36C25820Q0352.docx

36C25820Q0352

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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.

DUNS:

DUNS+4:

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. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

36C25820Q0352 08-10-2020 Deborah Branham 520-629-4615 08-24-2020

4:00 PM

Department of Veterans Affairs NCO22-Gilbert Network Contracting 3601 S. 6th Avenue Tucson AZ 85723 X X 621330 $8 Million N/A X Department of Veterans Affairs Northern Arizona VA Healthcare System

500 AZ 89

Prescott AZ 86301 Department of Veterans Affairs NCO22-Gilbert Network Contracting 3601 S. 6th Avenue Tucson AZ 85723

This is accomplished through the Tungsten Network located at:

http://www.fsc.va.gov/einvoice.asp This is mandatory and the sole method for submitting invoices.

Acquisition of Readjustment Counseling Services in support of the Prescott AZ Vet Center.

See Schedule (page 4) and performance work statement (pag 6) for complete description of requirement.

Contract will be one (1) base year with two (2) one (1) year option periods.

Acquisition conducted under the authority of 38 U.S.C.

1712A and FAR Parts 12 and 13.5.

POC for this solicitation is Deborah.Branham@va.gov X X Trevor Hood Contracting Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

(continuation from Standard Form 1449, block 18A.)

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

a. CONTRACTOR: (Offerors are requested to designate a point of contact for prompt contract administration).

Name:

Name of Company:

Street Address:

City, State, Zip Code:

Email:

Phone:

b. GOVERNMENT: Contracting Officer (36C258) 505-256-2856 Department of Veterans Affairs NCO22-Gilbert Network Contracting Attn: Contract Specialist 520-629-4615 x14615 Southern Arizona VA Health Care System 3601 S. 6th Avenue Tucson, AZ 85723

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor should be mailed to the following address:

3. INVOICES: Invoices shall be submitted in arrears:

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.

Payments are accomplished through the Tungsten Network located at http://fsc.va.gov/einvoice.asp This is the mandatory and sole Method of submitting invoices

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

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

Contract Period: Base POP Begin: 10-01-2020 POP End: 09-30-2021

Contract Period: Base POP Begin: 10-01-2020 POP End: 09-30-2021

Contract Period: Base POP Begin: 10-01-2020 POP End: 09-30-2021

Contract Period: Base POP Begin: 10-01-2020 POP End: 09-30-2021

Contract Period: Option 1 POP Begin: 10-01-2021 POP End: 09-30-2022

Contract Period: Option 1 POP Begin: 10-01-2021 POP End: 09-30-2022

Contract Period: Option 1 POP Begin: 10-01-2021 POP End: 09-30-2022

Contract Period: Option 1 POP Begin: 10-01-2021 POP End: 09-30-2022

Contract Period: Option 2 POP Begin: 10-01-2022 POP End: 09-30-2023

Contract Period: Option 2 POP Begin: 10-01-2022 POP End: 09-30-2023

Contract Period: Option 2 POP Begin: 10-01-2022 POP End: 09-30-2023

Contract Period: Option 2 POP Begin: 10-01-2022 POP End: 09-30-2023

GRAND TOTAL

*Quantities are estimates ONLY. This is an ID/IQ contract. Stated contract minimum(s) are the only guaranteed quantities. The guaranteed minimum on any option period is only guaranteed if the option is exercised.

**Place of Performance is Flagstaff, AZ ***Paid via separately issues Task Orders TASK ORDER PROCEDURES: The resulting contract will have services ordered via Task Order.

Task Order Procedures are listed in FAR 52.216-18 “Ordering” and FAR 52.216-19 “Order Limitations.”

Task Orders will be placed annually by the Administrating Contracting Officer.

B.3 PERFORMANCE WORK STATEMENT

1. BACKGROUND

1.1. On the basis of extensive Congressional testimony and Department of Veterans Affairs (VA) consultation with experts on war-related readjustment difficulties, the character of “readjustment counseling” was initially established during a 10-year legislative history between 1969 and 1979. In 1979, the Congress passed, and the President signed Public Law 96-22, which added to 38 United States Code (U.S.C.) Section 1712A, providing readjustment counseling to any eligible Vietnam era veteran. As implemented by VA in 1979, readjustment counseling is provided through a nation-wide system of community-based Vet Centers. In 1982, VA initiated a new organizational element, Readjustment Counseling Services (RCS), to administer the Vet Centers and the provision of readjustment counseling.

1.2. The term “readjustment counseling” means: Individual counseling, employment counseling, bereavement, benefits counseling, and referral services for eligible veterans who have psychosocial problems as part of readjustment to civilian life after military duty during the specified conflicts. The counseling may include traditional psychotherapeutic modalities but the purpose of psychotherapy (or any modality) must be, as a primary task, to address readjustment difficulties derived from military duties and the homecoming experience.

2. POLICY AND AUTHORITY

2.1. In April 1991, Congress amended 38 U.S.C. 1712A to authorize VA to furnish readjustment counseling to veterans of the Persian Gulf War and the conflicts in Lebanon, Grenada and Panama. The law further authorized VA to furnish, by contract with approved private sector providers, readjustment counseling to eligible veterans where VA cannot provide such services. Contract program operations are the responsibility of a coordinated effort by Veteran Center medical officials.

2.2. In October 1997, congress amended 38 U.S.C. 1712A to expand eligibility for readjustment counseling at Vet Centers to any veteran who served in the active military in a theater of combat operations during a period of war, or in any other area during a period in which hostilities occurred in such area. The law specified that the term “hostilities” means any armed conflict in which the members of the Armed Forces are subjected to danger comparable to a period of war, as determined by the Secretary in consultation with the Secretary of Defense. Under the amended law, veterans who served during the Vietnam era, but not in a theater of combat operations, will continue to be eligible for readjustment counseling if they seek or are furnished such counseling before January 1, 2000.

3. ELIGIBILITY FOR COUNSELING SERVICES

3.1. Public Laws 95-22, 97-72, 98-160, 99-576, 100-322, 10225 and 104-262, The Veterans Health Care Eligibility Reform Act of 1997, require VA to provide readjustment counseling services for:

3.1.1. Any veteran who served in a theater of combat operations during WWII and is eligible for one or more of the following three campaign medals:

3.1.1.1. The European-African-Middle Eastern Campaign Medal: awarded for theater military service to include combat operations, during the period December 7, 1941, through November 8, 1945.

3.1.1.2. The Asiatic-Pacific Campaign Medal: awarded for theater military service to include combat operations, during the period December 7, 1941, through March 2, 1946.

3.1.1.3. The American Campaign Medal: awarded for theater military service to include combat operations during the period of December 7, 1941, through March 2, 1946.

3.1.1.4. Any veteran who served in the theater of combat operations in Korea during the Korean War and is eligible for the Korean service Medal; awarded the theater military service to include combat operations during the period June 27, 1950, through July 27, 1954.

3.1.1.5. Any veteran who served in the theater of combat operations in Vietnam during the Vietnam era (February 28, 1961, through May 7, 1975).

3.1.1.6. Any veteran who served on active duty during the Vietnam era, but not in a theater of combat operations in Vietnam (August 5, 1964, through May 7, 1975) will not be eligible for contract counseling services.

3.1.1.7. Any veteran who served in the Lebanon Theater of operations (August 25, 1982 through February 26, 1984).

3.1.1.8. Any veteran who served in the Grenada Theater of operations (October 23, 1983, through November 21, 1983).

3.1.1.9. Any veteran who served in the Panama Theater of operations (December 20, 1989, through January 31, 1990).

3.1.1.10. Any veteran who served in the Persian Gulf War (August 2,1990 and ending by Presidential proclamation or law).

3.1.1.11. Any veteran who served in the Somalia Theater of operations (September 17, 1992 and ending by Presidential proclamation or law).

3.1.1.12. Any veteran who served in the former Republic of Yugoslavia, including Kosovo and Bosnia and Operations Joint Endeavor, Joint Guard and Joint Forge (November 20, 1995, and ending by Presidential proclamation or law).

3.1.1.13. Sexual trauma/harassment regarding veterans of both sexes, all eras. Counseling for sexual trauma/harassment is not covered by this contract.

3.1.1.14. Global War on Terrorism-Veterans who serve or have served in military expeditions to combat terrorism on or after September 11, 2001 and before a terminal date yet to be established.

3.1.1.15. Bereavement- Parents, spouses and children of Armed Forces personnel who have died in the service of their country. Family members of Reservists and Nation Guardsmen who die while on duty are included

3.2. Eligible veterans must also have been discharged under honorable conditions or with a character for which basic eligibility to receive VA benefits has been established through adjudicative decision by VA (e.g., in the case of veterans possessing Undesirable Discharges, Bad Conduct Discharges, or General Discharges Under Other Than Honorable Conditions).

3.3. Veterans possessing a Dishonorable Discharge are not eligible for services provided under this program.

3.4. Eligibility will be verified by the Director/COR usually by review of the DD214 submitted by the veteran.

3.5. In those situations where eligibility cannot be verified prior to authorization, the VA employee making the referral may authorize the referral to the Contractor on the basis of presumptive eligibility, if it is clinically determined that an emergency exists requiring provision of immediate readjustment counseling services. In such cases, the VA referrer will inform the veteran that if eligibility is not substantiated, the veteran will be billed for all counseling services received.

4. PROCEDURE FOR SERVICE INITIATION

4.1. Service initiation under this statement of work will be limited to referral only by Vet Center personnel, RCS District Director (DDs) or designees. The number, type and frequency of readjustment counseling services provided to the veteran or significant others (i.e., members of the veteran’s immediate family, legal guardian, or an individual with whom the veteran lives or certifies an intention to live with) will be a specifically authorized by referring Vet Center or RCS DDs or designees.

4.2 If a veteran visits the contractor’s office prior to contacting the Vet Center, the contractor shall provide the veteran the Vet Center contact information, so required interview, record, and official authorization is initiated and approved.

4.3 Upon determination of eligibility and completion of psychosocial assessment, determining the need for readjustment counseling services, a referral will be made by completion of contract Services Authorization Form (VA Form 10-5565B). The original shall be maintained within the client’s file maintained at the Vet Center. Copy 1 shall be mailed to the designated contract service provider and maintained in the client’s records within the contractor’s records. Disposition of Contractor’s records are property of the Department of Veterans Affairs.

4.4 After eligibility has been verified and the need for readjustment counseling clinically established, the Vet Center Director/COR will complete and sign VA Form 10-5565B, which officially effects a referral to the contract service provider. The completion and disposition of VA Form 10-5565B is to be implemented according to the instructions on the form.

5. REFERRALS AND AUTHORIZATION FOR COUNSELING SERVICES

4.

5.

5.1. Referrals to readjustment counseling contract providers may be made by:

5.1.1. Qualified Vet Center staff.

5.1.2. Veterans Health Administration (VHA) qualified mental health professionals (psychiatrist, psychologist, social worker, or a psychiatric nurse clinical specialist) at VA health care facilities can make referrals to the Vet Center. All referrals made by VHA mental health professionals who are not Vet Center staff, will be facilitated the Vet Center Director/Contracting Officer’s Representative (COR), as the latter will assume responsibility for monitoring the case once the referral is made.

5.2. Contract readjustment counseling includes the same mix of social and psychological services as provided at Vet Centers, with the exception of community outreach. The purpose of the contracts program, as intended by Congress and implemented by VA, is for the provision of readjustment counseling and not for general mental health services. Contract readjustment counseling may include social services and/or psychotherapy, but the services provided must address readjustment difficulties deriving from military duties and/or homecoming experiences. The provision of services for problems not having a clear and distinct relationship to military duty and readjustment to civilian life from military duty is not authorized.

5.3. Specifically, the difficulties which comprise war-related readjustment difficulties referable to a contract provider are the following:

5.3.1. Psychosocial problems related to exposure to war trauma.

5.3.2. Psychosocial problems related to other stressful experiences of military duty in a warzone.

5.3.3. Psychosocial problems related to post-war adjustment to civilian family and work roles.

5.3.4. Psychosocial problems related to type of military discharge.

5.3.5. Psychosocial problems related to substance abuse clinically associated with military duty or post-military readjustment.

5.3.6. Psychosocial problems related to post-war homecoming experiences.

5.3.7. Psychosocial concern over possible exposure to chemical and/or biological agents in the warzone.

5.3.8. Generalized alienation from society related to interruptions in the normal post-war readjustment process.

5.4. Prior to making a referral, the veteran must be interviewed by the VA referrer.

5.4.1. Although this may be either in person or by telephone, the referrer is responsible for ensuring that eligibility definitions and clinical assessment requirements are met. The clinical evidence should establish that the veteran’s problems are clearly related to the military experience, be reflected in the reason for referral, and be documented in the veteran’s record.

5.5. Self-referrals and referrals of veterans who were or are in the private contract provider’s caseload cannot be authorized, unless the assessment described above is carried out. In no event may VA be billed or required to pay for services delivered prior to authorization for care.

5.6. After eligibility has been verified and the need for readjustment counseling clinically established, the Vet Center Director/COR will complete and sign VA Form 10-5565B, which officially effects a referral to the contract service provider. The completion and disposition of VA Form 10-5565B is to be implemented according to the instructions on the form.

6. REFERAL MANAGEMENT - Referrals and ongoing assessment of counseling cases will be managed, as to ensure the availability of services to the largest number of eligible veterans within the limits of available resources.

6.1. The Contractor shall provide group and/or brief therapy whenever clinically feasible to facilitate serving the largest number of eligible veterans. Theater veterans exposed to war-zone stress will be considered the highest priority recipients for contract readjustment counseling.

6.2. Group counseling will be encouraged whenever clinically feasible as this method is both clinically indicated and cost effective for Veterans with readjustment difficulties. The composition of such groups must include at least 50 percent eligible war-zone Veterans for a contact provider to be reimbursed for the group counseling session. Exceptions to this may be granted by the Vet Center Director/COR when clinically indicated.

6.3. Contractor employees shall not be considered Government employees and shall not at any time identify themselves as such or perform community outreach in the name of or as the Vet Center or VA.

6.4. In accordance with the terms and conditions of this scope of work, the Professional Services Letter IL -11-82-26, and the VA Form 10-5565B, contractors shall be required to perform as follows:

6.5. All initial referrals to a contract provider will be for up to 3 visits for clinical assessment and brief counseling. The Director/COR will specify on VA Form 10-5565B, one, two, or three visits and the type of counseling to be provided (individual).

6.6. The contractor shall schedule the initial veteran counseling session (visit) within 10 working days from the date the veteran was first referred under the contract.

6.7. If additional visits are required upon completion of the 3 initial visits, the Contractor shall submit, a counseling plan documenting the need for continuing readjustment counseling to the Vet Center Director/COR. The contractor will ensure a DD214 is provided by the veteran and sent to the Vet Center Director/COR for verification. The contractor must maintain a copy in the clients file.

6.7.1. After reviewing the plan, the Director/COR may authorize the veteran for up to a block of 15 additional visits within a specified period. In similar fashion, subsequent re-authorizations are established (up to 15 visits) and updated case counseling plans are subject to evaluation prior to further authorization.

6.7.2. In an emergency situation and/or veteran crisis, additional visits may be authorized over the phone by the Director/COR. The contract provider updated counseling plan may be presented to the COR orally, but must be documented in the veteran’s file and followed with a written copy within forty-eight (48) hours.

6.7.3. Effective management of case progress and available funding requires that the Director/COR specify on the VA Form 10-5565B a time period within which a block of authorized visits must be delivered. For example, a veteran does not use all 13 sessions during the specified time, he may be reviewed and re-authorized for additional visits at the beginning of the next quarter. A visit will last a minimum of 45 minutes for an Individual/Family session and a minimum of 90 minutes for Group sessions.

6.7.4. The initial written counseling plan will be presented to the Director/COR no later than five working days from the completion of the third initial visit. This plan shall be documented in the veteran’s record by the Director/COR and contract provider.

6.7.5. The VA reserves the right to modify the treatment plan submitted by the Contractor. Coordination of the counseling plans to the VA referrer must occur in a timely manner, so there will be no disruption in the continuation of readjustment counseling. An updated treatment plan must be submitted and approved by the

6.7.6. Director/COR before subsequent client visits are authorized for the upcoming quarter.

6.7.7. While up to one visit per week is usually authorized, the Director/COR is under no obligation to authorize that frequency.

6.7.7.1. Frequency of visits of less than one time per week (e.g., once per two weeks, once per month) is clinically indicated in a substantial number of cases. It is the responsibility of the Director/COR to ensure that such frequency is obtained when indicated.

6.7.7.2. Visits of twice per week may be permitted in exceptional cases when authorized by the COR on the basis of clinical assessment.

6.8. Resource allocation per facility, overall needs of the total eligible veteran population in a particular locality, sound clinical practice, and the needs of an individual veteran will usually dictate a frequency of visits of one per week or less.

7. “SIGNIFICANT OTHERS” defined as, members of the Veteran’s immediate family, legal guardian, or individual with whom the Veteran lives of certifies an intention to live. May be seen conjointly with a Veteran in couple or family counseling by the contract service provider.

7.1. This will be limited to counseling for problems, which have a distinct relationship to the Veteran’s readjustment from military duty.

7.2. For couple or family counseling, billing and reimbursement will be at the established per session rate as specified in the contract.

7.3. Significant others may be seen without the Veteran present only when clinically required as an integral part of couple or family counseling. Such visits by significant others without the Veteran present, however, are limited to one visit per ten couple or family sessions that include the Veteran. Exceptions may be granted to the limitation on significant other visits only when clinically approved by the Director/COR.

7.4. As stipulated in the scope of work, there is a provision, which limits eligibility for readjustment counseling through a contract provider to 1 year from the time of the veteran’s first visit.

7.4.1. This provision is based upon existing knowledge regarding the etiology and longitudinal course of war-related readjustment difficulties to include post-traumatic stress disorder (PTSD) and upon program experience, which indicates that most veterans referred complete services within 1 year.

7.4.2. This provision should not be implemented in an arbitrary manner nor should it be applied in isolation from other indicators for clinical case progress.

7.4.3. In most cases authorization beyond 1 year should be short-term extensions designed to facilitate completing services or appropriate referral.

7.4.4. Determination for extension of eligibility for contract services beyond 1 year, will be determined by a clinical report and plan submitted by the contractor, that will be reviewed by the Director/COR, and approved by the District Director or designee.

7.4.5. To determine and approve a veteran for an extension, the following procedures will be followed:

7.4.5.1. The contract provider will submit a request with a report and plan, with clinical significance of need for additional services beyond one year. This is not an authorization for service, but report of further readjustment counseling need.

7.4.5.2. The Vet Center Director/COR will review this report, determine if extension is clinically significant, and will interview the veteran (in person or by telephone) to conduct an updated, comprehensive psychosocial assessment to ensure continuing clinical need for readjustment counseling.

7.4.5.3. If there is clinical indication for continuing readjustment counseling beyond 1 year, the Vet Center Director/COR must consult with the RCS District Director or designee prior to authorizing continuing visits.

7.4.5.4. All requests for readjustment counseling beyond 1 year, for more than brief transitioning purposes, must be reviewed and approved by the RCS District Director or designee and documented in the veteran’s clinical record.

7.5. If a veteran currently receiving services from a contract provider resides in a closer proximity to a newly selected contract provider or newly established Vet Center, the veteran may be transferred to the new contract provider or newly established Vet Center, in order to continue uninterrupted counseling from the most convenient service provider.

8. DELIVERABLES

8.1. Psychological Assessment

8.1.2. Psychological assessment shall be completed after the third counseling session and shall contain as a minimum the following information, which shall be submitted prior to requesting further re-authorizations from the Director/COR.

8.1.2.1. Presenting problem/history – to include frequency, duration, and severity of the problem. History of psychotherapeutic treatments received or sought as well as services being sought at the facility.

8.1.2.2. Social history- to include family composition, employment, lifestyle, alcohol/drug use, friends, support systems, medical problems, current psychological/medical treatment, typical day, recreation, client’s therapeutic goals.

8.1.2.3. Pre-military history – to include family of origin, school involvement, substance abuse, acting out, legal problems, trauma.

8.1.2.4. Military history – to include (pre/during/post deployment) adjustment, draft or volunteer, disciplinary actions, duties, injuries, disabilities, trauma, homecoming.

8.1.2.5. Post-military history – to include social/interpersonal functioning, schools, jobs, marriages, children, etc.

8.1.2.6. Observations – to include appearance, behavior, speech, affect, and mood.

8.1.2.7. Assessment – to include assessment of veteran and presenting problems. Discussion of the veteran’s strengths, assets, motivation, support systems, and counselor’s conceptualization and impression of the veteran. The relationship of the presenting problems to military history.

8.1.2.8. Critical issues – to include assessment of suicidal/homicidal ideation, history of and the need for intervention.

8.1.2.9. Plan – to include specific actions/steps to be pursued by counselor, referral, consultation, length of treatment anticipated.

8.1.2.10. Completion – shall include counselor’s signature, date, and the signature of the reviewing person (clinical coordinator) and the date reviewed.

8.2. Treatment Plans

8.2.2. Treatment plans content shall contain the following data/information

8.2.2.1. Specific actions/steps to be pursued by the counselor

8.2.2.2. Problems to be addressed

8.2.2.3. Identification of goals for therapy

8.2.2.4. Type of counseling or therapy recommended

8.2.2.5. Anticipated duration of counseling or therapy

8.2.2.6. Counselor’s signature and date

8.2.2.7. The government may provide these forms.

9. KEY PERSONNEL

9.1. The personnel specified in the offeror’s proposal shall be listed below after award and are considered to be essential to the work being performed hereunder. Prior to diverting any of the specified individuals to other programs, the Contractor shall notify the Contracting Officer reasonably in advance and shall submit justification (including proposed substitutions) in sufficient detail to permit evaluation of the impact on the program. No diversion shall be made by the Contractor without the written consent of the Contracting Officer: Provided: That the Contracting Officer may ratify in writing such diversion and such ratification shall constitute the consent of the Contracting officer required by this clause.

9.2. The listing of key personnel may be amended from time to time during the course of the contract to either add or delete personnel as appropriate. If the continued commitment of any key personnel is beyond the control of the Contractor, the Contractor shall notify the Contracting Officer immediately, and shall recommendations for the substitution of another person.

10. CAPABILITY TO PROVIDE MEDICATIONS AND PHYSICAL EXAMINATIONS

While the provision of medications and physical examinations are not considered a component of the readjustment counseling services required by this contract, and will not be provided, offerors must have the capability to provide such services directly or to arrange physical assessments, medical treatment and therapy through referral.

11. PROHIBITIONS

11.1. Contract providers are strictly prohibited from the use of commercial advertising of their readjustment counseling services under this contract in such a way as to imply that VA is endorsing or promoting the services.

11.2. Contract providers and/or their employees are strictly prohibited from performing community outreach as or for the Vet Center program.

12. QUALIFICATIONS OF CONTRACT PROVIDERS

12.1. Contract program readjustment counseling services should be provided by licensed clinical social workers, psychologists, psychiatrists, psychiatric clinical nurse specialists, or other master’s level licensed professional counselors from related disciplines such as Clinical Mental Health Counseling; Clinical Rehabilitation Counseling; Clinical Mental Health Counseling and Clinical Rehabilitation Counseling; OR a related field, from a program accredited by the Council on Accreditation of Counseling and Related Educational Programs (CACRREP). Examples of related mental health counseling fields include but are not limited to Addiction Counseling; Community Counseling; Gerontology Counseling; Marital, Couple, and Family Counseling. All providers identified on the contract must hold a valid Arizona state license.

13. CONTRACT TYPE:

13.1. The RCS Vet Center anticipates awarding a fixed price contract for 1 year with an option to extend for an additional two years.

14. GEOGRAPHICAL LOCATION OF CONTRACTOR/SERVICE PROVIDERS

14.1. Service providers must be physically located within the geographical boundaries of county Coconino and in the city of Flagstaff AZ for which contract award is made. The boundaries described herein are determined by RCS and local VA officials, based upon "geographical areas of need" (e.g., a given city, county, or locality where a Vet Center is present but, because of a large veteran population, cannot adequately provide services).

15. DEFINITIONS/ACRONYMS:

15.1. “CO” Contracting Officer

15.2. “Contractor” Provider of Readjustment Counseling Services.

15.3. “COR” Contracting Officer Representative

15.4. “FMS” Facilities Management Services

15.5. “RCS” Readjustment Counseling Services

15.6. “TL” Team Leader – not needed

15.7. “Significant Other” Members of the Veteran’s immediate family, legal guardian, or individual with whom the Veteran lives or certifies an intention to live.

15.8. “Director” Director Prescott Vet Center

15.9. “VA” Department of Veterans Affairs

15.10. “VAMC” Veterans Administration Medical Center

15.11. “VA patients” Veteran beneficiaries, inpatient and outpatient

16. RECORD KEEPING: The COR will define the exact counseling record information to be included by the contract provider upon each veteran counseling session(s).

16.1. A verification form is to be completed by each veteran for each therapy session. The verification form with the clients’ original signature will be attached to the monthly bill submitted to COR. The Contractor shall secure a signed acknowledgment of services from each client and for each visit for which they are invoicing the VA. The verification form must include the name of the veteran and VIF#, as well as length, date, and specific modality of the counseling session.

16.2. Provide only those services identified on the VA referral form.

16.3. Client numbers and records for significant others, will be maintained in the name of the veteran; however, counseling case notes/progress notes on visits by significant others shall be maintained as discrete and separate from the veteran’s notes for continuity of notation, and so they can be easily extracted if a request for the veteran’s counseling record is made.

16.4. Contractor shall maintain accurate and complete counseling records, which comply with the confidentiality requirements of Public Law 93-282 and the Privacy Act of 1974, Public Law 93-579. Contractor shall ensure the physical security of records and the prevention of disclosure of the records, reports, or other private information of clients except with the client's informed, written consent.

NOTE: Counseling records are considered the property of the VA. One year following termination of the contract, the Contractor shall turn the client folder over to the authorizing Vet Center or contact the Director of the Vet Center to determine to which Vet Center the folder should be sent. The same procedures will apply when the contract between the VA and the Contractor terminates.

17. CONTRACT MONITORING AND OVERSIGHT MANAGEMENT

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17.1. Quality control and administrative oversight of the overall contract agreement and basic processes of contract operations are the primary responsibilities of the Vet Center Director/COR.

17.2. Site visits will be conducted on at least an annual basis to the facilities of all contract providers by the Director/COR and/or other Government employees designated by the Contracting Officer and will include, but shall not be limited to, evaluation verification of the following:

17.2.1. Actual performance versus scheduled and reported performance regarding the number and type of visits provided and the amount billed.

17.2.2. Changes in technical performance which may affect financial status, personnel assigned to the contract, over extension of resources, etc.

17.2.3. The numbers of employees charged to the contract are actually performing work under the contract.

17.3. Site visits will be conducted in accordance with program standards and in compliance with monitoring guidelines developed and approved by VA Central Office.

18. PERIOD OF PERFORMANCE

18.1. The Contract period of performance is for one (1) base year with two (2) one (1) year options. The base period will be from October 1, 2020 – September 30, 2021.

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18.1.1. In renewing existing contracts, the Contracting Officer will request a current list of those employees working for the contractor under the contract. This listing will be compared with the existing contract. Any changes in personnel or employees proposed by the contractor will be brought to the attention of the Vet Center Director/COR. The Director/COR will review the information on the new personnel to ensure that the level and quality of service is consistent with the initial proposal and the terms of the original contract.

18.1.2. If readjustment counseling beyond the contract period is indicated, and if the contract is not renewed, the Contractor shall make appropriate referral to another counseling resource, in consultation with the original referrer. Exceptions to this requirement may be made, upon authorization, based on determination of the continuing need by the VA referring official. Requests for such exceptions shall be presented to the VA referrer.

18.1.3. The Government will reimburse the Contractor for completion of cases started during the period of the agreement, but duly authorized to extend beyond the legal termination date of the contract. All payment for work under this contract beyond September 30th of each year will be contingent on the availability of funds. Therefore, no work shall take place after that date unless specifically authorized in writing by the Contracting Officer.

18.1.4. The Government will be the sole judge as to whether a contract will be renewed, based on the determination of need. The VA reserves the right to allow this contract to expire and to issue a new Request for Quote (RFQ) if determined to be in the best interest of the Government.

19. INVOICE PROCEDURES

19.1. Reimbursement will generally only be for in-person counseling sessions. Tele-video and telephonic delivery of readjustment counseling services is acceptable but, in each case, will be at the discretion of the Vet Center Director and, when approved, will be reviewed for appropriateness every 90 days or if clinical events indicate a treatment plan review is necessary.

19.2. Reimbursement for veteran’s travel in connection with contract readjustment is not authorized.

19.3. A visit, for reimbursement purposes, will last a minimum of 45 minutes and will be deemed a single visit regardless of length beyond 45 minutes. A group counseling visit, for reimbursement purposes, will be 90 minutes in length. Participation in group counseling sessions constitutes one visit, regardless of length beyond 90 minutes.

19.4. Payments made under this agreement shall constitute the total cost of readjustment counseling services. The Contractor understands and agrees that no additional charges shall be billed to the veteran or his family, either by the Contractor or any third party furnishing required services, unless and until specific prior written authorization is obtained from the VA COR who initially authorized the provision of services.

19.5. All invoices shall be submitted monthly, in arrears.

19.6. Invoices shall be mailed in the original and duplicate copy, to the address listed in block 18a with a copy sent to the COR

19.7. All invoices shall include the information shown in subparagraphs (a) through (i) below and shall be accompanied by the receipt of services (VA Form 10-5565B) specifying the information shown in subparagraphs (10) through (12) below:

19.7.1. Contract number (and purchase order number, if applicable);

19.7.2. Vet Center or Station Number of Referring Unit

19.7.3. VIF/Client number;

19.7.4. Number of both individual visits and group visits;

19.7.5. Total number of individual visits;

19.7.6. Total number of group visits;

19.7.7. Basic contract rate (per type of counseling provided and per type of counselor), in accordance with bid schedule pricing in Section B of the contract;

19.7.8. Total dollar amount billed;

19.7.9. Month in which counseling services were provided;

19.7.10. Copies of the verification form including the Veteran’s original signature certifying receipt of services for each session provided, along with the Vet Center copy of the VA Form 10-5565B.

19.7.11. Counselor’s name, professional degree (or name, if applicable); and the type of therapy provided for all sessions. The clinician who provided service must be identified. Reimbursement will be based on costs for that clinician;

19.7.12. Veteran’s name and VIF number.

19.8. All invoices must be received by the 5th of the month following services rendered.

19.9. Failure to include all the above documentation (which constitutes a proper invoice) will result in delay of payment. Invoices will not be processed if there are any omissions.

(END PERFORMANCE WORK STATEMENT)

SECTION C - CONTRACT CLAUSES

ADDENDUM to FAR 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS Clauses that are incorporated by reference (by Citation Number, Title, and Date), have the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available.

The following clauses are incorporated into 52.212-4 as an addendum to this contract:

C.1 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

http://www.acquisition.gov/far/index.html http://www.va.gov/oal/library/vaar/

(End of Clause)

C.2 52.216-18 ORDERING (OCT 1995)

(a) Any supplies and services to be furnished under this contract shall be ordered by issuance of delivery orders or task orders by the individuals or activities designated in the Schedule. Such orders may be issued from 10/01/2020 through 09/30/2023.

(b) All delivery orders or task orders are subject to the terms and conditions of this contract. In the event of conflict between a delivery order or task order and this contract, the contract shall control.

(c) If mailed, a delivery order or task order is considered "issued" when the Government deposits the order in the mail. Orders may be issued orally, by facsimile, or by electronic commerce methods only if authorized in the Schedule.

(End of Clause)

C.3 52.216-19 ORDER LIMITATIONS (OCT 1995)

(a) Minimum order. When the Government requires supplies or services covered by this contract in an amount of less than $25,000.00, the Government is not obligated to purchase, nor is the Contractor obligated to furnish, those supplies or services under the contract.

(b) Maximum order. The Contractor is not obligated to honor—

(1) Any order for a single item in excess of $45,000.00;

(2) Any order for a combination of items in excess of $90,000.00; or

(3) A series of orders from the same ordering office within 30 days that together call for quantities exceeding the limitation in paragraph (b)(1) or (2) of this section.

(c) If this is a requirements contract (i.e., includes the Requirements clause at subsection 52.216-21 of the Federal Acquisition Regulation (FAR)), the Government is not required to order a part of any one requirement from the Contractor if that requirement exceeds the maximum-order limitations in paragraph (b) of this section.

(d) Notwithstanding paragraphs (b) and (c) of this section, the Contractor shall honor any order exceeding the maximum order limitations in paragraph (b), unless that order (or orders) is returned to the ordering office within 5 days after issuance, with written notice stating the Contractor's intent not to ship the item (or items) called for and the reasons. Upon receiving this notice, the Government may acquire the supplies or services from another source.

(End of Clause)

C.4 52.216-22 INDEFINITE QUANTITY (OCT 1995)

(a) This is an indefinite-quantity contract for the supplies or services specified, and effective for the period stated, in the Schedule. The quantities of supplies and services specified in the Schedule are estimates only and are not purchased by this contract.

(b) Delivery or performance shall be made only as authorized by orders issued in accordance with the Ordering clause. The Contractor shall furnish to the Government, when and if ordered, the supplies or services specified in the Schedule up to and including the quantity designated in the Schedule as the "maximum." The Government shall order at least the quantity of supplies or services designated in the Schedule as the "minimum."

(c) Except for any limitations on quantities in the Order Limitations clause or in the Schedule, there is no limit on the number of orders that may be issued. The Government may issue orders requiring delivery to multiple destinations or performance at multiple locations.

(d) Any order issued during the effective period of this contract and not completed within that period shall be completed by the Contractor within the time specified in the order. The contract shall govern the Contractor's and Government's rights and obligations with respect to that order to the same extent as if the order were completed during the contract's effective period; provided, that the Contractor shall not be required to make any deliveries under this contract after 09/30/2023 plus six months, if services are extended.

(End of Clause)

C.5 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

The Government may require continued performance of any services within the limits and at the rates specified in the contract. These rates may be adjusted only as a result of revisions to prevailing labor rates provided by the Secretary of Labor. The option provision may be exercised more than once, but the total extension of performance hereunder shall not exceed 6 months. The Contracting Officer may exercise the option by written notice to the Contractor within 30 days of expiration of current period of performance. The rates in effect at the time of the exercise of this option will be the rates in effect at any time an option is exercised under this clause.

(End of Clause)

C.6 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

(a) The Government may extend the term of this contract by written notice to the Contractor within 30 days of current POP expiration; provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 60 days before the contract expires. The preliminary notice does not commit the Government to an extension.

(b) If the Government exercises this option, the extended contract shall be considered to include this option clause.

(c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed three (3) years.

(End of Clause) C.7 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA ACQUISITION OF COMMERCIAL ITEMS (APR 2020)

(a) The Contractor agrees to comply with any provision or clause that is incorporated herein by reference to implement agency policy applicable to acquisition of commercial items or components. The following provisions and clauses that have been checked by the Contracting Officer are incorporated by reference.

[X] 852.203–70, Commercial Advertising.

[X] 852.209–70, Organizational Conflicts of Interest.

[] 852.211–70, Equipment Operation and Maintenance Manuals.

[] 852.214–71, Restrictions on Alternate Item(s).

[] 852.214–72, Alternate Item(s). [Note: this is a fillable clause.] [] 852.214–73, Alternate Packaging and Packing.

[] 852.214–74, Marking of Bid Samples.

[] 852.215–70, Service-Disabled Veteran-Owned and Veteran-Owned Small Business Evaluation Factors.

[] 852.215–71, Evaluation Factor Commitments.

[] 852.216–71, Economic Price Adjustment of Contract Price(s) Based on a Price Index.

[] 852.216–72,…