Ohio Problem Gambling Treatment & Telehealth Service Expansion for DBH

MISSION & GUIDING PRINCIPLESThe mission of the Ohio Department of Behavioral Health (DBH) is to provide statewide leadership of a high-quality mental health and addiction prevention, treatment and recovery system that is effective and valued by all Ohioans. DBH strives to be a national leader in implementing a comprehensive, accessible, and quality-focused system of addiction and mental health care and wellness for all Ohio citizens. PURPOSEThe Ohio Department of Behavioral Health (DBH) is seeking proposals from qualified contractors to further develop a statewide problem gambling system of care using an administrator and regional hub model that directly supports regional providers by building their capacity to increase access to gambling treatment and recovery support services and by enabling them to integrate telehealth as an option when clinically appropriate or when local access barriers exist. The proposed statewide telehealth addiction system includes two complimentary components: 1. A lead organization that will develop and provide training, technical assistance to the identified regional hub behavioral health organizations. 2. Five Region Behavioral Health Problem Gambling Hubs that will provide comprehensive problem gambling treatment and recovery services including telehealth. Hubs will also provide support to other behavioral health organizations in their regions as they develop their internal capacity. This structure ensures statewide consistency, local responsiveness, and access to high-quality clinical care for problem gambling. BACKGROUND(Problem gambling is a growing public health concern across the state, yet the service delivery system remains severely under-capacitated. Current data demonstrates that there are only 91 certified providers (June 2025) with an estimated 120 individuals who are clinically competent to deliver specialized gambling disorder treatment. This represents a fraction of the need particularly in rural, underserved, and high demand-communities where individuals face substantial barriers to timely care. Access limitations are compounded by affordability concerns and insurance coverage gaps. No-cost or sliding-fee scale gambling services are increasingly scarce, and only a portion of existing providers must either forgo treatment or travel long distances to obtain specialized care. These pressures disproportionately impact residents with limited financial means, transportation challenges, or co-occurring conditions requiring integrated care. SCOPE OF WORK AND DELIVERABLES(The Lead Organization The administrator will serve as the convenor of the system(s), providing the organizational, training, and quality assurances functions necessary to sustain and strengthen the network. This vendor does not provide direct treatment services but instead builds the infrastructure and capacity of the regional agencies. Lead Organization Core DeliverablesAdministrative or backbone organization will create a pathway for behavioral health organizations to become designated to provide the continuum of program gambling services. Identify a network of 5 regional hubs who are certified behavioral health organizations as part of application and include signed memorandum of understandings. One organization in each region of the state: Central, Northeast, Northwest, Southeast and Southwest. Develop an 18-month training plan to help support regional hubs. Ensure that identified providers offer a sliding fee scale. Provide incentive-based deliverables for regional hubs based on a tiered approach. Base Stipend $5,000.00 annually is guaranteed if hub meets baseline deliverables. Dedicate at least 10 staff hours per month to Problem Gambling Services outreach/marketing outside of billable services. Implement at least two new targeted outreach/marketing strategies annually. Submit semi-annual progress reports documenting activities, barriers and lessons learned. Performance Incentive additional $2,500.00 annually awarded if hub demonstrates measurable impact by:Achieving at least a 10% increase in problem gambling service referrals or service inquiries compared to previous year or initial 6 months. Expanding outreach to at least two priority populations within the catchment area. Hosting or participating in a minimum of three community awareness events annually. Excellence Bonus additional $2,500.00 annually awarded if hub exceeded expectations such as: Achieving a 20% or greater increase in problem gambling service referrals or service inquiries. Demonstrating innovative replicable outreach models that can be scaled statewide. Documenting partnerships that leverage non-problem gambling funding sources (e.g. local coalitions, healthcare systems, philanthropy).If the lead agency is also a certified provider of gambling disorder treatment services, the lead agency may, cover any shortfall in care, deliver direct clinical care to individuals seeking telehealth services. Such instances shall occur only when (a) no other qualified provider within the regional network is available to accept the referral, or (b) the client specifically requests to receive care from the lead agency's certified clinicians. The lead agency must demonstrate a good faith effort to connect the client with a regional hub provider prior to assuming direct care responsibilities. Documentation of these efforts, including contact attempts, provider availability, and client preference statements must be maintained and available for review. This documentation should reflect that all reasonable options for referral were exhausted before the lead agency-initiated treatment services. 1. Statewide Training for Regional Hubs Months 1-3. By the end of month 3, design, and deliver training to the three regional hubs and at least 10 of their local providers. Training must integrate peer support, financial education and counseling. Training must also be a train the trainer model with trainers embedded into each of the reginal hubsTraining will include modules on peer support, financial education and counseling. 2. Train-the-trainer Program Provide two opportunities of train-the-trainer sessions within 4 months. Train a minimum of 10 trainers (2 per hub) who will be embedded into their organization for ongoing capacity building.3. Learning Collaboratives (months 2-18, bi-monthly)Facilitate 9 bi-monthly learning collaboratives across 18 months starting month 2. Each session will engage at minimum, 2 staff members from each regional hub and cover evidence-based problem gambling treatment/telehealth best practices, marketing/outreach, compliance, and peer-to-peer problem solving.4. Regional Hub Coaching and Mentoring (monthly, months 3-18)Provide monthly one-on-one coaching sessions with each of the hubs (minimum of 15 sessions per hub across 18 months) Focus areas include organization development, workforce planning, and sustainability strategies for problem gambling services. 5. Best Practice Guide for Problem Gambling TreatmentBy month 6, publish a Problem Gambling Treatment Best Practice Guide covering: Evidence-Based telehealth approaches Integration of peer and financial counseling supports Workforce and sustainability strategies By month 12, update the guide with feedback from the field. 6. Monthly and Quarterly Status Reports (months 1-18)Submit 18 monthly reports and 6 quarterly reports to the DBH Office of Community & Family Resiliency. Reports will include Provider capacity data, telehealth utilization rates, workforce development activities, and identified barriers/solutions. 7. State-Level Aggregate Metrics (quarterly, months 3-18)Beginning in month 3, compile and submit quarterly aggregate data on: Number of providers trained in telehealth protocols Number of active telehealth clients served per hub Workforce growth and retention metrics. Client satisfaction data 8. Liaison Between Hubs and DBH (ongoing months 1-18)Act as liaison by holding monthly coordination calls with DBH staff (18 total). Ensure alignment with statewide standards while documenting local flexibilities/innovations. Produce call summaries and a running log of decisions and adaptations shared across hubs.9. Year-End Report (month 6 and 18)Deliver two comprehensive final reports at months 6 and 18 summarizing: Number of trainings delivered, and participants trained Number of collaborative sessions and coaching hours Sustainability plans developed by each hub Adoption and utilization of best practice guide Integration of peer and financial counseling supports Workforce and sustainability strategies Each report must include a regional hub spotlight section with success stories, challenges and sustainability strategies.Coordinate bi-monthly learning collaboratives with regional hub organizations to providers are prepared to deliver evidence-based telehealth clinical care, for individuals, families and groups. Develop process for agency requests for implementation support, compliance guidance, and operational troubleshooting. Provide monthly one-on-one coaching to each regional hub on organizational development, workforce planning, and sustainability strategies/practices across the continuum of problem gambling services to ensure enduring capacity beyond the funding period. Develop a gambling treatment best practice guide that outlines evidence-based approaches, telehealth protocols, and integration of ancillary supports within 6 months of the contract. This guide will provide regional providers with a consistent framework for delivering high-quality care while allowing flexibility to address local community needs.Data collection and reporting:Completion of DBH Office of Community & Family Resiliency Monthly and Quarterly status reportaggregate state-level metrics on provider capacity, telehealth utilization, and workforce development outcomes, submitting regular reports to DBH. Completion of year-end report that includes highlighting work of each regional hub.System coordination:Act as liaison between regional hubs and DBH, maintaining statewide standards while allowing local flexibility. Regional Hub Behavioral Health ProvidersRegional Spokes are geographically distributed service providers throughout the state that deliver direct clinical care for gambling disorder and other addiction treatment needs. These agencies will benefit from the administrators statewide training, technical assistance, while tailoring services to meet local needs. Hub Core Responsibilities:Direct Clinical Care and Supports:Provide problem gambling in-person and telehealth assessment, treatment, and recovery support services responsive to local demands. Adapt uniform screening to ensure that individuals that may present with gambling disorder are effectively identify and given appropriate clinical care and services. Offer financial counseling on site.Workforce Development:A minimum of two individuals per hub will engage in trainings, monthly coaching and bi-monthly community of practice to meet and professional development to ensure clinicians and staff are equipped with the latest evidence-based practices. Conveying agency should provide at least two MOUs with regional hubs with their proposal. Identify at least 2 individual per agency to receive the TOT and who can offer the training to other providers in their identified region. Report monthly, quarterly and annually to lead organization. Increase number of clinicians working to obtain GAMB endorsement by at least 2 per hub. identify and respond to unique regional needs while maintaining alignment with statewide standards and protocols. This may include serving as a hub for other service providers in the region, provide space for the administrator to conduct trainings and continuing education opportunities and supporting other activities and resources related to problem gambling. Data Collection: Submit service level data to administrator lead organization to support statewide reporting and continuous improvement. This includes monthly, quarterly and annual reporting. Overall Anticipated Objectives and OutcomesA cohesive statewide system of care addressing gambling addiction throughout the state.Enhanced provider capacity and provide additional supports for clients Increased service access for any Ohioan to receive gambling disorder clinical care, regardless of location, access to transportation, or income Help better sustain agencies dedicated to providing problem gambling services Key Performance Indicators (KPIs): The lead organization will measure and report on the following KPIsThe first phase (FY26) will act as a baseline and the second phase (SF27) will act as the comparative value for metric evaluation. Workforce CapacityKPI: Increase of 3% in number of trained/qualified problem gambling treatment providers by 3% per year. Measurement: Number of GAMB endorsements per year Client Engagement & OutcomesKPI: Improve client engagement and retention in treatment Measurement: % of clients completing treatment plan 3% reduction in early dropoutsGeographic CoverageKPI: Ensure 75% of Ohio counties have at least one physical provider or referral pathway for problem gambling treatment. Measurement: Mapping of providers and coverage maps. MINIMUM QUALIFICATIONS OF CONTRACTOR(A recipient of the proposal must hold certification as a community behavioral health center. Agencies must have a comprehensive knowledge of Ohio’s behavioral health system. Any sub-contracted agency will be held to the same standards as the recipient. Documentation of certification must be submitted as an appendix in the proposal for all agencies providing telehealth services. -Extensive experience working with clients who have a diagnosis of gambling disorder/pathological gambling.-Documentation verifying the use of HIPAA-compliant technology in the delivery of telehealth services. -Clinical professionals who treat clients with gambling disorder/pathological gambling via telehealth must possess the minimum qualifications as outlined by the Ohio licensure boards listed below. The following is a list of clinicians who can provide telehealth services with appropriate training: Ohio Chemical Dependency Professionals Board• An active LCDCII-GAMB under proper supervision• An active LCDCIII-GAMB under proper supervision• An active LICDC-GAMBOhio Counselor, Social Worker Marriage and Family Therapist Board• An active LSW with demonstrated competency* under proper supervision• An active LPC with demonstrated competency* under proper supervision• An active MFT with demonstrated competency* under proper supervision• An active LISW with demonstrated competency*• An active LPCC with demonstrated competency*• An active IMFT with demonstrated competency*Ohio Board of PsychologyAn active clinical psychologist with demonstrated competencyInternational Gambling Counselor Certification BoardAn active ICGC-IAn active ICGC-IIApplicants must provide a list of clinicians who are qualified to provide therapeutic services for their agency for disordered gambling as an attachment in their proposal.Contractor shall not be subject to an “unresolved” finding for recovery under Section 9.24 of Ohio Revised Code