36C25518R0327-014.docx

B.6 QUALITY ASSURANCE SURVEILLANCE PLAN

Contractor’s name: Mental Health Association For: Emergency Housing HCHV services

1. PURPOSE

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

What will be monitored?

How monitoring will take place?

Who will conduct the monitoring?

How monitoring efforts and results will be documented?

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

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

2. GOVERNMENT ROLES AND RESPONSIBILITIES

The following personnel shall oversee and coordinate surveillance activities.

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

Assigned CO: Kathleen Sciortino Organization or Agency: Network Contracting Office 15 Email: Kathleen.sciortino@va.gov Phone: (678) 365-6599

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

Assigned Primary COR: Patrick Murray Organization/Agency: Kansas City VAMC Email: John.Murray8@va.gov Phone: (816) 812-7568

Assigned Alternate COR: Cara Hall Organization/Agency: Kansas City VAMC Email: Cara.Hall1@va.gov Phone: (816) 812-7052

3. CONTRACTOR REPRESENTATIVES

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

1. Program Manager – Sondra Robinson

1. Other Contractor Personnel -

4. PERFORMANCE STANDARDS

1. Performance standards define desired services. The Government performs surveillance to determine if the contractor exceeds, meets, or does not meet these standards.

1. The Performance Work Statement includes performance standards. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the Acceptable Quality Level (AQL).

ID

Location in PWS

5.2.3.10

(2) behavioral health technician or certified nursing aide, or certified medication tech during the evening shift (3p.m.-11p.m.), and during the overnight shift (11p.m.-7 a.m.)

(7) days a week, and twenty-four (24) hours daily. One (1) Staff Member must be on the premises at all time.

5.3.1-5.3.17 5.4

5.2.3 5.2.3.5

Patient Safety

Contractor must have clear protocol for risk assessment and management r. Contractor will implement a risk assessment for Veterans who my cause any danger or harm to themselves or others immediately and provide the assessment to the COR.

6.1-6.4

7.1 3.1

The Contractor shall provide discharge planning and referrals for each Veteran, regardless of character of discharge from the facility, to appropriate community resources and services based upon a team assessment of health, social and vocational needs and the involvement of Veterans’ families as appropriate.

8.1

Contractor will seek extension of BDOC for Veterans approaching end of initial referral period or prior approved BDOC.

5.2.3.5 5.2.3.1 5.2.3.2 5.2.3.3

Veterans will have Individualized Service Plan entered into individual case record within the first two weeks of program admission Review ISP a minimum of every thirty (30) days thereafter in a clinical meeting with the Veteran.

16.1 16.2

PWS says: All contractor employees and subcontractor employees requiring access to VA information and VA information systems shall complete the following before being granted access to VA information and/or its systems:

Contractor will make reasonable efforts to discharge Veterans to permanent housing.

5. INCENTIVES

The Government shall use Favorable Past Performance reports to the Contractor’s performance as incentives. Incentives shall be based on exceeding, meeting, or not meeting performance standards.

6. METHODS OF QA SURVEILLANCE

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

a. VALIDATED USER/CUSTOMER COMPLAINTS. ID 3

b. 100% INSPECTION. (Evaluates all outcomes.) ID 1, 2,

c. RANDOM INSPECTION (Random sample of documents for review)

7. RATINGS

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

a. Exceeds Standard

b. Meets Standard

c. Failed to meet Standard

8. DOCUMENTING PERFORMANCE: The Government shall document positive and/or negative performance. Any report may become a part of the supporting documentation for any contractual action to include the annual past performance using CONTRACTOR PERFORMANCE ASSESSMENT REPORT (CPAR).

EXCEPTIONAL: Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Note: To justify an Exceptional rating, you should identify multiple significant events in each category and state how it was a benefit to the GOVERNMENT. However a singular event could be of such magnitude that it alone constitutes an Exceptional rating. Also there should have been NO significant weaknesses identified.

VERY GOOD: Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Note: To justify a Very Good rating, you should identify a significant event in each category and state how it was a benefit to the GOVERNMENT. Also there should have been NO significant weaknesses identified.

SATISFACTORY: Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Note: To justify a Satisfactory rating, there should have been only minor problems, or major problems the contractor recovered from without impact to the contract. Also there should have been NO significant weaknesses identified.

MARGINAL: Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

Note: To justify Marginal performance, you should identify a significant event in each category that the contractor had trouble overcoming and state how it impacted the GOVERNMENT. A Marginal rating should be supported by referencing the management tool that notified the contractor of the contractual deficiency (e.g. Management, Quality, Safety or Environmental Deficiency Report or letter).

UNSATISFACTORY: Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Note: To justify an Unsatisfactory rating, you should identify multiple significant events in each category that the contractor had trouble overcoming and state how it impacted the GOVERNMENT. However, a singular problem could be of such serious magnitude that it alone constitutes an unsatisfactory rating. An Unsatisfactory rating should be supported by referencing the management tools used to notify the contractor of the contractual deficiencies (e.g. Management, Quality, Safety or Environmental Deficiency Reports, or letters).

9. FREQUENCY OF MEASUREMENT

1. Frequency of Measurement: During contract performance, the COR will periodically analyze whether the negotiated frequency of surveillance is appropriate for the work being performed. Reports will be completed on a quarterly basis and a copy will be provided to the contractor.

1. Frequency of Performance Assessment Meetings: The COR shall meet with the contractor quarterly to assess performance and shall provide a written assessment.

Acknowledgement by:

Name:

Title:

Signature:

Date:

Cc: Kathleen Sciortino, NCO 15