36C26124Q0431 - REVISED Performance Work Statement.pdf

(REVISED) PERFORMANCE WORK STATEMENT

TEMPORARY RESIDENTIAL LODGING

VA Palo Alto Health Care System

1. PURPOSE: The contractor shall furnish services to veteran beneficiaries for whom such care is specifically authorized by the Veterans Health Administration (VHA) under the HopTel authority 38 U.S.C. 501, 1708, Part 60. Services shall be provided at a facility designed to provide temporary lodging of qualified Veterans including all services contained in this document.

To be eligible for placement in short stay beds, Veteran must be coming to the area for treatment, medical care or a Compensation and Pension examination. Furthermore, the Veteran should be homeless or at imminent risk of becoming homeless, eligible, and registered for VA services, and be medically stable and capable of self-care or accompanied by a caregiver able to provide the necessary care. A member of the family of such veteran or another person who accompanies such veteran to provide the equivalent of familial support is also eligible to stay in the temporary lodging. As a condition for receiving temporary lodging, a veteran must be required to travel either 50 or more miles, or at least two hours from his or her home to the VA health care facility. The facility Director at the VA health care facility of jurisdiction may make an exception to distance or time provisions based on exceptional circumstances, such as condition of the veteran, inclement weather or mode of transportation used by the veteran. Duration of stay: temporary lodging may be available the night before the day of the scheduled care if the veteran leaving his or her residence by 8:00 A.M. would be unable to arrive at the health care facility by the time of the schedule care. Temporary lodging may be available the night of scheduled care if, after the completion of the care, the veteran would be unable to return home by 7 p.m. When the veteran is undergoing extensive treatment or procedures, such as an organ transplant or chemotherapy, eligible persons may be furnished temporary lodging for the duration of the episode of care. Exceptions to duration of stay may be approved by the facility Director and COR. Upon acceptance of a VA patient by the facility, the contractor shall furnish temporary lodging herein described, at the per diem rate specified.

VA is obligated only to the extent authorized placements of patients are made under this contract.

1.1. All veterans must be eligible and registered for VA services to qualify for per diem. To be determined by Contracting Officer’s Representative (COR) or individual designated by the COR (designee).

1.2. The facility shall notify the COR or individual designated by the COR of admissions and discharges from the program within 72 hours.

1.3 The facility shall meet all City, State, and Federal requirements concerning safety and health codes. The facility shall maintain a current facility occupancy permit, insurance, and provide copies of these documents to the COR or designee. Documents need to be submitted with 30 days from the contract start date.

1.4. The intended IDIQ period of performance will be one (1) year with the option to extend services up to Four (4) additional ordering periods from date of award; at the discretion of the

Government. The type of contract intended to be awarded is an Indefinite Delivery/Indefinite Quantity (ID/IQ) contract and the pricing arrangement will be on a Firm-Fixed Price basis.

2. SERVICES: The contractor shall furnish each veteran authorized care under this contract with the following basic services:

2.1 Residential Lodging: The temporary lodging facility shall provide six (6) rooms, seven

(7) days per week. The temporary lodging facility shall provide sanitary space for lodging, including bed and furniture to store belongings. The facility shall provide storage space in an onsite refrigerator for veterans to store personal food. The facility shall establish and maintain sanitary procedures for washing dishes, cleaning equipment and work areas, and disposing of waste.

2.2 Laundry: Laundry facilities shall be provided for residents to do their own laundry.

2.3. Therapeutic Environment: Contractor shall provide a safe, Veteran centered environment with a minimum level of structure throughout the day to insure safety. A morning and evening check in for roll call is required. The Contractor will provide a community living type setting to support the comfort and therapeutic value of the Veteran’s stay. This setting will be conducive to social interaction and the fullest development of the resident’s rehabilitative potential during their stay. Veterans will be provided an environment where they will be treated with respect and dignity. The staff at this facility will collaborate with VA staff to support the Veteran’s service plan as needed. The contractor will have an emergency plan in place for Veterans who may pose a threat to self or others.

3. BILLING: Payments made by VA under this contract shall constitute the total cost of care and housing of the homeless veterans. Contractor agrees that no additional charges will be billed to the Veteran or the Veteran’s family, either by the Contractor or any third-party furnishing services or supplies required for such care, unless prior authorization is received in writing from the COR. The rate established will include the services listed in this document and will also include all services or supplies normally provided other residents by the facility without extra charge. Rate may not include cost of transportation or food the facility may choose to provide. The facility shall immediately notify the COR or COR designee regarding any interruption of contract services. Attendance records will be required and submitted with monthly billing.

3.1 No obligation will be incurred by the Department of Veterans Affairs under this contract until authorizations are issued by the COR or designee for this contract for specific beneficiaries.

3.2 Contractor shall submit attendance records and invoice to the COR by the 5th day of each month. Invoices shall be approved by the COR or COR designee before they are submitted by the contractor via the OB10 system for payment.

4. STAFFING: The contractor shall employ sufficient professional staff and other personnel to carry out the policies and procedures of the facility. There will be, at a minimum, a qualified employee on duty on the premises, or residing at the program and available for emergencies, 24 hours a day, 7 days a week. The House Manager(s) is required to receive yearly training from VA personnel as designated by the COR on Veteran-related issues. The house manager shall not be active in any Chemical Dependency Treatment Program (CDTP) or have been active in any CDTP for at least one year. Staff will provide ongoing support to veterans in order that they may achieve and maintain independence in the community and engage in qualifying VA treatment, medical care or a Compensation and Pension examination. The COR and/or the COR designee will be informed of any staff changes and will be provided a resume of the incoming personal.

5. RECORDS AND REPORTS: The contractor shall make available to the COR or designee, documentary information deemed necessary by the VA to conduct utilization review audits for the mandated national evaluation study as required by Section 2 of Public Law 100-6; to verify quality of housing of veterans, to assure confidentiality for veterans, and to determine the completeness and accuracy of financial records. The temporary lodging contractor shall maintain the wait list and work with the VA social worker coordinating consults, referrals, and admission to the temporary lodging facility. The facility shall maintain an individual client record on each veteran admitted under this contract. The facility shall comply with the requirement of the “Confidentiality of Alcohol and Drug Abuse Patient” (42 CFR, Part II) and the “Confidentiality of Certain Medical Records” (38 USC 4132).

All patient information shall be secured and confidential. Records will be made available on a need-to-know basis to appropriate VA staff members involved with the treatment program of the veterans concerned. The files shall include:

a. Reasons for referral.

b. Release of information

c. Data relating to the resident’s admission.

d. Copies of any medical prescriptions issued by physicians, including orders, if any, for medications to be taken.

e. Final summaries on each resident who leaves the program, to include reasons for leaving and the resident’s future plans

6. INSPECTION: The Department of Veterans Affairs Inspection Team is required to conduct an inspection annually not more than sixty (60) days prior to any contract renewal date. The inspection team will consist of COR as well as representatives from Domiciliary Service, Dietetic Service, and a Safety Manager.

6.1 In the event a patient receiving care under this contract dies, the facility will promptly notify the COR or designee and immediately assemble, inventory, and safeguard the patient's personal effects.

The funds, deposits and effects left by VA patients upon the premises of the Facility shall be delivered by the facility to the person or persons entitled thereto under the laws currently governing the Facility for making disposition of funds and effects left by patients, unless the beneficiary died without leaving a will, heirs, or next of kin capable of inheriting. Should a deceased patient leave no will, heirs, or next of kin, his effects become personal property of the United States in trust, and such property and funds on the premises will be delivered to the COR or designee.

7. LOCATION: The Contractor’s facility for providing these services shall be located within ten

(10) miles of the VA Palo Alto Health Care System’s Menlo Park Division, 798 Willow Road, Menlo Park, CA 94025.

8. Contractor’s Quality Improvement Monitors:

The quality control program is the driver for quality. The contractor is required to develop a comprehensive program of inspections and monitoring actions. The first major step to ensuring a “self-correcting” contract is to ensure that the quality control program, approved at the beginning of the contract, provides the measures needed to lead the contractor to success.

9. Performance Requirement Summary (PRS) The guaranteed minimum award amount for this contract is $1,000. The maximum aggregate value of orders that can be placed under this contract is $2,500,000.00. The Government does not guarantee that it will place any orders under this contract more than the guaranteed minimum award amount.

* EST QTY is founded upon utilizing 6 units per day, per performance period. This does not limit, nor does it guarantee the number of units to any specific number of units at any time. The number of units being utilize may vary from day to day. The total number of units per period shall not be exceeded unless authorized in writing by a warranted, VA Contracting Officer.

(REVISED) PERFORMANCE WORK STATEMENT