36C26118Q0096-0001006.docx

PERFORMANCE WORK STATEMENT

REVISION 6-12-18

1. Background

0. The U.S. Department of Veterans Affairs (VA) is seeking a contractor to assist with the provision of housing placement and case management services through the HUD-VASH program. The program is a partnership between the U.S. Department of Housing and Urban Development (HUD) and VA Supportive Housing (VASH) to place and maintain homeless Veterans in permanent, community based housing using HUD Section 8 Housing Choice Vouchers that are paired with ongoing VA case management services. Many of these Veterans have co-morbid conditions that include serious mental illnesses, substance abuse disorders, and other serious medical conditions. VA intends to engage a Contractor to provide housing placement services in Sonoma, Mendocino and Lake Counties along with ongoing case management services to HUD-VASH eligible Veterans and their families.

0. Contractors should be aware that HUD-VASH is a national program serving Veterans and their families throughout the country. This program continues to expand and has become one of the largest VA interventions to assist homeless Veterans. It represents one of VA’s most significant efforts to achieve the President’s goal of ending homelessness among Veterans. To be eligible for the HUD-VASH program, a Veteran must be:

1. Eligible for VA health care as determined by the local VA medical center

1. Determined to be homeless based on McKinney-Vento Act definitions by the local VA medical center HUD-VASH program with every effort made to identify and serve the most chronically homeless and vulnerable Veterans.

0. The target population for the HUD-VASH Housing Placement and Case Management contract includes chronically homeless Veterans who are the most vulnerable and may have severe mental health and/or substance abuse problems. Veterans may not be chronic and may fall into one of the priority groups such as women, women Veterans with children, OEF/OIF/OND Veterans, and/or Veterans who have physical health problems and/or Substance Use Disorders (SUD), with frequent emergency room visits, multiple treatment failures, and limited access to other social supports. Through this contract initiative, Contractor(s) will place individuals into housing while simultaneously providing case management and supportive services; and assist the Veteran in maintaining housing until the Veteran is eligible for discharge. The HUD-VASH program shall be reserved for homeless Veterans with serious mental health problems who have few resources and require long-term case management to either obtain and/or maintain permanent supportive housing.

2. In addition to targeting the most vulnerable homeless Veterans, HUD-VASH utilizes a Housing First approach in working with Veterans to ensure rapid housing placement and stabilization. Housing First is an approach that centers on providing homeless individuals with “housing first” and then providing services and treatment as needed. What differentiates a Housing First approach from other strategies is that there is an immediate need and primary focus on helping individuals and families quickly access and sustain permanent housing.

0. Through this contract, the VA seeks to expedite the placement of HUD-VASH Veterans and their families in affordable, permanent housing and assist them in maintaining housing thereafter. This housing must meet the criteria for inclusion in HUD‘s Section 8 Housing Choice Voucher program. Contractors are expected to provide housing as part of this contract, but they are expected to have appropriate staff and resources in place to assist Veterans in finding acceptable community based housing in a timely manner that meets Section 8 criteria. Housing inspections are conducted by the local Public Housing Authority or its agent. Some HUD-VASH housing units may be available through pre-approved project-based vouchers as agreed to by the local Public Housing Authority and the VA medical center.

0. The purpose of this contract is to enter into an Indefinite Delivery, Indefinite Quantity (IDIQ) firm fixed-price contract with a community partner (Contractor) who will provide housing placement, case management, and supportive services to Veteran beneficiaries as specified herein. All services shall be provided in accordance with the terms, conditions and provisions of this contract for a period of one year from the date of award, with the Government’s option to exercise four (4) one (1) year option periods. The Contractor shall provide all labor, supervision, supplies (including vehicles), and materials necessary to carry out the task specified in this Performance Work Statement (PWS). Performance will occur at the Contractor’s location and the San Francisco VA Healthcare System (SFVAHCS) unless otherwise required by work requirements listed in the PWS, or otherwise specified by the task orders issued under this contract. All services are to be performed li the Veteran Integrated System Network (VISN) 21 geographic areas.

0. VISN 21 geographic areas included in this contract and subsequent contract include the following VA Medical Center catchment areas: Sonoma, Mendocino and Lake Counties. The Contractor shall not commence performance on the resulting tasks order in the awarded contract until the Contracting Officer (CO) has conducted a kick off meeting or has advised the contractor that a kick off meeting has been waived.

0. The Contracting Officer’s Representative (COR) will evaluate all deliverables submitted. The COR is responsible for certifying invoices for payment only for deliverables received and deemed acceptable by the COR. A Quality Assurance Surveillance Plan (QASP) will be used by the COR to measure performance success and/or failure. VA Liaisons will be identified by the SFVAHCS HUD-VASH program. They will act as the clinical liaison for all Veteran related issues in conjunction with the COR between the Contractor and the VA homeless team. They will provide clinical oversight, but will not provide direct clinical supervision.

0. Veteran/voucher referrals will be made to the Contractor at the discretion of the VA Medical Center. Contractors will work with the amount of cases per year based on the needs of the VA Medical Center.

1. General Requirements

1. Contractor shall be able to provide services to eligible beneficiaries per year for whom such care is specifically authorized by the referring VA. Contractor shall perform the following task:

0. The Contractor will need to ensure sufficient full-time staffing is in place with ratios at a minimum of 35:1.

0. Team staff composition must include 50% masters level social workers (MSW) and 50% licensed clinical social workers (LCSW). The contractor supervisor must be a licensed clinical social worker (LCSW).

REPLACED WITH

0. Team staff composition must include 50% masters level social workers (MSW) and 50% licensed clinical social workers (LCSW). The contractor supervisor must be a licensed clinical social worker (LCSW). The SFVAMC will allow interested parties with currently employed MFTs with a minimum of three months HUD-VASH case management experience to be used for case manager duties. Future hires and interested parties that do not have an MFT with a minimum of three months HUD VASH case management experience currently on staff must use LCSWs or MSWs to perform case manager position.

0. Contractor shall provide 24/7 coverage point of contact in case of emergency

0. Contractor shall comply with HUD-VASH and SFVAHCS policy and procedures for Veterans receiving services under this contract.

0. While most services will be provided in the home, the team will visit Veterans if hospitalized or incarcerated. They will also accompany Veterans to ER’s and, as needed, to clinics or other appointments

0. When Veterans have achieved housing stability, the focus of the service support changes to support community integration and other goals, it does not diminish

0. Case Management services shall follow the principles and practices of the Housing First Model

0. Team shall participate in continuing education related training including the Housing First Model, trauma informed care, motivational interviewing, relapse prevention, supported employment, and supported education.

0. The Contractor shall be able to provide full staffing as outlined in task and deliverables within 60 days of contract award either through existing staff or new hires.

0. Contractor personnel shall maintain an active standing with the licensing boards in their respective profession in accordance with the below requirements:

9. Basic Life Support (BLS) is required for all professional staff;

9. American Heart Association certification is preferred but not required.

0. Contractor shall assist Veterans with obtaining and maintaining housing authorized by HUD and the Public Housing Authority in the area assigned.

0. Contractor shall work with Veterans and their families with a wide range of backgrounds and bio psychosocial challenges and vulnerabilities including severe mental illness, chronic and current substance abuse, and serious medical problems.

0. Contractor will receive cases from HUD-VASH program and will confirm that the Veteran meets the criteria for admission into the HUD-VASH program, which includes ability to live independently. The Contractor must complete Homeless Operations Management and Evaluation (HOMES) documentation, consistent with the HOMES Reporting Policy, including but not limited to changes to admission, housing, voucher, or employment status, and Computerized Patient Records System (CPRS) encounter documentation including but not limited to a screening/admission note, treatment plan, release of information forms, housing service agreement, suicide risk assessment, Advanced Directive Discussions, and safety plan. Contractor shall document using the SOAP format for all clinical notes and ensure all CPRS encounters are entered after the service provided but no later than 72 hours of service in accordance with SFVAHCS HUD-VASH Documentation Policy.

0. Contractor must meet SFVAHCS encounter and productivity expectations.

0. Contractor shall document Veteran encounters and change of Veteran status in the HOMES system within 72-hours of occurrence.

0. Contractor shall enter Veteran information, after obtaining a release of information, into the Coordinated Entry System that has been selected per county.

0. Contractor shall accompany Veterans to medical appointments, meetings, and other appointments as deemed necessary based on the clinical assessment. Contractor shall simultaneously work with Veterans to foster independence and a sense of self-determination.

0. Contractor shall participate in and coordinate with the VA COR/Liaison during weekly case conferences regarding updates and changes in the Veteran’s care plans to foster a collaborative relationship with the VA and Contractor in meeting the Veteran’s needs. Case conferencing may be done in person or by telephonic conference calls as determined by the VA COR.

0. The Contractor shall meet the same performance measures set forth for the VA by the VHA Homeless Program Office located in the technical manual “Performance Measures and Metrics”, this requirement shall include any subsequent updates and/or revisions, to include standards set forth in the VA Supportive Housing Target and Business Rules. Including the responsibility to update the Employment Tracker in HOMES, our most recently added performance measure.

0. The Contractor shall work with the Veteran on obtaining housing, maintaining housing, independent living skills, budgeting, and employment and/or assistance obtaining VA benefits.

0. The Contractor shall make all communications with the VA regarding this contract through the Network Contracting Office (NCO) 21, via the VA COR.

0. The Contractor shall demonstrate successful completion of the following tasks, validated by VA inspection, prior to receiving case management referrals and invoicing for payment:

0. Attend a post-award kick-off meeting within seven days of contract award

1. Contractor shall provide Identification of staff to work directly with referred Veterans as outlined in the Performance Work Statement and their achievement of VA security and credentialing procedures including:

0. Security/background investigation via National Agency Check with Written Inquiries (NACI) and a Special Agreement Check (SAC) which includes electronic fingerprinting for case managers and their supervisor working with Veterans. In order to complete this background check, the Contractor must provide staff member’s date of birth, social security number, hair color, eye color, home address, phone number, and email addresses. U.S Citizenship or legal resident status will be verified as part of this process.

0. In order for case managers and their supervisor to perform under this contract, they must complete the credentialing process through the VA’s VetPro system. VetPro is necessary for all licensed, registered or certified clinical staff members (e.g. LCSW, RN, CASAC.) Information will be provided by SFVAHCS for staff to begin this process online. A Federal Personal Identification Card will also be issued; this requires an in person visit to the SFVAHCS Human Resources Department for verification of documents and photographs of the individual staff member.

0. Completion of the VA’s online Rules of Behavior Training in the VA’s Talent Management System (TMS) is required for case managers and their supervisor working directly with Veterans under this contract. Contractor staff must self-register for a TMS account. This can be done online. This requirement is in addition to any other training that may be required of the Contractor(s) and any sub-contractor(s).

1. Contractor Outreach/Case Management Duties

2. The Contractor shall have procedures in place to ensure Veterans have access to case management services Monday – Friday 8am – 4:30pm, which shall include crisis management and referrals. The Contractor shall ensure consistency of case management services to enhance staff ability to engage and form relationships with Veterans and provide consistent and highly skilled interventions.

2. The Contractor shall have adequate and appropriate space available at the Contractor location for the VA staff to conduct group meetings with the Veterans under contract care. Contractor shall also submit a monthly tracking sheet derived from the HOMES OR7 and delivered in that format approved by the COR that provides status updates for Veterans receiving services under this contract regarding change in level of care, milestones met, employment/benefits, potential discharges, case management interventions, and other fields as approved by the COR. A list of all home visits to also be provided monthly to the VA Liaison.

2. Contractor shall ensure that sufficient staff are available to provide services to meet the documented needs of the Veterans and the VHA performance standards as referenced above, as well as the ability to make home visits consistent with the level of care each Veteran is being treated at in addition to the following:

2. Ensure consistency of Assertive Community Treatment (ACT) team services to enhance staff’s ability to engage and form relationships with Veterans and provide consistent and highly skilled interventions in keeping with the HF-ACT model.

2. Comply with documentation and data reporting as required by SFVACHS based on changing or subsequent local, VISN, or national HUD-VASH requirements and policies.

2. Contractor shall perform the following Case Management duties:

3. Engage the Veteran in the HUD-VASH process and perform interviewing, counseling, and case management of identified Veterans who are at risk; providing psychosocial assessments to identify treatment needs which affect Veteran’s adjustment to their environment, and establish treatment goals

3. Contractor will conduct high-risk screening, psychosocial assessment and treatment planning, actively involving the Veteran and their family or significant others, in coordination with the treatment team members. Psychosocial assessments will include goals for clinical treatment. Contractor coordinates and documents clinical case management and psychosocial services and documents the overall effectiveness of the case management services provided.

3. Specifically, Contractor will complete the following:

2. Psychosocial Assessment: The case manager is responsible for utilizing the “Social Work Psychosocial Assessment Note” template in CPRS. This assessment will be completed before the Veteran receives the HUD-VASH voucher from the local Public Housing Authority. The psychosocial assessment is updated when there are significant changes in the Veteran’s status or condition, but at a minimum of once every year.

2. Social Work Treatment Plan: The case manager is responsible for utilizing the “HUD-VASH SW Treatment Plan Note” template and progress note title in CPRS. The SW Treatment Plan will be completed at the same time the initial Psychosocial Assessment is completed. In addition, the case manager will use a collaborative approach in completing the plan with the Veteran. The Treatment Plan should be updated annually or when there are significant changes in the Veteran’s status or condition. For example, when Veteran goes from homeless to permanent housing, this is considered “significant change” and a review and update in Treatment Plan is required. Care should be taken to develop measurable goals, which are revisited during regular meetings between the case manager and the Veteran.

2. Review the Treatment Plan at least every ninety (90 days) in a clinical meeting with VA Liaison. Make changes in treatment plans in consultation with the Veteran and the VA liaison.

3. Utilize counseling strategies to include crisis intervention and case management including both short and long term services working toward long range HUD-VASH program discharge, otherwise known as “graduation.”

3. Screen each Veteran for suicidal and homicidal risk with each contact. This screening shall be documented in progress notes, suicide risk assessments, and safety plans. Contractor shall document the aforementioned in the VA medical record. If the Veteran is a danger to him/herself or others, the Contractor shall take immediate steps to provide appropriate intervention. Crisis management shall be coordinated and executed by the contractor and shall be reported to the VA COR and other VA staff in accordance with Section 8 – Contractor Reporting Requirements located in the U.S. Department of Housing and Urban Development Public and Indian Housing Notice PIH 2011-53(HA), issued 09/20/2011; this requirement shall include any subsequent changes, updates, or revisions to the PIH Notice.

3. Contractor will notify SFVA of any negative incident occurring with Veteran within one (1) working hour of being aware of the incident. Contractor will complete a written incident report within eight (8) working hours of notification, which may include VA Report of Contact documentation. Incidents include but are not limited to: death, fire, drug / police raid, suicide / suicide attempt, 911 call (police / fire dept. / paramedics / other), severe medical illness / emergency, severe psychiatric illness / emergency, sexual assault, act of violence by Veteran against other(s), abusive behavior by Veteran against staff, act of violence by other(s) against Veteran, abusive behavior by staff against veteran, accident, medication problems or adverse drug reactions, or other untoward events.

3. The VA Liaison may act as the Mental Health Treatment Coordinator.

3. Facilitate the Veteran’s involvement in therapeutic and work restoration programs, intervening and advocating on behalf of the Veteran.

3. Contractors shall provide and/or coordinate direct mental health and substance abuse counseling within their scope of practice and assist in securing available VA services using tele-mental health services when appropriate. The Contractor shall also facilitate the Veteran’s involvement in therapeutic and work restoration programs, such as Transitional Work Experience (TWE), as appropriate.

3. Contractor shall integrate Housing stabilization planning with relevant VA health and mental health services. Contractor shall refer and provide transportation to VA Medical Facilities, VA Regional Offices, and community-based agencies for a variety of services that may include health care, entitlements, vocational assistance, education, recreation, and any other needed assistance.

3. Contractor shall have procedures in place to ensure clients have 24/7 access to live person-to-person case management services which shall include crisis management and referral.

3. The Contractor will be paid a flat rate per Veteran per month based on services rendered in accordance with the requirements established in this PWS. The Contractor is encouraged to pursue case management discharge for Veterans. The VA may assign additional Veterans to the Contractor for case management services to replace those Veterans who have been discharged from the program. Assignment of additional Veterans for case management services is not guaranteed and will be dependent upon the demand for such services and the VA’s needs at that time.

3. The Contractor shall create and retain records that provide evidence of contacts with individuals and agencies engaged to support the Veteran’s housing and recovery needs. Members of the HF-ACT team must only work within the scope of their trained field of practice.

3. Clinical Documentations that must be completed by a MSW or LCSW:

13. Suicide Risk Assessment Prevention Plans (SRAPP)

13. Clinical reminders

13. Psychosocial Assessment and Treatment Plan

13. Case Management Stage determination

3. The Contractor shall create records in CPRS that provide evidence of contacts with individuals and agencies engaged to support Veteran’s housing and recovery needs.

1. Case Management Visits

3. Case management and home visits to Veterans shall be conducted in accordance with the HUD-VASH Directive and the SFVAHCS HUD-VASH Case Management Policy. The Contractor shall provide at the end of each month a list of all Veterans assigned to each level of care for review and verification of services rendered according to the needs of the Veteran.

3. The Contractor shall visit each Veteran face-to-face at the intervals required by the HUD-VASH Directive and the SFVAHCS HUD-VASH Case Management Policy. Visits are to take place in the Veteran’s home. Until the Veteran is housed or as clinically indicated once housed, visits may occur in the community, at the Contractor agency, or a place mutually agreed upon by the Veteran and Case Manager. Phone contacts, while an acceptable way to communicate with the Veteran, are not considered visits in meeting the minimum visit requirements for any acuity level. In the event the Contractor is unable to locate the Veteran for the required number of visits, the Contractor will document face-to-face attempts, phone calls, and letters sent to the Veteran including dates and times in CPRS as verification of services rendered.

1. There are five basic levels of case management: Intensive, Stabilization, Maintenance, Preparation for Discharge and Graduation/Discharge.

0. Acuity Level 5 – Intensive. The HUD-VASH Case Management team works with the Veteran to obtain clinical stability. At a minimum, weekly home visits are required, but even more frequent interactions may be needed.

0. Acuity Level 4 – Stabilization. At this stage, Veterans are more adept at managing their housing responsibilities and their physical, mental health, and substance use disorders are more stable as the Veteran works on addressing those issues that are most likely to lead to housing instability. At least twice a month home visits are required, with additional interactions as needed.

0. Acuity Level 3 - Maintenance. Case management services ensure that needed treatment, support, and mentoring assistance continue after placement in housing. Home visits need to occur at least every month, once the Veteran demonstrates stability, independence, and improved coping skill use and recovery. Other interactions, such as phone calls, may be indicated.

0. Acuity Level 2 - Preparation for Discharge. Veterans who have functioned at a very independent level for at least one year and sustained a low acuity level may be considered for this phase to practice and plan for discharge from HUD-VASH. Case management can be provided in the home, community, or at the medical center. During this phase, contacts are to occur at least quarterly and the focus of case management would address steps towards graduation from case management, and/or discharge

0. Acuity Level 1 - Graduation/Discharge. Graduation is for Veterans who no longer need the case management services in HUD-VASH, and thus, the Veteran is not required to participate in case management. A Veteran is discharged from HUD-VASH when he/she is no longer participating in case management. If the Veteran is retaining the HUD-VASH voucher for financial purposes only, he or she is considered in graduation status

3. In addition to documenting contact with the Veteran, the contractor shall also document in CPRS evidence of collateral contacts with individuals and agencies engaged to support the Veteran’s housing and recovery needs.

3. The designated Case Management Stage and corresponding minimum visit requirement determination shall require the concurrence of VA, based on the documented needs of the Veteran and a joint clinical case conference between the VA Liaison and Contractor, which will occur on a minimum of a quarterly basis as required by the HUD-VASH Directive and SFVAHCS policy. No changes in the visit schedule shall occur without concurrence from the VA Liaison. However, if a Veteran presents with an urgent need for increased contact, the Contractor will provide services based on the presenting needs prior to review with the VA Liaison.

1. Housing First

4. Housing First is an approach that centers on providing homeless individuals with housing quickly, and then providing services and treatment as needed. What differentiates a Housing First approach from other strategies is an immediate need and primary focus on helping individuals and families quickly access and sustain permanent housing. Housing First programs share four critical elements:

0. Focus on helping individuals and families access and sustain rental housing as quickly as possible and the housing is permanent;

0. A variety of services are delivered primarily following a housing placement to promote housing stability and individual well-being;

0. Services are time-limited or long-term depending upon the individual need;

0. Housing is not contingent on compliance with services. Participants must comply with a standard lease agreement and are provided with the services and supports necessary to help them to obtain and maintain housing and reintegrate into the community.

4. In addition to meeting all the task and deliverables for HUD-VASH case management contained herein, the Contractor shall also provide the following:

1. A combination of Masters Level Social Workers (50%) and Licensed Clinical Social Workers (50%) as well as a Licensed Clinical Social Worker as the HF-ACT Team Supervisor

1. The HF-ACT Team Supervisor and Case Managers must be full time employees and full time to this HUD-VASH contract.

1. Contractor Housing Placement & Stabilization Duties

5. The Contractor shall perform Housing Placement & Stabilization Duties that include:

0. Develop with the Veteran and VA Liaison a Treatment Plan before the HUD-VASH voucher is administered to the Veteran.

0. Consult with the VA Liaison and Veteran regarding any changes in the Treatment Plan and receive VA approval prior to any discharge from the program.

0. Accompany Veteran to any Public Housing Authority appointments including annual certifications, briefings, and interim appointments. Contractor shall assist Veteran in completing and submitting PHA and other Federal, local and state entitlement program paperwork (e.g. Social Security, food stamps, utility assistance, etc.)

0. Advocate with landlords on behalf of the Veteran to maintain a lease and advise any potential landlords that the contractor shall be providing assistance and case management services to the Veteran in order to help the Veteran remain successfully housed. Contractor shall ensure that the Veteran has completed the VA release of permitted information so communication between the landlord, Contractor, and VA can occur as needed.

0. Evaluate and assist the Veteran with budgetary needs to ensure the ability to maintain expenses related to housing while also assisting the Veteran with locating both community and Government resources (i.e. Social Security benefits, disability compensation, local food banks, clothing and furniture donations) as needed.

0. Assist the Veteran in making calls to utility providers to ask questions and resolve issues (including turning off or transferring utilities), ensure the Veteran is paying rent and utility bills in a timely manner and provide budgeting/money management assistance as needed.

0. Assist Veteran in applying for all eligible benefits, both VA and non-VA, including Veteran’s Benefits Administration (VBA), Employment Development Department (EDD, Social Security Administration (SSA), etc.

0. Performing site visits of HUD-VASH apartments to ensure that Veterans reside in healthy residences.

1. Housing First Support Team In addition to the requirements listed in Section Two of this document (General Requirements), the Contractor shall also ensure that sufficient staff is available to provide services to meet the documented needs of Veterans as well as the ability to make home visits consistent with Case Management Level and the needs of the Veteran.

1. Ending Case Management Services

7. Graduation from case management is the goal of the HUD-VASH program in order to help the Veteran achieve optimal functioning and the ability to live independently in the community. Some Veterans are able to achieve this goal more quickly than others. Contract Case Managers, VA Liaisons, and the Veteran shall meet to determine if the Veteran achieves this milestone and to develop an after care plan with the Veteran.

7. A Veteran that no longer needs case management, as determined above may still be eligible for rental assistance under the HUD Section 8 voucher program. If a HUD-VASH voucher is switched to a regular voucher, the family will not be subject to PHA’s waiting list because the family is already participating in PHA’s HCV program.

7. The Contractor shall re-assess any Veterans who do not meet the goals and objectives outlined in their housing case management plan to determine any barriers to compliance. The Contractor’s Case Manager shall work with the Veteran to eliminate any barriers, which may involve engagement issues, continued active use of substances, serious mental illness (SMI), or a history of violence. The case manager is expected to continue efforts to engage the Veteran, unless there is a risk to the safety of the Case Manager. These efforts might require using Motivational Interviewing Techniques to assist the Veteran in redefining goals and making needed changes to the housing and case management plan. The Contractor should consult with facility Mental Health leadership, police service, or other VA program staff such as SUD programs, Mental Health Intensive Case Management (MHICM), or other homeless programs for assistance in determining alternative clinical treatment approaches.

7. In some instances, discharge from the HUD-VASH Program may be required if the Veteran refuses, despite all efforts, to engage in case management or is lost to contact or for other extenuating circumstances. In some instances, if there is a need for a higher level of care, the contractor is responsible for discharge planning and aftercare planning to ensure Veteran receives appropriate level of services. Veterans who choose to participate in behaviors that are adverse enough to result in eviction from their housing unit, or arrest may be terminated from case management and may have their voucher revoked by PHA following the applicable laws and processes. In the event the Veteran is at risk of eviction, the Contractor shall schedule a case conference with the VA Liaison, Contractor, and Veteran to try and prevent eviction from happening. The Case Manger should always initiate appropriate consultation with the VA Liaison and VA COR on adverse events to determine the next course of action. The contractor is responsible for all aspects of discharge planning.

NOTE: Non-compliance with HUD-VASH does not necessarily lead to the loss of the Section 8 HCV voucher. PHA rescinds the HCV if the Veteran no longer meets, or is non-compliant with PHA requirements. The Veteran will receive written notification from PHA of this action.

7. Contractor Case Managers shall document with a progress note, no later than 72 hours from service, and in the HOMES system, when a Veteran leaves the program without prior notice or case conferencing. The VA Liaison and VA COR shall be notified immediately if this situation occurs.

1. Contractor Discharge Requirements

8. Veterans will be discharged from the case management portion of HUD-VASH upon successful community reintegration. Contractor Supervisor must have all graduations approved by VA Liaison.

8. The Contractor shall document in the VA medical record a discharge plan, a minimum of one month prior to a Veteran’s discharge date. The discharge plan shall include:

1. Veteran accomplishment

1. Veteran strengths

1. Areas where support may still be required

1. Veteran support system

1. Positive coping skills

1. VA and community resources accessible to the Veteran

1. Contact sheet of VA and community providers if help is needed in the future

1. Ongoing medical appointments

1. Voucher Porting

9. The Contractor shall provide services for two types of porting vouchers. One being within the VA catchment area, meaning the veteran can live within the jurisdiction of another PHA within the referring VAMC catchment area if the contractor can still provide case management; the other will be outside of the VAMC catchment area.

9. If a Veteran chooses to re-locate to another VAMC catchment area, the Contractor shall schedule a case conference with the VA Liaison. The VA Liaison will then determine that the new VAMC has a new HUD-VASH case management slot and that the new PHA has an available HUD-VASH voucher. HUD-VASH staff at the receiving VAMC must agree that they can and will provide case management services to the Veteran. The Contractor shall continue to provide case management services until such time as transfer is completed.

9. Once the porting transfer has been completed the Contractor shall complete a contractor closing documentation note in CPRS indicating that the Veteran is no longer part of the SFVAHCS HUD-VASH program.

1. Contractor Reporting Requirements

10. The Contractor shall notify VA of any negative incident occurring with the Veteran within one (1) hour of being informed or aware of the incident. Contractor shall complete a written incident report within 24 hours of notification. The Contractor shall provide documentation, as required by the VA COR describing the incident, analysis of cause and effect, and corrective action taken. Reportable incidents include:

0. Death

0. Fire

0. Drug/police raid

0. Suicide/suicide attempt

0. 911 call to police, fire, paramedics, or other

0. Severe medical illness/emergency

0. Severe psychiatric illness emergency

0. Sexual assault

0. Act of violence by Veteran against others

0. Abusive behavior by Veteran against staff

0. Acts of violence by others against Veteran

0. Abusive behavior by staff against Veteran

0. Accident

0. Medication problems or adverse drug reactions

10. The Contractor shall maintain documentation of Veteran assessments, service plans, individual contacts, progress reviews and other VA documentation requirements utilizing VA medical records system CPRS and HOMES.

10. The Contractor shall provide monthly written status reports to the VA Liaison which will include the number of Veterans receiving case management services and at what acuity level, as well as which PHA they are housed under, and number of home visits, along with the name and contact information of the Case Manager assigned to each Veteran.

10. The Contractor shall enter enrollment, contact, or incident information into HOMES at a maximum of 72 hours of completing admission screenings into the HUD-VASH program.

10. The Contractor shall coordinate and document clinical case management and psychosocial services, including the overall effectiveness of the case management services provided to the Veteran.

10. Contractor shall maintain written documentation in CPRS of any and all contacts with Veterans and any ancillary contacts such as family members, landlords, etc. made on behalf of the Veteran. All significant contact with Veterans shall be documented in the VA medical record within 72 hours. Significant contact includes:

0. Medical, psychiatric, and issues related to Veteran’s Housing Stabilization Plan.

0. Suicide, homicide, violence, accidents, substance abuse issues, or changes in the Veteran’s living status

0. All assistance provided to the Veteran related to attending required appointments

1. Records

11. The Contractor shall maintain all Veteran records in accordance with The Joint Commission and/or CARF standards. The Contractor is subject to all Federal, State, and local statutes regarding confidentiality of patient information. The VA shall be provided access to all records in the Contractor’s facility regarding the care of Veterans under this contract.

11. The Contractor personnel who obtain access to hardware or media which may manipulate or store records revealing treatment for drug or alcohol abuse, sickle cell anemia, or infection with HIV, medical quality assurance records, or any other sensitive information as defined by the VA shall not access such records unless absolutely necessary to perform their contractual duties. Any individual who has access to this data shall disclose such information to no one, including other employees of the Contractor not involved with the performance of the particular contractual duty for which access is necessary.

1. Contractor shall not use Government IT equipment and/or Government records to create or maintain any records that are not specifically tied to or authorized by the contract.

1. Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected by the Freedom of Information Act.

1. Contractor shall not create or maintain any records containing any Government Agency records that are not specifically required or authorized by the contract.

1. The Contractor shall not dispose of any records created while performing services under this contract without the prior written consent of the Contracting Officer. The Contractor shall put in place procedures to prevent the alienation or unauthorized destruction of records, including all forms of mutilation. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C 2701. Records may not be removed from the legal custody of the Agency or destroyed without regard to the provisions of the agency records schedules.

1. The Contractor shall obtain the Contracting Officer’s approval prior to engaging in any contractual relationship in support of this contract requiring the disclosure of information, documentary material, and/or records generated under, or relating to this contract. The Contractor shall abide by Government and VA guidance for protecting sensitive and proprietary information.

1. Life Skills

12. Contractor shall provide life skills education and assistance to Veterans that include:

0. Budgeting/Money Management Assistance

0. Locating local food banks

0. How to use coupons

0. Budget billing for utilities

0. Advice on how to maintain a clean and safe residence

0. Socialization

0. Spirituality – where and how to access these services if desired

0. Schedule of free/low cost community activities

0. Planned evening and weekend Psychosocial events

0. Community volunteer opportunities

0. Peer/tenant support group

0. Instruction on how to be a good neighbor/tenant

0. Mental Health Wellness Self-Management / mental health recovery living skills (if applicable)

0. Relapse prevention and harm reduction (if applicable)

0. Healthy lifestyle/living

0. Access to community resources

0. Parenting/family living skills (if applicable)

0. Family reunification and/or development of relevant social support networks

0. Assist with obtaining legal assistance-free/low cost resources such as:

18. Obtaining a driver’s license

18. Locating child support

18. Identifying the local liaison with VJO (Veterans Justice Outreach) program

0. Locating the local specialty or treatment court

0. Assistance with light house cleaning, shopping, and cooking.

1. Transportation

13. The Contractor shall make every effort to connect the Veteran with existing public transportation networks or other community provided transportation.

13. In cases where the Veteran is unable to access or use existing public transportation networks or other community provided transportation, the Contractor shall provide transportation for the Veterans to attend appointments at the VA, SSA, PHA, benefits agencies, landlords etc. Transportation may include bus passes, transit cards, or subsidized transportation services such as Access, and other identified needed services and entitlements.

1. Qualifications – Experience, Facility and Staffing

14. The Contractor will be a direct provider of case management and supportive housing.

14. The Contractor shall provide full staffing as outlined in contract within 60 days of the contract award either through existing staff or new hires.

14. The Contractor facility shall meet the following:

2. Conforms to the Life Safety Code, National Fire Protection Association (NFPA) #101 standards: http://www.nfpa.org/aboutthecodes/AboutTheCodes.asp?DocNum=101&cookie%5Ftest=1

2. Contractor shall possess a valid Business License/Certification for the State of California.

2. Contractor facility shall have a current Certificate of Occupancy permit or license as required by the authority that has jurisdiction to issue and must adhere to all applicable local, state, and federal laws.

2. Contractor’s facility shall be wheelchair accessible

2. Contractor shall be in compliance with Americans with Disabilities Act Guidelines for Buildings and Facilities. http://www.access-board.gov/adaag/html/adaag.htm

2. Contractor’s facility where services are to be provided shall be within the catchment areas of the VISN 21. Please refer to section 1.5 for geographical areas.

2. The Contractor personnel shall maintain active standings with the licensing boards governing their respective professions. Contractor shall ensure all professional staff are trained and certified in Basic Life Support (BLS), American Heart Association certification is preferred but not required.

14. Staffing responsibilities are described as follows:

3. LCSW (50%) and MSW (50%), including an LCSW contract supervisor, must be full-time on staff and assigned to the HUD-VASH contract. Schedule must permit 24-hour supervision of case management personnel for the purposes of clinical oversight, documentation and crisis management. The licensed independent practitioner must be available for team conferences as requested by the local VA Medical Center HUD-VASH program.

1. Standard of Conduct

15. The Government reserves the right to refuse acceptance of Contractor personnel whose personal or professional conduct jeopardizes the Veteran care. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, abuse, dereliction or negligence in performing directed tasks, or other abuse, or other conduct resulting in formal complaints by the Veteran, COR or VA staff. Contractor shall maintain professional boundaries with Veteran. Contractor staff shall under no circumstances engage in sexual activities or sexual contact with Veterans or their family members, even if such contact is consensual. Contractor and Contractor staff shall under no circumstances engage in any monetary transactions either in the form of lending or borrowing of money or purchasing goods with the Veteran. Contractor and Contractor staff shall under no circumstances take unfair advantage of any professional relationship or exploit Veteran or their family members to further their personal, religious, political, or business interests. Contractor staff should not engage in relationships with Veterans or their family members in whom there is a risk of exploitation or potential harm to the Veteran or Veteran family. Contractor is responsible for taking steps to protect Veterans and their family members and is responsible for setting clear, appropriate, and culturally sensitive boundaries.

15. Contractor shall comply with the Standards of conduct prescribed in SFVAHCS Policies.

15. Complaints concerning Contractor personnel’s conduct with Government employees or Veteran patients shall be dealt with by the Contractor and COR. The Contracting Officer is the final authority on validating complaints. In the event that Contractor personnel are involved and named in a validated complaint, the Government reserves the right to refuse acceptance of the services of such personnel. This does not preclude refusal in the event of incidents involving physical or verbal abuse. The final arbiter on questions of acceptability is the Contracting Officer. In the event the Government refuses acceptance of services of Contractor personnel, the Contractor shall immediately provide replacement personnel that are acceptable to the Contracting Officer. The cost of removing and replacing such personnel shall be borne solely by the Contractor.

1. Contractor Employee Requirements

16. Staffing shall be at a level to ensure all services listed in the contract are met for every Veteran served. The Contractor shall have sufficient staff with appropriate training to provide services as identified. Contractor shall ensure that sufficient staff remains available to provide services for the term of this contract.

16. All case managers and other staff of the Contractor shall be evaluated by VET PRO for privileging and credentialing in accordance with the policies and procedures of the VA Medical Center monitoring the contract, this includes a background check.

1. Substitution of Personnel

17. The Contractor shall utilize the personnel named in its proposal to perform the services required under this contract. In the event that any of the personnel named in the proposal are unable to perform the duties of this contract, for any reason such as death, illness, or resignation from the contractor’s employ, the contractor shall promptly submit to the Contracting Officer and COR, in writing, a detailed explanation of the circumstances necessitating the substitution. The Contractor shall submit this request in writing, along with a resume for the proposed substitute, and any other information that may be needed to approve or disapprove the proposed substitution. Any substitution of personnel shall occur without any increase to the contract price and without delay in the performance or delivery of services to the Government.

17. The Government shall have the right to require replacement of any contractor employee assigned to work on this contract, if the employee is determined not to possess the experience, education, credentials or ability required under the contract, or if said employee is for any other reason found to be unsuitable to perform the work required by the contract. The replacement shall meet the Personnel requirements stated in the contract. In the event the Government requires replacement Contractor personnel, the Contractor shall immediately provide replacement personnel that are acceptable to the Contracting Officer. The cost of removing and replacing such personnel shall be borne solely by the Contractor.

1. Contractor Liaison

18. The Contractor shall identify a point of contact for the management of billing of this contract who will work directly with the VA COR on the billing matters of this contract. This person shall have full authority to act for the Contractor on all matters relating to the daily operation of this contract. The person filling this role may be personnel performing under this contract. An alternate may be designated, but the Contractor shall identify, in writing, those times when the alternate shall act as the liaison.

Contractor Liaison:

Phone Number:

Fax Number:

Email Address:

1. Alcohol/Drug Screening

19. Contractor is responsible for ensuring their employees are not using alcohol or illegal drugs, while performing work under this contract, and are subject to random alcohol/drug testing performed by the Contractor. Contractor shall perform alcohol/ drug testing when there is a reasonable suspicion that an employee is using or is impaired by alcohol or illegal drugs while on duty. Reasonable suspicion of alcohol/drug use or impairment includes, but is not limited, to the following:

0. Observable phenomena, such as direct observation of drug use, possession or the physical symptoms of being under the influence of a drug;

0. A pattern of abnormal conduct or erratic behavior;

0. Arrest or conviction for a drug related offense or the identification of a Contractor physician as the focus of a criminal investigation into illegal drug possession, use, or trafficking;

19. Information provided either by reliable and…