DOCUMENT
G -- HCHV CERS Respite NMVAHCS - Attachment
- Notice Date
- 10/23/2017
- Notice Type
- Attachment
- NAICS
- 623220
— Residential Mental Health and Substance Abuse Facilities
- Contracting Office
- Department of Veterans Affairs;Contracting Section;3601 S. 6th Avenue;Tucson AZ 85723
- ZIP Code
- 85723
- Solicitation Number
- 36C25818Q0033
- Archive Date
- 1/30/2018
- Point of Contact
- Lillian D Sepulveda
- E-Mail Address
-
9-4614<br
- Small Business Set-Aside
- N/A
- Description
- This is a SOURCES SOUGHT ANNOUNCEMENT ONLY. It is neither a solicitation announcement nor a request for proposals or quotes and does not obligate the Government to award a contract. Requests for a solicitation will not receive a response. Responses to this sources sought must be in writing. The purpose of this sources sought announcement is for market research to make appropriate acquisition decisions and to gain knowledge of potential qualified Service Disabled Veteran Owned Small Businesses, Veteran Owned Small Businesses, 8(a), HubZone, other Small and Large Businesses interested and capable of providing the services described below. Documentation of technical expertise must be presented in sufficient detail for the Government to determine that your company possesses the necessary functional area expertise and experience to compete for this acquisition. Important information: The Government is not obligated to nor will it pay for or reimburse any costs associated with responding to this sources sought synopsis request. This notice shall not be construed as a commitment by the Government to issue a solicitation or ultimately award a contract, nor does it restrict the Government to a particular acquisition approach. The Government will in no way be bound to this information if any solicitation is issued. If response by Service Disabled Veteran Owned Small Business firms proves inadequate, an alternate set-aside or full and open competition may be determined. The North American Classification System (NAICS) code for this acquisition is 623220 ($15). Notice to potential offerors: All offerors who provide goods or services to the United States Federal Government must be registered in the System for Award Management (SAM) at www.sam.gov and complete Online Representations and Certifications Application (ORCA). All interested Offerors should submit information by e-mail, mail or ground carrier to: Southern AZ VA HealthCare System, 3601 S. 6th Avenue, Tucson, AZ 85743 or by e-mail to Lillian.Sepulveda@va.gov. All information submissions to be marked Attn: L. Danielle Sepulveda, Contracting Officer (9-90C) and should be received no later than 12:00 pm Pacific Time on October 30, 2017. After review of the responses to this announcement, the Government intends to proceed with the acquisition and a subsequent solicitation will be published. Responses to this notice shall include the following: (a) company name (b) address (c) point of contact (d) phone, fax, and email of point of contact (e) DUNS number (f) Cage Code (g) Tax ID Number (h) If respondent is VOSB or SDVOSB, respondent is to provide proof of www.vetbiz.gov certification. In addition, SDVOSB/VOSB Contractors are asked to acknowledge that they understand the limitations on sub-contracting pursuant to FAR 52.219-14, Limitations on Sub-Contracting, which will be included in the impending solicitation. Furthermore SDVOSB/VOSB contractors are asked to respond that they are capable of providing the requested services keeping within the parameters of this clause (i)If an Offeror proposes to use any subcontractors, joint ventures, or teaming arrangements the Offeror shall include the percentage and type of work the subcontractor will accomplish to include their certifications. (Any subcontractors, joint ventures, or teaming partners shall have the required certifications as described in the sources sought notice) (j) GSA Contract Number (h) must provide a capability statement that addresses the organizations qualifications and ability to perform as a contractor for the work described below. DRAFT PERFORMANCE WORK STATEMENT Health Care for Homeless Veterans Program Medical Respite Part 1 General Information GENERAL: This is a non-personnel services contract to provide care, treatment, and rehabilitative services, including case management services; and therapeutic transitional housing assistance for the Health Care for Homeless Veterans Programs (HCHV). The Government shall not exercise any supervision or control over the contract service providers performing the services herein. Such contract service providers shall be accountable solely to the Contractor who, in turn is responsible to the Government. Description of Services/Introduction: The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items and services necessary to perform Health Care for Homeless Veterans as defined in this Performance Work Statement except for those items specified as Government furnished property and services. The contractor shall perform to the standards in this contract. Background: The central goal of the HCHV program is to reduce homelessness among Veterans by conducting outreach to those who are the most vulnerable and who are not currently receiving VA services, and then engaging them in treatment and rehabilitation as well as in other VA programs and non-VA community programs that provide prevention and support services. The HCHV program was developed from the original Homeless Chronically Mentally Ill (HCMI) Program, a six month pilot project, established February 12, 1987. In recent years, VA s effort to eliminate Veteran homelessness has led to the development of a range of additional programs and initiatives implemented by VHA Central Office, Office of Clinical Operations, and Homeless Programs Office. Additionally, programs such as Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) have been expanded to include programmatic components that address the gaps in services for homeless Veterans. Because HCHV programs typically are the first to make contact with homeless Veterans, they frequently serve as the entry point for these services and thus, provide VA a way to outreach, assist, and offer homeless Veterans an Open Door to the continuum of VA services. In addition to this core mission, HCHV functions as a mechanism to contract with providers for community-based residential treatment for homeless Veterans. Because the least disruptive and most economically efficient way to end homelessness is to prevent its occurrence, VA has expanded its homeless initiatives to include support services aimed at the prevention of homelessness. Unlike VA s traditional homeless programs, which focus on treatment and rehabilitation of the individual Veteran, prevention services address those Veterans and their families who are at immediate risk for becoming homeless or who have recently become homeless. This group includes Veterans recently released from prison or who are otherwise involved with the criminal justice system. HCHV programs are well positioned to assist these Veterans in accessing the appropriate level of services through other VA programs and non-VA community programs. The HCHV program is vital for providing a gateway to VA and community-based supportive services for eligible Veterans who are homeless. This includes ensuring that chronically homeless Veterans and/or those with serious mental health diagnoses can be placed in community-based programs that provide quality housing and services that meet the needs of these special populations. Objectives: Clinical Assessment to provide determination of strengths, needs abilities and preference of each Veteran Initiation of case management to plan and coordinate the homeless Veteran s care Scope: HCHV Services address the cause and effects of homelessness in a community-based setting that provides direct services in a safe environment that supports recovery and meets the needs of homeless Veterans. Services include short-term residential treatment to Veterans who need an immediate housing placement as they seek permanent housing and/or additional care and services. The target population is eligible homeless Veterans who are being discharged from a hospital, received care in the Emergency Department, or other VA clinic and do not require hospital level care. The Veterans who are served have acute and post-acute medical care needs and/or who are too ill or frail to recover from a physical illness or injury independently, but who are not ill enough to be in a hospital. The Veterans served also need to be independent in Activities of Daily Living, unlike respite for caregivers, medical respite is a short-tern residential care that allows homeless individuals the opportunity to rest in a safe environment while accessing medical care and other supportive services. HCHV services may be responsible for the direct provision of case management and additional care and services. Additional care and services may include, but are not limited to, vocational training and skills development, and mental health and/or Substance Use Disorder (SUD) counseling. Period of Performance: The period of performance of this contract shall be for a five year period. Quality Control: The contractor shall develop and maintain an effective quality control program to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor s quality control program is the means by which he assures himself that his work complies with the requirement of the contract. As a minimum, the contractor shall develop QC procedures addressing the quality indicators. Within 30 days after contract award, Contractor shall submit electronic copies (compatible with Microsoft Word or PDF) of a comprehensive written QCP to the Contracting Officer (CO) and COR. Contractor shall submit copies of revisions to the QCP to the CO and COR within five working days when changes are made thereafter. After acceptance of the quality control plan the contractor shall receive the CO s acceptance in writing of any proposed change to his QC system. Quality Assurance: The Government will periodically evaluate the contractor s performance under this contract. Contractor shall provide the Government unrestricted access to facilities and records required to evaluate Contractor s performance under this contract. Recognized Holidays: Contractor shall perform residential services on the following holidays. Contractor shall bear the cost of any overtime and/or holiday pay to which its personnel may be entitled as a result of performing work under this contract. These costs shall not be billed to nor reimbursed by the Government. New Year s Day Labor Day Martin Luther King Jr. s Birthday Columbus Day President s Day Veteran s Day Memorial Day Thanksgiving Day Independence Day Christmas Day Hours of Operation: The Contractor shall conduct business at the residential facility 24 hours per day. Admissions will occur at any time as clinically needed from VA Social Work Staff with collaboration from the COR. The Contractor shall at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS. When hiring personnel, the Contractor shall keep in mind that the stability and continuity of the workforce are essential. Place of Performance: The work to be performed under this contract shall be performed at the contractor facility within 20 miles of the New Mexico VA Health Care System (NMVAHCS) 1501 San Pedro Dr. SE, Albuquerque, NM 87108. Evidence of Insurance Coverage: Before commencing work under this contract, the Contractor shall furnish certification to the CO that the coverage required (General & Professional Liability as well as Workers Comp) has been obtained and such policy shall state, This policy may not be changed or cancelled without written notice to the VA CO, Network Contracting Office 18, 3601 S. 6th Ave. Tucson, AZ 85723. Said policy must bear an appropriate loss payable clause to the United States as its interest may appear. Such evidence of insurance will not be waived. Security Requirements: The contractor, its personnel, and its subcontractors shall be subject to the Federal laws, regulations, standards, and VA Directives and Handbooks regarding information and information system security as delineated in this contract. The security requirements in -Contract Security are part of this contract and are incorporated herein by reference. 1.12.1. Contractors are to utilize/access TMS for training for mandatory, annual Information Security and Privacy and contractor rules of Behavior (TMS#10176 and TMS #10203). Physical Security: The contractor shall safeguard all Government equipment, information, and property provided for contractor use. Post Award Conference/Periodic Progress Meetings/Weekly Treatment Group Meetings: The Contractor shall attend any post award conference convened by the contracting activity or contract administration office. The CO, Contracting Officers Representative (COR), Alternate Contracting Officer's Representative (ACOR), and other Government personnel, as appropriate, may meet periodically with the contractor to review the contractor's performance. At these meetings the CO will apprise the contractor of how the Government views the contractor's performance and the contractor will apprise the Government of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues. Contractor shall attend weekly treatment group meetings with the VA COR. All meetings described herein shall be at no additional cost to the Government. Contracting Officer Representative (COR): The COR (and if applicable ACOR) will be identified by separate letter. The COR monitors all technical aspects of the contract and assists in contract administration. The COR is authorized to perform the following functions: monitor Contractor s performance of the technical requirements of the contract: perform inspections necessary in connection with contract performance: maintain written and oral communications with the Contractor concerning technical aspects of the contract: issue written interpretations of technical requirements, including Government specifications: monitor Contractor's performance and notifies both the CO and Contractor of any deficiencies; coordinate availability of Government furnished property, and provide site entry of Contractor personnel. The COR is not authorized to change any of the terms and conditions of this contract. Key Personnel: The Contractor shall utilize the personnel named in its proposal to perform the services required under this contract. In the event that any of the personnel named in the proposal are unable to perform the duties of this contract, for any reason such as death, illness, or resignation from the Contractor s employ, the Contractor shall promptly submit to the CO and COR, in writing, a detailed explanation of the circumstances necessitating the substitution within one business day of the personnel change event. See Attachment D1. The Contractor shall submit to the CO and COR, in writing, a plan for acting/interim coverage of the absent personnel within two business days after the start of an absence expected to last more than three days. This plan shall adequately address maintaining safety, security and service delivery within the program. The Contractor shall email notice of proposed changes of personnel to the COR and include a resume for the proposed substitute, and any other information that may be needed to approve or disapprove the proposed substitution to the CO and COR within 15 business days of the personnel change event. Contractor shall bear the expense of any replacement of personnel it makes. Any substitution of personnel shall be without any increase to the contract price and without delay in the performance or delivery of services to the Government. The Government shall have the right to require replacement of any Contractor or subcontractor employee assigned to work on this contract, if the Contracting Officer determines that the employee does not to possess the experience or ability required under the contract, or if said employee is for any other reason found to be unsuitable to perform the work required by the contract. The replacement must meet the Special Qualifications requirements stated in the 1.17. Contractor shall bear the expense of any replacement of personnel directed by the Government. Any substitution of personnel shall be without any increase to the contract price and without delay in the performance or delivery of services to the Government. Special Qualifications: The contractor shall ensure all employees possess and maintain current professional certification as described below during the execution of this contract. Contractor shall ensure the following staff performing services under this contract have the following qualifications and meet the following staffing ratios: 1:20. The contractor will employ sufficient personnel to carry-out the policies, responsibilities, and the program for the facility. There must be, as a minimum, at least one administrative staff member, or designee of equivalent professional capability, on duty on the premises or residing at the house and available for emergencies 24 hours a day, 7 days a week. Housing Manager High School Graduation or G.E.D. with a minimum of one year experience providing administrative services in an organization serving clients with social service needs. Clinical Supervisor - licensed in the State of New Mexico with one of the following: Licensed Professional Counselor, Licensed Marriage and Family Therapist, Licensed Independent Substance Abuse Counselor, Licensed Master of Social Worker or Licensed Clinical Social Worker. Case Manager - High School Graduation or G.E.D. and training with a minimum of one year experience working with homeless individuals with chronic medical, mental health and substance abuse problems and be able to assess and anticipate crises. PART 2 DEFINITIONS & ACRONYMS DEFINITIONS AND ACRONYMS: DEFINITIONS: ADMINISTRATIVE DISCHARGE. When the Veteran has been transferred to an alternate level of care with concurrence from the COR for medical, mental health, or substance abuse treatment to better meet the Veteran s clinical needs. BI-WEEKLY MEETINGS. Taking place every two weeks. CONTRACTED EMERGENCY RESIDENTIAL SERVICES (CERS). Target and prioritize homeless Veterans transitioning from literal street homelessness, Veterans being discharged from institutions, including those in need of medical respite, and Veterans who recently became homeless and require safe and stable living arrangements while they seek permanent housing. CERS Programs, either directly or through linkage with community and other VA services, provide time-limited services such as supporting mental health stabilization, SUD treatment services, and enhancement of independent living skills, vocational training, and employment services. Emphasis is placed on referral and placement in permanent housing or longer term residential programs utilizing VA and/or community resources. Lengths of stay in CERS typically range from 30 to 90 days with the option to extend based on clinical need. NOTE: CERS programs represent a consolidation of existing HCHV contract residential programs, previously designated as either residential treatment (RT) or emergency housing (EH). Since varying levels of supportive services have been present in both, as noted above, this consolidation reflects the range and flexibility of these services as currently constituted. CONTRACTOR. A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime contractor. CONTRACTING OFFICER (CO). A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government. CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S. Government appointed by the contracting officer to assist with administering the contract. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract. COMMUNITY INTEGRATION. Community integration (CI) refers to a person s belonging and full participation in society. CI traditionally has been defined by three main areas: employment or other productive activity, independent living, and social activity. CHRONICALLY HOMELESS. The HCHV program follows the Federal definition of the term chronically homeless from section 401 of the McKinney-Vento Homeless Assistance Act, 42 U.S.C. 11360 DEFECTIVE SERVICE. A service output that does not meet the standard of performance associated with the Performance Work Statement. DELIVERABLES SCHEDULE. A schedule of deliverables associated with the PWS. See ATTACHMENT 4 Deliverable Schedule. HEALTH CARE FOR HOMELESS VETERANS PROGRAM. The Health Care for Homeless Veterans (HCHV) program is an essential and critical part of VHA, providing a gateway to VA and community-based supportive services for eligible Veterans who are homeless. HCHV programs provide outreach services; care, treatment, and rehabilitative services, including case management services; and therapeutic transitional housing assistance under 38 U.S.C. 2032 in conjunction with Work Therapy under 38 U.S.C. 1718. The program uses Contracted Residential Services (see paragraph 5.d.) in community locations to engage homeless Veterans who have been underserved. Many of these Veterans would benefit from mental health and Substance Use Disorder (SUD) treatment but will not avail themselves of these services without the encouragement of outreach workers. HOMELESS. The HCHV Program follows the definition of homeless in 38 U.S.C. 2002(1) and section 103(a) of the McKinney-Vento Homeless Assistance Act, 42 U.S.C. 11302 (a). NOTE: the term homeless or homeless individual does not include any individual imprisoned or otherwise detained pursuant to an Act of Congress or state law. HOMELESS OPERATIONS MANAGEMENT AND EVALUATION SYSTEM. The Homeless Operations Management and Evaluations System (HOMES) is an online data collection system that tracks homeless Veterans as they move through VA s Homeless Programs. The system streamlines data collection processes and facilitates communication between VA homeless program staff and leadership on the local, regional, and national levels. By providing a centralized data collection system, HOMES enables VA to efficiently and effectively collect and manage access homeless Veteran data. Historically, when a Veteran entered a new VA homeless program or episode of care, homeless program staff would re-enter Veteran data into a program-specific system resulting in duplicated data across separate homeless program systems. Further, these systems did not share information about the Veteran and the care received. The HOMES system allows for single entry of Veteran data and satisfies program operations, management, and evaluation requirements. Any entry into the system is available to all homeless staff across all Veteran Integrated Service Networks (VISN). HOMES is designed so that critical data elements are compatible with HUD s Homeless Management Information System (HMIS), allowing VA and HUD to meet the goals of integrating community and VA data into a single Registry. HOMELESS MANAGEMENT INFORMATION SYSTEM. The Homeless Management Information System (HMIS) is a computerized data collection tool specifically designed to capture client level information over time on the characteristics and service needs of men, women, and children experiencing homelessness and the services provided to them. HMIS implementations can encompass geographic areas ranging from a single county to an entire state and are administered locally within the community (Continuum of Care) by one lead agency that is responsible for standards and privacy compliance, as well as HUD reporting and other funder required aggregate reporting. KEY PERSONNEL. Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the Key Personnel listed in the PWS. MEDICAL RESPITE. Medical respite refers to acute and post-acute medical care provided for homeless persons who are too ill or frail to recover from a physical illness or injury independently, but who are not ill enough to be in a hospital. Unlike respite for caregivers, medical respite is short-term residential care that allows homeless individuals the opportunity to rest in a safe environment while accessing medical care and other supportive services. Medical respite care can be offered in a variety of settings including freestanding facilities, homeless shelters, nursing homes, and transitional housing. The care can be provided through any one of a number of different models, including a visiting care team (e.g., visiting nurses, rotating teams), an in-house clinical team, and/or in direct consultation with an established care team at a medical facility in such a way that therapeutic care can be provided and a treatment plan can be carried out at the respite facility. NEGATIVE DISCHARGE. When: a.) the Veteran whereabouts are unknown; b.) the Veteran has had an episode of violence or has threatened violence against staff or other Veterans and must be discharged to maintain the safety of the facility; c.) the Veteran has had more than one episode of drug use at the facility, has failed to engage in or accept treatment alternatives, and must be discharged to maintain a safe and sober environment at the facility; d.) the Veteran s length of stay has exceeded 180 days from the date of admission and the COR has not approved continuation of treatment. PER DIEM: the VA will pay for the eligible Veteran s stay in a residential treatment bed for each day the Veteran resides at the facility. The VA also refers to this as bed days of care. Unless specifically excluded in this contract, the per diem rate established will include the services or supplies normally provided other patients by the facility without extra charge. It is the contractor s responsibility to have appropriate systems of verification of services in place to justify invoices and payments. VA pays per diem for each eligible Veteran s exclusive use of a residential treatment bed within a facility. Therefore, the contractor may not bill the VA and the VA will not pay per diem for beds that are used by more than one person at a time, such as in shifts. For example, it is not permissible to bill the VA for a bed that was used by an eligible Veteran at night but then given to someone else to sleep in during the day while the eligible Veteran was attending appointments outside of the facility. Contractors may only bill the VA for bed days of care for Veterans who are actively residing at the facility. PERFORMANCE REQUIREMENTS SUMMARY. The contractor service requirements are summarized into performance objectives that relate directly to mission essential items. The performance threshold briefly describes the minimum acceptable levels of service required for each requirement. These thresholds are critical to mission success. See ATTACHMENT 3 Performance Requirements Summary. PHYSICAL SECURITY. Actions that prevent the loss or damage of Government property. POSITIVE DISCHARGE. When: a.) the Veteran has been successfully placed as anticipated in transitional or permanent housing, or reunited with family, and has met the goals of his/her Individual Service Plan within 90 days or less; b.) the Veteran has been successfully placed as anticipated in transitional or permanent housing, or reunited with family, and has met the goals of his/her Individual Service Plan in greater than 90 days from the date of admission and the COR has approved continuation of fixed daily charge for payment. This information applies to Veterans approved to stay beyond 90 days as clinically warranted. QUALITY ASSURANCE. The Government procedures to verify that services being performed by the Contractor are performed according to acceptable standards. QUALITY ASSURANCE Surveillance Plan (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance. QUALITY CONTROL. All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements. RECOVERY MODEL. The recovery model is centered on the belief that it is possible for homeless Veterans with mental health conditions to re-establish normal roles in the community. The recovery model fully supports community integration and improved quality of life for Veterans who have been diagnosed with a serious mental health condition that impairs their ability to lead meaningful lives. Within this model, psychiatric rehabilitation services are collaborative and encourage the Veteran s self-determination. SUBCONTRACTOR. One that enters into a contract with a prime contractor. The Government does not have privity of contract with the subcontractor. SUPPORTIVE HOUSING. Supportive Housing is a combination of housing and services intended as a cost-effective way to help people live more stable, productive lives. Supportive housing is widely believed to work well for those who face the most complex challenges individuals and families confronted with homelessness and who also have very low incomes and/or serious, persistent health issues. Supportive housing can be coupled with social services such as job training, life skills training, alcohol and drug abuse programs, community support services, and case management. Supportive housing is intended to be an efficient, pragmatic solution that improves quality of life and, to the extent feasible, reduces the overall cost of care. SUPPORTIVE SERVICES. Supportive Services encompass a range of services that assist an individual in the transition from the streets or shelters into permanent or permanent supportive housing and that assist persons with living successfully in housing. Examples of supportive services include, but are not limited to: assistance in securing permanent housing; vocational assistance, including mentoring and coaching as well as job placement; income assistance and financial planning; relapse prevention; and social and recreational activities. TALENT MANAGEMENT SYSTEM (TMS). VA s web based training system. http://www.tms.va.gov Instructions for log on will be provided in post award meeting. TREATMENT TEAM. Treatment team includes: VA HCHV Social Worker, VA HCHV Program Manager, Contractor Clinical Supervisor, and Contractor Case Manager. UNACCEPTABLE DISCHARGE. When: a.) the Veteran is discharged to a homeless shelter or drop in setting after a length of stay greater than seven (7) days from the date of admission unless there is concurrence from the COR that there is no other alternative due to circumstances beyond the Contractor s control; b.) the Veteran is discharged to the streets at any point in time after the date of admission under any circumstances. VETERAN. A Veteran, for the purpose of HCHV programs, is a person who served in the active military, naval, or air service, and who was discharged or released under conditions other than dishonorable and is enrolled or eligible for VA health care under 38 CFR 17.36 or 17.37. An eligible veteran must meet the criteria specified in 38 CFR 63.3 to qualify for benefits under the HCHV program. WORK DAY. The number of hours per day the Contractor provides services in accordance with the contract. WORK WEEK. Monday through Friday, unless specified otherwise. ACRONYMS: ACOR Alternate Contracting Officer's Representative CARF Commission on Accreditation of Rehabilitation Facilities CBT Cognitive Behavioral Therapy CFR Code of Federal Regulations CERS Contracted Emergency Residential Services CO Contracting Officer CONUS Continental United States (excludes Alaska and Hawaii) COR Contracting Officer Representative COTS Commercial-Off-the-Shelf FAR Federal Acquisition Regulation HCHV Health Care for Homeless Veterans Programs HCMI Homeless Chronically Mentally Ill Program HIPAA Health Insurance Portability and Accountability Act of 1996 HUD-VASH Department of Housing and Urban Development-VA Supportive Housing LDSH Low Demand Safe Havens NMVAHCS New Mexico VA Health Care System OCI Organizational Conflict of Interest OCONUS Outside Continental United States (includes Alaska and Hawaii) ODC Other Direct Costs OEF Operation Enduring Freedom OIF Operation Iraqi Freedom OND Operation New Dawn POC Point of Contact PRS Performance Requirements Summary PWS Performance Work Statement QA Quality Assurance QAP Quality Assurance Program QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Program ROI Release of Information SUD Substance Use Disorder TE Technical Exhibit TMS VA Talen Management System VHA Veterans Health Administration PART 3 GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES GOVERNMENT FURNISHED ITEMS AND SERVICES: Veterans will be screened for entry to HCHV Contracted Residential Services to determine medical and psychiatric stability and their suitability for entry to the program by designated VA Staff. Services: The Government will provide a VA Case Manager who will ensure psychosocial needs are met and to facilitate assistance with an appropriate Contracted housing placement. The VA Case Manager will meet with Contractor weekly or bi-weekly for treatment group meetings to review Veteran treatment plans. The VA will obtain an initial Release of Information (ROI) from each Veteran for any information requested by outside parties during the Veteran s participation in the program before placing the Veteran in the program. Appropriate VA and/or community services must be coordinated by the VA HCHV program staff, as indicated, for aftercare or re-engagement regardless of exit circumstances. Materials: The Government will provide Contractor with training with the HOMEs program requirements (estimate of four hours), VA Assessment and Treatment forms and documentation training (estimate of one hour), space for weekly treatment team meetings, initial assessment, initial and recurrent treatment plan, and ongoing consultation regarding evidence based therapies approved by the VA. PART 4 CONTRACTOR FURNISHED ITEMS AND SERVICES CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES: General: The Contractor shall furnish all supplies, equipment, facilities and services required to perform work under this contract that are not listed under Section 3 of this PWS. Provide Treatment Services and Documentation of Services. Contractor shall provide the Contracted Emergency Residential Services described in the Performance Work Statement as outlined below. Contracted Emergency Residential Services (CERS)- Residential Care Facilities: The Contractor shall have site control of the residential care facility through ownership or valid lease. VA will conduct an inspection that Contractor sites must pass prior to contract award and annually 60 days prior to an option period being exercised. VA reserves the right to inspect any facility and associated services at any time under the terms of this contract. Contractor shall ensure its facilities are licensed as required for the particular setting and meet all applicable local, state, and Federal requirements concerning licensing and health codes. Contractor shall provide copies of valid licenses to the VA at the time of pre-inspection and during annual inspection reviews. Where applicable, the facility must have a current occupancy permit issued by the authority having jurisdiction. Contractor shall meet all the standards referenced in the Health Care for Homeless Veteran (HCHV) Contracted Provider Inspection Form provided in ATTACHMENT 2 which is incorporated herein by reference. Contractor shall ensure its facilities meet the following standards: NFPA 101: Life Safety Code. This code can be located at http://www.nfpa.org/aboutthecodes/AboutTheCodes.asp?DocNum=101# or within the published NFPA 101: Life Safety Code, 2012 edition Americans with Disabilities Act (ADA) to include facility safety and accessibility requirements of the disabled, see www.ada.gov. This also includes meeting standards for certified service dogs in the facility, see current standards at www.ada.gov/service_animals_2010.htm. Service Dog owner is responsible for supervision, care and feeding of animal. Contractors shall provide the following to each Veteran referred and admitted to the Contract Residential Care facility: Semi-private Sleeping accommodations that are safe and accessible to Homeless Veterans, particularly of vulnerable target populations such as the geriatric community that may have issues with things such as climbing stairs and ladders, along with a designated single standing bed with a mattress that is used exclusively by the individual Veteran from the time of admission to the time of discharge. This bed must be situated in a room that affords the Veteran safety, privacy and security. Appropriate linens/bedding for the bed including a pillow. A night stand for personal effects. Closet space sufficient to hang clothing. A Chest of Drawers with sufficient drawer space to hold Veteran clothing/personal effects. A safe and securely locked place for each Veteran to store his/her belongings that is readily accessible to the Veteran (such as a locking closet, a locking armoire, a locker, etc.). This securely locked space must be of sufficient size to contain a 17 laptop and/or other valuables/ medications. The locked space must also be permanently mounted in the facility so as not be easily removed from the facility. Laundry facilities (including detergent and dryer sheets/fabric softener) for Veterans to do their own laundry or laundry services provided as part of the Veteran s stay in the residential care program (at no cost to the Veteran). Contractor shall provide appropriate safety and security in all common areas, such as lounges, laundry rooms, shared kitchens, group rooms, entrances and exits, and hallways, through active monitoring. Monitoring may be done through video surveillance or frequent security staff observation (1-2 hour checks for staff observation). No video surveillance in private areas such as bathrooms or sleeping areas. Sanitary procedures shall be established by the Contractor. Veterans are to be taught such procedures and encouraged to follow them. Many Homeless Veterans need to be taught how to successfully keep their own residence clean after successful transition to stable housing. Contractor shall encourage Veterans to engage in the cleaning and upkeep of the facility. Such encouragement should be limited to Veteran s clinical abilities. The Contractors staff is responsible for ensuring a clean and sanitary living environment. The VA COR may perform random checks to ensure cleanliness. Contractors shall provide a safe and sober environment for all Veterans. These policies and procedures must be communicated to Veterans both verbally and in writing in a manner that is understandable to them upon admission to the facility. This communication must be documented in the Veteran s record by the Contractor. The following situations are to be enforced and addressed with the Veteran: Suspected or known drug or alcohol use or relapse by one or more Veterans; On-site contraband, weapons (including props or souvenirs that appear to be weapons), drugs, alcohol, or related paraphernalia ; On-site drug or alcohol testing methods (i.e., urine drug screens, breathalyzers, etc.) and frequency; Safe prescription medication storage and handling, including specific provisions for prescribed controlled substances; Safe prescription medication access, including specific provisions for safe disposal of medications and syringes; Assertive monitoring of controlled substances, including but not limited to signing in medications after receipt from pharmacy with an observed pill count by Contractor staff when clinically warranted; staff observation and recording of taking of controlled substances and other medications by Veterans when clinically warranted; Room inspections and daily bed checks of Veterans residing in the program, including methods and frequency. Daily tracking and documentation of Veteran s presence in the program at least once daily. If a Veteran has not been confirmed present in any one 24 hour period, the Contractor shall notify the COR immediately; Grievance process to address Veteran complaints with time frames for responses from the Contractor s program/facility management; Veteran abandonment of belongings in the facility, including time frames and procedures for disposal Process to elicit Veteran satisfaction with the facility and onsite services, including information collection methods and frequency, and process for utilizing the information for continual performance improvement purposes. Contractor shall provide Veterans three meals a day, seven days a week, or the means to purchase and prepare their own meals. These meals must meet USDA suggested nutritional guidelines or other medically directed requirements and the facilities/equipment to prepare three meals daily, that encourages social interaction. Meals provided by Contractor which are traditionally served hot should be served at an appropriate temperature. Contractors shall ensure that all food, whether purchased by Veterans or provided by Contractor, is stored, handled and served in a safe and sanitary manner that meets accepted industry standards and guidelines. Contractor staff shall assess Veterans who are preparing their own meals to ensure food is being handled and stored in a safe manner. The VA has particular concern for chronically homeless Veterans, many of whom are either undernourished or have developed poor eating habits or both, because of extended homelessness, chronic medical, mental health or substance abuse disorders. The Contractor shall ensure such Veterans are getting adequate nutrition. Contractor shall maintain a printed menu. Contractor shall provide a VA dietitian or the COR access to these menus at any time. 1.The Contractor shall develop a process to elicit Veteran feedback for the snacks and meals provided by the Contractor. The process will include information collection methods and frequency, and a process for utilizing the information for continual performance improvement purposes. 2. The VA dietitian or the COR may assess Veterans feedback with Contractor provided meals and snacks to determine the Contractor s success in meeting the requirement to provide satisfying and nutritious meals during annual facility inspection or at any point during the contract period. Contractor shall document all clinical information in accordance with CARF Standards as outlined in 5.2 Treatment Services and Documentation of Services. Veterans may be discharged from HCHV Contract Residential Care programs for positive, negative or administrative reasons. The date of discharge must be approved by the VA Case Manager for billing purposes. The Contractor shall provide discharge planning and referrals for each Veteran, regardless of character of discharge from the facility, to appropriate community resources and services based upon a team assessment of health, social and vocational needs and the involvement of Veterans families as appropriate. Discharges will be accomplished in collaboration with the COR to ensure appropriate resources are offered to Veteran. Veterans who engage in an episode of violence or threaten violence against staff or other Veterans must be discharged immediately to maintain the safety of the facility. Discharges will be characterized as follows: Positive Discharge a.) the Veteran has been successfully placed as anticipated in transitional or permanent housing, or reunited with family, and has met the goals of his/her Individual Service Plan within 90 days or less; b.) the Veteran has been successfully placed as anticipated in transitional or permanent housing, or reunited with family, and has met the goals of his/her Individual Service Plan in greater than 90 days from the date of admission and the COR has approved continuation of fixed daily charge for payment. This information applies to Veterans approved to stay beyond 90 days as clinically warranted. The performance goal is 50% or greater of all Veterans admitted to the program will be Positive Discharge Administrative Discharge the Veteran has been transferred to an alternate level of care with concurrence from the VA Case Manager for medical, mental health, or substance abuse treatment to better meet the Veteran s clinical needs. The performance goal is no more than 20% of all Veterans admitted to the program. Negative Discharge a.) the Veterans whereabouts are unknown; b.) the Veteran has had an episode of violence or has threatened violence against staff or other Veterans and must be discharged to maintain the safety of the facility; c.) the Veteran has had more than one episode of drug use at the facility, has failed to engage in or accept treatment alternatives, and must be discharged to maintain a safe and sober environment at the facility; d.) the Veteran s length of stay has exceeded 180 days from the date of admission and the COR has not approved continuation of treatment. The performance goal is no more than 30% of all Veterans admitted to the program. Unacceptable Discharge a.) the Veteran is discharged to a homeless shelter or drop in setting after a length of stay greater than seven (7) days from the date of admission unless there is concurrence from the COR that there is no other alternative due to circumstances beyond the Contractor s control; b.) the Veteran is discharged to the streets at any point in time after the date of admission under any circumstances. The performance goal is zero (0) occurrences. ABSENCES AND CANCELLATIONS The contractor shall notify the VA of unauthorized absences by a referred Veteran from the facility. Should a Veteran absent himself/herself from the Contractor's facility in an unauthorized manner i.e. Away without leave AWOL. Payment for services for that Veteran shall be continued for a maximum period of two days, provided there is an active outreach attempt on the part of the Contractor's staff to return the Veteran to the facility and there is a reasonable belief that the Veteran will return. Management of program dropout will be an element of quality assurance review of this program. Absences of the Veteran from the facility in excess of two days will not be reimbursable unless authorized in advance by the VA Homeless Program Manager. VA reserves the right to remove any or all Veterans from the facility at any time, without additional cost, when it is determined to be in the best interest of the VA or the Veteran. The contractor shall notify the authorizing VA facility immediately when a medical emergency occurs that requires hospitalization of a referred Veteran. It is agreed that the Veteran will be admitted to the appropriate VA facility. When such admission is not feasible because of the nature of the emergency, it is agreed that hospitalization in a non-federal hospital may be accomplished provided that VA authorization is obtained. If hospitalization of a non-emergency nature is required it is agreed that admission to the appropriate VA facility will be accomplished promptly. The contractor shall notify the authorizing VA facility immediately of any incidents involving veterans residing in the residential program. The contractor shall notify the VA Respite Liaison within 48 hours by telephone during the hours of 8:00am and 4:30pm Monday through Friday. For all incidents that occur after normal business hours, the contractor should notify the Administrator on Duty (ADD). The contractor shall provide the HCHV case manager and the COR with a copy of the incident report within 24 hours. The contractor shall maintain a copy of the incident report in the Veteran's case record. An incident includes but is not limited to active substance use, injury, assault, and unruly behavior, any calls to 911, or actions that disturbing to the general population at the facility. Contractor has 72 hours to complete a report of incident, showing cause of incident, what was done during this incident and how contracting personnel resolved this incident. Special Care Provisions for Female Veterans: Contractor shall give special attention to meeting the unique treatment needs of homeless women Veterans. These needs often may include assistance with managing sexual trauma, eating disorders, interpersonal violence, and caring for dependents while in treatment. Contractor shall ensure that women Veterans have access to female clinical staff (whether from the Contractor, VA or other community partner) for additional gender-specific treatment and/or supportive services as needed. Contractor shall maintain and adjust environments to support the safety, security, privacy and services for women Veterans. Contractor shall place special emphasis on privacy and security in mixed-gender facilities. Veteran residents have a right to be treated with dignity in a humane environment that affords them both reasonable protections from harm and appropriate privacy with regard to their personal needs. The Contractor shall ensure that the living environments include: Residential room and board in an environment that promotes a lifestyle free of sexual discrimination. An environment conducive to social interaction, supportive of recovery models and the fullest development of the resident's rehabilitative potential regardless of gender or sexual orientation. If housed with males provide separate and secure bathroom arrangements to ensure an acceptable level of privacy for personal hygiene and grooming. Medication Storage and Monitoring: Contractor shall provide appropriate space and security for the storage of medications. Contractor shall ensure there are appropriate policies and procedures that support the safe storage of medications for Veteran residents. This storage can be provided to the Veteran to secure his or her medications, or central storage can be provided by the Contractor. Contractor shall have written procedures that address storage while providing access to medications and safe disposal of medications and syringes. Contractor shall ensure that Veterans residing in the program are educated about these procedures and the importance of safely storing their medications. Transportation: The Contractor shall assist the Veterans with local transportation to scheduled meetings and appointments. The Contractor will be expected to help the Veteran access public transportation, including providing information and instructions necessary to enable Veterans to utilize public transportation. If VA staff determines that adequate public transportation is not available or appropriate for a Veteran, the Contractor shall arrange for alternative transport by car. PART 5 SPECIFIC TASKS SPECIFIC TASKS: Contractor shall perform the following tasks: Obtain a Release of Information (ROI) from Veteran for any information requested by outside parties during the Veterans participation in the program if applicable. Ensure all documentation is in accordance with the current CARF standards-. Provide Clinical Assessments within seven days of admission to determine strengths, needs, abilities and preferences of each Veteran and/or services to include: History of homelessness Mental health history Physical health history Substance use history Social history Education, vocation, and income history Legal history Strengths and Needs Abilities and Preferences Barriers/Vulnerabilities Military History Trauma History Provide on-site drug or alcohol testing methods (i.e., urine drug screens, breathalyzers), when clinically appropriate or when requested by the COR. Provide Case Management to plan and coordinate the homeless Veteran s care. At a minimum Case Management Services will include the following: Working toward the rapid placement of the Veteran in a safe setting, with an emphasis on utilizing housing first approaches wherever possible. Arranging, coordinating, and/or providing direct clinical services (enrollment, assessment, treatment plan, reassessment) and support. Using Recovery Model principles. Provide the following clinical skills/interventions in an individual or group setting as appropriate: Cognitive Behavioral Therapy (CBT), CBT skills, Mind Body Stress Reduction (MBSR), MBSR skills, Motivational Interviewing, and Psychoeducational tools, sober living skills, psychotropic medication education, or other clinically relevant interventions to assist Veterans in managing negative mental health symptoms. The goal in utilizing the above skills/interventions is to provide an environment in which Veterans can successfully transition into stable permanent housing after the Veteran has reduced the impact of negative mental health symptoms and improved their ability to successfully live independently. Provide Treatment Services and Documentation of Services provided in Veteran s record: Address the needs of special populations which may include women, OEF/OIF/OND,SMI, and chronically homeless. Provide routine updates to the Initial Treatment Plan developed in conjunction with the NMVAHCS Housing First Program. Individual treatment plan shall include specific goals, measurable objectives, targeted dates for completion, a designated responsible individual for addressing each goal. Plans may include goals that: Improve the Veteran s safety Assist the Veteran s overall physical and mental status and promote a healthy lifestyle Instill hope Increase employability or increase income, or improve income management Improve the Veteran s overall quality of life Improve the Veteran s self-esteem, self-efficacy, and independence Assist the Veteran in achieving an optimal level of psychosocial functioning Provide support services aimed at the prevention of homelessness Provide progress notes that document the following: Progress toward the Veteran s goals Veteran s participation in treatment Services provided Changes to treatment or service plan Provide program exit summary upon termination from the program for each episode of care. Medical care and services provided, and recommendations for follow-up care, shall be documented in this exit summary, which shall include at minimum: Date of Exit Type of Exit Veteran s perception of exit and agreement with exit Status of Treatment goals at time of exit Aftercare plan Provide incident report in writing to the COR by close of business on the day of the incident and a phone call immediately for any of the following: Death; Fire; Drug/police raid; Suicide/suicide attempt; 911 calls (police / fire dept. / paramedics / other); Drug overdose; Severe medical illness / emergency; Severe psychiatric illness / emergency; Sexual assault, harassment or attempt; Act of violence or abusive behavior by Veteran against other(s) or staff; Act of violence or abusive behavior by staff against Veteran; Accident with or without injury involving staff or Veteran(s); Medication problems or adverse drug reactions; Or any other clinical relevant incidents. Provide Treatment Planning: Individual treatment plans are developed through a joint effort of the Veteran, the Contractor, and the COR. Treatment plans shall be developed for each Veteran based on input from COR staff assessments, other VA clinical data, and the Veteran. The COR is expected to utilize the Mental Health Treatment Suite for the documentation of treatment plans in Computerized Patient Record System. NOTE: If clinically indicated and if staffing is available, interdisciplinary planning must be provided by the treatment team. HCHV program staff must monitor the quality of care provided by the contract facility through regular visits to the facility. This is accomplished with the weekly treatment group meetings discussed in 1.14. Provide Treatment Services: Contractor shall provide therapeutic and rehabilitative services as described in the Performance Work Statement and in the Individual treatment plan. In some cases, VA may complement the Contractor s program with added treatment services such as participation in VA Outpatient programs (e.g., CWT, Incentive Therapy, Mental Health Clinic, SUD treatment). Structured group activities as appropriate - examples include group therapy, social skills training, Alcoholics Anonymous, Narcotics Anonymous, vocational counseling and physical activities as appropriate. Collaboration with the VA program staff, which will provide supportive psychosocial services. Individual professional counseling, including counseling on self-care skills, adaptive coping skills and, as appropriate, vocational rehabilitation counseling, in collaboration with VA program and community resources. Assistance to develop responsible living patterns, to maintain an acceptable level of personal hygiene and grooming, and to achieve a more adaptive level of psychosocial functioning, upgraded social skills, and improved personal relationships. Support for an alcohol/drug abuse-free lifestyle provided in an environment conducive to social interaction and the fullest development of the resident's rehabilitative potential. Assistance to gain and to apply knowledge of the illness/recovery process in an environment supportive of recovery models. A program that promotes community interaction. Provide Exit/Discharge from Contract Residential Services: Exit or discharge planning for each Veteran starts at the time of admission into the Contracted program. Exit planning is for the Veteran to identify personal needs for obtaining housing, continuing recovery, care, treatment, and services after exit. Exit planning is addressed at each interdisciplinary treatment team meeting with the Veteran. Length of Stay is 60 days from date of admission but can be variable based on progress towards goals, objectives, and time frames listed in the treatment plan with VA Case Manager and COR approval. The timing of transition to the community is negotiated between the Veteran and the team. Contractor s staff are responsible for ensuring that access barriers to continuing outpatient care (e.g., distance, transportation, scheduling) are reduced or eliminated. Veterans may end participation in HCHV Contract Residential Services for any of the following reasons: The Veteran has accomplished the goals as defined in the treatment plan and is prepared for community integration with identified resources after exit. The Veteran requires treatment beyond program resources and is to transition to another level of care. The Veteran has failed to adhere to the rules and the regulations of the program. The treatment environment does not meet the Veteran s expectations or needs. The Veteran requests to leave before treatment goals are met. The Veteran has a personal emergency necessitating exit. There are circumstances when the treatment team may make a clinical decision to discharge a Veteran prior to program completion. These circumstances include: The Veteran exhibits dangerous and/or threatening behavior; The Veteran exhibits a pattern of relapse or unauthorized use of an addictive substance and a lack of engagement in treatment services. The Veteran refuses to engage in treatment planning. The Veteran has achieved maximum benefit from treatment in the program. The Veteran refuses to allow communication between VA and the Contractor that is necessary to ensure the safe and effective coordination of care. Whether the Veteran ends participation in the program, has completed the program, or is in the process of being discharged by the Contractor, the Contractor shall ensure the following occurs: The Veteran is involved in the exit planning process. The Veteran is provided clear information regarding exit. Continuity of VA and non-VA services for medical and mental health needs are arranged. The HCHV program staff is included in decisions regarding the setting and frequency of ongoing treatment and community recovery activities. The treatment team will follow-up with the Veteran post-discharge to facilitate access to continuing aftercare services. An assessment of the Veteran s dangerousness and overall mental health stability is made by the treatment team and appropriate action taken, according to the Contractor s policy. If the Veteran does not have permanent housing, the Contractor shall provide information that facilitates arrangements for transitional or temporary housing. The Contractor shall inform HCHV program staff of the Veteran s exit within 24 hours. If a Veteran refuses to participate in exit planning or if a Veteran drops out of treatment without seeing or contacting Contractor s staff, the Contractor shall notify the HCHV program staff, and assess the level of risk. If the Veteran is deemed to be an immediate danger to him or herself or others, the Contractor shall call the Veteran Crisis line (800-273-8255) for assistance. If safety concerns persist, local 911 should be called. PART 6 APPLICABLE PUBLICATIONS APPLICABLE PUBLICATIONS (CURRENT EDITIONS) 6.1. The Contractor shall abide by the following regulations, publications, manuals, and local policies and procedures which are made part of this contract and are incorporated herein by reference. Commission on Accreditation of Rehabilitation Facilities, CARF International VHA HANDBOOK 1162.09 Health Care for Homeless Veterans Program VHA HANDBOOK 1162.01 GRANT AND PER DIEM PROGRAM
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