36C25018R0764-003.pdf

QUALITY ASSURANCE SURVEILLANCE PLAN

For: Dayton Health Care for Homeless Veterans Program – Single Men and Women

Contract Number:

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:

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: KIM POWELL, KIM.POWELL@VA.GOV

Technical Representative: Not Applicable

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).

mailto:Davina.Perry@va.gov mailto:KIM.POWELL@VA.GOV

Task ID Indicator Standard Acceptable Quality Level

Method of Surveillance

Incentive

Medical Records

1 Upon review by Program Manager, or designee, all Homeless Veterans medical records reflect appropriate treatment provisions, and plan of care.

Veterans records reflect appropriate treatment provisions

100% VA Social Worker, at minimum, sees each Homeless Veterans monthly and reviews their chart to determine that contracted services are being provided accordingly

Exercise of Option Period and past performance

2 Upon review by Program Manager or designee, all Veteran’s in Emergency Contract Housing medical records reflect adherence to agree upon treatment guidelines and standards.

Homeless Veterans records reflect adherence to agree upon treatment guidelines and standards.

100% VA Social Worker performs a chart review, at a minimum bi-annually, on a sample of program participants and compiles results for review by Program Manager.

Exercise of Option Period and past performance

Accuracy of Invoices

3 Upon review by Program Manager, or designee, all invoices received from contractor are accurate.

Invoices received from the contractor are accurate.

90% On a monthly basis, invoices are checked by COR.

Any mistakes or deficiencies are reported between the VA and the contractor. The Program Manager assists as needed.

Exercise of Option Period and past performance

Veteran Satisfaction

4 Homeless Veterans complaints about the quality of care are measured by an evaluation form administered by the Program Manager, or designee.

All valid Homeless Veterans complaints are resolved in a timely manner by the contractor.

100% A satisfaction form is provided to each Veteran placed in residential treatment 30 days after admission into the program.

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 Program Manager shall use the surveillance methods listed in the administration of this QASP. Prior to the award of a contract and annually during the contract term, a multidisciplinary VA team shall conduct a survey of the Contractor’s facilities for Veterans’ food, shelter, and therapeutic services to assure the Contractor provides quality care in a safe environment. Inspections will also be carried out at least quarterly as part of the Quality Assurance Surveillance Plan and at such other times as deemed necessary by the Contracting Officer.

The inspection of the Contractor facilities will include the following:

a) General observation of residents to determine if they maintain an acceptable level of personal hygiene and grooming.

b) Assessment of whether the facility meets applicable fire, safety and sanitation standards.

c) Determining whether the facility is in attractive surroundings conducive to social interaction and the fullest development of the resident's rehabilitative potential.

d) Seeking evidence of facility-community interaction, demonstrated by the nature of scheduled activities or by information about resident flow out of the facility, e.g., community activities, volunteers, local consumer services, etc.

e) Observation of staff behavior and interaction with residents to determine if they convey an attitude of genuine concern, caring and safety.

f) Inspecting the types of meals and other nutrition provided to residents to see if appetizing, nutritionally adequate meals are provided in a setting, which encourages social interaction and if nutritious snacks between meals and bedtime are available for those requiring or desiring additional food, when it is not medically contraindicated.

Making a spot check of Veterans’ records to ensure accuracy with respect to Veterans’ length of stay and services provided to the Veterans.

7. 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:

• Exceeded Expectations

• Met Expectations

• Did Not Meet Expectations

THE CONTRACTOR WILL BE ADVISED OF THE FINDINGS OF THE

INSPECTION TEAM. IF DEFICIENCIES ARE NOTED DURING ANY

INSPECTION, THE CONTRACTOR WILL BE GIVEN A REASONABLE TIME TO

TAKE CORRECTIVE ACTION AND TO NOTIFY THE CONTRACTING OFFICER

THAT THE CORRECTIONS HAVE BEEN MADE. A CONTRACT WILL NOT BE

AWARDED UNTIL NOTED DEFICIENCIES HAVE BEEN ELIMINATED.

FAILURE BY THE CONTRACTOR TO TAKE CORRECTIVE ACTION WITHIN A

REASONABLE TIME WILL BE REPORTED TO THE VA CONTRACTING

OFFICER. IF CORRECTIONS ARE NOT MADE TO THE SATISFACTION OF THE

VA, THE CONTRACTING OFFICER WILL CONSULT WITH THE APPROPRIATE

OFFICIALS SO THAT SUITABLE ARRANGEMENTS CAN BE MADE TO

DISCONTINUE PLANS TO AWARD A CONTRACT, OR TO DISCHARGE OR

TRANSFER PATIENTS AND TO TERMINATE THE EXISTING CONTRACT, AS

APPROPRIATE.

8. 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.

9. 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