36C25723Q0664_1.docx

36C25723Q0664

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

36C25723-AP-2829

36C25723Q0664 10-18-2024 Carolyn Reneau, Contract Specialist 214-836-0603 11-17-2023 02:00pm

CDT

36C257 Department of Veterans Affairs VHA RPO West – NCO 17 Health Care Resources 11495 Turner Rd El Paso

TX

79936-1372 Carolyn Reneau 214-836-0603 Carolyn.reneau@va.gov X 624221 $13.5 Million Net 30 days N/A X 36C671 Department of Veterans Affairs South Texas Veterans Health Care Service 7400 Merton Minter San Antonio

TX

78229 36C257 See Block 9

36C104 Financial Services Center (FSC) Department of Veterans Affairs Submit invoices IAW VAAR 852.232-72 P.O. Box 149971 Austin, TX

78714-8971

(877) 353-9791

(512) 460-5540 See CONTINUATION Page Contractor shall provide housing, case management services, And rehabilitative services within the city of San Antonio for Veterans experiencing homelessness and/or chronic homelessness including Veterans diagnosed with severe mental illness and substance use disorders, in community-based residential facilities.

Estimated quantity of 41 beds per night, 365 days a year.

Schedule of supplies and Statement of Work starts on pages 6 - 27.

Authority:38 U.S.C. §8153-Sharing of Health-Care Resources Procedures: VAAR 873 Simplified Acquisition Procedures for Health-Care Resources See FAR 52.212-1 for submittal Instructions on Pages 48-51 See CONTINUATION Page X X X Carlos Jaquez, Contracting Officer

VA-VHA-2020-534D2907

Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

Contract Administration: All contract administration matters will be handled by the following individuals:

1. CONTRACTOR (Offerors are required to designate a person for prompt contract administration):

Point of Contact:

Title:

Phone:

Email:

2. GOVERNMENT: The Contracting Officer/Contract Specialist for Administration named below is responsible for the overall administration of the contract.

The Contractor is advised that only the Contracting Officer, acting within the scope of the contract and his/her duties and responsibilities and, after advice and consultation with the Contracting Officer's Representative (COR), has the authority to make changes which effect contract prices, quality, quantity, delivery terms and conditions, or the term of the contract.

In no event, shall any understanding or agreement, modification, change order, or other matters in deviation from the terms of this contract between Contractor and a person other than the Contracting Officer, be effective or binding upon the Government. All such actions must be formalized by the proper contractual document executed by the Contracting Officer.

3. CONTRACTING OFFICER'S REPRESENTATIVE: Prior to contract award, the Contracting Officer will designate a VA Medical Center employee as COR. All work coordination shall be made through the COR. The Contractor shall be provided a copy of the letter of delegation authorizing the COR at the commencement of the term of this agreement. No other person shall be authorized to act in such capacity unless appointed in writing by the Contracting Officer.

4. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the Contractor will be made in accordance with:

5. INVOICES: Invoices shall be submitted in arrears:

6. GOVERNMENT INVOICE ADDRESS: All invoices from the Contractor shall be 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. Currently Invoicing information is located at http://www.fsc.va.gov/einvoice.asp.

For inquires only:

7. POST AWARD ORIENTATION: The Contracting Officer will schedule a post award orientation for contract orientation purposes as required by VA Acquisition Manual, Part M842.502-70. (If Applicable)

8. SECURE 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 other 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.

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.

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

(End of Administration Data)

B.2 SCHEDULE OF SERVICES

B.2 SCHEDULE OF SERVICES

The Contractor shall provide housing, case management services, and rehabilitative services within the city of San Antonio for Veterans experiencing homelessness and/or chronic homelessness as defined by the U.S. Department of Housing and Urban Development (HUD), including Veterans diagnosed with severe mental illness and substance use disorders, in community-based residential facilities.

Contract Type:

The Government contemplates award of a Fixed-Price (FP), Indefinite Delivery Indefinite Quantity (IDIQ) contract resulting from this solicitation.

Place of Performance:

At Contractor’s Facility within the city of San Antonio, Texas.

Pricing Instructions:

Pricing information shall be submitted as a fixed price, per diem, per veteran rate. The quoted rate shall be submitted as an all-inclusive unit price per day (including all labor, incidental costs, and insurance premium payments for applicable insurance coverage) for the base and all option periods. Costs not incorporated into the Contractor’s price will not be reimbursed by the Government.

Estimated Quantities:

Quantities on the Schedule of Services are the yearly projected amounts. Contractual minimum and maximum: the guaranteed minimum contract amount, including the base year and any option years exercised, is $10,000.00 and the maximum contract amount, including the base year and any option years exercised, shall not exceed $10,000,000.00. The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum award amounts.

Orders:

Orders shall be placed against this IDIQ contract at the time of contract award, and as needed during the term of the contract. The Task Orders shall specify the estimated quantities of services for the period of performance and shall comply with FAR 52.216-18 and 52.216-19.

Ordering Procedures:

Only the Contracting Officer may place orders against resultant IDIQ contracts following this solicitation. Any changes to the below schedule of services shall only be made via written modification that is formally executed by the Contractor and Contracting Officer.

Note:

As part of price evaluation, the Government will evaluate its option to extend services (see FAR Clause 52.217-8). The evaluation will assume that the prices for any option exercised under FAR 52.217-8 will be at the same rates as those in effect under the contract at the time the option is exercised. The evaluation will therefore assume that the addition of the price or prices of any possible extension or extensions under FAR 52.217-8 to the total price for the basic requirement and the total price for the priced options has the same effect on the total price of all offer/bids relative to each other, and will not affect the ranking of offer/bids based on price, unless, after reviewing the offer/bids, the Government determines that there is a basis for finding otherwise. This evaluation will not obligate the Government to exercise any option under FAR 52.217-8.

Period of Performance:

Base Year: January 1, 2024 to December 31, 2024

Option Year One: January 1, 2025 to December 31, 2025

Option Year 2: January 1, 2026 to December 31, 2026

Option Year 3: January 1, 2027 to December 31, 2027

Option Year 4: January 1, 2028 to December 31, 2028

Grand Total: $___________________________

(End of Schedule of Services)

B.3 STATEMENT OF WORK

The statement of work is included as an attachment.

B.3 STATEMENT OF WORK

1) PURPOSE: CONTRACT RESIDENTIAL SERVICES.

The South Texas Veterans Health Care System (STVHCS) through its Health Care for Homeless Veterans (HCHV) program, is seeking 24-hour-per-day, 7-day-per-week (24/7) community based, recovery model, supportive housing within the city of San Antonio, that provides therapeutic and rehabilitative services in a safe environment to homeless, eligible Veterans. Contractor shall provide housing, case management services, and rehabilitative services within the city of San Antonio for Veterans experiencing homelessness and/or chronic homelessness as defined by the U.S. Department of Housing and Urban Development (HUD), including Veterans diagnosed with severe mental illness and substance use disorders, in community-based residential facilities.

2) BACKGROUND.

The Department of Veterans Affairs (VA) has been providing direct and specialized services for homeless Veterans for over thirty years. As part of the Plan to End Homelessness among Veterans announced in late 2009, the Veterans Health Administration (VHA) has been increasing both capacity of existing programs and services offered to program participants. The central goal of HCHV programs is to reduce homelessness among Veterans by conducting street outreach to Veterans who are homeless or experiencing housing instability and need case management assistance to end their homelessness and connect to community-based and VA-supported housing services, VA health care and other supportive services. In addition to outreach services, HCHV programs provide care, treatment, and rehabilitative services, including case management and therapeutic transitional housing assistance by contracting with community providers. The HCHV program is authorized by 38 U.S.C. 2031, 7301 (b) under which VA may provide “care and services under section 1710 of this title to Veterans suffering from serious mental illness and to Veterans who are homeless.” The Contract Residential Services (CRS) program is governed by the Health Care for Homeless Veterans Contract Residential Services Program VHA Directive 1162.04. The duties of, and standards applicable to, non-VA, community-based providers are authorized by 38 U.S.C. 501, 2031, and 63, and by 38 CFR Part 61.

STVHCS is seeking a Contractor to provide residential treatment services through the HCHV CRS program. STVHCS intends to award a Fixed Price, Indefinite Delivery Indefinite Quantity (IDIQ) contract to serve Veterans in San Antonio, Texas. The VA is only able to pay for services provided to Veterans themselves. The estimated quantity for this contract is Forty-One (41) beds for homeless Veterans in need of placement in a safe environment with onsite therapeutic support services. Many of these Veterans have co-morbid conditions that include serious mental illnesses, substance abuse disorders, and other medical conditions. The goal of the HCHV CRS CERS program is to stabilize Veterans’ mental health, substance abuse and other psychosocial problems in order to facilitate transition into permanent housing within no more than 180 days. Contractor shall provide placement of VA-referred Veterans (hereinafter referred to as Veterans) in a safe, residential setting while addressing Veterans’ complex needs through on-site case management and therapeutic support services. This housing must meet the criteria established by both HCHV clinical staff and VA fire and safety officials.

Definitions:

Contracted Residential Services (CRS). Services funded through HCHV to address the causes and effects of homelessness in a community-based setting that provides direct services in a safe environment that supports recovery and meets the needs of homeless Veterans. Where applicable, every effort must be made to ensure that community-based settings are equipped to provide for the safety and privacy of homeless women Veterans referred for residential services.

Contracted Emergency Residential Services (CERS). One of two CRS programs, CERS programs target and prioritize homeless Veterans transitioning from literal street homelessness, Veterans being discharged from institutions, including those in need of medical respite or recuperative care and Veterans who recently became homeless and require safe and stable living arrangements while they seek permanent housing. CERS Programs, either directly or through linkage with community and other VA services, provide time-limited services such as supporting mental health stabilization, substance use disorder (SUD) treatment services, enhancement of independent living skills, vocational training, and employment services. Emphasis is placed on referral and placement in permanent housing or longer-term residential programs utilizing VA and/or community resources. Lengths of stay in CERS typically range from 30 to 90 days with the option to extend based on clinical need.

Recovery Model. The recovery model is centered on the belief that it is possible for homeless Veterans with mental health conditions to re-establish normal roles in the community. The recovery model fully supports community integration and improved quality of life for Veterans who have been diagnosed with a serious mental health condition that impairs their ability to lead meaningful lives. Within this model, psychiatric rehabilitation services are collaborative and encourage the Veteran’s self-determination.

Bridge Housing. Bridge housing is transitional housing used for a short-term stay, usually 90 days or less, when a Veteran has been offered and accepted a permanent housing intervention (e.g., Housing and Urban Development – Veterans Affairs Supportive Housing (HUD-VASH), Supportive Services for Veterans Families (SSVF), Housing Coalition or other permanent housing option), but is not able to immediately enter the permanent housing.

Chronically Homeless. The HCHV programs follows the definition of “chronically homeless” in 42 U.S.C. § 11360(9) of the McKinney-Vento Homeless Assistance Act, 42 U.S.C. § 11302(a). NOTE: The term “homeless" or "homeless individual" does not include any individual imprisoned or otherwise detained pursuant to an Act of Congress or a State law.

Electronic Health Record. Electronic health record (EHR) is the digital collection of patient health information resulting from clinical patient care, medical testing, and other care-related activities. Authorized VA health care providers may access EHR to facilitate and document medical care. EHR comprises existing and forthcoming VA software including Computerized Patient Record System (CPRS), Veterans Information Systems and Technology Architecture (VISTA) and Cerner platforms. NOTE: The purpose of this definition is to adopt a short, general term (EHR) to use in VHA national policy in place of software-specific terms while VA transitions platforms.

Homeless Operations Management and Evaluation System. HOMES is VA’s primary platform for collecting intake, progress, and outcome information for homeless Veterans as they move through VA’s system of care. NOTE: For more information about HOMES and its policies, see https://vaww.homes.va.gov/VAHomesNew.aspx. This is an internal VA website that is not available to the public and access is restricted to VHA Homeless Programs staff with documentation or review status.

Homeless Veteran. The HCHV programs follows the definitions of “homeless Veteran” in 38 U.S.C. §§ 2002(1) and 103(a) of the McKinney-Vento Homeless Assistance Act, 42 U.S.C. § 11302(a). NOTE: The term “homeless" or "homeless individual" does not include any individual imprisoned or otherwise detained pursuant to an Act of Congress or a State law.

Performance Work Statement/Statement of Work. A PWS or SOW is a document that clearly describes the performance objectives and standards that are expected of the contractor in a government contract.

Quality Assurance Surveillance Plan. A Quality Assurance Surveillance Plan (QASP) is a systematic method to evaluate performance for the stated contract. The QASP identifies what is going to be inspected, the inspection process and who will do the inspecting. The results of those inspections shall then be used to document contractor performance.

Service Animal. Under the ADA, a service animal is defined as a dog that has been individually trained to do work or perform tasks for an individual with a disability. The task(s) performed by the dog must be directly related to the person's disability. Frequently Asked Questions about Service Animals and the ADA | ADA.gov

3) ORDERING ACTIVITIES AND OFFICERS.

a) VA shall designate a Contracting Officer Representative (COR) to monitor the contract performance and assist in contract administration. Upon contract award, a Delegation of Authority Memorandum delineating the responsibilities and limitations of the COR shall be provided to Contractor. Any commitments of changes, which affect the price, quantity, quality, or authority to amend or render a decision on questions of the fact in dispute, and related contract administration problems, are duties of the Contracting Officer and cannot be delegated to the COR.

b) Contractor shall not accept any instructions issued by any person(s) other than the Contracting Officer or the COR acting within the limits of his/her authority. Only those services specified herein are authorized. Before performing any service of a non-contract nature, Contractor shall advise the Contracting Officer of the reasons for additional work. Changes to the contract may be made only in writing by the Contracting Officer.

4) BASIC SERVICES REQUIRED OF CONTRACTOR.

a) PROGRAM REQUIREMENTS: Contractor must provide Contracted Emergency Residential Services (CERS) to Veterans. Contractor facility must meet minimum standards required for compliance with the Americans with Disabilities Act of 1990, Pub. L. No. 101-336, 104 Stat. 328 (1990). No funds shall be made available for capital improvements under the contract. Contractor shall offer a low-barrier environment and minimize access barriers. Contractor shall have a minimum set of rules designed to reestablish trust and engage the Veteran in needed treatment services as follows:

i) Acceptance of treatment cannot be a condition of admission or continued stay

ii) Repeated admission and/or past behavior cannot be a condition of admission or continued stay

iii) Demands shall be kept to a minimum

iv) Rules shall focus on staff and resident safety v)Infractions of rules shall be used as opportunities for engagement where feasible

b) ROOM AND BOARD: Room and Board shall be accessible to the Veteran seven days per week and twenty-four hours per day. Accommodations shall include a private or semi-private room, with no more than four (4) Veterans per room, and with a bed and other furnishings such as a dresser, storage. Personal linens and hygiene products to be provided, to include towels, pillows, blankets and bed sheets, shampoo, body soap and hand soap. Personal protective items to be provided, such as face masks and hand sanitizer to prevent communicable diseases. Contractor to provide over the counter COVID testing kits, if on site testing is required. Residents must be assisted in maintaining an acceptable level of personal hygiene and grooming. The environment must be conducive to social interaction, and supportive of the recovery model and of the fullest development of the Veteran’s rehabilitative potential. Contractor shall allow Veteran to store personal belongings for at least 72 hours after formal HCHV discharge.

c) MEALS: Meals shall meet current dietary guidelines set forth by the U.S. Department of Agriculture and U.S. Department of Health and Human Services, including any updates made to the guidelines. A minimum of three (3) nutritionally adequate meals per day must be provided in a setting that encourages social interaction. In addition, Contractor must make available snacks of nourishing quality (e.g., fruits, vegetables, protein sources) between meals and before bedtime for those requiring or desiring additional food, whether or not it is medically indicated. There shall not be more than a 14-hour span between evening meal and breakfast of the following day. Contractor shall provide alternative meals for Veterans with dietary restrictions if medically indicated (e.g., diabetic, renal and soft mechanical diets) and reasonable accommodation for Veterans with cultural/religious preferences around food (e.g., Kosher, Sikh.). Menus shall be followed as written and updated as necessary. If an item on the menu is not available a substitution of equal or greater nutritional value shall be provided. Food shall be prepared, served, and stored under sanitary conditions. Contractor shall provide storage space in an on-site refrigerator for Veterans to store and freely access personal food. Contractor shall establish and maintain sanitary procedures for washing dishes, cleaning equipment and work areas, and disposing of waste.

d) LAUNDRY FACILITIES: Contractor must provide laundry facilities and necessary detergent free of charge and adequate for Veterans to do their own laundry or to have laundry done at minimum one time per week.

e) TRANSPORTATION: Contractor shall assist the Veteran to access public transportation, including providing information and instructions necessary to enable Veterans to utilize public transportation. Transportation cannot be a barrier to the Veteran receiving services necessary to reach their treatment goals. If public transportation is inappropriate or inadequate, Contractor shall assist Veteran to identify alternative transportation available to accommodate Veteran’s needs (i.e., VA or community transportation programs). VA staff may also assist with logistical burdens. Contractor shall provide transportation to access urgent same day medical care when needed.

5) ADDITIONAL SERVICES REQUIRED OF CONTRACTOR

a) THERAPEUTIC/REHABILITATIVE SERVICES: Therapeutic and rehabilitative services shall be provided by Contractor and shall include:

i) Case Management: Contractor shall have two (2) Case Managers dedicated to the on-site case management of Veteran residents at least 40 hours per week per case manager. Contractor Case Managers shall be responsible for all case management activities as described herein. Case management shall include arranging, planning, coordinating, or providing direct services and support, referring, and providing linkage to VA and non-VA resources, providing crisis management, and monitoring, and intervening and advocating on behalf of Veterans to support transportation, credit, legal, and other needs. A Psychosocial Assessment shall be completed by Contractor Case Manager within 3 business days of Veteran’s admission to the program and shall include strengths, needs, abilities and preferences, history of homelessness and a thorough housing-needs assessment, mental health history, physical health history, substance abuse history, social history, education/vocation history, income history, legal history, military history, trauma history and barriers/vulnerabilities. A written Individual Program Plan (IPP) shall be developed by Contractor Case Manager for each Veteran within ten (10) business days of admission. The IPP shall be based on the Psychosocial Assessment, and shall include specific goals toward self-sufficiency, with emphasis on independent housing, measurable objectives, targeted dates for completion, and a designated individual responsible for addressing each goal. A written IPP Update shall be completed every 30 days by Contractor Case Manager detailing progress/barriers toward obtaining goals. Contractor Case Manager shall provide structured individual case management to address Veteran’s psychosocial needs and shall document case management in a progress note. Contractor shall assist Veterans in connecting with community resources, such as, but not limited to, applying for social service benefits, applying for VA benefits, money management/budgeting/financial planning, employment services, housing resources, religious/spiritual services, and social/recreational opportunities. Contractor Case Manager shall document in Veteran’s case file all structured activities that support Veteran in addressing goals and will promote and document Veteran’s involvement with community activities, volunteer activities, and local consumer activities. There shall be an expectation that progress notes are written professionally in a format that utilizes the clear setting of goals (e.g., SNAP, SOAP, DAP or SMART notes). Progress notes shall include, at a minimum, progress toward the Veteran’s goals, Veteran’s participation in treatment, services provided and any changes to IPP.

ii) Group Activities: Structured group activity shall occur at a minimum of one time per week – examples include group therapy, life skills training, social skills training, financial workshops, Alcoholics Anonymous, Narcotics Anonymous, vocational counseling, and recreational activities. For the purposes of the contract, “House Meetings” and VA Housing Resource Groups may not be counted as a structured group activity. Group Activities should have a therapeutic value and facilitation shall be the responsibility of Contractor’s clinical staff.

iii) Professional Counseling: Contractor shall provide professional counseling and clinical interventions in an individual or group setting, as appropriate, which may include self-care skills, adaptive coping skills, vocational rehabilitation, Cognitive Behavioral Therapy (CBT), Mind Body Stress Reduction (MBSR), Motivational Interviewing (MI), psychoeducational tools, sober living skills, psychotropic medication education, disease process/recovery education, or other clinically relevant interventions. The goal in utilizing the above interventions is to provide an environment in which Veterans can address barriers to independent living, and successfully transition into stable permanent housing. If a Veteran is deemed to be at risk of self-harm or risk of harm to others, Contractor staff shall complete an appropriate safety assessment and immediately contact 911 if Veteran is found to be in acute need of a higher level of care. Contractor shall also notify VA liaison or designee as soon as possible, but no later than one (1) business day.

iv) VA Coordination: Contractor Case Manager shall collaborate and coordinate with VA liaison or designee around medical, mental health, and discharge needs. VA liaison or designee and Contractor Case Manager shall have routine, as frequently as weekly but no less than monthly, meetings. Meetings may be held at Contractor facility or by video conferencing, to discuss each Veteran’s progress.

v) Permanent Housing Assistance: Contractor shall provide Veterans with direct and ongoing assistance in achieving permanent housing. As a primary goal of the HCHV program, plans for each Veteran’s transition to permanent housing must be clearly reflected in the IPP and in monthly IPP Updates. As part of this plan, Veteran’s housing history and needs must be assessed through the Psychosocial Assessment completed within three (3) business days of program admission. Assessments must identify Veteran’s housing history, strengths (i.e., positive prior rental history), and barriers (i.e., evictions, broken leases). Should Veteran refuse to engage with Contractor Case Manager regarding plans for permanent housing, motivational interviewing and other therapeutic techniques shall be used to address Veteran’s ambivalence. All efforts to engage Veteran regarding housing plans shall be clearly documented.

vi) Recovery: Contractor shall promote an alcohol/drug abuse-free lifestyle in an environment conducive to social interaction and supportive of the fullest development of the Veterans’ rehabilitative potential. Contractor shall assist Veterans to gain/apply knowledge of the recovery process in an environment supportive of recovery models. Automatic discharge of veteran shall not be required for substance use off Contractor campus grounds. Efforts, such as education and referral to SUD services and therapeutic techniques shall be used to address veteran's substance related issues. All interventions shall be clearly documented to demonstrate interventions and need for discharge when appropriate.

vii) Discharge Planning: Securing permanent housing shall be the primary discharge goal for every Veteran. Contractor Case Manager shall provide assistance with discharge planning. Discharge planning shall start with the creation of the IPP completed with each Veteran within ten (10) days of admission to the program. Contractor shall report all discharges to VA liaison or designee within one (1) business day of discharge and shall provide a Discharge Summary to VA liaison or designee within two (2) business days. The Discharge Summary shall include at minimum date of discharge, reason for discharge, character of discharge, status of treatment goals at time of discharge, housing/aftercare plan, income resources, and follow-up contact information if known.

b) MEDICATION MANAGEMENT: Contractor shall secure and monitor Veterans’ medications. Medications and narcotics shall be properly stored and controlled within a locked cabinet in a locked room. Each Veteran's medication should be stored in its own labeled container in the original prescription bottle with a legible prescription label. Contractor shall observe Veteran take medication as prescribed and shall record medication compliance. Documentation of compliance shall include: name of medication, time, date, dose, and initials of staff observing compliance. Contractor shall establish written procedures for ensuring Veterans confidentiality in the storage of medications and the keeping of medication records. Contractor shall have controlled substances (narcotics) counted daily at minimum by 2 staff members.

c) CRITICAL INCIDENTS AND MEDICAL EMERGENCIES: All medical emergencies and critical incidents shall be reported to VA liaison or designee and COR immediately, if feasible, and no later than within one (1) business day.

i) Critical Incidents/Medical Emergencies: Contractor shall notify VA liaison or designee and COR within one (1) business day when a critical incident or medical emergency, as defined below, occurs. Contractor shall document the incident, provide to VA liaison or designee and COR a copy of the incident report and shall maintain a copy of the incident report in Veteran’s case file.

In the event a beneficiary receiving care under the contract dies, Contractor shall promptly notify VA liaison or designee and COR and shall immediately assemble, inventory, and safeguard the Veteran’s personal effects. The funds, deposits, and effects left by Veteran upon the premises of the facility shall be delivered by Contractor to the person or persons entitled thereto under the laws currently governing the facility for making disposition of funds and effects left by Veteran, unless the beneficiary died without leaving a will, heirs, or next of kin capable of inheriting. When disposition has been made, the itemized inventory with a notation as to the disposition of the funds and effects will be forwarded to VA liaison or designee and a copy of the inventory will be maintained in Veteran’s case file. Should a deceased patient leave no will, heirs, or next of kin, his/her personal property and funds, wherever located, vest in, and become the property of, the United States in trust. In these cases, the contract facility shall forward an inventory of any such property and funds in its possession to VA liaison or designee and shall hold them (except articles of clothing necessary for proper burial) under safeguards until instructions are received from VA liaison or designee concerning disposition.

ii) Critical Incident: Critical Incidents shall include:

• Falls

• Assault (to Veteran or Contractor staff)

• Elderly/Dependent Adult Abuse or Neglect

• Fire

• Medical/Psychiatric Emergency/911 Calls/Hospitalization

• Suicide or Suicide Attempt

• Homicide

• Death

• Medication Problem, Irregularity or Adverse Drug Reaction

• Infectious Control Issues (e.g., bed bugs, TB, COVID or communicable disease)

• Active Substance Abuse

• Observation/Possession of Weapons

iii) Medical Emergency: A medical emergency is a medical event that requires provision of immediate medical services to, or hospitalization of, a Veteran.

VA may complement the non-VA community-based provider’s program with added treatment services such as participation in VA outpatient programs.

6) ELIGIBILITY, REFERRAL, AND ADMISSION.

It is understood that the type of Veterans to be housed under this contract shall require care and treatment services over and above the level of room and board. It is also understood that Veterans admitted may need more intensive case management than the general population.

a) Eligibility: To be eligible for placement in contract beds, all Veterans must be homeless and eligible and registered for VA services as per 24 CFR 576.2 and must meet the requirements of 38 U.S.C. 2031(a) and 38 CFR 63.3. A formal diagnosis is not required for the Veteran to participate in the program. Contractor shall provide housing and services to special Veteran populations, such as but not limited to the following: seriously mentally ill Veterans, Veterans who have abused drugs or alcohol for many years, medically compromised Veterans, and/or Veterans who have been involved with the legal system. VA is responsible for determining eligibility of Veterans prior to acceptance by Contractor for services.

b) Referral Process: Contractor shall be the primary point of contact for all incoming calls, inquiries and referrals from Veterans and community providers. Contractor shall provide education on program guidelines to include - behavior guidelines; pass requirements; and requirement for VA Release of Information (ROI). Contractor shall provide the veteran or community provider with a copy of the VA ROI form and provide education on how to submit the ROI to the contract facility. Contractor shall track available beds to assure that veterans are referred to CRS liaison and admitted timely. Contractor shall educate the veteran about bed availability. Contractor shall notify the CRS Liaison of veteran referral.

CRS Liaison shall complete a screening assessment to establish eligibility and refer to South Texas Veteran Healthcare System for preliminary required testing for congregate settings. CRS Liaison shall assure that the veteran has signed a VA ROI as part of the admission process.

Referring entities shall provide the following information and documentation to contractor to facilitate referral review and admission decision as available:

Documentation required for referral (prior to admission and completion of ROI):

• Admission History & Physical

• Last 3 days of physician notes, if less than 3-day admission, provide course of care

• Last 3 days of discharge planning notes, if less than 3-day admission, provide course of care

• Last 3 days of IDT notes if different from physician notes, if less than 3-day admission, provide course of care

• Suicide assessments and safety plans

• Discharge summary /Diagnosis (Not always available if veteran was not inpatient at time of referral. Emergency Department notes can be used)

• TB test Documentation

• COVID test Documentation, if required by contract site for admission

• VHA CPRS Patient Record Flag Note and Safety Plan, if applicable

The following documentation shall be provided upon admission and ROI completion:

• Signed ROI

• Medication list (If no meds prescribed, notate on fax face sheet with medical records)

• List of follow up appointments and referrals, already scheduled or needed (If no appointments in record, notate on fax face sheet with medical records)

• HVP Assessment Form Note (including CSSRS)

Negative TB screen within the last 6 months shall be required prior to admission to program. Veterans who refuse to allow communication between VA and Contractor regarding their treatment needs and ongoing care shall need to receive services elsewhere.

c) Admission: VA liaison and Contractor shall mutually determine an admission process that includes written eligibility criteria that is fair, objective, and compliant with applicable State and Federal laws. Eligibility information shall be made available to Veterans at intake and Contractor staff shall provide answers to questions about admission criteria and process. Same day admissions should be accommodated when possible. Within three (3) business days of admission, all Veterans admitted to program shall receive, and sign a receipt for, an Intake Packet which includes, at minimum (1) a description of Contractors services, (2) program rules and regulations, (3) program grievance policy, (4) program emergency procedures, including education on emergency exits and evacuation plan and (5) Veteran Rights and Reasonable Accommodation. Receipt shall list documents received in Intake Packet and shall be maintained by Contractor in Veteran’s case file.

7) TIMEFRAMES.

The initial stay authorized for a Veteran in the program shall be 90 days. There shall be no minimum stay criteria for admissions. It is understood that Contractor shall not be paid for care provided to a referred Veteran beyond the initial 90-day period, unless an extension of the authorization is provided in writing by VA. An extension of the stay for an additional 90 days may be authorized by VA liaison or designee, provided that there is (1) clinical indication that continued services are appropriate as determined by assigned CRS liaison and (2) the availability of funds. Only extraordinary circumstances must be considered in order to authorize extension of service periods in excess of 180 days, and such extensions shall be authorized by VA liaison or designee.

8) DENIAL OF ADMISSION.

Veterans cannot be denied entry to HCHV CRS based solely upon length of current abstinence from alcohol or non-prescribed controlled substances, the number of previous treatment episodes, the time interval since the last program entry, the use of prescribed controlled substances, disability, income, transgender orientation, sexual orientation, legal history, status as a victim of domestic violence or the use of a service animal. The screening process shall consider each of these special circumstances and determine whether the program can meet the individual Veteran's needs while maintaining program safety, security, and integrity.

9) RULES, POLICIES AND PROCEDURES.

Contractor shall have reasonable rules governing day-to-day life and activities in the facility in accordance with VHA Handbook 1162.04. Such rules shall 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 and regulations at intake and/or upon request. In addition, Contractor shall post the rules in a location readily accessible to Veterans. These rules shall include detailed Veteran Rights and the procedures that Contractor has in place to protect Veteran rights and dignity. Veterans shall be permitted to exercise these rights without fear of reprisal. If requested, and when feasible, Contractors shall reasonably accommodate Veterans whose compliance with program rules is limited by Veterans’ physical or mental disabilities, in accordance with the Americans with Disabilities Act, including those requirements covering reasonable accommodations for disabilities and the use of service animals, and all other applicable State or Federal laws. Contractor shall equally apply all rules, policies, and procedures to Veterans, unless a Veteran has asked for a reasonable accommodation due to his/her disability.

10) GRIEVANCE PROCEDURES.

Contractor shall have an internal grievance process that Veterans can use to resolve conflicts within the program. Contractor shall have written policies and procedures for resolving grievances, including a statement regarding the Veteran’s right to request reasonable accommodation, and each Veteran shall receive a copy of the grievance policies and procedures upon intake and upon sanction or discharge notice.

11) CIRCUMSTANCES FOR PROVIDER PAYMENT of ABSENCES AND CANCELLATION.

The Health Care for Homeless Veterans (HCHV) Contract Residential Services (CRS) program allows payment to a provider for an absent Veteran under the circumstances outlined below. The HCHV CRS Liaison shall review a HCHV CRS provider’s request for payment for an absent Veteran to ensure it meets the standards set by the HCHV National Program Office as set forth in VHA Directive 1162.04 Appendix C.

VA is obligated to pay only for beds occupied by referred Veterans. Contractor shall notify VA liaison or designee of unauthorized Veteran absences from the facility within one (1) business day of the absence.

The Department of Veterans Affairs (VA) shall pay per diem up to a maximum of 48 consecutive hours (2 bed nights of care) for the unscheduled absence or 96 hours (4 bed nights of care) for the scheduled absence of a Veteran under the following conditions:

a. Scheduled Absences. To receive payment, the absence must:

i. Be pre-planned, consistent with and support the Veteran’s individual service plan (e.g., family reunification, short term medical, substance use disorder (SUD) or psychiatric treatment).

ii. Have the reason documented in the individual Veteran’s case file, treatment record or service plan.

iii. Not result in the bed being filled by the provider.

iv. Not be for a break or vacation from treatment.

v. Not be used for extended educational or employment circumstances.

vi. Not be used to create more than 4 consecutive days of absence.

vii. A Veteran who is absent from the facility for more than 48 hours for an excused absence does not have to be discharged from facility immediately as long as Contractor is willing to hold the bed without receiving payment. However, the Veteran must be discharged after a 14-day absence and the appropriate exit form in HOMES must be completed.

b. Unscheduled Absences. To receive payment for an unscheduled…