36C24627Q0019.pdf

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. UEI: EFT:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

ARE ARE NOT ATTACHED. 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4 ADDENDA

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

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

36C24627Q0019 10-09-2026

Kamilah Nye 757-315-2510 10-27-2026

13:00 EDT

Department of Veterans Affairs

Network Contracting Office 6

100 Emancipation Drive

Hampton VA 23667

X 100

X

623220

$19 Million

NET 30

N/A

X

Salisbury VA Health Care System

Salisbury VA Medical Center

1601 Brenner Ave.

Salisbury NC 28144

Department of Veterans Affairs

Network Contracting Office 6

100 Emancipation Drive

Hampton VA 23667

Department of Veterans Affairs

Financial Services Center

PO BOX 149971

Austin TX 78714-9971

512-460-5049 512-460-5221

X

See CONTINUATION Page

Salisbury VAHCS Medical Respite Transitional Housing IDIQ:

Salisbury VA Medical Center, Kernersville Health Care Center

Charlotte Health Care Center, and Charlotte Community Based

Base Period of Performance (POP): 01/01/2027 - 12/31/2027

Option 1 POP: 01/01/2028 - 12/31/2028

Option 2 POP: 01/01/2029 - 12/31/2029

Option 3 POP: 01/01/2030 - 12/31/2030

Option 4 POP: 01/01/2031 - 12/31/2031

See Section B: Performance Work Statement

See Section D: Attachments

See Section E: Instruction to Offerors, Basis for Award.

Responses due by 13:00 EST, October 27, 2026.

POC: Kamilah Nye

Email: kamilah.nye@va.gov

See CONTINUATION Page

X X

Jamie Sullivan

Contracting Officer

Outpatient Clinic.

36C24627Q0019

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

B.3 DELIVERY SCHEDULE

B.4 PERFORMANCE WORK STATEMENT

SECTION C - CONTRACT CLAUSES

C.1 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.2 52.216-18 ORDERING (AUG 2020)

C.3 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.4 52.216-21 REQUIREMENTS (OCT 1995)

C.5 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.6 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

C.7 52.219-13 NOTICE OF SET-ASIDE OF ORDERS (MAR 2020)

C.8 52.219-14 LIMITATIONS ON SUBCONTRACTING (NOV 2025) (DEVIATION)

C.9 52.222-42 STATEMENT OF EQUIVALENT RATES FOR FEDERAL HIRES (MAY

2014)

C.10 52.222-90 ADDRESSING DEI DISCRIMINATION BY FEDERAL CONTRACTORS

(DEVIATION APR 2026)

C.11 52.240-91 SECURITY PROHIBITIONS AND EXCLUSIONS (NOV 2025)

(DEVIATION)

C.12 52.240-92 SECURITY REQUIREMENTS (DEVIATION) (NOV 2025)

C.13 52.240-93 BASIC SAFEGAURDING OF COVERED CONTRACTOR INFORMATION

SYSTEMS (DEVIATION) (NOV 2025)

C.14 VAAR 852.211-76 LIQUIDATED DAMAGES – REIMBURSEMENT FOR DATA

BREACH COSTS (FEB 2023) ALTERNATE I (FEB 2023)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.2 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.3 52.216-1 TYPE OF CONTRACT (NOV 2025) (DEVIATION)

E.4 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.5 52.240-90 SECURITY PROHIBITIONS AND EXCLUSIONS REPRESENTATIONS

AND CERTIFICATIONS (NOV 2025) (DEVIATION)

E.6 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C246 Jamie Sullivan

Department of Veterans Affairs

Network Contracting Office 6

100 Emancipation Drive

Hampton VA 23667

2. 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, or

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Monthly in Arrears

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

Requests.

VA Financial Service Center (FSC) Electronic Invoice Presentment and Payment System https://www.fsc.va.gov/einvoice.asp

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

AMENDMENT NO DATE

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

DESCRIPTION

OF SUPPLIES

SERVICES QTY UNIT UNIT PRICE AMOUNT

1.00 EA __________________ __________________

Base period Medical Respite Transitional Housing. See

Performance Work Statement. Services will be funded at the task order level.

UNIT PRICE: Daily rate per bed/veteran:

Contract Period: Base POP Begin: 01-01-2027 POP End: 12-31-2027

1.00 LT __________________ __________________

OY 1 period Medical Respite Transitional Housing. See

Performance Work Statement. Services will be funded at the task order level.

UNIT PRICE: Daily rate per bed/veteran:

Contract Period: Option 1 POP Begin: 01-01-2028 POP End: 12-31-2028

OY 2 period Medical Respite Transitional Housing. See

Performance Work Statement. Services will be funded at the task order level.

UNIT PRICE: Daily rate per bed/veteran:

Contract Period: Option 2 POP Begin: 01-01-2029 POP End: 12-31-2029

OY 3 period Medical Respite Transitional Housing. See

Performance Work Statement. Services will be funded at the task order level.

UNIT PRICE: Daily rate per bed/veteran:

Contract Period: Option 3 POP Begin: 01-01-2030 POP End: 12-31-2030

OY 4 period Medical Respite Transitional Housing. See

Performance Work Statement. Services will be funded at the task order level.

UNIT PRICE: Daily rate per bed/veteran:

Contract Period: Option 4 POP Begin: 01-01-2031 POP End: 12-31-2031

GRAND TOTAL __________________

B.3 DELIVERY SCHEDULE

ITEM

NUMBER SHIPPING INFORMATION QUANTITY

DELIVERY

DATE

0001 SHIP TO: W.G. Hefner Salisbury VA Medical Center 1601 Brenner Ave.

Salisbury, NC 28144

USA

1.00 01/01/2027 - 12/31/2027

1001 SHIP TO: W.G. Hefner Salisbury VA Medical Center 1601 Brenner Ave.

1.00 01/01/2028 - 12/31/2028

2001 SHIP TO: W.G. Hefner Salisbury VA Medical Center 1601 Brenner Ave.

1.00 01/01/2029 - 12/31/2029

3001 SHIP TO: W.G. Hefner Salisbury VA Medical Center 1601 Brenner Ave.

1.00 01/01/2030 - 12/31/2030

4001 SHIP TO: W.G. Hefner Salisbury VA Medical Center 1601 Brenner Ave.

1.00 01/01/2031 - 12/31/2031

B.4 PERFORMANCE WORK STATEMENT

1. DESCRIPTION

The W.G. “Bill” Hefner Veteran Affairs Health Care System (VAHCS) in Salisbury, North

Carolina provides diagnostic and therapeutic services in medicine, surgery, rehabilitation medicine, mental health, and skilled nursing home care. The Salisbury VA Health Care System covers a 21-county catchment area in central North Carolina. This facility also provides homeless support services to those Veterans requiring resources to aid them in the procurement of permanent housing through the Healthcare for Homeless Veterans (HCHV) Program.

HCHV programs provide care, treatment, and rehabilitative services, including case management and therapeutic transitional housing assistance by contracting with community providers. The

HCHV Contract Residential Services (CRS) programs target and prioritize homeless Veterans who require safe and stable living arrangements while they seek permanent housing. The

Contractor Facilities to be utilized will be restricted to community-based facilities that provide food, shelter, and therapeutic services in a supportive environment to meet their basic needs, and ultimately, to facilitate the improvement of their overall health and housing situation.

The Contractor shall furnish transitional housing and services for homeless Veterans who are beneficiaries of the W.G. “Bill” Hefner VAHCS and who are in need of medical respite or recuperative care where typical emergency housing programs may not be suitable but where hospital-level care is not needed. The Contractor shall provide these services in accordance with all applicable Federal, state and local regulations, laws, and ordinances and in accordance with their performance work statement and the terms and conditions stated herein.

2. REQUIREMENTS FOR PROGRAMS AND SERVICES

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

a) Housing accommodations which are accessible to the Veteran 24 hours per day, 7 days per week. Accommodations include a bed and other furnishings, such as a dresser, storage locker or designated secured space, and personal linens (pillows, sheets, blankets, towels/washcloths, etc.).

Bed, furniture, and linens shall be maintained in good working condition.

i. Accommodations must be at least 140 square feet for two non-related adults and 40 square feet per additional adult.

ii. The Contractor shall provide lockable storage for each Veteran.

b) Nutrition including at least 3 appetizing, nutritionally adequate meals per day, 7 days per week and availability of snacks of nourishing quality (e.g. fruits, vegetables, protein sources), between meals and at bedtime.

i. There will not be more than a 14-hour span between the evening meal and breakfast of the following day.

ii. The Contractor will provide alternative meals for Veterans with dietary restrictions, if medically indicated (e.g. diabetic, renal, and soft mechanical diets) and reasonable accommodations for Veterans with cultural/religious preferences around food (e.g.

Kosher, Sikh, etc.).

iii. Food shall be prepared, served, and stored under sanitary conditions.

iv. The Contractor will adhere to any nutritional guidelines outlined by the consulting VA dietitian. 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 have their laundry done at minimum one time per week, at no charge to the Veteran.

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

e) Quality case management and therapeutic services outlined in an individualized, person-centered care plan developed by the Veteran and the Contractor, with input from the VA

Liaison/Contracting Officer’s Representative (COR) as needed.

i. The Contractor shall engage the Veteran in a collaborative psychosocial assessment to inform the initial plan of care. The psychosocial assessment and initial care plan are expected to be completed within 5 business days of Veteran's admission to the program and made available to VA Liaison/COR or designee for review when requested.

ii. The person-centered care plan will encompass the following elements:

1). Strengths, 2). Needs and barriers 3). Goals 4.) Referrals that are beyond the scope of the established program, and 4). The signature of the Case Manager and the Veteran.

iii. The care plan goals should address the areas of housing, income/vocation/education, health/medical, mental health, substance use (if applicable), social, and any additional personal goals. The care plan goals should be clear, specific, measurable, individualized, and should identify the specific objectives, methods, and the responsible person to complete each goal.

iv. Care Plans should reflect the Recovery Model focus and approach and may include elements of motivational interviewing, harm reduction, critical time intervention, and other best practices that focus on the Veteran obtaining permanent housing at the appropriate level of care.

v. The Contractor shall provide individual case management meetings at least once per week that focus, at minimum, on housing search and stabilization, income and financial planning, self-care and adaptive coping skills, any necessary coordination of ongoing participation in care provided by VA or community medical, mental health, and/or substance use disorder providers, and ongoing discharge planning. Case management services should be aligned with the care plan goals and documentation of weekly progress notes should specify progress toward these goals.

vi. 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 at least a monthly basis. HSR Safety plan reviews and a copy of the Veteran’s Safety Plan will be documented in the chart.

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.

i. It is highly encouraged for group activities to involve regular community engagement and collaboration including outside expert speakers and field trips where Veterans are able to leave the facility.

g) Instruction in and assistance with improving health and personal hygiene, as needed. General observation of Veterans admitted to the program should indicate that they maintain an acceptable level of personal hygiene and grooming.

h) Monitoring and safe storage of all Veteran medications to include the following:

i. Storage in a medication room behind two locks, properly labeled, and logged.

ii. Veterans may self-administer medications, but storage shall ensure that no other residents are able to access individual Veteran’s medications.

ii. Medication Administration Records with Veteran and staff signatures, and at least weekly medication checks conducted by staff.

iii. Policy and procedures for medication disposal when Veteran is ordered to discontinue a medication or after Veteran discharges.

iv. Medication Assisted Treatment (MAT) cannot be used to rule out Veteran’s participation in an HCHV Program. This includes FDA-approved, prescribed use of morphine, methadone, suboxone, or other controlled substances in the treatment of substance use disorder.

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 for the Contractor.

i) 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 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.

i. Facility will conduct random urine drug screen testing and breathalyzer testing at least twice a month.

ii. Pursuant to these principles, drug testing alone may not be used to discharge or discipline a Veteran but may be used as a clinical intervention to modify behavior.

j) Transportation services for admission to the facility and for all care-plan-related appointments, at no additional cost to the Government and at no cost to the Veteran. Care-plan-related appointments include, but are not limited to, medical, mental health, substance use appointments, housing search, job search, benefits applications, and court appointments.

i. The Contractor shall provide Veteran with bus passes to access public transportation as appropriate. The Contractor’s facility should be located with ease of access to public transportation.

ii. If the Veteran is not medically able to utilize public transportation or if the

Contractor’s facility or the destination is not easily accessible by public transportation, then the facility shall provide private, door-to-door transportation. Private transportation may be provided by a facility vehicle with adequate insurance or via arranging and paying for rideshare, taxi, etc. on behalf of the Veteran.

k) Assistance with securing or increasing income based on Veteran’s needs and abilities through the establishment of competitive employment or by referral/application to Social Security and/or the Veteran Benefits Administration for disability and/or retirement/pension benefits. If appropriate to the needed level of care, the Contractor will also assist with referral to apply for

Aid and Attendance benefits.

l) Assistance in budget counseling and money management including promotion of savings while enrolled in the program. Progress here is to be documented in monthly care plan and weekly case notes.

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

n) Proactive engagement with Veterans to maximize access to any applicable and necessary healthcare services. Veterans will be referred to VA for primary care appointments and the

Contractor will support Veterans in making initial and subsequent appointments. The Contractor shall assist Veterans requiring emergency services (medical or psychiatric) with quickly accessing appropriate care from a VA or community facility.

o) The Contract program will be expected to meet the minimum target values for HCHV performance metrics as listed below. These metrics will be tracked at least quarterly with the VA

Liaison/COR providing the information to the Contractor. If not meeting the minimum target values, the VA Liaison/COR will work with the Contractor to create a Performance

Improvement Plan as appropriate. Ongoing failure to meet the minimum target values may result in an official contract deficiency, lowered performance ratings, removal of Veterans, or termination of the contract.

i. HCHV1 - % of exits to permanent housing >55% (exemption for medical respite program, tracked for information and planning purposes)

ii. HCHV2 - % Negative exits <20%

iii. Bed occupancy – 85% or greater

iv. Length of stay ≤60 days

p) The Contractor shall be able to accommodate Veterans who are in need of skilled home health services including, but not limited to, physical therapy, occupational therapy, wound care, and end-of-life care through home hospice or palliative care. The Contractor is not expected to provided the skilled services, but must be able to accommodate services from a home health agency coming to provide the services to the Veteran at the facility if ordered by their VA or community provider.

3. STAFFING/KEY PERSONNEL

a) The Contractor shall employ sufficient professional personnel to carry out the policies, responsibilities, and services of the facility required under this contract. The Contractor shall provide an overall staffing plan which indicates how the Contractor will meet the requirements of the contract. Within the staffing plan, the Contractor must identify each person functioning as

“key personnel” under this contract and provide the VA with a description of the services to be provided by each person. The Contractor shall assign to this contract personnel that by education and training (and, when required, by certification or licensure) are qualified to provided the services required. The Contractor will be required to submit a resume summarizing relevant skills and experience for all key personnel as well as a copy of current, active, and unrestricted license/certification where applicable. Minimum staffing requirements are as follows:

i. One managerial point of contact to provide primary oversight and administration of the program and the contract.

ii. At least one staff member on duty on the premises providing awake supervision of residents and staff 24 hours per day, 7 days per week. This staff member must have sufficient professional experience and authority to make decisions regarding the facility and the residents and/or must have the ability to contact an offsite administrator in case of an emergency 24 hours per day, 7 days per week.

iii. Sufficient case management/counseling personnel to provide to Veteran residents the direct case management and therapeutic services outlined above. The case manager(s) should have some training and experience working with homeless individuals, and experience working with individuals dealing with chronic medical, mental health, and/or substance use disorders. A bachelors-level professional with at least 3 years experience is required, and masters-level licensed mental health and/or substance use professional is preferred. Any exceptions to the required credentials or experience may be considered on a case-by-case basis with sufficient justification in consultation with the VA Liaison/COR and the Contracting Officer (CO).

iv. Sufficient medical personnel with appropriate experience, licensing, and credentialing to meet the medical needs of Veterans placed in the medical respite program. Typically, a registered nurse or higher medical professional will be on site daily.

v. All direct care staff shall have active Cardiopulmonary Resuscitation (CPR)/Basic Life

Support (BLS) certification so that staff is available and able to respond in an emergency

24 hours per day, 7 days per week.

b) The Contractor shall have a contingency plan in place to ensure equivalent coverage for any key personnel in the event of scheduled or unscheduled staff leave. Temporary substitutions of key personnel shall be permitted within the Contractor’s contingency plan. The contingency plan shall also be used if personnel leave the Contractor’s employment or are unable to continue performance in accordance with the terms and conditions of the contract until permanent replacements are in place.

c) During the first 90 calendar days of performance, the Contractor shall make no substitutions of key personnel unless the substitution is necessitated by illness, death, or termination of employment. The Contractor shall notify the CO, in writing, within 2 calendar days after the occurrence of any of these events and provide an explanation of the circumstances necessitating the proposed substitutions as well as resumes, license/certification (if applicable), and satisfactory background check for the proposed substitutes. The contractor will provide any additional information as requested by the CO.

i. For substitutions proposed by the Contractor after the initial 90 calendar day period, the

Contractor shall provide resumes, license/certification (if applicable), and satisfactory background check for the substitute personnel, together with any other additional information requested by the Contracting Officer, at least 15 days before the substitution is to occur. The Contracting Officer shall notify the Contractor within 15 calendar days after receipt of all required information if the VA refuses to accept the substitute key personnel.

d) The contractor will perform criminal background checks on all key contract personnel. The contractor will provide a copy of the satisfactory background check to the VA Liaison/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:

1. Murder, attempted murder, or manslaughter;

2. Arson;

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

4. Burglary;

5. Robbery;

6. Kidnapping;

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

8. Illegal use or possession of a firearm;

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

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

11. 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.d)i., regardless of the age of the conviction

e) The VA reserves the right to refuse or revoke acceptance of key personnel if personal or professional conduct, or lack of required skills or experience, jeopardizes Veteran care or interferes with the regular and ordinary operation of the facility and the contract program.

Breaches of conduct include, but are not limited to, intoxication or debilitation resulting from drug or alcohol use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by Veterans or other staff members to designated

Government representatives. The CO and VA Liaison/COR shall deal with issues raised concerning Contractor personnel conduct. The CO shall be the final arbiter on questions of acceptability and in validating complaints.

f) The Contractor will provide at least one staff person on-site at all times who has had training and orientation on the following topics. All staff identified as “key personnel” for the contract must have this training. Training shall be provided by the Contractor and should occur at the initiation of employment and at least annually thereafter. The Contractor will provide proof of completion to VA Liaison/COR annually and upon request.

i. CPR/BLS

ii. First Aid

iii. Privacy and HIPAA

iv. Crisis intervention and de-escalation techniques

v. Cultural sensitivity, including population specific information on homelessness

vi. Ethics and appropriate boundaries with clients

vii. Sexual harassment

viii. Universal Precautions (disease transmission prevention)

ix. Abuse and neglect reporting for children and adults

x. Harm Reduction philosophy and practices, including substance overdose education and prevention protocols and the use of naloxone

xi. Suicide Prevention

xii. Medication management at a level commensurate with the level of monitoring and oversight provided by the facility

xiii. Facility emergency procedures and policies, including fire safety

xiv. Ongoing training in facility policies and procedures

g) Contractor key personnel must complete training courses “VA Privacy and Information

Security Awareness and Rules of Behavior” and “HIPAA and Privacy Training” upon contract award and on an annual basis thereafter in the VA Talent Management System (TMS). Detailed instructions on TMS account setup will be provided by the VA Liaison/COR. Failure to complete this mandatory training listed above within the timeframe required shall be grounds for removal from work on the contract until such time as the training is completed.

h) The following acts are not permissible by any Contractor personnel while on duty and/or on facility premises:

i. Use of alcohol, drugs, intoxicating substances, 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 such substances.

ii. Using aggressive communication and/or gestures, which are perceived to be intimidating, demeaning, and/or degrading to Veterans, residents, or other staff, including the use of loud, indecent, or profane language and/or making threatening or obscene gestures.

iii. Gambling in any form

iv. Carrying of pistols, firearms, or any other weapons whether concealed or openly carried

v. Using tobacco or smoking outside of designated smoking areas

vi. Resorting to physical violence

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

viii. If transporting a Veteran, the 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.

ix. Engaging a Veteran in a verbal confrontation in an attempt to settle a disagreement.

x. Engaging in personal relationships with Veterans. Engaging in intimate physical relationships, personal friendships, or avoidable dual relationships with Veterans is prohibited.

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

xii. Entertaining of unauthorized guests at the facility.

i) The Contractor shall have a policy and procedures in place to ensure a drug-free workplace, including pre-employment drug testing for new employees, follow-up testing that is random and/or for-cause, safeguards for ongoing compliance, and consequences for any violations. The

Contractor must agree to complete testing at an outside, independent laboratory, when requested by the VA Liaison/COR or CO at no additional cost to the government.

4. FACILITY

a) The facility will be located within the Salisbury catchment area and within a 50-mile radius of the Salisbury VA Medical Center and/or a 25-mile radius of the Community Based Outpatient

Clinic (CBOC) and/or Health Care Centers (HCC).

b) The facility must have a current occupancy permit issued by the local and state governments in the jurisdiction where the facility is located.

c) The facility must be licensed and accredited, where applicable, as required by the authority having jurisdiction.

d) The facility must be in compliance with current standards of building safety codes and health and sanitization codes according to the authority having jurisdiction.

e) The facility must meet the following fire safety requirements:

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

Safety Code.

ii. Fire exit drills must be held and documented at least quarterly. Residents must be instructed in evacuation procedures when the primary and/or secondary exits are blocked.

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

iii. A written policy regarding tobacco smoking or use of e-cigarettes devices on the facility shall be established and enforced. The policy shall include a prohibition against the use of tobacco products inside the building. Any designated smoking area must be at least 25 feet from doorways or entrances.

iv. Portable fire extinguishers shall be installed at the facility. Use NFPA 10, Standard for

Portable Fire Extinguishers, as guidance in selection and location requirements of extinguishers. Requirements for fire protection equipment and systems shall be in accordance with NFPA 101. All fire protection systems and equipment, such as the fire alarm system, smoke detectors, and portable extinguishers; shall be inspected, tested, and maintained in accordance with the applicable NFPA fire codes and the results documented.

f) The facility should be in a central location, near public transportation, and near areas which provide access to employment, housing, and other resources.

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

h) The 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 5 business days. The Contractor is expected to notify the

VA Liaison/COR immediately with the plan for repair and any interim accommodation. During extreme weather conditions if the air conditioning or heating system cannot be repaired in 24 hours, alternate accommodations must be arranged.

i) The facility shall be kept clean, free of dirt, grime, mold, clutter, and/or other hazardous substances and damage that noticeably detracts from the overall appearance.

j) The facility shall have windows and doors that can be opened and closed in accordance with manufacturer standards.

k) The facility shall be equipped with first aid equipment, necessary personal protective equipment (PPE) an Automatic External Defibrillator (AED), a blood pressure monitor, a pulse oximeter, glucometer, and naloxone.

l) The facility must provide secure storage for all Veterans’ personal health information in a locked room and locked filing cabinet. Personal health information stored electronically must be in accordance with current federal standards.

m) In facilities that house both male and female Veterans, the Contractor must demonstrate that the safety of all residents is always maintained. Female Veterans must have secure and safe entrances, as well as separate living quarters and separate bathroom facilities.

n) The Contractor shall provide a working phone line that is accessible to Veterans to conduct care-plan related business.

o) The Contractor shall provide internet access and computer access for Veterans to aid in housing searches, other care-plan related tasks, and participation in virtual appointments.

p) The Contractor shall have available a means of receiving and sending encrypted/secure emails for necessary communication with the VA Liaison/COR and other VA staff as needed.

q) The facility shall be equipped with a generator or other means of back-up power to ensure that necessary medical equipment is able to function properly during a power outage. If the power is not restored within 24 hours, alternate accommodations must be arranged.

5. REFERRALS

a) The Contractor will serve Veterans who are literally homeless or at imminent risk of homelessness as defined according to the McKinney-Vento Homeless Assistance Act or subsequent relevant legislation.

b) Veterans served by the program must be eligible for VA healthcare.

c) The Contractor will serve Veterans with higher levels of medical needs than traditional shelters such as Veterans on home oxygen, recently discharged from a medical institution, recovering from injury, illness, or surgical procedure, in need of wound care, or on dialysis (the

Contractor does not have to provide dialysis on site); and provide support for other more complex medical needs. Veterans eligible for the medical respite program must require enhanced medical services to complete their medical recovery but will not meet acute care criteria for hospitalization. When necessary, the Contractor, VA Liaison/COR or designee, and VA medical staff as needed, will conduct a clinical review of medical needs to ensure the Contractor has capability to meet the Veteran’s care needs.

i. Veterans referred to the program may not be fully independent in all instrumental activities of daily living (IADLs), either at the time of entry or upon medical recovery.

The Contractor shall provide the necessary assistance with these tasks and shall help promote increased independence for the Veteran where possible.

ii. Veterans referred to the program will normally be fully independent with all activities of daily living (ADLs). Any modifications or assistance needed for a Veteran to complete an ADL will be considered on a case-by-case basis with the Contractor, VA Liaison/COR or designee, and VA medical staff as needed, to ensure the Contractor has capability to meet the Veteran’s care needs.

d) Veterans will be referred to the program by authorized VA personnel. The VA is responsible for determining eligibility of Veterans prior to admission to Contractor bed for services. The

Contractor is expected to work with identified VA Liaison/COR or designee to confirm eligibility; it is understood that payment for Veterans admitted without an initial determination of eligibility may not be authorized if the Veteran is found ineligible.

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

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

f)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 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.

g) The Contractor shall ensure that a signed VA Release of Information (ROI) is obtained for any

Veteran being admitted to the program and the ROI is placed into the individual case record and submitted to the VA Liaison/COR or designee via secure means. When possible, the VA will provide the Contractor with a signed VA ROI from the Veteran at the time of referral. If obtaining the signature would create a barrier or delay to housing, then verbal consent may be given and the Veteran will sign an ROI upon admission.

h) Along with the authorization for admission, the VA will send a centralized assessment form, and, when available, relevant physical and laboratory studies, confirmation of medical and mental health diagnoses, and a list of current medications.

i) The Contractor must be able to accommodate same-day admission of Veterans into the program, when requested, pending bed availability.

j) Veterans can not be denied entry into the program based solely upon length of current abstinence from alcohol or non-prescribed controlled substances, the number of previous treatment episodes, the time interval since the last program entry, the use of prescribed controlled substances, mental health diagnoses, or legal history.

6. LENGTH OF STAY, ABSENCES, AND CANCELLATION

a) The length of stay at the Contractor facility will be initially authorized for up to 60 days.

b) Some Veterans may be considered for extensions of their time in the program up to a total length of stay of 6 months, depending on the needs of the Veteran as mutually determined by the

Veteran, the Contractor’s staff, and VA Liaison/COR or designee. Any extension beyond the 60th day must be requested in writing to the VA Liaison/COR or designee by the Contractor at least 5 business days prior to the 60th day.

i. Extension will normally be approved on a month-to-month basis and further extensions must be requested in writing as noted above with justification included in the request.

ii. Only extraordinary circumstances will be considered in order to extend service periods in excess of 6 months for individual Veterans and may require case conferencing with

HCHV leadership for approval.

c) The Contractor is expected to complete routine clinical reviews to determine the continued need for medically enhanced services and to include the VA Liaison/COR in the review as well as consultation from VA medical providers if needed.

i. Once a Veteran has recovered to the point that their needs could be met in a traditional transitional housing or shelter setting, the Veteran may be transferred to another HCHV program, even if this occurs prior to the completion of the 60-day stay.

ii. The Contractor is required to notify the VA Liaison/COR or designee of a Veteran’s readiness for step-down placement within 1 business day of this determination.

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

Notice of scheduled absences should be submitted to the VA Liaison/COR or designee prior to the absence and notice of unscheduled absences should be submitted within 24 hours of the missed curfew.

e) The HCHV Contract Residential Services (CRS) program allows payment to a provider for an absent Veteran under the circumstances outlined below.

i. The HCHV CRS Liaison will review a HCHV CRS provider’s request for payment for an absent Veteran to ensure it meets the standards set by the HCHV National Program

Office.

ii. The VA will pay per diem up to a maximum of 48 consecutive hours for the unscheduled absence or 96 hours for the scheduled absence of a Veteran under the following conditions:

1. Scheduled Absences. To receive payment, the absence must:

(a) Be pre-planned, consistent with and support the Veteran’s individual service plan (e.g., family reunification, short term medical, substance use disorder (SUD) or psychiatric treatment).

(b) Have the reason documented in the individual Veteran’s case file, treatment record, or service plan.

(c) Not result in the bed being filled by the provider.

(d) Not be for a break or vacation from treatment.

(e) Not be used for extended educational or employment circumstances.

(f) Not be used to create more than 4 consecutive days of absence.

2. Unscheduled Absences. To receive payment for an unscheduled absence:

(a) The provider must have evidence of active outreach to locate and reengage the Veteran and document the steps taken in the Veterans individual case file, treatment record, or service plan.

(b) The provider may not fill the bed.

(c) The Veteran must be discharged from the HCHV CRS program if not located within 48 hours.

3. Inpatient Hospitalization. HCHV Contract Emergency Residential Services

(CERS) programs established as medical respite programs serve a specific subset of Veterans with complex needs. The per diem payment may be made to a HCHV medical respite provider if a Veteran requires inpatient medical or psychiatric treatment for a period of up to 7 days. The provider may not fill the bed during this time and should maintain contact with the VA Liaison and the Veteran, if authorized.

4. Ineligible Veteran. When a Veteran is admitted to a HCHV CRS program and found to be ineligible for HCHV CRS, VA will pay for a maximum of 4 days from the day of admission to allow the provider and VA Liaison time to locate and arrange alternate placement.

f) Requests for readmission shall be assessed and screened on an individual basis depending upon the needs of the Veteran as mutually determined by the Veteran, the VA Liaison/COR, and the VA HCHV Screening Team.

g) 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.

h) The Contractor shall be responsible for notifying the VA Liaison/COR or designee within 1 business day that a discharge has occurred and providing the written report of the discharge within 2 business days.

7. DOCUMENTATION

a) The Contractor shall provide written documentation constituted by the individual Veteran case record that verifies the provision of all supportive services required under this contract for each

Veteran participant.

i. Individual Veteran case records should include at least the following documentation:

1. Referral and assessment information provided by the VA at referral, including history and physical

2. Releases of Information – VA, Continuum of Care, and others as needed

3. Emergency contact and/or next-of-kin information

4. DD-214 or proof of request submission if not yet available

5. Signed and dated residential contract

6. Biopsychosocial assessment

7. Person-centered care plan and all monthly updates, signed and dated by the

Veteran and case manager

8. Weekly individual case management/progress notes

9. Suicide safety plan for any Veterans designated as high suicide risk

10. Results of random urine drug screens and breathalyzers

11. Medication Administration Records with Veteran and staff signatures, and confirmation of medication checks conducted by staff at least weekly.

12. Budget plan and monthly progress

13. Any engagement plans created in response to rule violations or other program participation concerns

14. Any incident reports involving the Veteran

15. Logs of AA/NA meeting attendance, employment logs, and housing search logs as applicable

16. Notes of group sessions (may be kept separately for group records)

17. Documentation of all absences and approved passes away from the program

18. Copies of extension requests and approvals

19. Discharge summary and completed Residential Treatment Exit Form, once discharged.

20. A copy of Veteran’s HMIS admission and discharge paperwork

ii. All notes are expected to be written professionally and in a format that utilizes the clear settings of goals and documents progress towards those goals (e.g. SNAP, SOAP, or

SMART notes).

b) VA Liaison/COR will furnish the Contractor with a Residential Treatment Exit Form. This form is used to report specific data required for the documentation of the exit in the Homeless

Operations and Management Evaluation System (HOMES). The completed form will be submitted to the VA Liaison/COR or designee within 2 business days of a Veteran discharge and will be stored in the Veteran case file.

c) 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.

d) Case records and data normally maintained and included in a medical record as a function of compliance with state or community licensing standards will be made available on a need to know basis to appropriate Department of Veterans Affairs staff members involved with the treatment program of the Veterans concerned. The Contractor shall make available to the VA, documentation and information deemed necessary by the VA to conduct utilization review audits, and ongoing inspections.

e) Veterans served through the VA contract program must have client level data entered into the local community Continuum of Care (CoC) Homeless Management Information System

(HMIS). Data entered must include, at a minimum, the Universal Data Elements from the current

HMIS Data Standards. A Release of Information for the CoC must be secured and maintained in the Veteran Individual Case Record. A copy of the HMIS admission and discharge paperwork should be filed in the Veterans clinical chart.

f) The Contractor shall maintain a daily census sign-in sheet to verify the Veteran’s attendance in the program on a daily basis. The contractor shall be responsible for collecting Veteran participant signatures on a daily basis such that the census is updated in real time. All excused and unexcused absences shall be clearly documented on the sign-in sheet, including the reason for the excused absence. This information is to be provided to the VA Liaison/COR or designee upon request and as a part of the monthly billing process.

8. INCIDENT REPORTING

a) The Contractor is expected to maintain open and ongoing communication with the VA

Liaison/COR or designee regarding concerns or issues related to Veterans, the facility, staffing, or contract management.

b) All critical incidents involving Veterans in the contract program must be reported to the VA within 24 hours. During normal business hours, the Contractor is expected to notify the VA

Liaison/COR or designee via telephone as soon as possible. If the incident occurs after hours, the

Contractor should notify the Salisbury VAHCS Health Administrative Specialist on Duty (HOD) via telephone. A written report, including any responses or follow-up actions in progress, will be sent to the VA Liaison/COR or designee via secure email within 2 business days. The Contractor shall maintain a copy of all critical incident reports in the involved Veteran’s individual case record. Names of other Veteran or residents involved should be redacted.

i. Critical incidents include, but are not limited to:

1. falls or other injuries

2. assaults or threats – physical, sexual, verbal

3. fire

4.…