ForHealthConsulting.umassmed.edu
Middlesex County
Restoration Center
Commission
Year Five Findings and
Recommendations
Prepared for: Prepared by:
Clerks of the Senate and the House of Middlesex County Restoration
Representatives Center Commission
Senate Committee on Ways and Means Supported by ForHealth Consulting™ at
UMass Chan Medical School
House Committee on Ways and Means
Chelsea Thomson, MPP
Joint Committee on Mental Health, Substance Use,
Health and Justice Policy Associate
and Recovery
Joint Committee on Health Care Financing Michael Kane
Senior Director, Criminal Justice Reform
Nov. 1, 2023
ForHealth Consulting at UMass Chan Medical School
Table of Contents
Introduction ............................................................................................... 3
Report Overview ....................................................................................... 5
Commission Processes ........................................................................... 6
Commission Meetings ............................................................................................... 6
Commission Administration ..................................................................................... 6
Commission Activities............................................................................................... 6
Reappointed and Introduced New Commission Members ................................................... 6
Identified and Operationalized Funding Sources ................................................................. 7
Provided Input on Substance Abuse and Mental Health Services Administration (SAMHSA)
Grant .................................................................................................................................. 7
Guided and Supported the Procurement Processes ........................................................... 8
Developed a Middlesex County Restoration Center Commission Website .........................12
Work Completed by Vendors in Support of the Restoration Center ... 13
Health Management Associates (HMA) .................................................................. 13
Task 1: Facility Siting .........................................................................................................13
Task 2: Community and Stakeholder Outreach and Engagement ......................................13
Task 3: Sustainability and Funding ....................................................................................13
Task 4: Marketing and Communications ............................................................................13
SAMHSA Planning Grant Recipients ...................................................................... 14
Implementation Timeline ........................................................................ 15
Implementation Plan and Timeline ......................................................................... 15
Middlesex County Restoration Center Commission | Year Five Findings and Recommendations 2
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Introduction
The Middlesex County Restoration Center Commission (Commission), established under
Chapter 69 of the Acts of 2018, An Act relative to criminal justice reform (Act), as amended by
Section 142 of Chapter 126 of the Acts of 2022, An Act Making Appropriations for the Fiscal
Year 2023, hereby submits its Year Five (November 2022 – October 2023) findings and
recommendations to the General Court as required by the Act. The Commission has worked
since its inception to do the following:
Investigate the gaps and needs in behavioral health and diversionary services in
Middlesex County that could prevent arrest and unnecessary emergency department
(ED) utilization among individuals with behavioral health conditions
Develop a service model for a Restoration Center pilot program in Middlesex County and
implement the program
The Act tasked the Commission with planning and implementing "a county restoration center
and program to divert persons suffering from mental illness or substance disorder who interact
with law enforcement or the court system during a pre-arrest investigation of the pre-
adjudication process from lock-up facilities and hospital emergency departments to appropriate
treatment."1 This report summarizes the activities the Commission completed in Year Five and
includes an overview of efforts to launch the Center.
ForHealth Consulting (previously known as Commonwealth Medicine), the healthcare consulting
and operations division of UMass Chan Medical School (UMass Chan), compiled this report on
behalf of the Middlesex County Restoration Center Commission.
Commission members included:
Middlesex Sheriff Peter J. Koutoujian, co-chair
Dr. Danna Mauch, president and CEO, Massachusetts Association for Mental Health,
co-chair
Senator Cindy Friedman, 4th Middlesex District
Representative Kenneth Gordon, Middlesex 21st District
Lydia Conley, president and CEO, Association for Behavioral Healthcare
Scott Taberner, special advisor, Executive Office for Health and Human Services
Nancy Connolly, assistant commissioner for forensic services, Department of Mental
Health
Deirdre Calvert, director, Bureau of Substance Addiction Services
Eliza Williamson, director of community education and training, National Alliance on
Mental Illness of Massachusetts
Chief Justice Paula Carey, Massachusetts Trial Court (Ret.)
1
Chapter 69 of the Acts of 2018.
Middlesex County Restoration Center Commission | Year Five Findings and Recommendations 3
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Chief Lester Baker, Framingham Police Department (through August 2023)
Chief Roy Frost, Billerica Police Department (beginning September 2023)
Audrey Shelto, president and CEO, Blue Cross Blue Shield of Massachusetts
Foundation
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Report Overview
First, this report describes activities the Commission completed in Year Five, which include the
following:
Summary of Commission meetings held in Year Five
Description of the procurement process for a consultant vendor to assist with four tasks
Description of the procurement process for a vendor to provide services at the
Restoration Center pilot program
Overview of activities in support of the Substance Abuse and Mental Health Services
Administration grant
Next, this report describes the work completed by:
Facility siting and community engagement consultant(s)
Planning grant recipients
Finally, this report outlines findings and recommendations, which include:
Implementation plan and timeline for the Restoration Center pilot program
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Commission Processes
This section describes the Commission processes to support the launch of the Restoration
Center.
Commission Meetings
In Year Five, the Commission met five times to do the following:
Introduce new Commission members
Review feedback received from potential bidders through the Request for Information
(RFI) process and provide guidance on next steps, including procuring a consultant(s)
and amending sections of the Request for Responses for a provider to operate the
Restoration Center
Develop a Request for Quotes for a facility siting and community engagement
consultant(s) to support the selected Restoration Center vendor with facility siting and
development, facilitation and community engagement, development of a sustainable
funding plan, and development of communication strategies and presentations
Identify sources of funding and secure such funding to support the Restoration Center
pilot program
Provide input on the Substance Abuse and Mental Health Services Administration
(SAMHSA) grant for congressionally-directed spending
Prepare for the launch of the Restoration Center pilot program
Commission Administration
The state fiscal year's 2023 budget allocated funding for the Commission to the Executive Office
of Health and Human Services (EOHHS) line item 4000-0300. EOHHS extended the
Intergovernmental Service Agreement with ForHealth Consulting to procure vendors to support
and operate the Restoration Center as well as assist with the launch of the Center.
Commission Activities
This section describes Year Five activities for the Commission.
Reappointed and Introduced New Commission Members
During the Feb. 8, 2023, Commission meeting, the Commission welcomed Chief Justice Paula
Carey (ret.), formerly of the Trial Court, as reappointed to the Commission, and Audrey Shelto,
president of the Blue Cross Blue Shield of Massachusetts Foundation, and Chief Lester Baker
of the Framingham Police Department, as the newest members of the Commission. In August
2023, Chief Baker resigned from the Commission after Governor Maura Healey appointed
Baker to the Peace Officer Standard and Training (POST) Commission. Chief Roy Frost of the
Billerica Police Department joined the Commission in September 2023.
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Identified and Operationalized Funding Sources
During Year Five, Commission members continued to pursue funding opportunities to blend and
braid funding for the Restoration Center. New funding sources identified and secured included:
An annual appropriation of $1.25 million in EOHHS line item 4000-0300 into the Criminal
Justice and Community Support Trust Fund in FY24
Commission members submitted a $1.5 million request for community project funding to
Senator Ed Markey, but it was not included in the final Senate budget. The Commission also
reengaged the Pew Charitable Trusts in a conversation to request funding to evaluate the
Restoration Center.
The Commission continued to identify additional funding sources and resources to sustain the
Restoration Center pilot program financially over the next four years. In support of the
Commission's goal to identify sustainable funding sources, Health Management Associates
(HMA) (the consultant EOHHS procured to assist with four tasks as described later in this
report) researched available funding opportunities and drafted a sustainability plan to present to
the Commission. The Commission, EOHHS, and HMA will work closely with the Restoration
Center vendor to source, apply for, and secure funding.
Provided Input on Substance Abuse and Mental Health Services
Administration (SAMHSA) Grant
Secured by Congresswoman Lori Trahan (MA-03) and issued via a grant from SAMHSA to
EOHHS in 2022, congressionally-directed funding provided $1.65 million to support the
Restoration Center for one year until Sept. 29, 2023. Following conversations with SAMHSA in
preparation for a no-cost extension request, EOHHS advised that it would be advantageous to
offer resources to providers to prepare the community for the soon-to-be-launched Center. The
key behavioral health service providers play a key role in ensuring the Center is aligned and
appropriately woven into the local continuum of care. Commission members discussed the
goals of these planning grants, anticipated applicants, and the role the resources would play in
jumpstarting activities for the Center. The Commission supported the planning grants to prepare
community members and stakeholders across Middlesex County for the Center and build
relationships with law enforcement, first responders, hospitals, and other key stakeholders.
EOHHS worked with the Massachusetts Behavioral Health Partnership (MBHP) to offer up to
$50,000 to each provider, with a maximum of $200,000 across all providers, to initiate work that
advances the objectives of the SAMHSA grant. Funds were available through the end of
September 2023, and the recipients' activities are detailed later in this report.
The Commission also discussed a no-cost extension request to extend the length of the project
past the Sept. 29, 2023, period of performance. EOHHS submitted a request to SAMHSA to
extend the funding period through Sept. 29, 2024, and subsequently received the extension.
Middlesex County Restoration Center Commission | Year Five Findings and Recommendations 7
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Guided and Supported the Procurement Processes
Supported by ForHealth Consulting, the Commission and EOHHS finalized the procurements
for the siting and engagement consultant(s) and Restoration Center pilot program vendor during
Year Five.
Initial Request for Proposals
ForHealth Consulting published (under the former name of Commonwealth Medicine) a Request
for Proposals (RFP) in April 2022 to competitively procure a provider entity to operate a four-
year Restoration Center pilot program. Upon the deadline in June 2022, ForHealth Consulting
did not receive any proposal submissions. However, before the response deadline, ForHealth
Consulting received a letter from a service provider in Middlesex County expressing interest in
serving as the Restoration Center provider entity that included an explanation for their decision
not to submit a proposal at the time due to the competing priority of launching the Community
Behavioral Health Center (CBHC) they had already received funding to develop.
In the first quarter of 2023, Massachusetts began the implementation of Community Behavioral
Health Centers (CBHCs), which offer walk-in behavioral health services for people with urgent
and crisis behavioral health needs, crisis assessment, intervention and stabilization, and other
services designed to reduce unnecessary ED utilization. The Restoration Center is envisioned
as providing additional capacity and capabilities beyond what a CBHC offers, focused especially
on the needs of individuals brought to the Center by first responders.
Request for Information
To gather stakeholder input and understand the barriers that potential bidders experienced
associated with the RFP that resulted in no bids, ForHealth Consulting released an RFI in
August 2022. In September, two potential vendors responded to the RFI and provided feedback
on changes to the RFP that may increase the likelihood of future bids. Vendors provided overall
feedback and specific insight on services, timing, and funding. These topic areas are outlined
below alongside the Commission's response.
Concern Commission’s Response
Overall concerns include The Commission requested and was subsequently
limited vendor organizational approved to use SAMHSA funding to secure consultant
capacity, lack of appropriate vendor(s) to assist the provider entity in addressing these
and available real estate, concerns.
community resistance to siting,
and limited expertise to
overcome siting issues.
Feedback about services The Commission clarified that a vendor:
included questions on the
has the option to apply to the Department of Mental
process of managing respite
Health (DMH) to provide respite beds under several
beds, concerns about the
Middlesex County Restoration Center Commission | Year Five Findings and Recommendations 8
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substance use disorder (SUD) different models, the vendor can refer Restoration
support unit, staffing capacity Center clients to the vendor's respite center, and
for both acute treatment clients will need to have applied, not be approved,
services (ATS) (sometimes for DMH services.
called medically monitored would provide harm reduction services/beds on-site
withdrawal management or and has the option to provide ATS and CSS on-site
detoxification) and clinical or arrange for clients to receive ATS and CSS at a
stabilization services (CSS), different site.
the 24-hour transfer timeline, has the option to expand upon existing CBHC
and potential duplication of services to meet the Middlesex Restoration Center
CBHC services. (MRC) service plan.
Responses indicated that The Commission:
vendors would require 18
determined that a vendor has the option to launch
months from the time a
some services in existing space and provide the full
building is secured until
array of Restoration Center services after an 18-
program launch and an
month ramp-up period.
additional $2 million+ to meet
clarified that a vendor has the option to leverage
RFP specifications.
existing services to stay within budget and that the
Commission would seek additional funding to
support the sustainability of the Restoration Center.
Upon agreeing on the recommended actions to address the RFI stakeholder feedback,
ForHealth Consulting solicited additional feedback on vendor concerns, obtained further input
from state-level stakeholders, including Senator Friedman's Office and the Middlesex Sheriff's
Office, on recommendations for nex