36C25718Q9874-004.pdf

Quality Assurance Surveillance Plan (QASP)

For: Emergency Residential Transitional services for VA authorized homeless Veterans

Contract Number: <Government will enter number upon award>

Contract Description: Contractor shall provide rapid placement in a supportive, residential setting to Veterans referred by the South Texas Veterans Healthcare System in need of emergency transitional housing, food, supportive services, case management and community referrals.

Contractor’s name:

1. PURPOSE

a. 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

b. 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.

c. This QASP is a “living document” and the Government may review and revise it on a regular basis.

However, the Government shall coordinate changes with the contractor. Copies of the original QASP and revisions shall be provided to the contractor and Government officials implementing surveillance activities.

2. GOVERNMENT ROLES AND RESPONSIBILITIES

The following personnel shall oversee and coordinate surveillance activities.

a. Contracting Officer (CO) - The CO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United

States in the contractual relationship. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment under this contract. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance.

Assigned CO: Jennifer Salerno-Diciuccio

b. Contracting Officer’s Representative (COR) - The COR is responsible for technical administration of the contract and shall assure proper Government surveillance of the contractor’s performance. The

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

Assigned COR:

c. Other Key Government Personnel –

3. CONTRACTOR REPRESENTATIVES

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

a. Program Manager - <Offeror will enter name(s) upon award>

b. Other Contractor Personnel - <Offeror will enter name(s) upon award>

4. PERFORMANCE STANDARDS

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

b. The Performance Requirements Summary Matrix below includes performance standards. The

Government shall use these standards to determine contractor performance and shall compare contractor performance to the Acceptable Quality Level (AQL) on a quarterly basis.

c. Contractor will be held to the same standard as VA personnel through quality assurance and performance monitoring to ensure compliance under this Contract. The Quality Assurance and

Performance Monitoring will be governed by the appointed COR who will be responsible for verifying compliance with the terms and conditions of the contract. After the contract is awarded, any incidents as evidenced by the monitoring procedures will be forwarded immediately to the Contracting Officer. In addition, the COR will forward the summary evaluation of the contractor performance to the Contracting

Officer once performance ends.

Item Task Indicator Standard

Acceptable

Quality

Level

Method of

Surveillance

Provide transitional housing

Veterans are provided emergency residential housing and transitional services.

Treatment services provided in agreement with the established plan of care developed at in-take

100% Observation and random inspection

Case

Management

Services

Ability to receive and place

Veterans on short-term notice

Contractor shall provide rapid, often times same day residential placement

95% Observation and random inspection

Compliance in completing progress reports as directed by

COR or other HCHV staff

Contractor provides Progress

Reports in the delineated format and in accordance with timelines established by the COR

95%

Review and

Evaluation of all

Required Reports

Scheduled visits with each

Veteran and designated open office hours

Contractor shall schedule open office hours and periodic visits with each Veteran to discuss progress towards discharge goals

95%

Observation and

Veteran queries/ complaints

Discharge Planning

Contractor conducts discharge planning with Veterans and in collaboration with VA HCHV case manager and submits plan to

VA HCHV case manager, COR and HPC upon actual discharge of

Veteran.

95%

Periodic Review and Evaluation of

Discharge Plans

Supportive

Services

Transportation

Veterans receive timely transportation to and from VA and community medical appointments

95%

Observation and

Veteran queries/ complaints

Storage, monitoring, issuance, and documentation of prescription drugs

Contractor will safeguard VA prescribed medications for

Veterans and issue them for self-administration at the prescriptive times. A log of medications management will be kept.

100%

Observation and random inspection of documentation

Opportunities for Veterans to participate in spiritual worship

Contractor will have onsite worship services and/or provide transportation for Veterans to attend worship services offsite

80%

Observation and

Veteran queries/ complaints

4 Housing

Safe, clean, and sanitary housing for all Veteran residents

Contractor provided room and board shall include a minimum per Veteran of one single bed, storage space, and one dresser;

indoor lounging/recreation area, and self-service laundry 95%

Observation and

Veteran queries/ complaints

Acceptable

Quality

Level

Method of

Surveillance

Records and

Reports

Client record for each

Veterans resident

Client records will include all information required in accordance with the SOW and be updated as necessitated by

Veteran progress

95%

Observation and random inspection of documentation

Dietetic

Services

The dietary needs of all

Veteran residents shall be met in accordance with sound nutrition consistent with

USDA standards.

Veteran residents shall be provided three nutritious meals and two snacks per day; Food shall be prepared, served, and stored under sanitary conditions

95%

Observation and

Veteran queries/ complaints

Qualifications/

Accreditation/

Licensing of

Contractor Staff

Contract shall provide sufficient staff in the number and position with the qualifications necessary to meet the Statement of Work and State guidelines.

Contractor shall possess State

Business License; Any licensed professional staff shall be certified or licensed by the state.

100% Observation and random inspection

8 Facility

Contractor facility conformance to all state and federal requirements as pertains to licensing, safety, and health codes.

Per the SOW, facility shall:

maintain conformance to all city, county, state and federal licensing requirements and health codes; meet Fire Safety and Joint Commission standards; have a current occupancy permit; meet ADA requirements

95% Periodic

Inspections

Acceptable

Quality

Level

Method of

Surveillance

Veteran

Resident Safety

Identification, Reporting, and

Resolution of facility safety

Issues

All identified safety issues shall be investigated immediately and corrected in a timely manner appropriate for the incident.

95%

Observation, random inspection, and Veteran queries/ complaints

Identification, Reporting, and

Resolution of Veteran safety

Incidents

Any incident involving an injury or severe illness to a

Veteran shall be reported immediately after occurrence to the COR and HPC. Notification shall be via telephone and/or e-mail with a follow-up written report provided within 24 hours.

95%

Observation, random inspection, and Veteran queries/ complaints

Patient

Satisfaction Patient Complaints

All patient complaints regarding quality of care are reported to the COR and HPC within 24 business hours

95% Veteran queries/ complaints

5. METHODS OF QA SURVEILLANCE

Various methods exist to monitor performance. There will be quarterly meetings held with the Contractor to discuss any issues. In addition, the COR shall use the following surveillance methods in the administration of this QASP:

a. Observation. Observations will be taken during any and all site visits by any HCHV or VA staff

(items 1-7, 9).

b. Veteran Queries and Complaints. HCHV staff relies on the Veteran to identify deficiencies.

Veterans will be queried as to the services being provided to them. Any identified concerns or complaints are then investigated and validated (items 2, 3, 4, 6, 9, 10).

c. Random and Periodic Inspection. Inspections will be accomplished randomly and no less than once per year (items 1, 2, 3, 5, 7, 8, 9).

d. Report Reviews/Evaluations. Reviews and Evaluations of required reports will be conducted as received. Deficiencies will be noted and communicated to the Contractor for corrective action (items 2, 3, 9).

6. DOCUMENTING PERFORMANCE

a. The Government shall document positive performance. Any report may become a part of the supporting documentation for any contractual action.

b. When unacceptable performance occurs, the COR shall inform the contractor within three (3) days of the unacceptable performance. This will normally be in writing unless circumstances necessitate verbal communication, in which case the notification will occur within one (1) day. In any case the COR shall document the discussion and place it in the COR file.

c. When the COR determines formal written communication is required, the COR shall prepare a

Contract Discrepancy Report (CDR), and present it to the contractor's program manager.

d. The contractor shall acknowledge receipt of the CDR in writing. The CDR will specify if the contractor is required to prepare a corrective action plan to document how the contractor shall correct the unacceptable performance and avoid a recurrence. The CDR will also state how long after receipt the contractor has to present this corrective action plan to the COR. The Government shall review the contractor's corrective action plan to determine acceptability.

e. Any CDRs may become a part of the supporting documentation for any contractual action deemed necessary by the CO. In addition, any performance that is below the standards set-forth in Section 4 may subject the Contractor to the termination for default provision or result in non-exercise of any future option periods.

Sample CDR can be found below.

CONTRACT DISCREPANCY REPORT

1. CONTRACT NUMBER 2. REPORT NUMBER FOR THIS DISCREPANCY

3. TO: (Contracting Officer) 4. FROM: (Name of COR)

5. DATES

a. CDR PREPARED b. RETURNED BY CONTRACTOR: c. ACTION COMPLETE

6. DISCREPANCY OR PROBLEM (Describe in detail. Include reference to PWS Directive; attach continuation sheet if necessary.)

7. SIGNATURE OF COR Date:

8. SIGNATURE OF CONTRACTING OFFICER Date:

9a. TO (Contracting Officer) 9a. FROM (Contractor)

10. CONTRACTOR RESPONSE AS TO CAUSE, CORRECTIVE ACTION AND ACTIONS TO PREVENT RECURRENCE.

(Cite applicable quality control program procedures or new procedures. Attach continuation sheet(s) if necessary.)

11. SIGNATURE OF CONTRACTOR REPRESENTATIVE Date:

12. GOVERNMENT EVALUATION. (Acceptance, partial acceptance, reflection. Attach continuation sheet(s) if necessary.)

13. GOVERNMENT ACTIONS (Acceptance, partial acceptance, reflection. Attach continuation sheet(s) if necessary.)

14. CLOSE OUT

NAME TITLE SIGNATURE DATE

CONTRACTOR

NOTIFIED

COR

CONTRACTING

OFFICER

7. FREQUENCY OF SURVEILLANCE.

a. Frequency of Surveillance. During contract performance, the COR will periodically analyze whether the negotiated frequency of surveillance is appropriate for the work being performed.

b. Performance Assessment Meetings. The COR shall meet with the contractor Quarterly to assess performance and shall provide a written assessment.

Signature – Contractor Representative

<Government will enter name upon award>

Signature – Contractor Representative

<Government will enter name upon award>

Signature – Contracting Officer’s Representative

Signature – Contracting Officer/Contracting Specialist

Jennifer Salerno-Diciuccio