36C25023Q0759_2.docx

36C25023Q0759 Medical Respite Care Services for Homeless Veterans (HCHV) – Richard L. Roudebush VA Medical Center

GENERAL INFORMATION

Network Contracting Office 10

PO Box 492 Ann Arbor MI 48106

POINT OF CONTACT*

Contract Specialist Cierra S. Joshua Cierra.Joshua@va.gov 734-222-7154

ADDITIONAL INFORMATION

DESCRIPTION

The Richard L. Roudebush VA Medical Center (RLRVAMC), in Indianapolis, Indiana has a need for a contractor who can provide services as part of its community-based Health Care for Homeless Veterans (HCHV) program. The HCHV program s Contract Residential Services (CRS), Medical Respite Care program target and prioritize Veterans experiencing homeless who are transitioning from literal street homelessness, being discharged from institutions, including those in need of medical respite, and who recently became homeless and require safe and stable living arrangements while they seek permanent housing. The VA contemplates making a single award. The government is interested in sources that can provide up to 1 Veteran bed for male, female or transgender patients. The Proposed NAICS Code is 624211, Temporary Shelters The procurement will be solicited utilizing FAR Parts 12, 13 and VAAR 873. This procurement will be for a 12-month base year with four option year renewals.

Special Notice Special Notice All questions shall be submitted in writing AFTER the solicitation is posted via email to Cierra.Joshua@va.gov . No Phone calls or Facsimiles shall be accepted.

Special Notice

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 CONTRA

CT: 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 C

OMMERCIAL SERVICES

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

36C25023Q0759 06-29-2023 Joshua, Cierra S.

734-222-7154 07-20-2023

3PM

EDT

36C250 Department of Veterans Affairs Network Contracting Office 10 P.O Box 492 Ann Arbor MI 48106 X 624221 $12 Million N/A X 36C583 Department of Veterans Affairs Richard L. Roudebush VA Medical Center 1481 West Tenth Street Indianapolis IN 46202-2884 36C250 Department of Veterans Affairs Network Contracting Office 10 P.O 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 X Healthcare for Homeless Veterans (HCHV) Contract Residential Services (CRS), Medical Respite for Richard L. Roudebush, VA Medical Center in Indianapolis, IN. in accordance with the Performance Work Statement (PWS). Please see Price Schedule starting on page 6.

This acquisition will be conducted using the procedures in FAR Part 12, 13 and VAAR 873, utilizing the authority of

38 USC 8153.

This will be a Firm Fixed Price, Indefinite Delivery, Indefinite Quantity (IDIQ) Contract X X 1(one) Michelle C. Ford Contracting Officer Page 1 of Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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):

Unique Entity Identifier (UEI): _____________________________

b. GOVERNMENT: Cierra S. Joshua, Contract Specialist

Michelle C. Ford, Contracting Officer

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 583)

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 PRICE SCHEDULE

The total need is for up to 1 male, female, or transgender beds at any given time. The quantities stated in this price schedule represent the Government’s best estimate, based on historical usage and projected need. Please note that they are only estimates and are not a guarantee of future orders. The contract minimum of any resultant Firm Fixed Price, Indefinite Delivery, Indefinite Quantity (IDIQ) contract will be one (1) day. If no services are utilized, the one bed-night cost will be paid at the LIN 0001 rate. The contract maximum order will not exceed 2,282 Bed-Nights.

Note: This contract is firm fixed price and does not include an economic price adjustment mechanism. In lieu of an EPA clause, the following price schedule contains five distinct price list. Offerors shall price out base year and all option years.

Base Year: September 1, 2023 through August 31, 2024

Option Year 1: September 1, 2024 through August 31, 2025

Option Year 2: September 1, 2025 through August 31, 2026

Option Year 3: September 1, 2026 through August 31, 2027

Option Year 4: September 1, 2027 through August 31, 2028

36C25023Q0759 Medical Respite Care Services for Homeless Veterans (HCHV) – Richard L. Roudebush VA Medical Center

Total Price to include base and all ordering periods for all Services: $_________________ Page 1 of Page 1 of

B.3 PERFORMANCE WORK STATEMENT

HCHV CONTRACT RESIDENTIAL SERVICES (CRS), MEDICAL RESPITE

A. PURPOSE.

The Department of Veteran Affairs Medical Center in Indianapolis, IN (Veteran Health Indiana) seeks contractors to provide services as part of its community-based Health Care for Homeless Veterans (HCHV) program. The HCHV program’s Contract Residential Services (CRS) programs target and prioritize Veterans experiencing homeless who are transitioning from literal street homelessness, being discharged from institutions, including those in need of medical respite, and who recently became homeless and require safe and stable living arrangements while they seek permanent housing.

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 program is to obtain a Contractor within the Veterans Health Administration (VHA) Indiana catchment area that can provide Medical Respite Care (MRC) temporary housing and supportive services in a community-based setting to Veterans with special needs who are experiencing homelessness. The Contractor shall provide a safe and secure environment that supports their therapeutic, rehabilitation goals and discharge to permanent housing.

Services shall be provided to eligible beneficiaries of the Richard L Roudebush, VA Medical Center (RLRVAMC) who may be discharging from the VA Medical Center or preparing for planned medical procedures, requiring stabilization prior to and after hospitalization. The contractor shall be required to provide a low-barrier therapeutic and rehabilitative milieu and attendant services to address medical rehabilitation, while targeting the underlying factors contributing to homelessness. The contractor shall not be required to provide detoxification or other acute level treatment.

C. SERVICES TO BE PROVIDED

I. GENERAL RESPONSIBILITIES: The contractor shall provide sufficient facilities to accommodate 1 male, female, transgender, or non-binary Veteran with residential placement which shall involve:

a. Registered Nurse on-site for no less than 5 hours per week. Additional hours may be necessary, commensurate with the needs of each Veteran.

b. 24 hours/7 days per week medication management.

c. Case management services on-site, provided by qualified personnel who are able to assess and provide referrals and monitoring of mental health conditions, as clinically indicated.

d. 24/7 residential staffing on-site.

e. Additional miscellaneous staffing structure for meeting this level of care, (i.e., nutrition, security, facilities, etc.).

The contracted Medical Respite program will offer services to male, female, transgender, and non-binary Veterans who require respite medical care stabilization due to sickness, injury, and preparation for and/or recovery from inpatient hospital care. It is understood that Veterans to be served under this contract will require care and services above the level of room and board.

The contractor’s staff shall provide therapeutic rehabilitative and recovery services, which shall be determined according to the needs of the Veteran. The intake assessment shall include the identification of the Veteran’s biopsychosocial needs that will inform the development of the Individual Care Plan for the Veteran. A nursing assessment and care plan addressing respite goals shall also be included in the ICP.

Contractor shall be capable of receiving referrals Monday through Friday during business hours of 8am to 4:30pm, excluding Federal holidays. Negative drug screens will not be a requirement for admission.

II. Respite Medical Care: The contractor shall provide Veterans with respite medical and mental healthcare in accordance with the plan of care developed by VA referring healthcare providers. The contractor shall provide an on-site registered nurse (RN), licensed by the state of Indiana and in good standing with their licensing board. The RN shall be onsite no less than 5 hours per week. Additional hours may be necessary, commensurate with the needs of each Veteran.

a. The RN shall provide education and assistance with medication management and treatment compliance within the scope of practice for nursing. The RN will support coordination of care with VA providers and the VA HCHV CRS Liaison to ensure for continuity of care. Veterans will also receive health education in areas such as sleep, nutrition, coping with chronic illnesses and pain management. The RN will monitor vital signs and follow up with VA medical staff as appropriate. Veterans will be assisted with the use of VA telehealth, as needed. When indicated, telehealth equipment will be provided to the Veteran by the VA. The RN shall oversee and assist with coordination of Veteran participation in in-home health care and outpatient services to address varying respite needs (i.e., Physical Therapy, Occupational Therapy, Wound care, etc.).

III. Case Management Services: The contractor shall have a Case Manager assigned to Veteran residents and on-site at least 10 hours per week. Additional hours may be necessary, commensurate with the needs of each Veteran. The Case Manager shall hold a bachelor’s degree and at least 6 months of experience in social services settings. The Contract Case Manager shall be responsible for the intake assessment of Veteran residents to develop a plan of care with consultation of the Veteran and VA staff. Therapeutic and rehabilitative services to be provided include but are not limited to the following:

a. 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 referral to including counseling on self-care skills, adaptive coping skills, financial planning, long-term transitional and permanent housing referrals, written care plan, referral for financial benefits. Additional counseling may include, professional and vocational rehabilitation counseling, in collaboration with VA programs and community resources.

b. Weekly scheduled visits with each Veteran resident and open office hours to discuss progress toward goals established at intake. Case Managers should possess the ability to respond to crisis situations with Veteran residents and provide access to emergency care as needed.

c. All Veterans will be referred for follow up care at the VA as determined by the Individual Care Plan and post-hospitalization discharge plans. Follow up services include but are not limited to Primary Care, Specialty Care, Outpatient Rehab Services, Mental Health, Substance Use Treatment, and Vocational services. Contractor shall support Veterans in making initial and subsequent follow up appointments and assist with coordinating transportation to and from scheduled appointments. Participation and progress made will be documented in the Veterans chart and reviewed in case consultation with the VA Liaison at least monthly.

d. Special attention shall be made to address High Suicide Risk (HSR) Veterans, as identified by VA Medical or Mental Health Staff, or the contracted Case Manager. On a weekly basis the contracted Case Manager will be required to update the VA Liaison on Veteran progress, changes, and/or safety concerns for HSR Veterans. Contracted Case Manager will review 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.

e. Provision of intensive weekly case management services, including assistance with completing and submission of applications for benefits (both VA and non-VA) obtaining necessary identification and records (i.e. birth certificate , DD 2-14, VA ID, state issued ID, etc.), referrals to transitional housing (both VA-GPD and non-VA transitional housing) and permanent housing resources such as Supportive Services to Veteran Families (SSVF), Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) and non-VA housing resources in the community.

f. Instruction in and assistance with health and person hygiene, establishment of income and or financial benefits, and strengthening budgeting skills to increase financial stability.

g. Discharge planning to appropriate transitional or permanent housing, including assistance with completing and submission of applications and referrals, as clinically indicated. This includes offer of referrals and linkages for Veterans that are asked to exit the program prior to successful completion, due to rule violation(s).

h. All contractor staff shall maintain proper documentation verifying services and case management efforts by all team members including but not limited to housing, benefits, and employment services, Case Manager and RN interactions/interventions, and program management staff. There will be an expectation that notes are written professionally in a format that utilizes clear goal setting and progress towards those goals (e.g., SNAP, SOAP, or SMART notes). Upon exit of the program, a discharge plan summarizing services provided during the Veteran’s stay, including Veteran’s engagement and achievement of goals, housing status, discharge placement and location, and aftercare plan will be placed in the Veteran record and available for VA Liaison to review.

i. Submission of required VA documentation to the VA Liaison, such as admission and discharge forms, incident reports, and progress reports will be provided by the Case Manager or designee in accordance with VA policy.

j. Programmatic updates and Veteran progress towards treatment goals will be reviewed during monthly staff meetings between the Contractor staff and the HCHV CRS Liaison.

IV. BASIC SERVICES: The Contractor shall furnish each Veteran resident under this contract with the following basic services:

a. ROOM AND BOARD: The contractor shall be required to provide sufficient facilities to accommodate 1 Veteran resident free of charge and shall be accessible to the Veterans 7 days a week and 24 hours per day. Accommodations will include a bed and other furnishings for clothing and personal properties such as a dresser, storage locker or designated secured space, and personal linens (towels, pillows, blankets and bed sheets, etc.). The contractor shall allow Veterans to store personal belongings for at least 72 hours after formal discharge. The Contractor is responsible for providing a sanitary food preparation area, supply food sufficient for at least three nutritious meals 7 days a week, and snacks of nourishing quality (e.g., fruits, vegetables, protein sources), between meals and bedtime. There will not be more than a 14-hour span between evening meal and breakfast of the following day. Contractor shall provide alternative food options for Veterans with dietary restrictions, if medically indicated (e.g., diabetic, renal, and soft mechanical diets) and reasonable accommodation for Veterans with cultural or religious preferences around food (e.g., Kosher, Sikh, Vegan, etc.). Food shall be prepared, transported, served, and stored under sanitary conditions, in accordance with local, state, and federal guidelines. The facility shall establish and maintain sanitary procedures for washing dishes, cleaning equipment and work areas, and disposing of waste. Sub-contracted food service providers will be subject to the same guidelines.

b. 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.

c. HOUSING SERVICES: 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 and 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 Detainer, evictions, etc.). Should Veteran refuse to engage with program staff regarding plans for housing transition, motivational interviewing, trauma informed care, 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 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:

· Assistance obtaining and reviewing Veteran’s free credit report, identifying housing strengths and/or barriers associated with current credit status

· 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.

· Reviewing and applying to affordable permanent housing options and Permanent Supportive Housing (PSH) program offerings, and assisting Veterans with making appropriate inquiries and submitting completed referrals to permanent housing programs

· Ensuring Veterans are enrolled in HMIS and entered into the Veteran Coordinated Entry System in order to access housing resources such as Housing and Urban Development-VA Supportive Housing (HUD-VASH), Contract Emergency Residential Services (CERS) and Grant and Per Diem (GPD).

· Conducting regular and individualized housing advocacy efforts, including transportation, assistance scheduling, meeting, and communicating with transitional housing programs, property managers and landlords, and engage in troubleshooting where referral, rental barriers or denials occur in the housing search process All housing efforts by Contractor shall be documented in the chart clearly and timely and will be presented to VA Liaison and/or inspection team 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.

d. FINANCIAL PLANNING: Referral to and follow up on all potential financial resources the Veteran may be eligible for (e.g., SSI, SSDI, Food Stamps, VA NSC pension, VA Disability, General Assistance, 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 activities appropriate to the Veterans individual circumstance must be documented monthly.

e. EMPLOYMENT SERVICES: Referral to all relevant employment and training opportunities the Veteran is eligible for and interested in will occur on a regular basis, as clinically indicated. Case managers will document all structured activities that support each Veteran in applying for employment or training opportunities, as appropriate, based on needs of the Veteran, as identified in the ICP.

f. RECOVERY: Support for an alcohol/drug abuse-free lifestyle should be 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. The contractor shall ensure that illicit drugs as defined by the federal government, drug paraphernalia, and alcohol are not permitted on the premises.

g. OCCUPANCY: It is expected that Contractor beds will be maintained at an average minimum of a 75% occupancy rate as calculated based upon number of bed nights available per month. 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 in consultation with the Contracting Officer and VA Liaison. Adjustments in contract funding may occur through modifications if occupancy is not maintained. Failure to maintain year to date occupancy rate at or above 75% may be grounds for immediate termination for convenience.

h. COMMUNITY ENGAGEMENT: Contractor shall collaborate and remain engaged with referral sources and other Veteran homeless service providers within the continuum of care. This will include coordinating admissions and discharges and participating in required staffing and case conferencing meetings.

i. DISCHARGE PLANNING: Permanent housing will be the primary discharge goal for every Veteran. All Veterans must have a discharge plan within one week of admission. Although discharge planning should have primary goals of permanent housing, referrals to lower levels of care may be required, based on the Veteran’s clinical needs and housing readiness. Transitional housing referrals may include VA Grant Per Diem (GPD) housing programs, community transitional housing programs, residential inpatient programs, and/or other Contracted Residential Services programs. Compliance with all VA regulations regarding discharges and timeliness of reporting is required of contractor. Case Manager 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., Homeless Management Information System (HMIS) ID number or encryption). Required paperwork required for discharging a Veteran from any HCHV program is also required within 24 business hours from known discharge. 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 shall include the VA Liaison prior to discharge. All Veterans scheduled for negative discharge based on behavior must be offered an opportunity to meet with the treatment team and work to determine the most therapeutic alternative temporary housing option for Veteran. This does not include violations for safety reasons. Please note: Profanity does not in and of itself constitute to 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 for improvement. All discharges are subject to the contractor’s 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 or designee in order to schedule an appeal.

j. GRIEVENCE PROCEDURES: Programs shall 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.

k. INTAKE PACKETS: All Veterans must receive an intake packet within 72 business hours of admission, which includes at minimum, the following information:

· Description of the contractor’s services

· Grievance policy

· Emergency procedures

· Rights and responsibilities

· Reasonable accommodation

l. EXTENSIONS- All extensions beyond 90 days must be requested in writing and approved by VA Liaison or designee.

m. MEDICATION MANAGEMENT: Medications and narcotics shall be properly stored, controlled, issued and recorded in compliance with physician’s orders. Contractor shall establish procedures for ensuring Veterans’ confidentiality in the storage of and record keeping of medications. 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:

· 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.

· Storing an individual’s MAT medication in a lock box in the program and having the individual be personally responsible for it.

· 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).

n. 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.

o. CRITICAL INCIDENT REPORTING: All critical incidents will be reported as soon as possible and no later than 24 hours. This includes the following:

i. Falls with injury

ii. Assault (to Veteran or Staff)

iii. Elderly/Dependent Adult Abuse or Neglect

iv. Sexual Assault

v. Fire (Veteran Involved)

vi. Medical/Psychiatric Emergency (911 Calls)

vii. Hospitalization

viii. Suicide or Suicide Attempt

ix. Homicide

x. Death

xi. Infectious Control (COVID-19, TB, etc.)

xii. Active Substance Abuse

xiii. Observation/ Possession of Weapons

xiv. On-site arrest of a Veteran by law enforcement The Contractor shall notify the authorizing VA Liaison or designee immediately of any incidents involving Veterans residing in the HCHV CRS program. When a medical emergency occurs that requires immediate medical attention, it is agreed that the Veteran will be transported 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 medical attention of a non-emergent nature is required, it is agreed that the Veteran will present to the appropriate VA facility promptly. The contractor shall make arrangements for admission and support the Veteran with any transportation issues that may arise to address the emergency.

The Contractor shall notify the VA Liaison of all incidents, emergent and non-emergent requiring medical care by telephone during the hours of 8:00am and 4:00 pm. For all incidents that occur after normal business hours, the Contractor should notify the VA Liaison the following business day. The Contractor shall provide the VA Liaison 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.

V. DOCUMENTATION: The Contractor shall provide treatment and discharge planning reflecting a team assessment of medical, social, and vocational needs and the involvement of the Veteran, VA staff and appropriate community resources in resolving problems and setting goals. An individual case record shall 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 shall 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:

i. Reasons for referral

ii. 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

iii. 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

iv. Nursing, Case management, and Mental Health notes written in a professional manner (i.e., SMART, SOAP, SNAP) will include the following: 1) A written and comprehensive Assessment, 2) Individual Care Plan 3) Financial Plan, 3) Discharge Plan, 4) documented progress and activity towards identified goals.

v. QASP Compliance Tool and all attendant supporting documentation demonstrating contractor compliance with contract

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

vii. Extension approval if relevant

viii. Waivers as appropriate

VI. 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 shall be provided a copy of the rules at intake or upon Veterans request. In addition, Contractor shall 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.

a. 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 shall 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 shall include:

i. Immediate contact with VA liaison

ii. 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

iii. Notice of, and access to, formal appeal procedures

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

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

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

D. ADDITIONAL CONTRACT REQUIREMENTS

I. PERSONNEL: The Contractor shall 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 shall 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 PWS.

a. Staff Training: Contractor shall 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.

i. CPR

ii. First Aid

iii. Crisis intervention

iv. Cultural sensitivity and Diversity, Equity, and Inclusion

v. Sexual harassment

vi. Universal Precautions (disease transmission prevention)

vii. Elder/Dependent Adult abuse reporting laws

viii. Harm Reduction philosophy

ix. Narcan

x. Housing First

xi. Suicide assessment and prevention (S.A.V.E. training)

xii. Medication management (for staff assigned to this duty)

xiii. State and Federal Fair Housing Law and ADA Requirements

xiv. Conflict resolution

xv. De-escalation and disruptive behavior management techniques

xvi. Confidentiality and privacy requirements.

Contractor shall perform criminal background checks on all staff members. Contractors shall agree not to hire staff members who are 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 fifteen (15) calendar 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 shall 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. 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.

When a Veteran is admitted to a HCHV CRS program and found to be ineligible for HCHV CRS, VA will pay for a maximum of 4 days from the day of admission to allow the provider and HCHV CRS Liaison time to locate and arrange alternate placement.

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 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 by the VA.

The initial stay for a Veteran should be no longer than 90 days. Any extension of the stay after 90 days must be authorized by the VA Liaison or designee, provided that there is clear clinical indication and availability of funds.