36C26219R0025-001.pdf

COMBINED SYNOPSIS/SOLICITATION FOR COMMERCIAL ITEMS

General Information

Document Type: Combined Solicitation/Synopsis

Solicitation Number: 36C26219R0025

Posted Date: 07/03/2019

Original Response Date: 08/02/2019

Current Response Date: 08/02/2019

Product or Service Code: Q519 – Medical Services/Psychiatry

Set Aside (SDVOSB/VOSB): Full and Open Competition (FOC)

NAICS Code: 624229 – Other Community Housing Services

Contracting Office Address

Department of Veterans Affairs

Network Contracting Office 22

4811 Airport Plaza Drive, Suite 600

Long Beach CA 90815

Description

This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Federal Acquisition Regulation (FAR) subpart 12.6, “Streamlined Procedures for Evaluation and Solicitation for Commercial Items,” as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; 36C26219R0025 is being requested, and a written solicitation document will not be issued.

This solicitation is a "request for proposals (RFP),". The solicitation document and incorporated provisions and clauses are those in effect through

Federal Acquisition Circular 2019-01.

The associated North American Industrial Classification System (NAICS) code for this procurement is 624229 – Other Community Housing

Services, with a small business size standard of $15 Million.

The VA Greater Los Angeles Healthcare System (VAGLAHS) at 11301 Wilshire Blvd., Los Angeles, CA 90073 is seeking to rapidly stabilize

Veterans’ medical, mental health, substance abuse and other psychosocial problems by partnering with two (2) Contractor(s) to assist with provisions of emergency residential placement and supportive services through the Health Care for Homeless Veterans - Low Demand Safe

Haven (HCHV-LDSH) model with in the West Los Angeles Veterans Affairs Healthcare System (WLAVAHS).

The VA’s requirement is to place a total of 80 veterans in two (2) separate Safe Haven facilities. Each Contractor is required to propose a facility that will be capable of allocating a maximum of 40 beds per day to veteran patients. The number of veterans is expected to fluctuate over time.

Each facility is expected to accommodate up to 40 veterans. VA and Contractor may mutually agree to assign veterans, up to a maximum of 40 veterans, to the Contractor’s facility, at the same price per bed per day currently in effect as shown in the Price Schedule. Offerors shall state in their proposal at the time of proposal submission how many veterans they can accommodate at one time and sate the address of the proposed facility

Period of Performance

This Firm Fixed Price (FFP) Indefinite Delivery Indefinite Quantity (IDIQ) period of performance is one (1) 12-month base period with four (4)

12-month option periods.

Base Year: TBD

Option Year 1: TBD

Option Year 2: TBD

Option Year 3: TBD

Option Year 4: TBD

Place of Performance

Work shall be performed at the Contractor’s facility within the WLAVAHS. Government furnished workspace shall not be provided for this effort. However, the Contractor shall be required to attend frequent meetings and planning sessions at the WLA VA medical center located at

11301 Wilshire Blvd., Los Angeles, CA 90073.

Schedule of Services and Price

The Government intends to award two (2) Firm Fixed-Price Indefinite Delivery Indefinite Quantity, (IDIQ) contract(s). Prices in this schedule represent an all-inclusive rate including labor, incidental costs, overhead, and insurance premium payments for applicable insurance coverage.

Costs not incorporated into the Contractor’s price will not be reimbursed by the Government.

The guaranteed minimum amount for this contact is $5,000.00. The maximum aggregate value of the orders that can be placed under this contract is $18,000,000.00. The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum amount.

**The previous option year pricing will apply to any extension pursuant to FAR 52.217-8

Each Contract Year is based on a 12 months calendar year. **

Base Year:

Period of Performance Months 1-12

(Actual dates TBD)

ITEM

NO.

DESCRIPTION UNIT Unit Price of Per Bed Per Day

1 Daily Room & Board / (in accordance with the Performance

Work Statement)

40 Beds $

Estimated Base Year Amount $

Option Year One:

Work Statement)

Estimated Option Year One Amount $

Option Year Two:

Work Statement)

Estimated Option Year Two Amount $

Option Year Three:

Work Statement)

Estimated Option Year Three Amount $

Option Year Four:

Work Statement)

Estimated Option Year Four Amount $

Estimated Value - Base Year $

Estimated Value – Option Year One (1) $

Estimated Value – Option Year Two (2) $

Estimated Value – Option Year Three (3) $

Estimated Value – Option Year Four (4) $

Estimated Total Value $

DESCRIPTION OF SERVICES/PERFORMANCE WORK STATEMENT (PWS)

Health Care for Homeless Veterans (HCHV) Contract Residential Services

Low Demand Safe Haven Program

1. BACKGROUND

The Department of Veterans Affairs (DVA) has been providing direct and specialized services for homeless Veterans for nearly 25 years. The

DVA’s plan to end homelessness among Veterans necessitates the enhancement of current homeless service capacity as well as developing new programs and initiatives with community and Federal partners.

The intent of this contract is for the VAGLAHS to engage community providers to offer homeless Veterans services through a “Safe Haven” model of residential care. Under the contract authority of VA’s HCHV Contracted Residential Services (CRS) programs, the VAGLAHS will solicit to community organizations to provide services following the HCHV-LDSH model.

The goal of the HCHV-CRS program is to rapidly stabilize Veterans’ medical, mental health, substance abuse and other psychosocial problems to place Veterans in other appropriate transitional or permanent housing within 180 days.

The VAGLAHS is seeking Contractor(s) to assist with provisions of emergency residential placement and supportive services through the HCHV-

LDSH model.

2. SCOPE

The VAGLAHS is seeking to fill a total of 80 beds annually in two (2) separate Safe Haven facilities. Each Contractor is required to propose a facility that will be capable of allocating a maximum of 40 beds per day to veteran patients.

The number of veterans is expected to fluctuate over time. Each facility is expected to accommodate up to 40 veterans. VA and Contractor may mutually agree to assign veterans, up to a maximum of 40 veterans, to the Contractor’s facility, at the same price per bed per day currently in effect as shown in the Price Schedule. Offerors shall state in their proposal at the time of proposal submission how many veterans they can accommodate at one time and sate the address of the proposed facility

This contract shall serve homeless, chronically homeless and/or vulnerable homeless Veterans with mental health, substance use, or co-occurring disorders in need of immediate placement in a safe environment with on-site supportive services. The housing must meet the criteria established both by HCHV clinical staff and VA fire and safety officials. This established criteria and annual check list is here in attached by reference at

Attachment B. Contractors are urged in the strongest terms to carefully review the requirements outlined in the Statement of Work to ensure that all facilities fire and safety and supportive services criteria can be met in a timely way.

The target population for HCHV-CRS Safe Haven includes Veterans experiencing chronic homelessness, Veterans with serious mental illnesses, and Veterans with chronic substance abuse disorders and/or serious and complex needs. This is not to be considered an emergency shelter placement. To be eligible for the HCHV CRS Safe Haven program, Veterans must:

• Be eligible for VA health care as determined by the local VA medical center.

• Be determined to be chronically homeless based on McKinney-Vento Act definitions [See Attachment H: McKinney-Vento Act Definition of Homelessness, for additional information] by the local VA medical center HCHV program.

• Be assessed by the HCHV program at the VA medical center to have mental health, substance abuse, or other serious psychosocial conditions or stressors that makes the Veteran highly vulnerable with a high likelihood of death due to homelessness and have been unable or unwilling to participate in more traditional supportive services.

Veterans are referred to the LDSH Contractor based on a demonstrated need for case management and supportive services to stabilize their mental health, substance abuse, medical and/or other co-occurring serious psychosocial issues to secure transitional or permanent housing as quickly as possible. The program shall target Veterans who are engaged in care through a collaborative partnership among the VAGLAHS, the Los Angeles

Coordinated Entry System Service Providers, Los Angeles Homeless Services Authority, and other Veteran-specific programs that target homeless Veterans. In addition, the program shall target Veterans who need to re-establish care with the VA health care system. Veterans may access transitional housing programs directly and through referrals in the community.

An authorized VA staff member shall be identified by the homeless program leadership at the VAGLAHS and assigned to the Contractor. She/he will act as the clinical liaison for all client-related issues between the Contractor and the West Los Angeles (WLA) VA homeless team. The

Liaison will provide clinical oversight, but they will not provide direct clinical supervision.

3. GOVERNMENT FURNISHED PROPERTY:

Government furnished property shall not be provided to the Contractor. All equipment required by the Contractor to perform work under this contract shall be provided by the Contractor at the Contractor’s expense.

4. IMPLEMENTATION TIMELINE

4.1 The contract facility and associated onsite services must pass inspection by VA staff and become fully operational within 30 days from the date of contract award.

4.2 Contractor shall identify all staff required per the Statement of Work and have them in place and available to provide the full range of case management and onsite services to Veterans, validated by VA inspection, prior to receiving Veteran referrals and invoicing for payment.

4.3 Contractor acknowledges that failure to pass inspection by VA staff within 30 days from the date of contract award will be a material breach of the terms of this contract and may result in the contract being terminated for cause in accordance with FAR 52.212-4(m) – Termination for

Cause.

5. TASKS & DELIVERABLES

5.1 Emergency Housing Facilities and Management

5.1.1Contractor shall have site control of the housing facility through ownership or valid lease.

5.1.2 Contractor shall ensure that the facility used for this contract meets fire and safety code imposed by the State law, and the Life

Safety Code of the National Fire and Protection Association [see Attachment G: Life Safety Code of the National Fire and Protection

Association for additional information]. Contractor shall bear all costs associated with ensuring compliance with these requirements; no additional funds will be made available by VA for capital improvements under this contract. All Contractor facilities, unless they are specifically exempted under the Life Safety Code, must have an operational sprinkler system.

5.1.3 Contractor shall ensure that the facility used for this contract meets the Americans with Disabilities Act (ADA) guidelines [see

ATTACHMNET C: Americans With Disabilities Act for additional information] for accessible accommodations for Veterans with physical limitations or impairments. This is also referred to as “Architectural Barriers Act compliant.” Contractor shall bear all costs associated with ensuring compliance with this requirement; no additional funds will be made available by VA for capital improvements under this contract. Veterans must not be segregated from the rest of the facility due to physical disability; they must have full access to the physical plant as well as the services and supports at the facility. Should a Veteran be referred to the Contractor in need of ADA-compliant bed and there is not one available, the Contractor shall refer the Veteran in need to an alternate location

[see ATTACHMNET C: Americans With Disabilities Act, for additional information].

5.1.4 If a Contractor determines that complying with ADA requirements would be prohibitive due to significant renovations or modernization at their facility, Contractor may subcontract with another emergency housing provider that meets the ADA requirements, provided the second emergency housing provider is able to meet all of the same facilities requirements as required by this contract.

Contractors utilizing a subcontractor must also have written policies and procedures that clearly describe how comparable on-site services shall be provided by the subcontractor to Veterans residing in the subcontractor’s facility. The Contractor shall retain full responsibility for meeting the terms of this contract, at the prices shown in the Price Schedule, when utilizing a subcontractor to meet ADA requirements.

5.1.5 Contractor facility shall be licensed as required for the particular setting under State or Federal authority, and shall meet all applicable local, state, and Federal requirements concerning licensing and health codes. Contractor must provide copies of valid licenses to the VA at the time of pre- award inspection and during annual inspection reviews. Where applicable, the facility must have a current occupancy permit issued by the authority having jurisdiction.

5.1.6 Contractor shall ensure the safety and privacy of all Veterans. Men and women shall have separate bathroom facilities. The facility must have female residential rooms or sections that are securely segregated or restricted from men to ensure safety and privacy. If the facility cannot accommodate both male and female Veterans at one location, the Contractor shall provide equivalent facilities and services for the opposite gender that meet the terms of this contract, at the prices shown in the Price Schedule.

5.1.7 Contractor shall provide a safe and sober environment for all residents that is consistent with the Safe Haven model of housing and services. The Contractor shall offer a low-demand environment with a minimum set of rules designed to re-establish trust in the chronically homeless Veteran and engage the Veteran in needed treatment services. Contractor shall have written policies and procedures in place that address the following concerns and situations:

5.1.7.1 Acceptance of treatment cannot be a condition of admission or continued stay.

5.1.7.2 Abstinence from alcohol or drugs cannot be a condition of treatment or continued stay, however drug testing may be utilized as a tool to assess for safety only

5.1.7.3 Utilization of the Safe Room. (reference 5.1.13)

5.1.7.4 Infractions of rules shall be used as opportunities for engagement.

5.1.7.5 Suspected or known drug or alcohol use or relapse by one or more residents and interventions based on the Safe Haven model.

5.1.7.6 Management of on-site contraband, weapons, drug or alcohol related paraphernalia (i.e., found alcohol, drugs, drug

“works”, etc.) and interventions based on the Safe Haven model.

5.1.7.7 Safe prescription medication storage and handling, including specific provisions for prescribed controlled substances.

5.1.7.8 Room inspections, including methods and frequency.

5.1.7.9 Grievance process to address resident complaints with time frames for responses from the Contractor’s program/facility management.

5.1.7.10 Client abandonment of belongings in the facility, including time frames and procedures for disposal.

5.1.7.11 Process to elicit client satisfaction with the facility and onsite services, including information collection methods and frequency, and process for utilizing the information for continual performance improvement purposes.

The Contractor shall communicate these policies and procedures to Veteran residents both verbally and in writing in a manner that is understandable to them upon admission to the contracted facility. This communication shall be documented in the Veteran’s client record by the Contractor.

5.1.8 The Contractor shall keep the house rules and expectations to a minimum, keep it simple, and shall focus on safety of the residents.

Most residents will have had difficulty in the past adhering to settings where strict rules are applied. The rules shall reward positive behavior, be enforceable, relate to the living situation, provide for safety of the residents and provide opportunities for engagement.

Residents shall not be penalized with discharge for the use of alcohol or drugs, as many of the residents that this program targets have failed programs in the past for their inability to stay clean and sober. Maintaining housing stability shall be the primary goal for each resident. To provide for the safety of the residents, the Contractor shall have written policies and procedures in place that clearly indicate the following are prohibited:

5.1.8.2 Dealing or use of illicit drugs at the facility

5.1.8.3 Buying or selling of alcohol or drugs in the facility

5.1.8.4 Sexual activity between residents

5.1.8.5 Violence or threat of violence by residents at the facility

5.1.8.6 Management of weapons including firearms.

5.1.8.7 Gambling.

5.1.9 Although rules must be kept simple and demands on the Veterans low, Contractor must ensure that staff at the facility stay continuously engaged with the residents. Contractor shall implement policies and procedures that ensure:

5.1.9.1 Regular room checks shall occur with a strong focus on maintaining a safe environment that promotes the well-being of all residents. Increased room checks and safety planning for Veterans determined to be high-risk is required with supporting documentation.

5.1.9.2 Staff is trained in providing flexible, respectful responses to infractions of rules.

5.1.9.3 Homeless Veterans shall not be discharged for drinking, use of drugs, non-compliance with prescribed medication or infractions of house rules that do not constitute a risk to their personal safety or the safety of the facility residents or staff.

5.1.9.4 Assertive engagement by the staff with Veterans regarding drinking, use of drugs, non-compliance with prescribed medication or infractions of house rules is the course of action to deal with these common problems of the Safe Haven facility.

5.1.9.5 Contractor shall provide the following to all Veterans admitted to the HCHV Contract Residential Care facility:

5.1.9.6 A designated bed that is used exclusively by the individual Veteran from the time of admission to the time of discharge.

This bed must be situated in a room that affords the Veteran safety, privacy and security.

5.1.9.7 Linens such as sheets, towels, blankets, and pillows shall be provided by the Contractor.

5.1.9.8 A safe and secure place for each Veteran to store his/her belongings that is readily accessible to the Veteran (such as a locking closet, a locking armoire, a locker, etc.).

5.1.9.9 Laundry facilities for Veterans to do their own laundry, including laundry detergent.

5.1.10 Contractor shall provide a clean and comfortable environment of care that meets the following conditions:

5.1.10.1 A structurally sound facility so as not to pose any threat to the health and safety of the Veterans and protect them from the elements;

5.1.10.2 Facility entries and exit locations that are capable of being utilized without unauthorized use and provide alternate means of egress in case of fire;

5.1.10.3 Provides each resident an acceptable place to sleep that is in compliance with appropriate codes and regulations;

5.1.10.4 Provides every room or space with natural or mechanical ventilation;

5.1.10.5 Is free of pollutants in the air at levels that threaten the health of residents;

5.1.10.6 Provides a water supply that is free from contamination;

5.1.10.7 Provides sufficient sanitary facilities to residents that are in proper operational condition, may be used in privacy, and are adequate for personal cleanliness and the disposal of human waste;

5.1.10.8 Provides adequate heating and or cooling in all parts of the facility; must achieve <75 degrees Fahrenheit for cooling and > 69 degrees Fahrenheit for heating.

5.1.10.9 Provides adequate natural or artificial illumination to permit normal indoor activities and to support the health and safety of residents;

5.1.10.10 Provides sufficient electrical sources to permit use of essential electrical appliance while assuring safety from fire;

5.1.10.11 Provides that housing and equipment are maintained in a sanitary manner free from pests, insects and vermin.

5.1.10.12 Provides that the facility has a warm, welcoming, and respectful atmosphere through its lighting and décor.

5.1.10.13 Contractor shall ensure that furniture is well maintained and comfortable, and that plants, table cloths and fruit baskets with fresh fruit are part of daily facility operations and upkeep.

5.1.10.14 Contractor shall provide a common area with books and reading material; computers to learn and enhance veteran’s computer skills and a recreation area for engaging with other members.

5.1.11 Contractor shall maintain a clean and comfortable environment of care that meets the conditions stated in section 5.1.10. Contractor shall bear all costs associated with ensuring compliance with these requirements; no additional funds will be made available by VA for capital improvements under this contract in the event corrective action is required to remedy a negative condition. Contractor must ensure that it has sufficient operating funds to maintain the facility according to the requirements of this contract.

5.1.12 The Contractor shall provide designated onsite office space and parking to an authorized VA staff member from the WLA VA

Medical Center. The office space must afford the authorized VA staff member and Veterans privacy and confidentiality when meeting. The authorized VA staff member is expected to be onsite at the Contractor facility two (2) to five (5) days per week in keeping with VA HCHV

LDSH program expectations.

5.1.13 Veterans who enter the program inebriated shall be kept separately from other participants in the program until they have been cleared to enter the general participant population. This shall require having a “safe room” where the Veteran can sleep separately from other participants in the program. Monitoring a Veteran in the Safe room procedures are as follows:

5.1.13.1 Inebriated individuals shall be closely observed and physically checked at least every 30 minutes during the first 12 hours. Close observation and physical checks shall continue beyond the initial 12-hour period for as long as the individual appears inebriated. Documentation and VA notification of such is required.

5.1.13.2 In all cases related to signs of withdrawal and acts of violence contact the local emergency response system then follow up with a phone call to the assigned HCHV Liaison.

5.1.13 Contractor shall provide nutritionally-adequate meals three (3) times per day, seven (7) days per week, 365 days/ year including holidays, in a setting that encourages social interaction. Nutritious snacks between meals and at bedtime shall be available for those requiring or desiring additional food, when it is not medically contraindicated. All food must be stored, handled and served in a safe and sanitary manner that meets accepted industry standards and guidelines.

5.1.14 The VA has particular concern for chronically homeless Veterans, many of whom are either undernourished or have developed poor eating habits or both, because of chronic medical, mental health or substance abuse disorders. A VA dietitian will assess printed menus as well as Veterans’ satisfaction with meals and the actual consumption of food offered in determining the Contractor’s success in meeting this requirement during annual facility inspection, or at any point during the contract period.

5.1.15 Contractor shall allow VA staff to inspect that facility and/or review Veteran participant treatment protocols at any time determined necessary by VA.

6. STAFFING AND SUPPORTIVE SERVICES

6.1 The Contractor shall employ sufficient personnel to carry out the policies, responsibilities, and programs of the facility 24 hours per day, seven

(7) days per week, 365 days per year including weekends and all state and federal holidays. Contractor shall provide, at a minimum:

6.1.1 Program Director or their designee: The Program Director or their designee shall be on call and available for emergencies 24 hours a day, seven (7) days a week, 365 days a year, including Federal and State Holidays. The Program Director or their designee shall have a bachelor’s degree in any field and at least one-year experience providing oversight of a residential homeless facility. The Program Director or their designee shall provide oversight of the following functions:

6.1.1.1 Provide clerical oversight of program management.

6.1.1.2 Complete and submit daily bed counts.

6.1.1.3 Provide supervision of Veteran Service Worker Staff and their Monitoring duties.

6.1.1.4 Respond to referrals and update reports to VA when needed.

6.1.1.5 Coordinate with VA regarding annual inspections and follow up with inspection results.

6.1.1.6 Complete and submit monthly invoices.

6.1.1.7 Submit incident reports to VA.

6.1.1.8 Meet with VA Liaison at a minimum on a monthly basis and as warranted.

6.1.2 Administrative Assistant: This is a full time (40 hours/week), on-site position. The Administrative Assistant shall be on site or residing at the residence and available for emergencies 24 hours a day, seven (7) days a week, 365 days a year, including Federal and State

Holidays. The Full-time administrative Assistant shall assist the Program Director or their designee with all his/her duties (as stated in section 6.1.1) while on site. Note: security staff alone, whether employed directly by the Contractor or subcontracted by the Contractor, is not sufficient to meet this requirement.

6.1.3 Licensed Clinical Supervisor: A professionally Licensed Clinical Supervisor available onsite 40 hours per week to provide ongoing supervision of cases and case management personnel. The clinical supervisor must be on call and available for emergencies 24 hours a day, seven (7) days a week, 365 days a year, including Federal and State Holidays.

6.1.3.1 The Clinical Supervisor shall be licensed by the state of California as a Licensed Clinical Social Worker, Licensed

Marriage & Family Therapist, Psychologist, or Licensed Professional Clinical Counselor.

6.1.3.2 have at least one-year of experience as a clinical supervisor of a residential homeless facility. The Licensed Clinical

Supervisor shall meet with VA Liaison at a minimum, monthly and as warranted.

6.1.4 Case Management Personnel: Case Management Personnel shall be on call and available for emergencies 24 hours a day, seven (7) days a week, 365 days a year, including Federal and State Holidays. Case Management Personnel shall provide necessary therapeutic interventions and activities and to ensure a meaningful integration of these efforts with those provided in the residential setting. Each

Veteran must have an assigned case manager responsible for coordinating and providing the supportive services specified in the contract.

6.1.4.1 Case Management Personnel shall have bachelor’s degree in a social service field.

6.1.4.2 Case managers must have training and experience working with homeless individuals with chronic medical, mental health and substance abuse problems and be able to assess and anticipate crises while implementing de-escalation techniques as needed.

6.1.4.3 The case manager to resident ratio shall be 1:20, unless consideration is given by the VA due to the unique staffing characteristics of the contract Safe Haven facility.

6.1.4.4 The clinical supervisor may not be used to fill the role of “case manager” in lieu of case management staff.

6.1.5 Veteran Service Worker (VSW): there shall be two (2) VSWs on-site, 24 hours a day, 7 days a week, 365 days a year, including

Federal and State Holidays. VSWs shall monitor Veterans and facilities to ensure a safe and secure environment. Facilitate medication distributions, document interactions and observations, communicate with program staff, coordinate services, resources and referrals, conduct UA’s and weekly meetings.

6.1.5.1 VSWs shall have a minimum of a high school diploma and experience working with homeless and/or substance abuse populations.

6.1.5.2 VSWs shall not be used to fill any other position in this contract other than their identified VSW role.

6.1.6 Security staff onsite after hours, weekends, and state and federal holidays.

6.1.7 All staff shall be certified in Basic Life Support (BLS) through the American Heart Association or equivalent program.

6.1.8 The Contractor staff may cover each other and support a team model of care (never covering a position higher than their qualifications allow), however full-time employment in two positions is not allowed. Each staff position must be accounted for independently of other staff positions.

6.1.9 The Contractor shall not employ any person who is an employee of the United States Government if the employment of that person would create a conflict of interest. The Contractor shall not employ any person who is an employee of the VA, unless such person seeks and receives approval in accordance with VA regulations. Nor shall the Contractor employ any person who, as a member would create a conflict of interest or the appearance of a conflict of interest, particularly with regard to influencing the contract negotiations or terms of the contract. In any such case, VA must review the matter and give its approval.

6.1.10 Contractor shall have general liability insurance coverage of $5 Million to $10 Million to cover employee malfeasance.

6.2 All employees working directly with Veterans must complete the following trainings provided by the Contractor upon hiring and annually.

The Contract is to then provide the list of completed trainings to the VA.

6.2.2 Motivational Interviewing

6.2.3 Critical Time Intervention

6.2.4 Stages of Change

6.2.5 Crisis Intervention

6.2.6 Cultural sensitivity

6.2.7 Sexual Harassment

6.2.8 Sensitivity to wider issues of homelessness

6.2.9 Universal Precautions (disease transmission prevention)

6.2.10 Adult abuse/neglect reporting laws

6.2.11 Harm Reduction philosophy

6.2.12 Suicide Prevention

6.2.13 Medication Monitoring

6.2.14 State and Federal Fair Housing Law & ADA Requirements

6.2.15 Conflict resolution

6.2.16 Customer Service

6.2.17 Professional Boundaries

6.2.18 Countertransference

6.2.19 Severe Mental Illness and Psychopathology

6.2.20 De-escalation Techniques

6.2.21 Conservatorship

6.2.22 Grave Disability Criteria

6.2.23 Housing First

6.2.24 Substance Abuse Treatment Options

6.2.25 Privacy and Confidentiality

6.3 Contractor shall complete the following Talent Management System (TMS) online trainings provided by the VA before the commencement of work on the contract:

6.3.2 VA Privacy and Information Security Awareness and Rules of Behavior (VA31167)

6.4 Contractor staff shall maintain clear boundaries to assure professional integrity and responsibility with Veterans at all times while conveying an attitude of genuine concern and caring.

6.5 Contractor staff shall under no circumstances engage in sexual activities or sexual contact with Veterans or their family members, including consensual sexual contact. Contractor shall under no circumstances take advantage of any professional relationship or exploit Veteran clients or their family members to further their personal, religious, political, or business interests. Contractor staff shall not engage in relationships with

Veterans or their family members in which there is a risk of exploitation or potential harm to the Veteran or Veteran family. These relationships may be those that occur outside of the professional environment or outside of a professional nature in which the Contractor works with the

Veteran and/or their family. Contractor shall take steps to protect Veterans and their family members and is responsible for setting and enforcing clear, appropriate, and culturally sensitive boundaries with Contractor staff.

6.5.1 The Contractor shall comply with the VA patient’s Bill of Rights as set forth 38 CRF17.33 Patient’s Rights which is incorporated herein by reference. The Contractor shall maintain Veterans’ privacy and confidentiality and must have systems in place that protect Veteran’s

Personal Identifying Information (PII) and Protected Health Information (PHI). This includes:

6.5.1.1 Having adequate private office space for Veterans to meet in confidence with their case manager.

6.5.1.2 Having secured paper and electronic filing systems to protect clients’ case records and other documentation.

6.5.1.3 Conducting ongoing training of staff about maintaining client privacy and confidentiality in all oral and written communications and interactions.

6.5.1.4 Ensuring that non-clinical/non-case management facility staff have access to Veteran information only as needed in order to meet the service requirements contained in the contract.

6.6 Contractor and VA homeless outreach staff shall conduct outreach activities to homeless veterans in conjunction with street outreach teams in the West Los Angeles VA catchment area. Outreach teams may be comprised of VA employees, Contractor outreach teams, Supportive Service of

Veteran Families (SSVF) leads, and/or Contractor. Fifty percent (50%) of the Veterans who enter this contract must be homeless Veterans with serious mental illness and persistent substance use problems that have not responded to traditional programs and meet the definition of a chronically homeless person are a primary target. For this program, the Government will use the U.S. Department of Housing and Urban

Development’s working definition of a chronically homeless person, who “in general, is an unaccompanied disabled individual who was been continuously homeless for over one year”. Engagement with the Veteran should be goal-directed with consistent staff geared toward building trust and getting the Veteran to accept and remain in the Safe Haven residence. Evidence-based practices, such as motivational interviewing and critical time intervention, should be utilized.

6.7 Contractors shall communicate policies and procedures to Veteran residents both orally and in writing in a manner that is understandable to each Veteran upon admission to the facility, ideally in the form of a written resident handbook that is orally reviewed by the assigned case manager with the Veteran. This communication must be documented in the Veteran’s client record.

6.8 The Contractor shall provide the following case management services to Veterans in the program:

6.8.1 Engagement of the Veteran in the service planning process. Contractor shall interview, counsel and case manage admitted Veterans by conducting psychosocial assessments to identify treatment needs which affect the Veterans’ adjustment to their environment and establish treatment goals. Contractor shall utilize counseling strategies to include crisis intervention and case management including both short and long-term services.

6.8.2 Contractor shall assess the psychosocial and environmental needs or dysfunction secondary to or exacerbating the social, substance or psychiatric problems, which might contribute to Veterans’ readjustment challenges in the community. Contractor shall establish and maintain an intensive therapeutic relationship with the Veteran, staff, and community programs/agencies, and shall formulate case-management treatment goals and plans that address identified needs, stressors and problems.

6.8.3 Contractor shall conduct high-risk screening, psychosocial assessment and treatment planning, actively involving the Veteran and their family or significant others, in coordination with the team members. Psychosocial assessments shall include goals for clinical treatment.

Contractor shall coordinate and document clinical case management and psychosocial services and document the overall effectiveness of the case management services provided. Specifically, Contractor shall:

6.8.3.1 Develop a highly individualized Individual Service Plan (ISP) with the Veteran consistent with low-demand program goals; the plan must specifically include provisions for Veteran placement into an appropriate transitional or permanent housing placement within 180 days. The housing placement planning must take into account all appropriate and available community-based housing options as well as the Veteran’s preferences regarding location and housing type.

The plan shall also be focused on getting the Veteran resident to accept services, especially mental health and substance use services that allow attainment of transitional or permanent housing. Acceptance of the services offered shall not be a condition of continued stay in the LDSH program. However, engagement and service delivery shall retain the expectation that the resident advance to permanent housing with support, recognizing that it will often be at his or her own pace.

6.8.3.2 Complete a written ISP within the first week of program admission and signed by the Contractor, the Veteran, and the authorized VA staff member.

6.8.3.3 Review ISP at a minimum every thirty (30) days thereafter in a clinical meeting with the Veteran. Updated plans must be promptly communicated to the authorized VA staff member.

6.8.3.4 Make changes in ISP in consultation with the Veteran.

6.8.3.5 Screen each Veteran for suicidal and homicidal risk with each contact at a minimum of weekly during case management sessions. This screening must be documented in regular progress notes in the Contractor’s clinical service records. If the

Veteran is a danger to him/herself or others Contractor shall take immediate steps to provide appropriate intervention.

Crisis management shall be conducted in consultation and coordination with the authorized VA staff member.

6.8.3.6 Coordinate with authorized VA staff member during weekly case conferences regarding updates and changes in

Veterans’ care plans to foster a collaborative relationship with the VAMC and Contractor in meeting Veterans’ needs.

Case conferencing may be done in person or by telephonic conference calls as determined by the VA medical center.

6.8.3.7 Obtain relevant Releases of Information to communicate and coordinate Veterans’ treatment with VA and other community-based service providers.

6.8.3.8 Work in close collaboration with the authorized VA staff member to ensure Veterans’ connections to needed VA medical, mental health, and substance abuse treatment and care.

6.8.3.9 Assist Veterans in completing housing applications and other benefits paperwork as needed. Contractor shall assist

Veterans in obtaining the needed documentation required for complete applications including birth certificates, driver’s license, income verification and any additional information required by housing resources and potential income supports.

6.8.3.10 Contractor shall accompany Veterans to housing interviews, medical appointments, and other appointments as clinically indicated while working with Veterans to foster independence and a sense of self-determination.

6.8.3.11 Contractor shall provide transportation for Veterans to attend appointments at the VA, potential housing placements, benefits agencies, meetings with landlords, etc. Transportation may include assistance in obtaining Metro cards, bus fare, or local subsidized transportation services such as Access, etc.

6.9 The Contractor shall provide the following onsite therapeutic and rehabilitative services including:

6.9.1 A variety of daily structured groups and activities to promote social skills building and healthy lifestyle (i.e., resident participation in psychosocial group sessions, topics based upon resident preference and recommendations by the residential treatment setting staff and authorized VA staff member; physical activities; facilitated outings or social activities in the local community). Daily activity schedules must be printed and posted in facility common areas to ensure Veteran awareness and promote participation.

6.9.2 Provide health and personal hygiene maintenance supplies for Veterans such as dental care products, hair care products, soap and shaving supplies, feminine care products, deodorant, and mild wound care products.

6.9.3 Monitoring of medications for those residents taking medications.

6.9.4 Supportive social services, in collaboration with the case managers, VA or other community resources; Supportive services include:

collaboration with accessing VA and/or other community benefits such as general relief and social security, helping link veterans to accessing

ID cards if necessary, linkages to requested support groups in the community such as AA, NA, outpatient medical and mental health services.

6.9.5 Professional counseling as required, including emphasis on self-care skills, adaptive coping skills, vocational counseling, in collaboration with the authorized VA staff member or community resources as appropriate.

6.9.6 Opportunities for immediate learning and/or development of responsible living with a goal of achieving a more adaptive level of psychosocial functioning.

6.9.7 Support for an alcohol and/or drug-free lifestyle.

6.9.8 Opportunities for learning, and internalizing knowledge of the illness and/or recovery process; improving social skills; and improving personal relationships.

6.9.9 Opportunities for client participation in community activities, volunteer opportunities, local consumer services, etc.

6.10 Contractor shall verbally notify VA through the authorized VA staff member at the local VA medical center of any negative incident occurring with a Veteran immediately. Contractor shall complete a written incident report within 24 hours of notification. On weekends and holidays, this notification shall be sent to the Transitional Housing Coordinator and/or HCHV authorized VA staff member. Reportable incidents include: death; fire; drug/police raid; suicide/suicide attempt; 911 call (police/fire department/paramedics/other); drug overdose; 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. Contractor shall follow the CRS Incident Reporting Policy [see ATTACHMENT F: CRS Incident

Reporting Policy, for additional information].

6.11 In the event a Veteran residing in a Contractor facility under this contract dies, the Contractor shall promptly notify the authorized VA staff member authorizing admission and immediately assemble, inventory, and safeguard the Veteran’s personal effects. The funds, deposits, and effects left by Veterans upon the premises of the facility shall be delivered by the director or manager of 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 Veterans unless the beneficiary died without leaving a will, heirs, or next of kin capable of inheriting. When disposition has been made, the itemized inventory with a notation as to the disposition has been made, they shall be immediately forwarded to the authorized VA staff member. If the Veteran died without leaving a will, heirs, or next of kin capable of inheriting, property and funds wherever located vests in and becomes property of the United States in trust. In these cases, the facility shall forward an inventory of any such property and funds in its possession to the appropriate VA office and shall hold them (except articles of clothing necessary for proper burial) under safeguard until instructions are received from the VA concerning disposition.

7. SUBSTITUTION OF PERSONNEL

7.1 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 task order, 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 a completed Contractor Change email to the COR and HCHV Liaison to include: the reason for the request, 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.

7.2 The Government shall have the right to require replacement of any Contractor or subcontractor employee assigned to work on this contract, if, in the Contracting Officer’s opinion, the employee is determined not to possess the experience 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. Replacement staff must meet the staff qualification requirements specified in Section 5 of the Performance Work Statement. 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.

8. ADMISSIONS, LENGTH OF STAY AND DISCHARGES

8.1 The goals of the HCHV LDSH Program are to:

8.1.1 Rapidly stabilize Veterans’ medical, mental health, substance abuse and other psychosocial problems by expediting placement of these

Veterans into safe, supportive emergency housing.

8.1.2 Place Veterans in other appropriate transitional or permanent housing no more than 180 days from the date of admission.

8.1.3 Veterans will be screened and referred to the Contractor by the authorized VA staff member, community providers, Coordinated Entry

Case conferencing, or other Outreach staff, community partners, or through self-referral. Except lack of available beds, the Contractor shall provide immediate admission to housing and services to these Veterans 24 hours per day, 7 days per week. If a Veteran presents at the facility during weekends, at night, or a holiday day, the Safe Haven provider may accept the Veterans. However, VA reserves the right of approval or disapproval for payment; payment will only be made if the Veteran’s stay at the Contractor facility is approved by the Contracting Officer or authorized VA staff member. The date of admission must be approved by the authorized VA staff member for billing purposes within 48 hours of admission. Engagement of homeless Veterans in the provision of housing placement, treatment and supportive services is a key element of the HCHV Contract Residential Care program. Therefore, management of program dropout shall be an element of the quality assurance review of this program. Referrals from the Inpatient hospital and the Emergency Department shall require pre-approval from the authorized

VA staff member or identified VA Registered Nurse.

8.1.4 Although demands are kept minimal in the Low-Demand/Safe Haven setting, expectations shall be kept high regarding the resident utilizing the time to access other residential treatment, transitional or permanent housing settings offered by VA and the community.

Continuous engagement shall be directed at helping the resident achieve goals of securing a more permanent setting. Maintaining housing stability shall always be the primary goal. Recognition and rewards shall be provided to help residents achieve these goals. The Contractor is expected to recognize successful Safe Haven Veterans with ceremonies, opportunities to provide peer support to other Veterans as appropriate, and invitations to share their experiences as successful alumni.

8.1.5 Contractor shall take action to place Veterans in other transitional or permanent housing suitable for the Veteran within 180 days from the date of admission to Contractor’s facility. Contractor shall not bill for per diem for Veterans whose length of stay exceeds 180 days from the date of admission without prior approval from the authorized VA staff member. The authorized VA staff member will not approve per diem for lengths of stay exceeding 180 days from the date of admission unless:

8.1.5.1There are extenuating clinical circumstances beyond the Contractor’s control that are barriers to the Veteran’s placement in housing;

8.1.5.2 There is documented evidence that the Contractor has exhausted every effort to place the Veteran in housing sooner;

and

8.1.5.3 The authorized VA staff member has been appropriately advised of these efforts well in advance of the 180-day limit;

and

8.1.5.4 The authorized VA staff member concurs that the Veteran shall continue to derive therapeutic benefits from a continued stay at the HCHV Contracted Residential Care facility

8.1.6 In the event that a Veteran’s length of stay exceeds 180 days from the date of admission to Contractor’s facility, and there is not approval from the authorized VA staff member for continued per diem, the Contractor shall not be paid per diem for that Veteran beyond the 180-day point and the Contractor shall retain the responsibility for finding suitable transitional or permanent housing in the community at Contractor’s own expense.

8.1.7 Veterans may be discharged from HCHV-LDSH program for positive/ negative behavior or administrative reasons. The date of discharge must be approved by the authorized VA staff member for billing purposes.