36C25018Q0581-001.docx

36C25018Q0581

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.

DUNS:

DUNS+4:

PHONE:

FAX:

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

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA

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

ARE

ARE NOT ATTACHED.

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

ARE

ARE NOT ATTACHED

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

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

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

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

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

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

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

515-18-4-5804-0014 36C25018Q0581 08-07-2018 Robert Kay robert.kay@va.gov 734-845-5591 08-21-2018

3.00 pm Eastern 36C250 Department of Veterans Affairs Network Contracting Office 10 PO Box 492 Ann Arbor

MI

48106 X 624221 $11 Million X N/A X 36C515 Department of Veterans Affairs Battle Creek VA Medical Center 5500 Armstrong Road Battle Creek

MI

49037 36C250 Department of Veterans Affairs Network Contracting Office 10 PO Box 492 Ann Arbor

MI

48106

Department of Veterans Affairs Financial Management System PO Box 149971 Austin

TX

78714-9971 877-353-9791 512-460-5540 Residential shelter beds for beneficiaries of the Battle Creek VA Medical Center. Facility to be located within the City Limits of Battle Creek, Michigan.

Please see the Price Schedule and PWS in Section B as well as the Addendum to the Instructions to Offerors in Section E.

This acquisition will be conducted using the procedures in FAR Part 12, Acquisition of Commercial Items, and FAR Subpart 13.5, Simplified Procedures for Certain Commercial Items.

X x One(1) Robert J. Kay Contracting Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

(continuation from Standard Form 1449, block 18A.)

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

b. GOVERNMENT: Robert Kay, Contracting Officer Department of Veterans Affairs Network 10 Contracting Office PO Box 492 Ann Arbor MI 48106 E-mail: Robert.Kay@va.gov Telephone: 734-845-5591

The Contracting Officer (CO) is responsible for the administration of this contract. The Contractor is advised that only the CO, acting within the scope of the contract and, after advice and consultation with the Contracting Officer’s Representative (COR), has the authority to make changes that affect:

· Contract prices and pricing issues

· Estimated quantities

· Delivery terms and conditions

· Term of the contract

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with: OB10 or current Electronic Invoice System: http://ob10.com/us/en/veterans-affairs-us/

3. INVOICES: Invoices shall be submitted 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.

OB10 or current Electronic Invoice System: http://ob10.com/us/en/veterans-affairs-us/

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

5. REVIEW REQUIRED REGISTRATION WITH CONTRACTOR PERFORMANCE ASSESSMENT SYSTEM (CPARS)

(d) Failure to have a current registration in the CPARS database, or to re-assign the report to the VA contracting officer within those sixty days, will result in the Government's evaluation being placed on file in the database with a statement that the contractor failed to respond.”

B.2 SUBCONTRACTING COMMITMENTS--MONITORING AND COMPLIANCE (JUN 2011)

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

B.3 PRICE SCHEDULE

The Contractor shall provide Emergency Residential Services to beneficiaries of the Battle Creek VA Medical Center, 5500 Armstrong Road, Battle Creek, MI, 49037, in accordance with all terms and conditions of the contract. The Contractor shall maintain the capability to provide services of up to 18 beds at any given time. The facility shall be located within the city limits of Battle Creek, Michigan.

Note: Indefinite Delivery, Indefinite Quantity Contract is being used because it is impossible to determine with any certainty the exact amount of services that will be required under this contract.

A task order shall be issued for the Battle Creek VA Medical Center, number of beds based on historical usage and projected need.

Contracts shall be IDIQ, Firm Fixed Price, with Five (5) One-year ordering periods.

The Contractor shall not receive payment except when a veteran occupies a bed, exclusive of the contract minimum for the Five (5) One-year ordering periods or as indicated in PWS, section C.1.a.

The total minimum of beds, or guaranteed minimum, for the contract is One (1) bed for the Five (5) One-year ordering periods. The maximum total value of the contract, inclusive of the Five 5 One-year ordering periods, shall not exceed 32,850 beds.

Ordering Period One (1) September 25, 2018 to September 24, 2019

CLIN Description Estimated Quantity Unit Unit Cost Estimated Total

0001 All deliverables and 6,570 Bed $________ $________ other documentation required by the Performance Work Statement shall be included in the charges for the daily rate.

Ordering Period Two (2) September 25, 2019 to September 24, 2020

CLIN Description Estimated Quantity Unit Unit Cost Estimated Total

1001 All deliverables and 6,570 Bed $________ $________ other documentation required by the Performance Work Statement shall be included in the charges for the daily rate.

Ordering Period Three (3) September 25, 2020 to September 24, 2021

CLIN Description Estimated Quantity Unit Unit Cost Estimated Total

2001 All deliverables and 6,570 Beds $________ $________ other documentation required by the Performance Work Statement shall be

Ordering Period Four (4) September 25, 2021 to September 24, 2022

CLIN Description Estimated Quantity Unit Unit Cost Estimated Total

3001 All deliverables and 6,570 Beds $________ $_________ other documentation required by the Performance Work Statement shall be included in the charges

Ordering Period Five (5) September 25, 2022 to September 24, 2023

CLIN Description Estimated Quantity Unit Unit Cost Estimated Total

4001 All deliverables and 6,570 Beds $________ $_________ other documentation required by the Performance Work Statement shall be

Estimated Contract Total: $____________

B.4 Performance Work Statement

BATTLE CREEK VA MEDICAL CENTER

EMERGENCY RESIDENTIAL SERVICES

A. PURPOSE.

The Battle Creek VA Medical Center, 5500 Armstrong Road, Battle Creek, Michigan 49037, requires Contractors to provide services as part of its Community-based Health Care for Homeless Veterans (HCHV) program. The goal of the HCHV program is to remove homeless Veterans from the street or habitation unfit for Veterans and place them in community-based, residential environments with sufficient supportive services to meet their needs and ultimately facilitate the improvement of their housing situation. The facility is to be located within the City Limits of Battle Creek, State of Michigan, USA.

B. BACKGROUND.

Through the HCHV program, VA provides supportive services to Veterans and facilitates their access to a broad range of medical, mental health, and rehabilitative services. The purpose of this solicitation is to obtain offers from Contractors in Battle Creek, Michigan who can provide housing, and supportive services to Homeless Veterans and/or their families in community-based Contracted Emergency Residential Services (CERS) facilities offering a safe and secure environment that supports their goals for recovery from homelessness. The Contractor will be required to provide a therapeutic and rehabilitative milieu and attendant services targeting the underlying factors contributing to homelessness. The Contractor will not be required to provide detoxification or other hospital level treatment.

C. SERVICES TO BE PROVIDED

I. BASIC SERVICES: The Contractor shall furnish each Veteran who has been approved as eligible by the VA and admitted for care under this contract with the following basic services:

a. ROOM AND BOARD: Room and Board shall be accessible to the Veteran 7 days a week and 24 hours per day. Accommodations will include a bed and other furnishings such as a dresser, storage locker or designated secured space, and personal linens (towels, pillows, blankets and bed sheets, etc.). The Contractor will allow Veteran to store personal belongings for at least 72 hours after formal HCHV discharge. At least three nutritious meals, 7 days a week will be provided for the Veteran. In addition, there will be availability of snacks of nourishing quality (e.g. fruits, vegetables, protein sources, etc.), between meals and bedtime for those requiring or desiring additional food, even when it is not medically indicated. 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. The facility shall provide storage space in an onsite refrigerator for Veterans to store and freely access personal food. The facility shall establish and maintain sanitary procedures for washing dishes, cleaning equipment and work areas, and disposing of waste.

b. PRIVACY REQUIREMENTS: The living environments of HCHV Contract housing must include:

(1) Separate and secure sleeping arrangements (unit or wing) for each gender or Veteran Family,

(2) Separate and secure bathroom arrangements for each gender or each Veteran family,

(3) Screening procedures and criteria for sex offenders (mixed gender facility), and

(4) Common areas (lounges, laundry rooms, group rooms) with appropriate security arrangements.

Additionally, mixed gender, multifamily facilities that share entrance and common areas (living room, kitchen, dayroom, etc.) must include onsite staffing available 24 hours a day, 7 days per week.

a. LAUNDRY FACILITIES: Laundry facilities and necessary detergent free of charge and adequate for residents to do their own laundry or to have laundry done at minimum one time per week.

b. THERAPEUTIC AND REHABILITATIVE SERVICES: Each Veteran will have an Individual Care Plan (ICP) completed by the Contractor with input from the Veteran and the VA Homeless Continuum Program Manager (or Designee). Therapeutic and rehabilitative services will be stated in the plan of care. Services which the Contractor must be able to furnish or provide shall be detailed in the QASP and will include:

1) Group Activities: Structured group activities, as appropriate, shall occur two 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.

2) VA Coordination: Collaboration and coordination with VA program staff, as needed, will include coordination of supportive psychosocial services. In particular, coordinated efforts must be made with the Liaison around medical, mental health, admission and discharge needs.

3) Case Management: A thorough written Individualized Care Plan (ICP) will be developed within 72 business hours of admission for each Veteran. This will include 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. 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. On a weekly basis the contracted case manager will be required to update the VA Liaison on Veteran progress and/or safety concerns for HSR Veterans. 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. All Veterans will be referred to VA for Primary Care and Mental Health appointments and Contractors will support Veterans in making initial and subsequent appointments. Efforts will be documented in the Veterans ICP and reviewed by the HCHV Liaison at least monthly. 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).

4) Staffing Ratio: Special Population Contracts (e.g. Sex Offenders, Family, SMI, Medical Respite programs, etc.) will maintain a minimum staffing requirement ratio of one full time dedicated case manager per 15 Veterans. All other programs are required to maintain low caseloads of no more than one full time dedicated Veteran case manager for up to 20 active Veteran clients. Exceptions may be granted in writing by the VA. Staff is defined as a paid professional or para-professional and does not include interns. The VA requires that case managers working with Veterans do not engage in case management of non-Veteran population unless a waiver has been granted by the VA. Each VA Liaison will have no more than two POC’s per program.

5) Permanent Housing Search: Programs are required to provide Veterans with direct and ongoing assistance in achieving permanent housing. As a primary goal of the HCHV program, plans for Veterans’ transition to permanent housing placements must be clearly reflected in each ICP and in weekly case management notes. As part of this plan, Veterans’ housing history and needs must be assessed through a formal and thorough Housing Assessment completed within 72 business hours of program admission. Housing Assessments must identify Veterans’ housing history, strengths (i.e. positive prior rental history), and barriers (i.e. Unlawful Detainers). Should Veteran refuse to engage with program staff regarding plans for permanent housing transition, motivational interviewing and other therapeutic techniques will be used to address Veteran ambivalence. All efforts to engage Veteran regarding housing plans, options, and resources shall be clearly documented and include any therapeutic techniques utilized. Contractor staff must provide direct assistance to Veterans in developing permanent housing plans and accessing appropriate housing resources. These services shall be provided weekly through one to one case management. Examples of expected housing services include: 1) assistance obtaining and reviewing Veteran’s free credit report, identifying housing strengths and/or barriers associated with current credit status; 2) Creating a Tenant Portfolio with Veteran that contains all relevant documents required in the rental process, including a completed sample rental application for Veteran, income verification documents, identification, applicable subsidies, etc.; 3) Reviewing affordable housing rental options and Permanent Supportive Housing (PSH) program offerings, and assisting Veterans with making appropriate rental inquiries and submitting completed rental applications; 4) Conducting regular and individualized housing advocacy efforts, including transportation, assistance scheduling, meeting, and communicating with property managers and landlords, and engage in troubleshooting where rental barriers or denials occur in the housing search process., . All housing efforts by Contractor shall be documented clearly and presented to HCHV Liaison upon request. Mere communication with Veterans regarding housing, without subsequent Contractor staff action and follow-up, shall not on its own meet the above requirements.

Sex Offender programs will have increased focus on discharge to stable or permanent housing placements as evidenced in ICP and QASP.

6) Financial Planning: Referral to and follow up on all potential financial resources the Veteran may be eligible for (e.g. SSI, SSDI, Food Stamps, NSC pension, GA, etc.). Case Managers will document all structured activities that support Veteran in developing a short and long term plan to understand and address their current financial situation and how to improve it. Financial planning efforts may be accomplished in group but preferably through one on one case management services. At minimum four financial planning activities appropriate to the Veterans individual circumstance must be documented monthly.

7) Employment Services: Referral to all relevant employment opportunities the Veteran is eligible for and interested in, Case Managers will document all structured activities that support Veteran in applying for employment as appropriate based on needs of Veteran as identified in the assessment.

8) Recovery: 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. 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.

9) Occupancy: It is expected that Contractor beds will be maintained at an average minimum of an 85% occupancy rate but at a preferred rate of 90% as calculated based upon number of bed nights available per quarter. If this rate is not consistently attained a Corrective Action Plan (CAP) will be developed by the Contractor as part of the QASP and/or process improvement plan. Adjustments in contract funding may occur through modifications if occupancy is not maintained. Failure to maintain year to date occupancy rate at or above 85% may be grounds for immediate termination for convenience.

10) Outreach: Contractor will be responsible to engage in outreach in the community both independently and in collaboration with Battle Creek VA Medical Center’s Homeless Continuum Program Designee(s) at least two times per month. In addition, clear documentation for outreach activities must be made available to Liaison upon request during the QASP review. Contractors will maintain occupancy by engaging in outreach services and will be knowledgeable about outreach best practices generally accepted in the community.

11) Discharge Planning: Securing permanent housing will be the primary discharge goal for every Veteran. All Veterans must have a discharge plan within two weeks of admission which integrates items included in Paragraph 5 above. Veterans must also apply for a minimum of two GPD programs, or one residential inpatient program and independent housing within the first month of admission. Compliance with all VA regulations regarding discharges and timeliness of reporting discharges is required by Contractor. Case Managers will provide assistance with discharge planning for every Veteran and report all discharges via email within 24 business hours using a secured process (e.g. HOMES ID number). Paperwork required for discharging a Veteran from any HCHV program is required via fax within 24 business hours from known discharge. Housing needs will be assessed upon acceptance to the program (within 72 business hours as noted in Paragraph 5) and resources will be coordinated for discharge to a successful community placement throughout the duration of the Veteran’s stay. A negative discharge for undesirable behavior is a committee decision that must include the VA Liaison prior to discharge. All Veterans scheduled for discharge based on behavior must meet with the treatment team and work with team to determine most therapeutic option for Veteran. This does not include violations for safety reasons or verbal abuse. Please note: Profanity does not in and of itself constitute abuse and shall not exclusively be considered grounds for discharge. Any and all actual or threatened violence will be grounds for discharge. Veterans may be discharged for safety reasons at any time. All negative discharges will be subject to a full team debriefing, including VA Liaison, to look for opportunities missed to intervene sooner. All discharges are subject to the Contractors grievance procedures and must allow clients the opportunity to be represented by the VA Liaison in the grievance process. Reasonable efforts must be made to coordinate with the Liaison in order to schedule an appeal. Lastly, all TQI measures must be met in order to receive the highest past performance rating. These include the following:

· HCHV1 (Exits to Permanent Housing - >50%

· HCHV2 (Negative Exits) -<30%

· Bed Occupancy > 85%, preferred 90%

· Length of Stay ≤ 60 Days

· VA Benefit Applications Pending -15%

· Non-VA Benefit Applications Pending -8%

12) Grievance Procedures: Programs must have an internal grievance process that Veterans can use to resolve conflicts within the program. Programs must have written policies and procedures for resolving grievances, including a statement regarding the client’s right to request reasonable accommodation, and must post them in a place conspicuous and be accessible to clients. In addition, each client shall receive a copy of the grievance policies and procedures, upon intake and upon receiving a warning or discharge notice.

13) Intake Packets: All Veterans must receive an intake packet within 72 business hours which includes, at minimum, the following information:

1. Description of the Contractors services

2. Grievance Policy

3. Emergency procedures

4. Patient rights and Reasonable Accommodation

14) Extensions- All extensions beyond 60 days must be approved in writing by HCHV Coordinator or Designee.

15) Medication Management: Medications and narcotics shall be properly stored, controlled, issued and recorded in compliance with physician’s orders. Contractor shall establish procedures for insuring Veterans confidentiality in the storage of and keeping of records concerning medication. Medication Assisted Treatment (MAT) cannot be used to rule out Veterans participation in an HCHV Program. This includes prescribed use of Vicodin, morphine, methadone 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).

16) Timeliness of Response- Contractor is expected to have a dedicated phone line for VA inquiries and referrals. Return calls from the program are expected within 4 hours during business hours Monday through Friday. This includes calls from VA Staff or the Liaison to the program.

· 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

17) Critical Incident Reporting- All critical incidents will be reported within 24 hours. This includes the following:

II. DOCUMENTATION: The Contractor shall provide treatment and discharge planning reflecting a team assessment of health, social and vocational needs and the involvement of the Veteran, the VA staff and appropriate community resources in resolving problems and setting goals. An individual case record will be created for each referred Veteran. Case records shall be maintained in security and confidence as required by the Confidentiality of Alcohol and Drug Abuse Patient Records (42 CFR part 2) and the Confidentiality of Certain Medical Records (38 USC 7332). 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 comply with applicable requirements of the Confidentiality of Alcohol and Drug Abuse Patient Records (42 CFR Part II) and the Confidentiality of Certain Medical Records (38 USC 7332). The files shall include:

· Reasons for referral

· All essential identifying data relevant to the resident and his/her family including a socio-cultural assessment, weekly progress reports or notes, and documentation of any case management interventions or patient care conferences

· For sites who implement Medication Management/Monitoring- Copies of any medical prescriptions issued by physicians, including orders, if any, for medications to be taken. Contractor must be in compliance with HCHV inspection requirements

· Case management notes written in a professional manner (i.e. SMART, SOAP, SNAP) will include the following: 1) A written and thorough Housing Needs Assessment, 2) Financial Plan, 3) Discharge Plan, and Individual Care Plan with attendant goals and documented activity indicating Veteran and Case Manager is actively working on identified goals.

· QASP Compliance Tool and all attendant supporting documentation demonstrating Contractor compliance with Contract

· Final summaries on each resident who leaves the program, to include reasons for leaving, the resident’s future plans, and follow-up locator information.

· Extension approval if relevant

· Waivers as appropriate

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

III. RULES, POLICIES AND PROCEDURES: The Contractor shall have reasonable rules governing day-to-day life and activities in the facility. Such rules clearly inform Veterans of the obligations upon which their continued participation in the program depends and the consequences for non-compliance. Veterans will be provided a copy of the rules at intake or upon Veterans request. In addition, Contractor will post the rules in a location readily accessible to clients and visitors. These rules must include detailed Patient Rights and the procedures that the Contractor has in place to protect the Veterans rights and dignity. Veterans must be permitted to exercise these rights without fear of reprisal. 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 assistance animals, and the California Fair Employment and Housing Act of 1973 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.

IV. PROCEDURES FOR NEGATIVE DISCHARGE OR SANCTION: Contractor must post rules in the Veterans Case Manager’s Office and provide Veteran with the rules which specify the reasons or conditions for which a Veteran may be sanctioned or discharged, including those behaviors which constitute gross misconduct and are grounds for immediate discharge from the program and those which would prompt a written warning if violated and potential discharge if violated repeatedly. Contractor will describe the formal appeal procedures through which clients may appeal program regulations, sanctions or discharges. This information must be provided to clients in writing upon intake and must be clear and easily understandable by clients.

This information will include:

· Immediate contact with VA liaison

· Timely due process provisions which should include two warning notices for violations which do not result in immediate discharge prior to issuance of a discharge notice and an opportunity for a case conference after warning is issued to the client

· Notice of, and access to, formal appeal procedures

· Notice of the conditions or process for re-admission to the program.

· Reasonable efforts to provide an appropriate referral to another facility or appropriate level of care as needed

· This does not apply to Veterans who are discharged for danger to self or others

D. ADDITIONAL CONTRACT REQUIREMENTS

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

I. PERSONNEL: The Contractor will employ sufficient personnel to carry out the policies, contract responsibilities, and the program for the facility. Case management staff must have appropriate and commensurate coverage for staff using authorized and unauthorized leave (e.g. holidays, sick leave, family care, etc.). There must be, at a minimum, one staff member on duty on the premises or residing at the facility and available for emergencies 24 hours a day, 7 days a week. In addition, there is an expectation that there is an administrative/clinical Designee that will be available for consultation for emergencies 24 hours a day, 7 days a week. The Contractor shall assign personnel that by education, training and when required, certification or licensure qualified to provide the Basic Services and Supplemental Services required by this SOW.

Staff Training: Contractor will provide at least one staff person on-site at all times who has had training and orientation on the following topics. Staff shall receive and document—at a minimum—one-time training per year on these subjects.

· CPR

· First Aid

· Crisis intervention

· Cultural sensitivity

· Sexual harassment

· Sensitivity to wider issues of homelessness

· Universal Precautions (disease transmission prevention)

· Child abuse/neglect reporting laws (if shelter provides services to children)

· Adult abuse/neglect reporting laws

· Harm Reduction philosophy

· Suicide Prevention

· Medication management

· State and Federal Fair Housing Law and ADA Requirements

· Conflict resolution

· De-escalation techniques

· Search and Seizure/Probable Cause in the Shelter Setting

Contractor will perform criminal background checks on all staff members that work with children. Contractors will agree not to hire Staff who is currently enrolled in a VA Homeless Program or who have ended participation in a VA Homeless Program within the past two years. Contractor must have a policy prohibiting staff from establishing sexual relationships with program clients.

The Contractor must identify each person functioning as “Key Personnel” under this contract, and provide to the VA a description of the services to be provided by such person, together with a resume summarizing that person’s relevant skills and experience.

During the first ninety (90) calendar days of contract performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death, or termination of employment. Within 14 days after substitutions necessitated by situations described above, the Contractor shall provide resumes for the substitute key personnel. For substitutions proposed by the Contractor after the initial 90 calendar day period, the Contractor shall provide resumes 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 fifteen (15) calendar days after receipt of all required information if the VA refuses to accept the substitute key personnel. 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 patient care or interferes with the regular and ordinary operation of the facility.

Temporary substitutions of key personnel shall be permitted in accordance with the Contractor’s contingency plan. The Contractor’s contingency plan to be utilized if personnel leave Contractor’s employment or are unable to continue performance in accordance with the terms and conditions of the resulting contract must be submitted as part of the Contractor’s offer.

II. REFERRALS, ADMISSIONS AND ELIGIBILITY: Contractor must utilize an admission process that includes written eligibility criteria that is fair, objective, and compliant with applicable State and Federal laws. Contractor will provide verbal and written notification that is readily accessible to all individuals, upon request, of reasons for non-acceptance. Notification of reasons for non-acceptance is not required to be given to those denied service/housing because of bed unavailability. The eligibility information must be made available to clients at intake and staff must provide answers to questions about the admission criteria and process. Contractors must have formal appeal procedures through which clients may appeal unfavorable admission or eligibility decisions and a copy of the policy for appeals is to be given to the Veteran at screening or intake.

The VA is responsible for determining eligibility of Veterans prior to acceptance by the Contractor for services. After receipt of a Release of Information (ROI) a written pre-approval from VA Staff is required (hard copy, fax or e-mail are acceptable) and shall be provided to the Contractor for each Veteran referred for services under the contract. If there is an urgent need to admit a Veteran and VA Staff is not available to provide a written approval in a timely manner a verbal approval is acceptable. Any admissions that occur without written/verbal approval must be verified by VA Staff within 24 business hours in order for the Contractor to receive payment for time spent prior to approval (e.g. admission after hours or during the weekend). Written documentation of eligibility verification, signed by an authorized VA Staff, shall be obtained by the Contractor as soon as possible for each Veteran referred for services under the contract for inclusion in the Veterans program file.

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

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

The initial stay for a Veteran should be no longer than 60 days. Some Veterans may be considered for up to 90 days depending on the needs of the Veteran as mutually determined by the Veteran, the Contractor’s staff, and HCHV Coordinator or Designee. Any extension of the stay after 90 days must be authorized by the VA Homeless Continuum Program Manager or Designee, provided that there is clear clinical indication and availability of funds. Only extraordinary circumstances will be considered in order to extend Service periods in excess of 6 months for individual Veterans and these must be authorized by the Medical Center Director or Designee.

It is understood that the type of Veterans to be cared for under this contract will require care and treatment services over and above the level of room and board. To be eligible for placement in emergency contract beds, all Veterans must be homeless or at imminent risk of becoming homeless and be eligible and registered for VA services. Contractors are encouraged to provide housing and or services to special Veteran populations, such as but not limited to the following: medically compromised Veterans, Veterans with young children, Veterans with sex offender status, seriously mentally ill Veterans, Veterans who have abused drugs or alcohol for many years, and/or Veterans who have been involved with the legal system.

III. Denial of Services: Veterans cannot be denied entry to HCHV Contracted Residential Services 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, disability or legal history. This includes a Veterans status of being a victim of Domestic Violence and as such cannot be considered during the screening process. The screening process must consider each of these special circumstances and determine whether the program can meet the individual Veteran's needs while maintaining the program's safety, security, and integrity. All Contractors must employ a harm reduction approach.

IV. ABSENCES AND CANCELLATION: The Contractor shall notify the VA of unauthorized absences by a referred Veteran from the facility within 24 hours of Veterans absence. Should a Veteran absent himself/herself from the Contractor’s facility in an unauthorized manner, payment for services for that Veteran shall be continued for a maximum period of 24 hours, provided there is a documented active outreach attempt on the part of the Contractor’s staff to return the Veteran to the facility and there is a reasonable belief that the Veteran will return. Management of program dropout rate will be an element of quality assurance review of this program. The CERS Liaison may authorize payment for excused absences up to 72 hours if there is a compelling medical or mental health need and the excused absence is verified a priori.

VA reserves the right to remove any or all Veterans from the facility at any time, without additional cost, when it is determined to be in the best interest of the VA or the Veteran. This includes discharge from facility for ongoing bed bug infestation.

The Contractor shall notify the authorizing VA facility immediately when a medical emergency occurs that requires hospitalization of a referred Veteran. It is agreed that the Veteran will be admitted to the appropriate VA facility. When such admission is not feasible because of the nature of the emergency, it is agreed that hospitalization in a non-federal facility is acceptable. If hospitalization of a non-emergent nature is required it is agreed that admission to the appropriate VA facility will be accomplished promptly. The Contractor will make arrangements for admission and support the Veteran with any transportation issues that may arise.

The Contractor shall notify the authorizing VA facility immediately of any incidents involving Veterans residing in the Contract Emergency Residential program. The Contractor shall notify the VA case manager by telephone during the hours of 8:00am and 4:30pm. For all incidents that occur after normal business hours, the Contractor should notify the HCHV Staff the following business day. The Contractor shall provide the HCHV case manager and the COR with a copy of the incident report within 24 business hours. The Contractor shall maintain a copy of the incident report in the Veteran’s case record. Please see above in Basic Services for details regarding what constitutes Critical Incident Reporting.

V. CONTRACTOR STAFF CONDUCT/COMPLAINTS HANDLING: Contractor personnel shall be expected to treat referred Veterans with dignity and respect and abides by standards of conduct mirroring those prescribed by current federal personnel regulations. The Contractor shall comply with the VA Patient's Bill of Rights as set forth in 38 CFR 17.34a (copy available upon request).

The VA reserves the right to exclude Contractor staff members from providing services to Veterans under this contract based on breaches of conduct, including conduct that jeopardizes patient care or interferes with the regular and ordinary operation of the facility.