36C24218R0102-006.docx

36C24218R0102 X X X Contracting Officer Lauren M. Helming

ONE

(1) Schedule of Supplies/Services begins on Page 9.

as described herein.

Canandaigua VA Medical Center (VAMC) in Canandaigua, NY, Services for eligible referred Veteran beneficiaries of the Contractor is to provide Safe Haven/Low-Demand Housing

/veterans-affairs http://www.tungsten-network.com/us/en Tungsten Network

Canandaigua NY 14424 400 Fort Hill Ave.

Network Contracting Activity Department of Veterans Affairs

X N/A X $11 Million 624221 Canandaigua NY 14424 400 Fort Hill Ave.

Department of Veterans Affairs

9:00 AM EDT

04-30-2018 585-393-7590

HELMING, LAUREN

03-29-2018 36C24218R0102

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

STANDARD FORM 1449

INFORMATION CALL:

7. FOR SOLICITATION

Prescribed by GSA - FAR (48 CFR) 53.212

PREVIOUS EDITION IS NOT USABLE

(REV. 2/2012)

AUTHORIZED FOR LOCAL REPRODUCTION

31c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 30c. DATE SIGNED 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30a. SIGNATURE OF OFFEROR/CONTRACTOR

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

DATED ________________________________. YOUR OFFER ON SOLICITATION

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________

ARE NOT ATTACHED

ARE

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE NOT ATTACHED.

ARE

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

25. ACCOUNTING AND APPROPRIATION DATA

(Use Reverse and/or Attach Additional Sheets as Necessary)

AMOUNT

UNIT PRICE

UNIT

QUANTITY

SCHEDULE OF SUPPLIES/SERVICES

ITEM NO.

24.

23.

22.

21.

20.

19.

SEE ADDENDUM

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED 17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

FAX:

PHONE:

DUNS+4:

DUNS:

TELEPHONE NO.

CODE

18a. PAYMENT WILL BE MADE BY

FACILITY CODE

CODE

17a. CONTRACTOR/OFFEROR

CODE

16. ADMINISTERED BY

CODE

15. DELIVER TO

RFP

IFB

RFQ

14. METHOD OF SOLICITATION

13b. RATING

DPAS (15 CFR 700)

RATED ORDER UNDER

13a. THIS CONTRACT IS A

12. DISCOUNT TERMS

SEE SCHEDULE

MARKED

TION UNLESS BLOCK IS

11. DELIVERY FOR FOB DESTINA-

SIZE STANDARD:

NAICS:

8(A)

EDWOSB

SMALL BUSINESS PROGRAM

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

WOMEN-OWNED SMALL BUSINESS

SMALL BUSINESS

VETERAN-OWNED

SERVICE-DISABLED

BUSINESS

HUBZONE SMALL

SMALL BUSINESS

% FOR:

SET ASIDE:

UNRESTRICTED OR

10. THIS ACQUISITION IS

CODE

9. ISSUED BY

TIME

8. OFFER DUE DATE/LOCAL

b. TELEPHONE NO. (No Collect Calls)

a. NAME

6. SOLICITATION ISSUE DATE

5. SOLICITATION NUMBER

4. ORDER NO.

3. AWARD/EFFECTIVE DATE

2. CONTRACT NO.

1. REQUISITION NO.

PAGE 1 OF

Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA (Continuation from Standard Form 1449, Blocks 5 – 18)

1. CONTRACT ADMINSTRATION: All contract administration matters will be handled by:

1. CONTRACTOR:

Name: _____________________________________________ Address: ____________________________________________

City/State/Zip: ________________________________________

TAX ID # ___________________

DUNS # ____________________

Point of Contact: _______________________________________

E-Mail: _______________________________________________

Phone Number: _________________________________

Fax Number: ___________________________________

1. GOVERNMENT:

Lauren M. Helming, Contracting Officer Department of Veterans Affairs Canandaigua VA Medical Center Network Contracting Office 2 (NCO 2) 400 Fort Hill Avenue, Bldg 34 Canandaigua, NY 14424

Phone: 585-393-7590 Fax: 585-393-7883 Email: Lauren.Helming@va.gov

The VA shall provide a list of all VA Points of Contact (POC), including names, departments, telephone and fax numbers to the successful contractor upon award.

1. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

[X] 52.232-33, Payment by Electronic Funds Transfer – System for Award Management [ ] 52.232-34, Payment by Electronic Funds Transfer – Other than System for Award Management

1. INVOICES: Invoices shall be submitted in arrears:

1. GOVERNMENT INVOICE ADDRESS: All invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72, Electronic Submission of Payment Requests.

The Financial Services Center, http://www.tungsten-network.com/us/en/veterans-affairs

1. ACKNOWLEDGMENT OF AMENDMENTS:

The Offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

Signed copies of any issued amendments must be submitted with proposal response.

1. CONTRACT MODIFICATIONS:

The Contractor is advised that only the Contracting Officer, acting within the scope of the contract and his/her duties and responsibilities and after advice and consultation with the Contracting Officer’s Representative (COR), has the authority to make changes that will affect contract prices, quantity, quality, delivery terms and conditions, or the term of the contract. In no event shall any understanding or agreement, modification, change order, or other matters in deviation from the terms of this contract between Contractor and a person other than the Contracting Officer be effective or binding upon the Government. All such actions must be formalized by the proper contractual document executed by the Contracting Officer.

1. CONTRACTING OFFICER’S REPRESENTATIVE:

Prior to award, the Contracting Officer will designate a Contracting Officer’s Representative (COR). All work coordination shall be made through the COR. The Contractor shall be provided a copy of the letter of delegation authorizing the COR at the commencement of the term of this agreement. No other person shall be authorized to act in such capacity unless appointed in writing by the Contracting Officer.

1. SYSTEM FOR AWARD MANAGEMENT (SAM):

SAM Registration: Offeror must be registered in the System for Award Management (SAM). SAM includes the functionality of the previous Central Contractor Registration (CCR) and Online Representations and Certifications Applications (ORCA). No contract will be entered into with an unregistered contractor. Internet access allows registration by completing an electronic online registration application at http://www.sam.gov/.

The electronic record in the Online Representations and Certifications (ORCA) will serve as an alternative to completing provisions 52.212-3 Offeror Representations and Certifications – Commercial Items. However, offerors must read and complete 52.212-3(b) and any other sections of 52.212-3 as applicable to this procurement.

1. AWARD WITHOUT DISCUSSION/TYPE OF CONTRACT:

As stated in 52.212-1(g), each offer should contain the best terms from a price and technical standpoint, as the Government intends to evaluate offers and make awards to Offerors without holding discussions. The Government intends to enter into a single firm fixed-price (FFP), indefinite quantity indefinite delivery (IDIQ) contract for the required services. The Government shall determine (based on the stated evaluation factors) the proposal found to be most advantageous to the Government. Offerors must submit a price for each line item for all performance periods.

1. PROPOSAL DELIVERY:

Offers for furnishing the services in the schedule are to be submitted electronically via email to Lauren Helming at Lauren.Helming@va.gov. Note that there is a 5 MB size limit per message. Late submissions, modifications and withdrawals will be handled as described in provision 52.212-1 “Instructions to Offerors – Commercial Items”. Faxed offers will not be accepted.

In order to be considered "responsive" to this solicitation Offerors must provide pricing for the base period and all option periods and must include all required documentation. All offers are subject to terms and conditions of this document. A submission checklist is included for your reference which begins on Page 98.

Proposals shall be submitted following the format outlined in SECTION E.1 – ADDENDUM to 52.212-1 INSTRUCTIONS TO OFFERORS – COMMERCIAL ITEMS (FEB 2012). Offeror shall address the evaluation factors listed in Section E.10 52.212-2, EVALUATION – COMMERCIAL ITEMS, to be considered for award. Contractor is responsible for ensuring the offer includes both a Technical Proposal and Price Proposal. There shall be no mention of pricing in the Technical Proposal.

1. TECHNICAL INQUIRIES:

Technical inquiries shall be made in writing via email to Lauren M. Helming, Contract Specialist at Lauren.Helming@va.gov. Inquiries must be received a minimum of 10 business days before the closing date listed in Block 8 of the Form 1449. If warranted, responses to inquiries will be incorporated into a written amendment posted to the Federal Business Opportunities website at http://www.fbo.gov.

1. ATTENTION OTHER THAN SMALL BUSINESSES:

A subcontracting plan is required in accordance with Federal Acquisition Regulation 52.219-8 and 52.219-9 and Department of Veterans Affairs Acquisition Regulation 852.219-9. Any proposed subcontracting plans must be submitted with initial offers. If during performance the subcontractor becomes ineligible to provide services, the Contractor must notify the VA immediately.

The subcontracting goals are as follows: Small Business-17%; Small Disadvantaged Business-5%; Veteran-Owned Small Business-7%; Women-Owned Small Business-5%; Service-Disabled Veteran -Owned Small Business-3%; and HUBZone Small Business-3%.

1. SOLICITATION/CONTRACT:

This solicitation and resulting contract adheres to the format defined in Federal Acquisition Regulation (FAR) Parts 12 and 15. An official copy of the FAR can be obtained at https://www.acquisition.gov/far/ .

1. CONTRACT PERFORMANCE:

The Contractor shall be required to begin services under this contract by the start date of the base period, which may be within as few as 5 days following award. Offerors should thoroughly review the specifications and become familiar with all requirements prior to submitting a proposal. Failure to understand the contract requirements shall not relieve the successful Offeror from performing in accordance within the strict meaning and intent of the specifications. Pricing shall include all equipment, supplies facilities, management, personnel, and labor necessary to perform specifications as outlined herein. The Government will not reimburse any costs not incorporated into the Offeror price.

1. POST AWARD ORIENTATION (Awards over $1M):

The Contracting Officer will schedule a post award orientation conference for contract orientation purposes as required by IL 003A3-12-04, which is available at http://www.va.gov/oal/docs/library/ils/il12-04.pdf.

1. STATUS AS INDEPENDENT ENTITIES:

None of the provisions of this contract are intended to create or shall be deemed or construed to create any relationship between VA and the Contractor other than that of independent entities contracting with each other solely for the purpose of effecting the provisions of this contract. Neither VA nor the Contractor, nor any of their respective agents, employees or representatives, shall be construed to be the agent employee or representative of the other.

1. NON-SOLICITATION:

Neither the Contractor nor any employee, agent or subcontractor of the Contractor shall solicit or attempt to convince or otherwise persuade any veteran not to participate or to discontinue participation in the services provided under this contract.

1. LIMITATIONS ON SUBCONTRACTING-- MONITORING AND COMPLIANCE (JUN 2011):

This solicitation includes FAR 52.219-14 Limitations on Subcontracting. Accordingly, any contract resulting from this solicitation will include this clause. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) retained by VA to assist in assessing the contractor's compliance with the limitations on subcontracting or percentage of work performance requirements specified in the clause. To that end, the support contractor(s) may require access to contractor's offices where the contractor's business records or other proprietary data are retained and to review such business records regarding the contractor's compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor's compliance with the limitations on subcontracting or percentage of work performance requirement.

1. SUBCONTRACTING COMMITMENTS – MONITORING AND COMPLIANCE (JUN 2011):

This solicitation includes VAAR 852.215-70, Service-Disabled Veteran-Owned and Veteran-Owned Small Business Evaluation Factors, and VAAR 852.215-71, Evaluation Factor Commitments. Accordingly, any contract resulting from this solicitation will include these clauses. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) to assist in assessing contractor compliance with the subcontracting commitments incorporated into the contract. To that end, the support contractor(s) may require access to the contractor's business records or other proprietary data to review such business records regarding contract compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor compliance with the subcontracting commitments.

1. ALTERNATE SECURITY LANGUAGE IN LIEU OF UPDATED VAAR DATA SECURITY CLAUSE FEBRUARY 2012:

Any contractor and/or subcontractor retained to do work for VA under this contract that requires the access, use, storage, modification, or transmission of VA Sensitive Personal Information (SPI) must follow and adhere to the security controls, enhancements, compensating controls, protocols, regulations, and VA directions as the Contracting Officer (CO) shall direct, including, but not limited to those derived from the Federal Information Security Management Act (FISMA), OMB Circular No. A-130 and VA Handbook 6500/6500.6. The contractor must report any data breach according to the protocols and timeframes in HB 6500.

If any contractor/sub-contractor retained to do work for VA under this IAA requires access, use, etc., of VA SPI as aforesaid, and if an actionable data breach occurs because of the contractor/subcontractor’s acts, omissions, or negligence in following the VA-directed security controls, enhancements, compensating controls, protocols, and/or measures, including, but not limited to the sources above, the contractor/subcontractor is further subject to the statutory requirement to assess liquidated damages against contractors and/or subcontractors under 38 U.S.C. §5725 in the event of a breach of Sensitive Personal Information (SPI)/Personally Identifiable Information (PII). Said liquidated damages shall be assessed at $37.50 per affected Veteran or beneficiary. A breach in this context includes the unauthorized acquisition, access, use, or disclosure of VA SPI which compromises not only the information’s security or privacy but that of the Veteran or beneficiary as well as the potential exposure or wrongful disclosure of such information as a result of a failure to follow proper data security controls and protocols.

Secure Fax: All faxes should contain the following language: “This fax is intended only for the use of the person or office to which it is addressed and may contain information that is privileged, confidential, or protected by law. All others are hereby notified that the receipt of this fax does not waive any applicable privilege or exemption for disclosure and that any dissemination, distribution, or copying of this communication is prohibited. If you have received this fax in error, please notify this office immediately at the telephone number listed above.”

1. PRIVACY AND CONFIDENTIALITY:

Contractors to the Department of Veterans Affairs may be exposed to sensitive information. Information may be overheard, seen on documents or electronic devices, or observed that could potentially violate the privacy and confidentiality of our Veterans, employees, volunteers and their families. Regulations such as, but not limited to the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Freedom of Information (FOIA) and Privacy Act of 1974 have been enacted to protect sensitive information from being improperly disclosed. Information should not be divulged or released to anyone unless specifically authorized by this contracts or its attached documents accordance with the contracted services. Failure to comply with applicable statutes and regulation can result in the termination of this contract and civil and criminal penalties, including fines and imprisonment. All suspected or actual breeches of privacy and confidentiality should be reported immediately to the Contracting Officer, Contracting Officer’s Representative (COR) or the Facility Privacy Officer.

1. CONTRACTOR COORDINATOR: The Contractor shall identify in writing to the CO their contact person(s) who shall serve as liaisons between the Contractor and VA and who shall ensure that services are performed in accordance with the contract specifications. The Contractor’s contact person(s) shall be available during VA regular administrative work hours, exclusive of national holidays.

Point of Contact: _______________________________________

1. AUTHORIZED NEGOTIATORS: The offeror represents that the following persons are authorized to negotiate on its behalf with the Government in connection with this Request for Proposals and have the actual power to legally bind the Offeror and make representations relative to the Offeror’s proposal and any resultant contract.

36C24218R0102

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B.2 SCHEDULE OF SUPPLIES/SERVICES (Continuation from Standard Form 1449 Block 20)

INSTRUCTIONS FOR COMPLETION OF SCHEDULE OF SUPPLIES/SERVICES:

The Contractor shall provide Safe Haven/Low-Demand Housing Services for eligible beneficiaries of the Department of Veterans Affairs Canandaigua VA Medical Center (VAMC), in accordance with the Performance Work Statement (PWS) and all terms and conditions herein. The Schedule establishes an all-inclusive daily rate for all costs associated with the required services provided by the Contractor. The daily rate is to be expressed as a rate per eligible Veteran, per day. Payment will only be made for Veterans referred to the Contractor by an authorized official at the VA Medical Center. Contract performance period will be for one base period, plus four (4) one (1) year renewable options which are at the discretion of the Government and are subject to the availability of fiscal year funds.

Offerors must complete all portions of the Schedule of Supplies/Services schedule below by entering an all-inclusive unit cost for each CLIN, along with the Total Estimated Annual Cost for each CLIN. This is to be computed by multiplying the estimated quantity by the proposed unit cost for each CLIN.

Do not leave any CLIN prices blank, partial pricing is not acceptable. If there is no cost for a CLIN, enter $0.00 as the unit cost and the total estimated cost. Proposals that do not include pricing for all CLINs in all performance periods will be considered incomplete and removed from any further consideration.

BASE YEAR: Date of Award through August 31, 2014

Estimated Total for Base Year: $_____________________

OPTION YEAR 1: September 1, 2014 through August 31, 2015

Estimated Total for Option Year 1: $_____________________

OPTION YEAR 2: September 1, 2015 through August 31, 2016

Estimated Total for Option Year 2: $_____________________

OPTION YEAR 3: September 1, 2016 through August 31, 2017

Estimated Total for Option Year 3: $_____________________ OPTION YEAR 4: September 1, 2017 through August 31, 2018

Estimated Total for Option Year 4: $_____________________ Estimated Total for Base + All Option Years: $_____________________ ESTIMATED QUANTITIES: All quantities listed herein are estimated annual quantities. Actual placements will be based on the number of chronically homeless Veterans requiring Safe Haven/Low-Demand housing services and payment will only be provided for the quantity of beds occupied by a VA-referred Veteran. The Government is not obligated to purchase any specified amount of services under this contract, but will be obligated to make payment for all services requested and received in the quantities and of the quality requested. The Government does not guarantee or imply that any fixed number of orders/referrals for services will be placed under the resultant contract.

GUARANTEED MINIMUM: The Government will order at least $54,000.00 in services during the base year of the contract. (Note: The guaranteed minimum order amount applies to the base year only. Award of the additional option years is not guaranteed nor is there a guaranteed minimum order amount in any given option year that is exercised.). Failure to submit a proposal for any request for proposal issued during the base period in accordance with the terms and conditions of this contract will result in the contractor's forfeiture of the guaranteed minimum amount.

MAXIMUM TOTAL CONTRACT AMOUNT: The potential aggregate contract total over the term of the entire contract (base year and four potential option years), is $3,612,000.00.

B.3 PERFORMANCE WORK STATEMENT

1. PURPOSE:

The Department of Veterans Affairs (VA) Canandaigua VA Medical Center, located in VISN 2 in New York State, has a need for low-demand “Safe Haven” housing services as part of its Community Based Health Care for Homeless Veterans (HCHV) program. The goal of the HCHV program is to remove homeless Veterans from the street or habitation unfit for Veterans and place them in community-based, residential environments with sufficient services to meet the needs of those Veterans. Under the authority of Section 203, P.L. 112-191, the Canandaigua VAMC will contract with a community organization to provide “Safe Haven” services as a ‘specialty model’ of housing services to eligible beneficiaries of the Canandaigua VAMC. This model of HCHV transitional housing will offer the services defined below. Contractor facility must be located within a 15-mile radius of the Canandaigua VAMC.

1. BACKGROUND:

Through the HCHV program, VA provides case management services to Veterans and facilitates their access to a broad range of medical, mental health, and rehabilitative services. The purpose of this solicitation is to obtain offers from contractors who can provide care and sufficient services to veterans who are homeless, in community-based residential settings that offer a safe and secure environment to support veterans’ rehabilitation and recovery goals. It is understood that the Veterans being served through this contract may have been diagnosed with severe mental illness and/or substance use disorders. The Contractor will be required to provide residential and case management services, but shall not provide clinical or detoxification or other hospital level treatment – those services will be provided by the VA at VA facilities. All facilities will encourage Veterans to complete their agreed upon recovery plans prior to discharge.

1. SERVICES TO BE PROVIDED:

1. BASIC SERVICES. The contractor shall furnish each Veteran referred for care under this contract with the following basic services:

a. ROOM AND BOARD: Room and board to include a bed and other furnishings, such as a dresser, storage (to include at least one lockable drawer), and personal linens (towels, bed sheets, blankets, and pillow.) Mattresses must be in good condition and fully encased with protective covering. The bed must be designated for use exclusively by the individual Veteran from the time of admission to the time of discharge. Residents must be provided with basic personal hygiene products. The residence must be able to accommodate both male and female Veterans, ensuring adequate privacy and safety for all.

b. MEALS: Contractors must provide appetizing, nutritionally adequate meals three times per day, seven days per week, in a setting that encourages social interaction. Nutritious snacks between meals and at bedtime must be available for those requiring or desiring additional food, when it is not medically contraindicated. All food must be stored, handled and served in a safe and sanitary manner that meets accepted industry standards and guidelines. 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 chronic medical, mental health or substance abuse disorders. A VA dietitian may assess printed menus as well as Veterans’ satisfaction with meals and the actual consumption of food offered in determining the contractor’s success in meeting this requirement during annual facility inspection or at any point during the contract period.

c. LAUNDRY FACILITIES: Laundry facilities and products shall be available for no additional fees for residents to do their own laundry or to have laundry done.

d. THERAPEUTIC AND REHABILITATIVE SERVICES: Therapeutic and Rehabilitative Services determined to be needed by each individual Veteran referred for treatment as stated in the plan developed by the contractor, with input from the Veteran and the VA HCHV Liaison (or designee). The treatment plan will encompass the following elements: 1). Strengths, 2). Needs, 3). Referrals that are beyond the scope of the established program, and 4).The signature of the Case Manager and the Veteran. The treatment plan goals should address the areas of housing, mental health, health/medical, social, and vocational and/or educational. The treatment plan goals should be clear, specific, measurable, individualized, and should identify the specific objectives, methods, and the responsible person to complete each goal. The plan should be completed within 5 business days of admission with monthly reviews and/or updates and maintained in the Veteran’s case record. Weekly progress notes should specify the Veterans progress towards treatment plan goals. At a minimum a documented weekly case visit shall occur between Case Manager and Veteran.

Services which the contractor must be able to furnish shall include:

1. Safe Haven Contractor will offer a low-demand environment with a minimum set of rules designed to re-establish trust in the homeless Veteran population and engage the Veteran in needed treatment services.

a. Acceptance of treatment will not be a condition of admission or continued stay;

b. Abstinence from alcohol or drugs will not be a condition of admission or continued stay; and,

c. Infractions of rules should be viewed as opportunities for engagement.

2. Regularly occurring (at least once a week) house meetings run by staff with mandatory attendance of Veterans, unless otherwise clinically indicated as determined on an individual basis.

3. Structured group activities must be offered at minimum of 3 times per week – examples include social recreational/peer support groups, linkage to vocational services/counseling and physical activities as appropriate. Additionally, educational groups shall be offered on topics including but not limited to: budgeting, cooking class, role playing group (making grocery list, how to access community resources, calling landlords), etc. Activity schedules must be printed and posted in facility common areas to ensure Veteran awareness and promote participation.

4. Supportive case management, including guidance on self-care skills and adaptive coping skills for independent living in collaboration with VA program and community resources. Documentation in the case record is required for every case management interaction.

5. 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.

6. 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.

7. Assistance to gain and to apply knowledge of the illness/recovery process in an environment supportive of recovery models.

8. A program that promotes community interaction.

e. ADMISSION: The Contractor must have the ability to accommodate immediate admissions 24-hours per day, 7 days per week. All admissions must have concurrence of VA for payment to be authorized. During off-tour hours concurrence will be provided by the Administrator on Duty who can be reached at 585-394-2000. If concurrence is not provided by VA, payment will not be authorized under any circumstances.

f. DISCHARGE PLANNING: The Contractor shall participate in the discharge planning process and provide written summary within 72 hours of discharge, reflecting a Contractor/VA team assessment of health, social and vocational needs and the involvement of the Veteran, the VA staff and appropriate community resources in resolving problems and setting goals. Written summary shall also report to the VA the status of housing under one of the following categories: (1) Having one’s own apartment, room, or house, (2) Halfway house/institution/other residential level of care, (3) None, (4) Unknown/Other.

g. DOCUMENTATION: An individual case record will be created for each referred Veteran. Case records shall be maintained in security and confidence as required by all applicable state and federal confidentiality laws, regulations, and policies. At a minimum, records must contain VA referral documentation, approved treatment plan, documentation of all case management interactions, and log of Veteran’s stay. In addition, the Contractor will participate in local HUD Continuum of Care efforts, and will ensure that all Veterans served are entered into the HUD Homeless Management Information System (HMIS) Registry. The VA HCHV liaison shall have unrestricted access to all records pertaining to referred Veterans residing at Safe Haven, to include electronic medical records, immediately upon request (within 24 hours).

1. SHIFT REPORTS: HCHV liaison will be sent a report via encrypted email upon the end of each shift that will relay the condition of each Veteran on that shift as a communication tool within 1 hour of established shift change.

h. OTHER: The contractor shall comply with the principles listed in 38 CFR 17.707(b) to provide housing and supportive services in a manner that is free from religious discrimination.

1. ADDITIONAL CONTRACT REQUIREMENTS

3. PERSONNEL

a. 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 staff member with Cardio-Pulmonary Resuscitation (CPR) certification, on duty on the premises or residing at the house providing awake supervision of residents 24 hours a day, 7 days a week.

b. The Contractor shall assign to this contract personnel that by education and/or training (and, when required, certification or licensure) are qualified to provide the Basic Services and Supplemental Services required by this PWS.

c. The Contractor must identify each person functioning as key personnel under this contract, and provide to the VA HCHV liaison a description of the services to be provided by such person. The VA HCHV liaison shall be provided a listing of all points of contact and their respective function, and shall be provided with an updated copy whenever changes in personnel occur.

3. MEDICATION STORAGE AND MONITORING

a. The Contractor shall provide appropriate storage and security for the storage of medications, and shall have appropriate policies and procedures in place 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. The Contractor shall review the VA HCHV Medication Review Inspection Checklist (Attachment X) and determine which of the three (3) Medication Control Systems (Medication Management, Medication Monitoring, or Individual Storage) their facility will follow. Contractor is responsible for reviewing and complying with the requirements on the checklist for their selected Medication Control System. Please note, this checklist is subject to change at any time without prior notice.

b. The Contractor shall have written procedures that address storage while providing access to medications and safe disposal of medications and syringes. Veterans residing in the program shall be educated about these procedures and the importance of safely storing their medications.

3. WRITTEN POLICIES & PROCEDURES/RESIDENT HANDBOOK

a. Contractors must provide a safe and secure environment for all residents. Contractors must have written policies and procedures in place that address the following concerns and situations, and must communicate policies and procedures to Veteran residents both verbally and in writing in a manner that is understandable simple to understand terms (acronyms defined) to each Veteran upon admission to the facility, in the form of a written resident handbook that is verbally reviewed by the assigned case manager with the Veteran. This communication must be documented in the Veteran’s client record. Contractors must have written policies and procedures in place that address the following concerns and situations:

i. Suspected or known drug or alcohol use or relapse by one or more residents

ii. On-site contraband, weapons (including props or souvenirs that appear to be weapons), drug or alcohol related paraphernalia (i.e., found alcohol, drugs, drug “works”, etc.)

iii. If applicable, on-site drug or alcohol testing methods (i.e., urine drug screens, breathalyzers, etc.) and frequency

iv. Safe prescription medication storage and handling. Ensure VA HCHV Medication Review Inspection Checklist (Attachment X) is reviewed for expectations. Please note, this checklist is subject to change at any time without prior notice.

v. Safe prescription medication access, including specific provisions for safe disposal of medications and syringes, as needed. Ensure VA HCHV Medication Review Inspection Checklist (Attachment X) is reviewed for expectations. Please note, this checklist is subject to change at any time without prior notice.

vi. Procedure for Veterans to notify Contractor of any changes in medications.

vii. Physical room inspections and bed checks of Veterans residing in the program at each shift.

viii. Grievance process to address resident complaints with time frames for responses from the contractor’s program/facility management and to have these policies and procedures clearly posted in plain sight for the Veterans to reference.

ix. Client abandonment of belongings in the facility, including time frames and procedures for disposal. This information should be posted in plain sight for the Veterans reference as well.

x. Process to elicit client satisfaction with the facility and onsite services, including information collection methods and frequency, and process for utilizing the information for continual performance improvement purposes. This information should be posted in plain sight for the Veterans reference as well.

xi. Policy for pest control, including and not limited to bed bugs, rodents, and other pests, and handling of any occurrences in a timely manner (within 48 hours).

3. REFERRALS

a. The VA is responsible for determining eligibility of Veterans prior to referral to the Contractor for treatment. A written referral signed by an authorized VA official shall be provided to the Contractor for each Veteran referred through the contract. Any verbal referrals shall be followed upon with a written referral within 72 hours. Under no circumstances shall the VA be responsible for payment for any individuals without a hard copy referral signed by an authorized VA ordering official. VA will provide as much clinical information as possible upon admission, with full psychosocial assessment to be provided within 72 hours of admission. All referrals will be accomplished ONLY with the appropriate VA Release of Information by the veteran to be referred.

b. A list of authorized VA ordering officials for the contract shall be provided to the Contractor upon award of the contract. Ordering officials may be added or deleted from the list during the term of the contract at the discretion of VA Contracting Officer. The Contractor shall be provided an updated list of authorized VA ordering officials whenever such changes are made.

c. It is understood that the Contractor will not be paid for care provided to a referred Veteran beyond the period authorized in the referral, unless an extension of the authorization is provided in writing by the VA.

d. The initial referral period for a Veteran may be up to 180 days, depending upon the needs of the Veteran as mutually determined by the Veteran, the Contractor’s staff, and VA Homeless Program Coordinator or designee. An extension of the referral period may be authorized by the VA Homeless Program Coordinator or designee, provided that funding is available. Treatment periods in excess of 12 months for individual Veterans must be authorized by the Behavioral Health Care Line Manager or designee.

e. It is understood that the Contractor will encourage Veterans to complete their agreed upon recovery plans prior to discharge. Management of program dropout will be an element of quality assurance review of this program.

3. ABSENCES, CANCELLATION, AND EMERGENCIES/INCIDENTS

a. The contractor shall notify the VA HCHV Liaison of unauthorized absences by a referred Veteran from the facility within 24 hours. Should a Veteran absent himself/herself from the Contractor’s facility in an unauthorized manner, payment for services for that Veteran shall be continued for a maximum period of three 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. Contractor shall attempt to reach Veteran via telephone one time per shift for a period of 72 hours, and all attempts are to be documented in the Veteran case record.

Absences of the Veteran from the facility in excess of three days will not be reimbursable unless authorized in advance by the VA HCHV Liaison. The VA will only provide payment for one 72-hour episode of unauthorized absence per Veteran.

NOTE: An authorized absence, or pass, can be considered for purposes that are expected to further the recovery goals of a Veteran (e.g., job-related absences, family visits, housing searches, medical, etc.) All requests for pass must be submitted in writing by the Veteran to the VA HCHV Liaison through the contractor at least 48 hours prior to the time requested. Authorized absences shall not exceed 48 hours per month per Veteran, unless otherwise approved by the VA HCHV Liaison.

b. 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.

c. The contractor shall take any actions they deem necessary in the event of a medical or psychiatric emergency. Any action taken must be in compliance with all Federal, State, and local laws, regulations, and ordinances. In the event of a medical or psychiatric emergency that requires hospitalization, the Veteran shall be transported to the closest hospital, preferably a VA facility. The VA will not be liable, responsible, or incur any financial obligation to the contractor or any third party as the result of any actions taken by the contractor under this provision. The contractor shall notify the assigned VA HCHV Liaison immediately (within 24 hours) by telephone when a medical or psychiatric emergency occurs that requires hospitalization of a referred Veteran leaving a voicemail if necessary.

d. All other incidents that involve acts of physical, verbal or sexual aggression shall also be reported to the VA HCHV Liaison by telephone immediately (within 24 hours). For all incidents that occur after normal business hours, the Contractor shall follow their established emergency procedures. In instances of significant concern a voicemail should be left for the HCHV Manager at 585-208-7219. All patient safety incidents must be investigated, confirmed and resolved in collaboration with the VA HCHV Liaison. Conclusions and findings must be reported to the HCHV liaison via email within 3 business days.

3. CONTRACTOR STAFF CONDUCT/COMPLAINTS HANDLING

a. Contractor personnel shall be expected to treat referred Veterans with dignity and respect and shall comply with the VA Patient's Bill of Rights as set forth in 38 CFR 17.34a (copy available at: http://www.va.gov/health/rights/).

b. The VA reserves the right to exclude Contractor staff members from providing services to Veterans under this contract based on breaches of conduct, including conduct that jeopardizes patient care, violates Veteran’s privacy, or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by Veterans or other staff members to designated Government representatives. Patient complaints are to be reported to the HCHV Liaison within 24 hours of receipt without fear of retaliation to the Veteran reporting the complaint. The Contractor and Contracting Officer’s Representative shall deal with issues raised concerning contractor personnel conduct. The Contracting Officer shall be the final arbiter on questions of acceptability and in validating complaints.

c. Provider shall develop grievance procedures for staff and residents, if not already in place at time of contract award, and shall ensure staff and residents are familiar with the grievance process, as well as patient rights.

d. Failure to comply with the conduct requirements as specified in the contract may result in unfavorable performance ratings and/or contract termination.

3. TRANSPORTATION

a. The Contractor shall assist the Veterans with local transportation to scheduled meetings and appointments related to the recovery plan of the Veteran, including the cost of transportation for Veterans without income. Examples of appointments that may require transportation include, but are not limited to: healthcare appointments, employment or housing opportunity appointments, and appointments for obtaining services related to the Veteran’s recovery, such as with the Department of Social Services. The Contractor shall help the Veteran access public transportation, including providing information and instructions necessary to enable Veterans to utilize public transportation. While it is expected that the majority of transportation needs can be satisfied by 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. Any costs associated with transportation shall be considered part of the basic services provided. It is anticipated that the furthest point a Veteran may require transportation to is the Rochester-Metro area (approximately 30 miles), however, the quantity of Veterans requiring travel to this area is expected to be limited.

3. FACILITY

a. Contractor facilities must provide appropriate safety 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 staff observation.