36C26125R0006 0002.docx

36C26125R0006

5. PROJECT NUMBER (if applicable)

CODE

7.

ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF

PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.

is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR

OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED

STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER

16A. NAME AND TITLE OF

CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF

SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer) None

612MCP

Department of Veterans Affairs Network Contracting Office (NCO) 21 3237 Peacekeeper Way, Bldg 200 Suite 204 McClellan Park CA 95652

612MCP

Department of Veterans Affairs Network Contracting Office (NCO) 21 3237 Peacekeeper Way, Bldg 200 Suite 204 McClellan CA 95652 To all Offerors/Bidders

36C26125R0006 11-21-2024

X X X ** HOUR & DATE for Receipt of Offers is EXTENDED to: 12-18-2024 12:00PM PST X

a. The purpose of this amendment is to:

(1) Answer vendor questions

(2) Extend the solicitation due date and time from December 11, 2024 12:00PM PST to December 18, 2024 12:00PM PST

(3) Revise performance work statement section 36.1.

IMPORTANT: Offeror must acknowledge this amendment and submit a signed copy with proposal.

Joleo Dianala Contracting Officer Solicitation Questions and Answers HUD-VASH Housing Placement and Case Management Services for San Francisco County

1. Is 3588 the amount of yearly visits per year for the Veterans? Is the billing rate the price per visit?

a. Yes, the quantity of 3588 is the estimate number of case management visits per year. The billing rate (unit price) within B.2 Price/Cost Schedule for HUD VASH Case Management Service is the all-inclusive rate for each visit that meets the definition of encounter (home visit).

Performance work statement section 1.9 provides information on the projected quantities and unit rate:

Projected Quantities / Units – San Francisco VA Health Care System seeks a Contractor to receive up to 180 HUD-VASH vouchers (clients) distributed over Acuity Levels 2-5. Case Manager caseloads are projected at one (1) case manager to 36 VASH clients. Services will be invoiced per an all-inclusive “unit rate” per face-to-face clinical encounter (home visit). Encounters (home visits) are defined to include a documented, face-to-face contact between a Veteran Client and a Contracted Case Manager provider who exercises independent judgment in the provision of services to the individual. To be included as an encounter, services rendered must be documented.

2. Will the majority of Veterans be Intensive (chronically homeless) or coming from SSVF which sometime are already housed and stabilized? Is level 1 intensive and level 2-5 stabilization-graduation?

a. The case will be distributed to the vendor based on VA Medical Center need, and the number of cases in each acuity level is always in flux, but we aim to distribute an even number of cases in each acuity category.

Provided below are the acuity levels:

Acuity Level 5 – Intensive Acuity Level 4 – Stabilization Acuity Level 3 - Maintenance Acuity Level 2 - Preparation for Discharge Acuity Level 1 - Graduation/Discharge

3. Is the latest document dated Nov 26,2024 considered to be an amendment? And if so, where on the document am I supposed to sign?

a. Yes, 36C26125R0006 0001 posted on 11/26/2024 is an amendment. Amendments will contain “AMENDMENT OF SOLICITATION” at the top of the first page. The amendment number is stated in block 1.

For each amendment, please complete and sign Block 15 on page 1.

All amendments must be signed and submitted with your proposal by the due date and time. It’s the vendor’s responsibility to check for amendments on SAM.gov.

4. This solicitation states it's a flat rate per veteran per month. However, on the pricing schedule, the estimated quantity is 3,588. What does that number represent?

a. The performance work statement section 36.1 has been revised to clarify that the rate is based on per Veteran encounter. The quantity of 3588 is the estimate number of case management visits per year.

5. Are the 180 vouchers/clients new vouchers or transfer vouchers?

a. Both transfer of existing cases and new cases can be assigned to the contractor.

6. Should the contractor propose a Peer Support Specialist, would the Medi-Cal PSS Certificate be allowable or does it need to be the VA approved PSS Certificate?

a. Should the contractor propose a Peer Support Specialist (PSS) for their case management team, a PSS Certificate is acceptable.

Please note that only case manager encounters (home visits) are billable.

7. Should the contractor propose a Substance Abuse Counselor, what would be the required licensure and degree?

a. Should the contractor propose a Substance Abuse Counselor for their case management team, the contractor would be responsible for determining the counselor’s qualifications.

Please note that only case manager encounters (home visits) are billable.

8. Does the VA require an office location at the time of contract award or would there be an acceptable start up period while building up a billable caseload?

a. A start up period is acceptable.

Please carefully review the ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS - COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES as the instructions require Offerors to submit a plan to establish a facility within 120 days of contract award.

9. Are HUD-VASH referrals coming from a VA By-Name list?

a. Many referrals do come from a VA By-Name list, but occasionally there are other sources of referrals.

10. Will VA based training be on-site, virtual, or a combination of both? If on-site, is there a set required number of days that new staff will be required to participate in?

a. VA based training can be a combination of both. Most trainings are completed virtually, but there are occasional in-person trainings. For on-site training, there is no set required number of days that new staff are required to participate in. When on-site training is available, VA does encourage participation.

11. Does the solicitation require us to demonstrate how we will increase the total number of veterans served beyond the initial 180 vouchers over the course of the contract, and how will the evaluators assess our capacity to scale our services overtime?

a. No.

12. We kindly request a one-week extension to allow us to adequately incorporate the answers to our submitted questions, as some may significantly impact our response.

a. The solicitation due date and time is hereby extended from December 11, 2024 12:00PM PST to December 18, 2024 12:00PM PST.

B.3 PERFORMANCE WORK STATEMENT

1. BACKGROUND

1.1. 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 U.S. Department of Housing and Urban Development (HUD) – VA Supportive Housing (VASH) program. The program is a partnership between HUD and VA to place and maintain homeless Veterans in permanent, community-based housing using HUD Section 8 Housing Choice Vouchers (HCV) that are paired with ongoing VA case management services. Many of these Veterans have co-morbid conditions that include serious mental illnesses, substance use disorders, and other serious medical conditions. VA intends to engage a Contractor to provide housing placement services in the in San Francisco County, along with ongoing case management services to HUD-VASH eligible Veterans and their families.

1.2. The Contractor shall meet all requirements in accordance with VHA Directive 1162.05(2) “Housing and Urban Development Department of Veterans Affairs Supportive Housing Program”. The Contractor shall be responsible for maintaining compliance with this Directive at all times and shall be responsive to all future updated Handbooks and/or Directives. This Directive can be found at https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=5437

1.3. The target population for this contract is Veterans that demonstrate the most need or vulnerability based on their unique clinical and/or psychosocial circumstances. Veteran eligibility and prioritization are outlined in Directive 1162.05(2).

1.4. Through this contract initiative, Contractor(s) will support Veterans in obtaining housing while simultaneously providing case management and supportive services to assist Veterans in maintaining housing.

1.5. 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 search and 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 five ordering periods from the date of award. The Contractor shall provide all labor, supervision, supplies, 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 County area, unless otherwise required by work requirements listed in the PWS, or otherwise specified by the task orders issued under this contract.

1.6. The following contract implementation checklist is provided as a guide to meeting the terms outlined in the Performance Work Statement. Potential Contractors should be aware that there may be variation among and between VA medical centers in the steps needed to complete these tasks, and that items identified here may be subject to change based on evolving local, regional or national requirements.

1.7. The Contractor shall not commence performance on the resulting tasks order in the awarded contract until the Contracting Officer (CO) has conducted a kickoff meeting within 30 days or has advised the Contractor that a kickoff meeting has been waived.

1.8. 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 San Francisco VA Health Care System 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. Multiple CORs may be appointed to handle administrative, clinical or other duties as assigned. At some facilities, the COR and HUD-VASH Liaison roles may be filled by a single individual.

1.9. Projected Quantities / Units – San Francisco VA Health Care System seeks a Contractor to receive up to 180 HUD-VASH vouchers (clients) distributed over Acuity Levels 2-5. Case Manager caseloads are projected at one (1) case manager to 36 VASH clients. Services will be invoiced per an all-inclusive “unit rate” per face-to-face clinical encounter (home visit). Encounters (home visits) are defined to include a documented, face-to-face contact between a Veteran Client and a Contracted Case Manager provider who exercises independent judgment in the provision of services to the individual. To be included as an encounter, services rendered must be documented.

2. GENERAL REQUIREMENTS

2.1. The Contractor shall be able to provide services to HUD-VASH eligible Veterans/Veteran families for whom such care is specifically authorized by the referring VAMC. Contractor shall perform the following tasks:

2.1.1. The Contractor is recommended to use a case management team approach whenever possible which may include a mix of mental health and addiction treatment professionals, social workers, nurses, psychologist, housing specialists, and peer specialists to meet the clinical needs of Veterans served.

2.1.2. The Contractor shall provide case management support.

2.1.3. The Contractor shall comply with HUD-VASH San Francisco VA Health Care System policy and HOMES policies and procedures regarding documentation and evaluation standards for Veterans receiving services under this contract.

2.1.4. While most services will be provided in the community or a Veteran’s home, the team will visit Veterans if hospitalized or incarcerated and will also accompany Veterans to clinics, emergency visits, or other appointments as needed.

2.1.5. When Veterans have achieved housing stability, the focus of the service support changes to support for maintaining housing, community integration, and other goals as defined by the Veteran.

2.1.6. Discuss with VA liaison before discharge to ensure it complies with the VA discharge SOP.

2.1.7. Case Management services shall follow the principles of Housing First.

2.1.8. 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.

2.1.9. The 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/Liaison.

2.1.10. 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. This includes the responsibility to update the Housing and Employment Tracker (HET) in HOMES

2.1.11. The Contractor shall work with the Veteran on obtaining housing, maintaining housing, strengthening independent living skills including independence in transportation, budgeting, and employment and/or assistance obtaining appropriate VA and non-VA benefits.

2.1.12. The Contractor shall make all communications with the VA regarding this contract via the VA COR/Liaison.

2.2. The Contractor shall submit a staffing plan for approval to the VA Liaison/COR, that includes information about how supervision will be provided, upon award and as changes may occur. The Contractor will know the local community and its homeless services. The Contractor will have relationships with local agencies/providers.

3. STAFFING

3.1. 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:

3.1.1. 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.

3.1.2. 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. SW, RN, LPMHC). Staff must be cleared through VetPro based on their current status and may not perform work at a lower level than their education status while awaiting VetPro clearance. Information will be provided by San Francisco VA Health Care System HUD-VASH Program for staff to begin this process online. A Federal Personal Identification Card will also be issued; this requires an in person visit to the San Francisco VA Health Care System Human Resources Department for verification of documents and photographs of the individual staff member.

3.1.3. Completion of the VA’s online Information Security and Privacy combined Awareness Training Course and the Privacy Policy Awareness Training Course in the VA’s Talent Management System (TMS) is required for all staff and their supervisor working directly with Veterans under this contract. The Privacy Awareness Training requirement may be fulfilled under additional privacy awareness training options. In order to complete online VA Privacy and Information Security Training, Contractor staff must set up a VA Employee Education System 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).

3.1.4. The Contracting team shall participate in continuing education related training including Housing First, trauma informed care, motivational interviewing, relapse prevention, supported employment, and supported education, offered through TMS, HUD-VASH staff meetings/trainings, and other forums.

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

3.1.5.1. Basic Life Support (BLS) certification meeting local standards is required for all technical and professional staff;

3.1.5.2. Maintain compliance with state reporting requirements.

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

3.2.1. A Mental Health provider at the highest level of their professional license to practice independently in their state (i.e., a Licensed Independent Practitioner (LIP)) as the Case Management Team Clinical Supervisor, and a multi-disciplinary team sufficient to meet the clinical needs of Veterans served and make home visits consistent with the Social Work Treatment Plan.

3.2.2. Appropriate number of Case Managers to carry the task provided in the PWS for each Veteran receiving service under this contract.

3.2.3. The Case Management Team Supervisor and Case Managers must be full time employees and full time to this HUD-VASH contract.

3.3. Staffing responsibilities are described as follows:

3.3.1. The clinical supervisors’ 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. In addition, he/she must ensure appropriate supervision of any non-clinical/non-licensed Contractor staff providing related supportive services to Veterans to ensure quality of care, such as peer support specialists, vocational service counselors, etc. The licensed independent practitioner must have an active, current, unrestricted license.

3.3.2. Case Managers will have a minimum of a Master’s degree from an accredited institution in the social sciences or family therapy

3.3.3. Other staff may include Housing Specialists, Certified Substance Abuse Counselors, Registered Nurses, Licensed Vocational Nurses, Licensed Practical nurses, and/or Peer Support Specialists

4. DOCUMENTATION

4.1. The Contractor must complete Homeless Operations Management and Evaluation (HOMES) documentation, consistent with the HOMES policies, and Electronic Health Record (EHR) documentation, in accordance with national and local policies. This EHR documentation may include, but not be limited to: changes to admission, housing, voucher, or employment status, encounter documentation, screening/admission notes, release of information forms, housing service agreements, suicide risk assessments, Advanced Directive Discussions, discharge notes and safety plans. Contractor shall document encounters using the Subjective, Objective Assessment Plan (SOAP) format for all clinical notes and ensure all encounters are entered within 72 hours of service in accordance with national and local policies. In addition to documenting contact with the Veteran, the Contractor shall also document in the EHR evidence of collateral contacts with individuals and agencies engaged to support the Veteran’s housing and recovery needs.

4.2. The Contractor will comply with additional documentation and/or data reporting as required by San Francisco VA Health Care System based on changing or subsequent local, VISN, or national HUD-VASH requirements. Additional required documentation includes but is not limited to initial and annual Psychosocial Assessment, Social Work Treatment Plan, Patient Health Questionnaire-9, Columbia Suicide Severity Rating Scale-Screener, Columbia Suicide Severity Rating Scale- Comprehensive, and Behavioral Contract.

4.3. An approved, assigned licensed independent clinical provider must sign off on all notes if the staff member providing direct services to the Veteran is not independently licensed.

4.4. Any signed documentation shall be scanned into the electronic medical record via the VA medical records office. The Contractor shall maintain compliance with local policies and procedures regarding documentation requirements and timelines.

5. HOUSING FIRST

5.1. Housing First is an approach that centers on providing homeless individuals with housing quickly, while 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:

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

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

5.1.3. 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.

6. REFERRALS AND ADMISSIONS

6.1. Referrals and admissions to HUD-VASH may be conducted by the VA or by the Contractor. One of the following scenarios may apply: (local site selects based on preferred local processes; delete whatever does not apply)

6.1.1. Referrals and admissions to HUD-VASH are conducted by the VA. Once admitted, HUD-VASH Veterans are referred to the Contractor for case management services.

7. CONTRACTOR CASE MANAGEMENT TEAM DUTIES

7.1. The Contractor shall have procedures in place to ensure Veterans have access to case management services Monday – Friday during normal tours of duty.

7.2. 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 and community visits consistent with the level of care each Veteran is being treated at in addition to the following:

7.2.1. Ensure consistency of team services to enhance staff ability to engage and form relationships with Veterans and provide consistent and highly skilled interventions in keeping with the principles of Housing First.

7.2.2. Review and update the HUD-VASH Social Work Treatment Plan with the Veteran quarterly and document the review and any changes to the plan in the VA medical record.

7.3. Contractor shall perform the following Case Management duties:

7.3.1. Engage the Veteran in the HUD-VASH process and perform assessment, counseling, and case management of identified Veterans who are at risk, provide psychosocial assessments to identify treatment needs which affect Veteran’s adjustment to their environment, and establish treatment goals with the primary purpose of obtaining and maintaining housing.

7.3.2. Actively involving the Veteran and their family or significant others in coordination with the team members, based on the psychosocial assessments, develop HUD-VASH Social Work Treatment Plans with the Veteran using his/her language whenever possible, ensuring he/she has a copy of the plan including goals for clinical treatment and discharge from case management; The initial HUD-VASH Social Work Treatment Plan must be completed within 2 weeks of admission.

7.3.3. Contractor shall integrate Social Work Treatment Planning with relevant VA health and mental health services. Contractor shall refer as needed 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.

7.3.4. Utilize counseling strategies to include crisis intervention and Motivational Interviewing including both short- and long-term services working toward long-term goal of housing stability and discharge from HUD-VASH.

7.3.5. Screen each Veteran for suicidal and homicidal risk per local and national policy or procedure. This screening shall be documented in progress notes, suicide risk assessments, and safety plans as appropriate per local and national policy. 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 consistent with local standards by the Contractor and shall be reported to the VA COR/Liaison and other VA staff, including the local Suicide Prevention Coordinator.

7.3.6. Facilitate the Veteran’s involvement in therapeutic and work restoration programs, as well as supporting team-based interventions across the Veteran’s individual treatment team and advocating on behalf of the Veteran.

7.3.7. 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 Homeless Veterans Community Employment Services (HVCES), as appropriate.

7.3.8. The Contractor is encouraged to pursue case management discharge for Veterans, when clinically appropriate. 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.

7.3.9. All electronic communication completed by contracted staff related to HUD-VASH case management duties must be conducted from that staff member’s official VA e-mail address and must include a signature block that identifies their status as a VA HUD-VASH contract employee.

8. CONTRACTOR HOUSING PLACEMENT AND STABILIZATION DUTIES

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

8.1.1. Assist Veteran and family members being housed with the Veteran in securing vital documents, such as a DD-214, a birth certificate, a social security card, income verification, etc. required to obtain a Section 8 housing voucher

8.1.2. 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, SNAP benefits, utility assistance, etc.)

8.1.3. 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. Advocate with landlords on behalf of the Veteran to maintain a lease. Contractor shall ensure that the Veteran has completed the VA release of information so communication between the landlord, Contractor, and VA COR/Liaison can occur as needed.

8.1.4. Verify whether the Veteran is paying rent and utility bills in a timely manner and provide budgeting/money management assistance as needed.

8.1.5. Evaluate and assist the Veteran with budgeting education to promote the ability to manage expenses including those 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.

8.1.6. Assist the Veteran in making calls to utility providers to ask questions and resolve issues (including restoring, turning on, turning off or transferring utilities),

8.1.7. Assist Veteran in increasing income by applying for all eligible benefits, both VA and non-VA, including Veterans Benefits Administration (VBA), Social Security Administration (SSA), and pursuing employment opportunities.

8.1.8. Contractor shall provide life skills education and assistance to Veterans in accordance with VHA Directive 1162.05(2) and local policies

9. CASE MANAGEMENT VISITS

9.1. Case Management visits to Veterans shall be conducted in accordance with the HUD-VASH Directive and local Standard Operating Procedures.

9.2. The Contractor shall visit each Veteran face-to-face at the intervals required by the HUD-VASH Directive and local Standard Operating Procedures. Face-to-face visits shall be conducted in accordance with local behavioral health and safety flags. Visits which are not required to take place in the Veteran’s home 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 Electronic Health Record as verification of services rendered.

9.3. Video calls to clients (VVC) can be counted in lieu of 25% of required face-to-face home visits per client per month for acuity level 5 clients.

9.4. Home visits to HUD-VASH apartments verify whether Veterans reside in healthy residences. Appropriate support and education will be given to Veterans who are not maintaining a hygienic residence.

9.5. Contractor shall adhere to transition between case management stages and discharge criteria consistent with national policy and local VAMC Standard Operating Procedures.

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

9.7. The Contractor shall re-assess any Veterans who do not meet the goals and objectives outlined in their HUD-VASH Social Work Treatment Plan to determine any barriers to housing stability. 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. Contractor shall consult with VA COR/Liaison when Veterans present a safety risk to the case manager and follow local policies and procedures regarding disruptive behavior reporting and compliance with CRPS flags.

9.7.1. These efforts might require using Motivational Interviewing Techniques to assist the Veteran in redefining goals and making needed changes to the HUD-VASH Social Work Treatment Plan. The Contractor should consult with facility Mental Health leadership, police service, or other VA program staff such as SUD programs, VA Disruptive Behavior Committee Members, or other homeless programs for assistance in determining alternative clinical treatment approaches.

9.8. 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 Manager should always initiate appropriate consultation with the VA Liaison and VA COR on adverse events to determine the next course of action.

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

9.9.1. 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.

9.9.2. 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.

9.9.3. 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.

9.9.4. 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

9.9.5. 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.

10. TRANSPORTATION

10.1. Contractor shall work with Veterans to foster independence in transportation and a sense of self-determination.

10.2. The Contractor shall make every effort to connect the Veteran with existing public transportation networks or other community provided transportation. 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, Contractor-owned or operated vehicles, subsidized transportation services, and other identified needed services and entitlements.

10.3. Contractor shall accompany Veterans to medical appointments, meetings, and other appointments as deemed necessary based on the assessment completed by a member of the case management team.

11. VOUCHER RECONCILIATION WITH THE PHA

11.1. At least quarterly, the Contractor will reconcile data with the COR/Liaison to determine that status of all HUD-VASH vouchers. This includes any vouchers that are being used by Veterans who have graduated from the program.

12. CONTRACTOR DISCHARGE REQUIREMENTS

12.1. Veterans may be discharged from HUD-VASH for a variety of reasons and need discharge plans developed in collaboration with the Veteran to transition the Veteran’s services back to the VA whenever possible. 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 be shared with the Veteran and shall include all the required elements as defined in national and local policies. In limited situations this may not be possible.

12.1.1. When Veterans have accomplished their goals, no longer need case management services, and have reintegrated into the community, Veterans will be discharged from the case management portion of HUD-VASH and retain the HUD-VASH voucher as long as they remain financially eligible. All such discharges from case management will occur after the Veteran’s case management services have been transferred back to the VA for after care services. Prior to the Veteran’s case management transfer to the VA; the Contractor will initiate a case conference meeting with the Contractor staff, VA Liaison/COR, and Veteran. When a Veteran transfers to another HUD-VASH site, collaboration with the receiving site and Veteran to develop a transition plan will be documented in the EHR

12.1.2. When a Veteran voluntarily leaves the HUD-VASH program such as if the Veteran chooses non-VASH housing or is unhappy with the program, the Contractor will collaborate with the Veteran on a discharge plan. Whenever possible, prior to the Veteran’s discharge, the Contractor will initiate a case conference meeting with the Contractor staff, VA Liaison/COR, and Veteran

12.1.3. When a Veteran is discharged involuntarily, every effort will be made by the Contractor to develop a discharge plan with the Veteran prior to discharge and initiate a case conference meeting with the Contractor staff, VA COR/Liaison, and the Veteran.

12.1.4. When a Veteran is no longer financially eligible for HUD-VASH, the Contractor shall document a discharge plan transitioning services back to the VA in the EHR and give a copy to the Veteran,

12.1.5. When a Veteran is being discharged because the Veteran cannot be located, a discharge plan cannot be developed with input from the Veteran. The Contractor should note this in the EHR

12.1.6. When a Veteran is too ill to continue participating in the program, the Veteran should be discharged upon transition to the appropriate level of care. There should be a warm hand-off to the new care team and it should be documented in the EHR

12.1.7. A Veteran who will be incarcerated for longer than 89 nights must be discharged. Every effort should be made to develop a discharge plan with the Veteran prior to incarceration.

12.1.8. A Veteran who dies is discharged from HUD-VASH.

12.2. If a Veteran leaves the program without prior notice or case consulting, the VA COR and Liaison should be notified immediately

12.3. When a Veteran is discharged from HUD-VASH, the Contractor must document this in the EHR per local policy and in HOMES.

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

13. VOUCHER PORTING

13.1. 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 is outside of the VAMC catchment area.

13.2. 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 if the new VAMC has a new HUD-VASH case management slot and if 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.

13.2.1. Once the porting transfer has been completed the Contractor shall complete a Contractor closing documentation note in the electronic health record and exit in HOMES indicating that the Veteran is no longer part of the San Francisco VA Health Care System HUD-VASH program.

14. CONTRACTOR REPORTING REQUIREMENTS

14.1. Contractor shall submit a quarterly tracking sheet derived from the HOMES OR7 Report and delivered in that format approved by the COR/Liaison 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. This is also to verify that services have been provided according to the needs of the Veteran

14.2. The Contractor shall follow local incident reporting procedures and notify VA of any negative incident occurring with the Veteran within twenty-four (24) hours 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:

14.2.1. Death

14.2.2. Fire

14.2.3. Drug/police raid

14.2.4. Suicide/suicide attempt

14.2.5. 911 call to police, fire, paramedics, or other

14.2.6. Severe medical illness/emergency

14.2.7. Severe psychiatric illness emergency

14.2.8. Sexual assault

14.2.9. Act of violence by Veteran against others

14.2.10. Abusive behavior by Veteran against staff

14.2.11. Acts of violence by others against Veteran

14.2.12. Abusive behavior by staff against Veteran

14.2.13. Accident

14.2.14. Medication problems or adverse drug reactions

14.3. The Contractor shall provide quarterly written status reports of quarterly internal audits to ensure quality assurance of case management services to the VA COR/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, along with the name and contact information of the Case Manager assigned to each Veteran.

14.4. The Contractor shall document the overall effectiveness of the case management services provided to the Veteran as outlined in the QASP.

15. RECORDS

15.1. The Contractor shall maintain all Veteran records in accordance with The Joint Commission and/or Commission on Accreditation of Rehabilitation Facilities (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.

15.2. 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.

15.2.1. 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.

15.2.2. 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.

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

15.2.4. 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.

15.2.5. 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 (and any sub-contractor) shall abide by Government and VA guidance for protecting sensitive and proprietary information.

16. FACILITIES

16.1. The Contractor shall have adequate and appropriate space available at the Contractor location for the VA staff to conduct meetings with Veterans and contracted staff members under contract care contracted staff members to conduct meetings with Veterans under contracted care. The Contractor shall also have the ability to place Contractor staff at VA facilities to provide access to Veterans through coordination with the COR or through San Francisco VA Health Care System HUD-VASH Coordinator. The Contractor will provide one Contractor staff at a local VA facility (San Francisco VA Community Based Outpatient Clinic) to participate in the daily HUD-VASH Officer of the Day (OD) rotation to provide services to “walk-in” Veterans interested in HUD-VASH program through coordination with the COR or through San Francisco VA Health Care System HUD-VASH Coordinator. It is estimated that the Contractor staff will perform the role of HUD-VASH Officer of the Day (OD) approximately one day every 1-2 months.

16.2. The Contractor facility shall meet the following:

16.2.1. 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

16.2.2. If applicable, the Contractor shall possess a valid Business License/Certification for the state of California.

16.2.3. If applicable, the 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.

16.2.4. The Contractor’s facility shall be wheelchair accessible

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

16.2.6. The Contractor’s facility where services are to be provided shall be within the catchment areas of the San Francisco VA Health Care System.

17. STANDARD OF CONDUCT

17.1. The Government reserves the right to…