependency professionals, these amounts are inclusive of
agency benefits, overhead, materials necessary for these positions and transportation costs.
4. Budget forms (Appendix B available MS Excel spreadsheet) and budget narrative must be included.
PART 6 OVERALL PROPOSAL REQUIREMENTS
A. Proposal Items.
A proposal must contain responses to each of the items identified below (maximum number of pages for
each requirement is included below):
1. Overall Proposal Cover Page (1 page); this form is found at the end of this RFP document
2. Proposer Qualifications (2 pages);
3. Executive Summary (1 page);
4. Eligibility /Qualification Section (12 pages);
5. Overall Program Narrative (5 pages);
6. Program Narrative: Crisis Diversion Facility (18 pages); and
7. Program Narrative: Mobile Crisis Team (8 pages).
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8. Budget Section (3 pages each for budget, justification and start -up, for a total of 9 pages); and
9. Required Attachment(s):
Attachment A, Signed MIDD 10b Affidavit (Statement of Assurance 1 page)
Attachment B, Budget Forms (9 pages each for CDF and Mobile Crisis team
Attachment C, Agency References (3 pages supplied by proposer; no form included with this
RFP)
Organize responses with the proposal cover page on top and all other items in the same order as they
appear in this RFP. Responses must contain the above items to be eligible for review.
The response must use standard size type (a font size of no less than 11 points). The response must be
typed on 8.5 X 11 -inch white paper with 1 inch margins and double -sided format. Single spacing is allowed.
Each page must be numbered sequentially. Please submit one (1) original and ten (10) copies of the
proposal.
Responses must be prepared simply and economically, providing a straightforward and concise, but
complete and detailed description of your ability to meet the requirements outlined in this document.
Emphasis shall be on the completeness of content. Fancy bindings, colored displays, and promotional
materials will not be accepted. We encourage the use of recycled paper.
PART 7 SPECIFIC PROPOSAL REQUIREMENTS
A. Overall Proposal Cover Page (1 page)
Complete the Overall Proposal Cover Page (found as the last page to this RFP) and attach it to the top of
the proposal packet submitted.
B. Proposer Qualifications (2 pages)
Section II, Part 4, Proposer Qualifications, sub -items numbered 1 -4.
C. Executive Summary (1 page) required for all proposals
Provide a summary of your entire proposal. It must specify the funding you are applying for in the first 5
lines of the executive summary (that is, Crisis Diversion Facility, Mobile Crisis Team, or a combination
thereof), describe the target population(s), and provide a brief description of the proposed program
activities and expected outcomes.
D. Eligibility /Qualification Section (up to 10 pages) required for each proposal Organize responses
in this section in the same order as they appear in this section, numbering 1 -9.
1. Describe the proposer's history and experience with developing and providing crisis mental health
and chemical dependency /substance abuse services with adults.
2. Describe the proposer's history and experience with providing crisis stabilization services to
individuals with mental illness and /or chemical dependency.
3. Describe the proposer's knowledge and experience with working with peer -to- peer support. Provide
specific examples of this work, including successes and challenges.
4. Describe the proposer's experience with and process for assisting mentally ill and chemically
dependent adults in the following:
4.1. Developing community and natural supports;
4.2. Accessing housing and residential services; and
4.3.. Developing effective partnerships with other adult serving systems and community services to
jointly serve mentally ill and chemically dependent adults.
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5. Describe the proposer's experience with working with law enforcement and the criminal justice
system.
5.1. Specify how law enforcement will be included in the planning and implementation of services.
6. Describe the proposer's experience with working with medical first responders, hospitals and
psychiatric inpatient hospitals.
6.1. Specify how medical first responders, hospitals and psychiatric inpatient hospitals will be
included in the planning and implementation of services.
7. Describe the proposer's history and experience with the following:
7.1. Serving special populations including specific expertise with:
7.1.1. Criminal justice,
7.1.2. Physical health, and
7.1.3. Developmental disability issues
Other Requirements
8. Describe the proposer's experience with program evaluation, including the collection of both process
and outcome measures.
9. Provide a realistic timeline for the 12 months of the project, including start -up (chart or graph)
showing key activities, milestones, and responsible staff. [Note: The timeline should be part of this
section. It should not be placed in an appendix.]
E. Overall Program Narrative (up to 5 pages) required for each proposal Organize responses in this
section in the same order as they appear in this section, numbering 1 -6.
1. Discuss the capability and experience of the applicant organization and other participating
organizations with similar projects and populations. Demonstrate that the applicant organization and
other participating organizations have linkages to the population of focus and are culturally
competent.
2. Describe how the proposer will work in partnership with other adult crisis serving agencies.
3. Describe the proposer's plan for developing and maintaining effective working relationships with
system partners, include plan for the following partners:
a. Mental health providers,
b. Substance abuse providers,
c. Criminal justice system,
d. Law enforcement,
e. Hospitals,
f. Medical first responders, and
g. Developmental disabilities.
4. Document your ability to collect and report on the MIDD evaluation plan. Describe your plan for data
collection, management and reporting
5. Describe how data will be used to manage the project and assure continuous quality improvement.
6. Describe and discuss how you will work with other Crisis Diversion Services providers. Describe and
discuss how you will work with the provider(s) who receive awards for the other component(s).
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F. Program Narrative: Crisis Diversion Facility (up to 12 pages) required if seeking funding in this
category Organize responses in this section in the same order as they appear in this section, numbering
1 -15.
1 Provide a complete list of staff positions for the Crisis Diversion Facility (CDF) project, showing the
role of each and their level of effort and qualifications (education, professional and past work
experience). Include the CDF Project Director, Clinical Director and other key personnel, such as
supervisory personnel.
a. Describe how the proposer will recruit new staff to the project.
b. Include timelines and strategies to reach full staffing capacity within 6 months of award date.
c. Include a copy of the proposer's organizational chart, noting how the CDF will be incorporated
into the organizational structure.
d. Include the resumes for individuals already identified (no more than 2 pages each placed in
appendix).
e. Include a copy of the job description, including qualifications (no more than 1 page placed in
appendix) for positions to be hired /filled.
2. Discuss how key staff have experience with delivering 24 hours /day mental health and /or substance
abuse services.
a. Discuss how key staff have demonstrated experience in serving individuals in mental health and
chemical dependency crisis
b. Discuss how key staff are familiar with the culture and language of the population of focus
3. Identify and describe the proposed location for the CDF.
a. Include evidence that the proposed site is secured or a letter of commitment from site owner
verifying readiness to site CDF at proposed location. (Copy of letter of commitment or other
evidence can be included as Appendix C and does not count toward the section page limit.)
b. Include evidence that the local municipality is aware of your location and that you will work
collaboratively on permitting and zoning requirements if awarded
c. Include evidence that the proposer will work with the local municipality on a neighbor relations
plan to foster good neighbor relationships.
d. Copies of letters of commitment or other evidence (required in 3 a -c) can be included as Appendix
C and does not count toward the section page limit.
4. Describe the resources available for the proposed project (e.g., facilities, equipment), and provide
evidence that services will be provided in a location that is adequate, accessible, compliant with the
Americans with Disabilities Act (ADA), and amenable to the population of focus.
5. Describe the evidence based treatment approach to be used within the CDF and relationship to the
values expressed in Section II, Part 2, Item C, Values.
6. Describe what services will be coordinated between the CDF and the Crisis Diversion Interim
Services and Mobile Crisis Team (i.e., triage, screening, assessment, transportation, etc...) and how.
7. Describe how the proposed project will address the physical plan and service components expressed
in Section II, Part 2, Item B, Physical Plant.
8. Clearly state the unduplicated number of individuals you propose to serve through the CDF (annually,
including the types and numbers of services to be provided and anticipated outcomes). Describe how
the population of focus will be identified, engaged, screened, assessed and referred.
9. Describe how project planning, implementation and assessment will include client input.
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10. Describe how the project components will be embedded within the existing mental health and
chemical dependency service delivery system. Identify any other organizations that will participate in
the proposed project. Describe their roles and responsibilities and demonstrate their commitment to
the project. (Copy of letter of commitment or other evidence can be included as Appendix C and
does not count toward the section page limit.)
11. Describe the law enforcement referrals and coordination aspect of the project.
12. Describe the hospital (emergency room, ambulance, medical first responders and psychiatric
hospitals) referrals and coordination aspect of the project.
13. Describe the proposed discharge plan for individuals leaving the CDF, detailing how they will be
transported home (or to other level of care) and linked to ongoing mental health and /or chemical
dependency services.
14. Describe the potential barriers to successful conduct of the proposed project and how you will
overcome them.
15. Describe how program continuity will be maintained when there is a change in the operational
environment (e.g., staff turnover, change in project leadership) to ensure stability over time.
G. Program Narrative: Mobile Crisis Team (up to 8 pages) required if seeking funding in this
category Organize responses in this section in the same order as they appear in this section, numbering
1 -7.
1 Provide a complete list of staff positions for the Mobile Crisis Team project, showing the role of each
and their level of effort and qualifications. Include the Project Manager and other key personnel, such
as supervisory personnel.
a. Describe how the proposer will recruit new staff to the project.
b. Include timelines and strategies to reach full staffing capacity within 6 months of award date.
c. Include a copy of the proposer's organizational chart, noting how the Mobile Crisis Team will be
incorporated into the organizational structure.
d. Include the resumes for individuals already identified (no more than 2 pages each placed in
appendix).
e. Include a copy of the job description, including qualifications (no more than 1 page placed in
appendix) for positions to be hired /filled.
2. Discuss how key staff has demonstrated experience in serving the population of focus and are
familiar with the culture and language of the population of focus. Describe how the staff are qualified
to serve multicultural and multilingual populations.
3. Describe the proposer's experience with providing mobile crisis mental health and substance abuse
services.
4. Describe the proposer's experience with working with law enforcement and medical first responders
to respond to mental health and substance abuse crises.
5. Describe the proposer's plan for transportation of individuals needing crisis mental health and
substance abuse services.
6. Describe the resources available for the proposed project (e.g., facilities, equipment). Describe the
evidence based treatment approach to be used by the team and relationship to the values expressed
in Section II, Part 2, Item C, Values..
7. Describe what services and transportation will be coordinated between the Mobile Crisis Team and
the CDF and Crisis Diversion Interim Services and how.
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H. Budget Section (3 pages) required for each funding category (CDF Mobile Crisis Team)
1. Provide a line item budget per proposed project (CDF and /or Mobile Crisis Team), including a start up
budget and an annualized budget.
2. Provide a detailed budget narrative and justification, including timelines.
3. The startup budget should cover no more than six (6) months and be limited to staffing, training,
transportation for the CDF and Mobile Crisis Team, and shall include building modifications,
permitting, equipment and furniture for the CDF only.
PART 8 PROPOSAL REVIEW PROCESS
A. Proposal Evaluation Criteria
As shown below, a possible total of 430 points for the CDF component and 330 points for the Mobile
Crisis Team component will be awarded for the written response to the RFP in the following categories:
Category Maximum Points
Overall Proposal Cover Page (1 page) Not rated
Executive Summary (1 page) 10 points
Eligibility /Qualification Section (10 pages) 120 points
Overall Program Narrative (5 pages) 50 points
Program Narrative: Crisis Diversion Facility (12 pages) 180 points
Program Narrative: Mobile Crisis Team (8 pages) 80 points
Budget Section* (3 pages allowed for each form, justification, start annual budgets)
Crisis Diversion Facility Budget 30 points
Mobile Crisis Team Budget 30 points
*budget form, narrative justification, start up and annualized budget required
Required Material Required Screened out if not received.
Appendix A, MIDD lob Affidavit (Statement of Assurance 1 page)
Appendix B, Budget Forms (3 pages)
Agency References (3 pages).
Other Materials
Appendix C, Evidence and Letters of Support (no page limit) 30 points (evidence)
10 points (letters of support)
SCS Certification See Part 10 below. As applicable, proposer may receive 10% of
written evaluation points available for the programs submitted 10%
All applications must be complete to be accepted for review. All applications will be screened for
completeness. Incomplete applications will not be reviewed.
B. Decision Process
A panel of raters selected by King County will review responses. The responses will be rated according
to the points specified in Evaluation Criteria above.
Within two (2) weeks of the response deadline the rating panel will meet. At that meeting the panel will:
Review each member's independent ratings of the responses;
Tabulate scores for each proposal;
Review references; and
Generate a final ranking for all responses.
RFP No. 1056 -10RLD
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Respondents will be ranked according to total score. The highest ranked proposal(s) may be asked to
participate in an interview. If interviews are conducted, they will have a maximum value of 50 points.
Final awards would then be based on the sum total of the written proposal and interview scores. If held,
following the interview process, the successful respondent(s) will enter into contract negotiations. All
proposers will be notified of the results.
Note: As include in Section I of this RFP, information regarding any potential protest or appeals action is
available by contacting the buyer listed on page 1 of this document.
PART 9 REFERENCE INFORMATION
Clark, J. (2004). Non Specialty First Appearance Court Models for Diverting Persons with Mental Illness:
Alternatives to Mental Health Courts. Delmar, NY: Technical Assistance and Policy Analysis Center for Jail
Diversion.
Johnsrud, M. (2004). The Bexar County Jail Diversion Program: Measuring the Potential Economic and Societal
Benefits, Policy Report. The University of Texas at Austin, Center for Pharmacoeconomic Studies.
Rueland, M. (2004). A Guide to Implementing Police -Based Diversion Programs for People with Mental Illness.
Delmar, NY: Technical Assistance and Policy Analysis Center for Jail Diversion.
SAMHSA (2009). Practice Guidelines: Core Elements for Responding to Mental Health Crises. HHS Pub.
No. SMA -09 -4427. Rockville, MD: Center for Mental Health. Services, Substance Abuse and Mental Health
Services Administration.
SAMHSA (2005). Roadmap to Seclusion and Restraint Free Mental Health Services. DHHS Pub. No. (SMA)
05 -4055. Rockville, MD, Center for Mental Health Services, Substance Abuse and Mental Health Services
Administration, 2005.
Juvenile Justice Operational Master Plan. http:l /your.kingcounty.gov /exec /jjomp/
Adult Justice Operational Master Plan
http: /www.kingcounty.gov/ exec strategy StrategicPlan /AJOMP /AJOMP %201.aspx
The 10 year Plan to End Homelessness http: /www.cehkc.org /planl0 /plan.aspx
Veterans and Human Services Levy Service Improvement Plan
http://www.kingcounty.gov/operations/DCHS/Services/Levy.aspx
King County Mental Health Recovery Plan
http: /www. kingcounty. gov /healthservices /MentalHealth/ Recovery/ KcMentalHealth /MHRecoveryPlan.aspx
PART 10 KING COUNTY CONTRACTING OPPORTUNITIES PROGRAM
The purpose of the King County Contracting Opportunities Program is to maximize the participation of Small
Contractors and Suppliers (SCS) through the use of rating points in the award of King County competitively
bid contracts for the acquisition of goods and services. The program is open to all firms that are certified as
an SCS by King County's Business Development and Contract Compliance Office. Not- for Profits are not
eligible for participation.
A "Small Contractor or Supplier" (SCS) means that a business and the person or persons who own and con-
trol it are in a financial condition, which puts the business at a substantial disadvantage in attempting to
compete for public contracts. The relevant financial condition for eligibility under the Program is set at fifty
percent (50 of the Federal Small Business Administration (SBA) small business size standards using the
North American Industrial Classification System (NAICS), and an Owners' Personal Net Worth less than
$750K dollars.
A "Certified Firm" means a business that has applied for participation in King County's Contracting Oppor-
tunities Program, and has been certified as an SCS by the King County Business Development and Contract
Compliance (BDCC) office. Information about becoming a Certified Firm, as well as a list of Certified Firms,
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may be obtained by visiting the King County's Contracting Opportunities Program Website address:
http: /www.kingcounty.gov/ exec BusinessDev /contractingopps.aspx (you may search SCS firms by access-
ing the "SCS Directory" tab on the left side of the screen) or contacting the BDCC office at (206) 205 -0700.
In the evaluation of proposals, ten percent of the possible points based on programs submitted will be allot-
ted for SCS participation. King County will count only the participation of SCSs that are certified by King
County at the date and time of proposal submittal. After tabulation of the selection criteria points of all prime
submitters, the appropriate SCS points shall be added to the score of all proposals that meet at least one of
the two following sub- criterion:
1. If the Prime submitter who is an SCS firm and includes the SCS certification number on page one of
this submittal is eligible to receive the maximum points for this criterion (please note that not -for-
profits are ineligible for SCS certification and prime participation)
2. If the Prime submitter is not an SCS but will use SCSs for at least 5% of the total contract labor hours
in the work to be performed in this contract, and who complete the following table and include it in
their proposal submission:
SCS Sub- Contact Name Work to be performed Percentage of
Certification Contractor Phone Total Hours
Number Name
SCS participation shall be counted only for SCSs performing a commercially useful function according to
custom and practice in the industry. A commercially useful function is defined as a specific scope of work for
which the SCS has the management and technical expertise to perform using its own workforce and
resources.
PART 11 INSURANCE
The selected Consultants shall furnish, at a minimum, Commercial General Liability, to include Products and
Completed Operations, in the amount of $3,000,000 combined single limit aggregate. Professional Liability,
Errors Omissions in the amount of $3,000,000 is also required. In addition, evidence of Workers' Com-
pensation and Stop -Gap Employer's Liability for a limit of $1,000,000 shall be provided.
Such policy /policies shall endorse King County, and its appointed and elected officials, officers,
agents and employees as additional insureds.
King County reserves the right to approve deductible /self insured retention levels and the acceptability of in-
surers.
PART 12 REQUIRED FORMS
The following completed forms will be required from the selected contractor(s), prior to contract award:
A. King County Personnel Inventory Report
B. Affidavit and Certificate of Compliance with King County Code 12.16
C. Statement of Compliance Union or Employee Referral Agency Statement (if applicable)
D. King County Code 3.04.120 and Consultant Disclosure Form (if applicable)
E. 504 /ADA Disability Assurance of Compliance and Corrective Action Plan
F. Equal Benefits Compliance Declaration Form
Copies of these forms are available by contacting the King County Procurement and Contract Services
Division. They are available in paper form, or may be obtained via e-mail. Please contact Cathy Betts at
206- 263 -9291 or Roy L. Dodman at 206 263 -9293, or by sending an e- mailed request to
cathy.betts @kingcounty.gov or roy.dodman @kingcounty.gov
PART 13 BID PROPOSAL CHECKLIST
A. One (1) signed copy of entire RFP package.
B. One (1) signed copy of any Addendum that was issued. (If it has signature box at bottom of first page, it
must be returned.)
C. One (1) unbound copy of proposal response marked "Original." (Include the required cover page,
attachments and appendixes.)
D. Ten (10) copies of proposal response. (Include the required cover page, attachments and appendixes for
with each copy.
E. One (1) CD -ROM, with either one (1) pdf version of the proposal, one (1) Microsoft Word version of the
proposals (2000 -2005 edition), or both. (Please label your CD's with proposer's name.)
F. Complete the Bid Identification Label below (or reasonable facsimile) and attach it to a prominent place
on the exterior of the submission envelope, box, etc.
PART 16 EXHIBIT
URGENT SEALED BID ENCLOSED
Do Not Delay Deliver Immediately
z King County
I u
Bid No.
Bid Title
Due Date
Exhibit A: Sample Contract (hyperlink)
Vendor
King County Procurement
Contract Services Section
Chinook Bldg, 3 Floor, 401
Fifth Avenue
CNK -ES -0340
Seattle, WA 98104 -2333
RFP 1056 -10RLD
MIDD Crisis Division
Services REBID
RFP No. 1056 -1ORLD
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PART 14 ATTACHMENTS
Attachment A: Sample Budget Justification
Attachment B: Mental Illness and Drug Dependency Plan (MIDD) Crisis Diversion Facility (10b)
Planning Workgroup
PART 15 APPENDICES
Appendix A: MIDD 10b Statement of Assurance (must be signed required at time of submittal)
Appendix B: Budget Forms (sample of forms included in RFP; use the MS Excel form available on the
County Procurement web site or by contacting the Buyer listed on Page 1)
Appendix C: Evidence and Letters of Support Not a published form; proposer supplies this material.
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RFP No. 1056 -10RLD
Page 22 of 33
Attachment A Sample Budget Justification
A. Personnel: an employee of the applying agency whose work is tied to the application
RFP REQUEST
Position 1 Name 1 Annual Salary/Rate 1 Level of Effort 1 Cost
Executive Director I John Doe 1 $64,890 110% $6,489
I Coordinator I To be selected I $46,276 100% 1 $46,276
TOTAL $52,765
JUSTIFICATION: Describe the role and responsibilities of each position.
The executive director will provide oversight of grant, including fiscal and personnel management,
community relations and project implementation and evaluation. The coordinator will coordinate project
services and project activities, including training, communication, data collection and information
dissemination.
RFP REQUEST (enter in Personnel section) $52,765
B. Fringe Benefits: List all components of fringe benefits rate
RFP REQUEST
Component 1 Rate I Wage Cost
FICA 1 7.65% 1 $52,765 $4,037
Workers Compensation 1 2.5% 1 $52,765 $1,319
Insurance 1 10.5% I $52,765 $5,540
TOTAL $10,896
JUSTIFICATION: Fringe reflects current rate for agency.
RFP REQUEST (enter in Fringe Benefits section).... $10,896
C. Travel: Explain need for all travel. Local travel policies prevail.
RFP REQUEST
Purpose of Location Item
Travel
Training (be as Out of state Airfare
specific as
possible)
Local travel
Rate Cost
$200 /flight x 2 persons $400
Hotel 1 $100 /night x 2 persons x 2 nights 1 $400
Per Diem (meals) 1 $46 /day x 2 persons x 2 days 1 $184
1 Mileage 1 3,000 miles @.485 /mile 1 $1,455
TOTAL 1 $2,439
JUSTIFICATION: Describe the purpose of travel and how costs were determined.
Cost for two staff to attend evidence based training in Ohio. Local travel is needed to attend local
meetings, project activities, and training events. Local travel rate is based on agency's privately owned
vehicle (POV) reimbursement rate.
RFP REQUEST (enter in Travel section) $2,439
RFP No. 1056 -1ORLD
Page 23 of 33
D. Equipment: an article of tangible, nonexpendable, personal property having a useful life of more than
one year.
RFP REQUEST
Item(s) Rate Cost
Laptop Computer I $900 $900
Printer $300 I $300
Projector I $900 I $900
TOTAL I $2,100
JUSTIFICATION: The laptop computer and printer is needed for both project work and presentations.
The projector is needed for presentations and outreach workshops. All costs were based on retail values
at the time the application was written.
RFP REQUEST (enter in Equipment section) 2,100
E. Supplies: office supplies and other materials, often having one -time use.
RFP REQUEST
Item(s) Rate Cost
General office supplies $50 /mo. x 12 mo. $600
Postage $37 /mo. x 8 mo. $296
Copies 8000 copies x .10 /copy $800
TOTAL $1,696
JUSTIFICATION: Describe need and include explanation of how costs were estimated.
Office supplies, copies and postage are needed for general operation of the project. The laptop
computer is needed for both project work and presentations. The projector is needed for presentations
and outreach workshops. All costs were based on retail values at the time the application was written.
RFP REQUEST (enter in Supplies section) 1,696
F. Consultant: generally amount paid to non employees for services or products. A consultant is a non
employee who provides advice and expertise in a specific program area.
RFP REQUEST (Consultant)
Name Service I Rate I Other I Cost
To be selected Architect I $400 /day 15 days 1 $2,000
Travel I .485 /mile 1 360 miles I $360
I TOTAL I $2,360
JUSTIFICATION: Explain the need for each agreement and how they relate to the overall project.
RFP REQUEST (enter in Consultant section) 2,360
G. Contractual: Goods, services and other approved outside contracts.
RFP REQUEST (Contract)
I Entity
1 To be selected
1 Product/Service
11.5 minute Public Service Announcement (PSA)
!Cost
1 $2,300
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RFP No. 1056 -1ORLD
Page 24 of 33
Entity 1 Product/Service J Cost
To be selected Training 1 $2,000
TOTAL 1 $4,300
JUSTIFICATION: Explain the need fo'r each agreement and how they relate to the overall project.
H. Other: expenses not covered in any of the previous budget categories
RFP REQUEST
1 Item 1 Rate I Cost
Rent 1 $15 /sq.ft x 700 sq. feet 1 $10,500
I Telephone $100 /mo. x 12 mo. 1 $1,200
1 Brochures 1 .89 /brochure X 1500 brochures 1 $1,335
TOTAL 1 $13,035
JUSTIFICATION: Break down costs into cost/unit, i.e., cost/square foot. Explain the use of each item re-
quested.
Rent and telephone are necessary to operate the project. The monthly telephone costs reflect the of
effort for the personnel listed in this application. Brochures will be used at various community functions
(health fairs and exhibits).
RFP REQUEST (enter in Other section) 13,035
I. Indirect cost rate: Indirect costs are costs that are not directly accountable to a particular function or
product.
RFP REQUEST
Base I Rate I Cost
I $63,661 1 8% 1 5,093
JUSTIFICATION: Break down base costs and justify indirect rate. 8% of personnel and fringe (.08 x
$63,661).
RFP REQUEST (enter in Indirect section) $5,093
8% of personnel and fringe (.08 x $63,661)
BUDGET SUMMARY:
I Category RFP Request
1 A. Personnel $52,765
B. Fringe $10,896
C. Travel $2,439
D. Equipment $2,100
E. Supplies $1,696
F. Consultant $2,360
G. Contractual $4,300
H. Other $13,035
Total Direct Costs* $89,591
I. Indirect Costs $5,093
I Category
1
Total Project Costs 1
TOTAL DIRECT COSTS:
RFP REQUEST (enter in Total Direct Costs section) $89,591
INDIRECT COSTS:
RFP REQUEST (enter in Indirect Costs section) $5,093
TOTAL PROJECT COSTS: Sum of Total Direct Costs and Indirect Costs
RFP REQUEST (enter in Total Project Costs section) $94,684
RFP Request
$94,684
RFP No. 1056 -1ORLD
Page 25 of 33
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Attachment B
RFP No. 1056 -10RLD
Page 26 of 33
Mental Illness and Drug Dependency Plan (MIDD)
Crisis Diversion Facility (10b) Planning Workgroup
Medical Criteria
Behavioral Emergency: A person who is out of behavioral control, is deemed an imminent danger to self or
others and is unwilling to accept treatment, and likely to require seclusion or restraint to maintain their safety.
Persons experiencing a behavioral emergency are not appropriate for referral to the CDF,
Behavioral Crisis: A person who is experiencing acute exacerbation of an existing mental illness and is
willing to receive services or someone who may have suicidal ideation while exhibiting behavioral control.
Persons experiencing a behavioral crisis are appropriately referred to the CDF.
Consumers who are NOT appropriate for admission to Crisis Diversion Facility (CDF)
1. Temperature >101 degrees F.
2. Pulse outside of 50 120,
3. Blood pressure <90 or >200 systolic, or >90 diastolic,
4. Respiratory rate >24,
5. Glucose blood sugar level <60 or >300,
6. Red blood count: Hct <30 Hgb <10 grams,
7. Mental status which is lethargic, in a stupor, comatose or there is spontaneously fluctuating men-
tal status,
8. Toxic or rising levels of medications or other substances (some substances may require serum
levels to determine potential toxicity),
9. Deterioration of vital signs prior to transfer (vital signs must be taken within 2 hours of transfer), or
10. Conditions requiring medical services not provided at CDF, and
11. Withdrawal from alcohol, opiates and benzodiazepines, even if medications and /or a patch (i.e.,
Klonodine patch) are prescribed to assist with the withdrawals.
Medical services that are NOT provided at the CDF
1. Vital signs monitoring more frequent that Q 8 hours
2. Acute medical treatments,
3. Stat (within 1 hour) or urgent (within 4 hours) X -rays and blood work,
4. Oxygen, unless client brings in his or her own supply,
5. IV therapies,
6. Suctioning,
7. NG tubes,
8. Central catheter insertion and maintenance,
9. Medical isolation,
10. Feeding tube placement and management,
11. Initiation of bowel and bladder training,
12. Extensive skin care programs,
13. Acute wound care or orthopedic care,
14. In -house physical therapy or other rehabilitation programs,
15. Retraining for swallowing,
16. Renal or peritoneal dialysis
17. Management of first trimester pregnancy or beyond 36 weeks, or delivery.
RFP No. 1056 -1ORLD
Page 27 of 33
18. Management of advanced or complicated pregnancy and delivery,
19. Blood gases,
20. Management of infection and contagious disease. Any concerns that the consumer may have an in-
fection and/or contagious disease and the test results are not available at time of admission.
21. Post operative stabilizing demonstrated through labs or vital signs over a 48 -hour period,
22. Diabetes management with unstable blood sugars or blood glucose exceeding 400 within last 6
hours,
23. Management of patients who have ingested toxic amounts of substances who either have not been
evaluated in a medical setting and medically cleared, or if medically cleared are not yet fully con-
scious, and
24. Management of Delirium.
Though the CDF will strive to exhibit a welcoming profile to the community, the following non-
medical conditions are considered to be either unsafe or clinically inappropriate for admission to the
CDF:
1. Presenting primarily for disability or other eligibility evaluation,
2. Presenting with current felony charges,
3. Presenting with a level of violence surpassing the management capability of this facility,
4. Presenting primarily for domestic violence,
5. Presenting primarily for active sexual offender behavior,
6. Presenting primarily for detoxification or intoxication, and
7. Children under 18 years of age
129
130
Appendix A
Printed name of Authorized Representative
MIDD 10b Statement of Assurance
As the authorized representative of [insert name of applicant organization]
Signature of Authorized Representative Date
RFP No. 1056 -1ORLD
Page 28 of 33
I assure King County that we have reviewed
the Scope of Work and by accepting this award, we agree to comply with all elements of the Scope of Work,
in addition to the following:
Comply with the MIDD Evaluation Plan and MIDD Data Dictionary, which includes reporting re-
quirements, which will be individualized upon award;
Participate in the development of policies and procedures for the CDF, CDIS and /or Crisis Mobile
Team in partnership with King County;
Participate in monthly meetings with the MIDD 10b strategy oversight group; and,
Comply with the terms of the negotiated contract that arises from the award.
I understand that compliance with these assurances throughout the period of the project is a term and
condition of the award and failure to comply with them may result in sanctions including termination of the
award.
Appendix B King County MIDD 10b RFP Budgets
King County MIDD 10b
RFP Annual Budget
Complete a separate budget for each component applying for: CDF Mobile Crisis Team (specific which
component each budget is for)
(Note: this form is available in MS Excel format at the King County Procurement website, or by contacting the
buyer listed on page 1 of this RFP. The Excel version MUST be used in the proposal submission).
1 Personnel
Total Personnel
Fringe Benefits Rate
(include all
components)
Total Fringe Benefits 1 $0 $0
Total Personnel Costs
w /Benefits for Staff $0 $0
Non Personnel
Costs
Position
Equipment:
Computers and
Communication
Professional
Services
Office
Supplies /Furniture
Recruiting
Participants
Name
of FTE FTE level of Annual Total
effort Salary per Annual
FTE Salary
0
RFP No. 1056 -1ORLD
Page 29 of 33
$0 $0
131
Personnel
132
Training /Consultatio
n
Insurance
Rent Utilities
Miscellaneous
Repair and Maint.
Janitorial
Travel /Mileage
Other (please
specify)
Total Non
Personnel Costs
Provider
Administrative Costs
Indirect/Administrative Costs
RFP No. 1056 -10RLD
Page 30 of 33
of FTE FTE level of Annual Total
effort Salary per Annual
FTE Salary
$0
Total Costs so
Appendix B continued
King County M1DD 10b
RFP Start -up Budget
Complete a separate budget for each component applying for: CDF Mobile Crisis Team (specific which component
each budget is for)
Personnel
Total
Personnel
Position Name
Fringe Benefits
(include all
components) Rate
I I
I I
I I I
Total Fringe Benefits I $0 1 $0
1 1
Total Personnel Costs w /Benefits
for Staff $0 $0
1
Non Personnel Costs
Training /Consultation (please
specify)
Vehicle /transporation
One -time costs (required for CDF proposals only)
for building
remodeling
(please specify all building remodeling
related start -up costs)
1 1 I I I
Total Non Personnel Costs
Total Costs
$0
0
RFP No. 1056 -10RLD
Page 31 of 33
of FTE FTE level Annual Total
of effort Salary per Annual
FTE Salary
$0 $0
$o
133
134
RFP No. 1056 -10RLD
Page 32 of 33
EXHIBIT A SAMPLE CONTRACT
In order to inform proposers of the types of expected terms and conditions required by King County, sample
contracts are provided on the King County Department of Community and Human Services website located
at:
htto: /www.kinacountv.aov /operations /DCHS/ Business /Contractina /BoilerPlates.asox
These sample contracts represent the contractual language approved by various representative agencies
and departments within the County. Based on this approval, the County does not encourage deviations from
the terms and conditions contained in the contract. Requests for changes or modifications could create
delays in the contracting process with the selected contractor, and may result in the cancellation of
negotiations with the top- ranked proposer.
These contracts are being provided for informational purposes only.
4. Address
`flrgi riizatio
Currently DBfHR: Certified .Certification Numb
DBHR Certification Pending 0 Not DBHR Certified.
Currently Licensed License Number;.
State Licensure Pending L Not State Licensed
Currently State:,_ Certified Certification Number:
State Certification; Pending Not State Certified
Email:
Web Address:..
OVERALL PROPOSAL COVER PAGE
Complete the Cover Page and Attach to the Top of the Proposal Package Submitted
King County Mental illness and Drug Dependency (MIDD) Strategy 10b
Proposal for Crisis Diversion Services
1. Title of Proposed Project:,
2.. _.Organization „Name}
12: DBHR Certification for
service's:
13 Washington LidentUre for ri ental,
health services.
Washington °,State :Certification for
mental, health, evaluation .andtreatmen
services :I;
RFP No. 1056 -1ORLD
Page 33 of 33
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136
Attachment A: Hospital Diversion Criteria
Mental Illness and Drug Dependency Plan (MIDD)
Crisis Diversion Facility (10b) Planning Workgroup
Hospital Diversion Medical Criteria
Behavioral Emergency: A person who is out of behavioral control, is deemed an imminent danger to
self or others, and is unwilling to accept treatment, and likely to require seclusion or restraint to
maintain their safety. Persons experiencing a behavioral emergency are not appropriate for referral
to the CDF.
Behavioral Crisis: A person who is experiencing acute exacerbation of an existing mental illness
and is willing to receive services or someone who may have suicidal ideation while exhibiting
behavioral control. Persons experiencing a behavioral crisis are appropriately referred to the CDF.
Consumers who are NOT appropriate for admission to CDF
1. Temperature >101 degrees F.,
2. Pulse outside of 50 —120,
3. Blood pressure <90 or >200 systolic, or >90 diastolic,
4. Respiratory rate >24,
5. Glucose blood sugar level <60 or >300,
6. Red blood count: Hot <30 Hgb <10 grams,
7. Mental status which is lethargic, in a stupor, comatose or there is spontaneously
fluctuating mental status,
8. Toxic or rising levels of medications or other substances (some substances may require
serum levels to determine potential toxicity),
9. Deterioration of vital signs prior to transfer (vital signs must be taken within 2 hours of
transfer), or
10. Conditions requiring medical services not provided at CDF, and
11. Withdrawal from alcohol, opiates and benzodiazepines, even if medications and /or a
patch (Le., Klonodine patch) are prescribed to assist with the withdrawals.
Medical services that are NOT provided at the CDF
1. Vital signs monitoring more frequent that Q 8 hours,
2. Acute medical treatments,
3. Stat (within 1 hour) or urgent (within 4 hours) X -rays and blood work,
4. Oxygen, unless client brings in his or her own supply,
5. 1V therapies,
6. Suctioning,
7. NG tubes,
8. Central catheter insertion and maintenance,
9. Medical isolation,
10. Feeding tube placement and management,
11. Initiation of bowel and bladder training,
12. Extensive skin care programs,
13. Acute wound care or orthopedic care,
14. In -house physical therapy or other rehabilitation programs,
15. Retraining for swallowing,
16. Renal or peritoneal dialysis,
1056- 10_attachA.doc, Hospital Diversion Criteria Pagel
137
138
17. Management of first trimester pregnancy or beyond 36 weeks, or delivery,
18. Management of advanced or complicated pregnancy and delivery,
19. Blood gases,
20. Management of infection and contagious disease. Any concerns that the consumer may
have an infection and /or contagious disease and the test results are not available at time of
admission,
21. Post operative stabilizing demonstrated through Tabs or vital signs over a 48 -hour period,
22. Diabetes management with unstable blood sugars or blood glucose exceeding 400 within
last six hours,
23. Management of patients who have ingested toxic amounts of substances who either have
not been evaluated in a medical setting and medically cleared, or if medically cleared are not
yet fully conscious, and
24. Management of delirium.
Though the CDF will strive to exhibit a welcoming profile to the community, the following
non medical conditions are considered to be either unsafe or clinically inappropriate for
admission to the CDF:
1. Presenting primarily for disability or other eligibility evaluation,
2. Presenting with current felony charges,
3. Presenting with a level of violence surpassing the management capability of this facility,
4. Presenting primarily for domestic violence,
5. Presenting primarily for active sexual offender behavior,
6. Presenting primarily for detoxification or intoxication, and
7. Children under 18 years of age.
1056- 10_attachA.doc, Hospital Diversion Criteria Paget
Attachment B: Jail Diversion Criteria
DANIEL T. SATTERBERG
PROSECUTING ATTORNEY
MEMORANDUM
King County
TO: MIDD Oversight Committee
FM: Ian Goodhew, KCPAO
RE: Legal and Eligibility Structure for Crisis Diversion Facility (CDF) for Jail Bound Persons
I. Introduction: Diverting the Mentally Ill and Drug Dependent from Our Jails
In calling upon the county's criminal justice stakeholders to act, the council made the following specific
findings in support of its call for action:
2. Key leaders from the county criminal justice agencies agreed that the lack of access to ongoing
treatment and housing leads to crises that, by default, require criminal justice interventions that
are difficult, costly and most often ineffective in resolving problems.
4. Persistent problems arise from booking people who are unstable and disabled due to mental
illness and chemical dependency, creating a need for both pre booking diversion and diversion
after booking and before the filing of criminal charges.
Office of the Prosecuting Attorney
CRIMINAL DIVISION
W554 King County Courthouse
516 Third Ave
Seattle, Washington 98104
(206) 296-9540
FINAL
June 25, 2009
In 2006, the King County Council reached some alarming conclusions regarding the number of mentally ill
and chemically dependant individuals being housed in King County correctional facilities. In finding that the
King County Jail served as the "second largest mental health facility" in the state, with over two- thirds of that
same population in the throws of substance abuse, the county council formally requested the King County
Executive, council staff, the Prosecutor, the Sheriff, Superior Court, District Court and the Public Defender to
work together to address this growing problem by utilizing the county's new taxing authority granted to it by
the Washington State Legislature under Revised Code of Washington (RCW) 82.14.055.
1. The Juvenile and Adult Justice Operational Master Plans require the use of alternatives to
incarceration, including treatment alternatives and placement in treatment for people with mental
illness and chemical dependency problems, following any incarceration.
3. The need for crisis intervention training to help law enforcement handle people disturbed
by mental illness and chemical dependency safely and effectively; the need for a place, other than
jail, where someone in crisis can be brought for immediate assessment and placement in appropriate
ongoing care.
Page 1 of 14
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140
5. The average length of stay for felony inmates is 24 days, while the average length of stay for
mentally ill inmates is 158 days.
6. The average cost of incarceration for unstably mentally ill persons in the jail psychiatric unit is
about $300 per day as opposed to $95 per day for the average person in jail. An average cost per
"episode" for a mentally ill person is $47,000.
The council called upon the stakeholders within the criminal justice system to design programs to stabilize
people suffering from mental illness and chemical dependency, so that they would be diverted from jails
and emergency rooms by getting them proper treatment.
The council called for specific action including the following:
"...planning changes in criminal justice case processing to more effectively deal with people with
disabling mental illness and chemical dependency when appropriate service and housing options are
available in the community. The areas to be considered in this planning process are pre arrest
diversion, pre- booking diversion, the use of deferred prosecutions, altemative sentencing methods,
including therapeutic courts..."
II. Goals and Action Plan: Developing the Concept for a CDF
In October 2007, the council adopted the Mental Illness and Drug Dependency (MIDD) Action Plan. The
council set the following as the goals of the effort to fund mental illness and chemical dependency programs:
1. A reduction in the number of mentally ill and chemically dependent people using costly
interventions like jail, emergency rooms, and hospitals.
2. A reduction in the number of people who recycle through the jail, returning repeatedly as a result of
their mental illness or chemical dependency.
3. A reduction of the incidence and severity of chemical dependency and mental and emotional
disorders in youth and adults.
4. Diversion of mentally ill and chemically dependent youth and adults from initial or further justice
system involvement.
5. Explicit linkage with, and furthering the work of, other council directed efforts including, the Adult
and Juvenile Justice Operational Master Plans, the Plan to End Homelessness, the Veterans and
Human Services Levy Service Improvement Plan and the King County Mental Health Recovery Plan.
In order to achieve the goals of the MIDD Action Plan the MIDD Oversight Committee was convened in
order to map out strategies. The committee eventually developed and approved 37 strategies to
accomplish the goals of the action plan.
One of the most innovative and promising strategies outlined by the Oversight Committee was the
establishment of a CDF, a facility designed to take in mentally ill and drug dependant persons who were
either headed to jail for petty misdemeanor criminal offenses or who found themselves in hospital
emergency rooms. The facility would provide immediate services to people in crisis in order to steer
them away from the jail cell or repeat trips to emergency rooms, and eventually engage them in longer
term services that would stabilize their lives.
Page 2of14
With these goals in mind, the CDF sub committee began meeting in the spring of 2008 to brainstorm the
manner in which the facility could provide these immediate services to the population in need.
III. Leea1 Basis and Proposed Process for Diverting Individuals to a CDF in Lieu of Jail
A. Makine Decisions in the Law Enforcement Field about Crisis Diversion
One of the first questions posed in developing the concept of a CDF is how would individuals
suffering from mental illness and chemical dependency be diverted from our jails to a CDF? As
police, medical personnel and treatment providers in the field can attest, there are dozens of ways in
which a person suffering from mental illness and /or chemical dependency ends up in jail on a petty
criminal offense. Along the way, decisions are made by first responders, law enforcement and,
ultimately the individual themselves as to where and how the person ends up in jail or the emergency
room first, if medical treatment is needed prior to a jail booking.
However, it is important to note that in order to divert an individual from jail, the primary decision maker will
be the police officer on the street. He or she will have to make a series of decisions about the individual they
have come into contact with to determine whether or not the person is appropriate to go to jail, the hospital, or
a crisis diversion facility.
Has this person committed a crime?
Does this person appear to have a mental illness or chemical dependency issue?
Does the offense the person is alleged to have committed require mandatory arrest and booking into
jail?
Is the offense the person is alleged to have committed, an eligible offense for diversion to the CDF?
Does the person have prior criminal history that is violent or otherwise would disqualify the person
from being diverted to the CDF?
Does the person have any medical conditions at the time of arrest that requires immediate medical
treatment or referral to a hospital?
Does the person display any interest in being offered services at a CDF rather than being taken to and
booked into jail, or do the person's words and actions indicate they will be combative and non-
cooperative with the offering of services?
A patrol officer in the field will face each and every one of these questions when confronted with a person
who has committed a petty criminal offense but may be suffering from mental illness and/or chemical
dependency. Assuming that each of the questions provides an answer favorable to taking the person to the
CDF, rather than jail, we turn to a new set of questions about what if any legal authority exists to "hold" the
person at the facility in lieu of being booked into jail.
B. Current Pathway to Jail and Criminal Charges on Minor Criminal Offenses
When a police officer is called to the scene of a reported crime, he or she will conduct an initial investigation
to determine whether there is any immediate danger, what if any crime occurred, who committed that crime if
one was found to have occurred, and locate that particular suspect of the crime committed.
In a hypothetical example, a police officer responds to a convenience store at the corner of Third and James
in downtown Seattle. The store clerk reports that the man down the street in a red jacket came in and took
several items without paying. He tried to leave, but the clerk confronted him. The man smashed a store
window with a bottle of pop he was trying to steal and then fled. The clerk positively identified the man
down the street as the man who did it.
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142
The officer contacts the man down the street, who denies everything. However, when he is patted down,
several items that appear to have come from the store are found in his pocket. The clerk examines the items
and confirms they are from his store. The officer now has probable cause to arrest the suspect.
The officer has several options here. He can arrest and release the suspect, arrest and detain the suspect back
at the precinct for follow up questioning if the suspect is willing to talk, or the officer can book the suspect
into county jail.
If the officer decides to book the individual into county jail, the officer must complete a superform"
(Attachment A). The superform requires the officer to provide identifying information about the suspect, as
well as a signed statement 'under penalty of perjury' laying out the facts that establish probable cause to hold
the suspect in jail pending a court hearing.
The officer will complete the superform, drive the person to jail, and drop both the person and superform off
at the booking desk with jail staff. Jail staff will then process the person into jail and set the person on the
next available "first appearance" calendar before a judge. At this point the process differs between the City of
Seattle (and several other cities).
1. The Office of the Prosecuting Attorney (PAO) Process
For PAO cases, the hearing will typically occur within about 24 hours, depending on when the
person is booked into jail. Court rules and constitutional case law require the hearing to occur at a
maximum within 48 hours or the detention becomes suspect and subject to further litigation.
At the first appearance hearing a judge, prosecutor and "temporary" defense attorney will be present.
The judge will review the booking officer's signed "probable cause" statement to determine if there is
probable cause to hold the person for up to 72 hours so that the Prosecutor's Office can decide
whether they want to "rush" file a charge within that 72 hour window, or agree to the release the
person pending further investigation by the police and prosecutors.
The defense attorney can argue that the facts alleged in the "probable cause" statement by the officer
do not constitute "probable cause" and therefore the person should be let go immediately. The
attorney can also argue that bail should be imposed or no bail should be imposed based on the
seriousness of the allegations, the person's past criminal history for violence and/or his record of
appearing in court in the past when so ordered.
Once "probable cause" is found and bail is set, then the 72 hour period becomes the controlling time
period. If the prosecutor's office files a charge then arraignment is set about ten days out and the
person remains either in jail or out on bail depending if he or she is. able to post the bail imposed. If
in that 72 hour window the prosecutor does not file a charge, the person is unconditionally released
from jail at that time but told that charges could be filed at a later date. Based upon these potential
outcomes, a person may be held in jail from 24 hours up to 72 hours. If a charge is filed a person
may remain in custody for weeks, even months, awaiting trial.
2. The Seattle City Attorney's (SCA) Process
For SCA cases, a prosecutor makes a decision to file or not to file charges. This occurs the morning
after the defendant is booked, excluding Sundays. The hearing is similar to the PAO's first
appearance, except that the judge reads the police report. If the SCA files, the defendant is arraigned
and the case proceeds from there. If the SCA declines to file, the defendant is released from jail on
that case. The SCA may choose to file at a later time, on an out of custody basis.
Page 4 of 14
C. Legal Basis to Hold Persons at the Time of Arrest
When a person is arrested and booked into jail, the federal and state constitutions prohibit the government
from simply holding the person in custody for an extended period of time without a judicial officer reviewing
the basis upon which the person was put in jail in the first place. The initial basis upon which a person can be
held is made when a court finds "probable cause" that the crime alleged was committed. The court will base
its finding on the review of a statement of "probable cause" made by the arresting officer, which is a
statement signed under penalty of perjury by the officer, summarizing the evidence gathered at that point that
suggests the person in question committed a specific crime.
Assuming the initial detention is approved by a court, the state and federal constitutions then set a time limit
upon which a person can be held prior to being charged with the criminal offense. The government is
required to either: 1) officially charge the person and set an appropriate bail amount to allow conditional
release, or 2) release the person pending further investigation for potential charges in the future.
In Washington State, Criminal Rule (CrR) 3.2.1 limits the amount of time a person can initially be booked
and held in jail prior to a judicial officer reviewing the "probable cause" basis upon which the police officer
booked the person into jail.
CrR 3.2.1 states:
"Probable Cause Determination A person who is arrested shall have judicial determination of
probable cause no later than 48 hours following the person's arrest, unless probable cause has been
determined prior to such arrest."
The 48 hour rule codified in CrR 3.2.1 finds its origins in the United States Supreme Court Case of Riverside
v. McLaughlin. 500 U.S. 44 (1991) which held that a jurisdiction is immune from systemic constitutional
challenge if a person has an initial probable cause hearing within a 48 hour window from the time of their
arrest. The Riverside holding clarified the holding in Gerstein v. Pugh. 429 U.S. 103 (1975), which found
that the Fourth Amendment to the U.S. Constitution required a "prompt" judicial determination of probable
cause in order to justify extended pre trial detention following a warrantless arrest.
Based upon the 48 hour requirement for a court hearing, police officers would have the ability to divert a
person from jail booking to the CDF for up to a 48 hour period, without running into constitutional
prohibitions against holding a person on a criminal charge for too long a period of time. The officer could
complete his/her normal paperwork in the form of superform (Attachment A) which includes identifying
information of the person and a short statement under penalty of perjury that supports the initial arrest. This
document could then be diverted with the person to the CDF. At the same time, the officer could review with
the person an Agreement to Divert (Attachment B), have the person agree to divert to the facility, and then
take the person to the facility for evaluation and services rather than to jail.
Assuming the person agrees to being diverted, the officer can then deliver the person to the CDF, with the
agreement to divert and superform, which documents both the officer's basis to hold and then divert the
individual. The officer can leave the superform, agreement and person for an evaluation by diversion facility
staff of potential mental illnesses and/or chemical dependency issues. If the person meets the screening
criteria, facility staff will have up to 48 hours to get the person engaged in services offered. At some point
during this 48 hour window the engagement transitions from a 48 hour involuntary hold based upon a
criminal allegation and arrest into a voluntary acceptance of mental health and/or chemical dependency
services.
Page 5 of 14
143
144
If the person chooses not to engage in services, and/or becomes combative, uncooperative or threatening,
then CDF staff will temporarily detain the individual and re- contact law enforcement in order to take the
person back to jail on the criminal allegation.
No two cases will be the same. Consistent communication and back and forth will need to occur between law
enforcement and the CDF staff, as both will need each other's expertise depending on the situation. The hope
is that by diverting a number of mentally ill or drug dependant individuals from the county jail, we will
decrease their deterioration in our jails as well as decrease the number of return visits that individuals
committing petty criminal offenses with mental illness and chemical dependency are known to make through
our jail system.
Once a person is at the CDF, the use of the maximum 48 hour rule for judicial review may give way to other
legal basis to hold the individual at the CDF.
Under RCW 10.31.110 a police officer can refer a person suspected of committing a non felony crime to a
crisis stabilization unit (CSU) for examination by a MHP, who may then determine that civil involuntary hold
proceedings under RCW 71.05.180 may be more appropriate for the individual than the gradual voluntary
engagement of services that the CDF will steer them toward. In planning the CDF, a MHP will be on staff at
the facility to make this assessment within the three hour window required by 10.31.110 and then potentially
refer the person to a (CDMHP) for civil commitment proceedings. RCW 10.31.110 allows for a 12 hour
window once the person is brought to the CDF for this to happen.
If the MHP finds that commitment proceedings under RCW 71.05 are appropriate, the case will move out of
the criminal diversion context and into the civil commitment context, which allows for involuntary holds and
treatment under different authority.
Some may ask, "How would a typical case look in such a system The following is a hypothetical case:
D. Case Hvoothetical
1 RCW 10.31.110. Arrest Individuals with mental disorders
(1) When a police officer has reasonable cause to believe that the individual has committed acts constituting a non felony crime that is not a
serious offense as identified in RCW 10.77.092 and the individual is known by history or consultation with the regional support network to suffer
from a mental disorder, the arresting officer may:
(a) Take the individual to a crisis stabilization unit as defined in RCW 71.05.020(6). Individuals delivered to a crisis stabilization unit pursuant to
this section may be held by the facility for a period of up to twelve hours: PROVIDED, that they are examined by a mental health professional
within three hours of their arrival; (b) Refer the individual to a mental health professional for evaluation for initial detention and proceeding under
chapter 71.05; or (c) Release the individual upon agreement to voluntary participation in outpatient treatment.
(2) In deciding whether to refer the individual to treatment under this section, the police officer shall be guided by standards mutually agreed
upon with the prosecuting authority, which address, at a minimum, the length, seriousness, and recency of the known criminal history of the
individual, the mental health history of the individual, where available, and the circumstances surrounding the commission of the alleged offense.
(3) Any agreement to participate in treatment shall not require individuals to stipulate to any of the alleged facts regarding the criminal activity as
a prerequisite to participation in a mental health treatment alternative. The agreement is inadmissible in any criminal or civil proceeding. The
agreement does not create immunity from prosecution for the alleged criminal activity.
(4) If an individual violates such agreement and the mental health treatment alternative is no longer appropriate:
(a) The mental health provider shall inform the referring law enforcement agency of the violation; and
(b) The original charges may be filed or referred to the prosecutor, as appropriate, and the matter may proceed accordingly.
(5) The police officer is immune from liability for any good faith conduct under this section.
Page 6 of 14
On Friday, July 31, 2008, at around 8 :OOpm, Seattle police officer Scott Enright is called to the corner of
Third Avenue and James Street in response to a disturbance at the corner convenience store. Officer Enright
is a trained member of the Seattle Police Crisis Intervention Unit. He has particular training in spotting signs
of mental illness and/or chemical dependency in those he comes into contact with on the street.
Officer Enright arrives on the scene to discover a man later identified as James Smith outside of the
convenience store. The man is calmly sitting on the curb and appears to be talking to himself. The store
clerk is extremely upset and is yelling at the man sitting on the curb. The clerk reports to Officer Enright that
the man entered the store, yelled at the clerk and then tried to take a bag of potato chips without paying for
them. When the clerk confronted him, the man became upset, and knocked over a display stand of snacks in
the store, causing some minor damage. The man then walked out to the sidewalk with the clerk following.
The man sat down and remained on the curb until Officer Enright arrived.
The clerk immediately reported the theft and property destruction to Officer Enright. When Officer Enright
tries to speak with James Smith, he is able to positively identify Smith but cannot get any other information
out of him. However, Officer Enright observes signs of both heroin use and indications supportive of some
form of paranoia or other mental condition.
Officer Enright obtains a statement from the convenience store clerk in whom the clerk clearly identifies Mr.
Smith as putting a candy bar in his pocket without paying for it, and then knocking over and breaking a
display stand for products, when the clerk confronted him at the front door about the candy bar. The candy
bar is found in Mr. Smith's pocket, when he is searched, and the damage to the display stand is minimal.
Based upon the clerk's statement, Officer Enright has "probable cause" for the crimes of theft in the third
degree $50 and malicious mischief $50, both of which are simple misdemeanors. Officer Enright has
discretion whether to arrest Mr. Smith at all. He could simply arrest and release Mr. Smith at the scene
with the hope that if Mr. Smith is charged by the city prosecutor, he will receive notice of his court date
and appear, rather than fail to appear and have a warrant issued for his arrest. Officer Enright could also
transport Mr. Smith back to the police precinct and release him there. Finally Officer Enright could arrest
and book Mr. Smith into the county jail, where he would remain for up to 48 hours before an initial
hearing is held to determine his custody status.
Officer Enright has to balance the relative lack of seriousness of the crime alleged against the fact that if
he releases the suspect, Mr. Smith, he could be back in that convenience store in an hour causing a similar
or more violent problem. In the meantime, Officer Enright's observations of Mr. Smith have continued to
provide him with small indications that Mr. Smith may have some mental health issues.
If Officer Enright's concerns about Mr. Smith reappearing at the store are high enough, jail is the most
likely result. With the CDF, Officer Enright now has a choice. He can complete his normal superform
paperwork for jail booking, but also go over the option of a divert agreement with Mr. Smith or simply
take Mr. Smith to the CDF to see if Mr. Smith will engage in an evaluation and services. Officer Enright
knows that if he does, perhaps he can stabilize enough to avoid a stay in jail. Officer Enright also knows
that if Mr. Smith does not cooperate and engage in the services offered, he or a fellow officer could
receive a call to have Mr. Smith taken out of the CDF and booked into jail on the theft and malicious
mischief charges.
Attachment C is a detailed decision tree that tracks the flow of potential cases and individuals in such
situations to the Crisis Diversion Facility. The left side of the decision tree concentrates on potential criminal
arrests and charges being diverted to the CDF.
N. Eligibility Criteria for the MIDD Crisis Diversion Facility Based Upon Criminal Acts
Page 7 of 14
145
146
Before proceeding, it is important to understand what the term "diversion" means in the criminal justice
system context. In the context of KCMHC and the CDF, a diversion means that a person will be asked to
fulfill a contract with certain conditions in the contract, including things like attending treatment or
counseling sessions, possibly taking medications, or signing up for job training or educational opportunities.
In exchange for the person fulfilling these terms, the State (in this case the King County Prosecutor's office)
will agree not to file a criminal charge of theft or property damage or whatever the charge may be. If the
person follows through on the conditions for a certain period of time, the criminal charge will never be filed,
and the person will avoid the stigma and consequences of a criminal conviction. If the person fails to carry
out the conditions agreed upon, then the State can file the criminal charge and pursue punishment upon
conviction for that particular criminal act.
A. Kine County District Mental Health Court
The PAO currently allows dispositional continuances, in other words a diversion, of certain criminal charges
in King County Mental Health Court. (KCMHC) To qualify for a diversion in KCMHC persons must also
have limited to moderate criminal histories and no history of violent criminal convictions on their record in
order to be eligible. Convictions for assault would automatically disqualify a person from eligibility for
diversion to a CDF. Some other felony crimes like Robbery 2 would also disqualify an offender from
diversion unless a sufficient period of time has passed since the commission of that crime so as to allow it to
"wash out" for purposes of entry into KCMHC. The following is a list of current offenses that are allowed
into KCMHC:
Criminal trespass II
Theft 3 $50
Malicious mischief $50
Unlawful bus conduct
Failure to appear /respond (court summons)
Disorderly conduct
Obstructing
Resisting arrest
Use of drug paraphernalia
Possession of marijuana
Alcohol in a park
NVOL (No Valid Operator's License)
DWLS (Driving with License Suspended) 3
Furnishing liquor to minor
Minor in possession of alcohol
Minor frequenting tavern or lounge
Unlawful issuance of bank checks
Prostitution
Patronizing a prostitute
Loitering for purposes of prostitution
Possess fraudulent driver's license
Failure to obey
Theft of rental property.
In addition to the listed misdemeanor crimes the King County Prosecuting Attorney's Office (KCPAO)
may be willing to take felony level simple drug possession cases that are currently being sent to District
Court and filed as "expedited misdemeanors" and allow police officers to divert those expedited cases to
the CDF as well. Those charges would primarily consist of the following:
Violation of the Uniform Controlled Substance Act (VUCSA): simple possession of cocaine 3 grams
Page 8 of 14
VUCSA: simple possession of heroin 3 grams
VUCSA: simple possession of methamphetamine <3 grams
VUCSA: possession of legend drugs (prescription drugs without proper prescription).
B. Seattle Municipal Mental Health Court
Seattle Municipal Mental Health Court offers dispositional continuances, or diversion. In determining which
cases are eligible for a dispositional continuance, the SCA considers the facts of the crime charged, the
defendant's criminal history, the impact of a conviction on the defendant's housing, and any other factors that
may impact public safety. There is no specific list of charges that are eligible, but in practice most
dispositional continuances in Seattle Municipal Mental Health Court occur in cases where the offense
charged are of the type listed in subsection A above.
C. Eligibility Criteria for the Crisis Diversion Facility
In order to have a CDF that serves the mentally ill the, National GAINS center eligibility criteria appears to
be well targeted and should be followed. The person should have a likely mental illness and /or substance
abuse affecting behavior and committed or is about to commit a criminal offense that has been deemed
divertible under the above criteria. The person then must be screened for disqualifying violence criminal
history and or a history of civil commitment proceedings. The officer can check the criminal history in the
field and the mental heath professional can access The Extended Client Lookup System (ECLS) to determine
history and past diagnoses once the person is diverted to the CDF for follow up care.
Assuming hospital emergency rooms are allowed to refer patients into this facility, there will need to be some
assurance that police referrals receive first priority when there are capacity issues at the CDF.
The PAO does currently prohibit individuals in MHC from seeking a diversion if they have an arrest for a
violent incident in the last seven years. The reasoning is that we do not want actively psychotic individuals
with a history of violence to be placed in a non secure group setting.
Mentally ill individuals who do not qualify for MHC due to the current charge or due to a history of violence
will still have the opportunity to connect with mental health treatment with the hope of reducing recidivism.
The jail liaisons refer in- custody defendants to the 12 month co- occurring treatment program, Project
IMPACT and Project START, which comes with housing, case management services, mental health and
chemical dependency treatment including medication. They also have access to the housing voucher
program. If the same parameters were established for eligibility in the CDF, persons who were excluded
from the facility could still access services through MHC which takes referrals for misdemeanor and felony
cases and comes with its own resources.
What Offenses are not allowed to be diverted to the Crisis Diversion Facility?
violent current offense
violent criminal history
domestic violence offense (current state statute requires mandatory arrest and booking into jail)
Again, the most important factor that will determine who receives the resources that the CDF provides will be
the discretion of the police officer. We will need to rely on the officer's judgment and experience when it
comes to recognizing signs of mental illness and chemical dependency. The officer will also need to
recognize who may be ready to receive some help in dealing with the challenges that mental illness and
chemical dependency present.
Page 9 of 14
147
148
V. Conclusion
Police officers who arrest offenders for minor criminal acts have limited choices when the offender may
suffer from a mental illness and /or chemical dependency. This lack of choice can create a revolving door
of low level offenders who simply sit in jail and possibly deteriorate. The CDF is designed to give police
officers in the field who recognize mental illness and recurring chemical dependency a choice that can
help break the cycle of going in and out of jail. Each and every case will not fit the model described
above. However, if the population of low level offenders who have mental health and chemical
dependency issues in the jail can be lowered with the option of a CDF, then the entire community benefits
from having more productive community members and saves money by avoiding the repetitive cost of
housing certain individuals in jail because there is nowhere else for them to go.
Page 10 of 14
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Page 12 of 14
Police Incident
ATTACHMENT B
NOTICE TO DIVERT TO CRISIS DIVERSION FACILITY FOR
EVALUATION AND SERVICES
I, Officer of the Department am
providing notice to a suspect under
Department Incident that I am diverting the suspect from being
booked into King County Jail to the King County Crisis Diversion Facility.
I am diverting the suspect to the Crisis Diversion Facility because I have reason to
believe that the person suffers from some form of mental illness and /or chemical
dependency.
I have explained to the individual that I could book them into jail and that they
could be held for up to 48 hours before they appear before the County and have a
determination of probable cause made on the matter. I have explained to the person that I
am choosing to divert them to the Crisis Diversion Facility for up to 48 hours based upon
my concern that they suffer from some form of mental illness and /or chemical dependency.
I have further informed the suspect that they will be evaluated for a mental illness
and /or chemical dependency and receive services at the Crisis Diversion Facility. I have
explained to the person that they can remain at the Crisis Diversion Facility for up to 48
hours and that if he /she chooses not to engage in the services offered at the Facility, they
can be taken by police to jail on the charge for which he /she was arrested. Finally, I
explained that if the person participates in the recommended services successfully, no
criminal charges will be filed out of the Police Incident Number listed above.
Officer Signature Date CDF Staff Date
Page 13 of 14
151
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