36C25018R0294-003.pdf

QUALITY ASSURANCE SURVEILLANCE PLAN

For: Chillicothe Health Care for Homeless Veterans Families Program

Contract Number: To Be Determined

Contract Description: The contractor shall provide residential room and board, laundry facilities for residents to do their own laundry, and to assist Veterans in complying with the therapeutic, rehabilitative, and recovery services determined to be needed by the individual resident in a plan developed by the contractor with consultation by the Veteran and VA case manager and/or other appropriate VA staff.

Contractor’s name: To Be Determined

1. PURPOSE

This Quality Assurance Surveillance Plan (QASP) provides a systematic method to evaluate performance for the stated contract. This QASP explains the following:

What will be monitored.

How monitoring will take place.

Who will conduct the monitoring?

How monitoring efforts and results will be documented.

This QASP does not detail how the contractor accomplishes the work. Rather, the QASP is created with the premise that the contractor is responsible for management and quality control actions to meet the terms of the contract. It is the Government’s responsibility to be objective, fair, and consistent in evaluating performance.

This QASP is a “living document” and the Government may review and revise it on a regular basis. However, the Government shall coordinate changes with the contractor. Copies of the original QASP and revisions shall be provided to the contractor and Government officials implementing surveillance activities.

2. GOVERNMENT ROLES AND RESPONSIBILITIES

The following personnel shall oversee and coordinate surveillance activities.

a. Contracting Officer (CO) - The CO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United States in the contractual relationship. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment under this contract. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance.

Assigned CO: DAVINA PERRY, Davina.Perry@va.gov; Network Contracting Office (NCO) 10

Contract Specialist: N/A

Organization or Agency: Network Contracting Office (NCO) 10; VISN 10 VA Healthcare System

b. Contracting Officer’s Representative (COR) - The COR is responsible for technical administration of the contract and shall assure proper Government surveillance of the contractor’s performance with guidance from the technical representative. The Technical Representative shall keep a quality assurance file. The COR or the Technical Representative is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf.

Assigned COR: ANITA GREEN, Anita.Green@va.gov

Technical Representative:

c. Other Key Government Personnel - Not Applicable.

3. CONTRACTOR REPRESENTATIVES

The following employees of the contractor serve as the contractor’s program manager for this contract.

a. Program Manager –

b. Other Contractor Personnel –

4. PERFORMANCE MEASURES

Performance measures are comprised of performance indicators (some characteristic of a deliverable that can be measured) and performance measures (a mark, measure or benchmark that government personnel use as a point of comparison when evaluating contractor performance). The Government performs surveillance to determine if the contractor exceeds, meets or does not meet these measures.

The Performance Requirements Summary Matrix, paragraph ‘C’ in the Performance-Based Statement of Work (PWS), includes performance measures. The Government shall use these measures to determine contractor performance and shall compare contractor performance to the Acceptable Quality Level (AQL).

Task ID

PERFORMANCE

Indicator

MEASURES

Standard

Acceptable Quality Level

Method of Surveillance

Incentive

Patient Safety

Patient safety incidents must be reported to the authorizing VA medical center and the COR.

100% All incidents reported immediately (within 24 hours.)

100% Observation and annual inspection

<Exercise of Option Period and past performance

Patient safety incidents must be investigated, confirmed and resolved.

100% All incidents are investigated, confirmed and resolved.

100% Observation and annual inspection

Exercise of Option Period and past performance

Patient safety incident investigations, conclusions and findings must be reported to the authorizing VA medical center and the COR.

100% Updates and findings of patient safety incident investigations are provided continuously (at least once a week.)

100% Observation and random inspection

Exercise of Option Period and past performance

Patient Satisfaction

Patient complaints about the quality of care are reported to the VISN Patient Advocate, the COR, and the Contractor Patient for resolution.

100% All patient complaints are reported immediately (within 24 hours.)

100%

User survey, observation and annual inspection

Exercise of Option Period and past performance

Providers and staff are familiarized with the process outlined in contractor’s grievance procedures as well as patient rights.

100% All providers and staff are educated.

100%

User survey, observation and annual inspection

Exercise of Option Period and past performance

5. INCENTIVES

The Government shall use Exercise of Option Period and past performance and/or any other incentive that was proposed in your solution as incentives. Incentives shall be based on exceeding, meeting, or not meeting performance measures.

6. METHODS OF QA SURVEILLANCE

Various methods exist to monitor performance. The COR and/or the Technical Representative shall use the surveillance methods listed below in the administration of this QASP.

a. DIRECT OBSERVATION. (Can be performed periodically or through 100% surveillance.)

b. ANNUAL INSPECTION.

The annual inspection will be conducted by a multi-disciplinary team composed of the HCHV Program Coordinator, the VAMC Fire Chief, Nursing, and Dietary. The Performance measure for these inspections is 100% compliance. Any noted deficiencies must be corrected within a given time frame established by the inspection team. These corrections are confirmed by a second inspection.

c. USER SURVEY. Random survey is conducted to solicit user satisfaction. Survey results may also generate inspections and sampling. Any unsatisfactory rating will result in an informal investigation consisting of Veteran interviews by HCHV Coordinator and interviews by HCHV Coordinator and Contractor staff.

8. RATINGS

Metrics and methods are designed to determine if performance exceeds, meets, or does not meet a given standard and acceptable quality level. A rating scale shall be used to determine a positive, neutral, or negative outcome. The following ratings shall be used:

9. DOCUMENTING PERFORMANCE

a. ACCEPTABLE PERFORMANCE

The Government shall document positive performance. Any report may become a part of the supporting documentation for any contractual action.

b. UNACCEPTABLE PERFORMANCE

When unacceptable performance occurs, the COR shall inform the contractor. This will normally be in writing unless circumstances necessitate verbal communication. In any case the COR shall document the discussion and place it in the COR file.

When the COR determines, formal written communication is required, the COR shall prepare a Contract Discrepancy Report (CDR), and present it to the contractor's program manager.

The contractor shall acknowledge receipt of the CDR in writing. The CDR will specify if the contractor is required to prepare a corrective action plan to document how the contractor shall correct the unacceptable performance and avoid a recurrence. The CDR will also state how long after receipt the contractor has to present this corrective action plan to the COR. The Government shall review the contractor's corrective action plan to determine acceptability.

Any CDRs may become a part of the supporting documentation for any contractual action deemed necessary by the CO.

10. FREQUENCY OF MEASUREMENT

a. Frequency of Measurement.

During contract performance, the COR will periodically analyze whether the negotiated frequency of surveillance is appropriate for the work being performed.

b. Frequency of Performance Assessment Meetings.

The COR shall meet with the contractor annually to assess performance and shall provide a written assessment.

Signature of Offeror / Contractor Signature of COR

Name and Title of Signer (Type or Print) Date Name of COR (Type or Print) Date