Enhanced Step-Down Program

The Enhanced Step-Down (ESD) Program – Mental Health and Intellectual and/or Developmental Disabilities (MH/IDD) initiative is a statewide grant opportunity administered by the New York State Office of Mental Health (OMH), in partnership with the Office for People With Developmental Disabilities (OPWDD). This program responds to the high rate of emergency room visits and extended inpatient stays among adults with co-occurring mental illness and intellectual or developmental disabilities. These individuals often cycle through emergency settings or remain hospitalized for extended periods due to the lack of appropriate transitional housing and care options. The ESD Program aims to create a structured, community-based alternative to hospital-based care, allowing for safer and more stable transitions back into the community. The ESD Program model is composed of two interrelated components: a Specialty Critical Time Intervention (CTI) Team and a Transitional Residential Setting (TRS). The CTI team delivers time-limited, evidence-based case management focused on assertive engagement, diagnostic clarification, behavioral planning, and transition support from the hospital to the community. The TRS provides up to six months of transitional residential care with structured activities, skill-building, and therapeutic support in a home-like setting. Not all individuals referred to ESD will enter the TRS; some will only require CTI support. This flexibility allows the program to tailor care to each individual’s needs. Funding for both components, including capital support for TRS development and operating support for services, is braided from FY 23-24 resources. Eligibility is limited to New York-based nonprofit agencies with 501(c)(3) status or public agencies operating licensed or certified OMH or OPWDD residential or clinical services. Individuals served must be age 18 or older, New York State residents, psychiatrically stable, and currently admitted to an inpatient psychiatric unit or emergency department. They must also have or be suspected of having an I/DD diagnosis with functional limitations. TRS placement further requires that individuals can self-administer medication with supervision, evacuate independently in emergencies, and live safely within the TRS setting. Applicants may apply to operate an ESD Program in any of five OMH regions: New York City, Western New York, Central New York, Hudson River, and Long Island. A separate application is required for each region of interest. Up to five programs will be funded—one in each region. Capital funding may be used for property acquisition, construction, or rehabilitation. Selected applicants will work with OMH’s Bureau of Housing Development and Support to determine capital costs and site feasibility. The contract term is five years, with OMH and OPWDD planning for long-term funding models. Currently, operational expenses will be fully funded by state aid through net deficit financing. Applications must be submitted via the New York State Statewide Financial System (SFS) portal. All nonprofit applicants must be prequalified in the SFS system prior to submission. The RFP opens on July 9, 2024, with final proposals due by 2:00 PM EST on September 25, 2024. A non-mandatory bidders’ conference will be held on August 7, 2024. All questions must be submitted to [email protected] by August 14, 2024, and answers will be posted on September 4, 2024. Award notifications are anticipated by December 3, 2024, and contracts are expected to begin on April 1, 2025. Applicants must notify the Local Governmental Unit (LGU) for each county served under their proposal and include hospital Memoranda of Understanding (MOUs) as part of the application package. Evaluation of proposals will involve both a technical review and a financial assessment. Applicants must score a minimum of 70 points to be considered. Proposals will be rated on six categories: program description, agency performance, utilization review and quality improvement, diversity and recipient input, implementation readiness, and financial strategy. Each selected awardee will be expected to begin CTI services within three months of the contract start date, with TRS capital development progressing in parallel. This initiative represents a critical investment in cross-system support for some of New York’s most complex behavioral health populations.