Virtual Mental Health Care Services

/ I I , AGREEMENT BETWEEN THE SCHOOL BOARD OF DUVAL COUNTY, FLORIDA, AND HEADSPACE, INC. This Agreement is made and entered into effective November 1, 2022 (the "Effective Date"), and is by and between The School Board of Duval County, Florida, operating a district school system in the State of Florida (the "District"), and Headspace, Inc. (the "Contractor"). WIT N ES S ETH: Whereas, the District issued ITN 01-23/TW dated June 21, 2022 relating to Virtual Mental Health Care Services (the "Services"), a copy of which ITN is attached hereto and incorporated herein by this reference as Exhibit A; Whereas, the Contractor submitted a Proposal dated July 18, 2022, to the District in response to ITN 01-23/TW, and Contractor's proposal was selected by the District (the "Proposal"). A copy of Contractor's Proposal and Order Form is attached hereto and incorporated herein by this reference as Exhibit B; Whereas, the Contractor is interested in and capable of performing the desired Services for

the District and the District desires to have the Contractor perform the Services; Whereas, the parties therefore wish to set forth this understanding in writing in this Agreement. · ·· Now, therefore, in consideration of the mutual covenants and conditions contained herein, the parties agree as follows: ARTICLE I - SCOPE OF SERVICES 1.1 The recitals set forth above are true and correct and are incorporated into this Agreement by this reference. Defined terms used herein shall be as defined in this Agreement or as were defined in the ITN. 1.2 The scope of services to be performed by Contractor for the District are as set forth herein, in the ITN, in the Proposal, and in the Performance Guarantees set forth in Exhibit C.attached hereto and incorporated herein by reference. In addition, Contractor shall provide the following: a. Quarterly workshops that are theme specific based on member data; b. Five (5) credits (that can be applied towards the engagement menu, below; c. 2 launch webinars (live/ custom); d. 4 seats to our community platform which allows you to connect with other benefits leads to share best practices, etc.; and, e. 3 leadership workshops. Engagement Menu Service Credits Additional Launch webinar 1 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 Additional "Building a Mindful Community" webinar 2 Themed Webinar 2 Team all-hands/Company Meeting (Webinar) 1 Virtual Meditation session (30 minutes) 1 ARTICLE 11 -·COMMENCEMENT AND RENEWAL 2.1 The initial term of this agreement shall be for a period of two (2) years, commencing November 1, 2022, with three (3) potential annual renewal terms for one (1) year periods on the same terms and conditions with the exception being that any increase in the amount payable to Contractor' during any renewal period may not exceed CPI. ARTICLE Ill - COMPENSATION 3.1 The maximum indebtedness under this Agreement for the period from• November 1, 2022 through October 31, 2023, shall be $1,300,000.00. Fees shall be payable on a monthly basis and not in advance. Any implementation fee shall be waived. Fees for any additional webinars not set forth in Exhibits A and B shall be in the amount of $750.00 per webinar, and fees for any additional onsite visits not set forth in Exhibits A and B shall be in the amount of $3,000.00, plus reasonable travel expenses. ARTICLE IV -TERMINATION This Agreement may be terminated as set forth in the RFP, as responded to by Contractor in its Proposal. ARTICLE V - COMMUNICATIONS; RECORDS; NOTICES 5.1 The parties agree that all communications relating to the day-to-day activities shall be exchanged between the respective representatives of the District and the Contractor, which representatives shall be designated by the parties, in writing, promptly upon commencement of the Services. 5.2 The parties agree: (a) Subject to Contractor's reasonable security requirements and riot more than once every twelve (12) months, the District may, at its own expense, review Contractor's relevant billing records for a period not to exceed the preceding 12 months, for the purpose of assessing the accuracy of Contractor's invoices to the District. The District may employ such assistance, as it deems desirable to conduct such reviews, but may not employ the assistance of any entity that derives a substantial portion of its revenues from the provision of services that are substantially similar to the Services provided ' 2 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 hereunder or any person who has previously made prohibited use of Contractor's confidential information. The District shall cause any person retained for this purpose to execute a non-disclosure agreement. Such reviews shall take place at a time and place agreed upon by the parties. The District's normal internal invoice reconciliation procedures shall not be considered a review of Contractor's relevant billing records for purposes of this Agreement. (b) Contractor shall promptly correct any billing error that is revealed in a billing review, including refunding any overpayment by the District in the form of a credit as soon as reasonably practicable under the circumstances. (c) Contractor shall cooperate in any District billing review, providing Contractor billing records as reasonably necessary to verify the accuracy of Contractor's invoices. Contractor may redact from the billing records provided to the District any information that reveals the identity or confidential information of other Contractor customers or other Contractor confidential information that is not relevant to the purposes of the review. With regard to all E-Rate records relating to any services provided under this Agreement, Contractor will follow all Service Provider requirements for the USF Schools and Libraries Program as set forth on the USAC website and FCC rules. 5.3 The District's address for notices shall be as set forth in Section 14.7.14 of the RFP. ARTICLE VI - MISCELLANEOUS 6.1 The Article_ and Section headings are for reference and convenience only and shall not enter into the interpretation hereof. 6.2 The contract documents consist of this Agreement, the I RFP attached hereto as Exhibit A, and the Proposal and Order Form attached as Exhibit B. In the event of any conflict or ambiguity among these documents, the priority shall be assigned as follows: first to this Agreement, next to Exhibit B, and last to Exhibit A. 6.3 All of Contractor's exceptions to the RFP set forth in its Proposal, if any, are accepted except as may be specifically addressed in this Agreement. 6.4 This Agreement may be executed via facsimile and in one or more counterparts, each of which will be deemed an original, but all such facsimiles and counterparts will together constitute but one and the same instrument. IN WITNESS WHEREOF, the parties have duly executed this Agreement as of the date first above written. HEADSPACE, INC. By: ___ fabtd_· _o{i_(/1._e. __ _ Name: Patrick Lytle Title: General Counsel 3 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 Superintendent of Schools and Ex-Officio Secretary to the Board THE SCHOOL BOARD OF DUVAL COUNTY, FLORIDA Approved by the Board: October 10, 2022 4 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 EXHIBIT A ITN 01-23/TW dated June 21, 2022 relating to Virtual Mental Health Care Services 5 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 INVITATION TO NEGOTIATE {ITN) ITN NO. 01-23/TW Virtual Mental Health Care Services DUVAil COUNT'¥ 'P'iUIBill ti:: SCiHOOLS Anticipated Schedule: ITN Release Date: June 21, 2022 Response Due Date: July 18, 2022 by 4:00pm EST Submit Response To: Submit via e-mail to Terrence Wright: wrightt@duvalschools.org Finalist Interviews: Week of July 25, 2022 Location and Time to be Determined Page 1 of7 ITN No. 01-23/TW, Virtual Mental Health Care Services Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 1701 Prudential Drive Jacksonville, Florida 32207 Duval County Public Schools ITN: Virtual Mental Health Care Services ITN No. 01-23/TW 1.0 Background: Duval County Public Schools (DCPS or the District) is the nation's 20th largest school district. DCPS has more than 120,000 enrolled K-12 students and currently employs approximately 12,500 full-time and part­ time personnel. DCPS recognizes that the prevalence of behavioral health diagnoses is increasing, and more individuals are seeking mental health care. However, the access to behavioral health providers remains extremely limited, with Florida being one of the lowest ranking states in terms of availability of care. Educators are often faced with feeling responsible for their students' social-emotional wellbeing, in addition to managing their own mental health. DCPS is taking steps to implement a holistic mental health strategy in an effort to meet individuals where they're at and destigmatize mental health needs. In addition to behavioral health visits available through the self-funded health plan administered by Florida Blue, DCPS currently offers employees: • care navigation and coordination services through New Directions, which includes support in finding a provider and referrals to community resources. • an Employee Assistance Program (EAP) with a benefit of 6 visits per issue per year; • a complimentary, premium subscription to the Headspace meditation app; • monthly webinars and onsite presentations that focus on a variety of mental health topics; and • ongoing communication campaigns promoting the resources available through DCPS and the community. The Population of Focus: DCPS is seeking to expand access to care for its employees by offering a convenient, no-cost virtual mental health care benefit. Eligibility for these programs is defined as any regularly scheduled employee (full-time and part-time) without regard for any minimum hourly service requirement. This ITN is for a two-year agreement (with options to renew) to provide a comprehensive mental health care platform that will expand availability of care by connecting employees to a range of behavioral health solutions. Solutions should support the full spectrum of mental wellbeing, including clinical and subclinical concerns, life stressors and skill building. Vendor's response shall describe fully how they propose to accomplish the Scope of Services as defined in this ITN (see Section 2.0). If any services, functions or responsibilities not specifically described in this ITN are necessary for the proper performance and provision of services to the District, then they shall be deemed to be implied by and included within the scope of the services to the same extent and in the same manner as if specifically described herein. Page 2 of 7 ITN No. 01-23/TW, Virtual Mental Health Care Services Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 2.0 Scope of Services The virtual mental health care vendor shall provide the following services: 1. An ADA and HIPAA compliant technology platform, including a mobile application; access to services via video, telephone/voice, and chat/text messaging; and an online scheduling tool. 2. Mental wellbeing support, including in-the-moment access to behavioral health coaches and/or, 24/7 access to a crisis hotline; one-on-one coaching sessions; and on-demand, self-care tools for employees, on topics like meditation, stress, and improving sleep. 3. Mental health counseling, including one-on-one video sessions with licensed, masters-level mental health professionals; behavioral health screenings and solution-focused counseling using evidence-based practices; and the ability to provide referrals and/or community resources as appropriate. 4. Psychiatry services, including one-on-one video sessions with licensed, medical practitioners; ongoing evaluation, prescription, and medication management; care coordination with the employee's mental health counselor and behavioral health coach; and the ability to provide referrals as appropriate. 5. Ongoing marketing and promotional support, including collaboration with the District to plan and implement communication campaigns, and the ability to participate in and/or host virtual mental health webinars throughout the year. 6. Other value-added services such as: a. The ability to integrate with the District's EAP b. The ability to refer and participate in Florida Blue's provider network c. Accommodations to assign providers based on gender, sexual identity, race or ethnicity d. The ability to provide group counseling services e. Annual health fair attendance 3.0 Guidelines for Response: All responses to the ITN must be received no later than 4:00 p.m. (Eastern Time), on July 18, 2022. In order to maintain comparability and facilitate the review process, it is requested that submittals be organized in the manner specified below. Include all information requested herein in your submittal. Submittals not containing all required information will be rejected as nonresponsive. Respondents are encouraged to have dividing pages between the items below to assist in facilitating the evaluation process. 1. Cover Page: Include ITN number, subject, the name of the respondent, address, telephone number and the date. 2. Table of Contents: Include a clear identification of the material by section and by page number. Page 3 of 7 ITN No. 01-23/TW, Virtual Mental Health Care Services Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 3. Letter of Transmittal: Include the names of the persons who will be authorized to make representations for the respondent, their titles, addresses (including email address) and telephone numbers. 4. Proposal: Include the completed questionnaire worksheet below. 5. Appendix: Include any necessary documentation to support each response, using letters or numbers for identification. 4.0 Selection Criteria: 1. Ability to perform the scope of services outlined in section 2.0 2. Ability to provide in the moment access to care 3. Information system reporting capabilities· 4. Reporting capabilities 5. Communication and education 6. Implementation process 7. · Cost of proposed services 5.0 Process: All proposals received by the deadline will be reviewed. Interviews and negotiations with the finalists are scheduled for the week of July 25, 2022 (but subject to change). It is DCPS' sole discretion to determine the number of finalists to be interviewed. It is anticipated that upon the success of negotiations, an agreement will be reached to provide virtual mental health care services to DCPS' employee population. 6.0 General Terms and Conditions: 1. The District may, at its sole and absolute discretion, reject any and all, or parts of any and all Proposals; re-advertise this ITN; postpone or cancel, at any time, this ITN process; or waive any irregularities in this ITN, or in the Proposals received as a result of this ITN. The District also reserves the right to request clarification of information from any Proposer. 2. All expenses involved with the preparation and submission of Proposals to the District or any work performed in connection therewith, shall be borne by the Proposer. No Payment will be made for any responses received, any other effort required of or made, or expenses incurred by the Proposer. 3. The contract terms and conditions stipulated in this ITN are those desired by the District and preference will be given to those Proposals in full or substantial compliance therewith. However, after allowance for any deviations, all Proposals will be considered. Proposers are cautioned that restrictive deviations from the desired program must be clearly stated in the Proposal response. Questionnaire Responses to questions and requests for information- Questionnaire responses should be clear and concise and provided in Microsoft Word format. There must be an answer to all questions and information Page 4 of 7 ITN No. 01-23/TW, Virtual Mental Health Care Services Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 requests or a reason why there is no answer to a specific question or information request. Respondents may provide additional information as part of their proposals that, in the respondent's opinion, might serve to provide a clearer understanding of their services and capabilities. Appendix- each respondent should prepare an appendix, which may be in a separate binder, to include all the requested samples and other relevant materials that are part of the proposal. The appendix should have its own table of contents then a marked tab for each exhibit or set of exhibits. I. Que~tion . . . H e.., f ,~ r . R~j;.po~se .. . . . 1 Section 1: General Information 1. Briefly describe your company's background, location, and indicate any licenses and accreditations. 2. Describe your account manaqement structure. 3. Provide a minimum of three (3) references from companies with a minimum of 5,000 emoloyees. Section 2: Scope of Services 4. Please confirm your company can provide all the services listed in Section 2.0 Scope of Services. Please indicate any deviations below. a. Item 1: Technoloav Platform b. Item 2: Mental Wellbeinq Support C. Item 3: Mental Health Counselinq d. Item 4: Psychiatry Services e. Item 5: Communications Suooort f. Item 6: Value-added Services 5. Briefly describe your provider network, (coaches, therapists, psychiatrists, etc.). Indicate if providers are available on a local and/or national level. 6. Do you outsource any of your services? Please describe. 7. Describe the steps your company would take to resolve an access to care issue (i.e. a provider is unable to be assigned to a member in a timely manner}. 8. What is the length of time for each coaching, therapy, and psychiatry visit? 9. What is the average wait time for a coach, therapist, and/or psychiatrist? Provide the average wait time by month in the last 12 months. 10. Do you have a maximum number of services covered (per year, per month, per issue, etc.)? 11. How do you integrate with other vendors such as EAP, medical carrier, etc? Section 3: Technology & Security .. . Page 5 of 7 ITN No. 01-23/TW, Virtual Mental Health Care Services Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 1· Question I[ - , Respoflse I - - - 12.Do you offer push notifications? Text capabilities? 13. What languages is your platform available in? 14. Please describe the role of artificial intelligence in your deliverv, if any. 15. Please describe your HIPAA protocols, data protection, and security measures. Section 4: Screening & Evaluation 16. How do members enter the system and seek help? Does a member have to meet specific qualifications or need a formal diagnosis to access care? 17. What formal assessments do you include in your intake? What is the average duration of the intake/screeninq process? 18. What criteria is used to determine recommended services or triaqe? Section 5: Clinical Visits 19. Please describe the roles and qualifications of an employee's potential care team. 20. Does a member have direct access to a therapist? 21. Can a member request a change in therapist or coach? 22. If technology-based support (app, website) does not align with member preferences, is an in-person or over-the-phone option available? 23. Describe the collaboration & accountability between the coaches, therapists and/or psychiatrists to deliver the hiohest quality care. Section 6: Utilization & Outcomes 24. What is your average utilization rate? Please specify for the following: registration, coaching, therapy, psychiatry and self-guided tools, if applicable. 25. How do you calculate cost savings and Return on Investment (ROI)? What is your average ROI? Section 7: Reporting 26. Describe your standard, customized and ad hoc reporting capabilities. Indicate if there are additional costs associated with custom reports. In the appendix of your response, provide samples of the available reports. Section 8: Marketing & Communications 27. Briefly describe your best practices and recommended communication plan to promote engaqement and utilization of your services. In Page 6 of 7 ITN No. 01-23/TW, Virtual Mental Health Care Services Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 I I Question i[ Resp_e>nse ' - the appendix of your response, provide sample communication materials. 28. Confirm your ability to customize and/or co- brand materials. Section 9: Implementation 29. Explain your implementation process and provide a sample implementation schedule. 30. In the appendix of your response, provide a sample contract to be executed with the District prior to the project kickoff. Section 10: Cost & Performance·Guarantees 31. Please describe your pricing model including the following (as applicable): a. Implementation fee b. Administration or platform fee C. Per employee per month fee d. Cost per intervention e. Estimated annual cost 32. Indicate your proposed performance and/or ROI quarantees. Page 7 of7 ITN No. 01-23/TW, Virtual Mental Health Care Services Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 EXHIBIT B CONTRACTOR' S PROPOSAL and ORDER FORM 6 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 headspace healtti. a proposal prepared for: Duval County Public Schools Duval County Public Schools ITN Number: 01-23/TW Subject: Virtual Mental Health Care Services July 181 2022 Name of Respondent: Headspace Health (Ginger + Headspace) 2145 Michigan Ave. Santa Monica, CA 90404 Primary Contact: Tony Deacy RVP, Sales Headspace Health (Ginger+ Headspace) Email: adeacy@ginger.io Phone: 630.338.5963 This document contains confidential and proprietary information - not for unauthorized distribution. A mutually agreed upon contractual agreement supersedes the contents of this document. This proposal is valid for 60 days after submission. Confidential Information Headspace Health! 1 DoclD:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 Table of Contents Table of Contents Letter of Transmittal Proposal Executive Summary Program Differentiators Summary Questionnaire Pricing Appendix Attachment 1 - Ginger Sample Report Attachment 2 - Ginger Communication Playbook Attachment 3 - Ginger Communication Partnership Guide Attachment 4 - Ginger Implementation Summary Attachment 5 - Ginger Sample Implementation Plan Attachment 6 - Headspace for Work Overview Confidential Information .Headspace Health I 2 2 3 4 4 4 6 7 39 41 41 41 41 41 41 41 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 Letter of Transmittal July 18, 2022 Terrence Wright Duval County Public Schools 1701 Prudential Drive Jacksonville, FL 32207 Subject: Duval County Public Schools Thank you for the opportunity to share our on-demand mental healthcare solution with Duval County Public Schools. On behalf of the Headspace Health team, we are excited at the prospect of partnering with Duval County Public Schools to offer your employees access to incredible mental healthcare, including Ginger and Headspace services. We are committed to providing services for Duval County Public Schools as described in this RFP, and in accordance with the terms and conditions of any contract awarded pursuant to the RFP process. We look forward to discussing our proposal and solution with you further. Please contact me at adeacy@ginger.io, 630.338.5963, with any questions you may have. Sincerely, Tony Deacy Tony Deacy RVP, Sales Headspace Health (Ginger+ Headspace) Email: adeacy@ginger.io Phone: 630.338.5963 Confidential Information Headspace Hea Ith I 3 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 Proposal Executive Summary We truly appreciate the opportunity to present a proposal for our comprehensive suite of on­ demand mental healthcare services. We applaud your mission to improve access to care through a holistic, virtual solution that lessens the stigma associated with mental health issues. We look forward to partnering with you to solve the access, stigma, quality, and cost issues associated with getting mental healthcare. Unlike many traditional mental health vendors and new point solutions, we offer access to a comprehensive, on-demand mental health system that provides immediate access to care for common and complex issues - all through an easy-to­ access mobile app. This includes the ability to augment and coordinate with your preferred EAP, health plan, and other benefit vendors. Program Differentiators Ginger offers members high-quality, on-demand mental healthcare. Every member has access to personalized care, including real-time, text-based behavioral health coaching, guided self­ care, and video-based therapy and psychiatry. Our care providers, supercharged by augmented intelligence, work collaboratively to deliver evidence-based care that meets every member's unique needs. Additionally, as a part of our offering to Duval County Public Schools, we are including a more robust version of Headspace for all of your employees with access to live meditations and webinars, a self-service admin dashboard, marketing support, and engagement campaigns. Refer to Attachment 6 - Headspace for Work Overview for additional information. On-demand care for anyone: Mental health doesn't follow a 9-to-5 schedule. Day or night, we meet members with guided self-care, available on-demand, or live coaching, available within 2 minutes, 365 days a year. Our self-paced, skill-building content fits into everyday schedules and helps members take steady steps toward better mental wellbeing. For members who prefer to connect to a human in the moment of need, we can immediately connect them to an expert coach, trained to listen and provide coping strategies. Unlimited, 24/7 access to coaching and content is included in the PEPM fee. Proven, team-based model: Care works better, together. Our multidisciplinary, team-based approach brings coaches, therapists, and psychiatrists under one virtual roof to ensure no one falls through the cracks. The care team, superpowered by our EMR and augmented intelligence, works hand-in-hand around a care plan to provide the right level of care to members when they need it most. Peer-reviewed research shows that together is better: our multidisciplinary, team­ based care is proven to be more effective at helping members improve faster than coaching or Confidential Information Headspace Health I 4 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 therapy alone. Recent Ginger research indicates that 70% of members experience reduced depression symptoms and 59% of members experience reduced anxiety symptoms. Industry's only virtual provider system: We're not just an app; we're a provider group. 100% of Ginger therapists are W-2 employees who are fully dedicated to our culture, mission, and values. As full-time employees, Ginger clinicians receive full benefits, robust training, and participation in company initiatives. The result? Happy, satisfied clinicians who are empowered to practice at the top of their licenses, delivering positive outcomes for members. And we're not done building the best clinical workforce in the industry. Ginger is also spearheading a new path for future clinicians in digital health with the Ginger Training Institute, which provides an equivalent experience to current practicum and postdoctoral fellowships, but with the added benefit of specialization in our multidisciplinary, team-based, DEl&B focused, fully digital program. Innovative and comprehensive quality measurement: We work tirelessly to build the highest quality system of care that delivers improved member outcomes. Our clinical practitioners, research, computer and data science, and product development experts have built a system that has established a new standard for mental healthcare. Today, the Ginger system improves quality by capturing and analyzing outcomes metrics, conducting robust quality assurance reviews, and continuing to enhance our care team tools to ensure personalization and collaboration. These efforts ensure a consistent member experience and a standardized method to measure and track provider quality over time. Data-Driven Approach to Care: Ginger uses data science to scale care delivery via automation and intelligence. Using a rich data source that includes de-identified coach-member conversations, app utilization data, and clinical outc~mes, Ginger's data science efforts enable us to better understand member needs, personalize the experience, deliver high-quality care, and boost care team efficiency. Culturally responsive, inclusive care: We're dedicated to leveling the playing field and reducing the barriers to care for underrepresented populations and those experiencing intersectionality of identity. By developing content and resources for diverse audiences, hiring quality providers who reflect the diversity of our member population, and continuously training our care team on topics relating to LGBTQ+ identity, racial trauma, veterans, traditionally underserved communities, and more, we aim to increase access, improve outcomes, and realize a future where mental health is never an obstacle. Flexible EAP service options: Ginger focuses exclusively on providing immediate access to comprehensive mental health services - all via a secure and easy-to-access mobile app. With this being said, we are not just an app; we are a provider group that expands and improves access to a broad continuum of emotional and mental healthcare. Within this innovative offering, we can augment elements of a traditional EAP. This may include referrals to an EAP for in­ person support, work-life services, and other EAP programs. In fact, we currently do this on behalf of multiple employer clients in coordination with a range of EAP vendors. We look Confidential Information Headspace Health I 5 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 forward to using this experience to help you deliver a more effective, engaging mental health program in coordination with your preferred EAP. Summary Many aspects of the mental healthcare system are broken, including three fundamental challenges that our solution solves for: • Acceptance: Making it easier to talk about our mental health. • Access: Providing easy ways to get help, whether that is synchronous person-to-person or asynchronous self-directed care. • Affordability: Offering these solutions at a price that works for the average person. Our founders recognized this and reimagined the mental healthcare experience by bridging advanced technology and human interaction to help people address mental health issues - 24/7. We understand that employees are feeling more stressed, anxious, and burned out than ever before. With an escalating number of workers resigning from their jobs to prioritize their mental health,and wellbeing, employers are increasingly willing to invest in building a healthy and resilient workforce. Yet workplace challenges related to presenteeism, absenteeism, and retention belie systemic issues in mental healthcare that are creating barriers for employees. With the onset of COVID, organizations like Duval County Public Schools have experienced these issues at even greater levels. We are dedicated to overcoming these obstacles by offering beloved, affordable, and easily accessible on-demand mental healthcare services for all of life's moments. Confidential Information Headspace Health I 6 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 Questionnaire Responses to questions and requests for information - Questionnaire responses should be clear and concise and provided in Microsoft Word format. There must be an answer to all questions and information requests or a reason why there is no answer to a specific question or information request. Respondents may provide additional information as part of their proposals that, in the respondent's opinion, might serve to provide a clearer understanding of their services and capabilities. Appendix - each respondent should prepare an appendix, which may be in a separate binder, to include all the requested samples and other relevant materials that are part of the proposal. The appendix should have its own table of contents then a marked tab for each exhibit or set of exhibits. I . Question :1 . Respons~ j Section 1: General Information 1. Briefly describe your company's background, location, and indicate any licenses and accreditations. Confidential Information Ginger offers members high-quality, on­ demand mental healthcare. Every Ginger member has access to personalized care, including real-time, text-based behavioral health coaching, guided self-care, and video­ based therapy and psychiatry. Ginger care providers, supercharged by our augmented intelligence, work collaboratively to deliver evidence-based care that meets every member's unique needs. We're not just an app; we're a provider group that expands and improves access to a broad continuum of emotional and mental healthcare. Headspace Health (Ginger+ Headspace) is headquartered in Santa Monica, CA, and provides services to over 3,000 clients. Ginger and Headspace products are HITRUST CSF Certified. Ginger, along with Headspace, make up Headspace Health's holistic suite of enterprise offerings. Together, these two solutions provide members with high-quality 1 :1 care coupled with the flexibility of self- Headspace Health I 7 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 directed care, ensuring support for the complete spectrum of mental health needs, anytime, anywhere. 2. Describe your account management As part of our member- and client-centered structure. delivery model, we will assign a Client Executive to partner with you and serve as your master of resources for both Ginger and Headspace. Each of our Client Executive's brings extensive health and benefits experience serving large employers that have complex employee benefit ecosystems. We look forward to assigning a Client Executive after learning more about your employee population, benefit structure, and culture to ensure a strong fit and long-term partnership. Supported by a Client Success Team with extensive experience managing behavioral health programs, your Client Executive is accountable for: -Client and program oversight -Client relationships and ongoing operations -Problem solving and issue resolution -Engagement and communication -Reporting and insights -Strategy and tactics In addition to the Client Executive, an Implementation Manager will drive the onboarding process. Each enterprise-level implementation process includes a high standard of technical rigor with built in areas for customizations to meet the unique demands of our larger client base. The Implementation Manager assigned will be able to personally guide you from contract close to launch day, ensuring that all requirements are met for a seamless member experience. Confidential Information Headspace Health I 8 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 We look forward to learning how your employee populations and launch requirements align with our on-demand mental health solution. This may result in adjustments to the client support structure for a successful program launch and ongoing partnership. Everything we do, from personal interactions to data exchanges, revolves around our members and clients - your success is our success. 3. Provide a minimum of three (3) references Adtalem Global Education from companies with a minimum of 5,000 Dirk de Frietas employees. Global Total Rewards Consultant Email: dirkdefreitas@adtalem.com Phone: 954-706-2640 Vox Media Rebecca Graff Sr. Manager, Total Rewards Email: rebecca.graff@voxmedia.com Phone: 202-591-1140 Fisher Investments Moriah Del Puerto AVP, Total Rewards Email: m.delpuerto@fi.com Phone: 650-529-3902 Section 2: Scope of Services ' 4. Please confirm your company can provide all the services listed in Section 2.0 Scope of Services. Please indicate any deviations below. a. Item 1: Technology Platform Confirmed with the following exception: Ginger does not offer a telephone/voice service as part of our standard service offering. Ginger services are provided via mobile app that includes text-based chat, Confidential Information Headspace Health I 9 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 video appointments, and self-directed content. In most cases, clients utilize their EAP's telephone/voice service, which is already included in their EAP fees. b. Item 2: Mental Wellbeing Support Confirmed with the following exception: 24/7 crisis hotline - As an on-demand system, Ginger provides immediate access to care - 24/7, 365 days a year. Our behavioral health coaches respond in two minutes or less to outreach and provide care in the moment of need. While we are not a specific crisis hotline, we are a licensed behavioral healthcare system and as such have protocols established to manage escalated cases as we encounter them. This includes specific protocols to address low-, medium-, high-, and imminent-risk individuals. These protocols were created under the guidance of our clinical leadership team, using current industry guidelines and standards. If a telephone/voice service is needed, we can provide it at an additional fee. c. Item 3: Mental Health Counseling Confirmed ct. Item 4: Psychiatry Services Confirmed e. Item 5: Communications Support Confirmed f. Item 6: Value-added Services Confirmed with the following exceptions: Florida Blue - We have an executed contract with Florida Blue to be an in-network provider and anticipate finishing credentialing and operational set up by the end of 2022. Group counseling - Ginger does not currently offer group counseling services; Confidential Information Headspace Health I 1 O Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 however, we are piloting and scoping group care as part of our 2023 product roadmap. 5. Briefly describe your provider network, Ginger's care team is available to support (coaches, therapists, psychiatrists, etc.). members at the national and local level. Indicate if providers are available on a local and/or national level. Ginger's team of coaches are available 24/7 to support members locally and nationally. Unlimited, 24/7 access to coaches is included in the PEPM fee. Ginger's clinical team includes staff licensed to provide services in states where members are located. On average, each clinician is cross-licensed in three states. Based on Ginger's clinical demand forecasts and historical usage, we strive to balance our respective clinicians' multiple licensure across a mix of states predicted to have or have experienced in the past high, medium, and low demand for services to ensure our therapists and psychiatrists have the capacity to meet changing member needs. Video sessions with a therapist or psychiatrist may occur during or outside regular business hours seven (7) days a week (including evenings and weekends), making these visits very convenient and easy to access. Specific hours of availability may vary by location and specialty. Our typical response time is two minutes or less for our behavioral health coaching team and seven days to the first available appointment with a therapist or psychiatrist (clinical appointment times may vary based on member-specific needs and location). It is important to note that Ginger's behavioral health coaches are employed directly by Ginger as W2 employees. Additionally, our nationwide team of licensed clinicians (therapists and psychiatrists) includes W2 employees as well as a limited Confidential Information Headspace Health I 11 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 number of contractors. In fact, all of our therapists are W2 employees. Our care team documents within Ginger's unified EMR and are subject to the same oversight and QA processes from our clinical leadership team. Having our own W2 employees as coaches and therapists allows us to circumvent many of the problems that are inherent in the "traditional network model." For example: -We are not vying for the calendar space of providers who are also servicing members from other carriers/vendors. It allows ds the full40 hours of our providers and facilitates load balancing to ensure that members receive high quality care quickly. This also helps ensure that we are not over scheduling our providers (avoiding burnout). -We can hire directly for diversity and areas of specialty to effectively match the unique makeup of the populations we serve. -We have oversight of the quality of care that is being provided. Because the vast majority of the care team is W2 employees of Ginger, we are able to train and manage the output of the team to align with Ginger's evidence- based, measurement-based and culturally responsive model of care. This model includes our collaborative care approach where we have built in protocols and processes that ensure the team is working together with the member's best interest at the center of our focus. 6. Do you outsource any of your services? Ginger does not outsource the services Please describe. offered in this proposal. In fact, 100% of our coaches and therapists are currently W2 employees. In certain limited situations to ensure response time commitments, Ginger Confidential Information Headspace Health I 12 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 may leverage a third-party to support clinical interactions with members during a spike in utilization in a particular geographic region, or to meet a request for a unique area of specialty. 7. Describe the steps your company would We are committed to providing timely access take to resolve an access to care issue (i.e. to care, including taking member a provider is unable to be assigned to a preferences into account. If a member's member in a timely manner). presentation requires sooner access, their situation is reviewed by our coaching and clinical teams, and an appointment will either be adjusted internally, or our referral coordinators will support the member with an appropriate referral. 8. What is the length of time for each Therapy intakes are typically 60 minutes, coaching, therapy, and psychiatry visit? based on clinical need, with 45-minute follow-ups. Psychiatry intakes are typically 45 minutes, with 20-minute follow-ups. Members have unlimited, 24/7 access to coaches. The number and duration of text- based messages varies widely based on several factors. Our clients and members are geographically and demographically diverse, which drives different types of use. For example, some exchanges are short with many interactions; others are long and less frequent. We are also finding that some members use the dictate function (voice-to- text) on their phones, which further affects length and duration. Ultimately, the impact and success of each interaction is driven by our ability to personalize these exchanges at the member level. We are inclusive of many forms of expression and appreciate that each member is unique in their approach to texting with our coaches. 9. What is the average wait time for a coach, June 2022 - 54 seconds (median seconds to therapist, and/or psychiatrist? Provide the coach response) & 26 hours (average hours average wait time by month in the last 12 to first available appointment with a months. therapist/psychiatrist) Confidential Information Headspace Health I 13 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 Confidential Information May 2022 - 52 seconds (median seconds to coach response) & 19 hours (average hours to first available appointment with a therapist/psychiatrist) April 2022 - 52 seconds (median seconds to coach response) & 17 hours (average hours to first available appointment with a therapist/psychiatrist) March 2022 - 52 seconds (median seconds to coach response) & 17 hours (average hours to first available appointment with a therapist/psychiatrist) February 2022 - 52 seconds (median seconds to coach response) & 19 hours (average hours to first available appointment with a therapist/psychiatrist) January 2022 - 51 seconds (median seconds to coach response) & 97 hours (average hours to first available appointment with a therapist/psychiatrist) December 2021 - 48 seconds (median seconds to coach response) & 22 hours (average hours to first available appointment with a therapist/psychiatrist) November 2021 - 50 seconds (median seconds to coach response) & 22 hours (average hours to first available appointment with a therapist/psychiatrist) October 2021 - 50 seconds (median seconds to coach response) & 22 hours (average hours to first available appointment with a therapist/psychiatrist) September 2021 - 50 seconds (median seconds to coach response) & 19 hours Headspace Health I 14 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 (average hours to first available appointment with a therapisUpsychiatrist) August 2021 - 49 seconds (median seconds to coach response) & 17 hours (average hours to first available appointment with a therapisUpsychiatrist) July 2021 - 49 seconds (median seconds to coach response) & 14 hours (average hours to first available appointment with a therapisUpsychiatrist) Please note that the number of hours to the first available clinical appointment may vary based on member requests for specific clinician profiles and specialties as well as location. 10. Do you have a maximum number of Unlimited, 24/7 access to coaches and self- services covered (per year, per month, per directed content is included in the PEPM fee. issue, etc.)? We do not limit coaching sessions and provide unlimited access to self-care content. Based on previous discussions with Duval County Public Schools, our PEPM fee also includes up to 16 video counseling sessions with therapists or psychiatrists per member per year. Members that exhaust the 16 employer- provided clinical sessions included in the PEPM fee can continue with the same counselor/therapist with Ginger billing the service as a claim to the health plan, assuming Ginger is in-network with that plan. We have an executed contract with Florida Blue to be an in-network provider and anticipate finishing credentialing and operational set up by the end of 2022. The Ginger system is based on prevention and early intervention - approximately 80% Confidential Information Headspace Health I 15 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 of our members are subclinical and have their needs met by our coaching staff. Our coaches allow us to address individual needs while ensuring that therapy and psychiatry resources are available to those who prefer, request, or would benefit from clinical support. Together, this empowers us to deliver the right care, at the right time, and in the right place for each individual member. Throughout this process, we continually review status to ensure each member receives the right amount of support at the right time. This is managed through an evidence-based, member centric approach to step management that encourages utilization as needed without overuse. 11. How do you integrate with other vendors EAPs such as EAP, medical carrier, etc? Ginger can augment your existing EAP services by adding on-demand behavioral health coaching (unlimited 24/7 support within seconds), clinically-validated content, and access to video sessions with licensed therapists and psychiatrists. In fact, we currently do this on behalf of other employer clients and look forward to using this experience to help you deliver a more effective, engaging mental and emotional health program. We can provide referrals between EAPs and Ginger based on established protocols. When members present specific needs or require EAP services (e.g., in-person mental health support, legal/financial support), Ginger's coaching and member support teams can help connect members to EAP services. Health Plans Ginger currently maintains in-network (INN) arrangements as a provider with more than 20 different national and regional payers, Confidential Information Headspace Health I 16 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 Section 3: Technology & Security 12. Do you offer push notifications? Text capabilities? Confidential Information including entities such as Optum Behavioral Health, Cigna Behavioral Health, and several Blues plans. Ginger continues to add new plans every month. We have an executed contract with Florida Blue to be an in-network provider and anticipate finishing credentialing and operational set up by the end of 2022. After a member exhausts their available sessions (after their 16th session), they can continue to work with their Ginger clinician and Ginger will bill it as a claim to the in-network health plan. Other Ginger's member support and coaching teams have access to a "Benefits Tab" in our chat platform that contains an employer- approved list of other benefits available to the employee. For example, if a member requests or needs specialized in-person/in- office care, a coach may refer to the Benefits Tab and see that the member's employer offers a separate EAP, health plan, navigator, or other benefit program. The Ginger coach will then share this information with the member. Yes. While Ginger's coaches respond directly to members during chat interactions, we may also send system generated reminders to members (e.g., to re-engage with a coach after a period of inactivity). This is in addition to our ongoing population-level communication campaigns that are designed to increase engagement and access to care. Headspace Health I 17 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 Additionally, when members transition to therapy or psychiatry, coaches can continue supporting them in addressing day-to-day goals and challenges, as well as acting as an adjunct to the care plan put in place by their therapist or psychiatrist. For example, Ginger coaches may help with "homework assignments" in between therapy sessions and send comprehensive session notes to therapists to supplement their care plans. These more frequent coach touch points mean issues can potentially be flagged and addressed faster compared to traditional settings. 13. What languages is your platform Ginger services are available in English and available in? Spanish. 14. Please describe the role of artificial Ginger thinks about Al not as artificial but as intelligence in your delivery, if any. augmented intelligence. Our technology surrounds and supports our providers, reducing - and in many cases eliminating - administrative burden, as well as providing insights that can't be derived from traditional care channels. Here are a few ways we leverage Al: Automating clinical workflows - One of the most important ways we use Al is to help our team understand who to talk to next and why. By prioritizing tasks and recommending actions, we reduce the cognitive load on our coaches and clinicians, and improve decision making. Ultimately, these advances allow us to better scale care and reach more people who need support. Providing care insights - Natural language processing (NLP) allows us to derive greater insights from our coaching conversations. Key learnings from members' sessions, even complex discussions, are uncovered to optimize care. In some cases, this information might simply prompt us to use a Confidential Information Headspace Health I 18 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 new breathing exercise with a member. In other cases, it might direct us to incorporate a new approach, such as motivational interviewing, or add a therapist or psychiatrist to a member's care team. ' Flagging safety risks - In addition to deriving care insights, we also can swiftly identify red flags, which is critically important when it comes to mental health and safety. For example, our NLP identifies words such as "hopelessness," which can be a symptom of depression, but also suggest increased risk for suicide. Our care team then uses this information to assess risk and ensure members are getting the right level of care. Recommending content - Continually harnessing the richness of data, we have developed a content recommendation engine that actively personalizes self-guided content for members as new needs and challenges emerge during ongoing engagement with Ginger. This means we're deploying our clinically-validated content to members more effectively without requiring members to search for the most helpful content. 15. Please describe your HIPAA protocols, Ginger and Headspace are HITRUST CSF data protection, and security measures. certified. We are committed to protecting the privacy of its members. As a fundamental pillar to ensuring trust and providing the best possible support and care, our information privacy and security governance is aligned with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the International Organization for Standardization (ISO) 27001 and 27002 security standards, the National Institute of Standards and Technology (NIST) Special Publications 800 Series, the General Data Confidential Information Headspace Health I 19 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 Protection Regulation (GDPR (EU) 2016/679, and other relevant state and international breach notification and security regulations. We are willing to provide detailed information upon request. This may include penetration and vulnerability test results, network diagrams, data flow maps, and other supporting information. Section 4: Screening & Evaluation 16. How do members enter the system and At Ginger, you don't need a diagnosis to talk seek help? Does a member have to meet to someone, and that reduces the stigma specific qualifications or need a formal and barriers around getting help. diagnosis to access care? The Ginger member experience begins when eligible members successfully download the Ginger app and register - available through iOS and Android. After answering two simple questions - "tell us how you're feeling" and "what does this impact" - members can access self-care content and are connected to behavioral health coaches who provide on-demand support 24 hours a day, 7 days a week, via live, secure text-based chat. This new level of care gives members continuous access to help through an intelligent mobile app platform. Members who prefer or would benefit from a higher level of support are escalated to a nationwide team of licensed therapists and/or psychiatrists with the help of our coaches and member support team. Escalation is based on a combination of member preference, survey data, such as PHQ/GAD responses, member background from conversations, presenting concerns, and previous history. Confidential Information Headspace Health I 20 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 Coaches collaborate closely with this team of clinicians under a single virtual roof, leveraging a unified EMR. Coaches can continue supporting members with day-to- day goals and challenges, as well as acting as an adjunct to the care plan put in place by our therapists and psychiatrists. For example, Ginger coaches may help with "homework assignments" in between therapy sessions. More frequent coach touch points mean issues can be flagged and addressed faster compared to traditional settings. We continually review status to ensure each member receives the right amount of care at the right time. This is managed through an evidence-based, member-centric approach to step management that is underpinned by formal QA evaluations and ongoing clinical oversight. Together, this ensures each. member has the appropriate level of care. Ginger helps members across a wide range of issues (subclinical and clinical); however, our services may not be appropriate in all cases. Decisions regarding suitability for support are determined by our staff's judgment and specific guidelines. We refer individuals to other forms of support and care based on established protocols, including emergency services for acute crisis situations. This may also include referrals into an employer's EAP, health plan, navigator, or other benefit program based on member needs and preferences. 17. What formal assessments do you include Ginger asks members to complete the in your intake? What is the average duration following surveys, however, these are of the intake/screening process? optional and not used as gatekeepers to "pre-qualify" individuals for therapy or psychiatry. We believe immediate access to care is critical to achieving better mental health outcomes. Each survey only takes a couple minutes to complete. Confidential Information Headspace Health I 21 DoclD:dc770977a8b9a2bd71ab04e4f57b23197cOe69b2 Depression: Ginger assesses depression via the Patient Health Questionnaire (PHQ-9). The PHQ-9 is one of the most validated assessments in mental health and is commonly used by clinicians in diagnosing depression and monitoring treatment response. Anxiety: To assess and track anxiety outcomes, Ginger uses the Generalized Anxiety Disorder Screener (GAD-7), which is also well validated in the general population. Resilience and adaptability: Ginger uses the CD-RISC-10, which has demonstrated robust validity, reliability, and practicality in measuring resilience. A multidimensional construct involving variables such as temperament and personality, resilience relies on problem-solving skills that enable individuals to cope with traumatic life events. 18. What criteria is used to determine At Ginger, you don't need a diagnosis to talk recommended services or triage? to someone, and that reduces the stigma and barriers around getting help. Members can conveniently connect with Ginger's team of behavioral health coaches - 24/7, 365 days a year. Unlimited, 24/7 access is included in the quoted PEPM fee. Taking a preventative approach to emotional health, we address issues before they evolve into greater challenges and provide support anywhere at anytime. Coaches assist members in taking slow, steady steps that lead to meaningful change in their lives, helping them overcome challenges in any number of domains, from sleep to mood to relationships. They check-in regularly to offer support and encouragement, track successes and setbacks, and provide resources, tips, and strategies to facilitate progress. Confidential Information Headspace Health I 22 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 Confidential Information As a licensed medical provider, our highly­ trained and supervised coaches have the ability to transition members to our team of licensed therapists and psychiatrists for those who prefer or would benefit from a higher level of support. This is typically based on a combination of member preference, member's presenting concerns, questionnaire data, such as automated PHO/GAD results, member background from conversations, and previous history. As referenced above, key criteria may include: -Member Preference -Severity of Symptoms (symptoms outside the scope of coaching or require clinical care in addition to coaching) -Complexity (member has more than one diagnosis or constellation of symptoms that indicate need for clinical care) -Risk (self-harm or other high risk behaviors) PHO/GAD Scores - Anxiety and depression symptoms don't resolve with coaching alone or suggest the need for therapy or medication -Keywords (automated detection system identifies multiple mentions of "key" words) -Usage Patterns (high usage patterns or needs frequent support) When escalation is needed for a higher level of care, coaches review options the member has available to them through Ginger, as well as through their employer's other benefits - all of this information is quickly available to the coach. Next, the coach will discuss the referral with the member, communicating the reason for the referral and detailing the options. The coach will work with the member to determine the best Headspace Health I 23 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 Confidential Information course of action for them and support the member in taking next steps, such as getting an appointment with a Ginger therapist or psychiatrist in coordination with our Member Support team. Coaches may also direct them to their EAP, health plan, or navigator for example. When members transition to a Ginger therapist or psychiatrist, they may continue working with coaching; coaching can continue supporting them in addressing day­ to-day goals and challenges, as well as acting as an adjunct to the care plan put in place by a Ginger therapist or psychiatrist. For example, Ginger coaches may help with "homework assignments" in between therapy sessions and send comprehensive session notes to therapists to supplement their care plans. These more frequent coach touch points mean issues can potentially be flagged and addressed faster compared to traditional settings. For individuals with more severe psychiatric conditions, coaches will strongly encourage a member to seek additional care, or in some cases require the member to do so in order to continue in coaching. Examples of situations that require escalation include: individuals with chronic mental illness and severe trauma, potential of harm to self or others, and significant mental instability (hallucinations, delusions, extreme mood swings, etc). Ginger helps members across a wide range of mental health issues (subclinical and clinical); however, our services may not be appropriate in all cases. Decisions regarding suitability for support are determined by our staff's judgment and specific guidelines. Our care team is always required to practice Headspace Health I 24 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 within their sphere of competence. We refer individuals to other forms of support based on specific protocols, including emergency services for acute crisis situations. Section 5: Clinical Visits 19. Please describe the roles and To address the spectrum of mental health qualifications of an employee's potential care needs, Ginger offers different levels of care team. using the strengths of three unique disciplines - coaching, therapy, and psychiatry: -Coaching offers members day-to-day support with learning skills and achieving goals; -Licensed therapists work with members to deepen self-awareness, identify and address ineffective patterns of behavior, and process thoughts and feelings; -Psychiatrists stand ready to support those in need of additional care, including prescribing and managing medications. Coach Credentials and Qualifications: -Minimum of an M.A. degree in Psychology- related field or coaching certification from an accredited training program (approved by the NBHWC); -A minimum of two (2) years of relevant experience, six (6) months of which must have occurred with direct supervision under a qualified, credentialed, or licensed supervisor); -Coaches are trained 200+ hours a year on effective methodologies, such as ' motivational interviewing, SMART goal setting, assessing stages of change/readiness, and more. Ginger coaches support members who are managing stress, anxiety, and depression as Confidential Information Headspace Health I 25 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 Confidential Information well as other complex issues caused by a variety of personal or professional challenges. First and foremost, coaches are there to listen, build rapport, and provide empathetic support. Coaching takes place via secure text-based chat, which is why coaches must have excellent writing skills and the ability to convey warmth through this medium. Coaches make members feel welcome and supported, and maintain a calm presence regardless of the circumstance. Over time, coaches assist members in taking slow, steady steps that lead to meaningful change in their lives. They check-in regularly to offer support and encouragement, track successes and setbacks, and provide resources, tips, and strategies to facilitate progress. Coaches are an integral part of each member's multidisciplinary team. They use previous experience, good judgment, and specific guidelines to discern when to I refer members to other internal and external resources. Coaches collaborate with Ginger's nationwide team of psychiatrists and therapists to help develop and reinforce decisions. Additionally, Ginger's on-demand health system leverages augmented intelligence to empower coaches to know when to reach out to members, when to suggest a higher level of support, and which members might be at risk. Because of Ginger's human­ driven, data-powered approach, members get the right care, at the right time. It is important to note that the support coaches provide is non-clinical in nature. Coaches are not licensed and do not make medical diagnoses, provide clinical treatment, or prescribe medications. Headspace Health I 26 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 Confidential Information Licensed Therapist Credentials and Qualifications: -Minimum of a Master's degree in psychology, social work, counseling, marriage and family therapy or other relevant field; -A license to practice (e.g., LCSW, LMFT, Licensed Psychologist) in good standing; -3+ years experience providing clinical psychotherapy to individuals, couples or families is preferred. Psychotherapy leverages knowledge gained from exploring past behavior and experiences to effect change in the present or future. Psychotherapy administered by a licensed clinician can be leveraged with coaching to ensure maximum benefit for a member. Ginger's licensed therapists provide virtual video sessions with patients over the Ginger mobile and video platform. They start by conducting evaluations and assessments according to patient needs and standards of care. They are passionate about practicing evidence-based care, measuring their impact, and continuously learning from their experiences and the community. Psychiatrist Credentials and Qualifications: -A minimum of an MD with completion of accredited psychiatry residency (board­ eligible/board-certified); -A minimum of 3+ years experience providing clinical psychiatry services; -A license to practice psychiatry. Headspace Health I 27 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 Ginger psychiatrists are medical doctors who have completed psychiatry residency training at top hospitals and schools. They are licensed and board-certified/eligible to practice in the state where members are located. Unlike a therapist, a psychiatrist is a medical doctor who can prescribe medication and monitor its effects on their members' health. They offer medication support for a variety of conditions from anxiety and depression to bipolar disorder and obsessive compulsive disorder (OCD). Ginger psychiatrists are passionate about practicing evidence-based care, measuring their impact, and continuously learning from their experiences and the community. They provide virtual video sessions with patients over Ginger's mobile and web-based video platform. They start by conducting evaluations and assessments according to patient needs and standards of care. They work with each member's care team, including coaches, therapists, and member support staff, to ensure comprehensive, well- rounded support. 20. Does a member have direct access to a Members can request access to a licensed therapist? therapist at anytime. At Ginger, we want to give every member the support they need, in a sustainable way. Coaching, which meets the needs of approximately 80% of members, and is offered as the entry point to our program, allows us to address individual needs, while therapy and psychiatry resources are available to those who prefer, request, or would benefit from clinical support. Together, this empowers us to deliver the right care, at the right time, and in the right place for each individual member. Confidential Information Headspace Health I 28 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 21. Can a member request a change in Yes. Members can request a change at therapist or coach? anytime. Our member support team stands ready to help members find a Ginger clinician or coach that is better aligned with their specific needs. 22. If technology-based support (app, If a member prefers to have an in-person/in- website) does not align with member office or phone visit with a therapist or preferences, is an in-person or over-the- psychiatrist, our team will simply refer them phone option available? to your health plan provider network, EAP, or other employee benefit program. 23. Describe the collaboration & Care works better, together. Our accountability between the coaches, multidisciplinary, team-based approach therapists and/or psychiatrists to deliver the brings coaches, therapists, and psychiatrists highest quality care. under one virtual roof to ensure no one falls through the cracks. The care team, superpowered by our EMR and augmented intelligence, works hand-in-hand around a care plan to provide the right level of care to members when they need it most. Peer-reviewed research shows that together is better: our multidisciplinary, team-based care is proven to be more effective at helping members improve faster than coaching or therapy alone. Recent Ginger research indicates that 70% of members experience reduced depression symptoms and 59% of members experience reduced anxiety symptoms. Additionally, having our own W2 employees as coaches and therapists allows us to provide collaborative care in a way that circumvents many of the problems that are inherent in the "traditional network model." Throughout this process, we continually evaluate status to ensure each member receives the necessary amount of support at the right time. This is managed through an evidence-based, member-centric approach to step management. Confidential Information Headspace Health I 29 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 For example, our coaches are available to members before, during, and after interactions with our nationwide team of therapists and psychiatrists. When members transition to a Ginger therapist or psychiatrist, they may continue working with the coaching team; coaches can continue to support them in addressing day-to-day goals and challenges, as well as act as an adjunct to the care plan put in place by a Ginger therapist or psychiatrist. For example, Ginger coaches may help with "homework assignments" in between therapy sessions and send comprehensive session notes to therapists to supplement their care plans. These more frequent coach touch points mean issues can potentially be flagged and addressed faster compared to traditional settings. Section 6: Utilization & Outcomes 24. What is your average utilization rate? Ginger sign-up rates across our employer Please specify for the following: registration, book of business are typically a~ound 10- coaching, therapy, psychiatry and self- 15% but vary based on a wide range of guided tools, if applicable. variables. We have seen clients achieve significantly higher rates by adhering to Ginger best practices and fostering a culture that reduces stigma around mental health. The Ginger system is based on prevention and early intervention - approximately 80% of engaged members are subclinical and have their needs met by our coaching staff. Our coaches allow us to address individual needs while ensuring that therapy and psychiatry resources are available to the remaining 20% that prefer, request, or would benefit from clinical support. It is important to note that Headspace for Work's low-barrier solution drives an approximate 20-30% adoption rate on Confidential Information Headspace Health I 30 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 average, creating an approachable front door to the full continuum of mental health services. 25. How do you calculate cost savings and Ginger tackles the four largest challenges in Return on Investment (ROI)? What is your the delivery of mental healthcare - access, average ROI? stigma, cost, and quality. Savings are realized because we serve the whole population, not just those in need of clinical care. Based on a comparison of Ginger's peer-reviewed outcomes and IBM MarketScan claims data, we can demonstrate an ROI of 4.2x. Ginger helps drive cost savings by: 1) Supporting everyone who needs care - not just the one 1 in 5 identified with a mental health diagnosis, and; 2) Getting people to the right care in lower-cost settings, stepping them up and back down from clinical care. ' Section 7: Reporting 26. Describe your standard, customized and Ginger's standard quarterly and annual ad hoc reporting capabilities. Indicate if there reports measures program success using are additional costs associated with custom the following metrics. Refer to Attachment 1 reports. In the appendix of your response, - Ginger Sample Report for additional detail. provide samples of the available reports. Engagement KPls -Signups (# members registered) - Signup rate (the % of eligible members registered) -Engaged members (# members engaging with Ginger services, broken out by all combinations of content and/or coaching and/or clinical services) -Engagement rate (the % of registered members engaged) -Sub-clinical retention (the % of members returning for coaching and/or content after their initial coaching session) Confidential Information Headspace Health I 31 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 Confidential Information -Clinical retention (the % of members returning for clinical services after their initial therapy/psychiatry intake appointment) -Total coaching sessions delivered - Includes member cohorts based on # sessions completed -Total clinical appointments delivered - Includes member cohorts based on # appointments completed -Total content cards completed - Includes by-topic breakdown and trending content categories Member Satisfaction -Average coaching rating (members rate their coaching experience on a 1- to 5-star scale after each chat session - minimum 20 messages sent by member). -Average clinician rating (members rate their clinical experience on a 1- to 5-star scale after each appointment) Access KPls -Coach response time (median # seconds between a member's message and a coaches' response) -Average Hours to First Available Appointment is the average duration between a member's initial referral and the earliest available appointment -Average Days to First Completed Appointment is the average duration between a referral and the day/time in when the initial appt is delivered Trend Charts -Engagement and access KPls displayed over weekly, monthly and quarterly increments Headspace Health I 32 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 Outcomes KPls -GAD-7 (a standardized diagnostic tool for screening for and assessing the severity of Generalized anxiety Disorder) -Full symptom response (a GAD-7 score improvement of 50% or greater) -Partial symptom response (a GAD-7 score improvement of 30% or greater) -Any symptom response - -PHQ-9 (a standardized diagnostic tool for screening for and assessing the severity of depressive disorder) -Full symptom response (a PHQ-9 score improvement of 50% or greater) -Partial symptom response (a PHQ-9 score improvement of 30% or greater) -Any symptom response We also provide a wide range of ad hoc reports at no additional cost. For example, we can accommodate more frequent reporting on primary/standard key performance indicators (KPls), including activation/utilization upon request. We review each request for ad hoc/custom reports on a case-by-case to determine development effort and additional fees (if any). Section 8: Marketing & Communications 27. Briefly describe your best practices and Ginger's communications strategy is recommended communication plan to designed to achieve three primary goals: promote engagement arid utilization of your services. In the appendix of your response, -Introduce Ginger as your trusted partner provide sample communication materials. and welcome your employees to our healthcare system. Establish Ginger amongst your employees as confidential, stigma-free, on-demand mental health support delivered through a mobile app. Confidential Information Headspace Health I 33 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 Confidential Information -Meet your employees where they are, using a multichannel approach that is tailored to the specific communication needs of your employees - e.g., retail, corporate, field employees, management, distribution, etc. -Boost and track employee engagement and sign-ups with Ginger. We have found that every employee demographic and every organization's processes are unique, and Ginger is adept at identifying and understanding these differences. Using this insight, we create effective engagement communication plans that drive awareness using a variety of multi­ channel tactics, including digital, traditional, and interactive media, to execute on the campaigns. Raising awareness is a year-round effort that does not stop at launch. Our approach starts with: -Augmenting existing communication channels and learning from best practices; -Engaging your population using thoughtfully created content and creative; -Nurturing those who become members with improved app experiences and content campaigns, supporting them in their journey towards better mental health. We focus on engaging your population with year-round behavioral health campaigns that address typical member challenges. From strengthening relationships, to financial stress, and mindfulness, we are dedicated to reaching your employee population and giving them personalized support and care. We spread the word about Ginger in a way that makes the most sense for your Headspace Health I 34 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 Confidential Information population - whether it's a retail client with thousands of employees across hundreds of locations or an emerging tech company with a handful of employees located in one place. We look forward to working with you, sharing best practices and tactics, and leveraging what we learn. For example, Ginger's Communication Playback offers clients a set of launch essentials and campaigns that help streamline and optimize communications. Here's what to expect from our marketing partnership at launch and beyond. -Pre-launch: The primary objective during the pre-launch period is raising awareness of Ginger's services among your eligible population. During implementation, your Ginger team will provide access to evergreen content and creative to support your pre-launch communications efforts. -Launch: At this stage, employers should generate their eligible population's interest - educate them on the importance of mental health, make them aware of Ginger, and start driving adoption. A couple of days after you've introduced Ginger to your population, Ginger will launch the email series campaign to drive sign-ups and engagement with Ginger. -Post-launch: At the Discovery stage, we'll help gather insights from the launch and take a closer look at your population and channels. A couple weeks after launch, we will use those insights to develop and fine tune a communications plan for the quarter that will boost adoption, support your efforts, and continue to drive sign-ups and engagement. Headspace Health I 35 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2 28. Confirm your ability to customize and/or co- brand materials. Confidential Information -Ongoing: During the Nurture stage, we will refine your communications plan as needed and identify opportunities for collaboration. At a minimum, we will regroup once per quarter to review campaign performance and impact, and collaborate to develop a communications plan for the next quarter. The discovery session gives Ginger a better understanding of your goals, population, and internal processes-all are very valuable pieces of information that will inform the plan for the following quarter. After this session takes place, Ginger will develop an employee communications plan that fits your population's needs, meets people where they are, and focuses on supporting your internal channels and efforts. Upon sign off from both parties, the communications plan will allow us to seize opportunities for collaboration, learn, and take into account learnings from the launch. Refer to Attachment 2 - Ginger Communication Playbook and Attachment 3 - Ginger Communication Partnership Guide for additional detail. Ginger provides a wide range of standard and evergreen resources you can use throughout the year to keep the Ginger message fresh. These resources can be easily customizable by you and your team to facilitate execution and ensure consistency across all communications to eligible employees. While this flexibility exists for clients when producing and distributing their own communications, we do not typically allow clients to edit communications that Ginger distributes directly to members. This allows us to maintain a specific tone and brand that aligns with our best-in-class Headspace Health I 36 DoclD:dc770977a8b9a2bd71ab04e4f57b23197cOe69b2 ---- ---------- --- approach to communications. We look forward to learning more about this request to determine the most appropriate approach to supporting your communication needs. Section 9: Implementation ) 29. Explain your implementation process Ginger has refined its implementation and provide a sample implementation process into a scalable and flexible model schedule. that addresses the needs of small to large employers. For a typical employer client, implementation takes approximately 60 days, depending on scope and complexity. Before starting implementation, we collect the following essential assets from our clients: -Clean eligibility data -Summary of benefits and coverage (SBCs) -Email safelist requirements Each implementation begins with a kick-off meeting to learn, share, and address specific needs. This information forms the basis for client-specific launch and engagement plans. Major achievements of the implementation process include: -Contract execution (typically completed prior to implementation) -Technical integrations (SFTP set up) -Eligibility data alignment and exchange -Safelisting of Ginger IPs and Domains (email delivery testing) -Operational readiness and testing -Coach briefing on eligible population and available information -Review of reporting standards Confidential Information Headspace Health I 37 Doc1D:dc770977a8b9a2bd71ab04e4f57b23197c0e69b2