36C26020Q0049-000.docx

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Required Field Contract Opportunity Sources Sought Notice Q Sub-Acute Residential Detoxification Services 4/1/2020 - 3/31/2025 98327 36C26020Q0049 12-10-2019 N 623220 Department of Veterans Affairs Network Contracting Office 20 1495 Wilmington Drive, Suite 360 DuPont WA 98327 36C26020Q0049

This is a SOURCES SOUGHT NOTICE for market research purposes only to determine the availability of potential businesses with capabilities to provide the services described below. Potential offerors are invited to provide feedback via e-mail to Darlene Anderson at Darlene.Anderson4@va.gov . Responses will be used to determine the appropriate acquisition strategy for a potential future acquisition.

Sub-Acute Residential Detoxification Services: provide sub-acute residential alcohol and drug detoxification services to Veterans served by Veteran's Affairs Portland Health Care System (VAPORHCS), Oregon. The level of care will be Medically-Monitored Detoxification in a sub-acute residential setting.

Estimating 5 patients per month at an average stay of 5 days per patient.

The intended contract period is 5 years.

Referrals will come from the Department of Veterans Affairs, Portland, Oregon.

Potential contractors shall provide, at a minimum, the following information to Darlene Anderson at Darlene.Anderson4@va.gov :

1) Company name, address, point of contact name, phone number, e-mail address, and company’s Dun and Bradstreet number (DUNS). All companies wishing to do business with the federal government must be registered at https://www.sam.gov/ ; there is no charge.

2) Is your firm eligible for participation in one of the following small business programs? If so, please indicate the program. Anticipated North American Industry Classification System (NAICS) code is 623220, Residential Mental Health & Substance Abuse Facilities; the largest a firm can be and still qualify as a small business for Federal Government programs is no larger than $16.5 Million under NAICS code 623220.

_____ Small Business (SB) _____ Service Disabled Veteran Owned Small Business (SDVOSB) registered and verified in the VetBiz.gov VIP database (https://www.vip.vetbiz.va.gov/).

_____ Veteran Owned Small Business (VOSB) registered and verified in the VetBiz.gov VIP database (https://www.vip.vetbiz.va.gov/).

_____ HUBZone _____ Small Business 8(a) _____ Small Disadvantaged Business (SDB) _____ Women-Owned (WO) Small Business _____ Other (please specify)

3) Indicate if your business is located near the Department of Veterans Affairs, Portland Health Care System, 3710 SW U.S. Veterans Hospital Road, Portland, Oregon 97239:

_____ Our business is in Portland, Oregon, _____ miles from the VA.

_____ Other -- Please provide details about your location and how your location will be convenient to patients from the Portland, Oregon, area.

4) Does your company charge a daily rate? Do you charge more than the Oregon Health Authority Medicaid reimbursement rate, Substance Use Disorder Services (Provider Type 3), H0010, Alcohol/Drug services; sub-acute medically monitored detoxification? Please comment on how you charge for Sub-Acute Residential Detoxification Services that is medically-monitored detoxification in a sub-acute residential setting.

5) Provide a brief Capability Statement (less than 5 pages) with enough information to determine if your company can meet the requirement. The Capabilities Statement for this Sources Sought is not expected to be a Request for Quotations, Request for Proposals or Invitation for Bids, nor does it restrict the Government to an ultimate acquisition approach, but rather the Government is requesting a short statement regarding your company’s ability to provide the services listed above. Any commercial brochures or currently existing marketing material may also be submitted with the Capabilities Statement. Submission of Capabilities Statement will assist our office in tailoring the requirement to be consistent with industry standards. The capabilities will be evaluated solely for the purpose of determining to Set-Aside for the Small Business (SB) Community or to conduct as an Unrestricted Procurement. Other than small businesses may respond to this notice in the event the market does not indicate SB interest. This Sources Sought Notice is for information and planning purposes only and is not to be construed as a commitment by the Government. The Government will not pay for information solicited. Respondents will not be notified of the results of the evaluation. All interested contractors should notify this office via email by December 10, 2019. Submit response and information to: Darlene Anderson, Department of Veterans Affairs, Darlene.Anderson4@va.gov .

The DRAFT Statement of Work follows.

Thank you for your participation.

Performance Work Statement

SUB-ACUTE RESIDENTIAL DETOXIFICATION SERVICES

FOR THE

VA PORTLAND HEALTHCARE SYSTEM (VAPORHCS), OREGON

1.0. GENERAL: This contract is intended to provide sub-acute residential alcohol and drug detoxification services to Veterans served by Veteran's Affairs Portland Health Care System (VAPORHCS), OR. The level of care will be Medically-Monitored Detoxification in a sub-acute residential setting.

2.0. CONTRACT REQUIREMENTS:

2.1. The Contractor shall provide the following Medical Services:

a. A physical exam conducted by an RN at admission;

b. Medically-monitored detoxification from alcohol and drugs;

c. Detoxification from opioids utilizing buprenorphine and other agents as needed for symptom relief;

d. Detoxification from alcohol utilizing chlordiazepoxide or oxazepam and other agents as needed for symptom relief;

e. Monitoring and symptomatic relief from stimulant withdrawal;

f. Monitoring of chronic medical conditions during withdrawal;

g. Monitoring for mental health symptoms that emerge during withdrawal;

h. 24-hour Nursing coverage;

i. Availability of an on-call Physician 24 hours a day; and

j. Availability of the contract facility Medical Director by phone 24 hours a day for emergencies.

2.2. The Contractor shall provide the following Urgent Care Clinic services:

a. Medical management of chronic medical conditions;

b. Medical management or referral for acute medical conditions;

c. Medical management of complications of withdrawal;

d. Urgent Care Clinic will be staffed by a Physician or Nurse Practitioner 3 times per week;

e. Addiction Counselor or Rehabilitation Tech support; and

f. Availability of medical support for monitoring and documenting vital signs and behavior.

2.3. The Contractor shall provide the following Clinical Services:

a. Alcohol and drug counseling, and services below, by certified alcohol and drug counselors;

b. Written Biopsychosocial Assessment;

c. Written Treatment Planning and Discharge Planning

d. Individual and group supportive counseling;

e. Patient education on effects of alcohol and drugs, relapse prevention, and community treatment and housing resources; and

f. Availability of acupuncture for those requesting it.

2.4. The Contractor shall provide the following Support Services:

a. Separate sleeping and dining facilities for women;

b. Three meals a day, plus snacks and drinks;

c. Availability of laundry facilities;

d. Personal hygiene items as needed;

e. A second set of clothing, i.e., scrubs, robes, slippers;

f. A bed, bedding, and towels; and

g. A secure locker and/or wardrobe space for personal property.

2.5. The Contractor shall provide access and referral services:

2.5.1. Priority access to residential detox services will be provided each morning, Monday through Friday.

2.5.2. The Contractor shall accept same-day referrals as physician staff are available after pre-arranged admission appointments, provided the Veteran has been cleared for sub-acute Medically-Monitored Detoxification, up to the funding limits of the contract.

2.5.3. In the event that the funded contract treatment episodes are exhausted, the Contractor shall notify the Contracting Officer and VAPORHCS Detox Liaison that the standard non-contract admission procedures will be re-instituted.

2.5.4. The Contractor shall only accept Contract referrals from the VAPORHCS Substance Abuse Treatment Program.

2.5.5. The Contractor shall refer Veterans whose medical condition cannot safely be treated in the sub-acute residential level of care to the VAPORHCS Emergency Department (ED) or, in the event of diversion, to the nearest hospital. In a medical or psychiatric emergency or urgent care situation, the Contractor shall notify the VAPORHCS ED prior to returning a patient to the Medical Center.

2.5.6. The Contractor shall refer Veterans who leave early or AMA, as well as those who complete detoxification, to the most clinically appropriate level of VA substance abuse treatment, to include residential or outpatient substance abuse treatment at VAPORHCS or another VA facility.

2.5.7. The Contractor shall notify the VAPORHCS Substance Abuse Treatment Program (SATP) and forward documents to the designated SATP Detox Liaison person prior to discharge from Contractor's facility. Documents forwarded at the time of referral will include: Assessment, Active Medications sheet, all Progress Notes pertinent to the transfer, and the Discharge Note or Summary.

2.6. The Contractor shall adhere to all applicable accreditation and certification standards:

2.6.1. The Contractor shall meet applicable Joint Commission for the Accreditation of Healthcare Organization Life Safety Guidelines.

2.6.2. The Contractor shall notify VAPORHCS immediately and in writing of deficiencies in meeting accreditation, certification, or other Federal, State, or Local standards.

2.6.3. The Contractor shall abide by new accreditation or certification standards as they arise during the period of this contract.

2.7. The Contractor shall provide for the health and safety of patients and staff:

2.7.1. The Contractor’s facility shall conform to the standards of the Life Safety Code (National Fire Protection Association Standard #101) in effect on the date of contract award.

2.7.2. The Contractor shall meet all Federal, State and Local Laws, regulations, and codes pertaining to health and safety.

2.7.3. The Contractor shall assist VAPORHCS personnel to conduct periodic inspections of patient and employee safety, security, and sanitation practices throughout the facility at the discretion of the VA.

2.7.4. The Contractor shall notify VAPORHCS immediately and in writing of deficiencies in meeting Federal, State, or Local standards for health and safety of patients and staff.

2.7.5. The Contractor shall assure that the facility is secure during and after business hours by employing staff observation, locked doors, or cameras.

2.8. The Contractor shall provide for safe storage, administration, and dispensing of medications:

2.8.1. The Contractor shall provide locked storage for the Veteran's medications.

2.8.2. The Contractor shall maintain a system for monitoring and documenting the Veteran's medication compliance.

2.8.3. The Contractor shall notify the VAPORHCS Detox Liaison of prescription discrepancies, unanticipated side effects, adverse medical or psychiatric events, or other medication-related problems and shall seek reconciliation of such problems.

2.8.4. The Contractor shall maintain safe procedures for buying, storing, dispensing, administering, reconciling, and disposing of medications. The Contractor shall allow inspection by VAPORHCS personnel of these policies, procedures, and facilities.

2.9. The Contractor shall provide reports and information for Quality Assurance Monitoring:

2.9.1. The Contractor shall call or submit a list of all admitted Veterans referred by the Detox Liaison with each patient's name, Social Security number, date of birth (DOB), drug(s) of choice, outcome of treatment, and referral information from the Contractor to any subsequent program or facility. This shall be submitted to the Detox Liaison daily. The Contractor shall also inform the Detox Liaison of drop-outs from detoxification within 24 hours of the event.

2.9.2. The Contractor shall send a report on all VA-referred patients indicating the number of Veterans who have been referred to Detox, the number admitted, the number of Incomplete or Declined admissions, the number of Medical or Behavioral Discharges, the number of AMA discharges, and the number of Veterans referred to ongoing treatment at any VA Substance Abuse Treatment Program. This will be submitted to the Detox Liaison quarterly.

2.9.3. The Contractor shall report adverse medical and psychiatric events, such as medication errors, adverse reactions to medication, or sentinel events (loss of life or threat of injury to life or limb) to the Detox Liaison within 24 hours. A summary report of these events will be submitted quarterly to the Detox Liaison or designee.

3.0. DISCRIMINATION PROHIBITED:

3.1. The Contractor shall accept referral of and shall provide all services specified in this contract for any person determined eligible by the Directors, Mental Health and Neurosciences Division, VA Portland Health Care System (VAPORHCS), Oregon, or their designee, regardless of the race, religion, color, gender, national origin, disability, sexual orientation, gender identity, age, education, geographic origin, and skill characteristics of the person for whom such services are ordered. In addition, the Contractor warrants that subcontracting will not be resorted to as a means of circumventing this provision.

3.2. The Contractor shall not maintain nor provide dual or segregated patient facilities, which are segregated on the basis of race, religion, color, gender, national origin, disability, sexual orientation, gender identity, age, education, geographic origin, and skill characteristics. (Note: Services such as sleeping and dining quarters separated by gender are required by this Contract.) The Contractor shall neither require such segregated use by written or oral policies nor tolerate such use by local custom. The term "facilities" shall include but not be limited to rooms, wards, sections, drinking fountains, and entrances, and other like areas.

4.0. CLINICAL RECORDS:

4.1. All medical records concerning the Veteran's care in the Contracted program shall be readily accessible to the VA. Upon discharge or death of the patient, the Contractor shall retain medical records for a period of at least three years following termination of care. Patient records shall be maintained in conformance with the Privacy Act of 1974 (5 U.S.C. 552a). A medical record shall be maintained for each patient. All Medical records shall be treated according to the Special Confidentiality/Prohibition of Re-disclosure Regulations of 42CFRPart 2 (and updates) for Substance Abuse Treatment Programs. All medical records shall be treated in accordance with TAMPA requirements.

4.2. Security of information and IT systems: VAPORHCS has determined that the C&A requirements do not apply, and a Security Accreditation Package is not required.

5.0. SUPERVISION OF CONTRACT PERFORMANCE:

5.1. This contract for Medically-Monitored Detoxification will be supervised by the Contracting Officer (CO), Contracting Officer Representative (COR), Mental Health and Neurosciences Division (MHND) Clinical Consultant, and the Detox Liaisons at the Substance Abuse Treatment Program of VAPORHCS. The Contractor shall adhere to guidelines from those officials. The Contractor shall provide no more than 30 days of detoxification services to an individual Veteran in a calendar year. The Veteran shall be provided detoxification services at the expense of VA for a period not in excess of that stated in the Authorization received from VA, unless an extension of the authorization is provided in writing by the Substance Abuse Treatment Program of the VAPORHCS. The Detox Liaisons will be given information necessary to authorize and document the authorization in the Veteran's Computerized Patient Record System (CPRS) medical record.

5.2. The Government will have the right to inspection of the Contractor’s facility and all appurtenances by authorized VA representative(s) to ensure that acceptable safety, security, sanitation, and quality of environment standards are maintained and that the necessary clinical care to maintain the well-being of the patient is rendered.

5.3. Duly authorized representatives of the Government will provide follow-up supervision visits to Veterans placed to assure the extent, quality, and continuity of care and to determine whether acceptable standards are maintained and that adequate care is being rendered. These visits do not substitute for nor relieve the Contractor in any way of the responsibility for the agreed upon plan of care including the medical, psychiatric, and addiction treatment of the Veteran.

6.0. REPORTS:

6.1. The Contractor shall submit reports to the Detox Liaison or designee on the utilization of services for VA-referred patients. The Contractor shall send a report on all VA-referred patients indicating the number of Veterans who have been referred to Detox, the number admitted, the number of Incomplete or Declined admissions, the number of Medical or Behavioral Discharges, the number of AMA discharges, and the number of Veterans referred to ongoing treatment at any VA Substance Abuse Treatment Program. Utilization of service reports will include average length of stay and drop-out rate, a list of adverse medical/psychiatric events or sentinel events, outcomes of treatment, and performance improvement efforts. These reports shall be submitted quarterly.

6.2. The Contractor shall call or submit a list of all admitted Veterans referred by the Detox Liaison with each patient's name, Social Security number, DOB, drug(s) of choice, outcome of treatment, referral information from the Contractor to any subsequent program or facility, and program completion status. This shall be submitted to the Detox Liaison daily. The Contractor shall also inform the Detox Liaison of drop-outs from detoxification within 24 hours of the event.

6.3. The Contractor shall inform the Detox Liaison of sentinel events, adverse medical or psychiatric events, medication errors, or other emergencies within 24 hours of the occurrence.

7.0. TERMINATION OF SERVICES: The VAPORHCS reserves the right to remove any or all VA patients from the Contractor’s facility at any time, when it is determined to be in the best interest of the VA or the patients.

8.0. RATE DETERMINATION: The Contractor shall provide to the VAPORHCS services to enrolled Veteran patients in accordance with all terms, provisions, general conditions, and requirements as listed herein, and in accordance with the Price/Cost Schedule. Prices are inclusive of all services as may be necessary in the treatment of the patient.

9.0. ABSENCE: Absence of the patient from the Contractor's Program for longer than 24 hours will not be reimbursable.

10.0. CONTRACT ADMINISTRATION:

10.1. The Contracting Officer is the only person authorized to approve changes or modify any of the requirements under this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitments or issue changes which will affect price, quantity, terms or quality of performance of this contract.

10.2. In the event the contractor effects any such change at the direction of any person other than the Contracting Officer, the change shall be considered to have been made without authority and no adjustment will be made in the contract price to cover any increase in costs incurred as a result thereof.

11.0. PAYMENTS: Payments made by VA under this contract constitute the total cost of Contractor’s care. No additional charges will be billed to Medicare Part B, the beneficiary or his/her family, either by the ADC or any third-party furnishing services or supplies required for such care, unless and until specific prior authorization in writing is obtained from the VA facility authorizing placement. The contractor shall not solicit contributions, donations, or gifts from patients or family members.

12.0. PERFORMANCE STANDARDS:

12.1. Measure: Quality of Care

Performance Requirement: Referral to VA Substance Abuse Treatment Program at discharge.

Standard: VA-funded Veterans will be referred to ongoing substance use disorder treatment.

Acceptable Quality Level: GOAL: 90% of Veterans will be referred to VA SUD Programs prior to discharge.

Surveillance Method: Contractor will report and document quarterly the percent of VA-funded Veterans who were referred to ongoing SUD Tx at any VA.

Referral to continuing care in substance abuse treatment should always be attempted and documented. This is one measure of quality of care.

Veterans will be referred to ongoing substance abuse treatment: Contractor will note documentation of a referral to any VA substance abuse treatment program. This measure applies only to Veterans who complete the detox program. The acceptable level of quality will be 90% of VA-referred Veterans who complete the detox program will be referred to ongoing substance abuse treatment in any VA Program.

12.2. Measure: Quality of Care/Safety

Performance Requirement: Safe completion of detox.

Standard: VA-funded Veterans will complete the detox process.

Acceptable Quality Level: GOAL: 80% of Veterans will complete the detox program Surveillance Method: Contractor will document quarterly the percent of VA-funded Veterans who completed the detox program vs drop-outs Detoxification is a challenging process; we wish to measure the completion rate as an indicator of quality of care and patient safety. Contractor will monitor by a tracking document or conduct a chart review of VA-referred Veterans to identify the number who complete the detox treatment (numerator) divided by the number who are admitted for detox (denominator). We expect a completion rate of 80%, but will meet with Contractor if this figure needs revision.

12.3. Measure: Quality/Safety

Performance Requirement: Adverse medical or psychiatric events.

Standard: 100% of Adverse Events on VA-funded Veterans will be reported to VAPORHCS Detox Liaison within 24 hours.

Acceptable Quality Level: GOAL: 90% of adverse events reported within 24 hours.

Surveillance Method: Contractor will report adverse events daily to the Detox Liaison. Contractor will keep data and submit quarterly report on adverse medical or clinical events for VA-funded Vets.

Adverse events, such as medication errors, adverse medical reactions, and sentinel events, are a constant threat as well as a learning opportunity. Contractor will report number and type of medication errors, adverse medical reactions, and sentinel events to the PVAMC Detox Liaison within 24 hours. In addition, the Contractor will provide a quarterly report summarizing the number and type of adverse events. Acceptable level of quality is 90% timely reporting for both the daily and quarterly measures.

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