36C26121Q0017_1.docx

B. 3 PERFORMANCE WORK STATEMENT

1. SCOPE OF WORK

1.1. Contractor shall provide readjustment counseling services in accordance with the requirements listed in the Performance Work Statement (PWS). Work to be performed at Contractor’s place of business located in Fresno, CA catchment area

1.2. PERIOD OF PERFORMANCE: The period of performance (POP) shall be for one (1) year starting on the effective award date of the contract, with 2 ordering periods.

2. BACKGROUND

2.1. Public law authorizes the Department of Veterans Affair (VA) to provide readjustment counseling to combat veterans and guarantees readjustment counseling as a lifetime entitlement to war zone veterans under Readjustment Counseling Services.

2.2. Public Law authorizes the Department of Veterans Affairs to provide readjustment counseling services to combat veterans and their families.

2.3. The Vet Center mission is to provide outreach and counseling to assist all combat veterans of any conflict to resolve war-related psychological difficulties and to help them achieve a successful post-war readjustment to civilian life.

2.4. Legislation authorized VA to augment Vet Center services through contracts with private sector providers for provision of readjustment counseling to veterans who served during a period and in the theater of armed hostilities.

3. READJUSTMENT COUNSELING DUTIES

3.1. Consultation service, for purposes of this contract, is service provided by licensed mental health providers who are either clinical social workers, psychologists, Marriage and Family Therapists or other qualified counselors that will provide services specifically directed at improving the quality of care to post veterans dealing with readjustment difficulties.

3.2. Modalities of readjustment counseling include individual, group and family counseling; all of which must have as their central purpose the post-war readjustment of war zone veterans. This service does not include general mental health services, but only provides readjustment counseling for psychosocial difficulties related to post-war readjustment from military duty, for example:

3.2.1. Exposure to combat-related war trauma.

3.2.2. Exposure to other aspects of war zone stress.

3.2.3. Post-traumatic stress disorder (as defined by the current DSM) or other war-related social and psychological difficulties.

3.2.4. Stressors unique to military duty for eligible veterans.

3.2.5. Psychological concern over a possible service-connected condition.

3.2.6. Substance abuse connected with military duty and/or post-war homecoming and readjustment.

3.2.7. Difficult post-war experiences, including disrupted homecoming and unsuccessful re-entry into civilian roles.

3.2.8. Concern over possible Agent Orange, biological or chemical agent exposure or ramifications thereof.

3.2.9. Generalized alienation from society manifested by lack of expectable familial, educational or vocational activities.

3.2.10. Psychosocial difficulties related to type of military discharge for other than a dishonorable discharge

3.3. The provision of medications and physical examinations are not to be considered a component of readjustment counseling, and therefore, will not be provided under this contract as a reimbursable service to the contractor.

4. Service Management

4.1. Ongoing assessment of counseling cases for consultation will be managed, as to ensure all cases are properly reviewed and care delivered to the veterans are appropriate.

4.2. The Contractor shall provide group consultation and/or individual consultation reviewing and advising the staff on clinical issues that impact theater veterans exposed to war-zone stress.

4.3. Group consultation will be encouraged whenever clinically feasible as this method is both clinically indicated and cost effective for the Government. The composition of such groups must include all clinical staff. Exceptions to this may be granted by the Vet Center TL/COR when clinically indicated.

4.4. 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 the Vet Center or VA.

4.5. The contractor will provide Telehealth services to the assigned veterans in lieu of the face-to-face sessions (Individual, Family, Group) as stipulated in the PWS. The clinical hour is to be considered the same for a telehealth hour as it is for a face-to-face hour.

5. Deliverables

5.1. Review of Psychological Assessment

5.1.1. Psychological assessment shall be completed after the third counseling session and shall contain as a minimum the following information:

5.1.1.1. 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.

5.1.1.2. 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.

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

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

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

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

5.1.1.7. 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.

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

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

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

5.2. Review of Treatment Plan

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

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

5.2.1.2. Problems to be addressed

5.2.1.3. Identification of goals for therapy

5.2.1.4. Type of counseling or therapy recommended

5.2.1.5. Anticipated duration of counseling or therapy

5.2.1.6. Counselor’s signature and date

5.3. The Government may provide these forms.

6. Contracting Monitoring and oversight Management

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

6.2. Representatives of the VA and other Government agencies are authorized to visit premises of service contractors during business hours for purposes of evaluation and auditing which may include inspection of clinical records.

6.3. Site visits will be conducted on at least an annual basis to the facility by the RCS Regional Manager or designee, or other Government employees designated by the Contracting Officer and will include, but shall not be limited to, evaluation verification of the following:

6.3.1. Actual performance versus scheduled and reported performance regarding the number and type of consulting service provided and the amount billed.

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

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

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

7. Period of Performance

7.1. The Contract period of performance is for the base period and four (4) one-year option periods.

7.2. 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 TL/COR.

7.3. The TL/COR will review the information on the new personnel to ensure that the clinical credentials, level of licensing, and quality of service is consistent with the initial proposal and the terms of the original contract.

7.4. If readjustment counseling consultation beyond the contract period is indicated, and if the contract is not renewed, the Contractor shall make appropriate referral to another consulting resource, in consultation with the original referrer.

7.5. The Government will reimburse the Contractor for completion of services 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.

7.6. 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.

8. Invoice Procedures

8.1. Reimbursement will only be for in-person consultation sessions. Reimbursement is not authorized, for example, for telephone calls or for consultation between the Contractor and other individuals unless previously authorized by the COR/Team Leader.

8.2. Reimbursement for travel in connection with contract readjustment is not authorized.

8.3. A consultation session to the staff, for reimbursement purposes, will last a minimum of 120 minutes and will be deemed a single visit regardless of length beyond 120 minutes.

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

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

8.4.2. Invoices shall be electronically submitted to Austin and the original veteran services verification and duplicate cop of invoices mailed to the TL/COR for billing verification and accounting.

8.5. All invoices shall include the information shown in subparagraphs (1) through (9) below, and shall be accompanied by the receipt of services (VA Form 10-5565B) specifying the information shown below:

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

8.5.2. Vet Center or Station Number of Referring Unit;

8.5.3. VIF/Client number;

8.5.4. Number of both individual visits and group visits;

8.5.5. Total number of individual visits;

8.5.6. Total number of group visits;

8.5.7. 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;

8.5.8. Total dollar amount billed;

8.5.9. Month in which consultation services were provided;

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

8.5.11. All invoices must be received by the 1st of the month following services rendered.

8.6. 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.

9. Address for Invoices

9.1. See SF 1449 Block 18a, all invoices must be submitted electronically per the OB10 system.

10. Capability to Provide Medications and Physical Examinations

10.1. 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 consultation about such services

11. Prohibitions

11.1. Contract providers are strictly prohibited from the use of commercial advertising of their readjustment counseling consultation 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. DEFINITIONS/ACRONYMS

12.1. CO” Contracting Officer

12.2. “Contractor” Provider of Readjustment Counseling Services.

12.3. “COR” Contracting Officer Representative

12.4. “FMS” Facilities Management Services

12.5. “RCS” Readjustment Counseling Services

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

12.7. “TL” Team Leader

12.8. “VA” Department of Veterans Affairs

12.9. “VAMC” Veterans Administration Medical Center

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

13. UNIFORMS

13.1. Contractor employees shall maintain a neat personal appearance and maintain a professional decorum.

14. EQUIPMENT/SUPPLIES/FORMS

14.1. Contractor and employees assigned by the Contractor shall provide all required equipment, supplies and forms for performing services required by this contract.

15. QUALIFICATIONS

15.1. Contractor and employees assigned by the Contractor to perform the services covered by this contract shall be licensed in a State, Territory, or Commonwealth of the United States or the District of Columbia. They must:

15.1.1. Have a current license in the State of California as a doctoral level Psychologist or MSW level Social Worker to provide readjustment counseling services.

16. REFUSAL/DISMISSAL

16.1. VACCHCS reserves the right to refuse or dismiss contract personnel whose personal or professional conduct jeopardizes patient care or the regular and ordinary operation of the facility. Reasons for refusal or dismissal include, but are not limited to, unsatisfactory performance prior to and/or during the term of the contract, failure to receive favorable adjudication during a VA background investigation, failure to satisfy the requirements of the contract, physical or verbal abuse to patients, staff, or visitors, intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, ethical misconduct, conduct resulting in formal complaints by patients or other staff members, and any other valid reason considered objectionable.

17. CONTRACTOR PERSONNEL SECURITY REQUIREMENTS – INFORMATION SYSTEMS ACCESS

17.1. All Contractor and employees assigned by the Contractor will not have access to VA computer systems.

17.2. Contractor Responsibilities. In order to conduct a background investigation, the Contractor shall submit or have their contract personnel submit the following required forms to the Contracting Officer Representative (COR). The COR will arrange a time for contract personnel to complete fingerprint verification.

17.2.1. Standard Form 85, Questionnaire for Non-Sensitive Positions

17.2.2. Standard Form 86A, Continuation Sheet for Questionnaires

17.2.3. Optional Form 306, Declaration for Federal Employment

17.2.4. Electronic Fingerprint Verification OR FD 258, U.S. Department of Justice Fingerprint Applicant Chart

18. ACCESS TO AND SAFEGUARD OF VA INFORMATION/COMPUTER SYSTEMS

18.1. VA will not provide Contractor with access to VISTA (formerly referred to as DHCP) and/or other general files maintained on VA computer systems.

18.2. Contractor shall make its internal policies and practices regarding the safeguarding of medical and/or electronic information available to VA, and any other Federal agencies with enforcement authority over the maintenance and safeguard of such records, upon request.

18.3. Any changes in the laws, regulations, or VA/VHA policies or procedures governing the information covered by this section of the contract, during the term of this contract, shall be deemed to be incorporated into this contract.

19. COMPUTERIZED PATIENT RECORD SYSTEM (CPRS)

19.1. Contract personnel will not enter patient care information into CPRS.

20. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPPA) COMPLIANCE

20.1. Under HIPAA Privacy and Security Rules, the Contractor providing services under this contract is considered to be a “covered entity,” and thus is not required to enter into a Business Associate Agreement with VA. However, the Contractor must observe Public Law 104-191 and all respective regulations implementing this law while providing services under this contract.

21. NORMAL DUTY HOURS

21.1. Clients may be seen by the Contractor in the Contractor’s offices during the Contractor’s normal business hours, Mondays through Fridays, excluding weekends and Federal holidays. The Contractor should have availability for emergency telephone calls 24 hours a day seven days a week.

22. PERSONNEL POLICY

22.1. The Contractor shall be responsible for protecting the personnel furnishing services under this contract. To carry out this responsibility, the Contractor shall provide the following for these personnel:

22.1.1. Workers compensation

22.1.2. Professional liability insurance

22.1.3. Health examinations

22.1.4. Income tax withholding, and

22.1.5. Social security payments.

22.2. The parties agree that such personnel shall not be considered VA employees for any purpose and shall be considered employees of the Contractor.

23. RESPONSIBILITY

23.1. The government may evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment).

24. DOCUMENTATION/RECORDS

24.1. Contractor must have adequate administrative staff resources and experience to maintain accurate and complete counseling records, including VA authorization forms, number of visits, bills rendered, and payments received. All records should be of such as to satisfy administrative and quality assurance audits.

24.2. Contractors will maintain counseling records, which comply with the Privacy Act and are accurate, complete and in compliance with professional standards for clinical record keeping. In addition, the contract provider must provide in writing an initial comprehensive psychosocial assessment and counseling plan to the referrer no later than the completion of three initial visits and an updated counseling plan at the completion of each unit authorized visits thereafter. At the indicated intervals, this counseling plan will be required in order for further units of service to be authorized. Determination of adequacy of counseling plans will be based on the professional judgment of the COR in each case.

24.3. Counseling records are considered the property of the VA. Contractors’ clinical records on clients who are receiving or who have received services under a Readjustment Counseling Service contract are property of the Department of Veterans Affairs. When a client has been terminated from counseling or the contract has been terminated and a contract provider has completed all veteran cases, the following instructions apply to the disposition of all veteran client records:

24.4. Contractors providing services may maintain client records for up to one (1) year after the last authorized visit to ensure continuity of care for clients who tend to drop-in and dropout of treatment.

24.4.1. Those Contractors whose contract has expired or terminated will forward completed client records to the originating Vet Center.

24.4.2. Transfer of these records to the VA does not require client permission. This VA property was maintained by the Contractor for the VA, to assist in the VA’s provision of professional treatment for the client.

24.5. Under NO circumstances shall counseling records be destroyed.

24.6. VA has unrestricted access to the records generated by the Contractor pursuant to this contract.

25. ACKNOWLEDGMENT OF SERVICES

25.1. At the time services are rendered, the Contractor will secure a signed acknowledgment of services from each client for each visit that is billed to the VA. The Contractor will list the name of the client, name of counselor and professional degree, date of service, length of treatment, treatment modality, and client's signature, and the client will sign this record, with his/her signature serving as verification of receipt of the services as listed.

26. QUALITY ASSURANCE AND CONTRACT PERFORMANCE MONITORING

26.1. In accordance with VA regulations, a record-keeping system will be established and maintained by the COR to ensure contract compliance.

26.2. Upon verification of services, payment will be authorized by the COR.

26.3. Contractor agrees to provide services which meet or exceed the standards as established by the Joint Commission, the Department of Veterans Affairs and regulations of the medical staff bylaws of the VANCHCS.

26.4. The services specified herein may be changed by mutual written agreement of the parties, in accordance with the terms and conditions set forth herein.

27. TERMS OF THE AGREEMENT

27.1. This agreement is effective for the period identified in the “Schedule of Supplies and Service” and is subject to the availability of VA funds. Services will not be performed by the Contractor beyond the expiration date, unless specifically authorized to do so (in writing) by the Contracting Officer.

27.2. Contractor personnel performing services under this agreement will not be considered VANCHCS employees for any purpose and shall be considered employees of the affiliate. VA will not make payment for any holidays or leave including sick leave. In addition, the Contractor shall be required to provide their own worker’s compensation, liability insurance, health examinations, income tax withholdings and social security payments.

27.3. Contractor shall be responsible for protecting the personnel furnishing services under this agreement.

27.4. Contractor shall provide the applicable worker’s compensation, professional liability insurance, income tax withholding and social security payments.

28. ACKNOWLEDGMENT OF SERVICES

28.1. At the time services are rendered, the Contractor will secure a signed acknowledgment of services from each client for each visit that is billed to the VA. The Contractor will list the name of the client, name of counselor and professional degree, date of service, length of treatment, treatment modality, and client's signature, and the client will sign this record, with his/her signature serving as verification of receipt of the services as listed.

29. CONTRACT SERVICES MONITORING

29.1. Regular evaluations of the technical compliance with the terms of the contract and the level and types of contract services provided to veterans and significant others will be conducted. These may take the form of any of the following:

29.2. Self-evaluations performed by the contract provider, (e.g., quality assurance activities).

29.3. Representatives of VA and other Government agencies are authorized to visit the premises of service Contractors during business hours for purposes of evaluation and auditing, which may include inspection of clinical records.

30. CONTRACTOR FACILITY

30.1. Contractor facility must be handicapped accessible per Rehabilitation Act 29 U.S.C. Section 791 et. seq.

31. AVAILABILITY AND ACCESSIBILITY OF SERVICES

31.1. The Contractor shall make services, service locations, and service sites available and accessible in terms of timeliness, amount, duration, and personnel sufficient to provide the covered services. The Contractor is to provide all services required by this contract on a non-discriminatory basis to VA beneficiaries in a manner, similar to and within the same time availability, in which the Contractor provides these services to any other individual unless otherwise required by VA regulations or this contract. Changes of any of these aspects of the service must have prior approval of the Contracting Officer.

32. HOURS OF OPERATION

32.1. Clients may be seen by the Contractor in the Contractor’s offices during the Contractor’s normal business hours, Mondays through Fridays, excluding weekends and Federal holidays. The Contractor should have availability for emergency telephone calls 24 hours a day seven days a week.

33. GEOGRAPHICAL LOCATION OF ELIGIBLE SERVICE PROVIDERS/VA OBLIGATION.

33.1. Contractors must be physically located in the county in which they will provide service or within close proximity of the county or counties, which they will service (as listed in section Service and Price Schedule). VA will only make referrals to Contractors under this contract for circumstances where the VA or other Government facilities are not capable of furnishing needed services or cannot do so economically because of geographical distances.

34. HHS/OIG

34.1. To ensure that the individuals providing services under the contract have not engaged in fraud or abuse regarding Sections 1128 and 1128A of the Social Security Act regarding federal health care programs, the Contractor is required to check the Health and Human Services - Office of Inspector General (HHS/OIG), List of Excluded Individuals/Entities on the OIG Website (www.hhs.gov/oig) for each person providing services under this contract. Further the Contractor is required to certify in its proposal that all persons listed in the Contractor’s proposal have been compared against the OIG list and are NOT listed. During the performance of this contract the Contractor is prohibited from using any individual or business listed on the List of Excluded Individuals/Entities.

35. SITE VISIT PROCEDURES

35.1. There will be authorized on-site inspection of contract provider facilities on an annual basis. Contractor will respond to any clinical concerns or problems that develop during the term of the contract. Inspections are held for the purposes of monitoring, reviewing administrative and clinical procedures with a Contractor, and coordinating any procedural difficulties arising from the relationship of the contract provider with relevant VA staff. Comprehensive site visit reports covering areas of administrative and clinical operations will be prepared on each visit. The contract provider will be responsible for responding to any clinical and/or administrative problems and/or deficiencies arising from the findings of these reports.

36. VANCHCS RESPONSIBILITIES

36.1. The Contracting Officer will designate a VA employee as the COR. The COR will be responsible for overseeing and directing the services to be performed by under this agreement.