S02 36C25022Q0422 Solicitation Chillicothe HCHV 6-27-2022.docx

36C25022Q0422

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) 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. 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

06-27-2022 Thomas Demko Contract Specialist 513-235-3166 07-27-2022 12:01 pm

EDT

539/90C

Department of Veterans Affairs Network Contracting Office (NCO) 10 260 E. University Avenue Cincinnati OH 45219

X

624221 $12 Million

N/A

See Delivery Schedule

539/90C

Department of Veterans Affairs Network Contracting Office (NCO) 10 260 E. University Avenue Cincinnati OH 45219

Department of Veterans Affairs

FMS-VA-2(101)

Financial Services Center PO Box 149971 Austin TX 78714-9971

See CONTINUATION Page Provide services as part of the Chillicothe VAMC community-based Health Care for Homeless Veterans (HCHV) program for single male and female veterans.

See Schedule of Services: pages 5 and 6

See Performance Work Statement (PWS): pages 7 through 18

See CONTINUATION Page

Karen Williams 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:

a. CONTRACTOR’S NAME/ADDRESS/CITY/STATE/ZIP (Please print or type):

DUNS# _____________________________

260 East University Avenue Cincinnati, Ohio 45219

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with: 52.23233, Payment by Electronic Funds Transfer – System for Award Management

3. INVOICES: Invoices shall be submitted in arrears: Monthly

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. Invoicing shall be in accordance with the requirements of the Department of Veterans Affairs (VA) Financial Services Center (VAFSC). The latest information shall be used for invoicing and payments and may change during the period of performance of this acquisition. Current Invoicing information is located at: https://www.fsc.va.gov/einvoice.asp.

All invoices shall include the following:

· Invoice Number

· Invoice Date

· Purchase Order Number (will always begin with 610)

5. CHANGES/MODIFICATIONS TO THE CONTRACT: The Contracting Officer will be the only person authorized to approve changes or modify any of the requirements under this resultant contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer will be authorized to make commitments or issue changes that affect price, quantity, delivery or quality of performance of this resultant contract. In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer, the change shall be considered unauthorized by the local VAMC and no adjustment will be made in the contract price to cover any increase in cost incurred as a result thereof.

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

7. SECURE FAX: In accordance with VA Handbook 6500, the following statement is required on all fax cover sheets; if it is determined the ordering process will include a fax: “This fax is intended only for the use of the person or office to which it is addressed and may contain information that is privileged, confidential or protected by law. All others are hereby notified that the receipt of this fax does not waive any applicable privilege or exemption for disclosure and that any dissemination, distribution or copying of this communication is prohibited. If you have received this fax in error, please notify this office immediately at the telephone number listed above.”

8. POST-AWARD ORIENTATION: The Contracting Officer will schedule a post award orientation for contract orientation purposes as required by VAAM Part M842.5.

9. MANDATORY WRITTEN DISCLOSURES:

Mandatory written disclosures required by FAR clause 52.203-13 to the Department of Veterans Affairs, Office of Inspector General (OIG) must be made electronically through the VA OIG Hotline at http://www.va.gov/oig/contacts/hotline.asp and clicking on "FAR clause 52.203-13 Reporting." If you experience difficulty accessing the website, call the Hotline at 1-800-488-8244 for further instructions.

B. 2 SCHEDULE OF SERVICES

Contractor shall provide Healthcare for Homeless Veterans (HCHV) Treatment and Rehabilitative Services for up to ten (10) homeless veterans per day.

Period of Performance: October 1, 2022 (or date of award) through September 30, 2027.

The guaranteed minimum only applies to the first ordering period after award. The total minimum amount, or guaranteed minimum, for the initial year in which this contract is awarded is 10 beds (1 day). The total maximum number of days, inclusive of all ordering periods shall not exceed 24,100 days.

Reimbursement will be made to the contractor by issuance of individual task orders during the life of the contract. Only the Contracting Officer is authorized to place task orders against this contract, which will be issued annually for each ordering period.

3,650.00

DY

Emergency Housing for Single Male and Female Veterans under the Healthcare for Homeless Veterans (HCHV) Program (10 x 365= 3,650)

Ordering Period 1 POP Begin: 10-01-2022 POP End: 09-30-2023

Emergency Housing for Single Male and Female Veterans under the Healthcare for Homeless Veterans (HCHV) Program

Ordering Period 2 POP Begin: 10-01-2023 POP End: 09-30-2024

Emergency Housing for Single Male and Female Veterans under the Healthcare for Homeless Veterans (HCHV) Program

Ordering Period 3 POP Begin: 10-01-2024 POP End: 09-30-2025

Emergency Housing for Single Male and Female Veterans under the Healthcare for Homeless Veterans (HCHV) Program

Ordering Period 4 POP Begin: 10-01-2025 POP End: 09-30-2026

Emergency Housing for Single Male and Female Veterans under the Healthcare for Homeless Veterans (HCHV) Program

Ordering Period 5 POP Begin: 10-01-2026 POP End: 09-30-2027

GRAND TOTAL

B.3 PERFORMANCE WORK STATEMENT – Healthcare for Homeless Veterans Services

The Chillicothe VA Medical Center (Chillicothe VAMC) has a requirement for a community-based residential care center for homeless Veterans. Contractor(s) shall provide Healthcare for Homeless Veterans (HCHV) Treatment and Rehabilitative Services for up to ten (10) homeless Veterans per day who may have mental illness and/or substance use disorders in a residential care center located within the catchment area of the Chillicothe VAMC. The catchment area of Chillicothe VAMC is defined as including the following Ohio counties: Guernsey, Noble, Washington, Athens, Meigs, Fairfield, Hocking, Vinton, Jackson, Pickaway, Ross, Pike, Scioto, Fayette, Clinton, Highland, Adams.

PART I: GENERAL INFORMATION

1. Background Through the HCHV Program, Chillicothe VAMC provides Veteran’s case management services and facilitates their access to a broad range of medical, mental health, and rehabilitative services. The Contractor shall provide care, treatment, and rehabilitative services to Homeless Veterans in community-based treatment facilities offering a safe and secure environment that supports their rehabilitation goals. The Contractor shall be required to provide a safe, therapeutic, and rehabilitative milieu and attendant services.

The term residential care center may refer to a variety of housing options including, apartment style housing, group home, or institutional setting. 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.

1. Services to be Provided All Veterans placed by Chillicothe VAMC staff in the facility must be eligible Veterans for VA health care as described by the Department of Veterans Affairs guidelines. All Veteran residents shall be capable of self-preservation and performance of all ADLs (Activities of Daily Living). In an emergency, Veteran residents shall have sufficient capacity to recognize physical danger, the judgment that requires to immediate egress from the group residence, the capacity to follow a prescribed route of egress, and have the physical ability to accomplish such egress.

Contractor shall provide community-based residential care, treatment, and rehabilitative services for up to ten (10) homeless Veterans, who may have a mental illness and/or substance use disorder diagnosis, in a residential care center.

1. Applicable Documents

1. VHA Handbook 1162.09 Health Care for Homeless Veterans (HCHV) Program (http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3006)

2. VA patient’s Bill of Rights, 38 U.S. C 17.34a (http://www.va.gov/health/rights/patientrights.asp)

3. Life Safety Code of the National Fire Protection Agency: NFPA #101 (www.nfpa.org)

4. Confidentiality of Medical Quality Assurance Records: 38 U.S.C. 5701 (http://www.gpo.gov/fdsys/granule/USCODE-2010-title38/USCODE-2010-title38-partIV-chap57-subchapI-sec5701/content-detail.html); and 38 U.S.C. 7332 (http://www.gpo.gov/fdsys/granule/USCODE-2011-title38/USCODE-2011-title38-partV-chap73-subchapIII-sec7332/content-detail.html)

5. Disclosure of Patient Records: Records protected by 38 U.S.C. 5705; its implementing regulations at 38 U.S.C. 17.500-511; VHA Directive 98-016, 4b. (1) (d), 4.6(2)(c) and 4.6(4). These records may be disclosed only as authorized by 38 U.S.C. 5705 and the VA regulations. Disclosure of these records in violation of 5705 is a criminal offense under 38 U.S.C. 5705(e): (http://www.gpo.gov/fdsys/pkg/USCODE-2013-title38/pdf/USCODE-2013-title38-partIV-chap57-subchapI-sec5705.pdf)

PART II: WORK REQUIREMENTS

1. Personnel

0. Contractor shall retain Key Personnel to fulfill the requirements of this contract. Key Personnel include a Program Manager, one or more Case Manager(s) and one or more Monitor(s). A Program Manager shall manage the entire HCHV program and ensure that all residential standards and requirements are maintained and enforced. A Case Manager shall be present at the facility Monday through Friday during all business hours (or during after-hours if necessary) to assist the Veterans in securing permanent housing, appropriate employment and any and all available VA and community benefits. A Monitor shall be present during all non-business hours, weekends and holidays to ensure the safety and security of all Veterans. A Key Personnel shall be on the premises and available for emergencies 24 hours a day, 7 days a week. At least one Key Personnel, certified in cardio-pulmonary resuscitation (CPR) shall be on the premises at all times.

0. Temporary substitutions of Key Personnel shall be permitted in accordance with the Contractor’s Contingency Plan. The Contingency Plan shall include, at minimum, an outline of how the Contractor shall maintain the full day-to-day operations of the program and provide ongoing care to Veterans during periods when temporary substitutions are required and or there are inadequate staffing levels. The Contractor’s Contingency Plan to be utilized if personnel leave Contractor’s employment or is 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. The Contracting Officer Representative (COR) and the Chillicothe VAMC Liaison shall be notified, within one (1) business day of any temporary substitutions.

1. Technical Requirement

1. Contractor, through the Key Personnel, shall furnish each Veteran authorized care under this contract with the following basic services:

0. Contractor shall have a facility obtained (either leased/rented/owned) and made fully operational prior to the effective date of this contract (10/01/2022). The facility must pass the life safety inspection prior to any services rendered.

b. Facility shall be staffed 24 hours per day, 7 days a week; and can place Veteran same day as referral from HCHV Chillicothe VAMC staff.

c. Veterans may be on physician ordered special diets. Veterans shall have appetizing, nutritional meals provided in a setting that encourages social interaction. Nutritious snacks between meals and bedtime are also available for those requiring or desiring additional food when it is not medically contraindicated. Veterans shall have at least one hot meal other than breakfast. The Contractor shall maintain a written monthly meal plan. This plan shall be posted in a common area one week prior and during the month of which it applies. Many Veterans are either undernourished or have poor eating habits because of their chronic psychiatric disorders, which could be alcohol/drug abuse related behaviors.

d. Laundry facilities for residents to do their own laundry with no cost to the Veterans. Machines shall be maintained and in good condition to ensure availability of service.

e. Dining areas must be comfortable and adequate size to seat the maximum number of residents in the facility.

f. Common living areas must be comfortable and adequate in size to accommodate the maximum number of residents in the facility.

g. The facility shall maintain one functional lavatory (bathing and/or shower facility) for every six people living in the facility.

h. Bedrooms shall measure at least 100 square feet for a single room, or 25 square feet additional for each resident double occupancy room (or in a multi-resident room). Male and female residents shall have secure separate sleeping quarters. Bedrooms shall contain no more than four beds. Floor plan of facility/units shall be available for review and approval prior to award. NOTE: The complex nature of certain residents may dictate the need for single occupancy in a bedroom. Bedrooms shall contain a suitable bed furnished by the facility with, mattress, pillow, sheets/blankets, and towels. The facility shall be responsible for laundering the linens and towels at least weekly and keeping them in good condition. Mattresses must be kept in good condition and replaced as needed.

i. The Contractor will offer a low-demand environment meaning Veterans will be offered mental health and substance abuse services by the Chillicothe VA, but their participation in these services will not be contingent on their acceptance or continued stay in the facility.

j. Narcotic medication shall be kept in a secured locked location within a supervised area.

k. Facility shall have safe and functioning systems for: heating and cooling, hot and cold water, electricity, plumbing, sewage, food preparation (unless food is prepared off site), laundry, artificial and natural light, and ventilation. The residence shall be climate controlled to be heated not below 65 degrees Fahrenheit in the winter and cooled not above 75 degrees Fahrenheit in the summer.

l. All facility areas shall be kept clean and sanitized weekly. Chores may be assigned to Veterans, but Contractor must ensure areas are cleaned to sanitary standards.

m. A storage locker or designated secured space must be provided to each Veteran.

n. Contractor must allow Veteran to store personal belongings up to 72 hours after formal HCHV discharge.

o. Therapeutic, Rehabilitative, and Recovery Services shall be determined by the individual resident along with the Program Manager and Case Manager in consultation with the Chillicothe VAMC Liaison. An Individualized Care Plan (ICP) will be developed. Such a plan shall be developed based on the individual needs of the Veteran and include:

i. Case management services shall address self-care skills, housing needs, employment and/or income needs, financial planning in collaboration with Chillicothe VAMC programs or other community resources. A thorough written ICP will be developed within 2 weeks of admission for each Veteran and at a minimum updated weekly. In addition, special attention will be made to address High Suicide Risk (HSR) Veterans as identified by the Chillicothe VAMC Liaison, Chillicothe VA mental health staff, and/or the Case Manager. On a weekly basis the Case Manager will be required to update the Chillicothe VAMC Liaison on Veteran progress and/or safety concerns for HSR Veterans. Case Manager will review the HSR Safety Plans with the Veterans on a bi-weekly basis. HSR Safety Plan reviews and a copy of the Veteran’s Safety Plan will be documented in the Chart on a monthly basis. All Veteran’s will be referred to Chillicothe VAMC for Primary Care and Mental Health appointments and Contractor will support in making initial and subsequent appointments.

ii. Outreach activities shall be used to identify homeless Veterans that need housing assistance. These locations can be at local homeless shelters, missions, soup kitchens, street locations, halfway houses, rehab centers, treatment facilities, or other places (i.e., parks, outdoor areas). Outreach services will be provided at a minimum of 8 hours per week. A weekly log documenting the places and times that outreach occurred will be submitted to Chillicothe VAMC Liaison weekly. If a homeless Veteran is identified through these outreach activities and is believed to be eligible for admission into the facility, then the Program Manager or Case Manager shall immediately notify the Chillicothe VAMC Liaison. The homeless Veteran shall not be admitted into the facility until the Chillicothe VAMC Liaison grants approval.

iii. 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 2 weeks of program admission. Housing Assessment must identify Veteran’s housing history, strengths (i.e., positive prior rental history), and barriers (i.e., unlawful detainers/evictions). 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. These services shall be provided weekly through one-to-one case management.

iv. Examples of expected housing service include: 1.) Assistance obtaining and reviewing Veteran’s free credit report, identifying housing strengths and barriers associated with current credit status; 2.) Reviewing affordable housing rental options and making appropriate rental inquiries; 3.) Assisting in completing rental applications; 4.) Assisting in contacting property managers and scheduling meetings.

v. A Tenant Portfolio for each program participant will be required. At minimum it will contain a completed sample rental application for Veteran, income verification documents, photo identification, social security card, DD214 and or birth certificate, and free credit report. The Tenant Portfolio will be completed within 30 days of admission. All housing efforts by Contractor shall be documented clearly and presented to Chillicothe VAMC 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.

vi. Financial Planning: Referral and follow up on all potential financial resources the Veteran may be eligible for (e.g., Social Security, SSI, SSDI, Food Stamps, NSC pension etc.) Case Manager 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 preferable through one-on-one case management services. At minimum two financial planning activities appropriate to the Veteran’s individual circumstance must be documented monthly. A budget sheet identifying Veteran’s income and debts will be completed monthly with each Veteran and given to Chillicothe VAMC Liaison upon request.

vii. 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. 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.

viii. Group services shall be provided by Program Manager and Case Manager. Individual and group sessions shall be provided each week based upon the individual needs of the residents. The group services can be life skills, social skills, tenancy skills.

ix. Structured group activities shall be conducted twice per month. These may include physical activities when appropriate. Activities of structured groups may consist of group therapy, social skills training, vocational counseling, and physical activities as appropriate. Contractor shall submit sign in sheets to the Chillicothe VAMC Liaison for each group activity along with the description of the group activity.

x. Instruction and assistance with health and personal hygiene maintenance.

xi. Monitoring of medications, if instructed and as necessary.

xii. Assistance in learning and development of responsible living patterns to achieve a more adaptive level of psychosocial functioning, upgraded social skills, and improved personal relationships.

xiii. Support for an alcohol/drug abuse free lifestyle may include participation of Alcoholic Anonymous and Narcotic Anonymous meetings.

1. The facility shall have a current occupancy permit or license required by the authority having jurisdiction.

1. Program Manager and Case Manager shall conduct treatment and discharge planning for the Veteran. To resolve any problems and to set goals, a team assessment shall be used to reflect the health, psychosocial, vocational needs, and as appropriate the involvement of residents’ families and community resources. This shall be done in coordination with Chillicothe VAMC Liaison.

1. Contractor shall provide and arrange transportation to VA appointments and other appointments in the community for the Veteran. If Contractor determines that adequate public transportation is not available or appropriate for a Veteran, they shall arrange for alternative transport by car or taxi only after discussing the appropriateness with Chillicothe VAMC Liaison. The Contractor shall incur the cost of the transportation for the Veteran. The facility shall be located on a bus line and have access to areas that provide employment opportunities for those Veterans who are able to be employed. The Contractor shall be expected to help the Veteran access public transportation, including providing information and instructions necessary to enable Veterans to utilize public transportation.

1. Contractor must provide designated office space in the facility to Chillicothe VAMC Liaison. The office space must afford the Chillicothe VAMC Liaison and Veteran sufficient privacy and confidentiality.

1. The office must include a desk, desk chair, at least one office chair for the client to sit in, locking file cabinet, noise/sound control capabilities (i.e.: sound machine, music player), a desk top telephone to make local as well as long distance calls, and the office must have internet access capability. The Chillicothe VAMC Liaison is expected to be at the facility one (1) to two (2) days per week.

1. Contractor must provide Wi-Fi internet for Veterans to complete housing searches, job searches, and resource identification.

1. Special Care Requirements

0. In coordination with the Chillicothe VAMC Liaison, Imperative Levels of Care shall be developed by the Program Manager and Case Manager:

0. A program of therapeutic and rehabilitative mental health services shall be designed to promote a more adaptive level of psychosocial functioning, and to assist the Veteran in transitioning to independent housing.

2. A program regarding supportive health care that shall include the instruction and/or information related to personal hygiene to any Veteran.

2. Individual adjustment services including social diversion, recovery focused, recreational and spiritual opportunities.

2. Supporting Veterans, through motivation and education, to achieve and maintain independence in the activities of daily living and self-care.

2. Pest Prevention

4. There shall be a Pest Preventative Treatment plan in place which shall include prevention and remedy methods for the treatment of pests, such as bed bugs, rodents, which meet standard industry practices. The Chillicothe VAMC Liaison shall monitor the facility to ensure compliance with this protocol and successful results. Program Manager shall maintain an emergency housing contingency plan in the event of an infestation that renders the facility unfit for habitation.

1. Responsibility and Legal Obligations

1. Contractor shall conform to all regulations, Federal, State, and local authorities, governing the performance of contracted services.

1. The Contractor shall employ sufficient personnel to carry out the policies, responsibilities, and programs of the facility. There must be a Key Personnel on the premises, 24-hours a day, seven (7) days a week. Contractor shall make available to the Chillicothe VAMC Liaison, documentation/information deemed necessary to conduct review audits.

1. Contractor shall comply with the VA patient’s Bill of Rights as set forth in section 17.34a, Title 38, Code of Federal Regulations.

1. Contractor under this program must meet the following VA standards, based on regulations promulgated by Title 38 Code of Federal Regulations (CFR) Section 17.53b.

1. Contractors shall comply with VHA Supplemental Contract Requirements for Combatting COVID-19. See Section D attachment.

1. Residential Standards

1. Residential settings shall meet the following:

0. The standards of the Life Safety Code (National Fire Protection Association (NFPA #101).

0. The fire and safety code imposed by the State law.

0. City, State, and Federal requirements concerning licensing and health codes, including construction, fire, maintenance, and sanitation regulations.

0. All residential treatment settings shall meet ADA (Americans with Disability Act) requirements (www.ada.gov).

0. All residential treatment settings must be licensed as required for the setting under State or Federal authority.

1. In the performance of this contract, the Contractor shall take all necessary safety precautions. The Chillicothe VAMC Liaison shall contact the Program Manager of any noncompliance with the foregoing provisions and the corrective action to be taken. Once the Program Manager shows the receipt of notice, he/she shall immediately correct the conditions. Such notice, when served on the Program Manager, shall be deemed sufficient for the purposes aforesaid. If the Program Manager fails or refuses to comply promptly, the COR may issue an order stopping all or any part of the contract and hold the Contractor in material breach.

1. Accreditation and Licensing Accreditation by the Commission on Accreditation of Rehabilitation Facilities (CARF) is desirable, but not required. Where applicable, the residential treatment center shall have a current occupancy permit issued by the authority having jurisdiction.

1. Referrals

1. Chillicothe VAMC Liaison is responsible for verifying the Veteran's eligibility for VA healthcare services prior to referral to the Contractor for services. A written or verbal referral (hard copy, fax or e-mail are acceptable) from the Chillicothe VAMC Liaison shall be provided to the Contractor for each Veteran referred under the contract.

1. It is understood that the Contractor shall 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 to the Chillicothe VAMC Liaison.

1. The initial referral period for a Veteran may be up to 90 days (3 months), depending upon the needs of the Veteran as mutually determined by the Veteran, the Contractor, and Chillicothe VAMC Liaison. An extension of the referral period up to a total of six (6) months may be authorized by the Chillicothe VAMC Liaison, based on clinical assessment and if funding is available. Treatment periods more than six (6) months for individual Veterans must be authorized by the Chillicothe VAMC Liaison.

1. It is understood that the type of Veterans to be cared for under this contract may require care and treatment services over and above the level of room and board. To be eligible for placement, all Veterans must be homeless or at imminent risk of becoming homeless and be eligible for VA healthcare services.

1. Evidence of Insurance Coverage Before commencing work under the contract, the Contractor shall furnish the Chillicothe VAMC Liaison a certification within 30 days indicating that the coverage outlined in this contract has been obtained, and that it may not be changed or cancelled without written notice.

1. Records and Reporting

1. The Contractor shall notify the authorizing Chillicothe VAMC Liaison immediately when a medical emergency may occur, thus requiring the hospitalization of any resident receiving care at VA expense. If hospitalization of a non-emergency nature is required, it is agreed that admission to the Chillicothe VAMC hospital shall be accomplished consistent with eligibility criteria, as determined by Chillicothe VAMC Liaison.

1. In the event a Veteran dies, Contractor shall promptly notify the Chillicothe VAMC Liaison, who will authorize the immediate assembly and inventory of all Veteran’s personal effects. The funds, deposits, and effects left by the deceased Veteran, shall be delivered by Chillicothe VAMC Liaison to persons entitled.

1. Absence from the facility of the Veteran for more than 72 hours will be not reimbursable except with the prior approval of the Chillicothe VAMC Liaison. The Chillicothe VAMC Liaison shall determine if the absence is authorized. If a Veteran is found to be absent in an authorized manner, the payment for Veteran services shall be continued for a maximum period of three (3) days. There should be an active outreach attempt by the Contractor to return the Veteran to the facility. If a Veteran is found to be absent in an unauthorized manner, payment shall cease immediately.

1. Contractor shall maintain an individual record on each Veteran placed in the facility. The Contractor shall comply with the requirements of the “Confidentiality” of certain medical records (38 USC 7332), and (42 CFR, Part II). All case records shall be maintained with such security and confidentiality as required and shall be made available on a need-to-know basis to appropriate staff members involved with the treatment program of the Veterans concerned. In addition to reasons for referral, the clinical record maintained by the contract facility shall include:

3. All essential identifying data relevant to the resident and his/her family, including all assessments;

3. ICP shall be completed by Contractor, in collaboration with Chillicothe VAMC Liaison, and shall include data relating to the resident’s admission, anticipated length of stay, targeted goals and objectives for constructive changes and discharge planning.

3. A summary of all medical prescriptions issued by physicians, including orders, and if any medications need to be taken.

3. Final summaries on each resident who leaves the program, which includes a description of beneficial changes found during the residential period, reasons for leaving, the resident’s future, and follow up locator information. Contractor shall provide a copy of final summary to Chillicothe VAMC Liaison and Veteran within one week of the Veteran leaving the facility.

3. Upon discharge or death of the Veteran, medical records shall be retained by the Contractor for a period of at least three (3) years following termination of care.

1. Confidentiality of Veteran Records

1. In performance of this contract, Contractor shall not be considered part of Chillicothe VAMC for purposes of 5 U.S.C. 552a, 38 U.S.C. 5701 and 7332. Contractor shall obtain needed records from Chillicothe VAMC only with signed consent by Veteran.

1. Records created by Contractor while performing this contract are the property of Chillicothe VAMC, and shall not be accessed, released, transferred, or destroyed except in accordance with federal law, regulations, and policy. Access to data shall be limited to the minimum necessary for performance of the contract. Contractor shall take steps to ensure that access is limited to those employees who need access to the data to perform the contract. Contractor shall not copy information contained in the system, either by printing to paper or by copying to another digital format, without the express permission of Chillicothe VAMC Release of Information Office, except as is necessary to make single copies in the ordinary course of providing patient care. Contractor shall not comingle the data from the system with information from other sources. Contractor shall report any unauthorized disclosure of VA information to the Chillicothe VAMC Privacy Officer.

1. If this contract is terminated for any reason, Contractor shall provide within seven (7) days of the termination of the contract, the Chillicothe VAMC with all individually identified Chillicothe VAMC Veteran treatment records or other information in its possession, as well as any copies made pursuant to paragraph (2), above.

1. Certain information available from the database and other records created by the Contractor are medical quality assurance records protected by 38 U.S.C. 5705; its implementing regulations at 38 U.S.C. 17.500-511; VHA Directive 98-016, 4b. (1) (d), 4.6(2)(c) and 4.6(4). These records may be disclosed only as authorized by 38 U.S.C. 5705 and the VA regulations. Disclosure of these records in violation of 5705 is a criminal offense under 38 U.S.C. 5705(e).

1. Contractor shall follow all Chillicothe VAMC policies regarding the retention of records. In the alternative, Contractor may deliver the records to Chillicothe VAMC for retention.

1. Any changes in the law or regulations governing the information covered by this contract during the term of this contract shall be deemed to be incorporated into this contract. The Contractor shall educate its Key Personnel and Subcontractors of the requirements of this section and shall advise its Key Personnel and Subcontractors of any changes as they occur. On the Contractor’s request, the Chillicothe VAMC shall provide trainers who can education the Contractor’s Key Personnel and Subcontractors, of their obligations under this section.

1. The Contractor shall make its internal policies and practices regarding the safeguarding of medical and/or electronic information available to federal agencies with enforcement authority over the maintenance of those records upon request.

1. Inspection and Acceptance

1. It is agreed that the Department of Veteran Affairs shall have the right to inspect the facility and all appurtenances by an authorized representative(s) designated by the Department of Veterans Affairs.

1. A multi-disciplinary team consisting of some or all of the following (social worker, dietitian, nurse, and an engineering service safety officer), shall conduct an initial inspection of the facility and all appurtenances. Other inspection team members may be included, as needed. Subsequent inspections of the facility shall be made yearly by a multidisciplinary team including hospital personnel (appointed by the director), to assure that the facility is providing quality care within a safe environment. As Chillicothe VAMC program personnel accomplish site visits, attention shall be directed to the adequacy of Veteran’s records. Site visits shall also include a spot check of records to ensure the Contractor invoices accurately reflect the Veteran’s length of stay.

1. The Chillicothe VAMC dietitian (member of the inspection team) shall evaluate the printed menus. Three sufficient balanced meals shall be provided by the Contractor where the Veteran resides. Government food assistance programs such as food stamps shall not be used for this purpose. Meals must be prepared and served following the Ohio State Board of Health, Food, Safety and Sanitation Guidelines. Meals shall be prepared that are nutritionally balanced following USDA guidelines.

1. Contractor shall be advised of the findings of the inspection team. If deficiencies are noted during any inspection, the Contractor shall be given a reasonable time to take corrective action and to notify the Chillicothe VAMC Liaison that the corrections have been made. Facilities must also be made available for random inspections, as applicable.

1. The Chillicothe VAMC Liaison shall monitor the facility to ensure compliance with this contract. Any unsatisfactory conditions noted during an inspection shall be reported in writing to the COR. If corrections are not made to the satisfaction of the COR, consultation with the appropriate VA officials will commence and appropriate action, including termination of the contract, shall be undertaken.

1. The Safety Officer shall inspect the facility for conformity to the current Life Safety Code and submit the findings to the chairperson or liaison of the team. Other members of the team shall focus on an assessment of the quality of life within the facility, giving particular attention to the following indicators:

5. General observation of Veterans as to an acceptable level of personal hygiene and grooming.

5. Appropriate organized programs which include physical activities, and assistance with health, personal hygiene, employment, and employment training programs.

PART III: SUPPORTING INFORMATION

1. Security In the performance of this contract, the Contractor shall take such safety precautions to reasonably protect the lives and health of the Veterans. The Contracting Officer shall notify the Contractor of any noncompliance with the foregoing provisions and the action to be taken.

1. Performance Standards

0. Task: Records and Reports Standard: Daily sign-in sheets signed by Veterans. Individualized Care Plan (ICP) within 14 days of admission, progress notes for each client, documentation of Veteran participation in daily group activities, discharge summaries within 3 days of discharge and entry of Veteran data into HMIS system.

Performance Threshold: 95% of randomly selected cases.

Surveillance Method: Review by Chillicothe VAMC Liaison either randomly or at minimum quarterly.

0. Task: Staffing and Support Services Standard: Facility shall be staffed 24/7, Program Manager shall be available as needed 24/7. Facility shall employ sufficient staff to support Veterans in accomplishing goals outlined in ICP. At least one Key Personnel, certified in cardio-pulmonary resuscitation (CPR) will be on site 24/7.

Performance Threshold: 98% of the time.

Surveillance Method: On-site visits by Chillicothe VAMC Liaison either randomly or at a minimum quarterly.

0. Task: Housing Placement: Homeless Services Scorecard Standard: Contractor will follow the Homeless Services Scorecard provide to them by the VA Chillicothe VAMC Liaison, at the beginning of each fiscal year. Current fiscal year HCHV targets are as follows:

a-Veteran discharges shall be 55% or greater to permanent housing;

b-Veteran discharges shall be 20% or less negative exits (as defined in Homeless Services Scorecard).

Performance Threshold: Level: Veteran Discharges 55% or greater to permanent housing;

and Veteran discharges shall be 20% or less negative exits (as defined in Homeless Services Scorecard).

Surveillance Method: Quarterly data record review by the Chillicothe VAMC Liaison in conjunction with the Contractor.

0. Task: Emergency Housing Facilities & Management Standard: Facility meets or exceeds all requirements of fire, safety, licensure, Veteran privacy, and standards established by the Americans with Disabilities Act.

Performance Threshold: 98% of the time.

Surveillance Method: On-site visits by Chillicothe VAMC Liaison and /or other VA officials, either randomly or at a minimum quarterly.

1. Billing Unless specifically excluded in this contract, the per diem rate established shall include the services listed in the Performance Work Statement (PWS). Payment is authorized from the first day of admission and does not include the day of discharge. If a Veteran is admitted to or discharged from the facility on the same calendar day, payment shall not be authorized. Unauthorized absences from the program shall not be reimbursed. The Contractor shall submit electronic invoices by the 7th of every month.

(End of PWS)

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SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (NOV 2021)

(a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The Government must exercise its post-acceptance rights—

(1) Within a reasonable time after the defect was discovered or should have been discovered; and

(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.

(b) Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any Federal lending agency in accordance with the Assignment of Claims Act (31 U.S.C. 3727). However, when a third party makes payment (e.g., use of the Governmentwide commercial purchase card), the Contractor may not assign its rights to receive payment under this contract.

(c) Changes. Changes in the terms and conditions of this contract may be made only by written agreement of the parties.

(d) Disputes. This contract is subject to 41 U.S.C. chapter 71, Contract Disputes. Failure of the parties to this contract to reach agreement on any request for equitable adjustment, claim, appeal or action arising under or relating to this contract shall be a dispute to be resolved in accordance with the clause at Federal Acquisition Regulation (FAR) 52.233-1, Disputes, which is incorporated herein by reference. The Contractor shall proceed diligently with performance of this contract, pending final resolution of any dispute arising under the contract.

(e) Definitions. The clause at FAR 52.202-1, Definitions, is incorporated herein by reference.

(f) Excusable delays. The Contractor shall be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the Contracting Officer of the cessation of such occurrence.

(g) Invoice.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include—

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, line item number and, if applicable, the order number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice; and

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the…