Section A. The Deliverables

CA.1 Project Overview
CA.1.1 Background Information
The Department of Health and Community Services (HCS) provides a leadership role in health and community services programs and policy development for the province. This involves working in partnership with a number of key stakeholders including regional health authorities (RHAs), community organizations, private service providers, professional associations, post-secondary educational institutions, unions, consumers and other government departments.
HCS, in collaboration with the RHAs, is implementing a Home First philosophy to support individuals with complex needs to remain at home and in their communities. The establishment of supportive community based options for individuals living with dementia aligns with this approach to health care.
According to the Alzheimer Society of Newfoundland and Labrador there are over 10,000 people living with dementia in the province. This number is expected to increase to over 14,000 by 2035. Supporting individuals living with dementia and their families will require innovative approaches to ensure individuals are supported to live their best life.
The residential care system in Newfoundland and Labrador is comprised of long-term care homes, personal care homes and community care homes. People living with dementia in the community are at risk of potentially premature long term care placement when risk of elopement presents, or mild behaviours symptoms present, even if they do not need access to 24 hour nursing care. Specialized dementia care spaces will address a gap in community services by providing a secure environment and staff trained in supporting individuals with dementia who do not need 24-hour on-site nursing care, but can no longer live safely at home because of the level of supervision and support required with the activities of daily living.
CA.1.2 Procurement Objectives
The Department of Health and Community Services invites proposals from interested community based service providers to establish a specialized dementia care model, with a goal to improve care options and quality of life for people living with dementia.  
The objective of the request for proposals is to seek community based residential options to provide specialized dementia care for up to 15 individuals, for a one-year demonstration project. The project will be evaluated after one-year and the results of the evaluation will inform the development of one provincial program. This residential option will reflect a philosophy of resident centered care, where the dignity and autonomy of residents is respected and supported.
Proponents must demonstrate that they have the required staffing, model of care philosophy, and infrastructure to provide a secure environment for residents. Residents will be supported to live their best life, including support to complete activities of daily living and access to meaningful recreational activities. Recreational activities will be modified and individualized for residents in accordance with their preferences, interests and abilities.
The goal of this one year demonstration project is to assess the effectiveness of a new model of community based specialized dementia care that incorporates a resident centred approach focussing on quality of care and quality of life. At the end of the one year, the project will be evaluated with the results used to inform the development of one provincial program. The goal of specialized dementia care within the community, is to provide individuals living with dementia with an opportunity to age in place in a less restrictive, home-like environment.
CA.1.4 Target Population
Individuals eligible for a specialized dementia care model have the following attributes:
(a) Over the age of 55;
(b) A need for support and supervision demonstrated by the outcome of a clinical assessment by professional staff of the RHA;
(c) A diagnosis of dementia or a related cognitive impairment (moderate to advanced as indicated by a score of 3-6 on the RAI-HC cognitive performance scale or a score of 15 or less on the MMSE);
(d) A demonstrated risk of wandering from familiar areas and/or documented attempts to leave usual surroundings, where the risk would be great enough that the person cannot be maintained in a less restrictive environment;
(e) Medical conditions and co-morbidities that are well controlled by medications and other interventions;
(f) May exhibit behaviours that are inappropriate, but would respond well to supportive strategies, such that the behaviour could be managed in the environment;
(g) The ability to ambulate independently or with some assistance, including with mobility devices; and,
(h) May need support for set-up, cueing, and direction, and may need assistance with incontinence care or routine ostomy management.

CA.2 Overview of Deliverables
The Contracted Supplier will deliver a model of care for up to 15 individuals with dementia, where the dignity and autonomy of residents is respected and supported. Residents will be supported by the Contracted Supplier, in collaboration with the appropriate RHA, in appropriately accommodating each individual’s level of care needs and any transition planning as required, in particular once the pilot project is complete at the end of the one year.
Working collaboratively with the RHAs, residents and families, the Contracted Supplier will provide quality care that is delivered by trained staff in a safe and home-like environment. The Contracted Supplier will deliver a model of care to support individuals living with dementia in a residential care setting, specifically the resident will be provided:
(a) Access to private or semi-private (maximum two clients) accessible room
(b) Access to fully accessible bathroom space
(c) Meals and snacks
(d) Laundry services
(e) Housekeeping services
(f) Assistance with personal care in accordance with assessed needs
(g) Medication administration
(h) Access to recreational programming
(i) Supervision; and
(j) Support for behavioural interventions, in accordance with assessed needs

[End of Section A.]