36C25020Q0505-016.pdf

QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)

For: Emergency Shelter for homeless Veterans

Contract Description: The purpose of this contract is for Saginaw Veterans Administration Medical Center (VA) to engage community provider(s) (Contractor) who will provide emergency shelter to homeless Veterans along with services consistent with Health Care for Homeless Veterans (HCHV) program objectives (see below). The goal of this contract is to remove homeless Veterans from the street or places unfit for human habitation and place them in community-based, residential environments. These residences must have sufficient services to meet the needs of the Veterans served.

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: Karen Williams 2780 Airport Dr., Columbus, OH 43219, 614-257-5220, Karen.Williams4@va.gov.

Organization or Agency: Department of Veterans Affairs mailto:Karen.Williams4@va.gov

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. The COR shall keep a quality assurance file. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf.

Assigned Primary COR: Carly Huffman LMSW, CCFC, COR 1500 Weiss Saginaw, MI 48602 989-497-2500 ext. 11694 Carly.Huffman@va.gov

Program Manager: Carly Huffman LMSW, CCFC, COR

3. CONTRACTOR REPRESENTATIVES

The following employees of the contractor serve as the contractor’s program manager for this contract. (Name/Title/Address/Phone/Email)

Primary:

Alternate:

4. PERFORMANCE STANDARDS

The contractor is responsible for performance of ALL terms and conditions of the contract.

CORs will provide contract progress reports quarterly to the CO reflecting performance on this plan and all other aspects of the resultant contract. The performance standards outlined in this QASP shall be used to determine the level of contractor performance in the elements defined.

Performance standards define desired services. The Government performs surveillance to determine the level of Contractor performance to these standards.

The Performance Requirements are listed below in Section 6. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the standard and assign a rating. At the end of the performance period, these ratings will be used, in part, to establish the past performance of the contractor on the contract.

5. 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 periodically as part of the Quality Assurance Surveillance Plan and at such other times as deemed necessary by the Contracting Officer.

mailto:Carly.Huffman@va.gov

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) Observation of facility operations to see if appropriate organized activity programs are available during waking hours (including evenings) and degree to which a high level of activity is observed in the facility, such as individual professional counseling, physical activities, assistance with health and personal hygiene.

e) 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.

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

g) 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.

6. QASP PERFORMANCE REPORT DATE:______________________

Task ID Indicator Standard Acceptable Quality Level

Method of Surveillance

Performance Acceptable/

Unacceptable

Records keeping for Homeless Veterans.

Records keeping for Homeless Veterans.

Upon review by the COR, all Homeless Veterans medical records reflect appropriate treatment provisions, and plan of care.

Homeless Veterans records reflect accurate and appropriate treatment provisions.

100%

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

YES ____

NO ____

Upon review by the COR, all Homeless Veteran's medical records reflect adherence to agreed upon treatment guidelines and standards.

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

100%

VA Social Worker performs a chart review, at a minimum of monthly on a sample of program participants and compiles results for review by the COR.

YES ____

NO ____

Method of Surveillance

Performance Acceptable/

Unacceptable

Accuracy of Invoices 3

Upon review by COR, all invoices received from contractor are accurate.

Invoices received from the contractor are accurate; daily sign-in sheets are submitted to the COR at the end of the month.

100%

On a monthly basis, invoices are checked by COR.

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

Discharge Plans

Upon review by COR, appropriate discharge plans are made for Homeless Veterans for residential treatment (including those discharged for non-compliance).

Appropriate discharge plans are made for Homeless Veterans for residential treatment (including those discharged for non-compliance).

100%

On a monthly basis COR, ensures that Homeless Veterans placed in residential treatment continue to be offered appropriate housing and treatment options.

YES ____

NO ____

Homeless Veterans Satisfaction

Homeless Veterans complaints about the quality of care are measured by an evaluation form administered by the HCHV Coordinator, or designee.

All Homeless Veterans complaints should be responded within 24 to 48 hours after initial complaint. COR shall be notified within 24 to 72 hours of complaint via e-mail at Carly.Huffman@va.gov

95% Satisfaction 100% of

Complaints reported in a timely manner

A satisfaction form is provided to Veterans who are placed in residential treatment 30 days after admission into the program, which will document contractor’s responsiveness to complaints.

Method of Surveillance

Performance Acceptable/

Unacceptable

Residential Outcomes 6

Upon review of HCHV Discharge rates at least 55% of Veterans will a positive exit from HCHV shelter; and no more than 25% of Veterans will have a negative exit.

At least 55% of Veterans discharged from the Contracted shelter will have a successful discharge;

and no more than 25% of Veterans will have a negative exit.

>55% Positive Exits

<25% Negative Exits

All Veterans discharged from residential treatment will have a discharge form completed and this will be monitored through Homeless Operations Management and Evaluation System (HOMES) on a monthly, quarterly and annual basis.

YES ____

NO ____

Emergency Housing and Facilities Management

Upon scheduled or unscheduled inspection, Contractor’s facility meets fire, safety, ADA, licensure, safety and privacy guidelines;

additional safety measures for female Veterans and Veterans with minor children.

100% compliance with all required guidelines during the fiscal year reporting period.

100%

VA Team inspection on an annual or as needed basis. Periodic review of Contractor’s policies and records to ensure compliance.

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:

• Exceptional

• Very good

• Satisfactory

• Marginal **

• Unsatisfactory**

** Documentation with exact dates, times (specifics, not just generalization of what problems are) if ranked lower than satisfactory.

8. COR AND CONTRACTOR SIGNED ACKNOWLEDGEMENT OF QASP

X________________________________________________________________________

CARLY HUFFMAN LMSW, CCFC, COR DATE

X________________________________________________________________________

CONTRACTOR NAME/TITLE DATE