36C24218R0338-002.docx

36C24218R0338

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1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a

. THIS

CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

DUNS:

DUNS+4:

PHONE:

FAX:

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

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only) 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED.

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

ARE

ARE NOT ATTACHED

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

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE.

CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________.

YOUR

OFFER ON SOLICITATION

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

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

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

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

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

36C24218R0338 06-25-2018

LEITCH, SALLY L

585-297-1467 07-25-2018

4:30 PM

Department of Veterans Affairs Western New York Healthcare System 3495 Bailey Ave.

Buffalo NY 14215 X 624229 $15 Million X N/A X Department of Veterans Affairs WNY Healthcare System 3495 Bailey Avenue Buffalo NY 14215 Department of Veterans Affairs Western New York Healthcare System Network Contracting Office/ATTN 90NCA 2875 Union Road, Suite 3500 Cheektowaga NY 14227

Tungsten Network http://www.tungsten-network.com/uk/en

See CONTINUATION Page The Department of Veterans Affairs (VA), Network Contracting Office (NCO) 2, and the Upstate New York Healthcare System VA Medical Centers anticipate a base year + four (1) year options to extend services for Contract Residential Housing Services as part of its community based Health Care for Homeless Veterans (HCHV) program.

Major Sites include the full catchment areas of: Albany Bath, Buffalo (including Batavia), Canandaigua (including) Rochester), and the Syracuse New York VA Medical Centers.

All services shall be in accordance as described herein.

Schedule of Pricing begins on page 8.

Performance Work Statement (PWS) beings on page 10.

Instructions to Offerors begin on page 75.

See CONTINUATION Page X X Allan M Preston Contracting Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

36C24218R0338

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B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration will be handled by the following individuals:

a. Contractor: ______________________ Address: ______________________

Contractor Point of Contact (POC) for Contract: _____________________________

Contractor Alternate Point of Contact (POC) for Contract: _____________________________

Billing POC for Contract: __________________________ Title: __________________________ Phone: __________________________ Email: __________________________

DUNS NUMBER: _________________________TAX ID: ____________________

b. GOVERNMENT: Contracting Officer 00242 Allan Preston, 585-297-1469 Allan.Preston@va.gov Department of Veterans Affairs Network Contracting Office (NCO 2) 2875 Union Road Suite 3500 Cheektowaga NY 14227 Administrative Contracting Officer 00242 Sally L Leitch, 585-297-1467 Sally.Leitch@va.gov Department of Veterans Affairs Network Contracting Office (NCO 2) 2875 Union Road Suite 3500 Cheektowaga NY 14227

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

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [x] Monthly to: http://www.tungsten-etwork.com/uk/en/

4. 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.

Tungsten Network: http://www.tungsten-network.com/uk/en/

5. SECURE FAX: All faxes in regards to this contract shall contain the following on the coversheet:

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.

6. Contract Modifications: The Contractor is advised that only the Contracting Officer (CO) 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 the 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 the 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

7. Questions: All questions regarding this solicitation shall be submitted by email to the Administrative Contracting Officer at Sally.Leitch@va.gov. Questions must be received a minimum of 10 business days before the closing date listed in block 8 of page 1. If warranted, responses to questions will be incorporated into a written amendment posted to E-buy.

8. Proposal Delivery: Offers shall be submitted via email only. Proposals shall be submitted to Sally L. Leitch at Sally.Leitch@va.gov following the format outlined in Section E, Instructions to Offerors.

a. There is a 10MB size cap on emails.

b. If you need to send more than one email per volume or section that is fine

1. Make sure each email is titled as follows:

i. 36C24218R0338 – Volume XX – Section XX – Email XX of XX

ii. Then in the body of the email list the number of attachments

2. Once the entire package is submitted send a proposal submission email that summarizes all the emails for confirmation of receipt.

i. Please include the number of emails sent and a list of all the attachments

c. Faxed offers will not be accepted.

d. Mailed offers will not be accepted

9. System for Award Management (SAM): 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/.

10. Solicitation/Contract: This solicitation and resulting contract will adhere to the format defined in Federal Acquisition Regulation (FAR) 12.303 for the acquisition of commercial items. The contracting authority for this procurement is FAR parts 12 and 15. An official copy of the FAR can be obtained at https://www.acquisition.gov/far/.

11. Contract Performance: Offeror should thoroughly review the specifications and become familiar with areas of coverage 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 facility, management, professionals, technical and labor necessary to perform specifications as outlined herein. The Government will not reimburse any costs not incorporated into the Offeror price.

12. Post Award Orientation (Awards over $1 Million): 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.

13. Acknowledgment of Amendments: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

B.2 SPECIAL CONTRACT REQUIREMENTS

1. Contract Coordinator: The Contractor shall identify in writing to the Contracting Officer (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.

Name: ___________________________________________________ Title: ___________________________________________________ Phone: ___________________________________________________ Email: ___________________________________________________

2. 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 (RFP):

Name: ___________________________________________________ Title: ___________________________________________________ Phone: ___________________________________________________ Email: ___________________________________________________

B.3 SUBCONTRACTING PLAN

3. Attention Large 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.

· If you do not intend to subcontract, contractor shall note not applicable.

The subcontracting goals for 2017 are as follows: 10% Service Disabled Veteran Owned Small Business; 12% Veteran Owned Small Business; 3% Hubzone; 5% Small Disadvantaged Business; 5% Women Owned Small Business; and 45% Small Business.

B.4 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.

B.5 SUBCONTRACTING PLAN--MONITORING AND COMPLIANCE (JUN 2011)

This solicitation includes FAR 52.219-9, Small Business Subcontracting Plan, and VAAR 852.219-9, VA Small Business Subcontracting Plan Minimum Requirement. 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 the contractor's compliance with the plan, including reviewing the contractor's accomplishments in achieving the subcontracting goals in the plan. 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 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 compliance with the subcontracting plan.

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B.6 SCHEDULE OF SERVICES

The Contractor shall provide Transitional Housing Services for eligible beneficiaries of the Department of Veterans Affairs VISN 2 Medical Centers, 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 from January 1, 2019 through December 31, 2019, 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.

BASE YEAR: January 1, 2019 through December 31, 2019

OPTION YEAR 1: January 1, 2020 through December 31, 2020

OPTION YEAR 2: January 1, 2021 through December 31, 2021

OPTION YEAR 3: January 1, 2022 through December 31, 2022

OPTION YEAR 4: January 1, 2023 through December 31, 2023

Estimated Number of Bed Days by VA Medical Center, for the base + 4 option years:

Albany VAMC – 37,022 Bath VAMC – 3,657 Buffalo VAMC – 27,137 Canandaigua/Rochester VAMC – 32,687 Syracuse VAMC – 5,808

The figures provided above represent the estimated number of Veterans expected to be served for the base year + 4 option years, and were developed based on FY2014 through 2018 contract use, as well as community HUD Point in Time (PIT) counts of homeless Veterans in each county HUD Continuum of Care catchment area. The figures above are estimates only and should not be interpreted as a guarantee. Actual placements will be based on the number of Veterans requiring services.

Offerors are cautioned that multiple awards are anticipated in order to accommodate the various medical centers and catchment areas, and that Veterans will be placed in the facility that most adequately meets their goals at the time of referral.

Contract Minimum/Maximum:

The guaranteed minimum contract amount for any contract awarded as a result of this solicitation, including the base year and any option years exercised, is $2,000.00. The maximum contract amount for any contract awarded as a result of this solicitation, including the base year and any option years exercised, shall not exceed $5,000,000.00. A task order shall be issued at the start of each performance period.

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B.7 PERFORMANCE WORK STATEMENT – CONTRACT RESIDENTIAL HOUSING SERVICES

A. PURPOSE:

The Department of Veterans Affairs (VA) Medical Centers located in VISN 2 in New York State requires contractors to provide 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.

B. 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. The Contractor will be required to provide residential and case management services, but will not be required to provide 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 goals.

C. SERVICES TO BE PROVIDED:

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

i. 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 per Veteran in their room or ability to lock their room), and personal linens (towels, bed sheets, blankets, and pillow.) Mattresses must be in good condition and fully encased with protective covering. Residents must be provided with basic personal hygiene products.

1. In the event pests are present, contractor shall notify VA HCHV Liaison within 24 hours and provide a corrective action plan within 48 hours.

2. 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.

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

4. 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 VA HCHV Liaison (or designee). Treatment plan is to be submitted to the VA HCHV Liaison (or designee) for approval within five (5) business days. Services which the contractor must be able to furnish shall include:

i. A variety of daily structured groups and activities to promote social skills building and healthy lifestyle (i.e., resident participation in psychosocial group sessions, topics based upon resident preference and recommendations by the residential treatment setting staff and VA Liaison; physical activities; facilitated outings or social activities in the local community; social recreational/peer support groups, linkage to Alcoholics Anonymous, Narcotics Anonymous; linkage to vocational services/counseling). Daily activity schedules must be printed and posted in facility common areas to ensure Veteran awareness and promote participation.

ii. Health and personal hygiene maintenance; 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.

iii. Monitoring of medications, as applicable. Ensure VISN 2 HCHV CR Initial and Annual Inspection Form (Attachment 1 – Medication Review Section) is reviewed for expectations. Please not this checklist is subject to change at any time without prior notice.

iv. Treatment social services, in collaboration with the case managers, VA or other community resources.

v. Opportunities for immediate learning and/or development of responsible living with a goal of achieving a more adaptive level of psychosocial functioning.

vi. Opportunities for learning, and internalizing knowledge of the illness and/or recovery process; improving social skills; and improving personal relationships.

vii. Opportunities for client participation in community activities, volunteer opportunities, local consumer services, etc.

viii. Collaboration with the VA program staff, which will provide supportive psychosocial, therapeutic and rehabilitative services.

ix. Supportive case management, including guidance on self-care skills and adaptive coping skills for independent living in collaboration with VA program and community resources.

x. 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.

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

xii. A program that promotes community interaction.

xiii. Provides 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.

5. DISCHARGE PLANNING:

i. 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.

ii. Upon discharge, status of housing should be reported to the VA Medical Center under 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

iii. Status at time of Discharge:

1. Percentage of Veterans discharged from HCHV CRS programs to permanent housing. Contractor shall work with the VA HCHV CR Liaison to meet the FY 2018 (and subsequent year targets) target of 50% or greater of Veterans discharged from HCHV CR to permanent housing. This percentage is subject to change based on VACO HCHV CR program regulations. If there is a change, the HCHV CR Liaison will communicate any changes to the contractor within 30 days. This is a performance indicator in the Quality Assurance Surveillance Plan (QASP).

2. Contractor will work with VA CR Liaison to meet the FY 2018 (and subsequent year targets) target of having negative exits be below 20%. Percentage of Veterans with a negative exit from VHA Health Care for Homeless Veterans Contracted Residential Service (HCHV CRS) programs. The FY 2018 target is 20% or lower. Lower is better. This percentage is subject to change based on VACO HCHV CR program regulations if there is a change, the HCHV CR Liaison will communicate any changes to the contractor within 30 days. This is a performance indicator in the QASP.

iv. Contractor shall utilize (Attachment 3) VISN 2 HCHV Contract Residential Discharge Summary.

6. DOCUMENTATION:

i. 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. Case records and data normally maintained and included in a record as a function of compliance with state or community licensing standards will be made available on a need to know basis to the appropriate Department of Veterans Affairs staff members involved with the treatment program of the Veterans concerned. At a minimum, records must contain:

1. VA referral documentation

2. Approved treatment plan

3. Log of Veteran’s stay

4. Veteran acknowledgement of understanding of written procedures that address use, storage, access, and disposal of medications and syringes.

5. Veteran acknowledgement of understanding of written policies, procedures and handbooks upon admission to the Contractor facility.

6. VA release of information

7. VA extension referral documentation and approvals (if applicable)

8. Veterans written request for pass to the VA HCHV CR Liaison (if applicable)

9. Copy of any HCHV Incident Report (if applicable)

10. Copy of Veterans discharge summary

ii. When appropriate and where available, participates in HMIS. If not available, provides documentation as to why not available and what their process consists.

7. 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.

D. ADDITIONAL CONTRACT REQUIREMENTS:

1. PERSONNEL:

i. The contractor will employ sufficient professional personnel to carry out the policies, responsibilities, and the programs of the facility.

ii. 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 and available for emergencies 24 hours a day, 7 days a week.

1. Provide in the List of Key Personnel the specific person(s) with the CPR certification and include the following:

a. Name and Title

b. Copy of Certification

2. Any changes to specific person(s) with CPR certification will be updated in the List of Key Personnel no later than 10 business days.

iii. 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.

iv. The Contractor must identify each person functioning as “Key Personnel” under this contract, provide the VA HCHV CR Liaison the following information:

1. Name and Title of each person

2. Description of each person’s duties

3. Description of each person’s certifications and licensures

4. Copies of all certifications and licensures

v. The contractor shall provide the VA HCHV CR Liaison with an updated copy of “Key Personnel” whenever changes in personnel occur within a week of new personnel starting or terminating their position.

vi. All certifications and licensures of all Key Personnel shall be kept current and at the same level at contract award.

2. MEDICATION STORAGE AND MONITORING:

i. HCHV Contract Residential Programs shall provide appropriate space and security for storage of medications. This is of particular concern when the setting involves congregate living (multiple unrelated persons within the same residence). HCHV funded programs that provide transitional housing in congregate living settings should 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 in one of two ways:

1. A lockbox to secure his or her medications or

2. Central storage can be provided by the HCHV Contracted Residential Program.

ii. HCHV Contract Residential Programs shall have written procedures that address storage while providing access to medications and safe disposal of medications and syringes. Veterans residing in the program should be educated about these procedures and the importance of safely storing their medications.

iii. Policies and procedures shall explain and detail which of the three medication control systems are used by the agency. Ensure VISN 2 HCHV CR Initial and Annual Inspection Form (Attachment 1 – Medication Review Section) is reviewed for expectations.

1. Please note: this checklist is subject to change at any time without prior notice.

3. WRITTEN POLICIES & PROCEDURES/RESIDENT HANDBOOK:

i. Contractors must provide a safe and sober 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:

1. Suspected or know drug or alcohol use or relapse by one or more residents.

2. 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.)

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

4. Safe prescription medication storage and handling, including specific provision for prescribed controlled substances. Ensure VISN 2 HCHV CR Initial and Annual Inspection Form (Attachment 1 – Medication Review Section) is reviewed for expectations. Please note; this checklist is subject to change at any time without prior notice.

5. Safe prescription medication access, including specific provisions for safe disposal of medications and syringes, as needed. Ensure VISN 2 HCHV CR Initial and Annual Inspection Form (Attachment 1 – Medication Review Section)is reviewed for expectations. Please note; this checklist is subject to change at any time without prior notice.

6. If applicable, assertive monitoring of controlled substances, including but not limited to:

a. Signing in medications after receipt from pharmacy with an observed pill count by contractor staff;

b. Staff observation and recording of taking of controlled substances and other medications by Veterans

c. Ensure VISN 2 HCHV CR Initial and Annual Inspection Form (Attachment 1 – Medication Review Section) is reviewed for expectations. Please note; this checklist is subject to change at any time without prior notice.

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

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

9. Client abandonment of belongings in the facility, including time frames and procedures for disposal. These policies and procedures shall be clearly posted in plain sight for the Veterans to reference as well.

10. 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. These policies and procedures shall be clearly posted in plain sight for the Veterans to reference as well.

11. Policy for pest control, including and not limited to bed bugs, rodents, and other pests. The policy shall include a plan on how to handle any occurrences in a timely manner (48 hours). These policies and procedures shall be clearly posted in plain sight for the Veterans to reference as well.

4. REFERRALS:

i. ADMISSION:

1. The VA is responsible for determining eligibility of Veterans prior to referral to the Contractor for treatment. A written referral (only hard copy or fax are acceptable) signed by an authorized VA ordering officer shall be provided to the Contractor for each Veteran referred for services under the contract. All referrals will be accomplished ONLY with the appropriate VA Release of Information by the Veteran to be referred

2. 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 the VA Contracting Officer.

a. The Contractor shall be provided an updated list of authorized VA ordering officials whenever such changes are made.

i. In the event a referral is received from someone other than an individual listed on the authorized VA ordering officials list, the Contractor shall contact the VA HCHV Liaison for verification and further direction.

3. In the event a Veteran presents to the Contractor facility during off-tour hours without written referral from the VA, the Contractor shall notify the VA HCHV Liaison not later than 10:00 AM on the next business day. The VA HCHV Liaison will determine whether the Veteran is eligible for referral, and if so, provide a referral to the Contractor. 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.

4. 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 authorization is provided in writing by the VA. (Attachment 4 – VISN 2 HCHV Contract Residential Request for Extension of Per Diem is attached)

5. The initial referral period for a Veteran may be up to 90 days, depending upon the needs of the Veteran as mutually determined by the Veteran, Contractor’s staff, and VA Homeless Program Coordinator or designee.

a. An extension of the referral period up to a total of 6 months may be authorized by the VA Homeless Program Coordinator or designee, provided that funding is available.

b. Treatment periods in excess of 6 months for individual Veterans must be authorized by the VA Medical Center Director or designee.

6. 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.

5. ABSENCES AND CANCELLATION:

i. 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 two days, provided there is an active outreach attempt (as defined by at least once per day) 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. Absences of the Veteran from the facility in excess of two days will not be reimbursable unless authorized in advance by the VA HCHV Liaison. The VA will only provide payment for one (1) 48-hour episode of unauthorized absence per Veteran.

1. 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.)

a. 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.

ii. A daily census will be provided to the HCHV CR COR by noon daily submitted via fax.

iii. 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.

iv. The contractor shall notify the assigned VA HCHV Liaison immediately (within 24 hours) when a medical emergency occurs that requires hospitalization of a referred Veteran. The contractor shall notify the VA HCHV Liaison by telephone during the hours of 8:00am and 4:30pm. For all incidents that occur after normal business hours, the contractor should notify the Administrator on Duty (AOD) or contact HCHV Liaison and Facility Homeless Lead. In the event of a medical emergency that requires hospitalization, the Veteran shall be transported to the closest hospital, preferably a VA facility.

v. The Contractor shall notify the assigned VA HCHV Liaison immediately (within 24 hours) of any incidents involving Veterans residing in the residential program. The contractor shall notify the VA HCHV Liaison by telephone during the hours of 8:00am and 4:30pm. For all incidents that occur after normal business hours, the Contractor should notify the Administrator on Duty (AOD) and/or contact HCHV Liaison and Facility Homeless Lead. Incidents must be investigated, confirmed, and resolved. The contractor shall provide the VA HCHV Liaison 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.

6. CONTRACTOR STAFF CONDUCT/COMPLAINTS HANDLING:

i. Contractor personnel shall be expected to treat referred Veterans with dignity and respect and abide by the standards of conduct mirroring those prescribed by current federal personnel regulations. The Contractor 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/).

ii. 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 or interferes with the regular and ordinary operation of the facility. Breaches of conduct include but are not limited to:

1. Intoxication or debilitation resulting from drug use

2. Theft

3. Patient abuse

4. Dereliction or negligence in performing directed tasks

5. Or other conduct resulting in formal complaints by Veterans or other staff members to designated Government representatives.

iii. Patient complaints are to be reported to the VA 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.

1. If the issue cannot be resolved the Contracting Officer shall be the final arbiter on questions of acceptability and in validating complaints.

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

v. If an incident occurs, the contractor shall complete a VISN 2 HCHV Contract Residential Care Incident Report Form (Attachment 2) immediately and send to the COR within 24 hours.

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

7. TRANSPORTATION:

i. 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.

1. Examples of appointments that may require transportation include, but are not limited to:

a. Healthcare appointments

b. Employment or housing opportunity appointments

c. Appointments for obtaining services related to the Veteran’s recovery – such as Department of Social Services.

2. The Contractor shall help the Veteran access public transportation, including providing information and instructions necessary to enable the Veterans to utilize public transportation.

3. 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 at no additional cost.

a. Driver shall hold a valid driver’s license and the vehicle shall be fully insured.

b. Contractor shall maintain copies of licenses and insurance.

c. Contractor shall report to the COR within 24 hours all of the following (but not limited to):

i. All accidents with a Veteran in the vehicle

ii. Traffic violations when transporting a Veteran

iii. Parking violations when transporting a Veteran

d. Contractor shall maintain copies of all incident reports; insurance claims, claim payments, traffic/parking tickets, and proof of tickets were paid.

8. FACILITY:

i. 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.

ii. Monitoring may be done through video surveillance or frequent staff observation (at least twice per shift).

iii. It is the responsibility of the Contractor to properly maintain its facilities and the VA shall have no responsibility for paying or reimbursing the Contractor for such expenses.

iv. The contract facility must:

1. Have a current occupancy permit issued by the local and state governments in the jurisdiction where the facility is located. Any changes to the status of the occupancy certificate should be reported to the VA HCHV Liaison within 24 business hours.

2. Be in compliance with existing standards of State safety codes and local, and/or State health and sanitation codes.

3. Be licensed under State or local authority, as appropriate to the level of care provided.

4. Where applicable, be accredited by the State.

5. Be equipped with operational heating and ventilation systems. Any outages or issues/problems in regards to the operational status of the heating and ventilation systems will be reported to the VA HCHV Liaison within 24 business hours.

6. Be kept clean, free of dirt, grime, mold, or other hazardous substances as well as damages that would noticeably detract from the overall appearance and/or create a safety risk. The VA inspection team shall have final say as to whether this standard has been met. Be equipped with first aid equipment and an evacuation plan in case of emergency.

7. Have windows and doors that can be opened and closed in accordance with manufacturer standards.

8. Keep all outdoor pathways, doorways, entrances/exits clear of ice, snow, clutter, and debris to ensure safe access and egress. The VA inspection team shall have final say as to whether this standard has been met.

9. Develop a formal Contingency Plan to identify the contractors’ points of contact and cascade list in preparation for natural disasters, weather-related or other emergency events, as well as to demonstrate how the contractor will provide continued care and services for Veterans. The written plan will be provided to the VA HCHV Liaison or designee within two weeks of contract award.

v. The contractor facility must meet fire safety requirements, as follows:

1. The building must meet the requirements of the applicable residential occupancy chapters of the current version of NFPA 101, National Fire Protection Association’s Life Safety Code.

a. Any equivalencies or variances must be approved by the appropriate Veterans Health Administration Veterans Integrated Service Network (VISN) Director.

2. All residents in the facility must be mentally and physically capable of leaving the building, unaided, in the event of an emergency.

3. Fire exit drills must be held at least quarterly. Residents must be instructed in fire safety and evacuation procedures on admission to the contract facility, including what to do when the primary and/or secondary exits are blocked.

a. A written fire plan for evacuation in the event of fire shall be developed and reviewed annually. The plan shall outline the duties, responsibilities and actions to be taken by the staff and residents in the event of a fire emergency. This plan shall be implemented during fire exit drills.

4. A written policy regarding tobacco smoking in the facility shall be established and enforced. No smoking will be allowed in bedrooms, dining areas or other common areas such as bathrooms and living rooms.

5. Portable fire extinguishers shall be installed at the facility. Use NFPA 10, Portable Fire Extinguishers, as guidance in selection and location requirements of extinguishers.

6. Requirements for fire protection…