Complex Care

\n\n_ Department Off ce/Division/Program: DHHS/OBH/Debra Poulin & Sara Wade\n\u201aDepartment ee Administrator of Jennifer Levesque / Melinda Farrell\n2. Grant Coordinator:\nu apblisebie) Department Reference | 1H4-24-20258\n\nee, Amount: a 8. 880.000.00 \u201aAdvantage CT. | CT 10A\n(Contract/Amengment/Grant) Revised: $240,000.00 TROSH | 20231213000000001685\na \u201aEroposed Start ... Proposed |\n\n\u201aDate: ss Date:\nnn \u2014 Efeeive a \u2014\nPrevious End Date: ran | \u00bb New End Date:\n__[FProjectEndDate:| GrantendDete] I\n\n| \" VendorfProvider/\u00f6raniee Name, Walden Behavioral Care, LLC\nWEN, - . City, State:\n: 2 Brief Description of Complex Care\n:Goods/Services/Grant:. p\nPART II: JUSTIFICATION FOR VENDOR SELECTION\nCheck the box below for. the justification(s) that t applies to this request. che all that app\n\n. Competitive Process a a\nB: Amendment En Ei 1 : . ..H. State en Directed. vn\n\n= Single Source/Unique Vendor Er Federal Agency Directed.\n\n;

Proprietary/Copyright/Patents Be el: Willing and Qualified. =\n\n: . Emergency E = Sn, ae Client Choice\n\nF. University Cooperative Proc. i SE Other Authorization 2\n\nREV 11/9/2023 Page 1 0f3\n" "Procurement Justification Form (PJF}\n\nPlease respond to ALL of the questions in the following sections.\n\nPART Ill: SUOPPLEMENTAL INFORMATION\n\u201a1. .Provide a more detailed description and explain the need for the goods, services or grantto\nsupplement the response in Part I. ee\nThe purpose of this contract is to meet the care needs of one specific client needing out of State\nspecialized in-patient treatment services. This contract period will cover 30-36 days of treatment at\nthe facility, tne admission date has yet to be determined.\n\nClient requested a single-case agreement from OMS that was denied. Client appealed decision and\nit was denied based on IMD exclusion. Chief Hearing Officer cited 14-193 CMR ch 40 which obliges\nthe Office of Behavioral Health to conduct a prior authorization process to determine eligibility for\nout-of-state funding.\n\nThis contract is being amended to add funding to accommodate the treatment needs of Maine\n\n2. Provide a brief justification for. the: selected vendor to supplement.the response in Part Il.\n\nReference the RFP number, if applicable. aaa en: ne\nThis out of State provider operates a specialized PNMI type facility that specializes in treatment of\neating disorders. Due to this client\u2019s acuity, there is no other provider alternatives within the State of\nMaine that provide this in-patient level of specialized services.\n\n3, -Explain how the negotiated costs or rates are fair and reasonable; or how the funding was\n\nallocated to grantee. se\nWalden Inpatient Level of Care is $3,125 per day but the Office was able to negotiate a per diem\nrate of $1,625.00. The average length of stay is 30 days with some individuals completing\ntreatment in less than 30 days while others take longer. This contract represents a maximum length\nof stay of 36 days.\n\nAdmissions to the Provider after 11/1/23 will adhere to the MaineCare rate of $1400 per day.\n\nA Describe the plan for future competition for the goods or services. - a\n\nThe Department does not intend to RFP this service. | |\n\nPART IV: AMERICAN RESCUE PLAN ACT (ARPA) / MAINE JOBS & RECOVERY PLAN\n(MJRP)\nDoes this request utilize ARPA/MJRP funds?\n\nDI] Yes, MJRP funds (023) - If Yes, please attach the approved Business Case(s).\n\nDU] Yes, ARPA funds (025) - If Yes, please be aware of the requirements from awarding federal\nagencies.\n\nNo \u2014- IfNo, proceed to Part V.\n\nREV 11/9/2023 Page 2 0f 3\n" "Procurement Justification Form (PJF)\n\nPART V: APPROVALS\nThe signatures below indicate approval of this Progurement eu\n\nSignature of requesting\nhepartments Commissioner\n.(or.designee):\n\n. .Typed Name:\n\nSignature of DAF$ V Dodu an By:\nRroeirement m | / [lin ). \u20ac. Ml\u0131n\n\n..Typed Nana William J.E. Allen Date: | 3/26/2024\n\nNOI 0320240335 03/26/2024 - 04/01/2024\n\nREV 11/91/2023 Page 3 of 3\n"