Advancing Behavioral Health Integration through AHRQ's Academy for Integrating Behavioral Health and Primary Care

This is a Small Business Sources Sought notice (SBSS). This is NOT a solicitation for proposals, proposal abstracts, or quotations. The purpose of this notice is to obtain information regarding: (1) the availability and capability of qualified small business sources; (2) whether they are small business; HUBZone small businesses; service-disabled, veteran-owned small businesses; 8(a) small businesses; veteran-owned small businesses; woman-owned small businesses; or small disadvantaged businesses; and (3) their size classification relative to the North American Industry Classification System (NAICS) code for the proposed acquisition. Your responses to the information requested will assist the Government in determining the appropriate acquisition method, including whether a set-aside is possible. An organization that is not considered a small business under the applicable NAICS code should not submit a response to this notice. The Agency for Healthcare Research and Quality’s (AHRQ’s) mission is to produce evidence to make health care safer, and more accessible, effective, affordable and equitable, and to work within the U.S. Department of Health and Human Services (DHHS) and with other stakeholders including patients to make sure that the evidence is understood and used. AHRQ works to fulfill its mission by conducting and supporting health services research, both within AHRQ as well as in leading academic institutions, hospitals, physicians' offices, health care systems, and many other settings across the country. AHRQ’s research develops and disseminates evidence-based information on healthcare outcomes, quality, patient safety, cost, use and access. As a result of the pandemic, many more Americans—children, adolescents, adults—are suffering from anxiety and depression and are misusing alcohol and other substances. “Deaths of despair” from overdose and suicide are increasing rapidly. Those hit hardest by the pandemic are also most challenged by behavioral and mental health issues. They often lack access to behavioral and mental health care, face stigma from their families and communities, and their conditions go untreated or under treated. Behavioral and mental health can negatively affect a person’s physical health and add to the complexity of treating and managing patients’ chronic conditions. Primary care clinicians are often the first point of contact with the health care system for people living with behavioral and mental health conditions. Many behavioral health conditions – for example, uncomplicated depression, anxiety, and alcohol or opioid use disorder - can be successfully treated in primary care. Given the shortage of mental health professionals available for referral, primary care clinicians may be the only available source of care in underserved areas. While some conditions can be successfully diagnosed, treated and managed by primary care clinicians, others require more intense and specialized care. In those cases, primary care clinicians can coordinate with behavioral health clinicians and offer collaborative or stepped care. A growing body of research shows that integrated behavioral health improves health and patient experience, while reducing unnecessary costs in time, money, and delays. While there is a lot of evidence on the effectiveness of integrated behavioral health care, there are also substantial barriers to actually implementing it in practice and uptake remains suboptimal. For these reasons, HHS has set integration as a Departmental goal. In 2010, AHRQ established The Academy for Integrating Behavioral Health and Primary Care (the Integration Academy). The mission of the Integration Academy is to promote and support the integration of behavioral health into primary and ambulatory care settings. The Integration Academy has focused on dissemination of the latest evidence on integration including: a website where health professionals can learn about integration; a platform for sharing knowledge and resources; a library of tools and training resources; and a community of learning at the heart of which is the National Integration Academy Council, or NIAC, a standing technical expert panel with expertise in primary care, behavioral health, addiction medicine, medical education, health policy and financing, health equity and patient advocacy. One of the first tasks of the Integration Academy was to produce a “Lexicon for Behavioral Health and Primary Care Integration” which remains widely used today. Since then, the Integration Academy has produced playbooks and guides, curated compendiums of tools and resources, and supported the dissemination of AHRQ’s implementation projects on opioid and alcohol use disorders while maintaining a regular newsletter and calendar of events. Currently the Integration Academy website gets about 70,000 individual users a year without a sponsored outreach and marketing campaign. Objectives: To meet the growing demand both within and outside the Federal government for support to implement integrated behavioral healthcare, AHRQ will leverage the existing infrastructure and experience of the Integration Academy to increase the dissemination and implementation of evidence-based integration activities. Specifically, the objectives of this project are as follows to: Establish strategies to increase partnerships with a diverse group of stakeholders and organizations involved in behavioral health integration for the purpose of increasing partnerships and dissemination. Enhance the Integration Academy website (https://integrationacademy.ahrq.gov/) so that it is more widely accessible and more easily used by both primary care and behavioral health clinicians. Create and evaluate new resources based on the latest evidence about how to facilitate the implementation of integrated care across diagnosis, treatment, and management of mental and behavioral health care in primary care. Enhance the curation of the Integration Academy’s library of tools and resources and improve the search function so that users can find resources that address their specific questions. Collect and disseminate evidence-based resources of partner Federal agencies to ensure that their findings, tools, and other resources are available on the Integration Academy’s website. Federal partners include, but are not limited to the Centers for Disease Control and Prevention (CDC), Substance Abuse and Mental Health Services Administration (SAMHSA), the National Institutes of Health (NIH), Health Resources and Services Administration (HRSA), and the Veterans Health Administration. Increase the use of the Integration Academy’s resources The purpose of this task order is to support and expand the Integration Academy as a coordinating center and national resource to promote and support the integration of behavioral health into primary and ambulatory care settings. Under this task order, the Contractor shall: Project Administration Monitor the state of behavioral health integration in primary care and identify emerging needs and opportunities for networking and dissemination Maintain the Integration Academy website Produce and update the Integration Academy products and tools Disseminate the Integration Academy products, tools, and resources Update the Integrating Behavioral Health and Primary Care Playbook Redesign the Integration Academy website Update observations from exemplary sites to include exemplary primary care practices that integrate primary care and behavioral health for patients with substance use disorders Overview of Tasks: Task 1. Project administration The Contractor shall conduct project administrative tasks: Submit to the AHRQ Contracting Officer’s Representative (COR) an annual work plan, annual evaluation report, impact assessment plan (to assess the impact of the Integration Academy on advancing the field of behavioral health integration in primary care), and monthly progress reports; Conduct an annual kick-off meeting to provide an overview of the task order, including the proposed approach and methods; present the draft annual work plan; review and clarify the scope of work and delivery schedule for the contract; delineate further roles and responsibilities; establish communication protocols, and highlight any concerns and issues; and Conduct monthly progress meetings with the AHRQ COR, and any other relevant AHRQ personnel to discuss project management, administrative and technical challenges and proposed solutions related to the project, including any outstanding issues raised in the monthly progress reports. Task 2. Monitor the state of behavioral health integration in primary care and identify emerging needs and opportunities for networking and dissemination The Contractor shall produce an ecosystem map that comprehensively describes all federal agencies and non-federal organizations that are active players in the integration of behavioral health in primary care (i.e., organizations working to study and/or support integration), and the interactions and dependencies [SL(3] [KE(4] among the included organizations. The Contractor shall produce a directory of organizations included in the ecosystem map. To foster collaboration among the key federal agencies working to integrate behavioral health into primary care, the Contractor shall support quarterly virtual meetings of a workgroup of representatives from federal agencies with a responsibility to behavioral health integration. The federal workgroup will share, learn about, and align federal agency initiatives, integration knowledge, and resources; identify resource needs and research gaps that should be addressed to accelerate implementation of integration; and promote dissemination of integration resources. The Contractor shall support the existing National Integration Academy Council (NIAC), whose purpose is to provide technical expertise regarding the content on the Integration Academy website, support dissemination of Integration Academy information through affiliated organizations and networks and provide expertise to the federal workgroup as requested. A description of the current NIAC is available (https://integrationacademy.ahrq.gov/about/academy-team). The Contractor shall revise the current NIAC Governance Documents based on input from the AHRQ COR, the NIAC chairs, and the NIAC members. The Contractor shall host 4 NIAC meetings per year, one of which shall be held in-person at AHRQ headquarters in Rockville, MD and three of which will be virtual meetings. NIAC meetings shall be scheduled to maximize participation of the NIAC members, AHRQ staff, and representatives from federal agencies. Task 3. Maintain the Integration Academy website The Integration Academy website serves two functions: (1) it is the Integration Academy’s primary vehicle for public outreach and information dissemination and (2) it serves as a virtual repository for nearly all of the Integration Academy’s information, documentation, and deliverables. The core of the website is public facing, but the structure of the site also provides password-protected access to the “Academy Community,” in which interested users may access special features not available to non-members. The Integration Academy website must be hosted on AHRQ’s Amazon Web Services (AWS) Cloud Enclave, which is maintained by the AHRQ Division of Information Technology (DIT) and its contractor. The Integration Academy website requires a consistent look and feel across agency applications. Since the Integration Academy website resides on AHRQ’s AWS Cloud Enclave, the Contractor shall conduct all ongoing work in coordination with AHRQ staff (e.g., AHRQ DIT) and its Contractor. The Contractor shall use a content management system with similar functionality as Drupal to support and maintain the Integration Academy website. The Contractor shall use an agile development methodology though the Contractor is not required to follow a specific agile framework. The Contractor’s approach must be capable of producing AHRQ-required system deliverables and allow for AHRQ COR approval before moving from one project phase to another. This approval process corresponds to stage gate reviews in the HHS Enterprise Project Life Cycle (EPLC) process. The Contractor must also conform to AHRQ Configuration Management (CM) and change control standards, which require appropriate controls for managing software and documentation baselines, changes to software artifacts using an appropriate Integrated Development Environment or version management tool, and document change requests. The following diagram provides a high-level, conceptual view of the Agile Development Framework currently in place at AHRQ (also known as Scrum). The focus of this diagram is to highlight the various ceremonies, participants and activities involved in an agile approach and is not intended to be a comprehensive lifecycle process diagram. This diagram does not capture details related to the governance gate checks and reviews facilitated by HHS EPLC process. Figure 1. Agile Development Framework (attached to this notice) Task 4. Produce and update the Integration Academy products and tools A key function of the Integration Academy is to serve as a source of relevant and timely resources to support the integration needs of the primary care providers and health systems in a rapidly changing environment. The Contractor shall update and/or create new products and tools and/or update existing products and tools in response to needs identified by federal agencies and the NIAC, and to ensure that the Integration Academy website content remains current and informative to the target audience. For each contract year, the Contractor shall complete either, 1 large product, or 1 medium product plus 1 small product, or 3 small products. Examples of different size products are below: Large Improve the relevance and usability of the literature collection for intended end-users. Medium Develop or update a user guide or tools based on an AHRQ product, such as the systematic review on integrating behavioral health and primary care. Create a report that describes what infrastructure is needed to widely implement, scale, and spread integration of behavioral health into primary care and how it can be used to guide future investments. Small Organize and facilitate a stakeholder roundtable and write up the results as a commentary for posting on the Integration Academy website. Produce a topic brief (see examples here: https://integrationacademy.ahrq.gov/products/topic-briefs). Update the literature and references within existing Academy products (e.g., a Playbook, Atlas of Integrated Behavioral Health Care Quality Measures). Task 5. Disseminate the Integration Academy products, tools, and resources The Contractor shall plan and execute activities to disseminate Integration Academy products, tools, resources, and best practices to support the integration of behavioral health into primary care. The Contractor shall coordinate activities with AHRQ’s Office of Communications Division of Media Relations and Division of Outreach and Stakeholder Engagement. In execution of activities, the Contractor shall include the use of AHRQ outreach mechanisms, such as AHRQ News Now and the Integration Academy community listserv to promote and disseminate the Integration Academy website, products, resources, and web content. The AHRQ COR shall facilitate coordination with the appropriate liaisons of AHRQ’s Office of Communication to implement the promotion and dissemination in an orderly, synchronized manner. Task 6. Update the Integrating Behavioral Health and Primary Care Playbook The Contractor shall conduct an environmental scan and submit a report proposing recommendations for how the Integrating Behavioral Health and Primary Care Playbook, or the “Integration Playbook” (https://integrationacademy.ahrq.gov/products/playbooks/behavioral-health-and-primary-care), should be revised to bring the content up to date and to improve the usability of the format. Following approval of the report, the Contractor shall revise the Integration Playbook content and format. The Contractor shall conduct user testing of the updated Integration Playbook with up to 9 intended users, revise the Integration Playbook based on feedback from user testing, and replace the current Integration Playbook on the Integration Academy website with the final revised updated Integration Playbook. Task 7. Redesign the Integration Academy website The purpose of the Integration Academy website is to accelerate the adoption of integrated behavioral health in primary care by elevating awareness of integration as an important and feasible strategy, provide a central repository of the best current resources to support clinicians, systems, researchers, and policy makers seeking to integrate care, highlight news and trainings related to integration, and promote AHRQ resources related to integration. The Contractor shall develop and execute a plan to improve the usability of the current Integration Academy website. Task 8. Update observations from exemplary sites to include exemplary primary care practices that integrate primary care and behavioral health for patients with substance use disorders The Integration Academy website currently features a webpage with Observations from Exemplary Sites (https://integrationacademy.ahrq.gov/products/playbooks/behavioral-health-and-primary-care/observations-exemplary-sites). At the time of publication, few primary care practices provided integrated behavioral health for patients with substance use disorders (SUD), and thus the current webpage and report does not feature exemplars that provide integrated behavioral health care to patients with SUDs. Furthermore, not all behavioral health clinicians in integrated primary care practices have dedicated training in the treatment of patients with SUDs, indicating that there is critical need in the field to inform others how this can be done and done well in exemplary primary care practices. The Contractor shall conduct an (1) environmental scan, (2) develop a protocol for conducting in-depth case studies on 8 diverse, exemplary primary care practices that provide integrated behavioral health for patients with SUDs, (3) conduct in-depth case studies on the 8 primary care practices , and (4) submit an interactive report that highlights how each exemplary site integrates behavioral health for patients with SUD to be posted on the Observations from Exemplary Sites webpage (https://integrationacademy.ahrq.gov/products/playbooks/behavioral-health-and-primary-care/observations-exemplary-sites). Anticipated period of performance: Base period of 12 months, four option periods (12 months each). Capability Information Sought: Capabilities necessary to fulfill this requirement include: Expertise in behavioral health (including mental health integration and substance use disorder) and primary care integration, website design and maintenance, stakeholder engagement, dissemination, program evaluation, and meeting services. Ability to evaluate whether Integration Academy website, products, and tools have uptake and impact on behavioral health integration. Ability to identify the appropriate and important organizations and programs in the behavioral health integration field. Ability to maintain and redesign the Integration Academy website, and to meet federal IT security and privacy requirements. Ability to prioritize and identify relevant products and tools and how to update them to support the current needs of primary care clinicians and practices integrating behavioral health. Ability to develop and execute an effective and innovative dissemination plan that demonstrates knowledge of both behavioral health integration and up to date dissemination strategies. Ability to apply current approaches of user-based design to the Integration Academy website, products, and tools. The capability statement response to this Small Business Sources Sought notice should include the following information: Staff expertise, including their availability, experience, and formal and other training; Current in-house capability and capacity to perform the work; Corporate experience and information on prior projects of similar size and complexity; List any Government wide contracting vehicle for which the respondent has a contract (example, GSA schedule, etc). Information Submission Instructions Interested qualified small business organizations should submit a tailored capability statement for this requirement. The cover page must include the following: UEI number Organization name Organization address Size and type of business (e.g., 8(a), HUBZone, etc.) pursuant to NAICS code 541611 (Administrative Management and General Management Consulting Services). Technical point(s) of contact, including names, titles, addresses, telephone, and e-mail addresses. All Capability Statements sent in response to this SMALL BUSINESS SOURCES SOUGHT notice must be submitted electronically (via e-mail) to Christopher Mertens, Contract Specialist, [email protected] in MS Word, or Adobe Portable Document Format (PDF), no later than 10:00 AM on December 14, 2023. Responses should not exceed 15 single-sided pages (including the cover page, all attachments, resumes, charts, etc.) presented in single-space and using a 12-point font size minimum, that clearly details the ability to perform the aspects of the notice described above. 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