15 240104 SAGE COUNSELING CONTRACT SIGNED 6.6.24.PDF
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CONTRACT FELONY DIVERSION AND OFFENDER
EDUCATION PROGRAMS 240104-RFP
This contract is entered into this 26th day of June, 2024 by and between Maricopa County (“County”), a
political subdivision of the State of Arizona, and SAGE Counseling, Inc., an Arizona corporation
(“Contractor”) for the purchase of an alternative to traditional criminal case processing so specific individuals
accused of committing a crime may participate in an education or treatment program that addresses the
risk factors related to recidivism.
1.0
CONTRACT TERM
This contract is for a term of two years and six months, beginning on the 1st of July, 2024 and
ending the 31st of December, 2026.
2.0
OPTION TO RENEW
The County may, at its option and with the concurrence of the Contractor, renew the term of this
contract up to a maximum of two years and six months, (or at the County’s sole discretion, extend
the contract on a month-to-month basis for a maximum of six months after expiration). The
Contractor shall be notified in writing by the Office of Procurement Services of the County’s
intention to renew the contract term at least 60 calendar days prior to the expiration of the original
contract term.
3.0
CONTRACT COMPLETION
In preparation for contract completion, the Contractor shall make all reasonable efforts for an
orderly transition of its duties and responsibilities to another provider and/or to the County. This
may include, but is not limited to, preparation of a transition plan and cooperation with the County
or other providers in the transition. The transition includes the transfer of all records and other data
in the possession, custody, or control of the Contractor that are required to be provided to the
County either by the terms of this agreement or as a matter of law. The provisions of this clause
shall survive the expiration or termination of this agreement.
4.0
PRICE ADJUSTMENTS
Any requests for reasonable price adjustments must be submitted 60 calendar days prior to
contract expiration. Requests for adjustment in cost of labor and/or materials must be supported
by appropriate documentation. The reasonableness of the request will be determined by comparing
the request with the Consumer Price Index or by performing a market survey. If County agrees to
the adjusted price terms, County shall issue written approval of the change and provide an updated
version of the contract. The new change shall not be in effect until the date stipulated on the
updated version of the contract.
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5.0
PAYMENTS
5.1
As consideration for performance of the duties described herein, County shall pay
Contractor the sum(s) stated in Exhibit A – Vendor Information and Pricing.
5.2
Payment shall be made upon the County’s receipt of a properly completed invoice.
5.3
INVOICES
5.3.1
In addition to any requirements listed in program details, the contractor shall
submit one legible copy of their detailed invoice before payment(s) will be made.
Invoices shall be received by the eighth of each month. Incomplete invoices will
not be processed. At a minimum, the invoice must provide the following
information:
•
Company name, address, and contact information
•
County bill-to name and contact information
•
Contract serial number
•
County purchase order number
•
Program and participant name
•
Invoice number and date
•
Payment terms
•
Dates of service or delivery
•
Number of sessions/case management hours
•
Contract item number(s)
•
Description of purchase (product or services)
•
Pricing per session
•
Extended price
•
Total amount due
5.3.2
Labor, services, and maintenance must be billed as a separate line item.
5.3.3
Problems regarding billing or invoicing shall be directed to the department as listed
on the purchase order.
5.3.4
Payment shall only be made to the contractor by Accounts Payable through the
Maricopa County Vendor Express Payment Program. This is an Electronic Funds
Transfer (EFT) process. After contract award the contractor shall complete the
Vendor Registration Form located on the County Department of Finance Vendor
Registration Web Site (https://www.maricopa.gov/5169/Vendor-Information).
5.3.5
Discounts offered in the contract shall be calculated based on the date a properly
completed invoice is received by the County.
5.3.6
EFT payments to the routing and account numbers designated by the contractor
shall include the details on the specific invoices that the payment covers. The
contractor is required to discuss remittance delivery capabilities with their
designated financial institution for access to those details.
5.4
APPLICABLE TAXES
5.4.1
It is the responsibility of the contractor to determine any and all applicable taxes
and include those taxes in their proposal. The legal liability to remit the tax is on
the entity conducting business in Arizona. Tax is not a determining factor in
contract award.
5.4.2
The County will look at the price or offer submitted and will not deduct, add, or alter
pricing based on speculation or application of any taxes, nor will the County
provide Contractor any advice or guidance regarding taxes. If you have questions
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regarding your tax liability, seek advice from a tax professional prior to submitting
your bid. You may also find information at https://www.azdor.gov/Business.aspx.
Once your bid is submitted, the offer is valid for the time specified in this solicitation,
regardless of mistake or omission of tax liability. If the County finds overpayment
of a project due to tax consideration that was not due, the contractor will be liable
to the County for that amount, and by contracting with the County agrees to remit
any overpayments back to the County for miscalculations on taxes included in a
bid price.
5.4.3
Tax Indemnification: Contractor and all subcontractors shall pay all Federal, State,
and local taxes applicable to their operation and any persons employed by the
Contractor. Contractor shall, and require all subcontractors to, hold Maricopa
County harmless from any responsibility for taxes, damages, and interest, if
applicable, contributions required under Federal and/or State and local laws and
regulations, and any other costs including: transaction privilege taxes,
unemployment
compensation
insurance,
Social
Security,
and
workers’
compensation. Contractor may be required to establish, to the satisfaction of
County, that any and all fees and taxes due to municipality or the State of Arizona
for any license or transaction privilege taxes, use taxes, or similar excise taxes are
currently paid (except for matters under legal protest).
6.0
AVAILABILITY OF FUNDS
6.1
The provisions of this contract relating to payment for services shall become effective when
funds assigned for the purpose of compensating the Contractor as herein provided are
actually available to County for disbursement. The County shall be the sole judge and
authority in determining the availability of funds under this contract. County shall keep the
Contractor fully informed as to the availability of funds.
6.2
If any action is taken by, any State agency, Federal department, or any other agency or
instrumentality to suspend, decrease, or terminate its fiscal obligations under, or in
connection with, this contract, County may amend, suspend, decrease, or terminate its
obligations under, or in connection with, this contract. In the event of termination, County
shall be liable for payment only for services rendered prior to the effective date of the
termination, provided that such services are performed in accordance with the provisions
of this contract. County shall give written notice of the effective date of any suspension,
amendment, or termination under this section, at least 10 days in advance.
7.0
STRATEGIC ALLIANCE for VOLUME EXPENDITURES (SAVE)
The County is a member of the SAVE cooperative purchasing group. SAVE includes the State of
Arizona, many Phoenix metropolitan area municipalities, and many K-12 unified school districts.
Under the SAVE Cooperative Purchasing Agreement, and with the concurrence of the successful
respondent under this solicitation, a member of SAVE may access a contract resulting from a
solicitation issued by the County. If contractor does not want to grant such access to a member of
SAVE, state so in contractor’s bid. In the absence of a statement to the contrary, the County will
assume that contractor does wish to grant access to any contract that may result from this bid. The
County assumes no responsibility for any purchases by using entities.
8.0
INTERGOVERNMENTAL COOPERATIVE PURCHASING AGREEMENTS (ICPAs)
County currently holds ICPAs with numerous governmental entities. These agreements allow those
entities, with the approval of the Contractor, to purchase their requirements under the terms and
conditions of the County contract. It is the responsibility of the non-County government entity to
perform its own due diligence on the acceptability of the contract under its applicable procurement
rules, processes, and procedures. Certain governmental agencies may not require an ICPA and
may utilize this contract if it meets their individual requirements. Other governmental agencies may
enter into a separate Statement of Work with the Contractor to meet their own requirements. The
County is not a party to any uses of this contract by other governmental entities.
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9.0
DUTIES
The Contractor shall perform all duties stated in Exhibit B – Scope of Work, or as otherwise directed
in writing by the procurement officer.
10.0
TERMS AND CONDITIONS
10.1
INDEMNIFICATION
10.1.1 To the fullest extent permitted by law, and to the extent that claims, damages,
losses, or expenses are not covered and paid by insurance purchased by the
contractor, the contractor shall defend, indemnify, and hold harmless the County
(as Owner), its agents, representatives, officers, directors, officials, and employees
from and against all claims, damages, losses, and expenses (including, but not
limited to attorneys' fees, court costs, expert witness fees, and the costs and
attorneys' fees for appellate proceedings) arising out of, or alleged to have resulted
from, the negligent acts, errors, omissions, or mistakes of the contractor, a
subcontractor, anyone directly or indirectly employed by them, or anyone for
whose acts they may be liable relating to the performance of this contract.
10.1.2 Contractor's duty to defend, indemnify, and hold harmless the County, its agents,
representatives, officers, directors, officials, and employees shall arise in
connection with any claim, damage, loss, or expense that is attributable to bodily
injury, sickness, disease, death, or injury to, impairment of, or destruction of
tangible property, including loss of use resulting therefrom, caused by negligent
acts, errors, omissions, or mistakes in the performance of this contract, but only to
the extent caused by the negligent acts or omissions of the contractor, a
subcontractor, anyone directly or indirectly employed by them, or anyone for
whose acts they may be liable, regardless of whether or not such claim, damage,
loss, or expense is caused in part by a party indemnified hereunder.
10.1.3 The amount and type of insurance coverage requirements set forth herein will in
no way be construed as limiting the scope of the indemnity in this section.
10.1.4 The scope of this indemnification does not extend to the sole negligence of County.
10.2
INSURANCE
10.2.1 Contractor, at Contractor’s own expense, shall purchase and maintain, at a
minimum, the herein stipulated insurance from a company or companies duly
licensed by the State of Arizona and possessing an AM Best, Inc. category rating
of B++. In lieu of State of Arizona licensing, the stipulated insurance may be
purchased from a company or companies, which are authorized to do business in
the State of Arizona, provided that said insurance companies meet the approval of
County. The form of any insurance policies and forms must be acceptable to
County.
10.2.2 All insurance required herein shall be maintained in full force and effect until all
work or service required to be performed under the terms of the contract is
satisfactorily completed and formally accepted. Failure to do so may, at the sole
discretion of County, constitute a material breach of this contract.
10.2.3 In the event that the insurance required is written on a claims-made basis,
Contractor warrants that any retroactive date under the policy shall precede the
effective date of this contract and either continuous coverage will be maintained,
or an extended discovery period will be exercised for a period of two years
beginning at the time work under this contract is completed.
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10.2.4 Contractor’s insurance shall be primary insurance as respects County, and any
insurance or self-insurance maintained by County shall not contribute to it.
10.2.5 Any failure to comply with the claim reporting provisions of the insurance policies
or any breach of an insurance policy warranty shall not affect the County’s right to
coverage afforded under the insurance policies.
10.2.6 The insurance policies may provide coverage that contains deductibles or self-
insured retentions. Such deductible and/or self-insured retentions shall not be
applicable with respect to the coverage provided to County under such policies.
Contractor shall be solely responsible for the deductible and/or self-insured
retention and County, at its option, may require Contractor to secure payment of
such deductibles or self-insured retentions by a surety bond or an irrevocable and
unconditional letter of credit.
10.2.7 The insurance policies required by this contract, except Workers’ Compensation
and Errors and Omissions, shall name County, its agents, representatives, officers,
directors, officials, and employees as additional insureds.
10.2.8 The policies required hereunder, except Workers’ Compensation and Errors and
Omissions, shall contain a waiver of transfer of rights of recovery (subrogation)
against County, its agents, representatives, officers, directors, officials, and
employees for any claims arising out of Contractor’s work or service.
10.2.9 If available, the insurance policies required by this contract may be combined with
Commercial Umbrella Insurance policies to meet the minimum limit requirements.
If a Commercial Umbrella insurance policy is utilized to meet insurance
requirements, the Certificate of Insurance shall indicate which lines the
Commercial Umbrella Insurance covers.
10.2.9.1 Commercial General Liability
Commercial General Liability (CGL) insurance and, if necessary,
Commercial Umbrella insurance with a limit of not less than $1,000,000
for each occurrence, $2,000,000 Products/Completed Operations
Aggregate, and $2,000,000 General Aggregate Limit. The policy shall
include coverage for premises liability, bodily injury, broad form property
damage, personal injury, products and completed operations and
blanket contractual coverage, and shall not contain any provisions which
would serve to limit third party action over claims. There shall be no
endorsement or modifications of the CGL limiting the scope of coverage
for liability arising from explosion, collapse, or underground property
damage.
10.2.9.2 Professional Liability Insurance
Contractor shall maintain Professional Liability insurance and, if
necessary, Commercial Umbrella insurance, which will insure and
provide coverage for Professional Liability of the contractor, with limits
of no less than $5,000,000 for each claim.
10.2.9.3 Sexual Molestation and Physical Abuse
When services involve working with these groups of individuals, the
insurance requirements in the contract need to be revised to include
coverage for "sexual molestation and physical abuse". Coverage for
this type of claim, or allegation, is excluded from standard general
liability policies. Therefore, contractors whose services include working
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with and/or caring for children/elderly and disabled persons should have
their policies specifically endorsed to include this coverage.
10.2.9.4 Commercial General Liability – Occurrence Form
10.2.9.4.1 Policy shall include bodily injury, property damage and
broad form contractual liability coverage.
10.2.9.4.2 The policy shall be endorsed to include coverage for
physical/sexual abuse and molestation/criminal sexual
misconduct, with limits of no less than $5,000,000 for each
claim (see Commercial General Liability)
10.2.10 Certificates of Insurance
10.2.10.1 Prior to contract award, Contractor shall furnish the County with valid
and complete Certificates of Insurance, or formal endorsements as
required by the contract in the form provided by the County, issued by
Contractor’s insurer(s), as evidence that policies providing the required
coverage, conditions and limits required by this contract are in full force
and effect. Such certificates shall identify this contract number and title.
10.2.10.1 In the event any insurance policy(ies) required by this contract is (are)
written on a claims-made basis, coverage shall extend for two years past
completion and acceptance of Contractor’s work or services and as
evidenced by annual certificates of insurance.
10.2.10.2 If a policy does expire during the life of the Contract, a renewal certificate
must be sent to County 15 calendar days prior to the expiration date.
10.2.10.3 Certificates of Insurance shall identify Maricopa County as the certificate
holder as follows:
Maricopa County
c/o Risk Management
301 W Jefferson St, Suite 910
Phoenix, AZ 85003
10.2.11 Cancellation and Expiration Notice
Applicable to all insurance policies required within the insurance requirements of
this contract, Contractor’s insurance shall not be permitted to expire, be
suspended, be canceled, or be materially changed for any reason without 30 days
prior written notice to Maricopa County. Contractor must provide to Maricopa
County, within two business days of receipt, if they receive notice of a policy that
has been or will be suspended, canceled, materially changed for any reason, has
expired, or will be expiring. Such notice shall be sent directly to Maricopa County
Office of Procurement Services and shall be mailed, or hand delivered to 301 W.
Jefferson, Suite 700, Phoenix, AZ 85003, or emailed to the procurement officer
noted in the solicitation.
10.3
FORCE MAJEURE
10.3.1 Neither party shall be liable for failure of performance, nor incur any liability to the
other party on account of any loss or damage resulting from any delay or failure to
perform all or any part of this contract, if such delay or failure is caused by events,
occurrences, or causes beyond the reasonable control and without negligence of
the parties. Such events, occurrences, or causes include, but are not limited to,
acts of God/nature (including fire, flood, earthquake, storm, hurricane, or other
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natural disaster), war, invasion, act of foreign enemies, hostilities (whether war is
declared or not), civil war, riots, rebellion, revolution, insurrection, military or
usurped power or confiscation, terrorist activities, nationalization, government
sanction, lockout, blockage, embargo, labor dispute, strike, and interruption or
failure of electricity or telecommunication service, and pandemic.
10.3.2 Each party, as applicable, shall give the other party notice of its inability to perform
and particulars in reasonable detail of the cause of the inability. Each party must
use best efforts to remedy the situation and remove, as soon as practicable, the
cause of its inability to perform or comply.
10.3.3 The party asserting Force Majeure as a cause for non-performance shall have the
burden of proving that reasonable steps were taken to minimize delay or damages
caused by foreseeable events, that all non-excused obligations were substantially
fulfilled, and that the other party was timely notified of the likelihood or actual
occurrence which would justify such an assertion, so that other prudent
precautions could be contemplated.
10.4
ORDERING AUTHORITY
Any request for purchase shall be accompanied by a valid purchase order issued by a
County department or directed by a Certified Agency Procurement Aid (CAPA) with a
purchase card for payment.
10.5
PROCUREMENT CARD ORDERING CAPABILITY
County may opt to use a procurement card (Visa or Master Card) to make payment for
orders under this contract.
10.6
NO MINIMUM OR MAXIMUM PURCHASE OBLIGATION
This contract does not guarantee any minimum or maximum purchases will be made.
Orders will only be placed under this contract when the County identifies a need and proper
authorization and documentation have been approved.
10.7
PURCHASE ORDERS
10.7.1 County reserves the right to cancel purchase orders within a reasonable period of
time after issuance. Should a purchase order be canceled, the County agrees to
reimburse the Contractor for actual and documentable costs incurred by the
Contractor in response to the purchase order. The County will not reimburse the
Contractor for any costs incurred after receipt of County notice of cancellation, or
for lost profits, or for shipment of product prior to issuance of purchase order.
10.7.2 Contractor agrees to accept verbal notification of cancellation of purchase orders
from the County procurement officer with written notification to follow. Contractor
specifically acknowledges to be bound by this cancellation policy.
10.8
BACKGROUND CHECK
Respondents may be required to pass multiple background checks (e.g. Sheriff’s Office,
County Attorney's Office, Courts, as well as Maricopa County general government) to
determine if the respondent is acceptable to do business with the County. This applies to,
but is not limited to, the company, subcontractors, and employees, and the failure to pass
these checks shall deem the respondent non-responsible.
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10.9
SUSPENSION OF WORK
The procurement officer may order the Contractor, in writing, to suspend, delay, or interrupt
all or any part of the work of this contract for the period of time that the procurement officer
determines appropriate for the convenience of the County. No adjustment shall be made
under this clause for any suspension, delay, or interruption to the extent that performance
would have been so suspended, delayed, or interrupted by any other cause, including the
fault or negligence of the Contractor. No request for adjustment under this clause shall be
granted unless the claim, in an amount stated, is asserted in writing as soon as practicable
after the termination of the suspension, delay, or interruption, but not later than the date of
final payment under the contract.
10.10
STOP WORK ORDER
10.10.1 The procurement officer may, at any time, by written order to the Contractor,
require the Contractor to stop all, or any part, of the work called for by this contract
for a period of 90 calendar days after the order is delivered to the Contractor, and
for any further period to which the parties may agree. The order shall be specifically
identified as a stop work order issued under this clause. Upon receipt of the order,
the Contractor shall immediately comply with its terms and take all reasonable
steps to minimize the incurrence of costs allocable to the work covered by the order
during the period of work stoppage. Within a period of 90 calendar days after a
stop work order is delivered to the Contractor, or within any extension of that period
to which the parties shall have agreed, the procurement officer shall either:
10.10.1.1 cancel the stop work order; or
10.10.1.2 terminate the work covered by the order as provided in the Termination
for Default or the Termination for Convenience clause of this contract.
10.10.1.3 The procurement officer may make an equitable adjustment in the
delivery schedule and/or contract price, and the contract shall be
modified, in writing, accordingly, if the Contractor demonstrates that the
stop work order resulted in an increase in costs to the Contractor.
10.11
TERMINATION FOR CONVENIENCE
Maricopa County may terminate the resultant contract for convenience by providing 60
calendar days advance notice to the Contractor.
10.12
TERMINATION FOR DEFAULT
10.12.1 The County may, by written Notice of Default to the Contractor, terminate this
contract in whole or in part if the Contractor fails to:
10.12.1.1 deliver the supplies or to perform the services within the time specified
in this contract or any extension;
10.12.1.2 make progress, so as to endanger performance of this contract; or
10.12.1.3 perform any of the other provisions of this contract.
10.12.2 The County’s right to terminate this contract under these subparagraphs may be
exercised if the Contractor does not cure such failure within 10 business days (or
more if authorized in writing by the County) after receipt of a Notice to Cure from
the procurement officer specifying the failure.
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10.13
PERFORMANCE
It shall be the contractor’s responsibility to meet the proposed performance requirements.
Maricopa County reserves the right to obtain services on the open market in the event the
contractor fails to perform, and any price differential will be charged against the contractor.
MCAO (Maricopa County Attorney’s Office) will perform contract monitoring and reserves
the right to impose a corrective action plan for contractors not meeting expectations.
10.14
CONTRACTOR EMPLOYEE MANAGEMENT
10.14.1 Contractor shall endeavor to maintain the personnel proposed in their proposal
throughout the performance of this contract.
10.14.2 If Contractor personnel’s employment status changes, Contractor shall provide
County a list of proposed replacements with equivalent or greater experience.
10.14.3 Under no circumstances shall the implementation schedule to be impacted by a
personnel change on the part of the Contractor.
10.14.4 Contractor shall not reassign any key personnel identified in their proposal without
the express consent of the County.
10.14.5 County reserves the right to immediately remove from its premises any Contractor
personnel it determines to be a risk to County operations.
10.14.6 County reserves the right to request the replacement of any Contractor personnel
at any time, for any reason.
10.15
INSPECTION OF SERVICES
10.15.1 The Contractor shall provide and maintain an inspection system acceptable to
County covering the services under this contract. Complete records of all
inspection work performed by the Contractor shall be maintained and made
available to County during contract performance and for as long afterwards as the
contract requires.
10.15.2 County has the right to inspect and test all services called for by the contract, to
the extent practicable at all times and places during the term of the contract.
County shall perform inspections and tests in a manner that will not unduly delay
the work.
10.15.3 If any of the services do not conform to contract requirements, County may require
the Contractor to perform the services again in conformity with contract
requirements, at no cost to the County. When the defects in services cannot be
corrected by re-performance, County may:
10.15.3.1 require the Contractor to take necessary action to ensure that future
performance conforms to contract requirements; and
10.15.3.2 reduce the contract price to reflect the reduced value of the services
performed.
10.15.4 If the Contractor fails to promptly perform the services again or to take the
necessary action to ensure future performance in conformity with contract
requirements, County may:
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10.15.4.1 by contract or otherwise, perform the services and charge to the
Contractor, through direct billing or through payment reduction, any cost
incurred by County that is directly related to the performance of such
service; or
10.15.4.2 terminate the contract for default.
10.16
USAGE REPORT
Unless otherwise indicated, the contractor shall furnish the County a usage report, upon
request, delineating the acquisition activity governed by the contract. The format of the
report shall be approved by the County and shall disclose the quantity and dollar value of
each contract item by individual unit of measure.
10.17
STATUTORY RIGHT OF CANCELLATION FOR CONFLICT OF INTEREST
Notice is given that, pursuant to A.R.S. § 38-511, the County may cancel any contract
without penalty or further obligation within three years after execution of the contract, if any
person significantly involved in initiating, negotiating, securing, drafting, or creating the
contract on behalf of the County is at any time, while the contract or any extension of the
contract is in effect, an employee or agent of any other party to the contract in any capacity
or consultant to any other party of the contract with respect to the subject matter of the
contract. Additionally, pursuant to A.R.S. § 38-511, the County may recoup any fee or
commission paid or due to any person significantly involved in initiating, negotiating,
securing, drafting, or creating the contract on behalf of the County from any other party to
the contract arising as the result of the contract.
10.18
OFFSET FOR DAMAGES
In addition to all other remedies at Law or Equity, the County may offset from any money
due to the Contractor any amounts Contractor owes to the County for damages resulting
from breach or deficiencies in performance of the contract.
10.19
SUBCONTRACTING
10.19.1 The Contractor may not assign to another Contractor or subcontract to another
party for performance of the terms and conditions hereof without the written
consent of the County. All correspondence authorizing subcontracting must
reference the bid serial number and identify the job or project.
10.19.2 The subcontractor’s rate for the job shall not exceed that of the prime Contractor’s
rate, as bid in the pricing section, unless the prime Contractor is willing to absorb
any higher rates. The subcontractor’s invoice shall be invoiced directly to the prime
Contractor, who in turn shall pass-through the costs to the County, without mark-
up. A copy of the subcontractor’s invoice must accompany the prime Contractor’s
invoice.
10.20
AMENDMENTS
All amendments to this contract shall be in writing and approved/signed by both parties.
Maricopa County Office of Procurement Services shall be responsible for approving all
amendments for Maricopa County.
10.21
ADDITIONS/DELETIONS OF REQUIREMENTS
The County reserves the right to add and/or delete materials and services to a contract. If
a service requirement is deleted, payment to the Contractor will be reduced proportionately,
to the amount of service reduced in accordance with the bid price. If additional materials
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or services are required from a contract, prices for such additions will be negotiated
between the Contractor and the County.
10.22
RIGHTS IN DATA
10.22.1 The County shall have the use of data and reports resulting from a contract without
additional cost or other restriction except as may be established by law or
applicable regulation. Each party shall supply to the other party, upon request, any
available information that is relevant to a contract and to the performance
thereunder.
10.22.2 Data, records, reports, and all other information generated for the County by a third
party as the result of a contract are the property of the County and shall be provided
in a format designated by the County or shall be and remain accessible to the
County into perpetuity.
10.23
ACCESS TO AND RETENTION OF RECORDS FOR THE PURPOSE OF AUDIT AND/OR
OTHER REVIEW
10.23.1 In accordance with Section MC1-372 of the Maricopa County Procurement Code,
the Contractor agrees to retain (physical or digital copies of) all books, records,
accounts, statements, reports, files, and other records and back-up documentation
relevant to this contract for six years after final payment or until after the resolution
of any audit questions, which could be more than six years, whichever is longest.
The County, Federal or State auditors and any other persons duly authorized by
the department shall have full access to and the right to examine, copy, and make
use of, any and all said materials.
10.23.2 If the Contractor’s books, records, accounts, statements, reports, files, and other
records and back-up documentation relevant to this contract are not sufficient to
support and document that requested services were provided, the Contractor shall
reimburse Maricopa County for the services not so adequately supported and
documented.
10.24
AUDIT DISALLOWANCES
If at any time it is determined by the County that a cost for which payment has been made
is a disallowed cost, the County shall notify the Contractor in writing of the disallowance.
The course of action to address the disallowance shall be at sole discretion of the County,
and may include either an adjustment to future invoices, request for credit, request for a
check, or a deduction from current invoices submitted by the Contractor equal to the
amount of the disallowance, or to require reimbursement forthwith of the disallowed amount
by the Contractor by issuing a check payable to Maricopa County.
10.25
STRICT COMPLIANCE
Acceptance by County of a performance that is not in strict compliance with the terms of
the contract shall not be deemed to be a waiver of strict compliance with respect to all other
terms of the contract.
10.26
VALIDITY
The invalidity, in whole or in part, of any provision of this contract shall not void or affect
the validity of any other provision of the contract.
10.27
SEVERABILITY
The removal, in whole or in part, of any provision of this contract shall not void or affect the
validity of any other provision of this contract.
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10.28
RELATIONSHIPS
10.28.1 In the performance of the services described herein, the Contractor shall act solely
as an independent Contractor, and nothing herein or implied herein shall at any
time be construed as to create the relationship of employer and employee, co-
employee, partnership, principal and agent, or joint venture between the County
and the Contractor.
10.28.2 The County reserves the right of final approval on proposed staff. Also, upon
request by the County, the Contractor will be required to remove any employees
working on County projects and substitute personnel based on the discretion of
the County within two business days, unless a different time period was previously
approved by the County.
10.29
NON-DISCRIMINATION
Contractor agrees to comply with all provisions and requirements of Arizona Executive
Order 2009-09, including flow down of all provisions and requirements to any
subcontractors. Executive Order 2009-09 supersedes Executive Order 99-4 and amends
Executive Order 75-5 and is hereby incorporated into this contract as if set forth in full
herein. During the performance of this contract, contractor shall not discriminate against
any employee, client, or any other individual in any way because of that person’s age, race,
creed, color, religion, sex, disability, or national origin. (Arizona Executive Order 2009-09
can be viewed at https://apps.azsos.gov/public_services/register/2009/46/governor.pdf)
10.30
WRITTEN CERTIFICATION PURSUANT to A.R.S. § 35-393.01
If vendor engages in for-profit activity and has 10 or more employees, and if this agreement
has a value of $100,000 or more, vendor certifies it is not currently engaged in, and agrees
for the duration of this agreement to not engage in, a boycott of goods or services from
Israel. This certification does not apply to a boycott prohibited by 50 U.S.C. § 4842 or a
regulation issued pursuant to 50 U.S.C. § 4842.
10.31
CERTIFICATION REGARDING DEBARMENT AND SUSPENSION
10.31.1 The undersigned (authorized official signing on behalf of the Contractor) certifies
to the best of his or her knowledge and belief that the Contractor, its current
officers, and directors:
10.31.1.1 are not presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from being awarded any
contract or grant by any United States department or agency or any
state, or local jurisdiction;
10.31.1.2 have not within a three-year period preceding this contract:
10.31.1.2.1 been convicted of fraud or any criminal offense in
connection with obtaining, attempting to obtain, or as the
result of performing a government entity (Federal, State or
local) transaction or contract; or
10.31.1.2.2 been convicted of violation of any Federal or State antitrust
statutes or conviction for embezzlement, theft, forgery,
bribery, falsification or destruction of records, making false
statements, or receiving stolen property regarding a
government entity transaction or contract;
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10.31.1.3 are not presently indicted or criminally charged by a government entity
(Federal, State or local) with commission of any criminal offenses in
connection with obtaining, attempting to obtain, or as the result of
performing a government entity public (Federal, State or local)
transaction or contract;
10.31.1.4 are not presently facing any civil charges from any governmental entity
regarding obtaining, attempting to obtain, or from performing any
governmental entity contract or other transaction; and
10.31.1.5 have not within a three-year period preceding this contract had any
public transaction (Federal, State or local) terminated for cause or
default.
10.31.2 If any of the above circumstances described in the paragraph are applicable to the
entity submitting a bid for this requirement, include with your bid an explanation of
the matter including any final resolution.
10.31.3 The Contractor shall include, without modification, this clause in all lower tier
covered transactions (i.e. transactions with subcontractors or sub-subcontractors)
and in all solicitations for lower tier covered transactions related to this contract. If
this clause is applicable to a subcontractor or sub-subcontractor, the Contractor
shall include the information required by this clause with their bid.
10.32
VERIFICATION REGARDING COMPLIANCE WITH A.R.S. § 41-4401 AND FEDERAL
IMMIGRATION LAWS AND REGULATIONS
10.32.1 By entering into the contract, the Contractor warrants compliance with the
Immigration and Nationality Act (INA using E-Verify) and all other Federal
immigration laws and regulations related to the immigration status of its employees
and A.R.S. § 23-214(A). The Contractor shall obtain statements from its
subcontractors certifying compliance and shall furnish the statements to the
procurement officer upon request. These warranties shall remain in effect through
the term of the contract. The Contractor and its subcontractors shall also maintain
Employment Eligibility Verification forms (I-9) as required by the Immigration Reform
and Control Act of 1986, as amended from time to time, for all employees performing
work under the contract and verify employee compliance using the E-Verify system
and shall keep a record of the verification for the duration of the employee’s
employment or at least three years, whichever is longer. I-9 forms are available for
download at www.uscis.gov.
10.32.2 The County retains the legal right to inspect documents of Contractor and
subcontractor employees performing work under this contract to verify compliance
with paragraph 10.32.1 of this section. Contractor and subcontractor shall be given
reasonable notice of the County’s intent to inspect and shall make the documents
available at the time and date specified. Should the County suspect or find that the
Contractor or any of its subcontractors are not in compliance, the County will
consider this a material breach of the contract and may pursue any and all remedies
allowed by law, including, but not limited to: suspension of work, termination of the
contract for default, and suspension and/or debarment of the Contractor. All costs
necessary to verify compliance are the responsibility of the Contractor.
10.33
CONTRACTOR LICENSE REQUIREMENT
10.33.1 The Contractor shall procure all permits, insurance, and licenses, and pay the
charges and fees necessary and incidental to the lawful conduct of his/her
business, and as necessary complete any requirements, by any and all
governmental or non-governmental entities as mandated to maintain compliance
with and remain in good standing. The Contractor shall keep fully informed of
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existing and future trade or industry requirements, and Federal, State, and local
laws, ordinances, and regulations which in any manner affect the fulfillment of a
contract and shall comply with the same. Contractor shall immediately notify both
the Office of Procurement Services and the department of any and all changes
concerning permits, insurance, or licenses.
10.34
INFLUENCE
10.34.1 As prescribed in MC1-1203 of the Maricopa County Procurement Code, any effort
to influence an employee or agent to breach the Maricopa County Ethical Code of
Conduct or any ethical conduct, may be grounds for disbarment or suspension
under MC1-902.
10.34.2 An attempt to influence includes, but is not limited to:
10.34.2.1 A person offering or providing a gratuity, gift, tip, present, donation,
money, entertainment or educational passes or tickets, or any type of
valuable contribution or subsidy that is offered or given with the intent to
influence a decision, obtain a contract, garner favorable treatment, or
gain favorable consideration of any kind.
10.34.3 If a person attempts to influence any employee or agent of Maricopa County, the
chief procurement officer, or his designee, reserves the right to seek any remedy
provided by the Maricopa County Procurement Code, any remedy in equity or in
the law, or any remedy provided by this contract.
10.35
CONFIDENTIAL INFORMATION
10.35.1 Any information obtained in the course of performing this contract may include
information that is proprietary or confidential to the County. This provision
establishes the Contractor’s obligation regarding such information.
10.35.2 The Contractor shall establish and maintain procedures and controls that are
adequate to assure that no information contained in its records and/or obtained
from the County or from others in carrying out its functions (services) under the
contract shall be used by or disclosed by it, its agents, officers, or employees,
except as required to efficiently perform duties under the contract. The Contractor’s
procedures and controls, at a minimum, must be the same procedures and controls
it uses to protect its own proprietary or confidential information. If, at any time
during the duration of the contract, the County determines that the procedures and
controls in place are not adequate, the Contractor shall institute any new and/or
additional measures requested by the County within 15 business days of the
written request to do so.
10.35.3 Any requests to the Contractor for County proprietary or confidential information
shall be referred to the County for review and approval, prior to any dissemination.
10.36
PUBLIC RECORDS
Under Arizona law, all offers submitted and opened are public records and must be
retained by the County at the Maricopa County Office of Procurement Services. Offers shall
be open to public inspection and copying after contract award and execution, except for
such offers or sections thereof determined to contain proprietary or confidential information
by the Office of Procurement Services. If an offeror believes that information in its offer or
any resulting contract should not be released in response to a public record request, under
Arizona law, the offeror shall indicate the specific information deemed confidential or
proprietary and submit a statement with its offer detailing the reasons that the information
should not be disclosed. Such reasons shall include the specific harm or prejudice which
may arise from disclosure. The records manager of the Office of Procurement Services
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shall determine whether the identified information is confidential pursuant to the Maricopa
County Procurement Code.
10.37
INTEGRATION
This contract represents the entire and integrated agreement between the parties and
supersedes
all
prior
negotiations,
proposals,
communications,
understandings,
representations, or agreements, whether oral or written, expressed, or implied.
10.38
UNIFORM ADMINISTRATIVE REQUIREMENTS
By entering into this contract, the Contractor agrees to comply with all applicable provisions
of
Title
2,
Subtitle
A,
Chapter
II,
Part
200—UNIFORM
ADMINISTRATIVE
REQUIREMENTS, COST PRINCIPLES, AND AUDIT REQUIREMENTS FOR FEDERAL
AWARDS contained in Title 2 C.F.R. § 200 et seq.
10.39
GOVERNING LAW
This contract shall be governed by the laws of the State of Arizona. Venue for any actions
or lawsuits involving this contract will be in Maricopa County Superior Court, Phoenix,
Arizona.
10.40
FORCED LABOR
10.40.1 By submitting a bid for this solicitation and/or entering into a contract as a result of
this solicitation, contractor agrees to comply with all applicable portions of Arizona
Revised Statutes Section 35-394. Contracting; procurement; prohibition; written
certification; remedy; termination; exception; definitions.
10.40.2 Contractor certifies that it does not currently, and agrees for the duration of the
contract, that it will not use:
10.40.2.1 The forced labor of ethnic Uyghurs in the People’s Republic of China.
10.40.2.2 Any goods or services produced by the forced labor of ethnic Uyghurs
in the People’s Republic of China.
10.40.2.3 Any contractors, subcontractors or suppliers that use the forced labor or
any good or services produced by the forced labor of ethnic Uyghurs in
the People’s Republic of China.
10.40.3 If contractor becomes aware during the term of the agreement that contractor is
not in compliance with this paragraph, the contractor shall notify the County within
five business days after becoming aware of the noncompliance. If the contractor
fails to provide a written certification to the County that the contractor has remedied
the noncompliance within 180 days after notifying the County of its noncompliance,
then the agreement terminates, except that if the agreement termination date
occurs before the end the 180 day period, the agreement terminates on the
agreement termination date.
10.41
PRICES
Contractor warrants that prices extended to County under this contract are no higher than
those paid by any other customer for these or similar services.
10.42
ORDER OF PRECEDENCE
In the event of a conflict in the provisions of this contract and Contractor’s license
agreement, if applicable, the terms of this contract shall prevail.
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10.43
UNIQUE ENTITY IDENTIFIER (UEI) AND SYSTEM FOR AWARD MANAGEMENT
REGISTRATION
All
contractors
that
receive
funding
must
have
a
UEI
number
through
https://sam.gov/content/entity-registration. Contractor must also remain current with the
System for Award Management www.sam.gov throughout the term of the contract.
10.44
RELIGIOUS ACTIVITIES
The contractor agrees that costs, planned or claimed, including costs incurred, shall not
include any expense for any religious activity.
10.45
POLITICAL ACTIVITY PROHIBITED
None of the funds, materials, property, or services contributed by the County or the
contractor under the agreement shall be used in the performance of this agreement for any
partisan political activity, or to further the election or defeat of any candidate for public
office.
10.46
EQUAL EMPLOYMENT OPPORTUNITY
10.46.1 The contractor shall not discriminate against any employee or applicant for
employment because of race, age, disability, color, religion, sex, or national origin.
The contractor shall take affirmative action to ensure applicants are employed and
that employees are treated during employment without regard to their race, age,
disability, color, religion, sex, or national origin. Such action shall include but is not
limited to the following: employment, upgrading, demotion or transfer, recruitment,
or recruitment advertising, lay-off or termination, rates of pay or other forms of
compensation, and selection for training, including apprenticeship.
10.46.2 Contractor shall comply with the following provisions:
10.46.2.1 Title VI and VII of the Civil Rights Act of 1964, as amended (42 U.S.C.
§§ 2000a, et seq.);
10.46.2.2 The Rehabilitation Act of 1973, as amended (29 U.S.C. §§ 701, et
seq.);
10.46.2.3 The Age Discrimination in Employment Act of 1967, as amended (29
U.S.C. §§ 621, et seq.);
10.46.2.4 The Americans With Disabilities Act of 1990 (42 U.S.C. §§ 12101, et
seq.); and Arizona Executive Order 2009-09, as amended, et seq.
which mandates that all persons shall have equal access to
employment opportunities.
10.46.2.5 Contractor understands that the United States has the right to seek
judicial enforcement of this assurance.
10.47
CERTIFICATION REGARDING LOBBYING
10.47.1 Contractor certifies, to the best of their knowledge and belief, that:
10.47.1.1 No federal appropriated funds have been paid or will be paid, by or on
behalf of the contractor, to any person for influencing or attempting to
influence an officer or employee of any agency. This applies to a
Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with the awarding of
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any federal contract, the making of any federal grant. Including the
making of any federal, loan the entering into of any cooperative
agreement, and the extension, continuation, renewal, amendment, or
modification of any federal contract, grant, loan, or cooperative
agreement.
10.47.2 If any funds other than federal appropriated funds, have been paid or will be paid
to any person for influencing or attempting to influence an officer or employee of
any agency, member of Congress, an officer or employee of Congress, or an
employee of a member of Congress in connection with this federal contract, grant,
loan, or cooperative agreement, the undersigned shall complete and submit
Standard Form-LLL, “Disclosure Form to Report Lobbying,” in accordance with its
instructions.
10.47.3 Contractor shall include Lobbying Certification language in the award documents
for all subcontractors (including sub-grants, and contract under grants, loans, and
cooperative agreements) and that all sub-recipients shall certify and disclose
accordingly.
10.47.3.1 The Lobbying Certification is a material representation of fact upon
which reliance was placed when this transaction is made or entered
into. Submission of this certification is prerequisite for making or
entering into this transaction imposed by section 1352, Title 31, U.S.
Code. Any successful proposer(s) who fail to file the required
certification shall be subject to a civil penalty of not less than
$10,000.00 and not more than $100,000.00 for each such failure.
10.48
CLEAN AIR ACT & CLEAN WATER ACT
Contractor must comply with all applicable standards, orders, or requirements issued under
section 306 of the Clean Air Act (42 U.S.C. 7606), section 508 of the Clean Water Act (33
U.S.C. 1368) Executive Order 11738, and Environmental Protection Agency regulations.
10.49
ENERGY POLICY AND CONSERVATION ACT
Contractor must adhere to the standards and policies relating to energy efficiency, which
are contained in the State energy conservation plan issued in compliance with the Energy
Policy and Conservation Act (Pub. L. 94-163, 89 Stat.871).
10.50
CONTRACT DISPUTES
All Contract disputes will be handled in accordance with the Maricopa County Procurement
Code, MCI-906
10.51
INCORPORATION OF DOCUMENTS
10.51.1 The following are to be attached to and made part of this Contract:
10.51.2 Exhibit A – Vendor Information and Pricing
10.51.3 Exhibit B – Scope of Work
10.51.4 Exhibit B-1 – Respondent Narrative
10.51.5 Exhibit C - Defendant Eligibility Requirements and Reimbursement Guidelines
10.52
NOTICES
All notices given pursuant to the terms of this contract shall be addressed to:
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For County:
Maricopa County
Office of Procurement Services
301 W. Jefferson St. Suite 700
Phoenix, Arizona 85003-1647
For Contractor:
SAGE Counseling, Inc.
Stephen Grams
1830 S. Alma School Rd. Suite 104
Mesa, AZ 85210
10.53
INQUIRIES
10.53.1 Inquiries concerning information herein must be submitted prior to the question
deadline date/time posted in the e-procurement platform, Periscope S2G, using
the link in the “Q&A” tab.
10.53.2 Administrative telephone/email inquiries shall be addressed to:
ANDREA STUPKA, PROCUREMENT OFFICER
TELEPHONE: (602) 506-3504
Andrea.stupka@maricopa.gov
10.53.3 Inquiries may be submitted by telephone but must be followed up in writing. No
oral communication is binding on Maricopa County.
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IN WITNESS WHEREOF, this contract is executed on the date set forth above.
CONTRACTOR
AUTHORIZED SIGNATURE
PRINTED NAME AND TITLE
ADDRESS
DATE
MARICOPA COUNTY
CHAIRMAN, BOARD OF SUPERVISORS
DATE
ATTESTED:
CLERK OF THE BOARD
DATE
APPROVED AS TO FORM:
DEPUTY COUNTY ATTORNEY
DATE
Michael Peugnet
1830 S. Alma School Rd., Suite 104, Mesa, AZ 85210
06/06/2024
Chief Operations Officer, SAGE Counseling
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EXHIBIT A
VENDOR INFORMATION AND PRICING
COMPANY NAME:
SAGE Counseling Inc.
DOING BUSINESS AS (dba):
MAILING ADDRESS:
1830 S Alma School Rd. Suite 104 Mesa AZ 85210
REMIT TO ADDRESS:
TELEPHONE NUMBER:
(480) 649-3352
FAX NUMBER:
(480) 649-3358
WWW ADDRESS:
https://sagecounseling.net/
REPRESENTATIVE NAME:
Stephen Grams
REPRESENTATIVE TELEPHONE NUMBER:
(602) 743-7243
REPRESENTATIVE EMAIL ADDRESS
info@sagecounseling.net
YES
NO
REBATE
WILL ALLOW OTHER GOVERNMENTAL ENTITIES TO
PURCHASE FROM THIS CONTRACT:
X
WILL ACCEPT PROCUREMENT CARD FOR PAYMENT:
X
PAYMENT TERMS:
NET 30 DAYS
Felony
Diversion
Program
Opioid Use -
Felony
Diversion
Program Pilot
Domestic
Violence
Diversion
Program
Assessment/Intake: this shall include
ORAS plus any additional screening
required for each program as defined
in the scope of work.
$180/ea
$180/ea
$180/ea
Behavioral Health Counseling - Group
$5.50/15 min
$5.50/15 min
$5.50/15 min
Behavioral Health Counseling 1:1
$80/hr
$80/hr
$80/hr
Case Coordination (Out of State/TPA)
$90/month
$90/month
$90/month
Case Management
$18/15 min
$18/15 min
$18/15 min
Other Fees:
Assessment Update
$55/ea
$55/ea
$55/ea
Intensive Outpatient Counseling (IOP)
$55/3 hours
$55/3 hours
$55/3 hours
Behavioral Health Counseling/Family
Therapy
$115/
$115/hr
$115/
Behavioral Health Counseling/Family Therapy: In Home
$130/hr
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Justice Court Diversion:
Option B
Intake for Justice Court if No ORAS
$75
Behavioral Health Counseling - Group
$5.50/15 min
Behavioral Health Counseling 1:1
$80/hr
Case Coordination (Out of State/TPA)
$90/month
Other Fees:
Education
$165/8 hour class
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EXHIBIT B
Scope of Work
1.0
INTENT
1.1
Maricopa County seeks responses from qualified respondents who can provide education
and programming for felony diversion and other educational programs to specific offenders
as an alternative to prosecution.
1.2
The purpose of all Maricopa County Attorney’s Office Diversion Programs is to offer an
alternative to traditional criminal case processing so specific individuals accused of
committing a crime may participate in an education or a treatment program that addresses
the risk factors related to recidivism. Reducing rates of recidivism while preserving limited
prosecutorial resources is a goal for all diversion programs and is ultimately beneficial to
the citizens of Maricopa County.
1.3
The Maricopa County Attorney has authorized the following diversion programs:
1.3.1
Felony Diversion Program (FDP) - The Felony Diversion Program is an education
and treatment program for offenders charged with crimes involving specific felony
offenses, including possessing controlled substances and meeting other eligibility
criteria. MCAO made 2918 referrals for this program in 2023.
1.3.2
Opioid Use – Felony Diversion Program Pilot – MCAO has partnered with
Maricopa County Public Health to offer this program for eligible offenders who, as
the parent/guardian, are charged with child abuse, neglect, endangerment, or
related offense and the circumstances of the offense are related to substance use,
particularly opioids. MCAO made 12 referrals for this program in 6 months in 2023.
1.3.3
Domestic Violence Diversion Program (DVDP) – Eligible offenders charged with
domestic violence, specific types of felony and misdemeanor offenses will be
diverted into a treatment program in lieu of prosecution. Treatment options include
curricula that explore motivational engagement in the intervention process and
build readiness to change, the context and use of violence, challenging attitudes,
and beliefs, cognitive restructuring, managing relationships, developing a safety
plan, and healthy boundaries. MCAO made 16 referrals for this program in 2023.
1.3.4
Justice Court Diversion - An education program for eligible offenders charged with
specific misdemeanor offenses and citations to avoid a conviction. This program
was recently enhanced by offering evidence-based curricula and implementing a
screening tool to identify better and address individual needs.
1.4
The County reserves the right to add or remove programs as it determines necessary.
Current contractors shall be expected to complete required treatment programs with
participants who are enrolled at the time of contract award, and upon contract termination,
contractors shall be expected to assist in the orderly transition of duties and/or records.
1.5
Other governmental entities under agreement with Maricopa County (County) may have
access to services provided hereunder (see also Sections 7.0 and 8.0 above).
1.6
The County reserves the right to add additional contractors, at the County’s sole discretion,
in cases where the currently listed contractors are of an insufficient number or skill-set to
satisfy the County’s needs or to ensure adequate competition on any project or task order
work.
1.7
Maricopa County reserves the right to award this contract to multiple vendors. The County
reserves the right to award in whole or in part, by item or group of items, by section or
geographic area, or make multiple awards, where such action serves the County’s best
interest.
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2.0
SCOPE OF WORK
2.1
GENERAL REQUIREMENTS
2.1.1
Contractors shall be responsible for providing quality evidenced based curricula
for treatment tracks and education programs in a community-based setting at
multiple locations throughout Maricopa County. All programs shall be approved by
MCAO prior to implementation.
2.1.2
Service delivery shall be culturally relevant and linguistically appropriate to the
population
served.
The
contractor
shall
be
responsible
to
provide
interpreter/language line services if other alternatives cannot be arranged.
2.1.3
The contractor shall comply with all professional and ethical obligations and code
of conduct of licensure and maintain good standing with the Arizona Bureau of
Medical Facilities Licensing (BMFL). Further, the contractor shall protect
information and records protected by federal confidentiality rules (e.g., 42 CFR
Part 2 and HIPAA Rules at 45 CFR Parts 160, 162, and 164) and state
confidentiality rules (e.g., A.R.S. §§ 12-2291 et seq.), and ensure that contractor
and its employees and subcontractors comply with said rules and employ all
administrative and physical safeguards as may be required by law to protect
confidential information.
2.1.4
The contractor shall hold and maintain during the performance of this contract, a
current, applicable Arizona Department of Health Services license that is in good
standing, for each facility from which services shall be provided. Contractor shall
ensure that all buildings and grounds, equipment and furnishings are maintained
in a manner that provides a safe, sanitary, and comfortable environment for youth,
visitors, and employees.
2.1.5
The contractor shall have the ability to send and receive encrypted information
electronically and have appropriate safeguards in place to protect any criminal
history information as well as personally identifiable information. Contractor shall
have ability to conduct telehealth visits by the time services are set to be delivered.
2.1.6
Unless otherwise indicated or required by law, staff providing services shall have
a master’s degree in a human services-related field and licensed to practice
independently by the Arizona Board of Behavioral Health Examiners or is exempt
from licensure pursuant to A.R.S. Title 32, Chapter 33 to deliver services.
However, services may also be delivered by Behavioral Health Technicians under
the supervision of a master’s level clinician. All staff delivering direct care services
shall possess sufficient education and aptitude to deliver services.
2.1.7
The contractor shall be responsible for ensuring the execution of any business
associate
agreements,
qualified
service
organization
agreements,
and
nondisclosure/confidentiality agreements that may be required under federal and
state confidentiality rules. Contractor shall use trained, appropriately licensed staff
and shall have sufficient capacity to accommodate program requirements in
accordance with industry standards.
2.1.8
Contractor may be required to attend, at contractor’s expense, workshops or
training sponsored by MCAO, or provide training to MCAO staff as requested by
the Director of the MCAO Diversion Strategies Group, the County Attorney or her
duly authorized employees, agents, or assigns.
2.1.9
Unless otherwise indicated, contractors shall administer the Ohio Risk
Assessment System – Community Supervision Tool (ORAS-CST) for offender
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assessment and rehabilitation in order to assess the offender’s overall risk to
reoffend, risk level score, and identify targeted criminogenic needs and domains.
2.1.9.1
ORAS-CST shall be administered within 30 days of referral by end users
certified in the ORAS-CST.
2.1.9.2
Contractor shall review existing social history and referral packet
including consent forms for all referrals prior to administering the ORAS-
CST.
2.1.9.3
Contractor shall administer assessment as intended with fidelity and
accuracy in an unbiased manner that yields appropriate results and
treatment recommendations.
2.1.9.4
All documentation supporting the fidelity of ORAS-CST scoring, notes,
client self-report, scoring and interview guide shall be retained in the
offender’s file (digital storage is acceptable).
2.1.9.5
Upon the ORAS’ determination of the offender’s overall risk to reoffend
and targeted criminogenic needs and domains, contractor shall assign
the offender to the appropriate “track” of treatment.
2.1.9.6
Contractor will develop a dynamic Individual Service Plan and goals
relative to the targeted criminogenic needs and domains, so the service
is beneficial and appropriate for the offender’s learning style, motivation,
abilities, and strengths.
2.1.9.7
Upon termination, the contractor shall complete and provide to MCAO:
using the MCAO Diversion Strategies Group Discharge Report template
with identified ORAS Risk Level, ORAS Risk Score, top three (3)
identified criminogenic needs and domains, treatment goals, offender
participation and engagement, case management goals and outreach,
financial obligation compliance, reasons for successful or unsuccessful
completion, and documented attempts by the contractor to engage the
offender. If drug testing is a requirement for the offender, provider testing
results, any aggravating or mitigating factors, and how the results were
integrated into the recommendation for successful or unsuccessful
discharge.
2.1.10 The contractor may use additional assessment tools in conjunction with the ORAS
pertinent to the offender’s specific needs.
2.1.11 The contractor shall be an AHCCCS provider, in good standing, and not subject to
any suspensions. The contractor shall maintain contracts with all AHCCCS
Complete Care Plans serving the Central Region Geographical Service Area.
2.1.12 All contractor materials, including but not limited to pamphlets, brochures, forms,
flyers shall conform with Maricopa County branding standards, and shall be
approved by MCAO before use. The contractor shall not include any
representation of the County Attorney, MCAO or the MCAO Felony or other
diversion programs.
2.1.13 Contractor shall develop a case file for all participants to include the consent
agreement, individual service plan, case notes, results of initial assessment. All
contacts shall be documented and included in the file notes. Case notes shall
demonstrate compliance or non-compliance with program requirements, and shall
include any referrals for additional or wrap around services, including employment
services, housing placement and assistance, etc.
SERIAL# 240104-RFP
2.1.14 All contacts between the contractor, offenders, and MCAO employees, agents and
assigns shall be conducted with professionalism, fairness, respect, and dignity to
the offender. The offender shall not be discriminated against based on race,
national origin, religion, gender, sexual orientation, gender identification, age,
disability, marital status, diagnosis, or source of payment.
2.1.15 Contractors shall ensure participating offenders exhibit progress on treatment
goals as outlined in the Individual Service Plan, and that discharge includes
strategies and resources for maintaining support and resilience in the community.
2.1.16 Contractors shall provide a standardized offender financial assessment process
that includes an application, instructions and a consistent sliding scale fee
structure based upon current Federal Poverty Guidelines (FPLs). The contractor
shall provide a copy of these documents to the County Attorney via the MCAO
Diversion Strategies Group. The documents shall be approved by the County
Attorney.
2.1.16.1 Contractor shall establish timeframes for completing the assessment
and shall notify participants of any financial obligations prior to rendering
services.
2.1.16.2 If the contractor allows an offender to complete all the diversion
requirements with an outstanding balance (only related to service non-
payment for contractor’s services), the offender will be discharged
successfully and that outstanding balance will need to be pursued with
the offender independently.
2.1.16.3 Any outstanding balance owed to the contractor, whether for successful
or unsuccessful discharge, shall be clearly identified in the Discharge
Report.
2.1.16.4 If the offender is permitted to reenter diversion at a later date, any
outstanding balance owed from previous contractor services must be
paid to the contractor within 30 calendar days from the time of referral.
No additional services can be scheduled by the contractor until this
balance is paid. If the offender pays their outstanding balance within the
30-calendar day timeframe, at that point, the contractor is permitted to
schedule the assessment and the offender will have the standard
timeframe from this date to participate in the enrollment processes.
2.1.16.5 If the offender is referred to reenter diversion with a prior outstanding
balance owed to the contractor and fails to pay the balance within 30
calendar days of referral, the contractor will complete the Non-
Enrollment Discharge Report as normal, with added information about
the outreach efforts regarding outstanding balance.
2.1.16.6 The contractor shall establish a policy which outlines a standardized
financial assessment process. The contractor shall provide a copy of this
policy to the County Attorney via the MCAO Diversion Strategies Group.
The policy shall be approved by the County Attorney.
2.1.17 For those offenders owing restitution, the offender shall make restitution payments
via the MCAO Diversion Payment Portal or mail payments directly to MCAO using
the approved payment methods. The contractor shall periodically check the MCAO
Diversion Payment Portal and remind the offender of the restitution obligation.
2.1.17.1 The contractor shall confirm that payments are made according to
program requirements, through the MCAO Diversion Payment Portal
SERIAL# 240104-RFP
and take appropriate action if not made. This may include multiple
reminders, discussions about barriers to payment with offender, etc.
2.1.17.2 Contractor shall work with offender to set payment amount and
frequency so that all restitution is fulfilled before being successfully
discharged from the program. The balance can be made in payments as
determined by the contractor.
2.1.17.3 Per the Consent Agreement, the offender’s failure to pay restitution as
owed by the determined due date may result in an unsuccessful
termination from the program. Treatment shall not be extended solely
because of unpaid restitution unless otherwise authorized by the
Director of Diversion Strategies Group.
2.1.17.4 The contractor shall ascertain if co-defendants agreed to pay as joint
and several liability requirements and verify restitution payments via the
MCAO Diversion Payment Portal prior to discharging the offender from
the Diversion Program.
2.1.17.5 Full restitution shall be paid before any successful discharge.
2.1.17.6 The total amount of restitution paid shall be documented on the MCAO
Discharge Report, whether successful or unsuccessful discharge.
2.1.18 For offenders who do not live near the contractor’s site for services (outside the
State of Arizona or outside of Maricopa County Arizona) when telehealth services
are not available:
2.1.18.1 It shall be the responsibility of the offender to locate a Third-Party
Administrator (TPA) in their jurisdiction that can provide comparable
services with consideration for the practicality and locality of the
jurisdiction to the specific diversion program requirements as
determined by the contractor.
2.1.18.2 The contractor shall be authorized to provide monthly case coordination
services and charge a monthly case coordination fee to the offender as
described in Exhibit A – Vendor Information and Pricing Page.
2.1.18.3 Provided the contractor and the TPA enter into the contractor’s Provider
Application and Agreement without any amendments or modifications
thereto, the TPA shall be considered to be approved by the County
Attorney. An executed copy of the contractor Provider Application and
Agreement shall be maintained in the offender’s file.
2.1.18.4 The contractor shall provide specific information about the TPA’s
services, the offender’s level of compliance, and how this supports a
successful or unsuccessful termination in the MCAO Discharge Report
template.
2.1.19 Contractor shall maintain detailed and accurate documentation of participation and
completion of the program. All absences (excused and unexcused) shall be
recorded. Regardless of the reason for the absences, in order to earn a successful
discharge, the offender must complete all required sessions.
2.1.20 A discharge report, using the MCAO approved Discharge Report template shall be
used to document the offender’s level of participation with the diversion program
requirements. Recommendations for successful or unsuccessful discharge shall
be supported in detail in the applicable sections in the Discharge Report.
SERIAL# 240104-RFP
2.1.21 The official Date of Discharge is defined as when the contractor has completed all
offender’s services. The Date of Discharge, author’s name, and the date when the
report was authored must be contained in the Discharge Report. Within the body
of the Discharge Report in the applicable section(s), the contractor will report when
the
offender
last
attended
service(s)
and
the
contractor’s
last
communication/outreach with the offender.
2.1.22 The Discharge Report must be submitted to MCAO within seven calendar days
from the Date of Discharge.
2.1.23 Provide requested diversion programs’ monthly metrics from the preceding month
to MCAO, by the 5th business day of the month.
2.1.24 Should public monies become available to the MCAO for diversion programs,
these funds may at the discretion of the County Attorney, be used in whole or part
to offset discounts provided by the contractor to the offender for program service
fees. As such, MCAO may impose offender eligibility requirements and an MCAO
Sliding Scale that shall be used to determine offender discounts and copays.
2.1.24.1 The use of public monies is subject to applicable legal requirements,
applicable approval processes or requirements, fiscal agent conditions
and requirements, expiration date, and available balance. The use of
public funds shall also require the contractor to maintain and provide
monthly metrics to MCAO regarding the offenders’ discounts. Contractor
reimbursement is contingent on the availability of funds and not
guaranteed. See Exhibit C - Defendant Eligibility Requirements and
Reimbursement Guidelines.
2.2
PROGRAM REQUIREMENTS
2.2.1
Felony Diversion Program (FDP) - The Felony Diversion Program is an
education and treatment program for offenders charged with crimes involving
specific felony offenses, including possessing controlled substances and meeting
other eligibility criteria.
2.2.1.1
Only certain offenders who are charged with specific felony offenses
may be eligible for and offered diversion. If diversion is accepted by the
offender, prosecution is suspended for two years so the offender can
participate in prescribed treatment.
2.2.1.2
After administering a validated risk to reoffend assessment for adults,
contractor shall provide treatment services to referred offenders using
an approved evidence-based curriculum/curricula.
2.2.1.3
The Felony Diversion Program shall have multiple treatment tracks,
gender based, where dose and duration of treatment services (treatment
tracks) shall be determined based on risk level and identified
criminogenic needs. Offenders who earn a Successful Discharge shall
have
their
pending
charges
dismissed.
Offenders
who
are
Unsuccessfully terminated will return to Court and prosecution will be
resumed.
2.2.1.4
Individual (1:1) counseling sessions may substitute for required group
counseling sessions in exigent situations and when it is in the best
interest of the offender. Examples of exigent situations include, but not
limited to: a risk to the group having the offender present (escalating
behaviors, threat to others and/or Contractor staff), the contractor has
determined that the offender has a clinical need for individual services
initially to successfully transition to group, and not enough participants
SERIAL# 240104-RFP
to form a group (foreign language spoken or offender risk level) and it is
in the offender’s best interest to not delay services. The contractor must
inform the offender of the additional cost of individual counseling
services.
2.2.1.5
Case Management services may be offered as a service to the offender
when deemed to be clinically necessary and of benefit to the overall
success of the offender. The cost of case management shall be
disclosed and agreed to by the offender prior to start of services. MCAO
has set the maximum amount to four (4) hours provided if MCAO is
paying for the service; however, the contractor may seek approval from
MCAO to exceed the maximum capacity with appropriate clinical
justification.
2.2.1.6
Contractor shall work with county contractor to provide for random and
variable offender urinalysis testing as determined by the clinician and
service plan, if approved by the County Attorney or the Director of the
MCAO Diversion Strategies Group. Any approved testing will be limited
by the Track maximum ranges. Approved urinalysis testing may be
directly provided by the contractor. Or, if the contractor cannot provide
approved urinalysis testing onsite, the contractor shall refer offenders to
a laboratory under contract with MCAO or County. It is the responsibility
of the contractor to monitor, manage, and track drug testing frequency,
integrate the results (or lack thereof) into the treatment plan, and ensure
that testing maximums are adhered to. The Contractor shall respond and
address each non-negative drug test result with the offender within three
business days to effect timely change. Other drug testing that the
offender may do outside of this diversion program will not be substituted
for diversion requirements.
2.2.1.7
For those offenders owing restitution, the contractor shall ensure that
payments are made according to program requirements and take
appropriate action if not made. FDP requires that 50% of the total
restitution be paid within the first 30 days of treatment. The balance can
be made in payments as determined by the contractor. No offender can
be successfully discharged from the program until restitution is paid in
full.
2.2.1.8
Contractor shall provide one to two designated staff to be assigned to
specified Court locations in Maricopa County to provide information and
education to offenders and attorneys about the MCAO Felony Diversion
Program. Information shall include: a brief orientation, completion of
required forms, scheduling a future intake appointment and
assessment(s), verifying insurance status, and general components of
the Program. MCAO will provide workspace for these activities to occur.
2.2.1.9
The Contractor may co-mingle MCAO FDP offenders with non-MCAO
referrals in treatment so long as there is not a mix of low risk level
offenders with moderate or high-risk offenders. It is the responsibility of
the contractor to have any non-MCAO referrals’ risk levels documented.
If not able/willing to assess non-MCAO referrals, MCAO diversion
participants should receive services only with MCAO diversion
participants by risk level and should state in proposal.
2.2.1.10 For those offenders who successfully complete the MCAO diversion, the
County Attorney will dismiss the charges with prejudice. If an offender
fails to successfully complete MCAO diversion, MCAO shall review the
reasons for the offender’s unsuccessful termination and decide what
action should be taken depending on the circumstances presented. If it
SERIAL# 240104-RFP
appears that the termination is solely due to an offender’s non-payment
of program costs and fees (not including restitution), MCAO shall consult
with the contractor to review the offender’s financial assessment
application, financial responsibility determination, and any other
available information regarding the offender’s financial circumstances.
MCAO shall determine whether to reinstate prosecution or undertake
alternatives.
2.2.2
Opioid Use – Felony Diversion Program Pilot – MCAO has partnered with
Maricopa County Public Health to offer this program for eligible offenders who, as
the parent/guardian, are charged with child abuse, neglect, endangerment, or
related offense and the circumstances of the offense are related to substance use,
particularly opioids.
2.2.2.1
The Pilot is intended to offer a diversion alternative and meet the unique
needs of offender cases originating out of the MCAO Family Violence
Bureau, referred to the existing Felony Diversion Program with a
diagnosis of Opioid Use Disorder (OUD), Alcohol Use Disorder (AUD),
or Substance Use Disorder (SUD) and filed criminal charges of Child
Abuse, Endangerment, Neglect, or Assault, where there was no fracture
or permanent injury to the child. The focus of the Pilot is to provide
therapeutic interventions to address the offender’s addiction, to hold the
offender accountable for their criminal actions, and improve child safety
in the home.
2.2.2.2
Contractor shall review existing social history and referral packet
information. After the Ohio Risk Assessment System – Community
Supervision Tool (ORAS-CST) has been completed which determines
the offender’s overall risk to reoffend and identified criminogenic need
areas, contractor shall administer an MCAO approved substance abuse
needs assessment to provide specific diagnosis and treatment areas. If
the substance abuse assessment requires staff training or certification,
licensing/registration fees, or other costs, this shall be the responsibility
of the contractor. For fidelity, the substance abuse assessment may
require that the contractor update or reassess the offender during
appropriate clinical intervals, or pre/post testing.
2.2.2.3
Contractor shall provide an evidence-based substance abuse specific
group counseling curriculum/curricula by treatment track for Standard
Outpatient and Intensive Outpatient offenders.
2.2.2.4
Contractor shall develop a dynamic Individual Service Plan (ISP) and
goals relative to the targeted criminogenic needs and domains, so the
service is beneficial and appropriate for the offender’s learning style,
motivation, abilities, and strengths. A copy of the ISP must be sent to
MCAO at the time of discharge.
2.2.2.5
Family Counseling and Parent Education: Offenders shall participate in
family counseling and/or parent education. The offender’s minor
child/ren (if appropriate) shall be encouraged to participate in family
counseling. The contractor shall have the ability to provide these
services in-person (either in the offender’s home or in-office), virtually,
or a combination of both. However, MCAO’s preference will be for in-
home services. The clinician shall determine a beneficial service
location. A component of family counseling and parent education is for
the clinician to observe and document the family environment for child
safety.
SERIAL# 240104-RFP
2.2.2.6
For offenders who are not insured by AHCCCS and for cost
considerations for the offender, family counseling and parent education
shall be capped at 12 total sessions for one or both services. Any family
counseling and parent education sessions beyond 12 hours shall be
approved by the MCAO Diversion Strategies Group Director or designee
prior to implementation. There is no limit to the number of family
counseling and/or parent education sessions for offenders who are
AHCCCS-insured.
2.2.2.7
Individual (1:1) counseling sessions may substitute for required group
counseling sessions in exigent situations and when it is in the best
interest of the offender. Examples of exigent situations include, but not
limited to: a risk to the group having the offender present (escalating
behaviors, threat to others and/or Contractor staff). The contractor has
determined that the offender has a clinical need for individual services
initially to successfully transition to group, and not enough participants
to form a group (foreign language spoken or offender risk level) and it is
in the offender’s best interest to not delay services. The contractor must
inform the offender of the additional cost of individual counseling
services.
2.2.2.8
Services for the offender’s child/ren: If the child/ren are not currently
receiving wraparound services specific to their needs, the contractor
shall offer to the offender (the parent/guardian) a referral to LaFrontera-
EMPACT (“EMPACT”). Services at EMPACT shall be voluntary and
information regarding services, expectations, and potential costs shall
be disclosed to the offender. Provided that the parent/guardian has
signed a Release of Information, the contractor shall coordinate services
with EMPACT and/or another applicable third-party agency.
2.2.2.9
The contractor shall coordinate services with EMPACT each month and
track monthly metrics related to family support services and the number
of coordinated case management meetings.
2.2.2.10 If a Release of Information is signed by the offender, the contractor shall
request and obtain the offender’s child/ren case records from the
Department of Child Safety (DCS) to review past and current services.
This information shall be used to determine appropriate services for the
family while in the Pilot.
2.2.2.11 Medication-Assisted Treatment (MAT) Services: if after a MAT
assessment and a recommendation is made for MAT, it is the offender’s
choice to participate. However, the contractor shall inform the offender
of the benefits of MAT and encourage participation, but the offender’s
decision to not participate cannot adversely affect their diversion status.
For those who participate, the contractor shall be required to coordinate
case services with the MAT provider.
2.2.2.12 If the offender agrees to participate in MAT, required services imposed
by the MAT provider, such as drug testing for medical reasons, will not
substitute for diversion program requirements.
2.2.2.13 Along with the program monthly metrics for the preceding month and
timeframes, the contractor shall track MAT services and provide to
MCAO: total number of offenders who were referred for a MAT
assessment. Of those assessed, through a signed Release of
Information, provide the total number of offenders who opted in for MAT
and the number of offenders who opted out of MAT.
SERIAL# 240104-RFP
2.2.2.14 For those offenders participating in MAT, prior to discharge (either
Successful or Unsuccessful) from the Pilot, the contractor shall provide
information to the offender about aftercare or other community
resources to reinforce the importance of continuing with these services.
2.2.2.15 Drug Testing requirements
2.2.2.15.1 The contractor shall refer the offender for random drug
testing at an MCAO approved, contracted laboratory. The
offender shall be tested for the MCAO selected drug panels,
within prescribed maximums (up to 40 drug tests) while in
the Pilot. The offender must submit to drug testing
concurrent to the treatment.
2.2.2.15.2 Urinalysis shall be the primary default method of drug
testing. However, the MCAO contracted laboratory may
offer an MCAO approved alternative method of testing, for
example saliva/oral fluid, if the offender cannot submit to
urinalysis due to exigent circumstances. The contractor
shall be required to document in the offender’s case file
what those exigent circumstances are for auditing
purposes.
2.2.2.15.3 The offender shall submit to random drug testing throughout
their participation in the Pilot, at an appropriate frequency
determined by the contractor’s clinical staff. Additionally, the
offender shall submit to weekly drug testing in their first
month/first 30 days. The offender must produce at least four
consecutive, negative test results towards the end of
treatment (approximately last 30 days) in order to earn a
Successful Discharge.
2.2.2.15.4 It is the responsibility of the contractor to monitor, manage,
and track drug testing frequency, integrate the results (or
lack thereof) into the treatment plan, and ensure that testing
maximums are adhered to. The contractor shall respond
and address each non-negative drug test result with the
offender within three business days of the provider’s
notification to effect timely change. Other drug testing that
the offender may do outside of this diversion program will
not be substituted for diversion requirements.
2.2.2.15.5 An offender’s report of prescribed medications shall be
verified by the contractor and documented in the case file.
Any positive result from a verified, prescribed medication
and other considerations shall be documented in the
offender’s electronic health record and the MCAO
Discharge Report at the time of termination.
2.2.2.15.6 If the offender tests positive for an illegal substance, the
contractor shall address the results with the offender within
three business days of the provider’s notification through
their Case Management services. Specifically for the Pilot
with child safety as a focus, the contractor shall also ask the
offender “Where were you using?” and “Where was/were
your child/children when you were using?” and document
the response and the appropriate course of action. If the
offender admits to using drugs in the presence of their child,
the contractor shall as a Mandatory Reporter per A.R.S.
SERIAL# 240104-RFP
§13-3620, notify law enforcement and/or the Arizona
Department of Child Safety (DCS) of the allegations of child
endangerment. Document notification in case notes.
2.2.2.15.7 Upon receipt of each positive test result for an illicit
substance from an offender in the Pilot, MCAO Diversion
staff shall send an email communication to the contractor’s
assigned point of contact to the offender’s case. The email
shall ask the contractor’s point of contact/case manager to
attest and provide the date that the positive test result for
illicit substances was addressed with the offender and if a
child endangerment report was made to DCS and/or law
enforcement. The contractor’s point of contact or case
manager shall provide a written response to MCAO
Diversion via email within 48 hours of receipt. The email
response from the contractor shall be uploaded into the
offender’s criminal record within the MCAO Case
Management System, Karpel. The contractor should not
rely on the emails from MCAO to prompt them to address
positive test results with the offender.
2.2.2.15.8 Mandated reporters are required by law, as defined by ARS
13-3620, to report all concerns of child abuse or neglect.
Department of Child Safety (DCS) provides this secure
website for mandated reporters of child abuse and neglect
to report non-emergency concerns, as authorized by ARS
13-3620. Should provider report an incident, the contractor
shall notify and submit an Incident Report to MCAO within
prescribed timeframes if law enforcement and/or DCS are
contacted
per
Mandatory
Reporting
Requirements.
Reporting this information to MCAO does not equate to an
automatic Unsuccessful Discharge from the Pilot. MCAO
shall decide if an unsuccessful discharge is warranted in
diversion based on review of the Incident Report and other
case factors and will then notify the contractor on next steps.
2.2.2.16 Inpatient Substance Abuse Services
The contractor shall have the ability to assess and determine if the
offender is in need of an inpatient substance abuse service for a period
of stabilization with a third-party provider before and/or during
participation in the Pilot. The contractor shall hold the diversion case
open for up to 90 days while the offender is receiving services with the
third-party provider and coordinate services. If it is anticipated that the
third-party provider services will exceed 90 days, the contractor shall
inform and staff the case with the Director of Diversion Strategies Group
or designee for next steps.
2.2.2.17 Case Management Services
Given the complexity of offender’s needs, family needs, and multi-
agency collaboration/coordination, the contractor shall initiate Case
Management Services for all offenders in the Pilot. Case Management
services shall be limited to up to 26 hours while in the Pilot, unless the
offender is verified to be an AHCCCS member. Any Case Management
service beyond 12 hours shall be approved by the MCAO Diversion
Strategies Group Director or designee prior to implementation.
SERIAL# 240104-RFP
2.2.2.18 Pregnant Offenders in the Pilot
2.2.2.18.1 Pregnant female offenders with substance use diagnoses
have unique needs and shall be carefully monitored while in
the Pilot. The contractor shall provide appropriate,
community-based referrals for this population and case
coordination while they are in the Pilot. The contractor, at a
minimum, shall provide information to pregnant offenders
about the Maricopa County SHIFT (Safe Healthy Infants
and Families Thrive) Program.
2.2.2.18.2 The contractor shall collect and report to MCAO each
month, the number of pregnant offenders referred to the
Maricopa County SHIFT Program.
2.2.2.19 Metrics and Reporting Outcome Requirements for the Pilot
The contractor shall be required to report on the Pilot monthly metrics
(total enrollment, new monthly enrollment, number of Successful and
Unsuccessful completions for previous month) similarly as required in
the SOW for the Felony Diversion Program. The contractor shall also
report outcomes and within timeframes as described in the Logic Model
for the Pilot.
2.2.2.20 Using Public Monies to Fund the Pilot
The contractor shall submit invoices for the Pilot to MCAO by the 8th
day of the month for applicable services from the preceding month. This
is to have adequate time for MCAO to review and then submit said
invoices to Maricopa County Procurement and then to Maricopa County
Department of Public Health (MCDPH) who will give final approval for
payment.
2.2.3
Domestic Violence Diversion Program (DVDP) – Eligible offenders charged with
domestic violence, specific types of felony and misdemeanor offenses will be
diverted into a treatment program in lieu of prosecution. Treatment options include
curricula that explore motivational engagement in the intervention process and
build readiness to change, the context and use of violence, challenging attitudes,
and beliefs, cognitive restructuring, managing relationships, developing a safety
plan, and healthy boundaries.
2.2.3.1
Only certain offenders who are charged with specific domestic violence
felony or misdemeanor offenses, or citations may be eligible for and
offered diversion. If diversion is accepted by the offender, prosecution is
suspended for two years so the offender can participate in the
prescribed program. It is anticipated that most referrals will be for
offenders with misdemeanors originating from the Justice Courts. The
offender must complete their diversion program within twelve months.
2.2.3.2
After administering a validated risk to reoffend assessment for adults,
contractor shall provide treatment services to referred offenders using
an approved evidence-based curriculum/curricula.
2.2.3.3
DVDP shall have multiple treatment tracks, gender based, where dose
and duration of treatment services (treatment tracks) shall be
determined on risk level and identified criminogenic needs.
2.2.3.4
Individual (1:1) counseling sessions may substitute for required group
counseling sessions in exigent situations and when it is in the best
SERIAL# 240104-RFP
interest of the offender. Examples of exigent situations include, but not
limited to: a risk to the group having the offender present (escalating
behaviors, threat to others and/or Contractor staff), the contractor has
determined that the offender has a clinical need for individual services
initially to successfully transition to group, and not enough participants
to form a group (foreign language spoken or offender risk level) and it is
in the offender’s best interest to not delay services. The contractor must
inform the offender of the additional cost of individual counseling
services.
2.2.3.5
Case Management services may be offered as a service to the offender
when deemed to be clinically necessary and of benefit to the overall
success of the offender. The cost of case management shall be
disclosed and agreed to by the offender prior to start of services. MCAO
has set the maximum to four (4) hours provided if MCAO is paying for
the service; however, the Contractor may seek approval from MCAO to
exceed the maximum capacity with appropriate clinical justification.
2.2.3.6
For those offenders owing restitution, the contractor shall ensure that
payments are made according to program requirements and take
appropriate action if not made. DVDP requires that 50% of the total
restitution be paid within the first 30 days of treatment. The balance can
be made in payments as determined by the contractor. No offender can
be successfully discharged from the program until restitution is paid in
full.
2.2.3.7
The Contractor may co-mingle MCAO DVDP offenders with non-MCAO
referrals in treatment so long as there is not a mix of risk levels. It is the
responsibility of the contractor to have any non-MCAO referrals’ risk
levels documented.
2.2.3.8
For those offenders who successfully complete the MCAO diversion, the
County Attorney will dismiss the charges with prejudice. If an offender
fails to successfully complete MCAO diversion, MCAO shall review the
reasons for the offender’s unsuccessful termination and decide what
action should be taken depending on the circumstances presented. If it
appears that the termination is solely due to an offender’s non-payment
of program costs and fees (not including restitution), MCAO shall consult
with the contractor to review the offender’s financial assessment
application, financial responsibility determination, and any other
available information regarding the offender’s financial circumstances.
MCAO shall determine whether to reinstate prosecution or undertake
alternatives.
2.2.4
Justice Court Diversion - A short-term, education program for eligible offenders
charged with specific misdemeanor offenses and citations to avoid a conviction.
This program was recently enhanced by offering evidence-based curricula and
implementing a screening tool to identify better and address individual needs.
2.2.4.1
To provide an intake, an approved evidence-based screening, and
appropriate education class(es) to referred offenders charged with
eligible misdemeanors or citations with the goal of successfully
completing this diversion program and getting their criminal charges
dismissed.
2.2.4.2
Only certain offenders who are charged with eligible misdemeanors
offenses or citations may be eligible for and offered diversion. If
diversion is accepted by the offender, prosecution is suspended for one
year so the offender can participate in the prescribed program; however,
SERIAL# 240104-RFP
the intake, screening, and education class(es) requirements must be
able to be scheduled and completed within 90 days from time of referral.
2.2.4.3
After administering a validated screening tool for adults, contractor shall
provide educational services to referred offenders using an approved
evidence-based curriculum/curricula.
2.2.4.4
The Justice Court Diversion program shall have at least two different
education tracks, focusing on the offender’s underlying identified needs
as determined by the screening tool. Because there will be a broad
range of charged misdemeanors and citations, these education tracks’
curricula should be broad enough to cover efforts to reduce recidivism
and improve cognitive skills and decision making. Therefore,
educational tracks should not be offense specific.
2.2.4.5
Offenders who earn a Successful Discharge shall have their pending
charges dismissed. Offenders who are Unsuccessfully terminated will
return to Court and prosecution will be resumed.
2.3
INCIDENT REPORTING
2.3.1
“Incident” means an unusual or significant event involving client(s) and/or staff,
which requires notification to the designated authorities.
2.3.2
“Incident Report” means a report that is verbal or written communication to the
MCAO as described below.
2.3.3
Health, Safety, and Welfare Incidents: The Contractor shall immediately report all
incidents impacting the health, safety, and welfare of clients served under this
contract to MCAO. This includes death or significant physical injury occurring at
any contractor facility or during any client contact.
2.3.4
Health, safety, and welfare incidents include the following when they occur while
a client was in a contract service and the event occurred on Contractor premises:
2.3.4.1
Physical assault that requires medical treatment beyond first aid.
2.3.4.2
Any medical treatment beyond first aid.
2.3.4.3
Emergency room or urgent care visits.
2.3.4.4
Request for emergency mental health stabilization provided by first
responders and/or crisis intervention teams.
2.3.4.5
Use of seclusion and/or restraint.
2.3.4.6
Actions which pose an immediate and serious threat directed toward
self, others, and/or offenders in the Contractor’s care and/or
Contractor’s staff.
2.3.4.7
Acts of inappropriate discipline or sexual behavior (consensual or not)
between staff and clients.
2.3.4.8
Any event that Contractor is aware of and is likely to have media interest.
2.3.5
Significant Incidents: The Contractor shall report the following significant incidents
involving clients served under this contract:
2.3.5.1
Death of a client that occurs while client was in a contract service.
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2.3.5.2
Weapons possession while in a contract service.
2.3.5.3
Acts by clients or staff where the Contractor involves law enforcement.
2.3.5.4
Traffic accidents involving clients transported by the Contractor or its
personnel, non-employees or transport contractor.
2.3.6
The contractor shall report incidents to the MCAO by telephone at 602-372-7300
by 5:00 pm on the next business day after the incident occurs or after becoming
aware of the incident.
2.3.7
The contractor shall report incidents to law enforcement as required by law and
according to the Contractor’s policies and procedures. Contractor shall comply with
all mandatory reporting requirements as required by law.
2.3.8
Incident Report Form: The contractor shall use the MCAO approved Incident
Report form to complete and submit incident reports.
2.3.9
The contractor must submit a written report to the MCAO via email to
mcaodiv@mcao.maricopa.gov not later than three calendar days after the incident
occurs or after becoming aware of the incident. All reports must be legible and be
signed by the staff who prepared the report as well as by the staff who approved
the report. The contractor shall maintain a file of written incident reports that are
available for review under this contract.
2.3.10 All incident reports will be maintained by MCAO’s Diversion Strategies Group as
directed by the Director. Upon notification of an incident the Director or his or her
designee will do the following:
2.3.10.1 Review the information to determine if the incident requires further
investigation.
2.3.10.2 Request additional information as needed and direct corrective action to
comply with this contract.
2.3.10.3 Refer the matter to any relevant authorities if necessary.
2.4
INSPECTION AND EVALUATION OF SERVICES/FACILITIES
2.4.1
The contractor shall provide and maintain an inspection system that continuously
ensures the services under this contract. Complete records of all inspection work
performed by the Contractor shall be maintained and made available to MCAO
during contract performance and for as long afterwards as the contract requires.
2.4.2
MCAO has the right to inspect all services and facilities and places during the term
of the contract called for by the contract, to the extent practicable with appropriate
notice, MCAO shall perform inspections in a manner that will not unduly delay the
work.
2.4.3
If any of the services or facilities do not conform to contract requirements, MCAO
may require the contractor to perform the services again in conformity with contract
requirements, at no cost to the County or MCAO.
2.4.4
MCAO may design and implement a system of program evaluation to use to
determine the contractor’s performance as contemplated by this contract. Such
evaluations may, in MCAO’s sole discretion, be shared with the Contractor.
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2.4.5
When the defects in services cannot be corrected by re-performance, the County
or MCAO may:
2.4.5.1
require the contractor to take necessary action to ensure that future
performance conforms to contract requirements.
2.4.6
If the contractor fails to promptly perform the services again or to take the
necessary action to ensure future performance in conformity with contract
requirements, the County may terminate the contract for default.
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EXHIBIT B-1
Narrative
General Requirements
5.6.1.1 Proposal (per scope of work/diversion program) – This section shall clearly state which
scope(s) of work respondent is responding to and contain an executive summary (an outline of the
general approach utilized in the proposal) and a statement of all of the programs and services proposed,
including conclusions and generalized recommendations. Proposals should be all-inclusive, detailing the
respondent’s best offer.
Executive Summary
SAGE Counseling was founded in 1998 to provide clinical and educational services for criminal justice
organizations and the child welfare system. The agency has grown to over 200 employees and 16 clinics
statewide, 9 of which are in Maricopa County. We currently provide services in-person in our clinics, virtually
through telehealth, in hybrid counseling groups, in clients’ homes, and in jails and prisons. SAGE’s clinics
are all licensed by the Arizona Department of Health Services including the provisions to provide
Misdemeanor Domestic Violence treatment and all DUI services. We are also contracted with the Arizona
Healthcare Cost Containment system (AHCCCS) and all of Arizona’s AHCCCS Managed Care
Organizations/Health Plans.
We are proud of the fact that since the agency was founded 25 years ago, when a contract under which we
had been providing services had exhausted all its renewals, and was re-issued through the formal
solicitation process, we were re-awarded the contract each time we submitted a new proposal, except for
once. We have received 40 contract re-awards from 41 RFP proposals in this situation. We believe this
track record demonstrates the quality of our programs and that our customers and clients have been highly
satisfied with the services we have been providing.
SAGE Counseling has been the treatment provider for the Felony Diversion Program (FDP) since its
inception in May of 2020. If we are awarded this contract again, we propose to facilitate basically the same.
The program is designed to reduce recidivism by mitigating clients’ criminogenic factors. It presently
consists of a comprehensive assessment that includes the Ohio Risk Assessment System (ORAS), and 6
separate Treatment Tracks that clients are placed in based on the results of their assessment. Each Track
has its own research-based curriculum, which is evidence-based and has been approved by the MCAO
Diversion Strategies Group.
Initial recidivism studies of successful graduates of the FDP have shown very positive results. Twelve
months postgraduation, clients who graduated during 2021 had only:
4.3% with a new submittal to MCAO (out of 936)
2.8% with a conviction for a new crime (out of 817 who were recorded in the Arizona Computerized
Criminal History System), and
0% who were sentenced to prison (out of 913).
Two years post-graduation, only 8.6% had a new submittal to MCAO (out of 936). Data for new convictions
and prison sentences for this period was not yet available.
In addition, a study of the program was conducted by two professors from Arizona State University whose
research report concluded, “These results suggest that FDP was very successful in reducing the likelihood
of recidivism, increasing the time to recidivism, and reducing the likelihood of serious recidivism.” It also
stated, “We have estimated overall that the program decreases recidivism by about 20 percentage points.”
Regarding FDP clients with the highest risk to recidivate, who are the most important clients to affect in
terms of benefiting our community, the researchers found, “…they fit into the larger pattern, suggesting
successful completion of FDP among those with the highest risk score is associated with a 52-percentage
point drop in recidivism rates.” They also wrote “This suggests that if use of the FDP were expanded among
higher risk populations the overall completion rate of FDP would not significantly change while the impact
of FDP would increase.”
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Since Attachment E below includes extensive information about the specifics of the Felony Diversion
Program, in this “outline of the general approach,” we have focused more on SAGE Counseling’s general
methodology and clinical approach in providing treatment for this population of criminal offenders.
SAGE Counseling’s treatment programs are grounded in the evidence-based principles that
intervention with clients in the criminal justice system is most effective when it is:
1. Founded on evidence-based interventions and practices.
2. Based on thorough assessment procedures.
3. Matched to clients’ specific risk and need levels.
4. Targeted to ameliorate multiple dynamic criminogenic needs.
5. Grounded primarily in a cognitive-behavioral approach.
6. Framed in Motivational Interviewing and The Stages of Change Model.
7. Provided by well-trained and well-supervised facilitators, and
8. Based on highly structured curricula developed for that specific clinical population.
Providing the highest quality services to our clients is always a driving force at SAGE Counseling. We take
seriously the value of employing Evidence-Based Practices (EBPs) in developing a wide range of
treatment options based on clients’ criminogenic needs. We provide individualized services by having
multiple Treatment Tracks for most of our treatment programs. For example, we have 4 separate Treatment
Tracks for Substance Abuse (plus education classes), 2 for Cognitive Restructuring (plus education
classes), and 5 for Domestic Violence Offender Treatment. Each Track has its own curriculum for which
our facilitators have been specifically trained (often requiring certification), which is key in assisting our
clients reaching their treatment goals and ultimately reducing recidivism.
For over 25 years, the general goals in our treatment program for offenders have included:
1. Eliminating criminal thinking, illegal behavior, and substance use.
2. Reducing victim-stancing and increasing clients’ responsibility for their behavior.
3. Teaching clients to change their beliefs and attitudes regarding excessive entitlement,
blaming others, and using Thinking Errors to support illegal behavior.
4. Improving self-efficacy concerning the ability to make self-directed, positive changes.
5. Increasing self-awareness, particularly regarding emotional states, personal triggers, and
offense patterns.
6. Increasing key personal skills, e.g., refusal skills, conflict resolution, anger management,
problem-solving, impulse modulation and mindfulness, stress management, and social
skills.
In addition to the 3 contracts, we currently have with the Maricopa County Attorney’s Office (MCAO), we
also have contracts to provide treatment for criminal offenders with:
1. The Arizona Department of Corrections Rehabilitation and Re-Entry (2)
2. The City of Phoenix Prosecutor’s Division (2)
3. The Maricopa County Sheriff’s Office (2)
4. The City of Peoria
5. The City of Glendale, and
6. The City of Avondale.
SAGE Counseling’s Clinical Approach and Methodology:
Our treatment methodology emphasizes full assessment, Cognitive Restructuring, Motivational
Interviewing, Stages of Change, Trauma-Responsive Care, Mindfulness, and a Strengths-Based approach.
We present clients with realistic opportunities for change through interventions that are targeted at
promoting positive change.
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Clients at SAGE are taught and encouraged to:
1. Accept responsibility for their offenses by learning how to identify and change thinking
errors, self-serving cognitive distortions, risky beliefs, minimizations, rationalizations, and
victim-stancing.
2. Intervene in their criminal offense and substance use patterns at the earliest possible
moment.
3. Identify specific high-risk situations for potential relapse or a return to criminal thinking or
behavior and quickly apply coping responses using cognitive-behavioral techniques, and
4. Engage in a resocialization process to learn new social skills for developing satisfying,
socially acceptable behavior, acquiring a positive self-concept, and developing new
attitudes and expectations.
In addition to what has already been addressed above, our overall program goals include building
motivation for positive change; increasing clients’ sense of personal responsibility and accountability; and
building pro-social values and beliefs. Some of the most significant of these pro-social values/beliefs are:
respecting the rights of others, honoring fairness and justice, having a respectful attitude toward authority,
taking personal responsibility for one’s life, identifying personal goals and ideals, and valuing supportive
relationships.
An effective program with criminal offenders must find ways to maintain the delicate balance between on
the one hand, holding clients accountable and challenging them about their problematic attitudes and
destructive behavior, and on the other hand, engaging them collaboratively to promote making positive
changes. Part of this process is to avoid power struggles that almost inevitably result from a stance of
aggressively “confronting the client’s denial.” At SAGE Counseling, we utilize Motivational Interviewing,
which is an evidence-based, client-centered approach that works to identify and enhance intrinsic
motivation within the client to change behavior. MET elicits positive change by helping clients explore and
develop discrepancies, resolve their ambivalence, and enhance self-efficacy.
Through Motivational Interviewing and the Stages of Change Model, we strive, first, to build clients’
motivation for treatment and, second, to strengthen their commitment to change. Realizing that a client’s
readiness to change is a dynamic condition, we respectfully, but firmly, challenge their current problematic
beliefs and assumptions. Our goal is to meet defendants where they are in the Stages of Change continuum
(pre-contemplation; contemplation; preparation; action; and maintenance), work collaboratively with them
to identify personal barriers and problematic beliefs, increase their ambivalence about their lifestyle, and
identify and overcome barriers to change. Clients’ self-determination and personal choice are always
emphasized, while we also assist them in exploring what they would like to improve in their current life
situation. We utilize OARS and FRAMES:
OARS:
Open Questions; Affirmations; Reflective Listening; Summarizing
FRAMES
Feedback; Responsivity; Advice; Menus of Change Options;
Empathic Counseling; Self-Efficacy
We also utilize a Strength-Based Approach that is responsive to clients’ individual needs and respectful
of their personal choices. Rather than focusing only on “symptoms” and “problems,” we work with our clients
to collaboratively explore where and how they have been successful in their lives. Discovering and naming
their specific skills and resources help clients focus on a positive future rather than only the problems of the
past.
1.0
INTENT
SAGE Counseling agrees to adhere to the terms listed in this section, and all subsections within
regarding the intent of this solicitation.
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2.0
SCOPE OF WORK
2.1
GENERAL REQUIREMENTS
2.1.1
Contractors shall be responsible for providing quality evidenced based curricula
for treatment tracks and education programs in a community-based setting at
multiple locations throughout Maricopa County. All programs shall be approved by
MCAO prior to implementation.
SAGE has read this section and agrees to comply with its requirements. We have
provided a detailed description of our multiple Treatment Tracks in Attachment E,
#5. SAGE has 16 licensed facilities throughout the state, and 9 locations (11
licenses) are in Maricopa County and all facilities are in a community-based
setting.
2.1.2
Service delivery shall be culturally relevant and linguistically appropriate to the
population
served.
The
contractor
shall
be
responsible
to
provide
interpreter/language line services if other alternatives cannot be arranged.
At SAGE, we emphasize being sensitive to cultural, ethnic, gender, sexual identity,
and age differences in all the services we deliver. We recognize that personal and
cultural beliefs play a central role in determining how clients view their lives,
substance use, criminal conduct, and their involvement in treatment. We provide
cultural competency/diversity training to all our staff in our continuum of care. We
encourage the inclusion of religious and cultural preferences, family support, and
initial identification of needs for a successful learning experience.
SAGE employs both administrative staff and clinical staff who speak English and
Spanish; however, SAGE can treat participants who speak any language. When a
participant has AHCCCS, SAGE utilizes the contracted interpreter from the health
plans. When the participant does not have AHCCCS, SAGE utilizes a service
called “Language Line”, that can interpret more than 240 languages. All translation
services are free of charge to SAGE clients.
2.1.3
The contractor shall comply with all professional and ethical obligations and code
of conduct of licensure and maintain good standing with the Arizona Bureau of
Medical Facilities Licensing (BMFL). Further, the contractor shall protect
information and records protected by federal confidentiality rules (e.g., 42 CFR
Part 2 and HIPAA Rules at 45 CFR Parts 160, 162, and 164) and state
confidentiality rules (e.g., A.R.S. §§ 12-2291 et seq.), and ensure that contractor
and its employees and subcontractors comply with said rules and employ all
administrative and physical safeguards as may be required by law to protect
confidential information.
SAGE has read this section and agrees to comply with its requirements. All of
SAGE’s facilities are in good standing with AZ BMFL and AHCCCS. As a provider
of Part 2 services, SAGE is required to protect health information according to 42
CFR Part 2 and HIPPA Rules. All staff are required to participate in annual training
regarding confidentiality rules, and all subcontracts are required to enter into
Business Associate Agreements (BAA’s) that ensure protection of confidential
information.
2.1.4
The contractor shall hold and maintain during the performance of this contract, a
current, applicable Arizona Department of Health Services license that is in good
standing, for each facility from which services shall be provided. Contractor shall
ensure that all buildings and grounds, equipment and furnishings are maintained
in a manner that provides a safe, sanitary, and comfortable environment for youth,
visitors and employees.
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SAGE has read this section and agrees to comply with its requirements. All of
SAGE’s facilities are in good standing with AZ BMFL and SAGE will continue to
keep all facilities in good standing with BMFL. SAGE follows a monthly
maintenance schedule and contracts with cleaning agencies as needed to ensure
facilities stay safe and sanitary.
2.1.5
The contractor shall have the ability to send and receive encrypted information
electronically and have appropriate safeguards in place to protect any criminal
history information as well as personally identifiable information. Contractor shall
have ability to conduct telehealth visits by the time services are set to be delivered.
SAGE has read this section and agrees to comply with its requirements. SAGE
currently utilizes Barracuda encryption program to send and receive secure emails.
SAGE utilizes Teams to conduct telehealth services. SAGE has been providing
telehealth services since 2020.
2.1.6
Unless otherwise indicated or required by law, staff providing services shall have
a master’s degree in a human services-related field and licensed to practice
independently by the Arizona Board of Behavioral Health Examiners or is exempt
from licensure pursuant to A.R.S. Title 32, Chapter 33 to deliver services.
However, services may also be delivered by Behavioral Health Technicians under
the supervision of a master’s level clinician. All staff delivering direct care services
shall possess sufficient education and aptitude to deliver services.
SAGE has read this section and agrees to comply with its requirements. SAGE
requires a master’s degree and/or independent license in order to be employed as
a clinician. All of our staff without an independent license receive supervision
and/or clinical oversight as appropriate based on the requirements of BMFL and
Arizona Board of Behavioral Health Examiners (AZ BBHE).
2.1.7
The contractor shall be responsible for ensuring the execution of any business
associate
agreements,
qualified
service
organization
agreements,
and
nondisclosure/confidentiality agreements that may be required under federal and
state confidentiality rules. Contractor shall use trained, appropriately licensed staff
and shall have sufficient capacity to accommodate program requirements in
accordance with industry standards.
SAGE has read this section and agrees to comply with its requirements. As
previously mentioned, SAGE requires Business Associate Agreements for any
contractor in which HIPPA and/or 42 CFR Part 2 rules may apply.
2.1.8
Contractor may be required to attend, at contractor’s expense, workshops or
training sponsored by MCAO, or provide training to MCAO staff as requested by
the Director of the MCAO Diversion Strategies Group, the County Attorney or her
duly authorized employees, agents, or assigns.
SAGE has read this section and agrees to comply with its requirements related to
training and/or workshops as required by this contract.
2.1.9
Unless otherwise indicated, contractors shall administer the Ohio Risk
Assessment System – Community Supervision Tool (ORAS-CST) for offender
assessment and rehabilitation in order to assess the offender’s overall risk to
reoffend, risk level score, and identify targeted criminogenic needs and domains.
SAGE has read this section and agrees to comply with its requirements. SAGE
has been utilizing the ORAS-CTS since the Fall of 2019, and all of our assessors
receive formal training on the ORAS. We not only have about 25 clinicians trained
and certified to administer it, but also 6 who are trained and certified to train others
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to be end users. More information specific to SAGE’s implementation of the ORAS
can be found in Attachment E, #1.
2.1.9.1
ORAS-CST shall be administered within 30 days of referral by end users
certified in the ORAS-CST.
SAGE has read this section and agrees to comply with its requirements,
as we have been doing for this diversion program.
2.1.9.2
Contractor shall review existing social history and referral packet
including consent forms for all referrals prior to administering the ORAS-
CST.
SAGE has read this section and agrees to comply with its requirements,
as we have been doing.
2.1.9.3
Contractor shall administer assessment as intended with fidelity and
accuracy in an unbiased manner that yields appropriate results and
treatment recommendations.
SAGE has read this section and agrees to comply with its requirements,
as we have been doing for this diversion program. MCAO Diversion
Strategies Group has assisted us in the requirement by evaluating our
assessors’ fidelity to UCCI’s standards for ORAS administration.
2.1.9.4
All documentation supporting the fidelity of ORAS-CST scoring, notes,
client self-report, scoring and interview guide shall be retained in the
offender’s file (digital storage is acceptable).
SAGE has read this section and agrees to comply with its requirements,
as we have been doing.
2.1.9.5
Upon the ORAS’ determination of the offender’s overall risk to reoffend
and targeted criminogenic needs and domains, contractor shall assign
the offender to the appropriate “track” of treatment.
SAGE has read this section and agrees to comply with its requirements,
as we have been doing for this diversion program. We have multiple
Treatment Tracks available for this diversion program.
2.1.9.6
Contractor will develop a dynamic Individual Service Plan and goals
relative to the targeted criminogenic needs and domains, so the service
is beneficial and appropriate for the offender’s learning style, motivation,
abilities, and strengths.
SAGE has read this section and agrees to comply with its requirements,
as we have been doing for this diversion program. Collaborative ISP
development is a key aspect of SAGE’s treatment programs.
2.1.9.7
Upon termination, the contractor shall complete and provide to MCAO:
using the MCAO Diversion Strategies Group Discharge Report template
with identified ORAS Risk Level, ORAS Risk Score, top three (3)
identified criminogenic needs and domains, treatment goals, offender
participation and engagement, case management goals and outreach,
financial obligation compliance, reasons for successful or unsuccessful
completion, and documented attempts by the contractor to engage the
offender. If drug testing is a requirement for the offender, provider testing
results, any aggravating or mitigating factors, and how the results were
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integrated into the recommendation for successful or unsuccessful
discharge.
SAGE has read this section and agrees to comply with its requirements,
as we have been doing for this diversion program. SAGE and the MCAO
Diversion Strategies Group have been meeting regularly for several
weeks and have succeeded in better aligning our discharge reports with
MCAO’s expectations.
2.1.10 The contractor may use additional assessment tools in conjunction with the ORAS
pertinent to the offender’s specific needs.
SAGE has read this section and agrees to comply with its requirements. SAGE
utilizes multiple assessment tools in conjunction with the ORAS, for example, the
TCU Drug Screen 5; and Generalized Anxiety Disorder-7. As requested, our
assessment instruments and processes are described in detail in Attachment E,
#1, #2, and #3.
2.1.11 Unless otherwise indicated respondents may propose alternative evidence-based
curriculum /curricula by treatment track. A detailed description of the proposed
curriculum, how long the agency has been using this curriculum, the number of
staff trained in this curriculum, and citations for meta-analyses of this curriculum
must be included in the proposal.
SAGE has read this section and agrees to comply with its requirements. We are
proposing to utilize the same evidence-based curricula that we are currently using
for our MCAO diversion programs and that we are submitting proposals for
here. All of them have been previously approved by MCAO. As requested, we
have also named each of the curricula, listed how long we have been utilizing each
of them, and gave the number of staff trained in each in one in Attachment E, #4.
Based on MCAO’s response to questions #9 and #12 in the County eProcurement
system, we have not cited any meta-analysis of the curricula or described them
further, because each one has previously been approved by MCAO.
2.1.12 The contractor shall be an AHCCCS provider, in good standing, and not subject to
any suspensions. The contractor shall maintain contracts with all AHCCCS
Complete Care Plans serving the Central Region Geographical Service Area.
SAGE has read this section and agrees to comply with its requirements, including
those related to remaining in good standing with AHCCCS. SAGE Counseling, Inc.
is contracted with all seven (7) AHCCCS ACC Health Plans, both (2) RHBA
AHCCCS Health Plans, and American Indian Health Plan, also through AHCCCS.
2.1.13 Contractors will accept multiple forms of payment such as cash, credit/debit cards,
and have the ability to accept private insurance, AHCCCS, or Medicare for
payment. Contractor fees shall be no higher than allowable AHCCCS rates for
services. Contractor shall assist participants with AHCCCS enrollment when
required.
SAGE has read this section and agrees to comply with its requirements. SAGE
does not normally accept cash due to safety concerns for our staff, however in
extreme circumstances when no other options are viable, SAGE has been willing
to accept cash. Additional forms of payment accepted include credit/debit cards
and AHCCCS. Most Medicare plans do not cover behavioral health services;
therefore, SAGE has not pursued Medicare payments. SAGE does bill primary,
private payer insurances first before billing AHCCCS as required under Medicaid.
SAGE counseling has a comprehensive process of providing assistance with
AHCCCS enrollment. This discussion can be found in Attachment E, section 12.
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2.1.14 All contractor materials, including but not limited to pamphlets, brochures, forms,
flyers shall conform with Maricopa County branding standards, and shall be
approved by MCAO before use. The contractor shall not include any
representation of the County Attorney, MCAO or the MCAO Felony or other
diversion programs.
SAGE has read this section and agrees to comply with its requirements as we have
been doing in the current program.
2.1.15 Contractor shall develop a case file for all participants to include the consent
agreement, individual service plan, case notes, results of initial assessment. All
contacts shall be documented and included in the file notes. Case notes shall
demonstrate compliance or non-compliance with program requirements, and shall
include any referrals for additional or wrap around services, including employment
services, housing placement and assistance, etc.
SAGE has read this section and agrees to comply with its requirements as we have
been doing in the current program. SAGE keeps all consent, ISP, assessment and
clinical documentation, which includes information related to compliance, non-
compliance and wrap around services, in our electronic health record system, as
required by the Bureau of Medical Facilities Licensing (BMFL).
2.1.16 All contacts between the contractor, offenders, and MCAO employees, agents and
assigns shall be conducted with professionalism, fairness, respect, and dignity to
the offender. The offender shall not be discriminated against based on race,
national origin, religion, gender, sexual orientation, gender identification, age,
disability, marital status, diagnosis, or source of payment.
SAGE has read this section and agrees to comply with its requirements as we have
been doing in the current program.
2.1.17 Contractors shall ensure participating offenders exhibit progress on treatment
goals as outlined in the Individual Service Plan, and that discharge includes
strategies and resources for maintaining support and resilience in the community.
SAGE has read this section and agrees to comply with its requirements as we have
been doing in the current program. SAGE documents on progress toward ISP
treatment goals on every clinical service provided. SAGE and the MCAO Diversion
Strategies Group have been meeting regularly for several weeks and have
succeeded in better aligning our discharge reports with MCAO’s expectations.
2.1.18 Contractors shall provide a standardized offender financial assessment process
that includes an application, instructions and a consistent sliding scale fee
structure based upon current Federal Poverty Guidelines (FPLs). The contractor
shall provide a copy of these documents to the County Attorney via the MCAO
Diversion Strategies Group. The documents shall be approved by the County
Attorney.
SAGE has read this section and agrees to comply with its requirements as we have
been doing in the current program. This section is fully discussed in Attachment E,
section 12.
2.1.18.1 Contractor shall establish timeframes for completing the assessment
and shall notify participants of any financial obligations prior to rendering
services. Contractor shall not allow participants to be in arrears for any
services. Arrears is defined as the participant having a balance due for
missing required payment(s) to the Contractor for services rendered.
The Contractor shall make efforts when notified by the participant that a
financial hardship exists and that other areas of documented assistance
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or possible eligibility for assistance have been met, including spreading
out services to give the participant additional time to pay the impending
fees. However, the spreading out of services’ time must be reasonable
and not jeopardize the clinical benefit of delaying services. Contractor
may also staff such cases with MCAO to determine next steps. MCAO
is not responsible for payment for any outstanding participants fees.
SAGE has read this section and agrees to comply with its requirements
as we have been doing in the current program. This section is fully
discussed in Attachment E, sections 11 and 12. In order to improve the
rate of successful completions, we are requesting an exception to allow
participants to be in arrears up to two group payments, which is the
financial policy SAGE has been following under our current contracts
with MCAO. Please see section 5.7 “Exceptions to Solicitation”.
2.1.18.2 The contractor shall establish a policy which outlines a standardized
financial assessment process. The contractor shall provide a copy of this
policy to the County Attorney via the MCAO Diversion Strategies Group.
The policy shall be approved by the County Attorney.
SAGE has read this section and agrees to comply with its requirements
as we have been doing in the current program. SAGE has a
comprehensive financial assessment policy in place per our current
contracts with MCAO.
2.1.19 For those offenders owing restitution, the offender shall make restitution payments
via the MCAO Diversion Payment Portal or mail payments directly to MCAO using
the approved payment methods. The contractor shall periodically check the MCAO
Diversion Payment Portal and remind the offender of the restitution obligation.
SAGE has read this section and agrees to comply with its requirements as we have
been doing in the current program.
2.1.19.1 The contractor shall confirm that payments are made according to
program requirements, through the MCAO Diversion Payment Portal
and take appropriate action if not made. This may include multiple
reminders, discussions about barriers to payment with offender, etc.
SAGE has read this section and agrees to comply with its requirements
as we have been doing in the current program.
2.1.19.2 Contractor shall work with offender to set payment amount and
frequency so that all restitution is fulfilled before being successfully
discharged from the program. The balance can be made in payments as
determined by the contractor.
SAGE has read this section and agrees to comply with its requirements
as we have been doing in the current program.
2.1.19.3 Per the Consent Agreement, the offender’s failure to pay restitution as
owed by the determined due date may result in an unsuccessful
termination from the program. Treatment shall not be extended solely
because of unpaid restitution unless otherwise authorized by the
Director of Diversion Strategies Group.
SAGE has read this section and agrees to comply with its requirements
as we have been doing in the current program.
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2.1.19.4 The contractor shall ascertain if co-defendants agreed to pay as joint
and several liability requirements and verify restitution payments via the
MCAO Diversion Payment Portal prior to discharging the offender from
the Diversion Program.
SAGE has read this section and agrees to comply with its requirements
as we have been doing in the current program.
2.1.19.5 Full restitution shall be paid before any successful discharge.
SAGE has read this section and agrees to comply with its requirements
as we have been doing in the current program.
2.1.19.6 The total amount of restitution paid shall be documented on the MCAO
Discharge Report, whether successful or unsuccessful discharge.
SAGE has read this section and agrees to comply with its requirements
as we have been doing in the current program.
2.1.20 For offenders who do not live near the contractor’s site for services (outside the
State of Arizona or outside of Maricopa County Arizona) when telehealth services
are not available:
2.1.20.1 It shall be the responsibility of the offender to locate a Third-Party
Administrator (TPA) in their jurisdiction that can provide comparable
services with consideration for the practicality and locality of the
jurisdiction to the specific diversion program requirements as
determined by the contractor.
SAGE has read this section and agrees to comply with its requirements
as we have been doing in the current program.
2.1.20.2 The contractor shall be authorized to provide monthly case coordination
services and charge a monthly case coordination fee to the offender as
described in Pricing Page.
SAGE has read this section and agrees to comply with its requirements
as we have been doing in the current program.
2.1.20.3 Provided the contractor and the TPA enter into the contractor’s Provider
Application and Agreement without any amendments or modifications
thereto, the TPA shall be considered to be approved by the County
Attorney. An executed copy of the contractor Provider Application and
Agreement shall be maintained in the offender’s file.
SAGE has read this section and agrees to comply with its requirements
as we have been doing in the current program.
2.1.20.4 The contractor shall provide specific information about the TPA’s
services, the offender’s level of compliance, and how this supports a
successful or unsuccessful termination in the MCAO Discharge Report
template.
SAGE has read this section and agrees to comply with its requirements
as we have been doing in the current program.
2.1.21 Contractor shall maintain detailed and accurate documentation of participation and
completion of the program. All absences (excused and unexcused) shall be
recorded. Regardless of the reason for the absences, in order to earn a successful
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discharge, the offender must complete all required sessions. Contractor shall
consult MCAO staff prior to removing a participant from the program for poor
attendance or behavior issues. A written report detailing the infractions leading to
removal from the program shall be provided to MCAO within 72 hours of student’s
removal from the program.
SAGE has read this section and agrees to comply with its requirements as we have
been doing in the current program. Based on our current contract, SAGE provides
a discharge report to MCAO within 7 days after the discharge of a client. SAGE
agrees to notify MCAO within 72 hours of a participant’s removal from the program
for behavior issues; however, we are requesting an exception regarding consulting
prior to removal for attendance issues. See section 5.7 “Exceptions to Solicitation”
for further information.
2.1.22 Contractor shall provide notification to MCAO within 72 hours of enrollment or
termination.
SAGE has read this section and agrees to comply with its requirements as we have
been doing in the current program.
2.1.23 Should public monies become available to the MCAO for diversion programs,
these funds may at the discretion of the County Attorney, be used in whole or part
to offset discounts provided by the contractor to the offender for program service
fees. As such, MCAO may impose offender eligibility requirements and an MCAO
Sliding Scale that shall be used to determine offender discounts and copays.
2.1.23.1 The use of public monies is subject to applicable legal requirements,
applicable approval processes or requirements, fiscal agent conditions
and requirements, expiration date, and available balance. The use of
public funds shall also require the contractor to maintain and provide
monthly metrics to MCAO regarding the offenders’ discounts. Contractor
reimbursement is contingent on the availability of funds and not
guaranteed. See Exhibit C Defendant Eligibility Requirements and
Reimbursement Guidelines
SAGE has read this section and agrees to comply with its requirements
related to the use of public monies, as we have been doing in the current
program.
2.3
INCIDENT REPORTING
2.3.1
“Incident” means an unusual or significant event involving client(s) and/or staff,
which requires notification to the designated authorities.
2.3.2
“Incident Report” means a report that is verbal or written communication to the
MCAO as described below.
2.3.3
Health, Safety, and Welfare Incidents: The Contractor shall immediately report all
incidents impacting the health, safety, and welfare of clients served under this
contract to MCAO. This includes death or significant physical injury occurring at
any contractor facility or during any client contact.
SAGE has read this section and agrees to comply with its requirements as we have
been doing in the current program.
2.3.4
Health, safety, and welfare incidents include the following when they occur while
a client was in a contract service and the event occurred on Contractor premises:
2.3.4.1
Physical assault that requires medical treatment beyond first aid.
2.3.4.2
Any medical treatment beyond first aid.
2.3.4.3
Emergency room or urgent care visits.
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2.3.4.4
Request for emergency mental health stabilization provided by first
responders and/or crisis intervention teams.
2.3.4.5
Use of seclusion and/or restraint.
2.3.4.6
Actions which pose an immediate and serious threat directed toward
self, others, and/or offenders in the Contractor’s care and/or
Contractor’s staff.
2.3.4.7
Acts of inappropriate discipline or sexual behavior (consensual or not)
between staff and clients.
2.3.4.8
Any event that Contractor is aware of and is likely to have media interest.
SAGE has read this section and agrees to comply with its requirements
as we have been doing in the current program.
2.3.5
Significant Incidents: The Contractor shall report the following significant incidents
involving clients served under this contract:
2.3.5.1
Death of a client that occurs while client was in a contract service.
2.3.5.2
Weapons possession while in a contract service.
2.3.5.3
Acts by clients or staff where the Contractor involves law enforcement.
2.3.5.4
Traffic accidents involving clients transported by the Contractor or its
personnel, non-employees or transport contractor.
SAGE has read this section and agrees to comply with its requirements
as we have been doing in the current program.
2.3.6
The Contractor shall report incidents to the MCAO by telephone at 602-372-7300
by 5:00 pm on the next business day after the incident occurs or after becoming
aware of the incident.
SAGE has read this section and agrees to comply with its requirements as we have
been doing in the current program.
2.3.7
The Contractor shall report incidents to law enforcement as required by law and
according to the Contractor’s policies and procedures. Contractor shall comply with
all mandatory reporting requirements as required by law.
SAGE has read this section and agrees to comply with its requirements as we have
been doing in the current program.
2.3.8
Incident Report Form: The Contractor shall use the MCAO approved Incident
Report form to complete and submit incident reports.
SAGE has read this section and agrees to comply with its requirements as we have
been doing in the current program.
2.3.9
The Contractor must submit a written report to the MCAO via email to
mcaodiv@mcao.maricopa.gov not later than three calendar days after the incident
occurs or after becoming aware of the incident. All reports must be legible and be
signed by the staff who prepared the report as well as by the staff who approved
the report. The Contractor shall maintain a file of written incident reports that are
available for review under this contract.
SAGE has read this section and agrees to comply with its requirements as we have
been doing in the current program.
2.3.10 All incident reports will be maintained by MCAO’s Diversion Strategies Group as
directed by the Director. Upon notification of an incident the Director or his or her
designee will do the following:
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2.3.10.1 Review the information to determine if the incident requires further
investigation.
2.3.10.2 Request additional information as needed and direct corrective action to
comply with this contract.
2.3.10.3 Refer the matter to any relevant authorities if necessary.
2.4
INSPECTION AND EVALUATION OF SERVICES/FACILITIES
2.4.1
The Contractor shall provide and maintain an inspection system that continuously
ensures the services under this contract. Complete records of all inspection work
performed by the Contractor shall be maintained and made available to MCAO
during contract performance and for as long afterwards as the contract requires.
SAGE has read this section and agrees to comply with its requirements as we have
been doing in the current program.
2.4.2
MCAO has the right to inspect all services and facilities and places during the term
of the contract called for by the contract, to the extent practicable with appropriate
notice, MCAO shall perform inspections in a manner that will not unduly delay the
work.
SAGE has read this section and agrees to comply with its requirements as we have
been doing in the current program.
2.4.3
If any of the services or facilities do not conform to contract requirements, MCAO
may require the Contractor to perform the services again in conformity with
contract requirements, at no cost to the County or MCAO.
SAGE has read this section and agrees to comply with its requirements as we have
been doing in the current program.
2.4.4
MCAO may design and implement a system of program evaluation to use to
determine the Contractor’s performance as contemplated by this contract. Such
evaluations may, in MCAO’s sole discretion, be shared with the Contractor.
SAGE has read this section and agrees to comply with its requirements as we have
been doing in the current program.
2.4.5
When the defects in services cannot be corrected by re-performance, the County
or MCAO may:
2.4.5.1
require the Contractor to take necessary action to ensure that future
performance conforms to contract requirements.
SAGE has read this section and agrees to comply with its requirements.
2.4.6
If the Contractor fails to promptly perform the services again or to take the
necessary action to ensure future performance in conformity with contract
requirements, the County may terminate the contract for default.
SAGE has read this section and agrees to comply with its requirements.
5.6.1.2 Qualifications – This section shall describe the respondent’s ability and experience related to the
programs and services proposed. All project personnel, as applicable, shall be listed, including a description
of assignments and responsibilities, a resume of professional experience, an estimate of the time each
would devote to this program, and other pertinent information.
SAGE Counseling, Inc. was founded in 1998 by Stephen Grams, a counselor licensed by the Arizona Board
of Behavioral Health Examiners. SAGE’s key focus has always been to provide treatment for people
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involved with the criminal justice and child welfare systems. We have consistently grown over the past 2+
decades and currently have over 200 employees, 16 clinics (9 of which are in Maricopa County) and
facilitate well over 300 outpatient counseling groups per week.
SAGE’s clinics are all licensed by the Arizona Department of Health Services including the provisions to
provide Misdemeanor Domestic Violence treatment and all DUI services. We are also contracted with the
Arizona Healthcare Cost Containment system (AHCCCS) and all of Arizona’s AHCCCS Managed Care
Organizations/Health Plans, which allows most of our clients to obtain services without any out-of-pocket
expenses.
SAGE has held contracts with the Maricopa County Attorney’s Office to provide clinical services for
diversion programs since 2009. Currently, we have 3 contracts with MCAO, one of which is the Felony
Diversion Program, which we have held since the program’s inception in the Spring of 2020. We were also
the only contracted provider for MCAO’s Felony Pre-Trial Intervention Program (FPIP), which began in
2015 and was a precursor to the FDP.
SAGE has also served tens of thousands of criminal offenders who were referred by the Maricopa County
Adult Probation Department (MCAPD), the Maricopa County Sheriff’s Office, the Maricopa County Pre-Trial
Services Department, the Arizona Department of Corrections Rehabilitation and Re-Entry (ADCRR), the
Maricopa County Superior Court, multiple municipal and justice courts, the Department of Child Safety, and
other governmental agencies.
SAGE’s “ability and experience related to the programs and services proposed” is also demonstrated by
the fact that we have served as the provider for MCAO’s Diversion Strategies Group for this specific
program for over 3 ½ years. We have 30 trained clinicians to administer the Ohio Risk Assessment System
(ORAS) and/or facilitate several different evidence-based curricula that we us in our multiple Treatment
Tracks. We also have clinicians who are trained to provide the necessary training to other clinicians to
become end users of the ORAS and several of our curricula. Additionally, we have 9 licensed clinics in
Maricopa County in which to provide services. We also have contracts with all of the AHCCCS eligible
Health Plans/Managed Care Organizations, which allows the majority of our clients to obtain services
without any out-of-pocket expenses.
The contracts and programs listed below summarize most of SAGE Counseling’s relevant experience for
this contract:
1. Maricopa County Attorney’s Office: We currently provide services under the following contacts:
a) Felony Diversion Program: Substance Abuse and Cognitive Restructuring Treatment, and Opioid
Use Pilot Program
b) Justice Court Diversion Program (Substance Abuse and Cognitive Skills Education)
c) Domestic Violence Diversion Program (Misdemeanor and Felony),
(We’ve held contracts with MCAO continuously since 2009.)
2. Arizona Department of Corrections, Rehabilitation and Reentry (ADCRR): Under the Transition
Services Program contract, we primarily provide Assessment, Counselling (Substance Abuse, Cognitive
Restructuring, Anger Management, and Parenting Skills), and Case Management. (Continuously since
2011).
3. Arizona Department of Corrections, Rehabilitation, and Re-Entry: Substance Abuse Treatment
Services for Coconino, Mohave & Yavapai Counties (Continuously from 2012 to 2023).
4. Maricopa County Adult Probation Department: Drug Treatment Education Fund (DTEF): From
SAGE’s inception in 1998 through 2017, we had the DTEF contract with Maricopa County Adult Probation.
We decided to stop receiving referrals under this contract in 2015 when the program had only a few referrals
per month, The contract included multiple treatment modalities, depending on the clinical needs of the
client, including:
a) Substance Abuse Education Classes
b) Motivational Enhancement Groups
c) Standard Outpatient Treatment
d) Intensive Outpatient Treatment
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e) Lapse/Relapse Prevention Groups
(18 years of Experience)
5. Arizona Department of Corrections, Rehabilitation, and Re-Entry: Contracted Substance Abuse
Treatment inside Arizona’s State Prisons (Continuously since 2022).
6. Arizona Department of Corrections, Rehabilitation and Reentry (ADCRR): Contracted DUI and
Substance Abuse Treatment for Women in the Perryville Prison: Provided DUI Screening, Education, and
Treatment, as well as long-term substance abuse treatment for women who were incarcerated in the
Perryville prison following a conviction for DUI. (From 2014 to 2019).
7. City of Phoenix Prosecutor’s Office: We provide services under the following contracts with the City’s
Prosecutor’s Office:
a) Cognitive Skills Diversion Program, Anger Management Diversion Program, and Domestic
Violence Diversion Program
b) Shoplifting Diversion Program
(We’ve held contracts with the City of Phoenix continuously since 2009.)
8. Glendale Municipal Court and Prosecutor’s Office: Provide a wide range of contracted clinical
programs for clients who have been convicted of criminal offenses or are in a diversion program. These
include DV charges, substance abuse treatment, cognitive skills program, anger management, and
parenting. (Contract implemented in June 2023.)
9. Peoria Municipal Court and Prosecutor’s Office: Provide a wide range of contracted clinical programs
for clients who have been convicted of criminal offenses or are in a diversion program. These include DV
charges, substance abuse treatment, cognitive skills program, anger management, and parenting.
(Contract implemented in October 2022.)
10. Mesa Municipal Court: SAGE is one of the treatment providers for the Court’s Domestic Violence
Treatment Court.
11. Maricopa County Sheriff’s Office: Provide services under the following contracts:
a) Substance Abuse Treatment (Currently being implemented)
b) Anger Management, Parenting Skills, and Employment Skills Building Educational Services
(We have held contracts with MCSO continuously since 2001.)
12. Scottsdale Municipal Court and Scottsdale Prosecutors’ Diversion: Under 5 different contracts,
SAGE provided behavioral health services for clients with a wide range of criminal charges and convictions.
Domestic Violence Offenses, Under-Aged Alcohol Consumption, and DUI were the primary charges. We
were the exclusive provider for the Prosecutor’s Division and the largest provider for the Municipal Court
until the City of Scottsdale decided to stop issuing contracts for those services. (6 Years of Experience.)
13. Maricopa County Pre-Trial Services: Substance Abuse Treatment Program: SAGE was the
exclusive, county-wide provider of out-patient substance abuse assessment and counseling services for
the Pretrial Services Division from about 2002 to 2008. The program began with a comprehensive
assessment with an extensive report being submitted to PSD, followed by out-patient counseling groups.
Many clients were randomly tested for substance use through UAs, and some were on electronic
monitoring. Because SAGE also provided extensive substance abuse services for the Maricopa County
Probation Department, many of these clients stayed in treatment at SAGE after being convicted and placed
on probation. (5 Years of Experience)
14. Maricopa County Family Drug Court Treatment Provider: SAGE was the first and only treatment
provider for this Drug Court until it was disbanded. (5 Years of Experience.)
15. Arizona Department of Corrections, Rehabilitation, and Re-Entry: Transition Program for High-Risk
Offenders with Co-Occurring Disorders in the Phoenix and Tucson Metropolitan Areas. Provided services
similar to the Transition Program described above, but for a higher-risk population (1+ Year of Experience).
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16. Arizona Department of Child Safety: We currently provide services under a contract for 3 programs:
Family Connections, Nurturing Parenting Program, and Substance-Exposed Newborn Program. (We have
held similar contracts with DCS continuously since 2003.)
17. Non-Contracted Services: Substance Abuse Assessment, Education, and Counseling; DUI
Screening, Education, and Treatment (24 Years of Experience). In addition to the above-referenced
contracted programs, SAGE has also provided clinical services including assessment, education,
counseling, and case management to tens of thousands of criminal offenders who were not covered under
any contract. Since our inception in 1998, we have provided extensive substance abuse treatment for
clients referred by the Maricopa County Adult Probation Department, the Arizona Department of
Corrections, and several Municipal Courts.
Project Personnel
All the requested information regarding project personnel has been provided in number 20 of Attachment
E. This includes a description of assignments and responsibilities. Per the Q&A response to the bid (Q15),
resumes are not required and therefore have not been included.
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Felony Diversion Program
2.5
PROGRAM REQUIREMENTS
2.5.1
Felony Diversion Program (FDP) - The Felony Diversion Program is an
education and treatment program for offenders charged with crimes involving
specific felony offenses, including possessing controlled substances and meeting
other eligibility criteria.
2.5.1.1
Only certain offenders who are charged with specific felony offenses
may be eligible for and offered diversion. If diversion is accepted by the
offender, prosecution is suspended for two years so the offender can
participate in prescribed treatment.
SAGE has read this section and agrees to comply with its requirements
regarding this diversion program.
2.5.1.2
After administering a validated risk to reoffend assessment for adults,
contractor shall provide treatment services to referred offenders using
an
approved
evidence-based
curriculum/curricula.
A
detailed
description of the proposed curriculum/curricula, how long the agency
has been using this curriculum, the number of staff trained in this
curriculum, and citations for meta-analyses of this curriculum must be
included in the proposal.
SAGE has read this section and agrees to comply with its requirements.
We currently administer a highly rated risk-to-reoffend instrument
(ORAS-CST) and have multiple curricula for our various Treatment
Tracks. We have provided a detailed description of the ORAS and
multiple curricula that respond to these questions in Attachment E, #1
and #4 below.
2.5.1.3
The Felony Diversion Program shall have multiple treatment tracks,
gender based, where dose and duration of treatment services (treatment
tracks) shall be determined based on risk level and identified
criminogenic needs. Offenders who earn a Successful Discharge shall
have
their
pending
charges
dismissed.
Offenders
who
are
Unsuccessfully terminated will return to Court and prosecution will be
resumed.
SAGE has read this section and agrees to comply with its requirements.
We have provided a detailed description of our multiple Treatment
Tracks in Attachment E, #5.
2.5.1.4
Individual (1:1) counseling sessions may substitute for required group
counseling sessions in exigent situations and when it is in the best
interest of the offender. Examples of exigent situations include, but not
limited to: a risk to the group having the offender present (escalating
behaviors, threat to others and/or Contractor staff), the contractor has
determined that the offender has a clinical need for individual services
initially to successfully transition to group, and not enough participants
to form a group (foreign language spoken or offender risk level) and it is
in the offender’s best interest to not delay services. The contractor must
inform the offender of the additional cost of individual counseling
services.
SAGE has read this section and agrees to comply with its requirements
as we have been doing in the current program.
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2.5.1.5
Case Management services may be offered as a service to the offender
when deemed to be clinically necessary and of benefit to the overall
success of the offender. The cost of case management shall be
disclosed and agreed to by the offender prior to start of services. MCAO
may place a maximum to the number of Case Management service
hours provided if MCAO is paying for the service; however, the
Contractor may seek approval from MCAO to exceed the maximum
capacity with appropriate clinical justification.
SAGE has read this section and agrees to comply with its requirements
as we have been doing in the current MCAO diversion program.
2.5.1.6
Contractor shall work with county contractor to provide for random and
variable offender urinalysis testing as determined by the clinician and
service plan, if approved by the County Attorney or the Director of the
MCAO Diversion Strategies Group. Any approved testing will be limited
by the Track maximum ranges. Approved urinalysis testing may be
directly provided by the contractor. Or, if the contractor cannot provide
approved urinalysis testing onsite, the contractor shall refer offenders to
a laboratory under contract with MCAO. It is the responsibility of the
contractor to monitor, manage, and track drug testing frequency,
integrate the results (or lack thereof) into the treatment plan, and ensure
that testing maximums are adhered to. The Contractor shall respond and
address each non-negative drug test result with the offender within three
business days to effect timely change. Other drug testing that the
offender may do outside of this diversion program will not be substituted
for diversion requirements.
SAGE has read this section and agrees to comply with its requirements
as we have been doing in the current program. SAGE has been
collaborating with Averhealth to accomplish these tasks and goals for
the FDP.
2.5.1.7
For those offenders owing restitution, the contractor shall ensure that
payments are made according to program requirements and take
appropriate action if not made. FDP requires that 50% of the total
restitution be paid within the first 30 days of treatment. The balance can
be made in payments as determined by the contractor. No offender can
be successfully discharged from the program until restitution is paid in
full.
SAGE has read this section and agrees to comply with its requirements
as we have been doing in the current diversion program. We also
manage restitution payments for other diversion programs.
2.5.1.8
Contractor shall provide one to two designated staff to be assigned to
specified Court locations in Maricopa County to provide information and
education to offenders and attorneys about the MCAO Felony Diversion
Program. Information shall include: a brief orientation, completion of
required forms, scheduling a future intake appointment and
assessment(s), verifying insurance status, and general components of
the Program. MCAO will provide workspace for these activities to occur.
SAGE has read this section and agrees to comply with its requirements
as we have been doing in the current program. Juanita, SAGE’s Court
Liaison, is currently working at the Maricopa County Superior Court
location 5 days per week for this contract.
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2.5.1.9
The Contractor may co-mingle MCAO FDP offenders with non-MCAO
referrals in treatment so long as there is not a mix of low risk level
offenders with moderate or high-risk offenders. It is the responsibility of
the Contractor to have any non-MCAO referrals’ risk levels documented.
If not able/willing to assess non-MCAO referrals, MCAO diversion
participants should receive services only with MCAO diversion
participants by risk level and should state in proposal.
SAGE has read this section and agrees to comply with its requirements
as we have been doing in the current program. In Attachment E, #6, we
have described how we determine the risk-to-recidivate level for both
MCAO and non-MCAO clients. We do not co-mingle low-risk clients with
moderate or high-risk ones in this program.
2.5.1.10 For those offenders who successfully complete the MCAO diversion, the
County Attorney will dismiss the charges with prejudice. If an offender
fails to successfully complete MCAO diversion, MCAO shall review the
reasons for the offender’s unsuccessful termination and decide what
action should be taken depending on the circumstances presented. If it
appears that the termination is solely due to an offender’s non-payment
of program costs and fees (not including restitution), MCAO shall consult
with the contractor to review the offender’s financial assessment
application, financial responsibility determination, and any other
available information regarding the offender’s financial circumstances.
MCAO shall determine whether to reinstate prosecution or undertake
alternatives.
SAGE has read this section and agrees to comply with its requirements
regarding evaluating the reasons certain clients do not successfully
complete the diversion program, as we have been doing in the program.
ATTACHMENT E: RESPONDENT QUESTIONNAIRE
1. ORAS Assessment Tool – Described understanding of ORAS. Provided information if
they are currently an ORAS user, have staff certified, if currently administering the ORAS
in person or virtually, and length of time using the ORAS, If not currently using the ORAS,
indicated how many staff would need to be trained, the need for an ORAS trainer in their
agency, length of time it would take to have staff trained and how they would support the
ORAS.
The University of Cincinnati’s Correctional Institute (UCCI) owns the rights to the ORAS, and to ensure
standardization and quality of administration and interpretation, they require formal training and certification.
SAGE has invested heavily in being able to utilize the Ohio Risk Assessment System-Community Screen
Tool (ORAS-CST). We began administering the instrument in the Fall of 2019 and have been utilizing it
either in-person or through telehealth in almost all of our assessments since mid-2020. We currently have
approximately 30 clinicians who are certified to administer the ORAS and 6 who are certified as
trainers of the ORAS. Having certified trainers allows us to train new end users when needed.
Top-rated risk assessment instruments have consistently shown higher accuracy in predicting recidivism
than relying on clinical judgment alone. Furthermore, empirical evidence has also demonstrated that
specialized risk assessment instruments are more accurate than general ones. Consequently, SAGE
utilizes the Ohio Risk Assessment System, Community Screen Tool (CST), to accurately evaluate clients’
risk-of-recidivism and identify key criminogenic factors.
The ORAS can typically be administered in 45 to 60 minutes in an interview and the resulting client profile
is organized into 8 domains based on the key criminogenic factors:
1. Criminal history
2. Education
3. Employment and finances
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4. Family and social support
5. Neighborhood problems
6. Substance abuse
7. Antisocial associates, and
8. Antisocial attitudes and behavioral problems.
The results classify clients into risk categories by gender ranging from low-risk to high-risk, and they also
indicate clients’ specific criminogenic needs.
Unlike more traditional statistically based instruments, the ORAS includes both static and dynamic risk in
its assessment structure. So, a client’s key dynamic risk factors (changeable issues) are identified, including
criminal thinking, criminal associates/weak social network, substance abuse, unstable employment, and
high-risk living situations. This allows us to apply the Risk, Needs, and Responsivity (RNR) principle to
match the client with the appropriate Treatment Track. At SAGE, our Tracks vary in terms of duration,
intensity, curriculum, case management, and drug monitoring, so specific criminogenic needs can be
effectively targeted and ameliorated. We also use multiple Treatment Tracks to separate low-risk-to-
recidivate clients from moderate and high-risk-to-recidivate clients.
Christopher Lowenkamp, Ph.D. and Ralph Serin, Ph.D. have outlined ten valuable Principles in Risk
Assessment that guides our approach:
1. Do not assume that scoring a risk scale is equivalent to making a decision. The latter necessitates
an analysis of the case beyond arriving at a risk estimate.
2. Use risk scales specific to the type of offender and desired outcome to increase predictive accuracy.
For example, a domestic violence instrument is a better predictor of intimate partner violence than
a general recidivism measure.
3. Be aware that static risk scales indicate the group of individuals who are at risk, whereas dynamic
risk scales purport to indicate why and when a particular individual is at risk.
4. Be wary of overriding risk estimates with clinical judgment. Validated risk scales are more accurate
in predicting client outcomes than clinical judgment.
5. Do not use multiple risk scales in the belief that it will increase predictive accuracy. Risk instruments
typically assess common factors, so more is not necessarily better.
6. Ensure proper training in administering a particular risk instrument, as this is more important than
job, age, or experience.
7. Be careful to target a client’s multiple criminogenic needs. Recidivism reduction is best realized
when more of the client’s needs are met.
8. Match client intervention to risk and need.
9. Do not target low-risk clients or put them in prolonged treatment with higher-risk clients.
10. Deliver interventions in a manner consistent with client’s level of functioning and motivation and
provide an adequate dosage of intervention to realize reductions in reoffending.
2. Additional Assessment Tool(s) – Provided information on their use of any additional
assessment tool(s), specific to a criminal justice involved population. Name of the tool(s),
any certification and/or expiration dates, length of time using the tool(s), how many staff
are trained, any trainers in their agency, refresher training schedule. May have provided
attachments related to this tool(s).
Providing responsive treatment requires effective assessments to identify the primary criminogenic
factors that will be addressed through various Treatment Tracks.
In our initial assessments, we typically utilize the following standardized evaluation tools:
1. ORAS-CST and ORAS Self-Assessment
2. The Continuum from the American Society of Addiction Medicine (ASAM)
3. Patient Health Questionnaire-9 (PHQ-9), and
4. Generalized Anxiety Disorder-7 (GAD-7).
Regarding the Continuum from AHCCCS, SAGE was an “early adopter,” and we began using it in late
2022. Prior to that, we had been using the ASAM Triage for about 3 years. We have been using the
PHQ-9 and GAD-7 since early 2019. All of our more than 25 assessors are trained in administering and
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interpreting all of these 4 instruments. They reference them in concert to finalize a diagnostic impression
and guide our clinicians in making clinical recommendations that are best suited to meet clients’
presenting issue(s) and criminogenic needs. The ASAM Continuum is required by the Arizona
Healthcare Cost Containment System (AHCCCS) as a central component of assessments for members
of AHCCCS. Both the ORAS and ASAM Continuum are particularly effective for evaluating clients
“specific to the criminal justice involved population,” so we have focused on them here. Additional
information concerning the PHQ-9 and GAD-7 can be provided, if requested.
The ASAM Criteria is highly recommended to conduct a multidimensional, biopsychosocial assessment
with recommendations for treatment for substance use disorders (SUD) and mental health conditions.
The ASAM recognizes the multi-dimensional aspects of substance and behavioral health disorders, as
well as the need for a continuum of care of services. It establishes a recommendation for treatment
based upon the assessment and the client’s presenting condition.
The ASAM Continuum is standardized, comprehensive, validated, and structured, and is based upon
the ASAM criteria that covers the 6 ASAM dimensions. It utilizes a Motivational Interviewing (MI)
approach that is patient-centered and engages both clients and clinicians. At the conclusion of the
assessment, the Continuum provides DSM-5 criteria and diagnoses for Substance Use Disorder (SUD);
the Addiction Severity Index (ASI) Composite Scores; identification of medical and psychiatric
conditions; and imminent risk considerations for evaluating a client’s appropriate level of care.
ASI Composite Scores rate severity in seven areas of the client’s life:
Medical; Employment; Alcohol; Drug; Legal; Family & Social, and Psychiatric
For certain programs, we also use the ASAM as a pre/post measure by comparing the Addiction
Severity Index (ASI) Composite Scores. Components of SAGE’s Comprehensive Assessment that
includes the ASAM Continuum are:
1. Demographic information including race, relationship status, emergency contacts, advance
directives, disability status, and insurance information.
2. Medical history including prescribed medications, surgery and hospitalizations, and family
medical history.
3. Vocational history including education status, degree(s), employment status, and barriers to
obtaining employment.
4. Psychiatric history including depression, anxiety, trauma, and other mental health history.
5. Presenting issue(s).
6. Substance use history:
a. Alcohol,
Cannabis,
Opiates,
Sedatives/Hypnotics/Anxiolytics,
Hallucinogens,
Stimulants, Inhalants, Synthetic drugs, Tobacco, Prior substance education and
treatment history, Other addictive behaviors.
7. Social & Legal history including cultural preferences, learning difficulties, self-care, basic needs
screening, criminal history, sex offense history, DUI history, and orders of protection/restraining
orders/no contact orders.
8. Risk assessment screening of a client’s feelings and risks for potential harm to self, harm to
others, food insecurities, and housing needs.
9. Mental Status Exam (MSE) to record the client’s appearance, speech patterns, behavioral
notes, mood, thought/perceptions, memory, insight, and perceived judgement.
10. Formal Diagnosis to include both F-code, behavioral/mental health/substance abuse, and Z-
code, Social Determinants of Health (SDOH).
11. Recommendation Summary, which provides a narrative summary and recommendations for
treatment.
3. Vendor’s Individualized Treatment Plan – Provided examples of treatment plans with
goals addressing criminogenic factors and time frames. Treatment plan is attached with
identified criminogenic factors/domains and a plan of action is described to address high
risk domains.
A sample of our Individualized Treatment/Service Plan can be requested if needed.
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4. Curriculum Used/Proposed – Described and provided information on any current or
proposed curriculum for the solicited program. Name and details of the curriculum,
background of the curriculum, support for evidence based, length of time and experience
using the curriculum, and the requirements for enrolled offenders. Attached examples of
lesson plans/modules and modality of treatment.
In accordance with the current contract for the Felony Diversion Program and to improve client outcomes,
SAGE has 6 different Treatment Tracks for this diversion program. They each have their own curriculum
and different modalities and also vary in duration, number of sessions per week, client composition, drug
monitoring, and the level of case management services. Key features include:
Low-risk-to-recidivate clients are separated from medium or high-risk ones in our groups.
Counseling groups are mostly gender specific (all substance abuse groups are).
Counselors are trained on each curriculum before they facilitate any group.
Three of our curricula require formal training and certification for facilitators, and for all 3 of
those curricula, SAGE has certified Trainers on staff.
Counseling groups are 2 hours in length, except for Track 4, our Intensive Outpatient
Program (IOP), and those groups are 3 hours.
The name of the specific Treatment Tracks and related curricula for the Felony Diversion Program are
listed below. They have all been approved by MCAO for that specific Track.
Treatment Track 1: Substance Abuse Early Intervention Program: Our curriculum for this Track is the
evidence-based “Group Therapy for Substance Abuse: A Stages-of-Change Therapy Manual,” by
Velasquez, Crouch, Stephens, and DiClemente (2016). It was developed specifically for criminal offending
substance abusers, utilizes a Trans-Theoretical Model (TTM) approach for substance abuse treatment, and
employs various evidence-based practices. The structure of the TTM incorporates two main principles:
Stages of Change and Processes of Change. This curriculum does not require formal certification for
training, and we have about 40 clinicians who are trained to facilitate it. We have 6 clinical supervisors and
clinical managers who provide our training.
Treatment Track 2: Substance Abuse Lapse/Relapse Prevention: For this Track, we are utilizing
SAMHSA’s evidence-based “Counselor’s Manual for Relapse Prevention with Chemically Dependent
Criminal Offenders,” which is #19 in their Technical Assistance Publication (TAP) series, along with portions
of Hazelden’s “Living in Balance” described immediately below. TAP 19 has many excellent exercises that
provide material for role playing and skill rehearsal. It systematically addresses both substance abuse and
criminal offending, both separately and jointly. These two curricula do not require formal certification for
training, and we have about 35 clinicians who are trained to facilitate them. We have 6 clinical supervisors
and clinical managers who provide our training.
Treatment Track 3: Substance Abuse Standard Outpatient Treatment (SOP). Our curriculum for this
Track is Hazelden’s “Living in Balance,” which is an evidence-based, cognitive-behavioral, substance
abuse treatment program that was introduced in 2015 and immediately included in SAMHSA’s National
Registry of Evidence-Based Program and Practices. The curriculum has 275 pages of facilitator guides and
over 1400 pages of group session materials that are divided into 37 different session topics. In addition to
the core recovery sessions that include relapse prevention, cognitive, social, emotional, and coping skills
development, the program also addresses several other related social determinants and criminogenic
needs, such as problematic attitudes and beliefs, health issues, chronic pain and opiates, financial
management, problematic social relationships, and parenting/family matters. This curriculum does not
require formal certification for training, and we have about 40 clinicians who are trained to facilitate it. We
have 6 clinical supervisors and clinical managers who provide our training.
Treatment Track 4: Substance Abuse Intensive Outpatient Program (IOP). We are utilizing the
evidence-based curriculum, “Criminal Conduct and Substance Abuse: Strategies for Self-Change (SSC),”
by Ken Wanberg, Ph.D. and Harvey Milkman, Ph.D. This is an interactive, cognitive-behavioral treatment
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program for clients with a history of both criminal conduct and substance abuse. SSC uses an integrated,
social accountability approach and focuses on the interaction of substance abuse and criminality. It has 3
independent Phases that focus on 3 Stages of Change. Clients complete all the sessions in a Phase before
graduating into the next one.
Phase 1: Challenge to Change: Building Knowledge and Skills for Responsible Living
Phase 2: Commitment to Change: Strengthening Skills for Self-Improvement, Change, and
Responsible Living
Phase 3: Taking Ownership of Change: Lifestyle Balance and Healthy Living
This curriculum requires 2 full days of training to facilitate and two additional days of training to become a
trainer. SAGE has 11 clinicians who are certified to facilitate it and two that are certified as trainers.
Treatment Track 5: Cognitive Behavioral Intervention—Low. This Track utilizes an evidence-based
curriculum called “Decision Points,” by Juliana Taymans, Ph.D., Jack Bush, Ph.D., and Steve Swisher,
M.Ed., MS (who had previously developed Thinking for a Change.) It is a cognitive-behavioral program for
reducing problematic behavior and recidivism (rather than directly focusing on substance use treatment like
the first 4 Tracks) and is based on principles with strong research support. It directly addresses the Risk-
Need-Responsivity approach to intervention with criminal offenders and teaches clients how to withdraw
from a “trouble cycle” where certain decisions creates problems that compound themselves. Decision
Points is comprised of 4 steps: Step 1) Identify My Thoughts and Feelings; Step 2) Think About Others
Who Care What I Do; Step 3) Think About Choices. Pick One; and Step 4) Identify A Motivating Thought.
Clients must demonstrate a mastery of each step and skill before advancing to the next one. This is done
through a combination of written exercises for each step inside and outside of class, as well as role playing
a risk situation while in class.
To facilitate Decision Points, a clinician must become formally certified which requires 4 full days of training
and passing a competency test. SAGE has 27 clinicians who are certified for this program and 5 certified
trainers.
Treatment Track 6: Cognitive Behavioral Intervention—Moderate to Very High: The second Treatment
Track in our Cognitive Skills program utilizes a curriculum that is a combination of three curricula: Decision
Points (as described above) and two others from Texas Christian University’s Institute of Behavioral
Research: “Unlock Your Thinking, Open Your Mind,” and “Getting Motivated to Change.” To assist with the
facilitation of this curriculum, we developed an extensive Lesson Plan, or Facilitator’s Guide, that includes
individual lesson plans that include a summary, schedule with steps and time frames, a list of participant
handouts, and the preparations that need to be made prior to the session.
The curricula were all developed for criminal justice clients and the TCU ones were registered in the
Substance Abuse and Mental Health Service Administration (SAMHSA’s) National Registry of Evidence-
Based Programs and Practices (until it was disbanded: http://nrepp.samhsa.gov). The TCU curricula draw
on the technique of Node-Link Mapping, which has been shown to be particularly effective with criminal
justice clients.
To facilitate Decision Points, a clinician must become formally certified which requires 4 full days of training
and passing a competency test. The TCU curricula do not require formal certification. SAGE has 27
clinicians who are certified for this program and 5 certified trainers.
Based on MCAO’s January 24th response to questions, we have not “attached examples of lesson
plans/modules,” since all these curricula have previously been approved by MCAO for their Tracks.
5. Continuum of Care/Levels of Care – Described and provided information on their current
offered or proposed levels of care as determined by an individual’s criminogenic factors,
history, needs and/or risk of re-offend. Provided a detailed description of their levels of
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care: frequency, duration, step down, aftercare services, community-based supports or
capability of referrals for additional support.
Research findings have consistently found that treatment responsivity and treatment matching are critical
components in achieving positive treatment outcomes (McLellan 1991). These evidence-based practices
depend on a solid initial clinical assessment that is supported by empirically based tools, as well as offering
multiple Treatment Tracks that are based on the results of the assessment. The combination of these
program components allows us to apply the Risk, Needs, and Responsivity (RNR) principle and match the
client with the appropriate Treatment Track. At SAGE, our Tracks vary in terms of duration, intensity,
curriculum, and case management supportive services and most are gender specific. This allows us to
effectively target and ameliorate specific criminogenic needs.
Responsive treatment that is delivered in a manner consistent with the client’s learning styles and abilities,
motivation, gender, cultural preferences, ability to handle confrontation, race, etc. reduces barriers and
improves overall outcomes. It is always SAGE’s goal for our programs to focus on the primary criminogenic
factors that have been shown to have the greatest impact on lowering crime and with a methodology that
provides realistic opportunities for change.
Regarding “aftercare services, community-based supports or capability of referrals for additional support,”
during our assessments we establish formal diagnoses that include F-codes (behavioral/mental
health/substance abuse), and Z-codes (Social Determinants of Health (SDOH). This practice supports
making appropriate referrals at any point during treatment, and also referring clients for additional aftercare
services once they are nearing the end of their program with SAGE Counseling.
Identification of a client’s primary criminogenic needs greatly assists us in developing an effective
Individualized Service Plan and placing clients in the most effective level of care. It also helps us target
important social determinants of health that need to be addressed, such as clients’ living situations,
employment, and financial status. Our Treatment Tracks for the Felony Diversion Program include:
Treatment Track 1: Substance Abuse Early Intervention Program: This Track is only for overall low-
risk clients with a moderate to high substance abuse criminogenic need (as determined by our
comprehensive assessment including the ORAS) and entails one counseling group per week. The group
structure is open, and the total number of assigned sessions is typically 10, although female clients who
scored in the Low/Moderate range on the ORAS are assigned 15-20 sessions. Drug monitoring is included,
and some case management services are available, depending on clients’ needs. The groups are gender
specific.
Treatment Track 2: Substance Abuse Lapse/Relapse Prevention: Similarly, to Track 1, number two has
one counseling group a week and includes only overall low-risk clients with a moderate to high substance
abuse criminogenic need (as determined by our comprehensive assessment including the ORAS). The
number of sessions is typically 10, although female clients who scored in the Low/Moderate range on the
ORAS are assigned 15-20 sessions. The groups are gender specific. Drug monitoring is included, and case
management services are available, depending on clients’ needs.
Treatment Track 3: Substance Abuse Standard Outpatient Treatment (SOP). This Track is for overall
moderate-risk clients with a moderate to high substance abuse criminogenic need (as determined by our
comprehensive assessment including the ORAS) and includes 2 groups per week. The groups are gender
specific, and the number of sessions ranges from 20 – 34, depending on clients’ needs. In lieu of a formal
step-down structure in counseling groups, clients meet with their case manager at least once following their
final group. Drug monitoring is included, and case management services are available, depending on
clients’ needs.
Treatment Track 4: Substance Abuse Intensive Outpatient Program (IOP). This Track is for overall
high or very high-risk to recidivate clients with a moderate to high substance abuse criminogenic need (as
determined by our comprehensive assessment including the ORAS). It is built around 3 stages of change
and has 3 independent Phases with clients completing the sessions in a Phase before graduating to the
next one. All groups are 3 hours in length. Clients begin with 3 groups per week, then step down to two,
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and during the 3rd and final Phase, have only 1 group per week. This Track has a limited open structure
for entry, is gender specific, and includes 50 total sessions to successfully graduate.
Due to the severity of clients’ criminogenic needs, the group sessions in this Track are supplemented with
individual counseling. Drug monitoring is included, and case management services are available based on
clients’ needs.
Treatment Track 5: Cognitive Behavioral Intervention--Low: This Track serves clients with an overall
low risk to recidivate and low to high criminogenic needs (as determined by our comprehensive assessment
including the ORAS). It entails one, 2-hour group counseling session per week for a total of 12 sessions.
Treatment Track 6: Cognitive Behavioral Intervention—Moderate to Very High: The second Treatment
Track in our Cognitive Skills program is for overall moderate and high-risk to recidivate clients where their
primary need is not substance abuse (as determined by our comprehensive assessment including the
ORAS). It entails two, 2-hour counseling groups per week for a total of 25 sessions. This Track has a limited
open structure for entry.
When a client’s needs surpass our level of care offerings, we refer him/her to other treatment providers.
We commonly make referrals for services and treatment needs such as Medically Assisted Treatment
(MAT), Partial Hospitalization Programs (PHP), Residential Treatment, Primary Health Care (PCP), and/or
Psychiatric Treatment. Additionally, as part of a client’s individualized service plan (ISP), it is a standard
practice at SAGE to recommend other community services such as peer support programs, job programs,
or physical health services, as applicable.
6. MCAO Participants: Co-mingling of Participants with Others and Risk Levels –
Described and provided a detailed plan if MCAO participants will be co-mingled with
participants referred from other agencies. The information provided should address how
different risk levels will be kept separated during treatment. Detailed information was
provided related to how different risk levels will differ in treatment plan.
As described above, we employ multiple Treatment Tracks that vary in terms of duration, intensity, modality,
and curriculum, so that criminogenic needs can be more effectively targeted and mitigated. We also use
these multiple Treatment Tracks to separate low-risk-to-recidivate clients from moderate and high-risk-to-
recidivate ones. We do not blend low-risk clients in this program (based on our administration of the ORAS
including overrides), in the same counseling groups with those who are moderate or high-risk. Item #5
above describes how only specific risk-to-recidivate clients are eligible in each of our Treatment Tracks.
Since we initiated the Opioid Use Felony Diversion Program Pilot in late 2022, we have utilized the same
comprehensive assessment protocol including the ORAS and ASAM Continuum for all new treatment
clients, as described above in Sections #1, #2, and #3 above, whether they were referred by MCAO, another
organization, or self-referred. (We do not always conduct the same level of assessment for clients referred
specifically for education programs, as opposed to treatment.) This protocol has allowed us to consistently
and effectively determine the risk levels of all treatment clients and subsequently place them in the
appropriate Treatment Track. We do co-mingle clients from other organizations with MCAO clients in our
counseling groups, but we ensure that all the clients are appropriate clinically and have been assessed as
having the recidivism risk level designated for that Track.
Regarding “how different risk levels will differ in treatment plan,” our assessors utilize our various
assessment tools, including the ASAM Continuum and ORAS, and other sources of information. That
informs them of the specific risks and needs of clients, so they can be assigned to an appropriate specific
treatment regimen. Several factors are accounted for when determining “risk,” such as substance use,
criminal/legal history, education, employment and financial history, family history, attitudes, behaviors, and
more.
A client who is determined to be low-risk is recommended for a low-risk treatment schedule that might
include:
1. 10 sessions of 2-hour group counseling, 1x per week.
2. Case management services 1 – 2x per month, or as needed.
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3. Potentially a low level of drug monitoring.
Alternatively, the needs of a high-risk client are more substantial, and thus the treatment might include:
1. 50 sessions of 3-hour intensive level group counseling, initially 3x per week with a gradual step-
down.
2. Drug monitoring through random UA tests throughout the program.
3. 3 – 12 sessions of individual counseling, as appropriate.
4. Case management services 1 – 2x per month, or as needed.
5. Referrals for additional support services, as needed.
The above scenarios highlight two different treatment plans that are developed collaboratively with the
clients based upon differentiated treatment needs as demonstrated through the assessment. At SAGE
Counseling, and throughout healthcare in general, this approach is referred to as “The Golden Thread.” It
requires that a client’s treatment plan will factor in six related components: Assessment; Diagnosis;
Individualized Service Plan (ISP); Treatment Session Notes; Review of the Individualized Service Plan
(ISP); and Discharge Planning. Together, these clinical functions align with healthcare’s best practices to
provide individualized care, promote progress for both short and long-term treatment goals, and support
clients’ overall success.
7. Service Delivery – Described and provided information on their ability to provide services
across Maricopa County and if there are plans to expand locations/dates. Provided a
detailed class schedule or proposed class schedule. If services are provided remotely (tele-
health), a detailed description is provided as to how attendance and engagement is
measured/tracked, and what is the vendor’s class capacity/facilitator to client ratios for in
person and telehealth services. Describe the expectation of participation in remote
sessions and how those expectations are communicated with participants. Describe the
process of moving a participant to in-person sessions when they are not meeting the
expectations of remote sessions.
SAGE Counseling has been providing services throughout Maricopa County through telehealth and hybrid
modalities since the beginning of the pandemic in March of 2020. Even prior to the pandemic, SAGE
provided telephonic case management and engagement services to individuals who were unable to attend
in-office services at one of the 16 SAGE offices.
SAGE currently offers hybrid groups where the clinician and some participants are in-person, while other
clients participate digitally and are visible on a large video screen. SAGE will continue to offer hybrid,
telehealth-video, and in-person services to clients.
Attendance is tracked through our Electronic Health Record system, Credible, and through various reports
the group clinicians, case managers, and the management staff utilize to ensure clients are held
accountable for missed sessions and to ensure clients complete all required treatment. Each clinician
utilizes a roster report to track all clients’ remaining sessions as well as various details regarding their overall
treatment recommendations. SAGE limits group capacity to 15 total clients per group for both virtual and
hybrid groups. Group guidelines are reiterated at the start of groups including attendance guidelines,
participation, and overall group expectations. Overall treatment guidelines are also discussed at the time of
enrollment and during the assessment process. Clients that struggle with telehealth groups are required to
attend in person and are assigned to one of SAGE’s hybrid groups. As needed, the group Clinician or
assigned Case Manager will contact the client and reassign them to an alternative in person group.
Our Case Managers are familiar with working with clients to overcome obstacles to treatment, including not
having a device for video-enabled services. We provide resources and assistance to support their ability to
obtain a video-enabled device. For example, SAGE Counseling has partnered with T-Mobile to provide
certain clients who have accessibility issues with a smart phone for their use during treatment. The phones
will have unlimited talk/text/data and will allow those clients who do not have access to technology to attend
groups and appointments with SAGE virtually.
The use of these phones is not restricted to SAGE treatment and can be used by the client for work, school,
or personal tasks. The service fee will be paid by SAGE as long as the client is actively engaged in treatment
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and attending appointments with their case manager at least once a month. At the conclusion of their
treatment, the client will have the option to return the phone or to transfer service themselves.
SAGE conducts over 320 counseling groups per week, the majority of these being in Maricopa County and
offered in the evening. We also have morning, day, and weekend groups that are available. In addition to
separating clients by gender, we have multiple Treatment Tracks to better match client's criminogenic
factors, e.g., 4 for substance abuse treatment and 3 for Domestic Violence Offender Treatment. The Tracks
vary in terms of the total number of times they meet per week and the total number of groups assigned.
8. Multiple/Flexible Options for Participants – Described and provided information if
flexible options are available/offered: individual/group setting, open entry format to reduce
wait times, varied days for service, hours of operation include evenings and weekends,
same gendered groups, staff to participant ratio is safe and effective to meet the needs of
the participants.
SAGE Counseling has various options that include virtual, in person, or hybrid appointments for the initial
assessment, group and individual treatment. During the assessment process, SAGE will determine the
most effective and convenient treatment options for each client based on gender, location, and individual
clinical needs. The majority of SAGE’s groups have an open entry format as well as multiple day, night and
weekend group options to fit various client needs. All of SAGE’s Substance Abuse and Domestic Violence
groups are gender specific to meet treatment requirements and the general staff to client ratio for each
group is 1:12. SAGE’s current FDP group list is included on the following pages for reference.
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9. Culturally Relevant and Linguistically Appropriate – Provided information how they are
able to meet the cultural and language needs of the population served. Provided
information related to bilingual staff. If none the agency does not have bilingual staff or
bilingual staff are limited, provided information as to how language needs will be met.
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At SAGE, we believe everyone can learn and change. We strive to be culturally competent and sensitive
to the learning styles of our clients. The Socratic method of learning, prescribed throughout our treatment
programs, gives each person a chance to understand the material through his/her own world view.
Participation in class provides the opportunity to challenge ideas, beliefs, and behaviors they may have
inherited or adopted without awareness, and clients can, with further knowledge, choose beliefs and
behaviors that serve their goals. It is particularly striking that participants will often increase awareness of
important values learned in their culture of origin and strive to return to those values for the benefit of
themselves and their families.
We emphasize being sensitive to cultural, ethnic, gender, sexual identity, and age differences in all the
services we deliver. We recognize that personal and cultural beliefs play a central role in determining how
clients view their lives, substance use, criminal conduct, and their involvement in treatment. We provide
cultural competency/diversity training to all our staff in our continuum of care. For facilitators, a key goal is
to understand how our clients’ cultural socialization impacts their understanding of themselves and their
attitudes toward the program. We are attuned to the process of identity development, with a focus on the
client’s particular ethnic and cultural group. We encourage the inclusion of religious and cultural
preferences, family support, and initial identification of needs for a successful learning experience. SAGE
offers various Spanish only groups and as needed, we utilize 1:1 sessions to accommodate the language
needs through phone, virtual, and in person interpreter services.
10. Program Rules and Requirements – Provided a brief summary of the agency’s rules and
expectations as well as when and how this information is delivered to diversion participants.
Describe all methods of outreach and the strategies for re-engaging participants. (This full
document may be requested after award.)
Group expectations and general guidelines are reviewed at the time of enrollment, during the
assessment and prior to the start of each group when a new client is present. SAGE Counseling
staff attempt to contact clients who fail to make contact with SAGE after receiving referral
information to complete the enrollment process, or if the client misses the scheduled appointment.
Staff will attempt to contact clients via phone and email within 24 hours of receiving the referral.
These outreach attempts will be documented in a SAGE progress note. SAGE Counseling staff will
complete a minimum of 3 outreach attempts for clients that are not engaging in services prior to
closing the case at minimum and marking them inactive within the system. Additional reminder text
messages are also utilized for upcoming and missed appointments for clients. If there are no
successful outreach attempts, a discharge report will be submitted within 7 days of closing the case
file. The general group guidelines are summarized below. These guidelines are relayed to each
client throughout treatment.
SAGE Counseling Group Guidelines
Participation
•
Each group is scheduled for 2 hours (3 hours for IOP), please arrive on time and stay for
the entire duration in order to receive credit for the group session.
•
Distractions are not permitted, including background noise.
•
Please respect one another’s opinions and worldviews.
•
You are expected to be on video, facing the screen, at all times.
•
If attending virtually, you must be sitting up throughout the duration of the group.
•
You cannot be doing anything else but engaging in group. (e.g., Cannot be driving in car,
shopping, etc.)
•
There is also no smoking, vaping or eating allowed during the session (as we do in
person, clients should smoke/eat during break).
•
Use “I” statements when speaking vs. generalizing.
•
Group is a judgement free zone.
•
No discussion about politics.
•
Feel free to discuss religion or spirituality as it relates to you. Please do not tell others
what to believe.
Confidentiality
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•
No recording or taking pictures of sessions.
•
Do not use other clients’ names outside of the group.
•
You must be alone in the room. If you cannot be alone, please wear earphones.
•
We cannot speak to anyone outside of SAGE without a valid Release of Information on
file.
o
Exceptions to this rule:
▪
Intent to hurt self or others.
▪
Suspected abuse of child, elderly or disabled.
▪
Medical emergency.
Honesty
•
Please be honest. We are not the legal system and are here to help you succeed.
Support Sobriety
•
Group members are not allowed to attend intoxicated or under the influence.
o
This includes prescription medications that interfere with your ability to participate
in a meaningful and appropriate way.
o
This also includes exhibiting behaviors that might indicate intoxication such as
falling asleep or slurring words.
•
Please do not wear clothing that may trigger others in the group.
UA Compliance
•
Please remind clients that are required to complete UAs to make sure they are following
up on this. Compliance will be part of a successful discharge.
11. Notification of Cost – Described what is shown/provided to participants. Described
vendor fees, expectations of payment, how due dates are determined, and payment
schedule. Provided methods of acceptable payments. Described process of participant
outreach when payment is not made according to proposed schedule.
Notification of Cost at time of enrollment
At time of enrollment to the SAGE program, participants are informed of their assessment fee and
what they can expect to pay for group fees via telephone. Upon completion of their enrollment and
scheduling their assessment appointment, participants are sent a confirmation email that includes
the date and time of their assessment, as well as their anticipated assessment fee.
Within the confirmation email, participants are sent a link to complete their intake documents, which
includes financial responsibility information. Participants are required to review and sign this
document prior to SAGE completing the assessment.
Notification of Cost at time of assessment
SAGE provides a document to the client at completion of assessment called the
“Recommendations Summary” Within this document, the following information is provided:
▪
Assessment Fee, Case Management Fee, Group Rate Per Session, Individual Rate
Per Session, Education Fee, Number of Recommended Treatment Sessions, Service
Type, Weekly Schedule for Treatment Sessions, Start Date of Sessions, Session Start
Time, Session Language
Notification of Cost upon completion of assessment
Upon completion of assessment, SAGE clinicians send a summary email which includes the above
recommendations summary. This this email, the following payment information is included:
▪
Payment is expected prior to each service.
▪
Failure to make your payments on time may put you at risk of non-compliance and may
result in your unsuccessful discharge.
▪
You may pay online by visiting: https://sagecounseling.net/clientresources/
Methods of Acceptable Payment
SAGE accepts all major credit and debit cards as the primary source of payment and payments are
paid online as indicated above. Cash can be accepted in unusual circumstances.
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Outreach During Payment Non-Compliance
SAGE’s billing and collections department tracks and conducts outreach calls and/or emails to all
individuals who have outstanding balances. During this time, SAGE works with the individual to set
up a plan for payment and allows limited flexibility on payment arrangements of outstanding
balances.
12. Indigency Determination and Sliding Scale Considerations – Provided a detailed
process to determine, reduce and/or waive fees for an indigent participant who is not
AHCCCS eligible. Provided a list of documentation requested to verify income for sliding
scale eligibility. Provided process for reassessing a participant’s eligibility throughout their
enrollment with the agency. Described the process of assisting a participant with AHCCCS
eligibility determination if applicable.
Financial Determination Process
For clients who are not eligible for AHCCCS insurance, SAGE offers potential fee discounts based
on the clients’ financial situation. But any U.S. citizen who is indigent is eligible for AHCCCS. At the
initial referral, the Admissions Specialist will ask the client if he or she is insured with AHCCCS. If
the client is not insured with AHCCCS, the Admissions Specialist will inquire on the client’s financial
situation including (1) Number of people in the household and (2) Combined Annual Household
Income. The Admissions Specialist utilizes SAGE’s Sliding Fee Scale to review the information and
determine if the client may be AHCCCS eligible. If so, the client will be referred to the SAGE
Community Assistor for further assistance.
If the client is not insured with AHCCCS and determined to be ineligible for AHCCCS based on
review of their financial situation, the Admissions Specialist will ask the client if he or she desires
to complete a SAGE Financial Assessment Application. If the client chooses to accept the Financial
Assessment Application the client that is informed of the required supporting documentation and
due date to return all required documents within seven (7) days.
Upon receipt of a completed and on time application, a SAGE Billing Specialist completes the
financial assessment and fee determination process. If, as a result of the financial assessment
process, it is determined that the client is eligible for a discount per SAGE’s sliding fee scale, then
this discount will be effective as of the date that all required documentation was submitted. Once
the fee is determined, a SAGE Billing Specialist provides a written decision to the client on his or
her financial responsibility. This is completed within 5 business days of receiving the completed
application from the client. When complete, all documents are uploaded in SAGE’s EHR (Credible).
Documentation Requested Includes:
1) If unemployed:
a. Three (3) most recent payroll stubs or Prior Year Federal Income Tax Return.
b. Letter of Unemployment Benefits eligibility, stating monthly $ amount; or
unemployment denial letter, if applicable.
2) If currently employed:
a. 3 most recent payroll stubs.
3) Documentation supporting additional sources of income including:
a. Social Security, Medicaid, SNAP (former food stamps), Pension, Annuity,
Veterans’ benefits, Alimony, Child support, Military benefits, Businesses, Rent,
Interest, Dividends, Any other income
b. Documentation should show weekly or monthly benefits.
Reassessment during enrollment
During the course of the treatment program, if a client has a loss of AHCCCS eligibility or provides
notification of a change in financial circumstances, then the client will be provided the Financial
Assessment Application and the procedure and requirements discussed above will be applicable.
If, as a result of the financial assessment process, it is determined that a client is eligible for a
discount per the SAGE sliding fee scale, then this discount takes effect on the date of their first
service following the submission of a completed application. Any payments made by a client, after
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the application submittal date, in excess of the discounted fee, are applied in the form of a credit
towards future fees.
Assisting with Enrollment or Re-Enrollment with AHCCCS
SAGE employs two Navigators (or Community Assisters) to assist clients with AHCCCS eligibility,
enrollment, and re-enrollment. Their primary responsibilities include reviewing the AHCCCS
database daily to see whether our current clients are due for renewal, have lost their AHCCCS
insurance, or are eligible for benefits. When a client is determined to be AHCCCS eligible, one of
our SAGE navigators will outreach the client to inform them of all documents that are required to
complete the AHCCCS application. During this initial outreach, SAGE navigators offer one on one
assistance to complete the application process through HEA Plus (AHCCCS’s online member
enrollment program). If the client agrees, our navigators schedule 1 – hour AHCCCS application
appointments and support the client through the process of applying.
SAGE also employs a Court Liaison that provides similar assistance to individuals referred to our
Court Liaison. Additionally, SAGE’s Case Managers provide information about the Marketplace for
insurance under the Affordable Care Act, and assist clients in applying for that coverage, as
needed.
These combined efforts demonstrate our commitment to the community and help ensure that each
client is taking full advantage of all economic opportunities.
13. AHCCCS and Insurance Contracts – Provided documentation of contracts with all seven
AHCCCS Complete Care Plans. Provided documentation of all non-AHCCCS insurance
plans the agency is contracted with. If any contract is pending or due to change, detailed
information is provided about the changes and date(s) those changes go into effect.
SAGE Counseling, Inc. is contracted with all seven (7) AHCCCS ACC Health Plans, both (2) RHBA
AHCCCS Health Plans, and American Indian Health Plan, also through AHCCCS. These health
plans are indicated below:
1) Mercy Care ACC & Long Term Care (LTC)
2) Banner University Family Care & Long Term Care (LTC)
3) Care 1st Health Plan
4) Molina Complete Care
5) Health Choice Arizona
6) Arizona Complete Health
7) United HealthCare
8) American Indian Health Plan
9) Mercy Care RBHA
10) Care 1st RHBA
SAGE does not have any contracts pending and is not contracted with any non-AHCCCS insurance
plan. However, SAGE does occasionally receive and accept primary payer commercial payments
from Blue Cross Blue Sheild, Aetna and Cigna health insurance.
Vendor Qualification Requirements
14. Submitted copies of applicable AZ Department of Health Services licensure for each facility
where services will be provided.
a. Licenses should be for facilities located in Maricopa County, if awarded the County
may request copies of licenses outside Maricopa County.
SAGE has 16 licensed facilities throughout the state, all licensed by BMFL and credentialed by
AHCCCS. These have been identified in our proposal. We have included copies of licenses only
for the facilities in Maricopa County.
Licenses can be provided to MCAO upon request.
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15. Demonstrated that the agency has a minimum of two years of experience working with
adult offender populations. Described experience, history and knowledge of providing
evidence-based practices and programs to adult offender/criminal justice populations.
SAGE Counseling, Inc. is a licensed behavioral health provider with 25 years of experience
providing treatment and education services to adult offender populations in both outpatient and
incarcerated settings. SAGE has held contracts with MCAO to provide services to that clinical
population since 2009 and currently provides substance abuse, domestic violence, cognitive skills,
and education treatment for MCAO. A list of additional history and experience is listed in section
5.6.1.2. Currently, we provide 215 substance abuse and cognitive skills groups per week. Almost
all our substance abuse groups are gender-specific, and we follow the EBP of not blending low-
risk clients with moderate or high-risk ones.
All of SAGE’s programming is evidence-based, including utilizing the American Society of Addiction
Medicine’s (ASAM) Continuum Assessment, the Ohio Risk Assessment System to evaluate risk of
recidivism, and our multiple evidenced-based curricula. SAGE conducts a thorough Individualized
Service Plan (ISP) with all outpatient clients, which includes goal setting and monitoring goal
achievement and progress.
Vendor Reporting Requirements and Performance
16. Acknowledge if the vendor will meet all contract reporting and performance requirements
as described in the scope of work. If not, please explain what aspects of the requirements
will not be met.
SAGE Counseling, Inc. hereby acknowledges that we will meet all contract reporting and
performance requirements as described in the scope of work, unless we’ve explicitly indicated
otherwise in section 5.7 Exceptions to the Solicitation.
17. Acknowledge if the vendor will meet all the terms and conditions of the draft contract. If
not, please explain what aspects of the contract will not be met.
SAGE Counseling, Inc. hereby acknowledges that we will meet all of the terms and conditions of
the contract.
18. Acknowledge if the vendor will meet the technology capability requirements described in
the scope of work. If not, what aspects of the requirements will not be met.
SAGE Counseling, Inc. hereby acknowledges that we will meet the technology capability
requirements described in the scope of work.
Required Attachments
19. Organizational Chart
Provided with response, MCAO can request updated organization chart when needed.
20. Job Descriptions for positions responsible for delivering the diversion program.
a. Provide a list of the positions by title, a brief summary for each of their roles, and
how many staff you have in these roles.
MCAO can request job descriptions when needed.
21. Proposed fee schedule
a. Refers to the menu of services that the contractor may offer as applicable to this
population. This menu of services allows MCAO to know what services the
Contractor offers in the event that the diversion program requirements may need
to be modified in the future. This is not the same as Attachment D – Pricing Page,
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where the contractor is providing their proposed rates for the specific existing
required services by diversion program.
FEE SCHEDULE
SERVICE TYPE
Assessment
Assessment Update
Education
Case Management
Individual Counseling
Counseling Group
IOP Counseling Group
In Home Family Therapy
In Office Family Therapy
Out of State or County Coordination
Intake
Restitution Management
Drug Monitoring
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** We generally deliver our Education in 8-hour classes and counseling groups in 2-hour
sessions.
For AHCCCS clients only:
Reimbursement by AHCCCS for behavioral health services provided by SAGE Counseling is
contingent on those services being deemed “medically necessary” by the client’s AHCCCS health
plan. The vast majority of SAGE’s services have been approved by the appropriate health plan for
payment in the past; however, for those clients whose services are deemed to be not medically
necessary by their AHCCCS health plan, the clients become responsible to pay for their services
themselves. They are considered “self-pay” clients.
For AHCCCS-ineligible clients:
AHCCCS-ineligible clients will be given the opportunity to qualify for reduced fees in accordance
with the SAGE Counseling Sliding Fee Scale.
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Opioid Use - Felony Diversion Program Pilot
2.0
PROGRAM REQUIREMENTS
2.2.3
Opioid Use – Felony Diversion Program Pilot – MCAO has partnered with
Maricopa County Public Health to offer this program for eligible offenders who, as
the parent/guardian, are charged with child abuse, neglect, endangerment, or
related offense and the circumstances of the offense are related to substance use,
particularly opioids.
SAGE has served as the contracted treatment provider for this pilot program since
its initiation.
2.2.3.1 The Pilot is intended to offer a diversion alternative and meet the unique
needs of offender cases originating out of the MCAO Family Violence
Bureau, referred to the existing Felony Diversion Program with a diagnosis
of Opioid Use Disorder (OUD), Alcohol Use Disorder (AUD), or Substance
Use Disorder (SUD) and filed criminal charges of Child Abuse,
Endangerment, Neglect, or Assault, where there was no fracture or
permanent injury to the child. The focus of the Pilot is to provide
therapeutic interventions to address the offender’s addiction, to hold the
offender accountable for their criminal actions, and improve child safety in
the home.
SAGE has read this section and agrees to comply with its requirements to
provide evidence-based therapeutic interventions to address offenders’
addiction and other behavioral health issues.
2.2.3.2 Contractor shall review existing social history and referral packet
information. After the Ohio Risk Assessment System – Community
Supervision Tool (ORAS-CST) has been completed which determines the
offender’s overall risk to reoffend and identified criminogenic need areas,
contractor shall administer an MCAO approved substance abuse needs
assessment to provide specific diagnosis and treatment areas. If the
substance abuse assessment requires staff training or certification,
licensing/registration fees, or other costs, this shall be the responsibility of
the contractor. For fidelity, the substance abuse assessment may require
that the contractor update or reassess the offender during appropriate
clinical intervals, or pre/post testing.
SAGE has read this section and agrees to continue complying with its
requirements. We have been administering the ORAS for over 3 years,
and have many clinicians certified to administer it and several certified to
be trainers. Please see Section # 1 in Attachment E.
2.2.3.3 Contractor shall provide an evidence-based substance abuse specific
group counseling curriculum/curricula by treatment track for Standard
Outpatient and Intensive Outpatient offenders. A detailed description of
the proposed curriculum, how long the agency has been using this
curriculum, the number of staff trained in this curriculum, and citations for
meta-analyses of this curriculum must be included in the proposal.
SAGE has read this section and agrees to comply with its requirements.
We have provided detailed information regarding our Treatment Tracks for
this diversion program in Attachment E, #4.
2.2.3.4 Contractor shall develop a dynamic Individual Service Plan (ISP) and
goals relative to the targeted criminogenic needs and domains so the
service is beneficial and appropriate for the offender’s learning style,
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motivation, abilities, and strengths. A copy of the ISP must be sent to
MCAO at the time of discharge.
SAGE has read this section and agrees to comply with its requirements as
we have been doing in the current pilot opioid diversion program. Please
see Attachment E #3 below for a sample of our comprehensive ISP.
2.2.3.5 Family Counseling and Parent Education: Offenders shall participate in
family counseling and/or parent education. The offender’s minor child/ren
(if appropriate) shall be encouraged to participate in family counseling. The
contractor shall have the ability to provide these services in-person (either
in the offender’s home or in-office), virtually, or a combination of both.
However, MCAO’s preference will be for in-home services. The clinician
shall determine a beneficial service location. A component of family
counseling and parent education is for the clinician to observe and
document the family environment for child safety.
SAGE has read this section and agrees to comply with its requirements as
we have been doing in the current program. SAGE has been a contracted
provider for the Arizona Department of Child Safety continuously since
2003 and have developed strong expertise providing in-home family
counseling and parent education. We understand that part of these
services is to observe and document the family environment for child
safety.
2.2.3.6 For offenders who are not insured by AHCCCS and for cost considerations
for the offender, family counseling and parent education shall be capped
at 15 total sessions for one or both services. There is no limit to the number
of family counseling and/or parent education sessions for offenders who
are AHCCCS-insured.
SAGE has read this section and will comply with its requirements
regarding the number of counseling sessions.
2.2.3.7 Individual (1:1) counseling sessions may substitute for required group
counseling sessions in exigent situations and when it is in the best interest
of the offender. Examples of exigent situations include, but not limited to:
a risk to the group having the offender present (escalating behaviors,
threat to others and/or Contractor staff), The contractor has determined
that the offender has a clinical need for individual services initially to
successfully transition to group, and not enough participants to form a
group (foreign language spoken or offender risk level) and it is in the
offender’s best interest to not delay services. The contractor must inform
the offender of the additional cost of individual counseling services.
SAGE has read this section and agrees to comply with its requirements as
we have been doing in the current program. We agree to inform the client
of the cost of individual counseling services.
2.2.3.8 Services for the offender’s child/ren: If the child/ren are not currently
receiving wraparound services specific to their needs, the contractor shall
offer to the offender (the parent/guardian) a referral to LaFrontera-
EMPACT (“EMPACT”). Services at EMPACT shall be voluntary and
information regarding services, expectations, and potential costs shall be
disclosed to the offender. Provided that the parent/guardian has signed a
Release of Information, the contractor shall coordinate services with
EMPACT and/or another applicable third-party agency.
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SAGE has read this section and agrees to comply with its requirements to
refer clients’ children to EMAPCT when appropriate, as we have been
doing in the current program. We understand that services with EMPACT
are voluntary, and clients need to be notified of the potential costs.
2.2.3.9 The contractor shall coordinate services with EMPACT each month and
track monthly metrics related to family support services and the number of
coordinated case management meetings.
SAGE has read this section and agrees to comply with its requirements
regarding tracking designated metrics of the services with EMPACT.
2.2.3.10 If a Release of Information is signed by the offender, the contractor shall
request and obtain the offender’s child/ren case records from the
Department of Child Safety (DCS) to review past and current services.
This information shall be used to determine appropriate services for the
family while in the Pilot.
SAGE has read this section and agrees to comply with its requirements
concerning obtaining clients’ records from DCS, if available, and utilizing
them in determining clients’ treatment program.
2.2.3.11 Medication-Assisted Treatment (MAT) Services: if after a MAT
assessment and a recommendation is made for MAT, it is the offender’s
choice to participate. However, the contractor shall inform the offender of
the benefits of MAT and encourage participation, but the offender’s
decision to not participate cannot adversely affect their diversion status.
For those who participate, the contractor shall be required to coordinate
case services with the MAT provider.
SAGE has read this section and agrees to comply with its requirements as
we have been doing in the current program. Following an evaluation of
whether MAT services are appropriate for a client, in situations where MAT
services are recommended, we will encourage clients’ participation, but
realize that it is voluntary and will not affect their diversion status. SAGE
will coordinate services with the MAT provider.
2.2.3.12 If the offender agrees to participate in MAT, required services imposed by
the MAT provider, such as drug testing for medical reasons, will not
substitute for diversion program requirements.
SAGE has read this section and agrees to comply with its requirements as
we have been doing.
2.2.3.13 Along with the program monthly metrics for the preceding month and
timeframes, the contractor shall track MAT services and provide to MCAO:
total number of offenders who were referred for a MAT assessment. Of
those assessed, through a signed Release of Information, provide the total
number of offenders who opted in for MAT and the number of offenders
who opted out of MAT.
SAGE has read this section and agrees to comply with its requirements
regarding tracking and submitting information regarding clients’ MAT
services.
2.2.3.14 For those offenders participating in MAT, prior to discharge (either
Successful or Unsuccessful) from the Pilot, the contractor shall provide
information to the offender about aftercare or other community resources
to reinforce the importance of continuing with these services.
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SAGE has read this section and agrees to comply with the requirements
regarding notifying MAT clients of the importance of continuing treatment,
as well as the available aftercare and community resources.
2.2.3.15 Drug Testing requirements:
2.2.3.15.1 The contractor shall refer the offender for random drug testing
at an MCAO approved, contracted laboratory. The offender
shall be tested for the MCAO selected drug panels, within
prescribed maximums (up to 40 drug tests) while in the Pilot.
The offender must submit to drug testing concurrent to the
treatment.
SAGE has read this section and agrees to comply with its
requirements regarding drug monitoring services. In the
current program, we have been working with Averhealth for
these services.
2.2.3.15.2 Urinalysis shall be the primary default method of drug testing.
However, the MCAO contracted laboratory may offer an
MCAO approved alternative method of testing, for example
saliva/oral fluid, if the offender cannot submit to urinalysis due
to exigent circumstances. The contractor shall be required to
document in the offender’s case file what those exigent
circumstances are for auditing purposes.
SAGE has read this section and agrees to comply with the
requirements concerning urinalysis being the default method
of drug testing, as we have been doing in the current program.
We agree to document in clients’ clinical records the reasons
for any alternative method being used.
2.2.3.15.3 The offender shall submit to random drug testing throughout
their participation in the Pilot, at an appropriate frequency
determined by the contractor’s clinical staff. Additionally, the
offender shall submit to weekly drug testing in their first
month/first 30 days. The offender must produce at least four
consecutive, negative test results towards the end of
treatment (approximately last 30 days) in order to earn a
Successful Discharge.
SAGE has read this section and agrees to comply with its
specific requirements regarding the schedule of random drug
testing, as we have been doing in the current Opioid Use
Diversion Program.
2.2.3.15.4 It is the responsibility of the contractor to monitor, manage,
and track drug testing frequency, integrate the results (or lack
thereof) into the treatment plan, and ensure that testing
maximums are adhered to. The contractor shall respond and
address each non-negative drug test result with the offender
within three business days of the provider’s notification to
effect timely change. Other drug testing that the offender may
do outside of this diversion program will not be substituted for
diversion requirements.
SAGE has read this section and agrees to comply with its
requirements regarding the contractor’s role in managing
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certain tasks related to the drug testing program, as we have
been doing in the current program.
2.2.3.15.5 An offender’s report of prescribed medications shall be
verified by the contractor and documented in the case file. Any
positive result from a verified, prescribed medication and
other considerations shall be documented in the offender’s
electronic health record and the MCAO Discharge Report at
the time of termination.
SAGE has read this section and agrees to comply, when
possible, with its requirements of verifying and documenting
clients’ reports of their use of prescribed medications. We also
agree to document incidents of positive drug-test results for
prescribed medications in the clients’ files.
2.2.3.15.6 If the offender tests positive for an illegal substance, the
contractor shall address the results with the offender within
three business days of the provider’s notification through their
Case Management services. Specifically for the Pilot with
child safety as a focus, the contractor shall also ask the
offender “Where were you using?” and “Where was/were your
child/children when you were using?” and document the
response and the appropriate course of action. If the offender
admits to using drugs in the presence of their child, the
contractor shall as a Mandatory Reporter per A.R.S. §13-
3620, notify law enforcement and/or the Arizona Department
of Child Safety (DCS) of the allegations of child
endangerment. Document notification in case notes.
SAGE has read this section and agrees to comply with its
specific requirements concerning a case manager addressing
with a client the issue of any positive drug test for illegal
substances. We also agree to report to DCS and/or law
enforcement any incidents that qualify as needing mandated
reporting for child endangerment and documenting that in the
client’s files.
2.2.3.15.7 Upon receipt of each positive test result for an illicit substance
from an offender in the Pilot, MCAO Diversion staff shall send
an email communication to the contractor’s assigned point of
contact to the offender’s case. The email shall ask the
contractor’s point of contact/case manager to attest and
provide the date that the positive test result for illicit
substances was addressed with the offender and if a child
endangerment report was made to DCS and/or law
enforcement. The contractor’s point of contact or case
manager shall provide a written response to MCAO Diversion
via email within 48 hours of receipt. The email response from
the contractor shall be uploaded into the offender’s criminal
record within the MCAO Case Management System, Karpel.
The contractor should not rely on the emails from MCAO to
prompt them to address positive test results with the offender.
SAGE has read this section and agrees to comply with its
requirements regarding communication between MCAO and
SAGE staff and related tasks to be completed whenever a
client has a positive drug test for an illegal substance.
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2.2.3.15.8 Mandated reporters are required by law, as defined by ARS
13-3620, to report all concerns of child abuse or neglect.
Department of Child Safety (DCS) provides this secure
website for mandated reporters of child abuse and neglect to
report non-emergency concerns, as authorized by ARS 13-
3620. Should provider report an incident, the contractor shall
notify and submit an Incident Report to MCAO within
prescribed timeframes if law enforcement and/or DCS are
contacted per Mandatory Reporting Requirements. Reporting
this information to MCAO does not equate to an automatic
Unsuccessful Discharge from the Pilot. MCAO shall decide if
an unsuccessful discharge is warranted in diversion based on
review of the Incident Report and other case factors and will
then notify the contractor on next steps.
SAGE has read this section and agrees to comply with its
requirements regarding submitting an incident report to
MCAO anytime a SAGE staff member submits a mandated
report to DCS under ARS 13-3620.
As we have been doing in the current program, we understand
that such reports to DCS do not equate to an unsuccessful
discharge from the program.
2.2.3.16 Inpatient Substance Abuse Services:
The contractor shall have the ability to assess and determine if the
offender is in need of an inpatient substance abuse service for a period of
stabilization with a third-party provider before and/or during participation
in the Pilot. The contractor shall hold the diversion case open for up to 90
days while the offender is receiving services with the third-party provider
and coordinate services. If it is anticipated that the third-party provider
services will exceed 90 days, the contractor shall inform and staff the case
with the Director of Diversion Strategies Group or designee for next steps.
SAGE has read this section and agrees to comply with its requirements
concerning assessing whether clients need inpatient substance abuse
treatment. In situations where a diversion client has been placed in such
a treatment program, SAGE will coordinate services as we have been
doing for our current clients.
2.2.3.17 Case Management Services:
Given the complexity of offender’s needs, family needs, and multi-agency
collaboration/coordination, the contractor shall initiate Case Management
Services for all offenders in the Pilot. Case Management services shall be
limited to up to 26 hours while in the Pilot,unless the offender is verified to
be an AHCCCS member. Any Case Management service beyond 26
hours shall be approved by the MCAO Diversion Strategies Group Director
or designee prior to implementation.
SAGE has read this section and agrees to comply with its requirements
and limits concerning the provision of case management services for
clients in this pilot program, as we have currently been doing.
2.2.3.18 Pregnant Offenders in the Pilot:
2.2.3.18.1 Pregnant female offenders with substance use diagnoses
have unique needs and shall be carefully monitored while in
the
Pilot.
The
contractor
shall
provide
appropriate,
community-based referrals for this population and case
coordination while they are in the Pilot. The contractor, at a
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minimum, shall provide information to pregnant offenders
about the Maricopa County SHIFT (Safe Healthy Infants and
Families Thrive) Program.
SAGE has read this section and agrees to comply with its
requirements regarding treatment for pregnant women in this
program. We recognize that such clients have special needs,
and we will monitor them carefully and also make referrals to
SHIFT and other appropriate programs for services.
2.2.3.18.2 The contractor shall collect and report to MCAO each month,
the number of pregnant offenders referred to the Maricopa
County SHIFT Program.
SAGE has read this section and agrees to comply with its
requirements about reporting to MCAO the number of
pregnant clients referred to the SHIFT program.
2.2.3.19 Metrics and Reporting Outcome Requirements for the Pilot:
The contractor shall be required to report on the Pilot monthly metrics (total
enrollment, new monthly enrollment, number of Successful and
Unsuccessful completions for previous month) similarly as required in the
SOW for the Felony Diversion Program. The contractor shall also report
outcomes and within timeframes as described in the Logic Model for the
Pilot.
SAGE has read this section and agrees to comply with its requirements
regarding reporting specified metrics and outcomes in the Logic Model to
MCAO on a monthly basis.
2.2.3.20 Using Public Monies to Fund the Pilot:
The contractor shall submit invoices for the Pilot to MCAO by the 8th day
of the month for applicable services from the preceding month. This is to
have adequate time for MCAO to review and then submit said invoices to
Maricopa County Procurement and then to Maricopa County Department
of Public Health (MCDPH) who will give final approval for payment.
SAGE has read this section and agrees to comply with its requirements
concerning submitting invoices by the 8th of the month for applicable
services provided for this pilot program.
ATTACHMENT E: RESPONDENT QUESTIONNAIRE
1. ORAS Assessment Tool – Described understanding of ORAS. Provided information if
they are currently an ORAS user, have staff certified, if currently administering the ORAS
in person or virtually, and length of time using the ORAS, If not currently using the ORAS,
indicated how many staff would need to be trained, the need for an ORAS trainer in their
agency, length of time it would take to have staff trained and how they would support the
ORAS.
The University of Cincinnati’s Correctional Institute (UCCI) owns the rights to the ORAS, and to ensure
standardization and quality of administration and interpretation, they require formal training and
certification. SAGE has invested heavily in being able to utilize the Ohio Risk Assessment System-
Community Screen Tool (ORAS-CST). We began administering the instrument in the Fall of 2019 and have
been utilizing it either in-person or through telehealth in almost all of our assessments since mid-2020. We
currently have approximately 30 clinicians who are certified to administer the ORAS and 6 who are
certified as trainers of the ORAS. Having certified trainers allows us to train new end users when needed.
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Top-rated risk assessment instruments have consistently shown higher accuracy in predicting recidivism
than relying on clinical judgment alone. Furthermore, empirical evidence has also demonstrated that
specialized risk assessment instruments are more accurate than general ones. Consequently, SAGE
utilizes the Ohio Risk Assessment System, Community Screen Tool (CST), to accurately evaluate clients’
risk-of-recidivism and identify key criminogenic factors.
The ORAS can typically be administered in 45 to 60 minutes in an interview and the resulting client profile
is organized into 8 domains based on the key criminogenic factors:
1. Criminal history
2. Education
3. Employment and finances
4. Family and social support
5. Neighborhood problems
6. Substance abuse
7. Antisocial associates, and
8. Antisocial attitudes and behavioral problems.
The results classify clients into risk categories by gender ranging from low-risk to high-risk, and they also
indicate clients’ specific criminogenic needs.
Unlike more traditional statistically based instruments, the ORAS includes both static and dynamic risk in
its assessment structure. So, a client’s key dynamic risk factors (changeable issues) are identified, including
criminal thinking, criminal associates/weak social network, substance abuse, unstable employment, and
high-risk living situations. This allows us to apply the Risk, Needs, and Responsivity (RNR) principle to
match the client with the appropriate Treatment Track. At SAGE, our Tracks vary in terms of duration,
intensity, curriculum, case management, and drug monitoring, so specific criminogenic needs can be
effectively targeted and ameliorated.
Christopher Lowenkamp, Ph.D. and Ralph Serin, Ph.D. have outlined ten valuable Principles in Risk
Assessment that guides our approach:
1. Do not assume that scoring a risk scale is equivalent to making a decision. The latter
necessitates an analysis of the case beyond arriving at a risk estimate.
2. Use risk scales specific to the type of offender and desired outcome to increase predictive
accuracy. For example, a domestic violence instrument is a better predictor of intimate partner
violence than a general recidivism measure.
3. Be aware that static risk scales indicate the group of individuals who are at risk, whereas
dynamic risk scales purport to indicate why and when a particular individual is at risk.
4. Be wary of overriding risk estimates with clinical judgment. Validated risk scales are more
accurate in predicting client outcomes than clinical judgment.
5. Do not use multiple risk scales in the belief that it will increase predictive accuracy. Risk
instruments typically assess common factors, so more is not necessarily better.
6. Ensure proper training in administering a particular risk instrument, as this is more important
than job, age, or experience.
7. Be careful to target a client’s multiple criminogenic needs. Recidivism reduction is best realized
when more of the client’s needs are met.
8. Match client intervention to risk and need.
9. Do not target low-risk clients or put them in prolonged treatment with higher-risk clients.
10. Deliver interventions in a manner consistent with client’s level of functioning and motivation and
provide an adequate dosage of intervention to realize reductions in reoffending.
2. Additional Assessment Tool(s) – Provided information on their use of any additional
assessment tool(s), specific to a criminal justice involved population. Name of the tool(s),
any certification and/or expiration dates, length of time using the tool(s), how many staff
are trained, any trainers in their agency, refresher training schedule. May have provided
attachments related to this tool(s).
Providing responsive treatment requires effective assessments to identify the primary criminogenic factors
that will be addressed through various Treatment Tracks. For this diversion program, we conduct a
Comprehensive Family Assessment during the first home visit. We focus on child safety, risk factors,
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resiliency factors, the family’s level of functioning, current supports for the family and their needs, which are
utilized in developing their Individualized Service Plan.
In our initial assessments, we typically utilize the following standardized evaluation tools:
1. ORAS-CST and ORAS Self-Assessment
2. The Continuum from the American Society of Addiction Medicine (ASAM)
3. Patient Health Questionnaire-9 (PHQ-9), and
4. Generalized Anxiety Disorder-7 (GAD-7).
Regarding the Continuum from AHCCCS, SAGE was an “early adopter,” and we began using it in late
2022. Prior to that, we had been using the ASAM Triage for about 3 years. We have been using the
PHQ-9 and GAD-7 since early 2019. All of our more than 25 assessors are trained in administering and
interpreting all 4 of them. The instruments are referenced in concert to finalize a diagnostic impression
and guide our clinicians in making clinical recommendations that are best suited to meet clients’
presenting issue(s) and criminogenic needs. The ASAM Continuum is required by the Arizona
Healthcare Cost Containment System (AHCCCS) as a central component of assessments for members
of AHCCCS. Both the ORAS and ASAM Continuum are particularly effective for evaluating clients
“specific to the criminal justice involved population,” so we have focused on them here. Additional
information concerning the PHQ-9 and GAD-7 can be provided, if requested.
The ASAM Criteria is highly recommended to conduct a multidimensional, biopsychosocial assessment
with recommendations for treatment for substance use disorders (SUD) and mental health conditions.
The ASAM recognizes the multi-dimensional aspects of substance and behavioral health disorders, as
well as the need for a continuum of care of services. It establishes a recommendation for treatment
based upon the assessment and the client’s presenting condition.
The ASAM Continuum is standardized, comprehensive, validated, and structured, and is based upon
the ASAM criteria that covers the 6 ASAM dimensions. It utilizes a Motivational Interviewing (MI)
approach that is patient-centered and engages both clients and clinicians. At the conclusion of the
assessment, the Continuum provides DSM-5 criteria and diagnoses for Substance Use Disorder (SUD);
the Addiction Severity Index (ASI) Composite Scores; identification of medical and psychiatric
conditions; and imminent risk considerations for evaluating a client’s appropriate level of care.
ASI Composite Scores rate severity in seven areas of the client’s life:
Medical; Employment; Alcohol; Drug; Legal; Family & Social, and Psychiatric.
For certain programs, we also use the ASAM as a pre/post measure by comparing the Addiction
Severity Index (ASI) Composite Scores. Components of SAGE’s Comprehensive Assessment that
includes the ASAM Continuum are:
1. Demographic information including race, relationship status, emergency contacts, advance
directives, disability status, and insurance information.
2. Medical history including prescribed medications, surgery and hospitalizations, and family
medical history.
3. Vocational history including education status, degree(s), employment status, and barriers
to obtaining employment.
4. Psychiatric history including depression, anxiety, trauma, and other mental health history.
5. Presenting issue(s).
6. Substance use history:
a. Alcohol,
Cannabis,
Opiates,
Sedatives/Hypnotics/Anxiolytics,
Hallucinogens,
Stimulants, Inhalants, Synthetic drugs, Tobacco, Prior substance education and
treatment history, Other addictive behaviors.
7. Social & Legal history including cultural preferences, learning difficulties, self-care, basic
needs screening, criminal history, sex offense history, DUI history, and orders of
protection/restraining orders/no contact orders.
8. Risk assessment screening of a client’s feelings and risks for potential harm to self, harm
to others, food insecurities, and housing needs.
9. Mental Status Exam (MSE) to record the client’s appearance, speech patterns, behavioral
notes, mood, thought/perceptions, memory, insight, and perceived judgement.
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10. Formal Diagnosis to include both F-code, behavioral/mental health/substance abuse, and
Z-code, Social Determinants of Health (SDOH).
11. Recommendation Summary, which provides a narrative summary and recommendations
for treatment.
3. Vendor’s Individualized Treatment Plan – Provided examples of treatment plans with
goals addressing criminogenic factors and time frames. Treatment plan is attached with
identified criminogenic factors/domains and a plan of action is described to address high
risk domains.
A sample of our Individualized Treatment/Service Plan has been provided and can be requested as needed.
4. Curriculum Used/Proposed – Described and provided information on any current or
proposed curriculum for the solicited program. Name and details of the curriculum,
background of the curriculum, support for evidence based, length of time and experience
using the curriculum, and the requirements for enrolled offenders. Attached examples of
lesson plans/modules and modality of treatment.
In accordance with the current contract for the Opioid Use Felony Diversion Program Pilot, SAGE has 2
different Treatment Tracks for this diversion program. They each have their own curriculum and different
modalities and also vary in duration, number of sessions per week, client composition, drug monitoring, and
the level of case management services. Key features include:
All counseling groups are gender specific.
Counselors are trained on each curriculum before they facilitate any group.
One of the curricula requires formal training with certification for facilitators, and SAGE has
certified Trainers on staff for that program.
Counseling groups are either 2 or 3 hours in length, depending on clients’ needs.
The name of the specific Treatment Tracks and related curricula for the Opioid Use Felony Diversion
Program are listed below. They have both been approved by MCAO for that specific Track.
Treatment Track 3: Substance Abuse Standard Outpatient Treatment (SOP). Our curriculum for this
Track is Hazelden’s “Living in Balance,” which is an evidence-based, cognitive-behavioral, substance
abuse treatment program that was introduced in 2015 and immediately included in SAMHSA’s National
Registry of Evidence-Based Program and Practices. The curriculum has 275 pages of facilitator guides and
over 1400 pages of group session materials that are divided into 37 different session topics. In addition to
the core recovery sessions that include relapse prevention, cognitive, social, emotional, and coping skills
development, the program also addresses several other related social determinants and criminogenic
needs, such as problematic attitudes and beliefs, health issues, chronic pain and opiates, financial
management, problematic social relationships, and parenting/family matters. This curriculum does not
require formal certification for training, and we have about 40 clinicians who are trained to facilitate it. We
have 6 clinical supervisors and clinical managers who provide our training.
Treatment Track 4: Substance Abuse Intensive Outpatient Program (IOP). We are utilizing the
evidence-based curriculum, “Criminal Conduct and Substance Abuse: Strategies for Self-Change (SSC),”
by Ken Wanberg, Ph.D. and Harvey Milkman, Ph.D. This is an interactive, cognitive-behavioral treatment
program for clients with a history of both criminal conduct and substance abuse. SSC uses an integrated,
social accountability approach and focuses on the interaction of substance abuse and criminality. It has 3
independent Phases that focus on 3 Stages of Change. Clients complete all the sessions in a Phase before
graduating into the next one.
Phase 1: Challenge to Change: Building Knowledge and Skills for Responsible Living
Phase 2: Commitment to Change: Strengthening Skills for Self-Improvement, Change, and
Responsible Living
Phase 3: Taking Ownership of Change: Lifestyle Balance and Healthy Living
This curriculum requires 2 full days of training to facilitate and two additional days of training to become a
trainer. SAGE has 11 clinicians who are certified to facilitate it and two that are certified as trainers.
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Parenting Education/Skills Track: We are utilizing Texas Christian University’s (TCU) Institute of
Behavioral Research’s Partners in Parenting. It is included in SAMHSA’s National Registry of Evidence-
Based Program and Practices. It is a manualized program with parenting strategies and experiential
exercises for parents to discuss their experiences with others. We also provide clients with handouts from
TCU’s Institute of Behavioral Research on the following parenting issues: Toys, Sibling Rivalry, Language
Development, Learning to Read and Write, Disciplining Your Preschooler, Discipling Your Toddler, Fears,
Self-Esteem, Moving to a New Home, Temper Tantrum, Biting, Toilet Training, Children and Sleep, and
Childhood Stress: What Parents Can Do.
Based on MCAO’s January 24th response to questions, we have not “attached examples of lesson
plans/modules,” since these curricula have previously been approved by MCAO for their Tracks.
5. Continuum of Care/Levels of Care – Described and provided information on their current
offered or proposed levels of care as determined by an individual’s criminogenic factors,
history, needs and/or risk of re-offend. Provided a detailed description of their levels of
care: frequency, duration, step down, aftercare services, community-based supports or
capability of referrals for additional support.
Research findings have consistently found that treatment responsivity and treatment matching are critical
components in achieving positive treatment outcomes (McLellan 1991). These evidence-based practices
depend on a solid initial clinical assessment that is supported by empirically based tools, as well as offering
multiple Treatment Tracks that are based on the results of the assessment. The combination of these
program components allows us to apply the Risk, Needs, and Responsivity (RNR) principle and match the
client with the appropriate Treatment Track. Our Tracks for this program vary in terms of duration, intensity,
modality, curriculum, and are gender specific. This allows us to effectively target and ameliorate specific
criminogenic needs.
Responsive treatment that is delivered in a manner consistent with the client’s learning styles and abilities,
motivation, gender, cultural preferences, ability to handle confrontation, race, etc. reduces barriers and
improves overall outcomes. It is always SAGE’s goal for our programs to focus on the primary criminogenic
factors that have been shown to have the greatest impact on lowering crime and with a methodology that
provides realistic opportunities for change.
Identification of a client’s primary criminogenic needs greatly assists us in developing an effective
Individualized Service Plan and placing clients in the most effective level of care. It also helps us target
important social determinants of health that need to be addressed, such as clients’ living situations,
employment, and financial status. Our Treatment Tracks for the Opioid Use Felony Diversion Program
include:
Treatment Track 3: Substance Abuse Standard Outpatient Treatment (SOP). This Track is for overall
moderate-risk clients with a moderate to high substance abuse criminogenic need (as determined by our
comprehensive assessment including the ORAS) and includes 2 groups per week. The groups are gender
specific, and the number of sessions ranges from 20 – 34, depending on clients’ needs. In lieu of a formal
step-down structure in counseling groups, clients meet with their case manager at least once following their
final group. Drug monitoring is included, and case management services are available, depending on
clients’ needs.
Treatment Track 4: Substance Abuse Intensive Outpatient Program (IOP). This Track is for overall
high or very high-risk to recidivate clients with a moderate to high substance abuse criminogenic need (as
determined by our comprehensive assessment including the ORAS). It is built around 3 stages of change
and has 3 independent Phases with clients completing the sessions in a Phase before graduating to the
next one. All groups are 3 hours in length. Clients begin with 3 groups per week, then step down to two,
and during the 3rd and final Phase, have only 1 group per week. This Track has a limited open structure
for entry, is gender specific, and includes 50 total sessions to successfully graduate.
Individual Counseling Track: Due to the severity of these clients’ criminogenic needs, the group sessions
in this Track are supplemented with individual counseling, which can be provided in-home or through
telehealth. Curriculum material from any of the above-listed Tracks may be utilized to assist families in
achieving their ISP goals and the program’s general goals as outlined in Section 5.6.1.1.
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Family Counseling, In-Home or In-Office: This service is provided in-home whenever possible and is
tailored to meet clients’ and families' specific needs. Families are encouraged to include children when
appropriate. During each visit, the clinician observes the interactions among family members to identify
areas for clinical focus or referrals for additional services are warranted. The safety of children is always
evaluated during sessions. Curriculum material from any of the above-listed Tracks may be utilized in order
to assist the family in achieving their ISP goals and the program’s general goals outlined in Section 5.6.1.1.
Case Management Services: At the assessment, a SAGE clinician is assigned to the client who also
provides case management services for the client/family. This allows for a more intense level of services
that typically includes weekly in-home or virtual visits, individual and/or family counseling, identification and
assistance with resources or referrals needed for the family to achieve success, monitoring of group
attendance and UA compliance, and reinforcement and rehearsal of skills learned in the program.
Parenting Education/Skills Track: This is a 2-hour counseling group that meets once a week and covers
the curriculum described for Parenting Education/Skills Item #4 Curriculum above. It can be used in
conjunction with any other modalities in the program.
Medication Assisted Treatment MAT: Following the results of SAGE’s assessment or information
gathered during the treatment process, we refer clients for voluntary MAT services. SAGE coordinates such
treatment with our own program.
Children’s Services at La Frontera-EMPACT: If the children in the family are not already receiving
wraparound services, we refer them to EMPACT for voluntary services. SAGE coordinates such services
with our own programming.
Maricopa County’s Safe Healthy Infants and Families Thrive (SHIFT) Program: All pregnant women in
the program are referred to the SHIFT Program. Like MAT, this is a voluntary program for clients. SAGE
coordinates such services with our own services.
Due to the severity of these clients’ risk factors and criminogenic needs, enhanced drug monitoring and
case management services are provided, as clinically appropriate. If a client tests positive for any illegal
substance, we directly address that with him/her and ask the “required questions” to evaluate the safety of
any children in the home and follow the related attestation process. We also follow the guidelines of
mandated reporting in A.R.S 13-3620.
When a client’s needs surpass our level of care offerings, we refer him/her to other treatment providers.
We commonly make referrals for services and treatment needs such as Medically Assisted Treatment
(MAT), Partial Hospitalization Programs (PHP), Residential Treatment, Primary Health Care (PCP), and/or
Psychiatric Treatment. Additionally, as part of a client’s individualized service plan (ISP), it is a standard
practice at SAGE to recommend other community services such as peer support programs, job programs,
or physical health services, as applicable.
Regarding “aftercare services, community-based supports or capability of referrals for additional support,”
during our assessments we establish formal diagnoses that include F-codes (behavioral/mental
health/substance abuse), and Z-codes (Social Determinants of Health (SDOH). This practice supports
making appropriate referrals at any point during treatment, and also referring clients for additional aftercare
services once they are nearing the end of their program with SAGE Counseling.
6. MCAO Participants: Co-mingling of Participants with Others and Risk Levels –
Described and provided a detailed plan if MCAO participants will be co-mingled with
participants referred from other agencies. The information provided should address how
different risk levels will be kept separated during treatment. Detailed information was
provided related to how different risk levels will differ in treatment plan.
As described above, we employ multiple Treatment Tracks that vary in terms of duration, intensity, modality,
and curriculum, so that criminogenic needs can be more effectively targeted and mitigated. We also use
these multiple Treatment Tracks to separate low-risk-to-recidivate clients from moderate and high-risk-to-
recidivate ones. We do not blend low-risk clients (based on our administration of the ORAS including over-
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rides), in the same counseling groups in this program with those who are moderate or high-risk. Item #5
above describes how only specific risk-to-recidivate clients are eligible in each of our Treatment Tracks.
Since we initiated the Opioid Use Felony Diversion Program Pilot in late 2022, we have utilized the same
comprehensive assessment protocol including the ORAS and ASAM Continuum for all new treatment
clients, as described above in Sections #1, #2, and #3 above, whether they were referred by MCAO, another
organization, or self-referred. (We do not always conduct the same assessment for clients referred
specifically for education programs, as opposed to treatment.) This protocol has allowed us to consistently
and effectively determine the risk levels of all treatment clients and subsequently place them in the
appropriate Treatment Track. We do co-mingle clients from other organizations with MCAO clients in our
counseling groups, but we ensure that all the clients are appropriate clinically and have been assessed as
having the recidivism risk level designated for that Track.
Regarding “how different risk levels will differ in treatment plan,” our assessors utilize our various
assessment tools, including the ASAM Continuum and ORAS, and other sources of information. These
informs them of the specific risks and needs of clients, so they can be assigned to an appropriate specific
treatment regimen. Several factors are accounted for when determining “risk,” such as substance use,
criminal/legal history, education, employment and financial history, family history, attitudes, behaviors, and
more.
A client who is determined to be moderate-risk is recommended for a treatment schedule that might include:
1. 25 sessions of 2-hour group counseling, 2 times per week.
2. 5 sessions of in-home family counseling.
3. Case management services 1 – 2 times per month, or as needed.
4. Random drug monitoring .
Alternatively, the needs of a high-risk client are much more substantial, and thus his/her treatment schedule
might include:
1. 50 sessions of 3-hour intensive level group counseling, initially 3 times per week with a gradual
step-down.
2. Medication Assisted Treatment through a partner agency.
3. 5-8 sessions of individual counseling, as needed.
4. 5 sessions of in-home family counseling.
5. Case management services 1 – 2 times per month, or as needed.
6. Random drug monitoring throughout the program.
7. Referrals for additional support services, as needed.
The above scenarios highlight two different treatment plans that are developed collaboratively with the
clients based upon differentiated treatment needs as demonstrated through the assessment. At SAGE
Counseling, and throughout healthcare in general, this approach is referred to as “The Golden Thread.” It
requires that a client’s treatment plan will factor in six related components: Assessment; Diagnosis;
Individualized Service Plan (ISP); Treatment Session Notes; Review of the Individualized Service Plan
(ISP); and Discharge Planning. Together, these clinical functions align with healthcare’s best practices to
provide individualized care, promote progress for both short and long-term treatment goals, and support
clients’ overall success.
7. Service Delivery – Described and provided information on their ability to provide services
across Maricopa County and if there are plans to expand locations/dates. Provided a
detailed class schedule or proposed class schedule. If services are provided remotely (tele-
health), a detailed description is provided as to how attendance and engagement is
measured/tracked, and what is the vendor’s class capacity/facilitator to client ratios for in
person and telehealth services. Describe the expectation of participation in remote
sessions and how those expectations are communicated with participants. Describe the
process of moving a participant to in-person sessions when they are not meeting the
expectations of remote sessions.
SAGE Counseling has been providing services throughout Maricopa County through telehealth and hybrid
modalities since the beginning of the pandemic in March of 2020. Even prior to the pandemic, SAGE
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provided telephonic case management and engagement services to individuals who were unable to attend
in-office services at one of the 16 SAGE offices.
SAGE currently offers hybrid groups where the clinician and some participants are in-person, while other
clients participate digitally and are visible on a large video screen. SAGE will continue to offer hybrid,
telehealth-video, and in-person services to clients.
Attendance is tracked through our EHR system, Credible, and through various reports the group clinicians,
case managers, and the management staff utilize to ensure clients are held accountable for missed
sessions and to ensure clients complete all required treatment. Each clinician utilizes a roster report to track
all clients’ remaining sessions as well as various details regarding their overall treatment recommendations.
SAGE limits group capacity to 15 total clients per group for both virtual and hybrid groups. Group guidelines
are reiterated at the start of groups including attendance guidelines, participation, and overall group
expectations. Overall treatment guidelines are also discussed at the time of enrollment and during the
assessment process. Clients that struggle with telehealth groups are required to attend in person and are
assigned to one of SAGE’s hybrid groups. As needed, the group Clinician or assigned Case Manager will
contact the client and reassign them to an alternative in person group.
Our Case Managers are familiar with working with clients to overcome obstacles to treatment, including not
having a device for video-enabled services. We provide resources and assistance to support their ability to
obtain a video-enabled device. For example, SAGE Counseling has partnered with T-Mobile to provide
certain clients who have accessibility issues with a smart phone for their use during treatment. The phones
will have unlimited talk/text/data and will allow those clients who do not have access to technology to attend
groups and appointments with SAGE virtually.
The use of these phones is not restricted to SAGE treatment and can be used by the client for work, school,
or personal tasks. The service fee will be paid by SAGE as long as the client is actively engaged in treatment
and attending appointments with their case manager at least once a month. At the conclusion of their
treatment, the client will have the option to return the phone or to transfer service themselves.
SAGE conducts over 320 counseling groups per week, the majority of these being in Maricopa County and
offered in the evening. We also have morning, day, and weekend groups that are available. In addition to
separating clients by gender, we have multiple Treatment Tracks to better match client's criminogenic
factors, e.g., 4 for substance abuse treatment and 3 for Domestic Violence Offender Treatment. The Tracks
vary in terms of the total number of times they meet per week and the total number of groups assigned.
8. Multiple/Flexible Options for Participants – Described and provided information if
flexible options are available/offered: individual/group setting, open entry format to reduce
wait times, varied days for service, hours of operation include evenings and weekends,
same gendered groups, staff to participant ratio is safe and effective to meet the needs of
the participants.
SAGE Counseling has various options that include virtual, in person, or hybrid appointments for the initial
assessment, group and individual treatment. During the assessment process, SAGE will determine the
most effective and convenient treatment options for each client based on gender, location, and individual
clinical needs. The majority of SAGE’s groups have an open entry format as well as multiple day, night and
weekend group options to fit various client needs. All of SAGE’s Substance Abuse and Domestic Violence
groups are gender specific to meet treatment requirements and the general staff to client ratio for each
group is 1:12. SAGE’s current Substance Abuse group list can be requested as needed.
9. Culturally Relevant and Linguistically Appropriate – Provided information how they are
able to meet the cultural and language needs of the population served. Provided
information related to bilingual staff. If none the agency does not have bilingual staff or
bilingual staff are limited, provided information as to how language needs will be met.
At SAGE, we believe everyone can learn and change. We strive to be culturally competent and sensitive
to the learning styles of our clients. The Socratic method of learning, prescribed throughout our treatment
programs, gives each person a chance to understand the material through his/her own world view.
Participation in class provides the opportunity to challenge ideas, beliefs, and behaviors they may have
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inherited or adopted without awareness, and clients can, with further knowledge, choose beliefs and
behaviors that serve their goals. It is particularly striking that participants will often increase awareness of
important values learned in their culture of origin and strive to return to those values for the benefit of
themselves and their families.
We emphasize being sensitive to cultural, ethnic, gender, sexual identity, and age differences in all the
services we deliver. We recognize that personal and cultural beliefs play a central role in determining how
clients view their lives, substance use, criminal conduct, and their involvement in treatment. We provide
cultural competency/diversity training to all our staff in our continuum of care. For facilitators, a key goal is
to understand how our clients’ cultural socialization impacts their understanding of themselves and their
attitudes toward the program. We are attuned to the process of identity development, with a focus on the
client’s particular ethnic and cultural group. We encourage the inclusion of religious and cultural
preferences, family support, and initial identification of needs for a successful learning experience. SAGE
offers various Spanish only groups and as needed, we utilize 1:1 sessions to accommodate the language
needs through phone, virtual, and in person interpreter services.
10. Program Rules and Requirements – Provided a brief summary of the agency’s rules and
expectations as well as when and how this information is delivered to diversion participants.
Describe all methods of outreach and the strategies for re-engaging participants. (This full
document may be requested after award.)
Group expectations and general guidelines are reviewed at the time of enrollment, during the assessment
and prior to the start of each group when a new client is present. SAGE Counseling staff attempt to contact
clients who fail to make contact with SAGE after receiving referral information to complete the enrollment
process, or if the client misses the scheduled appointment. Staff will attempt to contact clients via phone
and email within 24 hours of receiving the referral. These outreach attempts will be documented in a SAGE
progress note. SAGE Counseling staff will complete a minimum of 3 outreach attempts for clients that are
not engaging in services prior to closing the case at minimum and marking them inactive within the system.
Additional reminder text messages are also utilized for upcoming and missed appointments for clients. If
there are no successful outreach attempts, a discharge report will be submitted within 7 days of closing the
case file. The general group guidelines are included below. These guidelines are relayed to each client
throughout treatment.
SAGE Counseling Group Guidelines
Participation
• Each group is scheduled for 2 hours (3 hours for IOP), please arrive on time and stay for the entire
duration in order to receive credit for the group session.
• Distractions are not permitted, including background noise.
• Please respect one another’s opinions and worldviews.
• You are expected to be on video, facing the screen, at all times.
• If attending virtually, you must be sitting up throughout the duration of the group.
• You cannot be doing anything else but engaging in group. (e.g., Cannot be driving in car, shopping,
etc.)
• There is also no smoking, vaping or eating allowed during the session (as we do in person, clients
should smoke/eat during break).
• Use “I” statements when speaking vs. generalizing.
• Group is a judgement free zone.
• No discussion about politics.
• Feel free to discuss religion or spirituality as it relates to you. Please do not tell others what to believe.
Confidentiality
• No recording or taking pictures of sessions.
• Do not use other clients’ names outside of the group.
• You must be alone in the room. If you cannot be alone, please wear earphones.
• We cannot speak to anyone outside of SAGE without a valid Release of Information on file.
o Exceptions to this rule:
▪ Intent to hurt self or others.
▪ Suspected abuse of child, elderly or disabled.
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▪ Medical emergency.
(VIOLATIONS OF THESE RULES MAY RESULT IN PROGRAM DISCHARGE).
Honesty
• Please be honest. We are not the legal system and are here to help you succeed.
Support Sobriety
• Group members are not allowed to attend intoxicated or under the influence.
o This includes prescription medications that interfere with your ability to participate in a meaningful and
appropriate way.
o This also includes exhibiting behaviors that might indicate intoxication such as falling asleep or slurring
words.
• Please do not wear clothing that may trigger others in the group.
UA Compliance
• Please remind clients that are required to complete UAs to make sure they are following up on this.
Compliance will be part of a successful discharge.
11. Notification of Cost – Described what is shown/provided to participants. Described
vendor fees, expectations of payment, how due dates are determined, and payment
schedule. Provided methods of acceptable payments. Described process of participant
outreach when payment is not made according to proposed schedule.
Notification of Cost at time of enrollment
At time of enrollment to the SAGE program, participants are informed of their assessment fee and what
they can expect to pay for group fees via telephone. Upon completion of their enrollment and scheduling
their assessment appointment, participants are sent a confirmation email that includes the date and time of
their assessment, as well as their anticipated assessment fee.
Within the confirmation email, participants are sent a link to complete their intake documents, which
includes financial responsibility information. Participants are required to review and sign this document prior
to SAGE completing the assessment.
Notification of Cost at time of assessment
SAGE provides a document to the client at completion of assessment called the “Recommendations
Summary” Within this document, the following information is provided:
▪
Assessment Fee
▪
Case Management Fee
▪
Group Rate Per Session
▪
Individual Rate Per Session
▪
Education Fee
▪
Number of Recommended Treatment Sessions
▪
Service Type
▪
Per Session Fee (stated again)
▪
Weekly Schedule for Treatment Sessions
▪
Start Date of Sessions
▪
Session Start Time
▪
Session Language
Notification of Cost upon completion of assessment
Upon completion of assessment, SAGE clinicians send a summary email which includes the above
recommendations summary. This this email, the following payment information is included:
▪
Payment is expected prior to each service.
▪
Failure to make your payments on time may put you at risk of non-compliance and may
result in your unsuccessful discharge.
▪
You may pay online by visiting: https://sagecounseling.net/clientresources/
Methods of Acceptable Payment
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SAGE accepts all major credit and debit cards as the primary source of payment and payments are paid
online as indicated above.
Outreach During Payment Non-Compliance
SAGE’s billing and collections department tracks and conducts outreach calls and/or emails to all
individuals who have outstanding balances. During this time, SAGE works with the individual to set up a
plan for payment, and allows limited flexibility on payment arrangements of outstanding balances.
12. Indigency Determination and Sliding Scale Considerations – Provided a detailed
process to determine, reduce and/or waive fees for an indigent participant who is not
AHCCCS eligible. Provided a list of documentation requested to verify income for sliding
scale eligibility. Provided process for reassessing a participant’s eligibility throughout their
enrollment with the agency. Described the process of assisting a participant with AHCCCS
eligibility determination if applicable.
Financial Determination Process
For clients who are not eligible for AHCCCS insurance, SAGE offers potential fee discounts based on the
clients’ financial situation. But any U.S. citizen who is indigent is eligible for AHCCCS. At the initial referral,
the Admissions Specialist will ask the client if he or she is insured with AHCCCS. If the client is not insured
with AHCCCS, the Admissions Specialist will inquire on the client’s financial situation including (1) Number
of people in the household and (2) Combined Annual Household Income. The Admissions Specialist utilizes
SAGE’s Sliding Fee Scale to review the information and determine if the client may be AHCCCS eligible. If
so, the client will be referred to the SAGE Community Assistor for further assistance.
If the client is not insured with AHCCCS and determined to be ineligible for AHCCCS based on review of
their financial situation, the Admissions Specialist will ask the client if he or she desires to complete a SAGE
Financial Assessment Application. If the client chooses to accept the Financial Assessment Application the
client that is informed of the required supporting documentation and due date to return all required
documents within seven (7) days.
Upon receipt of a completed and on time application, a SAGE Billing Specialist completes the financial
assessment and fee determination process. If, as a result of the financial assessment process, it is
determined that the client is eligible for a discount per SAGE’s sliding fee scale, then this discount will be
effective as of the date that all required documentation was submitted. Once the fee is determined, a SAGE
Billing Specialist provides a written decision to the client on his or her financial responsibility. This is
completed within 5 business days of receiving the completed application from the client. When complete,
all documents are uploaded in SAGE’s EHR (Credible).
Documentation Requested Includes:
1) If unemployed:
a. Three (3) most recent payroll stubs or Prior Year Federal Income Tax Return.
b. Letter of Unemployment Benefits eligibility, stating monthly $ amount; or
unemployment denial letter, if applicable.
2) If currently employed:
a. 3 most recent payroll stubs.
3) Documentation supporting additional sources of income including:
a. Social Security, Medicaid, SNAP (former food stamps), Pension, Annuity,
Veterans’ benefits, Alimony, Child support, Military benefits, Businesses, Rent,
Interest, Dividends, Any other income
b. Documentation should show weekly or monthly benefits.
Reassessment during enrollment
During the course of the treatment program, if a client has a loss of AHCCCS eligibility or provides
notification of a change in financial circumstances, then the client will be provided the Financial Assessment
Application and the procedure and requirements discussed above will be applicable.
If, as a result of the financial assessment process, it is determined that a client is eligible for a discount per
the SAGE sliding fee scale, then this discount takes effect on the date of their first service following the
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submission of a completed application. Any payments made by a client, after the application submittal date,
in excess of the discounted fee, are applied in the form of a credit towards future fees.
Assisting with Enrollment or Re-Enrollment with AHCCCS
SAGE employs two Navigators (or Community Assisters) to assist clients with AHCCCS eligibility,
enrollment, and re-enrollment. Their primary responsibilities include reviewing the AHCCCS database daily
to see whether our current clients are due for renewal, have lost their AHCCCS insurance, or are eligible
for benefits. When a client is determined to be AHCCCS eligible, one of our SAGE navigators will outreach
the client to inform them of all documents that are required to complete the AHCCCS application. During
this initial outreach, SAGE navigators offer one on one assistance to complete the application process
through HEA Plus (AHCCCS’s online member enrollment program). If the client agrees, our navigators
schedule 1 – hour AHCCCS application appointments and support the client through the process of
applying.
SAGE also employs a Court Liaison that provides similar assistance to individuals referred to our Court
Liaison. Additionally, SAGE’s Case Managers provide information about the Marketplace for insurance
under the Affordable Care Act, and assist clients in applying for that coverage, as needed.
These combined efforts demonstrate our commitment to the community and help ensure that each client is
taking full advantage of all economic opportunities.
13. AHCCCS and Insurance Contracts – Provided documentation of contracts with all seven
AHCCCS Complete Care Plans. Provided documentation of all non-AHCCCS insurance
plans the agency is contracted with. If any contract is pending or due to change, detailed
information is provided about the changes and date(s) those changes go into effect.
SAGE Counseling, Inc. is contracted with all seven (7) AHCCCS ACC Health Plans, both (2) RHBA
AHCCCS Health Plans, and American Indian Health Plan, also through AHCCCS. These health plans are
indicated below:
1) Mercy Care ACC & Long Term Care (LTC)
2) Banner University Family Care & Long Term Care (LTC)
3) Care 1st Health Plan
4) Molina Complete Care
5) Health Choice Arizona
6) Arizona Complete Health
7) United HealthCare
8) American Indian Health Plan
9) Mercy Care RBHA
10) Care 1st RHBA
SAGE does not have any contracts pending and is not contracted with any non-AHCCCS insurance plan.
However, SAGE does occasionally receive and accept primary payer commercial payments from Blue
Cross Blue Sheild, Aetna and Cigna health insurance.
Vendor Qualification Requirements
14. Submitted copies of applicable AZ Department of Health Services licensure for each facility
where services will be provided.
a. Licenses should be for facilities located in Maricopa County, if awarded the County
may request copies of licenses outside Maricopa County.
On the following pages, you will find a list of our licenses for each of our facilities. SAGE has 16 licensed
facilities throughout the state, all licensed by BMFL and credentialed by AHCCCS. These are identified
below. We have included copies of licenses only for the facilities in Maricopa County. Licenses can be
provided to MCAO upon request.
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15. Demonstrated that the agency has a minimum of two years of experience working with
adult offender populations. Described experience, history and knowledge of providing
evidence-based practices and programs to adult offender/criminal justice populations.
SAGE Counseling, Inc. is a licensed behavioral health provider with 25 years of experience providing
treatment and education services to adult offender populations in both outpatient and incarcerated settings.
SAGE has held contracts with MCAO to provide services to that clinical population since 2009 and currently
provides substance abuse, domestic violence, cognitive skills, and education treatment for MCAO. A list of
additional history and experience is listed in section 5.6.1.2. Currently, we provide 215 substance abuse
and cognitive skills groups per week. Almost all our substance abuse groups are gender-specific, and we
follow the EBP of not blending low-risk clients with moderate or high-risk ones.
All of SAGE’s programming is evidence-based, including utilizing the American Society of Addiction
Medicine’s (ASAM) Continuum Assessment, the Ohio Risk Assessment System to evaluate risk of
recidivism, and our multiple evidenced-based curricula. SAGE conducts a thorough Individualized Service
Plan (ISP) with all outpatient clients, which includes goal setting and monitoring goal achievement and
progress.
Vendor Reporting Requirements and Performance
16. Acknowledge if the vendor will meet all contract reporting and performance requirements
as described in the scope of work. If not, please explain what aspects of the requirements
will not be met.
SAGE Counseling, Inc. hereby acknowledges that we will meet all contract reporting and performance
requirements as described in the scope of work, unless we’ve explicitly indicated otherwise in section 5.7
Exceptions to the Solicitation.
17. Acknowledge if the vendor will meet all the terms and conditions of the draft contract. If
not, please explain what aspects of the contract will not be met.
SAGE Counseling, Inc. hereby acknowledges that we will meet all of the terms and conditions of the draft
contract.
18. Acknowledge if the vendor will meet the technology capability requirements described in
the scope of work. If not, what aspects of the requirements will not be met.
SAGE Counseling, Inc. hereby acknowledges that we will meet the technology capability requirements
described in the scope of work.
Required Attachments
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19. Organizational Chart
Provided with response, MCAO can request updated organization chart when needed.
20. Job Descriptions for positions responsible for delivering the diversion program.
a. Provide a list of the positions by title, a brief summary for each of their roles, and
how many staff you have in these roles.
MCAO can request job descriptions when needed.
21. Proposed fee schedule
a. Refers to the menu of services that the contractor may offer as applicable to this
population. This menu of services allows MCAO to know what services the
Contractor offers in the event that the diversion program requirements may need
to be modified in the future. This is not the same as Exhibit A – Pricing Page, where
the contractor is providing their proposed rates for the specific existing required
services by diversion program.
FEE SCHEDULE
We generally deliver our Education in 8-hour classes and counseling groups in 2-hour sessions.
For AHCCCS clients only:
Reimbursement by AHCCCS for behavioral health services provided by SAGE Counseling is contingent on
those services being deemed “medically necessary” by the client’s AHCCCS health plan. The vast majority
of SAGE’s services have been approved by the appropriate health plan for payment in the past; however,
for those clients whose services are deemed to be not medically necessary by their AHCCCS health plan,
the clients become responsible to pay for their services themselves. They are considered “self-pay” clients..
For AHCCCS-ineligible clients:
AHCCCS-ineligible clients will be given the opportunity to qualify for reduced fees in accordance with the
SAGE Counseling Sliding Fee Scale.
SERVICE TYPE
Assessment
Assessment Update
Education
Case Management
Individual Counseling
Counseling Group
IOP Counseling Group
In Home Family Therapy
In Office Family Therapy
Out of State or County Coordination
Intake
Restitution Management
Drug Monitoring
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Domestic Violence Diversion Program
2.0
PROGRAM REQUIREMENTS
2.2.4
Domestic Violence Diversion Program (DVDP) – Eligible offenders charged with
domestic violence, specific types of felony and misdemeanor offenses will be
diverted into a treatment program in lieu of prosecution. Treatment options include
curricula that explore motivational engagement in the intervention process and
build readiness to change, the context and use of violence, challenging attitudes,
and beliefs, cognitive restructuring, managing relationships, developing a safety
plan, and healthy boundaries.
2.2.4.1 Only certain offenders who are charged with specific domestic violence
felony or misdemeanor offenses, or citations may be eligible for and
offered diversion. If diversion is accepted by the offender, prosecution is
suspended for two years so the offender can participate in the prescribed
program. It is anticipated that most referrals will be for offenders with
misdemeanors originating from the Justice Courts. The offender must
complete their diversion program within twelve months.
SAGE Counseling agrees to adhere to the terms listed in this section, and
all subsections within regarding the intent of this solicitation.
2.2.4.2 After administering a validated risk to reoffend assessment for adults,
contractor shall provide treatment services to referred offenders using an
approved evidence-based curriculum/curricula. A detailed description of
the proposed curriculum, how long the agency has been using this
curriculum, the number of staff trained in this curriculum, and citations for
meta-analyses of this curriculum must be included in the proposal.
SAGE has read this section and agrees to comply with its requirements.
We currently administer a highly rated risk-to-reoffend instrument (ORAS-
CST) and have multiple curricula for our various Treatment Tracks. We
have provided a detailed description of the multiple curricula that respond
to these questions in Attachment E, #4 below.
2.2.4.3 DVDP shall have multiple treatment tracks, gender based, where dose and
duration of treatment services (treatment tracks) shall be determined on
risk level and identified criminogenic needs.
SAGE has read this section and agrees to comply with its
requirements. We have provided a detailed description of our multiple
gender specific Treatment Tracks in Attachment E, #5.
2.2.4.4 Individual (1:1) counseling sessions may substitute for required group
counseling sessions in exigent situations and when it is in the best interest
of the offender. Examples of exigent situations include, but not limited to:
a risk to the group having the offender present (escalating behaviors,
threat to others and/or Contractor staff), the contractor has determined that
the offender has a clinical need for individual services initially to
successfully transition to group, and not enough participants to form a
group (foreign language spoken or offender risk level) and it is in the
offender’s best interest to not delay services. The contractor must inform
the offender of the additional cost of individual counseling services.
SAGE has read this section and agrees to comply with its requirements as
we have been doing in the current program.
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2.2.4.5 Case Management services may be offered as a service to the offender
when deemed to be clinically necessary and of benefit to the overall
success of the offender. The cost of case management shall be disclosed
and agreed to by the offender prior to start of services. MCAO may place
a maximum to the number of Case Management service hours provided if
MCAO is paying for the service; however, the Contractor may seek
approval from MCAO to exceed the maximum capacity with appropriate
clinical justification.
SAGE has read this section and agrees to comply with its requirements as
we have been doing in the current MCAO diversion program.
2.2.4.6 For those offenders owing restitution, the contractor shall ensure that
payments are made according to program requirements and take
appropriate action if not made. DVDP requires that 50% of the total
restitution be paid within the first 30 days of treatment. The balance can
be made in payments as determined by the contractor. No offender can
be successfully discharged from the program until restitution is paid in full.
SAGE has read this section and agrees to comply with its requirements as
we have been doing in the current diversion program. We also manage
restitution payments for other diversion programs.
2.2.4.7 The Contractor may co-mingle MCAO DVDP offenders with non-MCAO
referrals in treatment so long as there is not a mix of risk levels. It is the
responsibility of the Contractor to have any non-MCAO referrals’ risk levels
documented.
SAGE has read this section and agrees to comply with its requirements as
we have been doing in the current program. In Attachment E, #6, we have
described how we determine the risk-to-recidivate level for both MCAO
and non-MCAO clients.
2.2.4.8 For those offenders who successfully complete the MCAO diversion, the
County Attorney will dismiss the charges with prejudice. If an offender fails
to successfully complete MCAO diversion, MCAO shall review the reasons
for the offender’s unsuccessful termination and decide what action should
be taken depending on the circumstances presented. If it appears that the
termination is solely due to an offender’s non-payment of program costs
and fees (not including restitution), MCAO shall consult with the contractor
to review the offender’s financial assessment application, financial
responsibility determination, and any other available information regarding
the offender’s financial circumstances. MCAO shall determine whether to
reinstate prosecution or undertake alternatives.
SAGE has read this section and agrees to comply with its requirements
regarding evaluating the reasons certain clients do not successfully
complete the diversion program, as we have been doing in the program.
ATTACHMENT E: RESPONDENT QUESTIONNAIRE
1. ORAS Assessment Tool – Described understanding of ORAS. Provided information if
they are currently an ORAS user, have staff certified, if currently administering the ORAS
in person or virtually, and length of time using the ORAS, If not currently using the ORAS,
indicated how many staff would need to be trained, the need for an ORAS trainer in their
agency, length of time it would take to have staff trained and how they would support the
ORAS.
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Top-rated risk assessment instruments have consistently shown higher accuracy in predicting recidivism
than relying on clinical judgment alone. Empirical evidence has also demonstrated that specialized risk
assessment instruments are more accurate than general ones. SAGE utilizes the Ohio Risk Assessment
System, Community Screen Tool (CST), to evaluate clients’ risk-of-recidivism and identify key criminogenic
factors.
The University of Cincinnati’s Correctional Institute (UCCI) owns the rights to the ORAS, and to ensure
standardization and quality of administration and interpretation, they require formal training and
certification. SAGE has seriously invested in being able to utilize the Ohio Risk Assessment System-
Community Screen Tool (ORAS-CST). We began administering the instrument in the Fall of 2019 and
have been utilizing it in almost all of our assessments since mid-2020. We currently have approximately
30 clinicians who are certified to administer the ORAS and 6 who are certified as trainers of the
ORAS. Having certified trainers allows us to train new end users when needed.
The ORAS can typically be administered in 45 to 60 minutes in an interview and the resulting client profile
is organized into 8 domains based on the key criminogenic factors:
1. Criminal history
2. Education
3. Employment and finances
4. Family and social support
5. Neighborhood problems
6. Substance abuse
7. Antisocial associates, and
8. Antisocial attitudes and behavioral problems.
The results classify clients into risk categories by gender ranging from low-risk to high-risk, and also score
clients’ specific criminogenic needs.
Unlike more traditional statistically based instruments, the ORAS includes both static and dynamic risk in
its assessment structure. So, a client’s key dynamic risk factors (changeable issues) are identified, including
criminal thinking, criminal associates/weak social network, substance abuse, unstable employment, and
high-risk living situations. This allows us to apply the Risk, Needs, and Responsivity (RNR) principle to
match the client with the appropriate Treatment Track. At SAGE, our Tracks vary in terms of duration,
intensity, and curriculum, so specific criminogenic needs can be effectively targeted and ameliorated. We
also use multiple Treatment Tracks to separate low-risk to recidivate clients from moderate and high-risk to
recidivate clients.
Christopher Lowenkamp, Ph.D. and Ralph Serin, Ph.D. have outlined ten valuable Principles in Risk
Assessment that guides our approach:
1. Do not assume that scoring a risk scale is equivalent to making a decision. The latter
necessitates an analysis of the case beyond arriving at a risk estimate.
2. Use risk scales specific to the type of offender and desired outcome to increase predictive
accuracy. For example, a domestic violence instrument is a better predictor of intimate partner
violence than a general recidivism measure.
3. Be aware that static risk scales indicate the group of individuals who are at risk, whereas
dynamic risk scales purport to indicate why and when a particular individual is at risk.
4. Be wary of overriding risk estimates with clinical judgment. Validated risk scales are more
accurate in predicting client outcomes than clinical judgment.
5. Do not use multiple risk scales in the belief that it will increase predictive accuracy. Risk
instruments typically assess common factors, so more is not necessarily better.
6. Ensure proper training in administering a particular risk instrument, as this is more
important than job, age, or experience.
7. Be careful to target a client’s multiple criminogenic needs. Recidivism reduction is best
realized when more of the client’s needs are met.
8. Match client intervention to risk and need.
9. Do not target low-risk clients or put them in prolonged treatment with higher-risk clients.
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10. Deliver interventions in a manner consistent with client’s level of functioning and motivation
and provide an adequate dosage of intervention to realize reductions in reoffending.
2. Additional Assessment Tool(s) – Provided information on their use of any additional
assessment tool(s), specific to a criminal justice involved population. Name of the tool(s),
any certification and/or expiration dates, length of time using the tool(s), how many staff
are trained, any trainers in their agency, refresher training schedule. May have provided
attachments related to this tool(s).
Providing responsive treatment requires effective assessments to identify the primary criminogenic
factors that will be addressed in various Treatment Tracks. In our initial evaluations, we typically utilize
the following standardized assessment tools:
1. ORAS-CST and ORAS Self-Assessment
2. The Continuum from the American Society of Addiction Medicine (ASAM)
3. Domestic Violence Severity Index-Revised (DVSI-R)
4. Patient Health Questionnaire-9 (PHQ-9), and
5. Generalized Anxiety Disorder-7 (GAD-7).
For this DVDP program only, we administer the Domestic Violence Severity Index-Revised (DVSI),
which we began using in 2022. The ORAS, American Society of Addiction Medicine (ASAM)
Continuum, and DVSI are particularly effective for evaluating clients referred by the criminal justice
system, so we have focused on them here. Additional information concerning the PHQ-9 and GAD-7
can be provided, if requested.
Regarding the Continuum required by AHCCCS, SAGE was an “early adopter,” and we began using it
in late 2022. Prior to that, we had been using the ASAM Triage for about 3 years. We have been using
the PHQ-9 and GAD-7 since early 2019. All of our more than 25 assessors are trained in administering
and interpreting all of these 5 instruments. They reference them in concert to finalize a diagnostic
impression and for guidance in making clinical recommendations that are best suited to meet clients’
presenting issue(s) and criminogenic needs.
The (ASAM) Continuum is as a central component of assessments for members of AHCCCS. It is
standardized, comprehensive, validated, and guided, and is based upon the “ASAM criteria” that cover
all 6 ASAM dimensions. The ASAM Criteria is a multidimensional biopsychosocial assessment with
recommendations for treatment services for substance use disorders (SUD) and mental health
conditions. The ASAM recognizes the multi-modal aspects of substance and behavioral health
disorders, as well as the continuum of care for treatment. It establishes a recommendation for treatment
based upon them and the client’s presenting condition.
It utilizes a Motivational Interviewing (MI) approach that is patient-centered and engaging to both clients
and clinicians. At the conclusion of the assessment the Continuum will provide DSM-5 criteria and
diagnoses for Substance Use Disorder (SUD); the Addiction Severity Index (ASI) Composite Scores;
identification of medical and psychiatric conditions; and imminent risk considerations that support
referring the client to the appropriate level of care.
ASI Composite Scores rate severity in seven areas of the client’s life:
Medical; Employment; Alcohol; Drug; Legal; Family & Social, and Psychiatric.
For certain programs, we also use the ASAM as a pre/post measure by comparing the Addiction
Severity Index (ASI) Composite Scores. Components of SAGE’s Comprehensive Assessment that
includes the ASAM Continuum:
1. Demographic information including race, relationship status, emergency contacts, advance
directives, disability status, and insurance information.
2. Medical history including prescribed medications, surgery and hospitalizations, and family
medical history.
3. Vocational history including education status, degree(s), employment status, and barriers in
obtaining employment.
4. Psychiatric history including depression, anxiety, trauma, and other mental health history.
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5. Presenting issue(s).
6. Substance use history:
a. Alcohol
b. Cannabis
c. Opiates
d. Sedatives/Hypnotics/Anxiolytics
e. Hallucinogens
f.
Stimulants
g. Inhalants
h. Synthetic drugs
i.
Tobacco
j.
Prior substance education and treatment history
k. Other addictive behaviors.
7. Social & Legal history including cultural preferences, learning difficulties, self-care, and basic needs
screening, criminal history, sex offense history, DUI history, orders of protection/restraining
orders/no contact orders.
8. Risk assessment screening of a client’s feelings and risks for potential harm to self, harm to others,
food insecurities, and housing needs.
9. Mental Status Exam (MSE) to record the client’s appearance, speech patterns, behavioral notes,
mood, thought/perceptions, memory, insight, and perceived judgement.
10. Formal Diagnosis to include both F-code, behavioral/mental health/substance abuse, and Z-code,
Social Determinants of Health (SDOH).
11. Recommendation Summary, which provides a narrative summary and recommendations for
treatment.
The DVSI-R is an 11-item statistical risk screening/assessment that examines the risk of intimate partner
violence (IPV). It is intended to assist clinicians in making recommendations based on the likelihood of
reoffending. The items refer to previous involvement in nonfamily as well as family violence, prior family
violence intervention or treatment, violations of protective orders or other forms of court supervision, prior
or current verbal or emotional abuse, the frequency and escalation of family violence in the past 6 months,
the use of objects as weapons, substance abuse, the presence of children during such incidents, and
employment status. Seven of the items relate to the behavioral history of the perpetrator and the remaining
four items examine substance abuse, the use of objects as weapons, employment status, and the presence
of children during the offence.
The tool generates a total risk score and two summary scores which relate to the:
1. Imminent risk of violence to the victim of an incident
2. Imminent risk to another person known to the perpetrator.
Risk is characterized as “low,” “moderate,” and “high.” Risk factors included in the assessment are based
on a thorough review of domestic violence literature and opinions made by consultations with judges,
lawyers, victim advocates, and police force personnel.
All these instruments are referenced in concert to finalize a diagnostic impression and guide our clinician
in making clinical recommendations that are best suited to meet the client’s presenting issue(s) and
criminogenic factors.
3. Vendor’s Individualized Treatment Plan – Provided examples of treatment plans with
goals addressing criminogenic factors and time frames. Treatment plan is attached with
identified criminogenic factors/domains and a plan of action is described to address high
risk domains.
A sample of our Individualized Treatment/Service Plan can be requested if needed.
4. Curriculum Used/Proposed – Described and provided information on any current or
proposed curriculum for the solicited program. Name and details of the curriculum,
background of the curriculum, support for evidence based, length of time and experience
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using the curriculum, and the requirements for enrolled offenders. Attached examples of
lesson plans/modules and modality of treatment.
In accordance with the current contract for the Domestic Violence Diversion Program, and to improve client
outcomes, SAGE has different Treatment Tracks for this diversion program that each have their own
curriculum. The Treatment Tracks have different modalities and vary in duration, number of sessions per
week, and client composition. For example:
•
Most of our counseling groups (and all of our DV and substance abuse groups) are gender specific.
•
Both curricula for the DVDP require formal certification based on structured training. For LSWV,
SAGE has certified Trainers on staff to continue training new counselors, as needed.
The 2 specific Treatment Tracks and related curricula for the Domestic Violence Diversion Program are
listed below. Each Track has multiple options with different specific requirements for graduations. All of
them have been approved by MCAO for their specific Track.
Treatment Track 1 for Male DVDP Clients: For all the variations in this Track, we use Cognitive Behavioral
Interventions—Interpersonal Violence (CBI-IPV), from the University of Cincinnati Correctional Institute
(UCCI). Initially under the direction of Ed Latessa, Ph.D. and later Kris Lowenkamp, Ph.D. and others, UCCI
has for many years been one of the premier criminal justice research, training, program evaluation and
curriculum development centers in the United States. In addition to several state-of-the-art curricula and
expansive research projects, they have also developed the ORAS risk assessment instrument that is a key
component in SAGE’s assessment process. This specific curriculum, Cognitive-Behavioral Interventions
for Interpersonal Violence targets criminogenic need areas and focuses on social, cognitive, and emotional
skill development. UCCI staff collaborated with MCAO and SAGE Counseling to select the best sessions
for each of our men’s Treatment Tracks, which are based on level of risk-of-recidivism and violence. The
program has a semi-open format with multiple entry points, and that allows us to place new clients in
counseling groups with little or no waiting time (unlike traditional closed groups).
Module Topics Include:
1. Motivational Engagement and Readiness for Change
2. Cognitive Restructuring and the Behavior Change
3. Violence Awareness
4. Emotional Regulation and Self-Control
5. Managing Interpersonal Relationships
6. Problem Solving
7. Success Planning
SAGE has 9 clinicians who are trained to facilitate this program.
Treatment Track 2 for Female DVDP Clients: For all the variations in this Track, we use Living Safely
Without Violence, by Marilyn Van Dieten, Ph.D. This gender-responsive program from an expert researcher
on treatment for women in the criminal justice system integrates cognitive-behavioral, strength-based, and
trauma-informed approaches. It focuses on emotional regulation, skill development, relationship skills, self-
awareness, social awareness, and utilizing community resources.
Session Topics Include:
1. Understanding Violence
2. The Living Safely Plan
3. What is a Healthy Relationship?
4. Making the Decision to Leave
5. Recognize and Regulate
6. Creating Calm
7. Staying Calm in Difficult Situations
8. Harmful Self-Talk
9. Challenging Harmful Self-Talk
10. Resolving Problems
11. Reaching Out
12. Expressing Your Wants and Needs
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13. Dealing with Conflict
14. Celebrating My Successes
SAGE has 28 clinicians who are trained to facilitate this program and 2 trainers.
Based on MCAO’s January 24th response to questions, we have not “attached examples of lesson
plans/modules,” since all these curricula have previously been approved by MCAO for their Tracks.
5. Continuum of Care/Levels of Care – Described and provided information on their current
offered or proposed levels of care as determined by an individual’s criminogenic factors,
history, needs and/or risk of re-offend. Provided a detailed description of their levels of
care: frequency, duration, step down, aftercare services, community-based supports or
capability of referrals for additional support.
Concerning treatment interventions, research has consistently shown that one size does not fit all, and that
addressing multiple criminogenic needs is more effective in lowering recidivism than only addressing one.
So, the identification of a client’s top criminogenic needs greatly assists us in developing an effective
individualized treatment plan. It also helps us target important social determinants of health that need to be
attended to, such as clients’ interpersonal relationships, living situation, employment and financial status.
Providing responsive treatment reduces barriers and improves outcomes because it is delivered in a
manner consistent with the clients’ learning style and abilities, motivation, gender, cultural preferences,
ability to handle confrontation, age, race, etc. It is always SAGE’s goal is to have our treatment programs
focus on the primary criminogenic factors that have been shown to have the greatest impact on lowering
crime and in a manner that provides clients with realistic opportunities for change.
Research findings have consistently found that treatment responsivity and treatment matching are critical
components in achieving positive treatment outcomes (McLellan 1991). These evidence-based practices
depend on a solid initial clinical assessment that is supported by empirically based tools, as well as offering
multiple Treatment Tracks that are based on the results of the assessment. The combination of these
program components allows us to apply the Risk, Needs, and Responsivity (RNR) principle and match the
client with the appropriate Treatment Track. At SAGE, our Tracks are gender-specific and vary in terms of
duration, intensity, and curriculum, so specific criminogenic needs can be effectively targeted and
ameliorated. The Treatment Tracks for the DV Diversion Program include:
Treatment Track 1 for Male DVDP Clients: There are multiple variations based on clients’ overall risk-to-
offend as evaluated by the ORAS, including overrides.
Overall low-risk clients must complete 12, two-hour group counseling sessions that meet one time
per week. The groups have a limited open structure, to reduce the wait time to enter a group.
Overall moderate to very-high risk clients must complete 20, two-hour group counseling sessions
that meet once per week. The groups have a limited open structure, to reduce the wait time to enter
a group.
Individual counseling sessions can be substituted for group sessions in exigent situations when it’s in the
best interest of the client. In addition, up to four (4) hours of case management services are available, as
deemed clinically necessary.
Treatment Track 2 for Female DVDP Clients: There are multiple variations based on clients’ overall risk-
to-offend as evaluated by the ORAS, including overrides.
Overall low-risk clients must complete 12, two-hour group counseling sessions that meet one time
per week. These groups have a closed structure, to enhance the sense of consistency and safety
in the program.
Overall low/moderate-risk clients must complete the same 12, two-hour group counseling sessions
that low-risk women do, meeting one time per week in a closed group structure. Then they also
complete 4 more two-hour group sessions, one time per week in an open group structure for a total
of 16 sessions.
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Overall moderate-risk clients must complete the same 12, two-hour group counseling sessions that
that low-risk women do, meeting one time per week in a closed group structure. Then they also
complete 8 more two-hour group sessions, one time per week in an open group structure for a total
of 20 sessions.
Overall High-Risk offenders complete 20 two-hour group counseling sessions in an open group
format, either 1 or 2 times per week. These high-risk clients are not co-mingled with low-risk clients.
Individual counseling sessions can be substituted for group sessions in exigent situations when it’s
in the best interest of the client. In addition, up to four (4) hours of case management services are
available, as deemed clinically necessary.
Regarding aftercare services, community-based supports or capability of referrals for additional support,
during assessments, we establish a formal diagnosis that includes F-code (behavioral/mental
health/substance abuse), and Z-code (Social Determinants of Health (SDOH). This practice supports us
making appropriate referrals at any point during treatment, and also for additional aftercare services once
a client is nearing the end of their program with SAGE Counseling.
When a client’s needs surpass our level of care offerings, we refer him/her to other treatment providers.
We commonly make referrals for services and treatment needs such as Medically Assisted Treatment
(MAT), Partial Hospitalization Programs (PHP), Residential Treatment, Primary Health Care (PCP), and/or
Psychiatric Treatment. Additionally, as part of a client’s individualized service plan (ISP), it is a standard
practice at SAGE to recommend other community services such as peer support programs, job programs,
or physical health services, as applicable.
6. MCAO Participants: Co-mingling of Participants with Others and Risk Levels –
Described and provided a detailed plan if MCAO participants will be co-mingled with
participants referred from other agencies. The information provided should address how
different risk levels will be kept separated during treatment. Detailed information was
provided related to how different risk levels will differ in treatment plan.
As described above, we employ multiple Treatment Tracks that vary in terms of duration, intensity, and
curriculum, so that criminogenic needs can be more effectively targeted and ameliorated. We also use
these multiple Treatment Tracks to separate low-risk to recidivate clients from moderate and high-risk ones.
We do not blend low-risk clients with those who are moderate or high-risk in counseling groups (based on
our administration of the ORAS including overrides). Section #5 above lists the specific risk-to-recidivate
clients that are allowed in each component of our DVDP Treatment Tracks.
For the Domestic Violence Diversion Program, we utilize the comprehensive assessment protocol including
the ORAS for all new treatment clients at SAGE (as described above in Sections #1, #2, and #3 above),
whether they were referred by MCAO, another organization, or self-referred. That has allowed us to
consistently and effectively determine all clients’ risk levels and then place them in the appropriate
Treatment Track. We do co-mingle clients from other organizations with MCAO clients in most of our
Treatment Tracks, but only when they are appropriate clinically and in terms of their recidivism risk level.
Regarding the treatment plans of clients with differing risk levels, our assessors utilize our various
assessment tools, including the ASAM Continuum, ORAS, DVSI, and other sources of information, to inform
them of the specific risks and needs of a client, so that we assign them to an appropriate specific treatment
regimen. Several factors are accounted for when determining “risk,” such as substance use, criminal/legal
history, education, employment and financial history, family history, attitudes, and behaviors, and more.
A client who is determined to be low-risk will be placed in a low-level treatment schedule that might include:
Only 12 sessions of a closed, 2-hour group counseling, 1 times per week.
Alternatively, the needs of a high-risk client are more substantial, and thus a treatment schedule might
include:
20 sessions of an open 2-hour, group counseling that meets 2 times per week,
•
Case management services 1 – 2x per month, or as needed.
•
Referrals for additional support services, as needed.
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In the above scenarios, we have highlighted two different treatment plans that are developed collaboratively
with the client based upon differentiated treatment needs as demonstrated during the assessment. At SAGE
Counseling, and throughout healthcare, this philosophy is referred to as “The Golden Thread,” which says
that a client’s treatment plan should factor in these five, related components: Assessment – Diagnosis –
Individualized Service Plan (ISP) – Treatment Session Notes – Review of the Individualized Service Plan
(ISP)– Discharge Planning. Together, these clinical functions provide individualized care, promote progress
for short and long-term treatment goals, support a client’s programmatic success, and align with
healthcare’s best practices.
7. Service Delivery – Described and provided information on their ability to provide services
across Maricopa County and if there are plans to expand locations/dates. Provided a
detailed class schedule or proposed class schedule. If services are provided remotely (tele-
health), a detailed description is provided as to how attendance and engagement is
measured/tracked, and what is the vendor’s class capacity/facilitator to client ratios for in
person and telehealth services. Describe the expectation of participation in remote
sessions and how those expectations are communicated with participants. Describe the
process of moving a participant to in-person sessions when they are not meeting the
expectations of remote sessions.
SAGE Counseling has been providing services throughout Maricopa County through telehealth and hybrid
modalities since the beginning of the pandemic in March of 2020. Even prior to the pandemic, SAGE
provided telephonic case management and engagement services to individuals who were unable to attend
in-office services at one of the 16 SAGE offices.
SAGE currently offers hybrid groups where the clinician and some participants are in-person, while other
clients participate digitally and are visible on a large video screen. SAGE will continue to offer hybrid,
telehealth-video, and in-person services to clients.
Attendance is tracked through our EHR system, Credible, and through various reports the group clinicians,
case managers, and the management staff utilize to ensure clients are held accountable for missed
sessions and to ensure clients complete all required treatment. Each clinician utilizes a roster report to track
all clients’ remaining sessions as well as various details regarding their overall treatment recommendations.
SAGE limits group capacity to 15 total clients per group for both virtual and hybrid groups. Group guidelines
are reiterated at the start of groups including attendance guidelines, participation, and overall group
expectations. Overall treatment guidelines are also discussed at the time of enrollment and during the
assessment process. Clients that struggle with telehealth groups are required to attend in person and are
assigned to one of SAGE’s hybrid groups. As needed, the group Clinician or assigned Case Manager will
contact the client and reassign them to an alternative in person group.
Our Case Managers are familiar with working with clients to overcome obstacles to treatment, including not
having a device for video-enabled services. We provide resources and assistance to support their ability to
obtain a video-enabled device. For example, SAGE Counseling has partnered with T-Mobile to provide
certain clients who have accessibility issues with a smart phone for their use during treatment. The phones
will have unlimited talk/text/data and will allow those clients who do not have access to technology to attend
groups and appointments with SAGE virtually.
The use of these phones is not restricted to SAGE treatment and can be used by the client for work, school,
or personal tasks. The service fee will be paid by SAGE as long as the client is actively engaged in treatment
and attending appointments with their case manager at least once a month. At the conclusion of their
treatment, the client will have the option to return the phone or to transfer service themselves.
SAGE conducts over 320 counseling groups per week, the majority of these being in Maricopa County and
offered in the evening. We also have morning, day, and weekend groups that are available. In addition to
separating clients by gender, we have multiple Treatment Tracks to better match client's criminogenic
factors, e.g., 4 for substance abuse treatment and 3 for Domestic Violence Offender Treatment. The Tracks
vary in terms of the total number of times they meet per week and the total number of groups assigned.
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8. Multiple/Flexible Options for Participants – Described and provided information if
flexible options are available/offered: individual/group setting, open entry format to reduce
wait times, varied days for service, hours of operation include evenings and weekends,
same gendered groups, staff to participant ratio is safe and effective to meet the needs of
the participants.
SAGE Counseling has various options that include virtual, in person, or hybrid appointments for the initial
assessment, group and individual treatment. During the assessment process, SAGE will determine the
most effective and convenient treatment options for each client based on gender, location, and individual
clinical needs. The majority of SAGE’s groups have an open entry format as well as multiple day, night and
weekend group options to fit various client needs. All of SAGE’s Substance Abuse and Domestic Violence
groups are gender specific to meet treatment requirements and the general staff to client ratio for each
group is 1:12. SAGE’s current DVD group list is included below for reference.
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9. Culturally Relevant and Linguistically Appropriate – Provided information how they are
able to meet the cultural and language needs of the population served. Provided
information related to bilingual staff. If none the agency does not have bilingual staff or
bilingual staff are limited, provided information as to how language needs will be met.
At SAGE, we believe everyone can learn and change. We strive to be culturally competent and sensitive
to the learning styles of our clients. The Socratic method of learning, prescribed throughout our treatment
programs, gives each person a chance to understand the material through his/her own world view.
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Participation in class provides the opportunity to challenge ideas, beliefs, and behaviors they may have
inherited or adopted without awareness, and clients can, with further knowledge, choose beliefs and
behaviors that serve their goals. It is particularly striking that participants will often increase awareness of
important values learned in their culture of origin and strive to return to those values for the benefit of
themselves and their families.
We emphasize being sensitive to cultural, ethnic, gender, sexual identity, and age differences in all the
services we deliver. We recognize that personal and cultural beliefs play a central role in determining how
clients view their lives, substance use, criminal conduct, and their involvement in treatment. We provide
cultural competency/diversity training to all our staff in our continuum of care. For facilitators, a key goal is
to understand how our clients’ cultural socialization impacts their understanding of themselves and their
attitudes toward the program. We are attuned to the process of identity development, with a focus on the
client’s particular ethnic and cultural group. We encourage the inclusion of religious and cultural
preferences, family support, and initial identification of needs for a successful learning experience. SAGE
offers various Spanish only groups and as needed, we utilize 1:1 sessions to accommodate the language
needs through phone, virtual, and in person interpreter services.
10. Program Rules and Requirements – Provided a brief summary of the agency’s rules and
expectations as well as when and how this information is delivered to diversion participants.
Describe all methods of outreach and the strategies for re-engaging participants. (This full
document may be requested after award.)
Group expectations and general guidelines are reviewed at the time of enrollment, during the
assessment and prior to the start of each group when a new client is present. SAGE Counseling
staff attempt to contact clients who fail to make contact with SAGE after receiving referral
information to complete the enrollment process, or if the client misses the scheduled appointment.
Staff will attempt to contact clients via phone and email within 24 hours of receiving the referral.
These outreach attempts will be documented in a SAGE progress note. SAGE Counseling staff will
complete a minimum of 3 outreach attempts for clients that are not engaging in services prior to
closing the case at minimum and marking them inactive within the system. Additional reminder text
messages are also utilized for upcoming and missed appointments for clients. If there are no
successful outreach attempts, a discharge report will be submitted within 7 days of closing the case
file. The general group guidelines are included below. These guidelines are relayed to each client
throughout treatment.
SAGE Counseling Group Guidelines
Participation
•
Each group is scheduled for 2 hours (3 hours for IOP), please arrive on time and stay for
the entire duration in order to receive credit for the group session.
•
Distractions are not permitted, including background noise.
•
Please respect one another’s opinions and worldviews.
•
You are expected to be on video, facing the screen, at all times.
•
If attending virtually, you must be sitting up throughout the duration of the group.
•
You cannot be doing anything else but engaging in group. (e.g., Cannot be driving in car,
shopping, etc.)
•
There is also no smoking, vaping or eating allowed during the session (as we do in
person, clients should smoke/eat during break).
•
Use “I” statements when speaking vs. generalizing.
•
Group is a judgement free zone.
•
No discussion about politics.
•
Feel free to discuss religion or spirituality as it relates to you. Please do not tell others
what to believe.
Confidentiality
•
No recording or taking pictures of sessions.
•
Do not use other clients’ names outside of the group.
•
You must be alone in the room. If you cannot be alone, please wear earphones.
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•
We cannot speak to anyone outside of SAGE without a valid Release of Information on
file.
o
Exceptions to this rule:
▪
Intent to hurt self or others.
▪
Suspected abuse of child, elderly or disabled.
▪
Medical emergency.
(VIOLATIONS OF THESE RULES MAY RESULT IN PROGRAM DISCHARGE).
Honesty
•
Please be honest. We are not the legal system and are here to help you succeed.
Support Sobriety
•
Group members are not allowed to attend intoxicated or under the influence.
o
This includes prescription medications that interfere with your ability to participate
in a meaningful and appropriate way.
o
This also includes exhibiting behaviors that might indicate intoxication such as
falling asleep or slurring words.
•
Please do not wear clothing that may trigger others in the group.
UA Compliance
•
Please remind clients that are required to complete UAs to make sure they are following
up on this. Compliance will be part of a successful discharge.
11. Notification of Cost – Described what is shown/provided to participants. Described
vendor fees, expectations of payment, how due dates are determined, and payment
schedule. Provided methods of acceptable payments. Described process of participant
outreach when payment is not made according to proposed schedule.
Notification of Cost at time of enrollment
At time of enrollment to the SAGE program, participants are informed of their assessment fee and
what they can expect to pay for group fees via telephone. Upon completion of their enrollment and
scheduling their assessment appointment, participants are sent a confirmation email that includes
the date and time of their assessment, as well as their anticipated assessment fee.
Within the confirmation email, participants are sent a link to complete their intake documents, which
includes financial responsibility information. Participants are required to review and sign this
document prior to SAGE completing the assessment.
Notification of Cost at time of assessment
SAGE provides a document to the client at completion of assessment called the
“Recommendations Summary” Within this document, the following information is provided:
▪
Assessment Fee
▪
Case Management Fee
▪
Group Rate Per Session
▪
Individual Rate Per Session
▪
Education Fee
▪
Number of Recommended Treatment Sessions
▪
Service Type
▪
Per Session Fee (stated again)
▪
Weekly Schedule for Treatment Sessions
▪
Start Date of Sessions
▪
Session Start Time
▪
Session Language
Notification of Cost upon completion of assessment
Upon completion of assessment, SAGE clinicians send a summary email which includes the above
recommendations summary. This this email, the following payment information is included:
▪
Payment is expected prior to each service.
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▪
Failure to make your payments on time may put you at risk of non-compliance and may
result in your unsuccessful discharge.
▪
You may pay online by visiting: https://sagecounseling.net/clientresources/
Methods of Acceptable Payment
SAGE accepts all major credit and debit cards as the primary source of payment and payments are
paid online as indicated above.
Outreach During Payment Non-Compliance
SAGE’s billing and collections department tracks and conducts outreach calls and/or emails to all
individuals who have outstanding balances. During this time, SAGE works with the individual to set
up a plan for payment, and allows limited flexibility on payment arrangements of outstanding
balances.
12. Indigency Determination and Sliding Scale Considerations – Provided a detailed
process to determine, reduce and/or waive fees for an indigent participant who is not
AHCCCS eligible. Provided a list of documentation requested to verify income for sliding
scale eligibility. Provided process for reassessing a participant’s eligibility throughout their
enrollment with the agency. Described the process of assisting a participant with AHCCCS
eligibility determination if applicable.
Financial Determination Process
For clients who are not eligible for AHCCCS insurance, SAGE offers potential fee discounts based
on the clients’ financial situation. But any U.S. citizen who is indigent is eligible for AHCCCS. At
the initial referral, the Admissions Specialist will ask the client if he or she is insured with AHCCCS.
If the client is not insured with AHCCCS, the Admissions Specialist will inquire on the client’s
financial situation including (1) Number of people in the household and (2) Combined Annual
Household Income. The Admissions Specialist utilizes SAGE’s Sliding Fee Scale to review the
information and determine if the client may be AHCCCS eligible. If so, the client will be referred to
the SAGE Community Assistor for further assistance.
If the client is not insured with AHCCCS and determined to be ineligible for AHCCCS based on
review of their financial situation, the Admissions Specialist will ask the client if he or she desires
to complete a SAGE Financial Assessment Application. If the client chooses to accept the Financial
Assessment Application the client that is informed of the required supporting documentation and
due date to return all required documents within seven (7) days.
Upon receipt of a completed and on time application, a SAGE Billing Specialist completes the
financial assessment and fee determination process. If, as a result of the financial assessment
process, it is determined that the client is eligible for a discount per SAGE’s sliding fee scale, then
this discount will be effective as of the date that all required documentation was submitted. Once
the fee is determined, a SAGE Billing Specialist provides a written decision to the client on his or
her financial responsibility. This is completed within 5 business days of receiving the completed
application from the client. When complete, all documents are uploaded in SAGE’s EHR (Credible).
Documentation Requested Includes:
1) If unemployed:
a. Three (3) most recent payroll stubs or Prior Year Federal Income Tax Return.
b. Letter of Unemployment Benefits eligibility, stating monthly $ amount; or
unemployment denial letter, if applicable.
2) If currently employed:
a. 3 most recent payroll stubs.
3) Documentation supporting additional sources of income including:
a. Social Security, Medicaid, SNAP (former food stamps), Pension, Annuity,
Veterans’ benefits, Alimony, Child support, Military benefits, Businesses, Rent,
Interest, Dividends, Any other income
b. Documentation should show weekly or monthly benefits.
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Reassessment during enrollment
During the course of the treatment program, if a client has a loss of AHCCCS eligibility or provides
notification of a change in financial circumstances, then the client will be provided the Financial
Assessment Application and the procedure and requirements discussed above will be applicable.
If, as a result of the financial assessment process, it is determined that a client is eligible for a
discount per the SAGE sliding fee scale, then this discount takes effect on the date of their first
service following the submission of a completed application. Any payments made by a client, after
the application submittal date, in excess of the discounted fee, are applied in the form of a credit
towards future fees.
Assisting with Enrollment or Re-Enrollment with AHCCCS
SAGE employs two Navigators (or Community Assisters) to assist clients with AHCCCS eligibility,
enrollment, and re-enrollment. Their primary responsibilities include reviewing the AHCCCS
database daily to see whether our current clients are due for renewal, have lost their AHCCCS
insurance, or are eligible for benefits. When a client is determined to be AHCCCS eligible, one of
our SAGE navigators will outreach the client to inform them of all documents that are required to
complete the AHCCCS application. During this initial outreach, SAGE navigators offer one on one
assistance to complete the application process through HEA Plus (AHCCCS’s online member
enrollment program). If the client agrees, our navigators schedule 1 – hour AHCCCS application
appointments and support the client through the process of applying.
SAGE also employs a Court Liaison that provides similar assistance to individuals referred to our
Court Liaison. Additionally, SAGE’s Case Managers provide information about the Marketplace for
insurance under the Affordable Care Act, and assist clients in applying for that coverage, as
needed.
These combined efforts demonstrate our commitment to the community and help ensure that each
client is taking full advantage of all economic opportunities.
13. AHCCCS and Insurance Contracts – Provided documentation of contracts with all seven
AHCCCS Complete Care Plans. Provided documentation of all non-AHCCCS insurance
plans the agency is contracted with. If any contract is pending or due to change, detailed
information is provided about the changes and date(s) those changes go into effect.
SAGE Counseling, Inc. is contracted with all seven (7) AHCCCS ACC Health Plans, both (2) RHBA
AHCCCS Health Plans, and American Indian Health Plan, also through AHCCCS. These health
plans are indicated below:
1) Mercy Care ACC & Long Term Care (LTC)
2) Banner University Family Care & Long Term Care (LTC)
3) Care 1st Health Plan
4) Molina Complete Care
5) Health Choice Arizona
6) Arizona Complete Health
7) United HealthCare
8) American Indian Health Plan
9) Mercy Care RBHA
10) Care 1st RHBA
SAGE does not have any contracts pending and is not contracted with any non-AHCCCS insurance
plan. However, SAGE does occasionally receive and accept primary payer commercial payments
from Blue Cross Blue Sheild, Aetna and Cigna health insurance.
Vendor Qualification Requirements
14. Submitted copies of applicable AZ Department of Health Services licensure for each facility
where services will be provided.
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b. Licenses should be for facilities located in Maricopa County, if awarded the County
may request copies of licenses outside Maricopa County.
SAGE has 16 licensed facilities throughout the state, all licensed by BMFL and credentialed by AHCCCS.
These are identified below. We have included copies of licenses in our proposal only for the facilities in
Maricopa County. Licenses can be provided to MCAO upon request.
15. Demonstrated that the agency has a minimum of two years of experience working with
adult offender populations. Described experience, history and knowledge of providing
evidence-based practices and programs to adult offender/criminal justice populations.
SAGE Counseling, Inc. is a licensed behavioral health provider with 25 years of experience providing
treatment and education services to adult offender populations in both outpatient and incarcerated settings.
SAGE has held contracts with MCAO to provide services to that clinical population since 2009 and currently
provides substance abuse, domestic violence, cognitive skills, and education treatment for MCAO. A list of
additional history and experience is listed in section 5.6.1.2. Currently, we provide 215 substance abuse
and cognitive skills groups per week. Almost all our substance abuse groups are gender-specific, and we
follow the EBP of not blending low-risk clients with moderate or high-risk ones.
All of SAGE’s programming is evidence-based, including utilizing the American Society of Addiction
Medicine’s (ASAM) Continuum Assessment, the Ohio Risk Assessment System to evaluate risk of
recidivism, and our multiple evidenced-based curricula. SAGE conducts a thorough Individualized Service
Plan (ISP) with all outpatient clients, which includes goal setting and monitoring goal achievement and
progress.
Vendor Reporting Requirements and Performance
16. Acknowledge if the vendor will meet all contract reporting and performance requirements
as described in the scope of work. If not, please explain what aspects of the requirements
will not be met.
SAGE Counseling, Inc. hereby acknowledges that we will meet all contract reporting and
performance requirements as described in the scope of work, unless we’ve explicitly indicated
otherwise in section 5.7 Exceptions to the Solicitation.
17. Acknowledge if the vendor will meet all the terms and conditions of the draft contract. If
not, please explain what aspects of the contract will not be met.
SAGE Counseling, Inc. hereby acknowledges that we will meet all of the terms and conditions of
the draft contract.
18. Acknowledge if the vendor will meet the technology capability requirements described in
the scope of work. If not, what aspects of the requirements will not be met.
SAGE Counseling, Inc. hereby acknowledges that we will meet the technology capability
requirements described in the scope of work.
Required Attachments
19. Organizational Chart
Provided with response, MCAO can request updated organization chart when needed.
20. Job Descriptions for positions responsible for delivering the diversion program.
a. Provide a list of the positions by title, a brief summary for each of their roles, and
how many staff you have in these roles.
MCAO can request job descriptions when needed.
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21. Proposed fee schedule
a. Refers to the menu of services that the contractor may offer as applicable to this
population. This menu of services allows MCAO to know what services the
Contractor offers in the event that the diversion program requirements may need
to be modified in the future. This is not the same as Attachment D – Pricing Page,
where the contractor is providing their proposed rates for the specific existing
required services by diversion program.
FEE SCHEDULE
SERVICE TYPE
Assessment
Assessment Update
Education
Case Management
Individual Counseling
Counseling Group
IOP Counseling Group
In Home Family Therapy
In Office Family Therapy
Out of State or County Coordination
Intake
Restitution Management
Drug Monitoring
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** We generally deliver our Education in 8-hour classes and counseling groups in 2-hour
sessions.
For AHCCCS clients only:
Reimbursement by AHCCCS for behavioral health services provided by SAGE Counseling is
contingent on those services being deemed “medically necessary” by the client’s AHCCCS
health plan. The vast majority of SAGE’s services have been approved by the appropriate
health plan for payment in the past; however, for those clients whose services are deemed to
be not medically necessary by their AHCCCS health plan, the clients become responsible to
pay for their services themselves. They are considered “self-pay” clients.
For AHCCCS-ineligible clients:
AHCCCS-ineligible clients will be given the opportunity to qualify for reduced fees in
accordance with the SAGE Counseling Sliding Fee Scale.
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Justice Court Felony Diversion Program
2.0
PROGRAM REQUIREMENTS
2.2.5
Justice Court Diversion - A short-term, education program for eligible offenders
charged with specific misdemeanor offenses and citations to avoid a conviction.
This program was recently enhanced by offering evidence-based curricula and
implementing a screening tool to identify better and address individual needs.
2.2.5.1 To provide an intake, an approved evidence-based screening, and
appropriate education class(es) to referred offenders charged with eligible
misdemeanors or citations with the goal of successfully completing this
diversion program and getting their criminal charges dismissed.
SAGE has read this section and agrees to comply with its requirements as
we have been doing in the current program.
2.2.5.2 Only certain offenders who are charged with eligible misdemeanors
offenses or citations may be eligible for and offered diversion. If diversion
is accepted by the offender, prosecution is suspended for one year so the
offender can participate in the prescribed program; however, the intake,
screening, and education class(es) requirements must be able to be
scheduled and completed within 90 days from time of referral.
SAGE has read this section and agrees to comply with its requirements as
we have been doing in the current program.
2.2.5.3 After administering a validated screening tool for adults, contractor shall
provide educational services to referred offenders using an approved
evidence-based curriculum/curricula. A detailed description of the
proposed screening tool to be used and curriculum, how long the agency
has been using this screening tool and curriculum, the method for delivery
of the services, the number of staff trained in this screening tool and
curriculum, and citations for meta-analyses of this curriculum must be
included in the proposal.
SAGE has read this section and agrees to comply with its
requirements. We have provided a detailed description of our Education
Curriculum in Attachment E, #5.
2.2.5.4 The Justice Court Diversion program shall have at least two different
education tracks, focusing on the offender’s underlying identified needs as
determined by the screening tool. Because there will be a broad range of
charged misdemeanors and citations, these education tracks’ curricula
should be broad enough to cover efforts to reduce recidivism and improve
cognitive skills and decision making. Therefore, educational tracks should
not be offense specific.
SAGE has read this section and agrees to comply with its requirements.
2.2.5.5 Offenders who earn a Successful Discharge shall have their pending
charges dismissed. Offenders who are Unsuccessfully terminated will
return to Court and prosecution will be resumed.
SAGE has read this section and agrees to comply with its requirements as
we have been doing in the current program.
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ATTACHMENT E: RESPONDENT QUESTIONNAIRE
1. ORAS Assessment Tool – Described understanding of ORAS. Provided information if
they are currently an ORAS user, have staff certified, if currently administering the ORAS
in person or virtually, and length of time using the ORAS, If not currently using the ORAS,
indicated how many staff would need to be trained, the need for an ORAS trainer in their
agency, length of time it would take to have staff trained and how they would support the
ORAS.
It is our understanding that MCAO plans to continue these diversion programs under essentially the same
structure as they were at the time of this solicitation. So, we decided to respond to these questions about
the Justice Court Program from that perspective. The current contract and program do not include the
ORAS or usually a comprehensive assessment. With MCAO’s approval, we instead conduct an intake
evaluation and utilize the Texas Christian University’s Drug Screen 5 (TCUDS5) to determine placement in
the Education Track. For clients who choose to use their Arizona Healthcare Cost Containment System
(AHCCCS) coverage, we do complete an assessment with the American Society of Addiction Medicine’s
(ASAM) Continuum.
SAGE began administering the Ohio Risk Assessment System-Community Screen Tool (ORAS-CST) in
the Fall of 2019 and have been utilizing it either in-person or through telehealth in almost all of our
assessments since mid-2020. The University of Cincinnati’s Correctional Institute (UCCI) owns the rights
to the ORAS, and to ensure standardization and quality of administration and interpretation, they require
formal training and certification. SAGE has invested heavily in being able to utilize the Ohio Risk
Assessment System-Community Screen Tool (ORAS-CST) in our assessment processes. We currently
have approximately 30 clinicians who are certified to administer the ORAS and 6 who are certified as
trainers of the ORAS. Having certified trainers allows us to train new end users when needed.
However, we do not utilize the ORAS for this Justice Court Diversion Program. Instead, we use the Texas
Christian University’s Drug Screen 5 (TCUDS5).
2. Additional Assessment Tool(s) – Provided information on their use of any additional
assessment tool(s), specific to a criminal justice involved population. Name of the tool(s),
any certification and/or expiration dates, length of time using the tool(s), how many staff
are trained, any trainers in their agency, refresher training schedule. May have provided
attachments related to this tool(s).
This Justice Court Diversion Program includes an educational intervention rather than counseling or
treatment. Consequently, we usually complete an intake evaluation rather than a comprehensive
assessment. But for clients in this program who choose to use their AHCCCS coverage, we conduct an
assessment and utilize the following standardized evaluation tools:
1. The Continuum from the American Society of Addiction Medicine (ASAM)
2. Texas Christian University’s Drug Screen 5 (TCUDS 5)
MCAO has approved both of these evaluation instruments. SAGE began administering the TCUDS5 in
about 2015, and we used it as part of the evaluation process for two different programs prior to this JCDP.
We also employed it as a pre/post treatment measure for one 90-day, outpatient treatment program. In the
JCDP, clients who score a “None” on the TCUDS 5 are placed in Track 2 for Cognitive Skills. Clients who
score “Moderate” or “Severe” are placed in Track 1 for Drug Education. Those clients who score in the
middle range with a “Mild” score can be placed in either Track based on the clinician’s judgement from the
entire evaluation. Most often, those clients are placed in Track 1, Drug Education. Those are the only two
Tracks available in this diversion program.
Regarding the Continuum from AHCCCS, SAGE was an “early adopter,” and we began using it in late 2022.
Prior to that, we had been using the ASAM Triage for about 3 years. All our more than 25 assessors are
trained in administering and interpreting both the Continuum and TCUDS 5. We have 5 key clinical
supervisors and managers who train our clinical staff on their administration. Our assessors use them to
make clinical recommendations that are best suited to meet clients’ presenting issue(s) and criminogenic
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needs. In this program, one of the main decisions that needs to be made is whether a client will be placed
in the Drug Education Class or the Cognitive Skills Education Class.
For AHCCCS covered clients who use their Medicaid coverage, the ASAM Continuum is required by
AHCCCS as a central component of assessments. The tool is standardized, comprehensive, validated, and
structured, and is based upon the ASAM criteria that cover the 6 ASAM dimensions. The Continuum
recognizes the multi-dimensional aspects of substance and behavioral health disorders, as well as the need
for a continuum of services, and it establishes a recommendation for treatment.
The Continuum utilizes a Motivational Interviewing (MI) approach that is patient-centered and engages both
clients and clinicians. At the conclusion of the assessment, the Continuum provides DSM-5 criteria and
diagnoses for Substance Use Disorder (SUD); the Addiction Severity Index (ASI) Composite Scores;
identification of medical and psychiatric conditions; and imminent risk considerations for evaluating a client’s
appropriate level of care.
ASI Composite Scores rate severity in seven areas of the client’s life: Medical; Employment; Alcohol; Drug;
Legal; Family & Social, and Psychiatric. Components of SAGE’s Comprehensive Assessment that includes
the ASAM Continuum are:
1. Demographic information including race, relationship status, emergency contacts, advance
directives, disability status, and insurance information.
2. Medical history including prescribed medications, surgery and hospitalizations, and family
medical history.
3. Vocational history including education status, degree(s), employment status, and barriers to
obtaining employment.
4. Psychiatric history including depression, anxiety, trauma, and other mental health history.
5. Presenting issue(s).
6. Substance use history:
b. Alcohol,
Cannabis,
Opiates,
Sedatives/Hypnotics/Anxiolytics,
Hallucinogens,
Stimulants, Inhalants, Synthetic drugs, Tobacco, Prior substance education and
treatment history, Other addictive behaviors.
7. Social & Legal history including cultural preferences, learning difficulties, self-care, basic needs
screening, criminal history, sex offense history, DUI history, and orders of protection/restraining
orders/no contact orders.
8. Risk assessment screening of a client’s feelings and risks for potential harm to self, harm to
others, food insecurities, and housing needs.
9. Mental Status Exam (MSE) to record the client’s appearance, speech patterns, behavioral
notes, mood, thought/perceptions, memory, insight, and perceived judgement.
10. Formal Diagnosis to include both F-code, behavioral/mental health/substance abuse, and Z-
code, Social Determinants of Health (SDOH).
11. Recommendation Summary, which provides a narrative summary and recommendations for
treatment.
For clients referred for this JCDP who do not use AHCCCS, SAGE’s intake process entails administering
the TCUDS 5 and addressing the following issues:
•
Information from MCAO for Current Charges, etc.
•
Legal History
•
Relationship Status
•
Education (Currently Attending or Highest Level Completed)
•
Primary Care Physician Contact Information
•
Medical History Including Current Medications
•
Reason for Seeking Treatment/Presenting Problem
•
Substance Use/Abuse Including Current or Past Use
•
History of Substance Abuse Ed or Treatment; Success with Treatment
•
12-Step Meeting Participation
•
History of Sobriety/Clean Time
•
Impact of Alcohol or Drug Use on Relationships and Physical, Mental, and Social Well-Being
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•
Family History of Drug or Alcohol Use
•
Family History to Include Marriage/Children, Current Living Situation
•
“Describe Your Childhood”
•
Any Current or Past Orders of Protection/Restraining Orders Filed
•
Behavioral Health History Including Current and Past Treatment/Diagnosis/Medications and
Prescriber Information
•
Suicidal or Homicidal at Time of Assessment
3. Vendor’s Individualized Treatment Plan – Provided examples of treatment plans with
goals addressing criminogenic factors and time frames. Treatment plan is attached with
identified criminogenic factors/domains and a plan of action is described to address high
risk domains.
A sample of our Individualized Treatment/Service Plan can be requested if needed. For the JCDP, we only
complete an ISP for clients who choose to use their AHCCCS coverage.
4. Curriculum Used/Proposed – Described and provided information on any current or
proposed curriculum for the solicited program. Name and details of the curriculum,
background of the curriculum, support for evidence based, length of time and experience
using the curriculum, and the requirements for enrolled offenders. Attached examples of
lesson plans/modules and modality of treatment.
In accordance with the current contract and Scope of Work for this Justice Court Diversion Program, SAGE
currently has 2 different Tracks for this program: Drug Education and Cognitive Skills Education. They each
consist of one, 8-hour Education Class and have their own specific curriculum. In addition, for each class
we developed Lesson Plans, or Facilitator Guides, that provide an outline of the class, a schedule with time
frames, list of handouts, and specific steps and instructions to follow for each session. The curricula and
Lesson Plans have all been approved by MCAO for the specific Track.
Treatment Track 1: Drug Education Program: The curriculum for this program is adopted from
Hazelden’s Living in Balance, and SAGE’s Lesson Plan organizes the 8-hour class for the facilitator. It is
an evidence-based, cognitive-behavioral, substance abuse treatment program that was introduced in 2015
and immediately included in SAMHSA’s National Registry of Evidence-Based Program and Practices. The
curriculum is divided into 37 different session topics, and this program focuses primarily on the core
recovery sessions that include relapse prevention, cognitive, social, emotional, and coping skills
development. The program also addresses several other related social determinants and criminogenic
needs. This Hazelden curriculum does not require formal certification for training, and we presently have
about 35 clinicians who are trained to facilitate it. We have 6 clinical supervisors and clinical managers who
provide our internal training.
Treatment Track 2: Cognitive Skills Program: This curriculum is a combination of two separate but
related curricula from Texas Christian University’s Institute for Behavioral Research: Getting Motivated to
Change and Unlock Your Thinking: Open Your Mind. SAGE’s Lesson Plan/Facilitator Guide organizes the
8-hour class for the facilitators. Both of these curricula were developed for criminal justice clients and were
registered in the Substance Abuse and Mental Health Service Administration (SAMHSA’s) National
Registry of Evidence-Based Programs and Practices (until it was disbanded: http://nrepp.samhsa.gov).
They draw on the technique of Node-Link Mapping, which has been shown to be particularly effective with
criminal justice clients.
Based on MCAO’s January 24th response to questions, we have not “attached examples of lesson
plans/modules,” since all these curricula have previously been approved by MCAO for their Tracks.
5. Continuum of Care/Levels of Care – Described and provided information on their current
offered or proposed levels of care as determined by an individual’s criminogenic factors,
history, needs and/or risk of re-offend. Provided a detailed description of their levels of
care: frequency, duration, step down, aftercare services, community-based supports or
capability of referrals for additional support.
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In accordance with the contract for this misdemeanor diversion program, clients are placed in one of two
different 8-hour Education Classes: Cognitive Skills Education or Drug Education. The placement decision
is based specifically on the results of the TCU Drug Screen 5, which has been approved by MCAO for this
specific program. The scoring criteria for making the placement into a Track are described in #2 above.
Our Tracks for the Justice Court Diversion Program include:
Treatment Track 1: Drug Education Program
Treatment Track 2: Cognitive Skills Program
Regarding “aftercare services, community-based supports or capability of referrals for additional support,”
during our intake or assessment, we are attuned to Social Determinants of Health (SDOH) and make
referrals for additional services when appropriate.
6. MCAO Participants: Co-mingling of Participants with Others and Risk Levels –
Described and provided a detailed plan if MCAO participants will be co-mingled with
participants referred from other agencies. The information provided should address how
different risk levels will be kept separated during treatment. Detailed information was
provided related to how different risk levels will differ in treatment plan.
In our counseling/treatment programs, we employ multiple Treatment Tracks that vary in terms of duration,
intensity, modality, and curriculum. With that structure, clients’ criminogenic needs can be more effectively
targeted and mitigated. We also use these multiple Treatment Tracks to separate low-risk-to-recidivate
clients from moderate and high-risk-to-recidivate ones. However, in this misdemeanor-level Educational
Program, we only have 2 different Education Classes to place clients in, and we do not evaluate clients for
the risk-to-recidivate. Consequently, in these two, short-term, 8-hour Education Classes, clients with
different risk levels are combined in the same educational session.
Regarding “how different risk levels will differ in treatment plan,” in this diversion program, the only
difference is which of the two Education Classes clients are placed in. We develop Individualized Service
Plans (ISPs) for clients who choose to use their AHCCCS coverage, but not for clients who are not under
AHCCCS. Please see a sample ISP in #3 above.
7. Service Delivery – Described and provided information on their ability to provide services
across Maricopa County and if there are plans to expand locations/dates. Provided a
detailed class schedule or proposed class schedule. If services are provided remotely (tele-
health), a detailed description is provided as to how attendance and engagement is
measured/tracked, and what is the vendor’s class capacity/facilitator to client ratios for in
person and telehealth services. Describe the expectation of participation in remote
sessions and how those expectations are communicated with participants. Describe the
process of moving a participant to in-person sessions when they are not meeting the
expectations of remote sessions.
SAGE Counseling has been providing services throughout Maricopa County through telehealth and hybrid
modalities since the beginning of the pandemic in March of 2020. Even prior to the pandemic, SAGE
provided telephonic case management and engagement services to individuals who were unable to attend
in-office services at one of the 16 SAGE offices.
SAGE currently offers hybrid groups where the clinician and some participants are in-person, while other
clients participate digitally and are visible on a large video screen. SAGE will continue to offer hybrid,
telehealth-video, and in-person services to clients.
Attendance is tracked through our EHR system, Credible, and through various reports the group clinicians,
case managers, and the management staff utilize to ensure clients are held accountable for missed
sessions and to ensure clients complete all required treatment. Each clinician utilizes a roster report to track
all clients’ remaining sessions as well as various details regarding their overall treatment recommendations.
SAGE limits group capacity to 15 total clients per group for both virtual and hybrid groups. Group guidelines
are reiterated at the start of groups including attendance guidelines, participation, and overall group
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expectations. Overall treatment guidelines are also discussed at the time of enrollment and during the
assessment process. Clients that struggle with telehealth groups are required to attend in person and are
assigned to one of SAGE’s hybrid groups. As needed, the group Clinician or assigned Case Manager will
contact the client and reassign them to an alternative in person group.
Our Case Managers are familiar with working with clients to overcome obstacles to treatment, including not
having a device for video-enabled services. We provide resources and assistance to support their ability to
obtain a video-enabled device. For example, SAGE Counseling has partnered with T-Mobile to provide
certain clients who have accessibility issues with a smart phone for their use during treatment. The phones
will have unlimited talk/text/data and will allow those clients who do not have access to technology to attend
groups and appointments with SAGE virtually.
The use of these phones is not restricted to SAGE treatment and can be used by the client for work, school,
or personal tasks. The service fee will be paid by SAGE as long as the client is actively engaged in treatment
and attending appointments with their case manager at least once a month. At the conclusion of their
treatment, the client will have the option to return the phone or to transfer service themselves.
SAGE conducts over 320 counseling groups per week, the majority of these being in Maricopa County and
offered in the evening. We also have morning, day, and weekend groups that are available. In addition to
separating clients by gender, we have multiple Treatment Tracks to better match client's criminogenic
factors, e.g., 4 for substance abuse treatment and 3 for Domestic Violence Offender Treatment. The Tracks
vary in terms of the total number of times they meet per week and the total number of groups assigned.
8. Multiple/Flexible Options for Participants – Described and provided information if
flexible options are available/offered: individual/group setting, open entry format to reduce
wait times, varied days for service, hours of operation include evenings and weekends,
same gendered groups, staff to participant ratio is safe and effective to meet the needs of
the participants.
SAGE Counseling has various options that include virtual, in person, or hybrid appointments for the initial
assessment, group and individual treatment. During the assessment process, SAGE will determine the
most effective and convenient treatment options for each client based on gender, location, and individual
clinical needs. The majority of SAGE’s groups have an open entry format as well as multiple day, night and
weekend group options to fit various client needs. All of SAGE’s Substance Abuse and Domestic Violence
groups are gender specific to meet treatment requirements and the general staff to client ratio for each
group is 1:12. SAGE’s current JCDP education class list is included below for reference.
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9. Culturally Relevant and Linguistically Appropriate – Provided information how they are
able to meet the cultural and language needs of the population served. Provided
information related to bilingual staff. If none the agency does not have bilingual staff or
bilingual staff are limited, provided information as to how language needs will be met.
At SAGE, we believe everyone can learn and change. We strive to be culturally competent and sensitive
to the learning styles of our clients. The Socratic method of learning, prescribed throughout our treatment
programs, gives each person a chance to understand the material through his/her own world view.
Participation in class provides the opportunity to challenge ideas, beliefs, and behaviors they may have
inherited or adopted without awareness, and clients can, with further knowledge, choose beliefs and
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behaviors that serve their goals. It is particularly striking that participants will often increase awareness of
important values learned in their culture of origin and strive to return to those values for the benefit of
themselves and their families.
We emphasize being sensitive to cultural, ethnic, gender, sexual identity, and age differences in all the
services we deliver. We recognize that personal and cultural beliefs play a central role in determining how
clients view their lives, substance use, criminal conduct, and their involvement in treatment. We provide
cultural competency/diversity training to all our staff in our continuum of care. For facilitators, a key goal is
to understand how our clients’ cultural socialization impacts their understanding of themselves and their
attitudes toward the program. We are attuned to the process of identity development, with a focus on the
client’s particular ethnic and cultural group. We encourage the inclusion of religious and cultural
preferences, family support, and initial identification of needs for a successful learning experience. SAGE
offers various Spanish only groups and as needed, we utilize 1:1 sessions to accommodate the language
needs through phone, virtual, and in person interpreter services.
10. Program Rules and Requirements – Provided a brief summary of the agency’s rules and
expectations as well as when and how this information is delivered to diversion participants.
Describe all methods of outreach and the strategies for re-engaging participants. (This full
document may be requested after award.)
Group expectations and general guidelines are reviewed at the time of enrollment, during the assessment
and prior to the start of each group when a new client is present. SAGE Counseling staff attempt to contact
clients who fail to make contact with SAGE after receiving referral information to complete the enrollment
process, or if the client misses the scheduled appointment. Staff will attempt to contact clients via phone
and email within 24 hours of receiving the referral. These outreach attempts will be documented in a SAGE
progress note. SAGE Counseling staff will complete a minimum of 3 outreach attempts for clients that are
not engaging in services prior to closing the case at minimum and marking them inactive within the system.
Additional reminder text messages are also utilized for upcoming and missed appointments for clients. If
there are no successful outreach attempts, a discharge report will be submitted within 7 days of closing the
case file. The general group guidelines are included below. These guidelines are relayed to each client
throughout treatment.
SAGE Counseling Group Guidelines
Participation
•
Each group is scheduled for 2 hours (3 hours for IOP), please arrive on time and stay for
the entire duration in order to receive credit for the group session.
•
Distractions are not permitted, including background noise.
•
Please respect one another’s opinions and worldviews.
•
You are expected to be on video, facing the screen, at all times.
•
If attending virtually, you must be sitting up throughout the duration of the group.
•
You cannot be doing anything else but engaging in group. (e.g., Cannot be driving in car,
shopping, etc.)
•
There is also no smoking, vaping or eating allowed during the session (as we do in
person, clients should smoke/eat during break).
•
Use “I” statements when speaking vs. generalizing.
•
Group is a judgement free zone.
•
No discussion about politics.
•
Feel free to discuss religion or spirituality as it relates to you. Please do not tell others
what to believe.
Confidentiality
•
No recording or taking pictures of sessions.
•
Do not use other clients’ names outside of the group.
•
You must be alone in the room. If you cannot be alone, please wear earphones.
•
We cannot speak to anyone outside of SAGE without a valid Release of Information on
file.
o
Exceptions to this rule:
▪
Intent to hurt self or others.
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▪
Suspected abuse of child, elderly or disabled.
▪
Medical emergency.
(VIOLATIONS OF THESE RULES MAY RESULT IN PROGRAM DISCHARGE).
Honesty
•
Please be honest. We are not the legal system and are here to help you succeed.
Support Sobriety
•
Group members are not allowed to attend intoxicated or under the influence.
o
This includes prescription medications that interfere with your ability to participate
in a meaningful and appropriate way.
o
This also includes exhibiting behaviors that might indicate intoxication such as
falling asleep or slurring words.
•
Please do not wear clothing that may trigger others in the group.
UA Compliance
•
Please remind clients that are required to complete UAs to make sure they are following
up on this. Compliance will be part of a successful discharge.
11. Notification of Cost – Described what is shown/provided to participants. Described
vendor fees, expectations of payment, how due dates are determined, and payment
schedule. Provided methods of acceptable payments. Described process of participant
outreach when payment is not made according to proposed schedule.
Notification of Cost at time of enrollment
At time of enrollment to the SAGE program, participants are informed of their assessment fee and what
they can expect to pay for group fees via telephone. Upon completion of their enrollment and scheduling
their assessment appointment, participants are sent a confirmation email that includes the date and time of
their assessment, as well as their anticipated assessment fee.
Within the confirmation email, participants are sent a link to complete their intake documents, which
includes financial responsibility information. Participants are required to review and sign this document prior
to SAGE completing the assessment.
Notification of Cost at time of assessment
SAGE provides a document to the client at completion of assessment called the “Recommendations
Summary” Within this document, the following information is provided:
▪
Assessment Fee
▪
Case Management Fee
▪
Group Rate Per Session
▪
Individual Rate Per Session
▪
Education Fee
▪
Number of Recommended Treatment Sessions
▪
Service Type
▪
Per Session Fee (stated again)
▪
Weekly Schedule for Treatment Sessions
▪
Start Date of Sessions
▪
Session Start Time
▪
Session Language
Notification of Cost upon completion of assessment
Upon completion of assessment, SAGE clinicians send a summary email which includes the above
recommendations summary. This this email, the following payment information is included:
▪
Payment is expected prior to each service.
▪
Failure to make your payments on time may put you at risk of non-compliance and may
result in your unsuccessful discharge.
▪
You may pay online by visiting: https://sagecounseling.net/clientresources/
Methods of Acceptable Payment
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SAGE accepts all major credit and debit cards as the primary source of payment and payments are paid
online as indicated above.
Outreach During Payment Non-Compliance
SAGE’s billing and collections department tracks and conducts outreach calls and/or emails to all
individuals who have outstanding balances. During this time, SAGE works with the individual to set up a
plan for payment, and allows limited flexibility on payment arrangements of outstanding balances.
12. Indigency Determination and Sliding Scale Considerations – Provided a detailed
process to determine, reduce and/or waive fees for an indigent participant who is not
AHCCCS eligible. Provided a list of documentation requested to verify income for sliding
scale eligibility. Provided process for reassessing a participant’s eligibility throughout their
enrollment with the agency. Described the process of assisting a participant with AHCCCS
eligibility determination if applicable.
Financial Determination Process
For clients who are not eligible for AHCCCS insurance, SAGE offers potential fee discounts based on the
clients’ financial situation. But any U.S. citizen who is indigent is eligible for AHCCCS. At the initial referral,
the Admissions Specialist will ask the client if he or she is insured with AHCCCS. If the client is not insured
with AHCCCS, the Admissions Specialist will inquire on the client’s financial situation including (1) Number
of people in the household and (2) Combined Annual Household Income. The Admissions Specialist utilizes
SAGE’s Sliding Fee Scale to review the information and determine if the client may be AHCCCS eligible. If
so, the client will be referred to the SAGE Community Assistor for further assistance.
If the client is not insured with AHCCCS and determined to be ineligible for AHCCCS based on review of
their financial situation, the Admissions Specialist will ask the client if he or she desires to complete a SAGE
Financial Assessment Application. If the client chooses to accept the Financial Assessment Application the
client that is informed of the required supporting documentation and due date to return all required
documents within seven (7) days.
Upon receipt of a completed and on time application, a SAGE Billing Specialist completes the financial
assessment and fee determination process. If, as a result of the financial assessment process, it is
determined that the client is eligible for a discount per SAGE’s sliding fee scale, then this discount will be
effective as of the date that all required documentation was submitted. Once the fee is determined, a SAGE
Billing Specialist provides a written decision to the client on his or her financial responsibility. This is
completed within 5 business days of receiving the completed application from the client. When complete,
all documents are uploaded in SAGE’s EHR (Credible).
Documentation Requested Includes:
1) If unemployed:
a. Three (3) most recent payroll stubs or Prior Year Federal Income Tax Return.
b. Letter of Unemployment Benefits eligibility, stating monthly $ amount; or
unemployment denial letter, if applicable.
2) If currently employed:
a. 3 most recent payroll stubs.
3) Documentation supporting additional sources of income including:
a. Social Security, Medicaid, SNAP (former food stamps), Pension, Annuity,
Veterans’ benefits, Alimony, Child support, Military benefits, Businesses, Rent,
Interest, Dividends, Any other income
b. Documentation should show weekly or monthly benefits.
Reassessment during enrollment
During the course of the treatment program, if a client has a loss of AHCCCS eligibility or provides
notification of a change in financial circumstances, then the client will be provided the Financial Assessment
Application and the procedure and requirements discussed above will be applicable.
If, as a result of the financial assessment process, it is determined that a client is eligible for a discount per
the SAGE sliding fee scale, then this discount takes effect on the date of their first service following the
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submission of a completed application. Any payments made by a client, after the application submittal date,
in excess of the discounted fee, are applied in the form of a credit towards future fees.
Assisting with Enrollment or Re-Enrollment with AHCCCS
SAGE employs two Navigators (or Community Assisters) to assist clients with AHCCCS eligibility,
enrollment, and re-enrollment. Their primary responsibilities include reviewing the AHCCCS database daily
to see whether our current clients are due for renewal, have lost their AHCCCS insurance, or are eligible
for benefits. When a client is determined to be AHCCCS eligible, one of our SAGE navigators will outreach
the client to inform them of all documents that are required to complete the AHCCCS application. During
this initial outreach, SAGE navigators offer one on one assistance to complete the application process
through HEA Plus (AHCCCS’s online member enrollment program). If the client agrees, our navigators
schedule 1 – hour AHCCCS application appointments and support the client through the process of
applying.
SAGE also employs a Court Liaison that provides similar assistance to individuals referred to our Court
Liaison. Additionally, SAGE’s Case Managers provide information about the Marketplace for insurance
under the Affordable Care Act, and assist clients in applying for that coverage, as needed.
These combined efforts demonstrate our commitment to the community and help ensure that each client is
taking full advantage of all economic opportunities.
13. AHCCCS and Insurance Contracts – Provided documentation of contracts with all seven
AHCCCS Complete Care Plans. Provided documentation of all non-AHCCCS insurance
plans the agency is contracted with. If any contract is pending or due to change, detailed
information is provided about the changes and date(s) those changes go into effect.
SAGE Counseling, Inc. is contracted with all seven (7) AHCCCS ACC Health Plans, both (2) RHBA
AHCCCS Health Plans, and American Indian Health Plan, also through AHCCCS. These health plans are
indicated below:
1) Mercy Care ACC & Long Term Care (LTC)
2) Banner University Family Care & Long Term Care (LTC)
3) Care 1st Health Plan
4) Molina Complete Care
5) Health Choice Arizona
6) Arizona Complete Health
7) United HealthCare
8) American Indian Health Plan
9) Mercy Care RBHA
10) Care 1st RHBA
SAGE does not have any contracts pending and is not contracted with any non-AHCCCS insurance plan.
However, SAGE does occasionally receive and accept primary payer commercial payments from Blue
Cross Blue Sheild, Aetna and Cigna health insurance.
Vendor Qualification Requirements
14. Submitted copies of applicable AZ Department of Health Services licensure for each facility
where services will be provided.
a. Licenses should be for facilities located in Maricopa County, if awarded the County
may request copies of licenses outside Maricopa County.
SAGE has 16 licensed facilities throughout the state, all licensed by BMFL and credentialed by AHCCCS.
These are identified below. We have included copies of licenses in our proposal only for the facilities in
Maricopa County. Licenses can be provided to MCAO upon request.
SERIAL# 240104-RFP
15. Demonstrated that the agency has a minimum of two years of experience working with
adult offender populations. Described experience, history and knowledge of providing
evidence-based practices and programs to adult offender/criminal justice populations.
SAGE Counseling, Inc. is a licensed behavioral health provider with 25 years of experience providing
treatment and education services to adult offender populations in both outpatient and incarcerated settings.
SAGE has held contracts with MCAO to provide services to that clinical population since 2009 and currently
provides substance abuse, domestic violence, cognitive skills, and education treatment for MCAO. A list of
additional history and experience is listed in section 5.6.1.2. Currently, we provide 215 substance abuse
and cognitive skills groups per week. Almost all our substance abuse groups are gender-specific, and we
follow the EBP of not blending low-risk clients with moderate or high-risk ones.
All of SAGE’s programming is evidence-based, including utilizing the American Society of Addiction
Medicine’s (ASAM) Continuum Assessment, the Ohio Risk Assessment System to evaluate risk of
recidivism, and our multiple evidenced-based curricula. SAGE conducts a thorough Individualized Service
Plan (ISP) with all outpatient clients, which includes goal setting and monitoring goal achievement and
progress.
Vendor Reporting Requirements and Performance
16. Acknowledge if the vendor will meet all contract reporting and performance requirements
as described in the scope of work. If not, please explain what aspects of the requirements
will not be met.
SAGE Counseling, Inc. hereby acknowledges that we will meet all contract reporting and performance
requirements as described in the scope of work, unless we’ve explicitly indicated otherwise in section 5.7
Exceptions to the Solicitation.
17. Acknowledge if the vendor will meet all the terms and conditions of the draft contract. If
not, please explain what aspects of the contract will not be met.
SAGE Counseling, Inc. hereby acknowledges that we will meet all of the terms and conditions of the draft
contract.
18. Acknowledge if the vendor will meet the technology capability requirements described in
the scope of work. If not, what aspects of the requirements will not be met.
SAGE Counseling, Inc. hereby acknowledges that we will meet the technology capability requirements
described in the scope of work.
SERIAL# 240104-RFP
Required Attachments
19. Organizational Chart
Provided with response, MCAO can request updated organization chart when needed.
20. Job Descriptions for positions responsible for delivering the diversion program.
a. Provide a list of the positions by title, a brief summary for each of their roles, and
how many staff you have in these roles.
MCAO can request job descriptions when needed.
21. Proposed fee schedule
a. Refers to the menu of services that the contractor may offer as applicable to this
population. This menu of services allows MCAO to know what services the
Contractor offers in the event that the diversion program requirements may need
to be modified in the future. This is not the same as Attachment D – Pricing Page,
where the contractor is providing their proposed rates for the specific existing
required services by diversion program.
FEE SCHEDULE
** We generally deliver our Education in 8-hour classes and counseling groups in 2-hour
sessions.
For AHCCCS clients only:
Reimbursement by AHCCCS for behavioral health services provided by SAGE Counseling is contingent on
those services being deemed “medically necessary” by the client’s AHCCCS health plan. The vast majority
of SAGE’s services have been approved by the appropriate health plan for payment in the past; however,
for those clients whose services are deemed to be not medically necessary by their AHCCCS health plan,
the clients become responsible to pay for their services themselves. They are considered “self-pay” clients.
For AHCCCS-ineligible clients:
AHCCCS-ineligible clients will be given the opportunity to qualify for reduced fees in accordance with the
SAGE Counseling Sliding Fee Scale.
Clarification Questions & Answers
Under Attachment E
#16 Acknowledge if the vendor will meet all contract reporting…
1. How will the restitution and/or other fees be tracked and reported?
SERVICE TYPE
Assessment
Assessment Update
Education
Case Management
Individual Counseling
Counseling Group
IOP Counseling Group
In Home Family Therapy
In Office Family Therapy
Out of State or County Coordination
Intake
Restitution Management
Drug Monitoring
SERIAL# 240104-RFP
When the consent form is received, the restitution is added to SAGE’s Electronic Health Record
(EHR). At the time of processing enrollments, the file is reviewed for restitution. The
Administrative Assistant (AA) is then notified that a client with restitution has completed their
assessment. The AA initiates notification of requirements to the client via phone and email. The
AA sets a reminder to follow up with that client at least 1 week prior to their 50% payment
deadline, and again at the time the final payment is due. A restitution report is utilized to conduct
a monthly review of all restitution files and the team runs a check in the MCAO payment portal to
confirm if any payment(s) have been made. All payments made are reflected in our EHR for
recordkeeping purposes. Upon discharge, SAGE reports restitution on our discharge summary.
This includes both the original amount required, and any amount paid (as applicable).
All other fee information is also tracked within our EHR. Fees are set up by contract and payer
type (i.e., AHCCCS, Contract, or Self-Pay). Fees are pulled to the client’s record as services are
completed and recorded within our EHR. Fees are initially communicated to the client when
scheduling their initial appointment. Fees are once again communicated at the time of
assessment and reported to the client via email in a “Recommendations Summary”.
SERIAL# 240104-RFP
EXHIBIT C
DEFENDANT ELIGIBILITY REQUIREMENTS AND REIMBURSEMENT GUIDELINES
Contractor of the Justice Court Diversion Program:
For all non-AHCCCS insured, the contractor will be reimbursed:
o 50% of the defendant’s intake, screening, and program service costs, as required by the diversion
program. Contactors will be reimbursed for received, contract-prescribed diversion services, at the
contractor’s approved rate. Adjustments to the contracted service must be approved by MCAO in
order for the Contractor to be reimbursed.
Contractors of the Developmental Disabilities – Felony Diversion Program (DD-FDP), Domestic
Violence Diversion Program (DVDP), Felony Diversion Program (FDP), Parenting Skills Diversion
Program, Serious Mental Illness – Felony Diversion Program (SMI-FDP), Veterans Diversion Program,
and Opioid Use – Felony Diversion Program Pilot (OU Pilot):
For all non-AHCCCS insured and financially assessed defendants (using Sliding Scale below)
contractors will be reimbursed for:
o 100% of the cost for the Assessment received by the defendant for the contract-prescribed service,
at the contractor’s approved rate;
o 100% of the cost for Case Management services, up to a prescribed maximum of hours as indicated
by the specific diversion program, if such fee is specified in the contractor’s contract at the
contractor’s approved rate;
o
50% for the Case Coordination Fee for managing out of state/out of County (if telehealth services
are not available) defendants receiving services through a Third Party Behavioral Health provider,
if such fee is specified in the contractor’s contract. If the contractor is billing the County/MCAO for
this Case Coordination Fee, no other treatment services can be billed to the County/MCAO; and
o Using the Sliding Scale below, the defendant’s discounted program costs for received, contract-
prescribed diversion treatment services, at the contractor’s approved rate. Adjustments to the
contracted service must be approved by MCAO in order for the Contractor to be reimbursed.
Note: A defendant will be ineligible to receive a discount in program costs given any of the following
circumstances: 1) The defendant is unwilling to be financially assessed or does not comply with
financial assessment requirements or does not complete the financial assessment process within set
timelines, 2) The defendant is financially assessed, and it is determined that the defendant is AHCCCS-
eligible but refuses to apply for AHCCCS, or 3) The defendant is financially assessed, and it is
determined that the defendant does not qualify for a discount – see Sliding Scale below. If the
defendant’s financial circumstances change while in diversion, the defendant may request a
reconsideration of their financial assessment determination by the contractor.
Household
Size
2023
Federal
Poverty
Levels
1
$14,580
$0
$19,392
$19,393
$24,203
$24,204
$29,014
$29,015
$33,826
2
$19,720
$0
$26,232
$26,233
$32,735
$32,736
$39,243
$39,244
$45,750
3
$24,860
$0
$33,072
$33,073
$41,268
$41,269
$49,471
$49,472
$57,675
4
$30,000
$0
$39,900
$39,901
$49,800
$49,801
$59,700
$59,701
$69,600
5
$35,140
$0
$46,740
$46,741
$58,332
$58,333
$69,929
$69,930
$81,525
6
$40,280
$0
$53,580
$53,581
$66,865
$66,866
$80,157
$80,158
$93,450
7
$45,420
$0
$60,420
$60,421
$75,397
$75,398
$90,386
$90,387
$105,374
8
$50,560
$0
$67,260
$67,261
$83,930
$83,931
$100,614
$100,615
$117,299
For each additional
person over 8, add to
FPL:
$5140 annual
Adjusted for
AHCCCS Feb 2023,
add:
$570 month/or
$6840 annual
$0 Defendant Copay
25% Defendant Copay 50% Defendant Copay 75% Defendant Copay 100% Defendant Pay
$117,300
$105,375
$33,827
$45,751
$57,676
$69,601
0% Discount Range
$81,526
$93,451
MCAO Sliding Scale for ARPA Funds Using 2023 Federal Poverty Levels & AHCCCS Eligibility as of 2/13/23
Covered by Medicaid 75% Discount Range
50% Discount Range
25% Discount Range
AHCCCS-Insured
Non-AHCCCS-Insured
SERIAL# 240104-RFP
Contractor Reimbursement Requirements and Comments:
o
Contractors must be registered vendors with Maricopa County. If you are an unregistered
vendor, please use the following links to register: Doing Business/Vendor Registration |
Maricopa County, AZ Maricopa County VSS (hostams.com)
o
Once registered, contractors must invoice against a Purchase Order Number, which will be
provided in a subsequent email message.
o
Contractors will submit an itemized invoice to MCAO for the preceding month, with defendant
details as indicated in the MCAO diversion program contract. The Purchase Order Number
must be referenced on the invoice.
o
The effective date is March 7, 2022. Contractor reimbursements and defendant co-pays
become effective for defendants referred to the diversion program on or after the effective date.
No contractor reimbursements or defendant co-pays will be honored retroactively.
o
Reimbursement to contractors is contingent upon the availability of ARPA funds and is not
guaranteed.
o
It is the responsibility of the Contractors to track service maximums. Providing additional
services to defendants outside of diversion requirements will be viewed as voluntary services
and will not be reimbursed.
o
ARPA funding expires on December 31, 2025, unless reauthorized by the Maricopa County
Board of Supervisors.
o
Contractors must submit to MCAO monthly reports detailing the aggregate number of
defendants receiving ARPA funds, by Sliding Scale tier, for the preceding month.
o
Use of ARPA funds for training and certification will be distributed as determined by MCAO.