36C24219R0109-002.docx

36C24219R0109 Contracting Officer Allan Preston x X (HCHV) program as described herein.

Center as part of the Health Care for Homeless Veterans Residential Housing Services at the Northport VA Medical

/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 Canandaigua NY 14424-1159 400 Fort Hill Avenue Canandaigua VA Medical Center Department of Veterans Affairs X N/A $15 Million 624229 X Canandaigua NY 14424 400 Fort Hill Ave.

Department of Veterans Affairs

3:30 PM EDT

09-06-2019 585-393-7297

SCHRADER, HEATHER

08-05-2019 36C24219R0109

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 ADMINSTRATION DATA (Continuation of SF 1449 Blocks 5-18)

1. Contract Administration: All contract administration matters will be handled by the following individual(s):

a. Contractor _____________________________________________

Address _____________________________________________

City/State/Zip _____________________________________________

Point of Contact (name) _____________________________________________

Telephone Number _____________________________________________

Fax Number _____________________________________________

Email Address _____________________________________________

TAX ID Number _____________________________________________

DUNS NUMBER _____________________________________________

b. Government:

Heather Schrader, Contract Specialist Department of Veterans Affairs, Canandaigua VA Medical Center 400 Fort Hill Avenue, Bldg. 34A Room 148 Canandaigua, NY 14424

Allan Preston, Contracting Officer Department of Veterans Affairs 2875 Union Road, Suite 3500 Cheektowaga, NY 14227

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 [ ] 52.232-36, Payment by Third Party

INVOICES: Invoices shall be submitted in arrears:

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

2. 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.

3. 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/

4. CONTRACT PERFORMANCE: Contractor shall begin services within 30 days after the date of award of this contract.

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. The Government will not reimburse any costs not incorporated into the Offeror’s price.

POST AWARD ORIENTATION: The Contracting Officer will schedule a post award orientation for contract orientation purposes as required by Procurement Policy Memorandum (PPM) 2019-01 at: http://www.va.gov/oal/docs/business/pps/ppm201901.pdf.

5. TECHNICAL INQUIRIES: Direct all technical inquiries in writing to Contract Specialist, Heather Schrader via email at: Heather.Schrader@va.gov. ALL inquiries must be in writing.

6. ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

B.2 PRICE SCHEDULE OF SERVICES

The Contractor shall provide services for eligible Veterans in accordance with the performance work statement (PWS). The price schedule of services 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 per eligible Veteran, per day rate. Payment will only be made for Veterans referred to the Contractor by an authorized official at the VA Medical Center.

Offerors must complete all portions of the price schedule of services below by entering an all-inclusive unit cost for each CLIN, along with a total estimated annual cost. This is to be computed by multiplying the estimated quantity by the proposed cost for each CLIN.

Do not leave any CLIN prices blank. Partial pricing is not acceptable. Proposals that do not include pricing for all CLINs in all performance periods will be considered incomplete and removed from any further consideration.

PERIOD OF PERFORMANCE

BASE YEAR: 01/01/2020 through 12/31/2020

Total for Base Year $______________________________________________

OPTION YEAR 1: 01/01/2021 through 12/31/2021

Total for Option Year 1 $______________________________________________

OPTION YEAR 2: 01/01/2022 through 12/31/2022

Total for Option Year 2 $______________________________________________

OPTION YEAR 3: 01/01/2023 through 12/31/2023

Total for Option Year 3 $______________________________________________

OPTION YEAR 4: 01/01/2024 through 12/31/2024

Total for Option Year 4 $______________________________________________

CONTRACT TOTALS

ESTIMATED QUANTITIES: All quantities listed herein are estimated annual quantities. Actual placements will be based on the number of homeless Veterans requiring housing services and payment will only be provided for the quantity of beds occupied by a VA-referred Veteran. Except as described in the “Guaranteed Minimum” paragraph below, 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 $250,000.00 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.)

MAXIMUM TOTAL CONTRACT AMOUNT: The potential aggregate contract total over the term of the entire contract (base year and four option years) is $7,838,000.00.

ORDERING PROCEDURES: VA has the sole authority to place Veterans in the Contractor’s program on the VAMC campus. Contractor shall be paid for Veteran’s placed by the VAMC upon VA’s confirmation of Veteran eligibility and appropriateness of care. A task order will be issued at least once for each performance period.

36C24219R0109 AWARD BASED ON INITIAL OFFERS: Offerors are advised of the possibility that award may be made without discussion. Accordingly, offerors are cautioned to submit their initial offers based on their most favorable terms, pricing and technical factors.

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B.3 PERFORMANCE WORK STATEMENT

1. PURPOSE: The Department of Veterans Affairs (VA) Medical Center located in Northport, New York requires a Contractor to provide on-site 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 other places considered unfit for human habitation and place them in community-based, residential environments with sufficient services to meet the needs of those Veterans.

This 34-bed program shall be provided on the grounds of the Northport VAMC in building 11. The program at the Northport VAMC is for Veterans who are eligible for VA health care and referred by the VAMC. No other Veterans or homeless individuals are allowed to use/occupy the space/beds on the VAMC campus. The Contractor will be expected to work in close collaboration with the VAMC leadership and staff to implement the program as defined in this PWS.

2. 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. Contractors must be able to provide care and sufficient services to Veterans who are homeless, in community-based residential setting that is on-site at the Northport VA Medical Center. The VAMC requires the Contractor to 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. The Contractor will be expected to work collaboratively with a variety of VA programs and services to encourage Veterans admitted to the HCHV program to complete their agreed upon recovery goals.

Primary target populations are within the catchment areas of Nassau and Suffolk Counties, and include chronically homeless, chronically mentally ill Veterans, Veterans with chronic substance abuse disorders and/or serious medical problems and complex needs.

3. FREQUENTLY USED ACRONYMS:

A. ADA: Americans with Disabilities Act B. CO: Contracting Officer C. COR: Contracting Officer’s Representative D. CS: Contract Specialist E. FAR: Federal Acquisition Regulation F. HCHV: Health Care for Homeless Veterans G. HEARTH: Homeless Emergency Assistance and Rapid Transition to Housing H. HMIS: Homeless Management Information System (HMIS) is the term used to describe a class of database applications used to confidentially aggregate data on homeless populations served in the United States.

I. NACI: National Agency Check with Written Inquiries J. NCO: Network Contracting Office K. VA: Veterans Affairs (U.S. Department of...)

L. VAMC: Veterans Medical Center M. VHA: Veterans Health Administration (sub-agency within the U.S. Department of Veterans Affairs) N. VISN: Veterans Integrated Service Network (regional grouping of VA Medical Centers)

4. WEBSITES:

A. VA Homeless Programs: http://www.va.gov/HOMELESS/hchv.asp B. Harm Reduction Strategies in Case Management: http://www.harmreductionnetwork.mb.ca/docs/infokit.pdf & http://harmreduction.org/about-us/principles -of-harm-reduction/ C. Homeless Management Information System (HMIS): http://www.hudexchange.info/programs/hmis/ D. McKinney-Vento/HEARTH Act Definition of Homelessness: http://www.hudhre.info/hearth/

5. SERVICES TO BE PROVIDED BY THE CONTRACTOR:

A. ROOM AND BOARD (location and equipment (bed) provided by VA):

1) A designated bed that is used exclusively by the individual Veteran from the time of admission to the time of discharge.

a. The bed must be situated in a room that affords the Veteran safety, privacy and security.

b. VA will not pay for bed sharing, as it is not allowed on this contract. Beds shall not be used for more than one person at a time.

2) Contractor to provide personal linens (towels, bed sheets, blankets, and pillow).

3) Residents must be provided with basic personal hygiene products.

4) In the event pests are present, Contractor shall notify VA HCHV Liaison within 24 hours B. MEALS: Contractors is responsible for providing 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. The Contractor is required to provide any food preparation equipment such as: electric oven/stove, microwave, etc.

C. LAUNDRY/LAUNDRY FACILITIES: The Contractor is responsible for providing laundry services to Veterans at no cost. They may provide washing machines, electric dryers and products/supplies for residents or a laundry service. However, it is the VA’s preference to have residents learn skills for independent living by doing their own laundry on-site.

D. THERAPEUTIC AND REHABILITATIVE SERVICES: The Contractor must provide individualized, on-site therapeutic and rehabilitative services determined to be needed by each Veteran admitted to the HCHV program. The therapeutic and rehabilitative services must be detailed in the individual service plan (a.k.a. “treatment plan”) developed by the Contractor, with input from the Veteran and VA HCHV Liaison (or designee). Services which the Contractor must be able to furnish shall include:

1) 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.

2) 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.

3) Monitoring of medications, as applicable. Ensure VISN 2 HCHV Contract Residential Care Initial and Annual Inspection Form (Attachment D.5 HCHV Inspection Form – Medication Review Section) is reviewed for expectations. Please note, this checklist is subject to change at any time without prior notice.

4) Professional counseling as required, including emphasis on self-care skills, adaptive coping skills, vocational counseling in collaboration with the VA HCHV Liaison or other community resources as appropriate.

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

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

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

8) Collaboration with VA program staff providing supportive psychosocial, therapeutic and rehabilitative services.

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

10) 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.

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

12) A program that promotes community interaction.

13) 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.

E. CASE MANAGEMENT:

1) Contractor will carry the responsibility for interviewing, counseling and case managing for the identified Veterans by conducting psychosocial assessments to identify treatment needs which affect the Veterans’ adjustment to their environment and establish treatment goals.

2) Contractor will utilize counseling strategies to include crisis intervention and case management including both short and long-term services.

3) The VA has a strong preference for the use of harm reduction strategies in the case management process to effectively engage the population being served and maximize the chances for successful placement in community-based permanent housing as quickly as possible.

4) Contractor will assess the psychosocial and environmental needs or dysfunction secondary to or exacerbating the social, substance or psychiatric problems, which might contribute to the Veterans’ readjustment challenges in the community.

5) Contractor establishes and maintains an intensive therapeutic relationship with the Veteran, family, staff, community programs/agencies, and is responsible for formulating case management treatment goals and plans that address identified needs, stressors, and problems.

6) Contractor will conduct high-risk screening, psychosocial assessment and treatment planning, actively involving the Veteran and their family or significant others, in coordination with the team members and the VA.

7) The Contractor shall provide psychosocial assessments that include goals for clinical treatment. The Contractor is responsible for coordinating and documenting clinical case management and psychosocial services and documenting the overall effectiveness of the case management services provided. Specifically, but not limited to:

a. Develop and complete a written Individual Service Plan with the Veterans within one week of admission. Plan shall include provisions for Veteran placement in appropriate permanent housing within 60 to 90 days of admission to the HCHV Contract Residential Care facility at Northport but no more than 180 days. Housing Placement planning must take into account all appropriate and available community-based housing options as well as the Veterans preferences regarding location and housing type. The completed written plan shall be signed by the Contractor, Veteran, and the VA HCHV Liaison.

b. Review plans at a minimum every 30 days thereafter in a clinical meeting with the Veteran. Updated plans must be promptly communicated to the VA HCHV Liaison.

c. Make changes in plans in consultation with the Veteran.

d. Meet regularly with each Veteran for case management and counseling purposes. At a minimum, the Contractor will meet with each Veteran two times per month.

e. Screen each Veteran for suicidal and homicidal risk with each contact. This screening must be documented in regular progress notes in the Contractor’s clinical service records. If the Veteran is a danger to him/herself or others, the Contractor will take immediate steps to provide appropriate intervention. Crisis management will be conducted in consultation and coordination with the VA HCHV Liaison.

f. Coordinate with the VA HCHV Liaison during weekly case conferences regarding updates and changes in Veteran’s care plans to foster a collaborative relationship with the VAMC, Contractor and Veteran. Case conferencing may be done in person or by telephone conference calls as determined by the VA Medical Center.

g. Obtain relevant Release of Information to communicate and coordinate Veteran’s treatment with VA and other community-based service providers.

h. Work in close collaboration with the VA Liaison to ensure Veteran’s connections to needed VA medical, mental health, substance abuse treatment and care.

i. Contractor will take primary responsibility for assisting Veterans in completing housing applications and any other benefits paperwork as needed. Contractor will assist Veterans in obtaining the needed documentation required for complete applications including but not limited to, birth certificates, driver’s license, income verification and any additional information required by housing resources and potential income supports.

j. Contractor shall accompany Veterans to housing interviews, medical appointments, and other appointments as needed while working with Veterans to foster independence and a sense of self-determination.

F. DOCUMENTATION, RECORDS and REPORTS: All records and reports must be stored in a locked file cabinet behind a locked door.

1) 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:

a. VA referral documentation

b. Biopsychosocial assessment plan within one week of admission, and as updated

(1) Assessment & Plan shall include but not be limited to:

· All identifying data relevant to the resident and his/her family

· Medical problems and medications

· Mental health problems and medications

· Substance abuse history

· Housing history and preferences

· Income supports or benefits

· Employment/vocational issues

· Information relating to the Veteran’s admission including reason for referral and targeted goals for constructive changes which are to be attained during the residential rehabilitation episode and anticipated length of stay, if known.

c. Individual Service Plan completed within one week of program admission signed by the Veteran, Contractor and the VA HCHV Liaison. Plans shall include but not be limited to:

(1) Provisions for Veteran placement into an appropriate permanent housing placement within 60-90 days of admission to the HCHV Contract Residential Care facility at the Northport VAMC but no more than 180 days.

(2) Housing placement planning must take into account all appropriate and available community-based housing options as well as the Veteran’s preferences regarding location and housing type.

(3) Provisions for the stabilization and/or treatment of biopsychosocial issues and stressors.

(4) This may include provisions of care within the contracted facility, connections to the VAMC medical and mental health care, and/or referrals and connections to community based resources.

(5) Plans shall be updated every 30 days from the date of the initial plan, and include any measures of movement toward rehabilitation goals, with particular focus on the attainment of community based housing.

d. Progress notes for each case management and Individual Service Plan encounter to include information regarding progress toward meeting the Veterans goals.

e. Documentation of Veteran participation in on-site daily structured activities and groups.

f. Log of Veteran’s stay

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

h. Veteran acknowledgement of understanding of written policies, procedures and handbooks upon admission.

i. All appropriate and necessary release of information form(s) to coordinate Veteran care

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

k. Veterans written request for pass to the VA HCHV Contract Residential Care Liaison (if applicable)

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

m. Copy of Veterans discharge summary

2) Enter information in the Homeless Management Information System (HMIS) web-based software application found at: https://www.hudexchange.info/programs/hmis/

a. This a software application is designed to record and store client-level information on the characteristics and service needs of homeless persons. It is typically a web-based software application that homeless assistance providers use to coordinate care, manage their operations, and better serve their clients. HMIS implementations can encompass geographic areas ranging from a single county to an entire state. An HMIS knits together homeless assistance providers within a community and creates a more coordinated and effective housing and service delivery system. The U.S. Department of Housing and Urban Development (HUD) and other planners and policymakers at the federal, state and local levels use aggregate HMIS data to obtain better information about the extent and nature of homelessness over time. Specifically, an HMIS can be used to produce an unduplicated count of homeless persons, understand patterns of service use, and measure the effectiveness of homeless programs. Homeless Management Information Systems were first developed in the late 1990’s in response to a mandate by Congress requiring States to collect this data as a condition of receiving federal money from HUD to serve homeless populations. The impetus behind this mandate was to reduce and eventually solve homelessness, a problem which could never be solved if it was not understood and if progress toward that goal was not tracked. Most HMIS applications also serve as outcome-based systems that facilitate timely, efficient, and effective access to needed services and supports for persons who are homeless. For instance, percentage of individuals who are housed is a metric used for evaluation. Other data fields focus on developing a picture of unduplicated counts, use of specific services and the effectiveness of the local homeless assistance systems. HMIS is helpful to HUD in evaluating success in different grantee jurisdictions and in reporting to Congress; HUD has begun a renewed emphasis on having its Continuum of Care grantees convert to HMIS.

3) Maintain an active medication list for each Veteran G. 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.

6. ADDITIONAL CONTRACT REQUIREMENTS:

A. PERSONNEL: The Contractor will employ sufficient professional personnel to carry out the policies, responsibilities, and the programs of the facility.

1) A full-time administrative staff member on duty and on-site and available for emergencies 24 hours a day, 7 days a week. Please note: Security staff alone is not sufficient to meet this requirement. The staff member must be an employee of the Contractor.

2) It is required that there is a Director of the program and/or facility on-call and available for emergencies 24 hours a day, 7 days a week.

3) A professionally credentialed clinical supervisor (minimum LCSW) available to make on-site visits, at minimum once per week, and provide ongoing supervision of cases to case management personnel.

a. These visits shall be scheduled in collaboration with the VA COR.

b. Clinical supervisor must be on-call and available for emergencies 24 hours a day, 7 days a week.

4) Sufficient case management personnel with a master’s degree in Social Work (LMSW) or Mental Health Counseling (LMHC) to provide the necessary therapeutic interventions and activities and to ensure a meaningful integration of these efforts with those provided in the residential setting.

a. Case managers must have training and experience working with homeless individuals with chronic medical, mental health and substance abuse problems and be able to assess and anticipate crises.

b. Each Veteran must have an assigned case manager responsible for coordinating and providing the treatment services specified in this Performance Work Statement (PWS).

(1) There must be at least 2 case managers for this program (case manager to veteran ratio should not exceed 1:20); at least one case manager must be onsite Monday through Friday between 8 AM and 8 PM.

5) At least one staff or security member with Cardio-Pulmonary Resuscitation (CPR) on-site 24 hours a day, 7 days a week.

a. Provide in the list of key personnel the specific person(s) with the CPR certification and include the following:

(1) Name and Title

(2) Copy of Certification

6) The Contractor shall assign personnel to this contract that have the necessary education and/or training (and, when required, certification or licensure) to provide the services required by this PWS.

7) The Contractor must identify each person functioning as “key personnel” under this contract, provide the VA HCHV Contract Residential Care Liaison the following information:

a. Name and Title of each person

b. Description of each person’s duties

c. Description of each person’s certifications and licensures

d. Copies of all certifications and licensures

B. SUBSTITUTION OF KEY PERSONNEL:

1) In the event that any of the personnel named in the list of key personnel are unable to perform the duties of this contract, the Contractor shall promptly submit to the Contracting Officer and COR, in writing, a detailed explanation of the circumstances necessitating the substitution within one business day of the personnel change event.

2) The Contractor shall submit to the Contracting Officer and COR, in writing, a contingency plan within two business days. This plan must adequately address maintaining performance, staffing, safety, and security on this requirement.

3) Prior to new personnel being allowed to work on this requirement, the Contractor shall submit all the necessary requirements for the proposed substitute within 15 business days of the personnel event change to the Contracting Officer, including but not limited to:

a. Resume

b. Licenses

c. Any other information required for the VA to approve or deny the proposed substitution.

4) The Government shall reserve the right to require replacement of any Contractor personnel assigned to work on this contract. Meaning, Contractor personnel that are determined not to possess the experience, ability, or any other reason found to be unsuitable to perform the work required by the contract.

5) The Contractor shall provide the VA HCHV Contract Residential Care Liaison with an updated copy of “key personnel” whenever changes in personnel occur within a week of new personnel starting or terminating their position.

6) All certifications and licensures of all key personnel shall be kept current, at the same level, as at contract award.

7. MEDICATION STORAGE AND MONITORING:

A. The contractor 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 programs must ensure there are appropriate policies and procedures that support the safe storage of medications for Veteran residents. This storage must be provided to the Veteran:

1) An immovable lockbox to secure his or her medications; and

2) Central storage provided for narcotics/controlled substances by the contractor 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 should be educated about these procedures and the importance of safely storing their medications.

1) Policies and procedures shall explain and detail which of the two medication control systems are used by the agency. Ensure VISN 2 HCHV Contract Residential Care Initial and Annual Inspection Form (Attachment D.5 HCHV Inspection Form – Medication Review Section) is reviewed for expectations. Please note: this checklist is subject to change at any time without prior notice.

8. WRITTEN POLICIES and PROCEDURES/RESIDENT HANDBOOK:

A. 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 easy to understand (acronyms defined). These policies and procedures must be provided 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) Allowable personal items

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

3) 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.)

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

5) Safe prescription medication storage and handling, including specific provision for prescribed controlled substances. Ensure the VISN 2 HCHV Contract Residential Care Initial and Annual Inspection Form (Attachment D.5 HCHV Inspection Form – 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

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

8) Daily sign-in sheets

9) Grievance process to address resident complaints with timeframes for responses from the Contractor’s management. These policies and procedures shall be clearly posted in plain sight for the Veterans to reference.

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

11) Process to asses client satisfaction with the facility and on-site 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.

12) 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.

9. REFERRALS:

A. ADMISSION:

1) All Veterans must present to the Northport VAMC Emergency Room for a medical and mental health evaluation 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 Officers for the contract shall be provided to the Contractor upon award. Ordering Officers may be added or deleted from the list during the term of the contract at the discretion of the VA Contracting Officer. The Contractor shall be provided an updated list of authorized VA Ordering Officers whenever such changes are made.

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

3) In the event a Veteran presents to the Contractor’s location at the Northport VAMC during off-tour hours without written referral from the VA, the Contractor shall notify the VA HCHV Liaison no later than 10:00 a.m. 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 Officer.

a. 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 (refer to attachment D.7 Request for Extension of Per Diem Form)

b. 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.

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

d. The VA HCHV Liaison will not approve per diem for lengths of stay exceeding 180 days from the date of admission unless:

(1) There are extenuating clinical circumstances beyond the Contractor’s control that are barriers to the Veteran’s placement in housing;

(2) There is documented evidence that the Contractor has exhausted every effort to place the Veteran in housing sooner;

(3) The VA HCHV Liaison has been appropriately advised of these efforts well in advance of the 180-day limit; and

(4) The request for extension form is completed and the VA HCHV Liaison concurs and approvals obtained for the Veteran to continue to derive therapeutic benefits from a continued stay at the HCHV Contracted Residential Care facility.

e. Treatment periods in excess of 6 months for individual Veterans must be authorized by the COR.

(1) Any services provided beyond 90 days without an approved extension will not be billable to the VA.

(2) Any services provided beyond the approved extension will not be billable to the VA.

f. 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.

10. ABSENCES AND CANCELLATION:

A. DAILY CENSUS: A daily census will be provided to the HCHV Contract Residential Care COR by noon daily submitted via fax.

1) Authorized Absences: An authorized absence is defined as an absence that is planned in advance, approved, and benefits the Veteran’s clinical treatment or community reintegration.

a. Veteran residents will be allowed up to two consecutive bed days of care of authorized absence from the facility per month.

b. The Contractor shall hold the bed and will be reimbursed for the two bed days of care of authorized absence.

c. Authorized absences shall be requested in advance and in writing to the VA HCHV Liaison for approval or denial. Documentation shall be provided that includes: what the absence is needed for, date and time the Veteran will be back on the premises, Contractor staff emergency contact information and contact information of a point of contact where the Veteran will be for the two day absence.

d. Copies of this documentation must be kept on file with the Contractor for verification, billing and audit purposes.

e. Any exceptions to these authorized absence rules will be at the discretion of the COR and Contracting Officer.

2) Unauthorized Absences: An unauthorized absence is defined as an absence that is unplanned in advance, not approved, and the Veteran’s whereabouts are unknown.

a. The Contractor shall notify the VA HCHV Liaison of unauthorized absences by an admitted Veteran from the facility within 24 hours.

b. 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 one day, 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.

c. Unauthorized absences of the Veteran from the facility in excess of one day will not be reimbursable unless authorized in advance by the VA HCHV Liaison.

d. The VA will only provide payment for one, 24-hour episode of unauthorized absence (i.e. one bed day of care) per Veteran per admission.

3) Removal of Veterans: 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.

4) Incidents and Medical Emergencies:

a. 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 8:00 a.m. and 4:30 p.m., Monday through Friday. For all incidents that occur after normal business hours (weekends, holidays, evenings, nights), the Contractor should notify the Administrator on Duty (AOD) or contact the HCHV Liaison and the Northport VAMC Social Work Section Chief for Homeless Programs. In the event of a medical and/or psychiatric emergency that requires evaluation, the Contractor shall contact the VA Emergency Department at extension 2555 to be transported to the Emergency Department in Building 200 on the Northport VA Medical Center campus.

b. 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 8:00 a.m. and 4:30 p.m. For all incidents that occur after normal business (weekends, holidays, evenings, nights), the Contractor should notify the Administrator on Duty (AOD) or contact the HCHV Liaison and the Northport VAMC Social Work Section Chief for Homeless Programs. Incidents must be investigated, confirmed, and resolved.

c. In the event a Veteran residing in the HCHV Contract Residential Care program under this contract dies, the Contractor will immediately notify the VA Liaison authorizing admission and immediately assemble, inventory, and safeguard the Veteran’s personal effects.

(1) The funds, deposits, and effects left by Veterans upon the premises of the facility shall be delivered by the director or manager of the facility to the person or persons entitled thereto under the laws currently governing the facility for making disposition of funds and effects left by Veterans unless the beneficiary died without leaving a will, heirs, or next of kin capable of inheriting.

(2) When disposition has been made, the itemized inventory with a notation as to the disposition has been made, they will be immediately forwarded to the VA HCHV Liaison.

(3) Property and funds wherever located vests in and becomes property of the United States in trust. In these cases, the facility will forward an inventory of any such property and funds in its possession to the appropriate VA office and will hold them (except articles of clothing necessary for proper burial) under safeguard until instructions are received from the VA concerning disposition.

d. The Contractor shall provide the VA HCHV Liaison with a copy of the incident report within 48 hours.