36C24118Q9270-002.docx

FY 2019

Performance Work Statement (PWS) VA Healthcare for Homeless Veterans (HCHV) Contractual Services for the Provision of Transitional Residence Beds VA Bedford Medical Center (518)

1. INTRODUCTION: The Department of Veterans Affairs’ (VA) “Breakthrough Initiative 8 to continue progress to end Veteran’s homelessness” calls for enhancing current homeless service capacity as well as developing new programs and initiatives in concert with community and federal partners. The intent of this Performance Work Statement (PWS) is for VA Medical Centers to engage community provider(s) to offer Veterans, some of whom are homeless, services through a “Transitional Residence” model of residential care.

The VA Bedford Medical Center, through the Healthcare for Homeless Veterans (HCHV) Program, is committed to meeting the temporary housing needs of all of our Veterans.

1.1 Purpose: The goal of the HCHV Transitional Residence Program is to ensure and improve the viability of patient flow from the inpatient acute hospital setting to other programs within the facility such as VMHAP, Grant & Per Diem, Domiciliary and Crescent House. The program has five (5) beds in total and has been in existence since 2006.

There exists a secondary cohort of Veterans who benefit from the availability of the Transitional Residence beds. These Veterans are enrolled in VMHAP and are commonly referred to as “commuter Veterans”. They are temporarily quartered in the Rogers House while awaiting placement into the Domiciliary Program. When they exceed the Rogers House length of stay, Veterans are frequently discharged to shelters while awaiting placement into the Domiciliary, which poses a greater risk for relapse and homelessness.

This program presents a significant cost savings for the facility when compared to the current practice of delaying discharge from the Acute Psychiatric Service (Unit 78G). This program also supports the VA’s “Breakthrough Initiative 8 to continue progress to end Veteran’s homelessness.”

The VA Bedford Medical Center will contract through procedures in line with their own business practices and contracting services. Costs associated with Veteran care will be determined by bed days of care, per month.

1.2 Policy: The Secretary of the VA has set a zero-tolerance policy for homelessness within the Veteran population. As part of the Breakthrough Initiative 8, the Veterans Health Administration (VHA) intends to increase both capacity of existing programs and services offered to program participants. This plan calls for utilizing new models of care, not previously offered by VA.

1.3 Background: The VA has been providing direct and specialized services for homeless Veterans for over 20 years. Beginning in 1987 with 43 pilot programs that provided street outreach and residential community services, VA Homeless Programs have developed and expanded to become the largest integrated provider of homeless services in the country. Despite these resources, on any given night HUD estimates that there are still over 39,000 Veterans who are homeless. The emergency housing needs subsumed under this scope are normally provided by numerous housing sources which cumulatively do not have adequate availability to serve our complex homeless Veteran population. The VA Bedford Medical Center has worked to support emergency shelter beds since November 2011 due to the increasing need of complex Veterans who cannot navigate local shelters or who have emergent needs. As part of the facility’s efforts to end Veteran homelessness, the facility would like to request continued efforts to see the emergency shelter needs of homeless Veterans met in the Bedford area. These additional emergency (temporary) shelter housing beds located with the Bedford community are needed to better serve our homeless population struggling to work on their own individual mental health, substance abuse and housing needs. These beds offer additional access to serving our homeless Veteran. The Healthcare for Homeless Veterans (HCHV) team provides intensive case management for Veterans presently served in the emergency homeless bed program. The Period of Performance reads as follows:

1.4. Place of Performance: The work to be performed under this contract will be performed at the Contractors facility which must pass inspection by VA Personnel (see attached inspection sheet).

1.5 Type of Contract: The Veterans Affairs will award a Firm Fixed Price Contract with estimated quantities.

1.6 Post Award Conference/Periodic Progress Meetings: The Contractor agrees to attend any post award conference convened by the contracting activity or contract administration office in accordance with Federal Acquisition Regulation Subpart 42.5. The contracting officer, Contracting Officers Representative (COR), and other Veterans Affairs personnel, as appropriate, may meet periodically with the contractor to review the contractor's performance. At these meetings the contracting officer will apprise the contractor of how the Veterans Affairs views the contractor's performance and the contractor will apprise the Veterans Affairs of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues. These meetings shall be at no additional cost to the Veterans Affairs.

2. SCOPE OF WORK:

2.1 Provide access for up to five (5) beds with a length of stay (LOS) up to 60 days which will be monitored and tracked with a VA Social Worker in the HCHV Program. Provide private areas in a safe and appropriate facility for male and female Veterans.

2.2 Provider will provide all linen including sheets, towels, pillows and blankets as well as a locked storage box during LOS.

2.3 Three (3) meals per day.

2.4 Provide transportation to VA Bedford Medical Center Monday through Friday as needed for appointments.

2.5 Provide an environment where Veterans can safely store and administer their own medication.

2.6 Collaborate with the designated VA Social Worker for all Veteran referrals.

2.7 Obtain a signed Release Of Information from the Veteran for verbal communication during LOS, reciprocal with VA.

2.8 Provide case management services in collaboration with the VA Social Worker while the Veterans are housed in the designated beds.

2.9 Assessment, evaluation, discharge and referral assistance as needed and indicated.

2.10 Maintain safe environment and pass annual inspection of facility by VA approved site team.

2.11 Collaborate with VA outpatient Mental Health providers to arrange for follow-up and aftercare services.

2.12 Collaborate daily with VA Social Worker bed occupancy and bed availability.

2.13 Comply with VHA confidentiality and HIPPA guidelines.

2.14 Work in concert with the VA Bedford Medical Center Social Work Chief.

2.15 Agree to return Veteran back to VA Bedford Medical Center if medically indicated for inpatient hospitalization as long as it’s not deemed a medical emergency at which time 911 would be contacted and transfer to the nearest and most appropriate hospital is warranted.

2.16 Provider will treat customers (Veterans, their representatives, visitors, and all VHA staff) in a courteous, tactful, and respectful manner. Handles conflicts and problems in dealing with the customer constructively and appropriately.

2.17 Protect printed and electronic files containing sensitive data in accordance with the provisions of the Privacy Act of 1974 and other applicable laws, federal regulations, VA statutes and policy, and VHA policy, JC and HIPPA. Protect the data from unauthorized release or from loss, alteration, or unauthorized deletion. Signed releases are required for the sharing of verbal &/or written information between VA and SCRC under this agreement.

3. CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES:

3.1 General: The Contractor shall furnish all supplies, equipment and services required to perform all tasks within the performance work statement.

4. PERFORMANCE REQUIREMENT 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.

Performance Objective (The Service required—usually a shall statement)

Method of Surveillance

PRS # 1.

The contractor shall provide private areas in safe and appropriate facility/facilities for Veterans to stay in for up to 60 days within the VA Bedford catchment area.

The contractor will have an appropriate facility with private areas ready for Veterans to move into upon the start of the contract.

PRS# 2

The contractor shall provide healthy, nutritious, and appropriate food including fresh food for the residents that meet the requirements of the Nutrition department at VA Bedford.

PRS# 3

The contractor shall provide transportation for residents to VA Bedford VA for medical, substance use, and mental health care appointments and for CWT/VCT as needed .

PRS# 4

The contractor shall provide 24/7 awake staffing at the facility/facilities housing the Transitional Residence Veterans.

PRS#5

The contractor will assist Transitional Residence Veterans with transitioning into either permanent housing or an appropriate treatment setting upon discharge.

5. DELIVERABLES SCHEDULE

N/A

Tim Driscoll /Corey Labbe

6. VA Bedford Medical Center Agrees to Provide:

6.1 Clinical consultation and guidance as needed to collaborate and assist each Veteran.

6.2 Collaborative assistance for transfer assistance and coordination.

6.3 Provide Drug of Abuse in Urine (DAU) testing as needed.

6.4 Obtain necessary Release Of Information for referral assistance and communication.

6.5 Allow any provider under this scope to attend educational training and seminars provided or sponsored by VA Bedford Medical Center, which would improve or enhance the staff’s expertise and provide skill building.

6.6 VA Social Worker to perform daily (weekday) contact with provider liaison to discuss bed availability.

6.7 Financial reimbursement for BDOC (Bed Days of Care-utilization) occupied by Veterans.

6.8 We reserve the right to increase the need of emergency beds as the need arises with modification.

Contract Security according to VA Handbook 6500.6 Appendix A Modified

GENERAL

Contractors, contractor personnel, subcontractors, and subcontractor personnel shall be subject to the same Federal laws, regulations, standards, and VA Directives and Handbooks as VA and VA personnel regarding information and information system security.

ACCESS TO VA INFORMATION AND VA INFORMATION SYSTEMS

a. A contractor/subcontractor shall request logical (technical) or physical access to VA information and VA information systems for their employees, subcontractors, and affiliates only to the extent necessary to perform the services specified in the contract, agreement, or task order.

b. All contractors, subcontractors, and third-party servicers and associates working with VA information are subject to the same investigative requirements as those of VA appointees or employees who have access to the same types of information. The level and process of background security investigations for contractors must be in accordance with VA Directive and Handbook 0710, Personnel Suitability and Security Program. The Office for Operations, Security, and Preparedness is responsible for these policies and procedures.

c. Contract personnel who require access to national security programs must have a valid security clearance. National Industrial Security Program (NISP) was established by Executive Order 12829 to ensure that cleared U.S. defense industry contract personnel safeguard the classified information in their possession while performing work on contracts, programs, bids, or research and development efforts. The Department of Veterans Affairs does not have a Memorandum of Agreement with Defense Security Service (DSS). Verification of a Security Clearance must be processed through the Special Security Officer located in the Planning and National Security Service within the Office of Operations, Security, and Preparedness.

d. Custom software development and outsourced operations must be located in the U.S. to the maximum extent practical. If such services are proposed to be performed abroad and are not disallowed by other VA policy or mandates, the contractor/subcontractor must state\ where all non-U.S. services are provided and detail a security plan, deemed to be acceptable by VA, specifically to address mitigation of the resulting problems of communication, control, data protection, and so forth. Location within the U.S. may be an evaluation factor.

e. The contractor or subcontractor must notify the Contracting Officer immediately when an employee working on a VA system or with access to VA information is reassigned or leaves the contractor or subcontractor’s employ. The Contracting Officer must also be notified immediately by the contractor or subcontractor prior to an unfriendly termination.

VA INFORMATION CUSTODIAL LANGUAGE

a. Information made available to the contractor or subcontractor by VA for the performance or administration of this contract or information developed by the contractor/subcontractor in performance or administration of the contract shall be used only for those purposes and shall not be used in any other way without the prior written agreement of the VA. This clause expressly limits the contractor/subcontractor's rights to use data as described in Rights in Data - General, FAR 52.227-14(d) (1).

b. VA information should not be co-mingled, if possible, with any other data on the contractors/subcontractor’s information systems or media storage systems in order to ensure VA requirements related to data protection and media sanitization can be met. If co-mingling must be allowed to meet the requirements of the business need, the contractor must ensure that VA’s information is returned to the VA or destroyed in accordance with VA’s sanitization requirements. VA reserves the right to conduct on site inspections of contractor and subcontractor IT resources to ensure data security controls, separation of data and job duties, and destruction/media sanitization procedures are in compliance with VA directive requirements.

c. Prior to termination or completion of this contract, contractor/subcontractor must not destroy information received from VA, or gathered/created by the contractor in the course of performing this contract without prior written approval by the VA. Any data destruction done on behalf of VA by a contractor/subcontractor must be done in accordance with National Archives and Records Administration (NARA) requirements as outlined in VA Directive 6300, Records and Information Management and its Handbook 6300.1 Records Management Procedures, applicable VA Records Control Schedules, and VA Handbook 6500.1, Electronic Media Sanitization. Self-certification by the contractor that the data destruction requirements above have been met must be sent to the VA Contracting Officer within 30 days of termination of the contract.

d. The contractor/subcontractor must receive, gather, store, back up, maintain, use, disclose and dispose of VA information only in compliance with the terms of the contract and applicable Federal and VA information confidentiality and security laws, regulations and policies. If Federal or VA information confidentiality and security laws, regulations and policies become applicable to the VA information or information systems after execution of the contract, or if NIST issues or updates applicable FIPS or Special Publications (SP) after execution of this contract, the parties agree to negotiate in good faith to implement the information confidentiality and security laws, regulations and policies in this contract.

e. The contractor/subcontractor shall not make copies of VA information except as authorized and necessary to perform the terms of the agreement or to preserve electronic information stored on contractor/subcontractor electronic storage media for restoration in case any electronic equipment or data used by the contractor/subcontractor needs to be restored to an operating state. If copies are made for restoration purposes, after the restoration is complete, the copies must be appropriately destroyed.

f. If VA determines that the contractor has violated any of the information confidentiality, privacy, and security provisions of the contract, it shall be sufficient grounds for VA to withhold payment to the contractor or third party or terminate the contract for default or terminate for cause under Federal Acquisition Regulation (FAR) part 12.

g. If a VHA contract is terminated for cause, the associated BAA must also be terminated and appropriate actions taken in accordance with VHA Handbook 1600.01, Business Associate Agreements. Absent an agreement to use or disclose protected health information, there is no business associate relationship.

h. The contractor/subcontractor must store, transport, or transmit VA sensitive information in an encrypted form, using VA-approved encryption tools that are, at a minimum, FIPS 140-2 validated.

i. The contractor/subcontractor’s firewall and Web services security controls, if applicable, shall meet or exceed VA’s minimum requirements. VA Configuration Guidelines are available upon request.

j. Except for uses and disclosures of VA information authorized by this contract for performance of the contract, the contractor/subcontractor may use and disclose VA information only in two other situations: (i) in response to a qualifying order of a court of competent jurisdiction, or (ii) with VA’s prior written approval. The contractor/subcontractor must refer all requests for, demands for production of, or inquiries about, VA information and information systems to the VA contracting officer for response.

k. Notwithstanding the provision above, the contractor/subcontractor shall not release VA records protected by Title 38 U.S.C. 5705, confidentiality of medical quality assurance records and/or Title 38 U.S.C. 7332, confidentiality of certain health records pertaining to drug addiction, sickle cell anemia, alcoholism or alcohol abuse, or infection with human immunodeficiency virus. If the contractor/subcontractor is in receipt of a court order or other requests for the above mentioned information, that contractor/subcontractor shall immediately refer such court orders or other requests to the VA contracting officer for response.

l. For service that involves the storage, generating, transmitting, or exchanging of VA sensitive information but does not require C&A or an MOU-ISA for system interconnection, the contractor/subcontractor must complete a Contractor Security Control Assessment (CSCA) on a yearly basis and provide it to the COTR.

INFORMATION SYSTEM HOSTING, OPERATION, MAINTENANCE, OR USE

a. VA prohibits the installation and use of personally-owned or contractor/subcontractor owned equipment or software on VA’s network. If non-VA owned equipment must be used to fulfill the requirements of a contract, it must be stated in the service agreement, SOW or contract. All of the security controls required for government furnished equipment (GFE) must be utilized in approved other equipment (OE) and must be funded by the owner of the equipment. All remote systems must be equipped with, and use, a VA-approved antivirus (AV) software and a personal (host-based or enclave based) firewall that is configured with a VA approved configuration. Software must be kept current, including all critical updates and patches. Owners of approved OE are responsible for providing and maintaining the anti-viral software and the firewall on the non-VA owned OE.

b. All electronic storage media used on non-VA leased or non-VA owned IT equipment that is used to store, process, or access VA information must be handled in adherence with VA Handbook 6500.1, Electronic Media Sanitization upon: (i) completion or termination of the contract or (ii) disposal or return of the IT equipment by the contractor/subcontractor or any person acting on behalf of the contractor/subcontractor, whichever is earlier. Media (hard drives, optical disks, CDs, back-up tapes, etc.) used by the contractors/subcontractors that contain VA information must be returned to the VA for sanitization or destruction or the contractor/subcontractor must self-certify that the media has been disposed of per 6500.1 requirements. This must be completed within 30 days of termination of the contract.

SECURITY INCIDENT INVESTIGATION

a. The term “security incident” means an event that has, or could have, resulted in unauthorized access to, loss or damage to VA assets, or sensitive information, or an action that breaches VA security procedures. The contractor/subcontractor shall immediately notify\ the COTR and simultaneously, the designated ISO and Privacy Officer for the contract of any known or suspected security/privacy incidents, or any unauthorized disclosure of sensitive information, including that contained in system(s) to which the contractor/subcontractor has access.

b. To the extent known by the contractor/subcontractor, the contractor/subcontractor’s notice to VA shall identify the information involved, the circumstances surrounding the incident (including to whom, how, when, and where the VA information or assets were placed at risk or compromised), and any other information that the contractor/subcontractor considers relevant.

c. With respect to unsecured protected health information, the business associate is deemed to have discovered a data breach when the business associate knew or should have known of a breach of such information. Upon discovery, the business associate must notify the covered entity of the breach. Notifications need to be made in accordance with the executed business associate agreement.

d. In instances of theft or break-in or other criminal activity, the contractor/subcontractor must concurrently report the incident to the appropriate law enforcement entity (or entities) of jurisdiction, including the VA OIG and Security and Law Enforcement. The contractor, its employees, and its subcontractors and their employees shall cooperate with VA and any law enforcement authority responsible for the investigation and prosecution of any possible criminal law violation(s) associated with any incident. The contractor/subcontractor shall cooperate with VA in any civil litigation to recover VA information, obtain monetary or other compensation from a third party for damages arising from any incident, or obtain injunctive relief against any third party arising from, or related to, the incident.

LIQUIDATED DAMAGES FOR DATA BREACH

a. Consistent with the requirements of 38 U.S.C. §5725, a contract may require access to sensitive personal information. If so, the contractor is liable to VA for liquidated damages in the event of a data breach or privacy incident involving any SPI the contractor/subcontractor processes or maintains under this contract.

b. The contractor/subcontractor shall provide notice to VA of a “security incident” as set forth in the Security Incident Investigation section above. Upon such notification, VA must secure from a non-Department entity or the VA Office of Inspector General an independent risk analysis of the data breach to determine the level of risk associated with the data breach for the potential misuse of any sensitive personal information involved in the data breach. The term 'data breach' means the loss, theft, or other unauthorized access, or any access other than that incidental to the scope of employment, to data containing sensitive personal information, in electronic or printed form, that results in the potential compromise of the confidentiality or integrity of the data. Contractor shall fully cooperate with the entity performing the risk analysis. Failure to cooperate may be deemed a material breach and grounds for contract termination.

c. Each risk analysis shall address all relevant information concerning the data breach, including the following:

(1) Nature of the event (loss, theft, unauthorized access);

(2) Description of the event, including:

(a) date of occurrence;

(b) data elements involved, including any PII, such as full name, social security number, date of birth, home address, account number, disability code;

(3) Number of individuals affected or potentially affected;

(4) Names of individuals or groups affected or potentially affected;

(5) Ease of logical data access to the lost, stolen or improperly accessed data in light of the degree of protection for the data, e.g., unencrypted, plain text;

(6) Amount of time the data has been out of VA control;

(7) The likelihood that the sensitive personal information will or has been compromised (made accessible to and usable by unauthorized persons);

(8) Known misuses of data containing sensitive personal information, if any;

(9) Assessment of the potential harm to the affected individuals;

(10) Data breach analysis as outlined in 6500.2 Handbook, Management of Security and Privacy Incidents, as appropriate; and

(11) Whether credit protection services may assist record subjects in avoiding or mitigating the results of identity theft based on the sensitive personal information that may have been compromised.

d. Based on the determinations of the independent risk analysis, the contractor shall be responsible for paying to the VA liquidated damages in the amount of $______ per affected individual to cover the cost of providing credit protection services to affected individuals consisting of the following:

(1) Notification;

(2) One year of credit monitoring services consisting of automatic daily monitoring of at least 3 relevant credit bureau reports;

(3) Data breach analysis;

(4) Fraud resolution services, including writing dispute letters, initiating fraud alerts and credit freezes, to assist affected individuals to bring matters to resolution;

(5) One year of identity theft insurance with $20,000.00 coverage at $0 deductible; and

(6) Necessary legal expenses the subjects may incur to repair falsified or damaged credit records, histories, or financial affairs.

TRAINING

a. All contractor employees and subcontractor employees requiring access to VA information and VA information systems shall complete the following before being granted access to VA information and its systems:

(1) Sign and acknowledge (either manually or electronically) understanding of and responsibilities for compliance with the Contractor Rules of Behavior, Appendix E relating to access to VA information and information systems;

(2) Successfully complete the VA Cyber Security Awareness and Rules of Behavior training and annually complete required security training;

(3) Successfully complete the appropriate VA privacy training and annually complete required privacy training; and

(4) Successfully complete any additional cyber security or privacy training, as required for VA personnel with equivalent information system access [to be defined by the VA program official and provided to the contracting officer for inclusion in the solicitation document – e.g., any role-based information security training required in accordance with NIST Special Publication 800-16, Information Technology Security Training Requirements.]

b. The contractor shall provide to the contracting officer and/or the COTR a copy of the training certificates and certification of signing the Contractor Rules of Behavior for each applicable employee within 1 week of the initiation of the contract and annually thereafter, as required.

c. Failure to complete the mandatory annual training and sign the Rules of Behavior annually, within the timeframe required, is grounds for suspension or termination of all physical or electronic access privileges and removal from work on the contract until such time as the training and documents are complete.