SF30 Amendment 36C24623R0042 0002.pdf

5. PROJECT NUMBER (if applicable)

CODE 7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER 3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO. 1. CONTRACT ID CODE

FACILITY CODE CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR

ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office. is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES

SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER 16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30 PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243

(Type or print) (Type or print)

(Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code)

(If other than Item 6)

(Specify type of modification and authority)

(such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer)

02-27-2023

None

Department of Veterans Affairs

Network Contracting Office 6

100 Emancipation Drive

Hampton VA 23667

Department of Veterans Affairs

Network Contracting Office 6

100 Emancipation Drive

Hampton VA 23667

To all Offerors/Bidders

36C24623R0042

02-09-2023

X

X X

See CONTINUATION Page

The purpose of this amendment is to (1.) provide answers to questions, (2.) provide a revised Performance Work Statement and (3.) provide a revised Price Schedule. The Performance Work Statement and Price Schedule have been revised to reflect a needed capacity of five (5) to 20 beds per day.

Daniel Spaulding

Contracting Officer, NCO 6

CONTINUATION PAGE

36C24623R0042 Amendment 0002 – Questions and Answers

1. QUESTION: How many Veterans will need housing initially?

a. ANSWER: The facility will have capacity to serve a minimum of five (5) and a maximum of 20 Veterans at one location. The initial need depends on the number of homeless veterans identified for placement.

2. QUESTION: How many beds are available for the contract?

a. ANSWER: The facility will serve a maximum of 20 Veterans at one location.

3. QUESTION: Is there a cap for the daily rate?

a. ANSWER: The ‘daily rate’ will be the firm fixed price rate quoted by the offeror if awarded a contract. See Price Schedule of the SF1449 solicitation.

4. QUESTION: We have a place of performance in mind but it needs some build out, will submitting the proposed built out drawing suffice or the property has to be ready even before we submit our proposal?

a. ANSWER: Proposed built out drawings will not suffice. The property must exist and be operational before any proposal is submitted.

A.1 PERFORMANCE WORK STATEMENT

PERFORMANCE WORK STATEMENT (REVISED 2/27/2023 – AMENDMENT 0002)

1. DESCRIPTION

The Department of Veterans Affairs Medical Center and the W.G. Bill Hefner VA Medical

Center provides diagnostic and therapeutic services in medicine, surgery, rehabilitation medicine, psychiatry, and skilled nursing home care. This facility also provides homeless support services to those Veterans requiring resources to aid them in the procurement of permanent housing. The

Contractor shall furnish transitional housing for the beneficiaries of the Department of Veterans

Affairs Medical Center (VAMC) and the W.G. Bill Hefner VA Medical Center (VA). Failure to provide ongoing transitional housing, may result in unfavorable contract performance evaluation which may result in contract termination.

The contract facility will be located within the Salisbury community or within a 50-mile radius of the Salisbury WG Bill Hefner VA Medical Center and/or a 25-mile radius of the Charlotte and

Kernersville VA Heath Care Centers (HCC).

The contract facility must have a current occupancy permit or license required by the authority having jurisdiction.

The Contractor shall provide temporary residential housing to include but not limited to, beds, restroom, bathrooms, kitchen facilities, and related furnishings. Adequate safety and security measures in accordance with VA standards and in conformance with state and local safety and health codes as outlined in 38 CFR, Section 17.53b http://vaww.ceosh.med.va.gov, shall be in place in order to provide optimum safety for Veterans. The Contractor will provide food at a minimum of three balanced meals daily and healthy snacks daily to each Veteran. The

Contractor will provide personal hygiene items, first aid supplies, and lockable storage. The

Contractor shall provide services to beneficiaries for whom such care is specifically authorized by the Department of Veterans Affairs Medical Center herein after referred to as the VA. The

Contractor shall provide to the VA, housing and supportive services for homeless Veterans in accordance with all terms and conditions, provisions and requirements listed herein for the sum listed above. This rate is inclusive of all services as may be necessary in the treatment of the

Veteran. Unless specifically excluded in this contract, the per diem rate established will include the services listed in this document and will also include all services normally provided other patients by the facility without extra charge.

The Contractor shall furnish services to beneficiaries from whom such care is specifically authorized by the Salisbury VA Health Care System. It is understood that the type of Veterans to be cared for under this contract will normally require care and services over and above the level of simple room and board.

The Contractor will serve Veterans who meet the following definition of homelessness:

a) An individual who lacks a fixed, regular, and adequate nighttime residence

b) An individual or family with a primary nighttime residence that is a public or private place not designed for or ordinarily used as a regular sleeping accommodation for human beings, including a car, park, abandoned building, bus or train station, airport, or camping ground.

c) An individual or family living in a supervised publicly or privately-operated shelter designated to provide temporary living arrangements (including hotels and motels paid for by

Federal, State, or local government programs for low-income individuals or by charitable organizations, congregate shelters, and transitional housing);

Veterans may also meet any of the following criteria:

a) Homeless Veterans that are diagnosed with ongoing Mental Illnesses such as: Depression, Bipolar, Schizophrenia, Post Traumatic Stress Disorder (PTSD), and/ or Substance Use

Disorder.

b) Veterans discharged from the Military on or after September 11, 2001, and served in a theatre of operation or an area of conflict where the Veteran received hazardous duty pay and/or war of duty pay.

http://vaww.ceosh.med.va.gov/

2. REQUIREMENTS

The number of beds required will range from 5 to 20. These can be at one facility or spread out over several facilities. The facility will need to have capacity to serve a minimum of five (5) and a maximum of 20 Veterans at one location.

The Contractor shall furnish each Veteran authorized care under this contract with the following basic services:

a) Room and Board shall be accessible to the Veteran 7 days a week and 24 hours per day.

Accommodations to include a bed and lockable furnishings such as a dresser, lockable storage, and personal linens (towels, pillows, blankets and bed sheets, etc.), with minimum

140 square feet of living space for two non-related adults and 40 square feet per additional adult. The Contractor will allow Veteran to store personal belongings for at least 72 hours after formal HCHV discharge.

b) Meals - including at least three nutritionally adequate meals a day, seven days a week and availability of at least two nutritious snacks of nourishing quality (e.g. fruits, vegetables, protein sources, etc.), between meals and at bedtime for those requiring or desiring additional food, when it is not medically contraindicated by the Veteran’s Primary Care Physician.

There will not be more than a 14 hour span between evening meal and breakfast of the following day. Contractor will provide alternative meals for Veterans with dietary restrictions if medically indicated (e.g. diabetic, renal and soft mechanical diets) and reasonable accommodation for Veterans with cultural/religious preferences around food (e.g. Kosher, Sikh, etc.). Food shall be prepared, served and stored under sanitary conditions. Contractor will adhere to nutritional guidelines outlined by consulting VA Dietician. The local VA

Medical Center dietitian may consult with the initial inspection team and the team making subsequent assessments, in evaluating not only the printed menus but also the patients' satisfaction with meals and the actual consumption of food offered.

c) Laundry facilities and detergent for residents to do their own laundry or to have laundry done, at no charge to the Veteran at minimum on time per week.

d) Hygiene products, to include, but not limited to washcloths, soap, feminine products, deodorant, toothpaste, and toothbrush, shall be made accessible to Veteran and their dependents.

e) Therapeutic and Rehabilitative Services determined to be needed by the individual Veteran in a Person-Centered Treatment Plan developed by the Veteran and the Contractor with input from the VA Liaison/COR.

i. The Contractor shall conduct treatment and discharge planning reflecting a team assessment of health, social and vocational needs and the involvement of Veterans and appropriate community resources in resolving problems and setting goals. Psychosocial assessment and initial treatment plan are expected to be completed within five business days of Veteran's admission to the program and made available to VA Liaison/COR for review.

ii. The Contractor is expected to provide VA Liaison/COR with regular reports on changes in Veteran’s status, including all changes and observations concerning the Veteran's bio-psychosocial needs and status on meeting goals at least monthly or sooner when there are significant changes. Monthly progress reports will be provided to the VA Liaison/COR by the fifth work day of each month.

iii. The Person-Centered Treatment Plan will encompass the following elements:

1) Strengths,

2) Needs,

3) Goals,

4) Referrals that are beyond the scope of the established program, and

5) The signature of the Case Manager and the Veteran.

The treatment plan goals should address the areas of housing, mental health, health/medical, social, and vocational, and any additional personal goals. The treatment plan goals should be clear, specific, measurable, individualized, and should identify the specific objectives, methods, and the responsible person to complete each goal, and timeframe for goal to be completed. The plan should be completed within five business days of Veteran’s admission to the program with monthly reviews and/or updates.

iv. Structured individual case management, at minimum, weekly including counseling on self-care skills, adaptive coping skills, financial planning, permanent housing search, written care plan, referral for financial benefits. Additional counseling may include, professional and vocational rehabilitation counseling in collaboration with VA programs and community resources.

1) In addition, special attention will be made to address High Suicide Risk (HSR)

Veterans as identified by the VA Liaison, VA Mental Health Staff and/or the contracted Case Manager. Contracted case manager will review the HSR Safety

Plans with the Veteran on a bi-weekly basis. HSR Safety plan reviews and a copy of the Veteran’s Safety Plan will be documented in the chart.

2) Weekly progress notes should specify the Veteran’s progress towards treatment plan goals. Treatment Plans should reflect Recovery Model focus and approach.

All Contractors will provide proper documentation verifying services and case management efforts by all team members including, but not limited to housing, benefit and employment specialists, and program management staff. There will be an expectation that notes are written professionally in a format that utilizes the clear settings of goals and documents progress towards those goals (e.g. SNAP, SOAP, or SMART notes).

v. All Veterans will be referred to VA for Primary Care appointments and Contractors will support Veterans in making initial and subsequent appointments. Efforts will be documented in the Veterans’ Treatment Plan and reviewed by the HCHV Liaison at least monthly.

f) Structured group activities, as appropriate, shall occur at least 2 times per month – examples include group therapy, life skills training, social skills training, financial workshops, Alcoholics Anonymous, Narcotics Anonymous, vocational counseling and physical activities as appropriate. For the purposes of this contract “House Meetings” and VA Housing

Resource Groups may not be counted, as a structured group activity should have a therapeutic value and facilitation shall be the responsibility of the Contractor. Should a

Veteran have mental health, medical, family and/or employment obligations which directly conflicts with this requirement alternate group activates will be arranged and/or the

Contractor will clearly document efforts made to accommodate the Veteran.

g) Instruction in and assistance with health and personal hygiene.

h) Monitoring of all Veteran and dependent’s prescriptions in a medication room behind two locks properly labeled, logged for self-administration, and disposed of when Veteran and dependents are ordered to discontinue them or post-client discharge. Facility will maintain

Medication Administration Records with Veteran and staff signatures and weekly medication checks conducted by staff.

i. Medication Assisted Treatment (MAT) cannot be used to rule out Veterans participation in an HCHV Program. This includes prescribed use of Vicodin, morphine, methadone, suboxone, oxygen, etc. Reasonable accommodation for individuals in MAT is required provided the requested accommodation does not require major financial or administrative commitments that would be considered an

“undue burden.” Examples of reasonable accommodations include:

1) Arranging for the individual to take medication at their clinic, physician’s office, or another off-site location – when consistent with the individual’s treatment plan.

2) Storing an individual’s MAT medication in a lock box in the program and having the individual be personally responsible for it.

3) Arranging to have the housing facility keep MAT medications in a locked cabinet (Copies of Inspection Packet requirements relating to medication management are available upon request).

i) Supportive social services, in collaboration with the VA Liaison/COR, or other contract/community resources.

j) Assistance in learning and development of responsible living patterns to achieve a more adaptive level of psychosocial functioning, upgraded social skills, and improved personal relationships.

k) 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.

Facility will conduct random UDS testing and breathalyzer testing at least twice a month.

Facility will provide assistance to gain and to apply knowledge of the recovery process in an environment supportive of recovery models, including a focus on Harm Reduction rather than strict abstinence and supportive of a Housing First approach. Pursuant to these principles, drug testing may not be used to discharge or discipline a Veteran but may be used as a clinical intervention to modify behavior.

l) Transportation to contracted facility upon admission when needed by Veteran.

Transportation provided to treatment plan related appointments, such as care at the VA

Medical Center and/or outside VA Choice Providers, as appropriate, as well as job and housing search efforts or provide vouchers for use of public transit.

m) Assistance with securing income through the establishment of competitive employment or by referral to Social Security and/or the Veteran Benefits Administrations, Health Care for

Homeless Veterans (HCHV) Employment Services and/or community employment resources.

n) Assistance in and/or referral to individual professional counseling, including counseling on self-care skills, adaptive coping skills, and vocational rehabilitation counseling.

o) Assistance in budget counseling and money management. Progress here is to be documented in monthly treatment plan and weekly case notes.

p) Assistance in securing permanent housing or housing that appropriately meets the needs of the Veteran post discharge. Progress here to be documented in monthly treatment plan and weekly case notes.

q) Although rules are kept simple and demands on the Veterans low, staff at the facility shall stay continuously engaged with the Veterans. Regular biweekly room/bed checks shall occur with a strong focus on maintaining a safe environment that promotes the well-being of all

Veterans.

r) The Contractor shall work towards discharge planning upon admission and this planning effort should be reflected in the Person-Centered Treatment Plan.

s) The Veteran shall be referred to VA for inpatient residential services, intensive outpatient services, and/or the Contractor shall provide this service if licensed. If the Veteran remains in the Contractor’s program following hospitalization, the treatment plan shall be amended to reflect any healthcare or treatment changes. The following treatment modalities may be utilized: Harm Reduction, the Recovery Model, Critical Time Intervention, Motivational

Interviewing, Seeking Safety, and/or the Stages of Change.

t) HCHV performance measures and requirements set forward in this solicitation must be met in order to receive the highest past performance rating. These include the following:

i. HCHV1 - % Exits to permanent housing >55%

ii. HCHV2 - % Negative exits <20%

iii. Bed Occupancy – 85%

iv. Length of Stay ≤150 days

3. PERSONNEL

a) The Contractor shall assign to this contract personnel that by education and training (and, when required, certification or licensure) are qualified to provide the services as denoted in the Performance Work Statement. The Contractor must identify each labor category to be utilized for this effort and provide a description of the skills and experience required per labor category, along with resumes.

b) Key personnel will be identified in the proposal and shall be considered key personnel essential for the successful completion of the work performed under the contract. The

Contractor agrees that such personnel shall not be removed, diverted, or replaced from the work without notifying the VA Liaison/COR in writing.

c) The Contractor shall employ a combination of the following staff members:

i. A paraprofessional or administrative staff member of equivalent professional capability on duty on the premises or residing at the house and available for emergencies 24 hours a day, 7 days a week.

ii. A Bachelors level mental health professional (BA, BS, BSW etc.) to provide case management to include engagement in mental health services, continuity of care, linkage to community resources, maintenance and expansion of social networks, collaboration with physicians and hospitals, advocacy, training in independent living skills, individual supportive counseling, crisis intervention and monitoring, budgeting skills, and Veteran life-skills groups. Individual case management sessions should be conducted at least weekly. This staff member should have a minimum of three years’ experience in providing services to mentally ill individuals with complex psychosocial stressors to include chronic homelessness and/or PTSD.

iii. A Masters level licensed mental health and/or substance use professional (LCSW, LCMHC, LCAS, Clinical Psychologist, etc.) to provide clinical case management services as listed in the Requirements section of this document. This staff member will be responsible for the initial intake assessment, psychosocial assessment, Person Centered

Treatment plans with monthly updates, discharge planning, and weekly individual sessions with Veterans in the absence of a bachelors level case manager. This staff member should have three years’ experience in providing services to those with Severe and Persistent Mental Illness (SPMI) and /or Veteran specific issues including PTSD, Military Sexual Trauma (MST), combat related trauma and chronic homelessness.

d) The Contractor shall train staff to provide a low-demand, trust-building environment. The environment shall be highly supportive, where Veterans can rest, feel safe and be subject to few demands.

e) Staff shall be trained in providing flexible, respectful responses to infractions of rules.

f) All Contractor key personnel shall complete the following:

i. Sign and acknowledge (either manually or electronically) understanding of and responsibilities for compliance with the Contractor Rules of Behavior, Appendix

E relating to access to VA information and information systems;

ii. Successfully complete the VA Cyber Security Awareness and Rules of Behavior training and annually complete required security training;

iii. Successfully complete the appropriate VA privacy training and annually complete required privacy training;

iv. Successfully complete any additional cyber security or privacy training, as required for VA personnel with equivalent information system access

g) The Contractor shall provide to the Contracting Officer and the VA Liaison/COR a copy of the training certificates and certification of signing the Contractor Rules of Behavior for each applicable employee within 1 week of the initiation of the contract and annually thereafter, as required. These online courses are located at the following web site:

https://www.tms.va.gov/plateau/user/login.jsp. Detailed instructions on account setup will be provided to the successful offeror.

h) Failure to complete the mandatory annual training and sign the Rules of Behavior annually, within the timeframe required, is grounds for removal from work on the contract until such time as the training and documents are complete.

i) The contractor will perform criminal background checks on all key contract personnel identified in the proposal. The contractor will provide a copy of the satisfactory background check to the COR. The contractor must not employ individuals who –

i. Have been convicted within 7 years by a court of law of any of the following offenses or their equivalent in a state or territory:

i. Murder, attempted murder, or manslaughter;

ii. Arson;

iii. Assault, battery, assault and battery, assault with a dangerous weapon, mayhem or threats to do bodily harm;

iv. Burglary;

v. Robbery;

vi. Kidnapping;

vii. Theft, fraud, forgery, extortion or blackmail;

viii. Illegal use or possession of a firearm;

ix. Rape, sexual assault, sexual battery, or sexual abuse;

x. Child or elder abuse, or cruelty to children or elders; or

xi. Unlawful distribution or possession with intent to distribute a controlled substance; or

ii. Have had a finding entered within 6 months into an applicable State registry or with the applicable licensing authority concerning abuse, neglect, mistreatment of individuals or misappropriation of property.

iii. An individual assessment must be performed to determine suitability for employment for any conviction defined in paragraph 3.i)i., regardless of the age of the conviction

4. REFERRALS

a) Salisbury VAMC will determine Veteran eligibility prior to admission. They shall provide the Contractor with a signed VA Release of Information (ROI) from the Veteran, unless signature is a barrier to housing in which case verbal consent may be given and the Veteran sign an ROI upon admission. The Contractor shall establish personnel authorized to complete the admission process when requests are made for services, even when Veteran admission occurs after normal business hours (Monday – Friday 8:00am-4:30pm). Contractor shall contact Veteran within 24 hours of receipt of referral to arrange admission.

b) A centralized assessment form completed by VA clinical staff shall follow each admission authorization as soon as possible after completion. The VA shall provide the contracted agency with centralized assessment form, physical and laboratory studies, and confirmation of chronic mental illness.

c) Orders, requests, or changes to admission status shall only be made by the HCHV VA

Liaison/COR. The Contractor shall make no deviation and is responsible for providing direction to its staff regarding Veteran admissions.

d) A list of authorized key personnel shall be made available to the VA Liaison/COR upon award of the contract. Employees may be added or deleted from the list during the term of the contract at the discretion of VAMC Salisbury. The VA Contracting Office shall be notified to such changes as they occur.

e) Salisbury VAMC will furnish the Contractor with the USPEQ survey/website. The USPEQ survey will measure Veterans satisfaction at exit from program. Contractor will provide surveys for Veterans to complete upon exit from program and submit to VA in sealed envelope or allow Veteran to submit to HCHV Department at Salisbury VAMC.

f) Salisbury VAMC will furnish the Contractor with a Residential Treatment Exit Form. This form will measure the following program outcomes: Housing, Employment/Income, and

Clinical Improvements. The Contractor will complete and submit to the VA Liaison/COR the discharge form within 2 business days of a Veterans discharge from the residential program.

The Contractor will file the discharge form and the agency's discharge summary in the

Veteran's closed chart.

5. ABSENCES AND CANCELLATION

a) The Contractor shall notify the authorizing VA of Veteran absences from the facility.

Absences of the Veteran from the facility in excess of forty-eight (48) hours shall not be billed except those with the prior approval of the VA Liaison/COR. Should a Veteran referred to a residential treatment facility be absent himself/herself in an unauthorized manner, payment for services for that Veteran to the Contractor would be continued for a maximum period of two days provided there is an active outreach attempt on the part of the

Contractor to return the Veteran to the facility and a strong likelihood that the Veteran will return. Contractor must document absences of the patient and efforts to locate and return

Veteran to program successfully within forty-eight (48) hours, submitting evidence of such to

VA HCHV Liaison within twelve (12) hours of absence after curfew with follow up report on outcome of absence within forty-eight (48) hours. Management of program dropout will be an element of quality assurance review of this program.

b) It is understood that the beneficiary may be provided facility care at the expense of the VA for a period not to exceed that stated in the length of treatment plan contracted, unless an extension of the authorization is provided in writing by the VA.

c) The VA reserves the right to remove any or all patients from the facility at any time without additional cost, when it is determined to be in the best interest of the VA or the patient.

d) Length of stay at Contractor facilities will be initially authorized for up to 150 days, depending upon the needs of the Veteran as mutually determined by the Veteran, the

Contractor staff, and VA HCHV Treatment Staff. An additional five months of contract supported residential treatment may be authorized by the VA Liaison/COR when funding is authorized. A written request for extension must be submitted, with justification of the need and providing separate documentation of the Veteran’s satisfactory progress toward goals in program to the VA Liaison/COR, at least 5 business days prior to Veteran reaching 150 days in program. VA Liaison/COR will provide written authorization of any exception to the 150 day per Veteran length of stay as requested and justified for a Veteran to meet housing placement goals.

e) Extensions beyond the ten months may only be authorized for those Veterans who may be in transition, or classified under OIF/OEF/OND, or Veteran families, or female Veterans as these Veterans may require longer-term intensive clinical treatment.

f) It is understood that unoccupied placement is not reimbursable by the VA.

g) Request for readmission shall be accessed and screened on an individual basis depending upon the needs of the Veteran as mutually determined by the Veteran and the VA HCHV

Screening Team.

6. CONDUCT

a) The Contractor shall make available to the VA, documentary information deemed necessary by the VA to conduct utilization review audits for the mandated national evaluation study as required by the Section 2 of Public Law 100-6;

http://www.fas.org/sgp/crs/misc/RL34024.pdf to verify quality of patient care for Veterans, to assure confidentiality of Veteran record information and to determine the completeness and accuracy of financial records.

b) Contractor personnel shall complete annual VA TMS Training (HIPPA and VA Privacy) and other trainings recommended by VA Liaison/COR.

c) The Contractor shall comply with the principles listed in 38 CFR 17.707(b)

(http://edocket.access.gpo.gov/cfr_2002/julqtr/pdf/38cfr17.710.pdf) to provide housing and supportive services in a manner that is free from religious discrimination.

d) The Contractor shall comply with the VA Patient Bill of Rights as set forth in the Code of

Federal regulations, Section 17.34a, Title 38 (copy is available upon request).

e) The Contractor shall develop written house rules that are simple, consistent and focus on the safety of Veterans. The rules shall be enforceable, relate to the living situation, and provide opportunities for engagement. The rules shall be provided to Veterans upon admission into the program.

http://www.fas.org/sgp/crs/misc/RL34024.pdf

f) The Contractor shall not charge Veterans any fee for care to include acceptance of cash, food stamps, or other public assistance. No exchange of monies or bartering between Contractor and Veterans shall occur.

g) The following acts are not permissible by any Contractor Personnel:

i. Use of intoxicating liquors, narcotics or controlled substances of any kind (excluding doctors’ prescriptions which do not impair driver’s driving ability) while on duty or reporting for duty while under the influence of alcohol, narcotics or controlled substances of any kind (excluding doctors’ prescriptions which do not impair driver’s driving ability).

ii. Utilizing aggressive communication styles, which is perceived to be intimidating, demeaning, and degrading to Veterans.

iii. Gambling in any form

iv. Carrying of pistols, firearms or concealed weapons

v. If smoking while on facility premises, this and other uses of tobacco will occur only in designated smoking areas

vi. Resorting to physical violence

vii. Spitting in prohibited places or any other unsanitary, offensive or insensitive practices or behavior.

viii. Use of loud, indecent or profane language and/or making threatening or obscene gestures toward customers or other employees.

ix. If transporting a Veteran, driver shall not stop for personal business. Driver shall not leave vehicle when it is occupied by a Veteran passenger. The driver shall not leave the vehicle with the key in the ignition at any time.

x. Engage Veteran in a verbal confrontation in an attempt to settle a disagreement.

xi. Engage in personal relationships with Veterans. Engaging in intimate physical relationships, personal friendships or avoidable dual relationships with Veterans is prohibited. Training on Ethics and Boundaries will be provided by VA upon request.

xii. Soliciting or accepting tips from Veterans, their family members, or others at any time.

xiii. Entertaining of unauthorized guests at the facility.

7. INCIDENT REPORTING

a) The Contractor shall notify the authorizing VA facility immediately when a medical emergency occurs that requires hospitalization of a Veteran receiving care at VA expense.

Veteran hospitalization beyond two days (48 hours) will require Contractor to consult with

VA Liaison/COR about possible Veteran discharge.

b) The Contractor shall notify the authorizing VA facility immediately of any incidents involving Veterans residing in the residential program. All critical incidents will be reported within 24 hours. This includes the following:

• Falls

• Assault (to Veteran or Staff)

• Elderly/Dependent Adult Abuse or Neglect

• Sexual Assault

• Fire (Veteran Involved)

• Medical/Psychiatric Emergency (911 Calls)

• Hospitalization

• Suicide or Suicide Attempt

• Homicide

• Death

• Infectious Control (TB, etc.)

• Active Substance Abuse

• Observation/ Possession of Weapons

i. If the facility is co-located within a community-based facility, incidents involving other residents, i.e., sentinel events leading up to or resulting in causalities shall be reported to the authorizing VA facility within 24 hours. The Contractor shall notify the VA Liaison/COR by telephone during the hours of 8:00am and 4:30pm. For all incidents that occur after normal business hours, the Contractor shall notify the

Administrator on Duty (AOD). The Contractor shall provide the VA Liaison/COR with a copy of the incident report within 24 hours. The Contractor shall maintain a copy of the incident report in the Veterans clinical chart.

8. CONFIDENTIALITY & DATA ENTRY

a) It is agreed that the VA readily has access to all records concerning the Veteran's care in the facility. All clinical charts shall be kept in a locked filing cabinet in a locked office area.

Contractor facility staff should not utilize flash drives and/or any other removable devices to store Veterans personal identifying information. Veteran personal information/data should not be co-mingled with other non-Veteran information/data, (i.e., one computer system should be utilized to store Veteran only information and data.) The facility computer should be username and password protected with Ctrl-Alt-Delete access and with a timed lock-out setting. The facility’s hard drive that stores Veteran information should be encrypted with

FIPS 140-2 compliance for encryption. All Veteran data should be backed up weekly on an external hard drive. The hard drive should be stored in a locked cabinet in a locked office.

The C&A requirements do not apply, and a Security Accreditation package is not required.

b) It is expected that the Contractor participates and enters all Veterans into the local HMIS data entry system. The Homeless Management Information Systems (HMIS) are electronic repositories of client-level information collected over time about persons who experience homelessness within each community across the country. Each separate Continuum of Care

(CoC) is affiliated with an HMIS project. Data collected in HMIS are typically entered by the homeless providers who provide shelter, housing, and other services to persons to help prevent or address homelessness; thus, HMIS are community data partnerships, frequently managed by the local CoC identified as the lead homeless planning body by the U.S.

Department of Housing and Urban Development (HUD).

i. HMIS are designed to facilitate case management, data collection, and performance assessment for local continuums and federal agencies. HMIS has been adopted by the

VA and HUD as the official client data collection and management system for homeless providers to use to collect client-level data from persons who are homeless.

HMIS is also a federal response to Congressional Directive to measure the extent and nature of homelessness and assess the effectiveness of homeless programs.

ii. The existing HMIS not only have funding and management structures already in place, but they have also been built upon federally defined HMIS Data and Technical

Standards which are closely aligned with the VA’s homeless data collection needs.

These HMIS standards ensure that HMIS implementations throughout the country meet baseline privacy, security, and functional requirements and that all systems consistently collect the data elements that the federal government has determined are necessary to understand homelessness and measure the effectiveness of homeless programs. A copy of the HMIS admission and discharge paperwork should be filed in the Veterans clinical chart.

9. COMPLAINTS HANDLING

a) The VA Liaison/COR shall monitor the service provided. The Contractor shall educate its staff and Veterans on its grievance procedures as well as its clients rights. The Contractor shall cooperate with the VA Liaison/COR in providing information and answering questions in a timely manner when requested. It is expected that the Contractor educate its staff and residents on its complaint procedures as specified in the HCHV Client Handbook.

b) Contractor shall notify the VA Liaison/COR of all Veteran complaints within 24 hours. All complaints received directly by the VA Liaison/COR should be forwarded to the Contractor and shall be investigated promptly. After investigation and disposition, the Contractor shall respond to the VA Liaison/COR with a resolution within five (5) business days.

10. TRANSPORTATION

a) The Contractor shall provide Veterans with transportation (at no additional cost to the

Government) to and from care at the VAMC, community resource appointments (such as, the

Department of Social Services, the Employment Security Commission, Social Security, Vocational Rehabilitation, the Veterans Service Office, etc.), community and/or non-VA treatment appointments, as well as job and housing search efforts.

b) The Contractor shall provide Veterans with bus passes to access transportation if available and feasible in the local community. If the Veteran is not medically able to utilize public transportation, the facility shall provide private transportation. The Contractor’s facility geographical location shall have ease of access to the local bus route (within one mile of facility).

c) Transportation will be coordinated between the VAMC Salisbury and the Contractor for all scheduled admissions. If a Veteran requests homeless services after-hours, the Contractor will be responsible for transporting the Veteran from the Medical Center to the site once the

Veteran has been determined eligible for admission.

11. CONTRACTOR FACILITY

a) Facility shall be equipped with operational air conditioning /heating systems. In the event these systems are not operational for any reason, it is expected that the Contractor have the system repaired and operational within five (5) business days. During extreme weather conditions if air conditioning or heating system cannot be repaired in 24 hours, alternate accommodations must be arranged.

b) Facility shall be kept clean, free of dirt, grime, mold, clutter, and/or other hazardous substances and damage noticeably detracting from the overall appearance at all times.

c) Facility shall be equipped with first aid kit, fire extinguishers fully charged and non-expired, fire/carbon alarms, and posted evacuation plans.

d) Facility shall have windows and doors that can be opened and closed in accordance with manufacturer standards.

e) Facility must secure all Veterans personal health information in a locked room and locked filing cabinet. Personal health information stored electronically must be in accordance with

Federal Information Processing Standard (FIPS) Publication 140-2.

f) At the minimum, one bedroom, one bathroom as well as all common areas (dining areas, means of egress, etc.) shall meet Americans with Disabilities Act (ADA) requirements for accessibility.

12. FACILITY POLICY

a) The facility agrees and warrants that it does not maintain nor provide dual or segregated patient facilities, which are segregated on the basis of race, creed, color, or national origin.

The facility may neither require such segregated use by written or oral policies nor tolerate such use by local custom. The term "facilities" shall include but not limited to rooms, wards, sections, eating areas, drinking fountains, entrances, etc.

b) The facility agrees to accept referral of and to provide all services specified in this contract for any person determined eligible by the VA Liaison/COR or her/his designee, regardless of race, color, religion, sex or national origin of persons for whom such services are ordered. In addition, the facility warrants that subcontracting will not be resorted to as a means of circumventing this provision.

c) Facilities that house both male and female residents must demonstrate the safety of all residents is always maintained. This includes ensuring separate entrances, living quarters, and bathroom facilities. Facilities shall accommodate persons of all gender identities.

d) Contractors will develop a written policy for transgender clients that provides for safe, secure and dignified case management as well as accommodate the special requirements needed for privacy. Transgender clients will have access to sleeping accommodations and bathroom facilities based on their gender of identification, regardless of physical characteristics or gender conformity. People who do not clearly identify as male or female should have access to whichever sleeping and/or bathroom accommodation helps them feel safest. Where there are single-use showers and bathrooms in the facility designated for residents, transgender residents will be told about them and welcome to use them, but not required. It is the

Contractors responsibility to promote a safe environment for transgender clients amongst the general population.

e) If requested, Contractors must reasonably accommodate Veterans whose compliance with program rules is limited by the Veterans’ physical or mental disabilities, in accordance with the Americans with Disabilities Act, the Federal Fair Housing Amendments Act, Section 504 of the Rehabilitation Act, including those requirements covering reasonable accommodations for disabilities and the use of service animals, and all other applicable State or Federal laws.

Contractor must equally apply all rules, policies and procedures to Veterans, unless a Veteran has asked for a reasonable accommodation due to his/her disability.

f) It is agreed that duly authorized representatives of the VA will provide follow-up supervision visits to Veterans placed to assure the continuity of care and to assist in the Veteran's transition back into the community. It is understood that these visits do not substitute nor relieve the facility in any way of the responsibility for the daily care and treatment of the

Veteran.

g) Upon discharge or death of the Veteran, records on all VA beneficiaries will be retained by the facility for a period of at least three years following the termination of care.

h) The facility will not accept food stamps or welfare from Veterans.

i) The facility warrants that all applicable fire laws are being complied with and there are no recommendations of fire officials which have not been resolved.

j) The Contractor shall comply with the VA Patient's Bill of Rights as set forth in the Code of

Federal regulations, Section 17.34a, Title 38 (copy is available upon request).

k) The VA Liaison/COR in collaboration with the existing community homeless coalitions and networks, shall identify and refer all patients to the Contractor.

13. INSPECTION AND ACCEPTANCE

a) It is agreed that the VA will have the right to inspection of the Contractor Facility and all appurtenances by VA Liaison/COR or appointed representative(s) designated by the VA.

b) Prior to the award of a contract, a multidisciplinary VA team consisting of a Licensed Mental

Health Professional, Dietitian, Registered Nurse, a VA Police Officer, and a Facilities

Management Safety Officer shall conduct a survey of the Contractor facility. Contractor facilities to be utilized will be restricted to community-based facilities that provide food, shelter, and therapeutic services in a supportive environment.

c) At the time of the initial inspection the following should be made accessible on site:

i. a 3-5-day food supply with the accompanying menu for least one week

ii. a mock clinical chart

iii. furnishings for Veterans

iv. residential facilities in compliance with the standards listed in this contract

d) Contractor shall provide a written disaster plan that has been coordinated with the local emergency management entity. The disaster plan shall encompass natural and manmade disasters.

e) The Contractor will be advised of the finding of the inspection team. If deficiencies are noted during any inspection, the facility will be given a reasonable time to notify the Contracting

Officer and to ensure that the corrections have been completed. A contract will not be awarded until noted deficiencies have been resolved. The Contractor will have seven days from contract award date to become operational.

f) The VA shall monitor the Contractor’s program and inspect the Contractor’s facility to ensure compliance with this contract. Any unsatisfactory conditions noted during an inspection of contract facility will be reported in writing to the VA Contracting Officer. If corrections are not made to the satisfaction of the VA, the Contracting Officer will consult with the appropriate officials so that suitable arrangements can be made to discharge, transfer

Veterans, and/or to terminate the contract.

g) Subsequent inspections of the Contractor Facilities must be made yearly by a multidisciplinary VA team (listed above) to assure the facility provides quality care in a safe environment. During these inspections, attention will be directed to the adequacy of

Veterans' records to ensure conformity to HCHV written policies and procedures, applicable state or local guidelines and/or applicable accrediting bodies (e.g., Commission on

Accreditation of Rehabilitation Facilities (CARF) and/or The Joint Commission (TJC). Site visits will also include a spot check of records to ensure Contractor invoices accurately reflect the Veteran's length of stay. Veteran records should include the following documentation:

i. Referral, screening and assessment forms

ii. VA Release of Information

iii. DD 214

iv. Signed and dated residential contract

v. Completed psychosocial assessment

vi. Person Centered Treatment plan

vii. Weekly individual and group progress notes

vii. Copies of urine drug screens

ix. Medication list with documentation of medication checks

x. Budget plan

xi. Alcoholic Anonymous (AA) / Narcotic Anonymous (NA) meeting and employment logs, if applicable

14. SAFETY

The VA Liaison/COR and/or appointed VA Inspection staff will inspect the facility for conformity to the current Life Safety Code and will focus on an assessment of the quality of life within the Contractor facilities, giving particular attention to the following factors:

a) General observation of Veterans indicates they maintain an acceptable level of personal hygiene and grooming.

b) The facility meets applicable fire, safety and sanitation standards in attractive surroundings conducive to social interaction and the fullest development of the Veteran’s rehabilitative potential.

c) In facilities that house both male and female Veterans, female Veterans have secure and safe entrances, living quarters, and separate bathroom facilities.

d) The facility should be in a central location, near public transportation, and near areas which provide employment.

e) Appropriate organized activity programs during waking hours (including evenings) reflecting a high level of activity in the facility or in the linked facilities, for example individual professional counseling, physical activities, assistance with health and personal hygiene.

f) There is evidence of facility-community interaction. This may be demonstrated by the nature of scheduled activities or by information about resident flow out of the facility, e.g., community activities, volunteers, local consumer services, etc.

g) Staff behavior and interaction with Veterans convey an attitude of genuine concern, respect and caring.