36C26322Q0622.pdf

PAGE 1 OF 811. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. DUNS: DUNS+4:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

36C26322Q0622 09 June 2022

Matthew Dale 651-293-3010 30 June 2022

5PM CST

36C263 Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

316 Robert Street N. STE. 506 St. Paul MN 55101

X

624221

$12 Million

Net 30 X

N/A

X

36C636

Department of Veterans Affairs Nebraska-Western Iowa VA Medical Center 4101 Woolworth Avenue Omaha, NE 68105

36C263

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

316 Robert Street N. STE. 506 St. Paul MN 55101

Y

Department of Veterans Affairs Financial Services Center PO Box 149971

Austin TX 78714-9971

See CONTINUATION Page

Solicitation for emergency shelter and related services for the Nebraska-Western Iowa VA Health Care System.

Services to be provided in Omaha, Nebraska for eligible Veterans in accordance with the terms of the B.3 Performance Work Statement.

See E.7 Instructions to Offerors for additional information.

See CONTINUATION Page

Matthew Dale Contracting Officer

36C26322Q0622

Table of Contents

Section B - Continuation of SF 1449 Blocks

B.1 Contract Administration Data B.2 Schedule B.3 Performance Work Statement B.3.1 PWS Addendum: VHA Supplemental Contract Requirements for Combatting COVID-19 B.4 VA Information and Information System Security / Privacy Language B.5 Records Management Obligations (NARA Language)

Section C - Contract Clauses

C.1 52.212-4 Contract Terms and Conditions— Commercial Products and Commercial Services (Nov 2021) C.2 52.204-21 Basic Safeguarding of Covered Information Systems (Nov 2021) C.3 52.216-18 Ordering (Aug 2020) C.4 52.216-19 Order Limitations (Oct 1995) C.5 52.216-22 Indefinite Quantity (Oct 1995) C.6 52.217-8 Option to Extend Services (Nov 1999) C.7 52.217-9 Option to Extend the Term of the Contract (Mar 2000) C.8 VAAR 852.212-70 Provisions and Clauses Applicable to VA Acquisition of Commercial Items (Apr 2020) C.9 VAAR 852.219-71 VA Mentor-Protégé Program (Dec 2009) C.10 VAAR 852.219-72 Evaluation Factor for Participation in the VA Mentor-Protégé Program (Dec 2009) C.11 VAAR 852.219-75 Subcontracting Commitments Monitoring and Compliance (Jul 2018) C.12 VAAR 852.219-76 Subcontracting Plans Monitoring and Compliance (Jul 2018) C.13 52.252-2 Clauses Incorporated by Reference (Feb 1998) C.14 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders-Commercial Products and Commercial Services (May 2022)

Section D - Contract Attachments

Section E - Solicitation Provisions

E.1 52.212-1 Instructions to Offerors—Commercial Products and Commercial Services (Nov 2021) E.2 52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Nov 2021) E.3 52.209-7 Information Regarding Responsibility Matters (Oct 2018) E.4 52.233-2 Service of Protest (Sep 2006) E.5 52.252-1 Solicitation Provisions Incorporated by Reference (Feb 1998) E.6 VAAR 852.273-73 Evaluation- Health Care Resources (Jan 2003) E.7 Instructions to Offerors (Addendum #1 to VAAR 852.273-73) E.8 Evaluation of Option to Extend Under FAR 52.217-8 (Addendum #2 to VAAR 852.273-73) E.9 52.212-3 Offeror Representations and Certifications—Commercial Items (Nov 2021)

36C26322Q0622 | Section B Continuation of SF1449 | NWI HCHV Homeless Shelter Services

Section B - Continuation of SF 1449 Blocks

B.1 Contract Administration Data (continuation from Standard Form 1449, block 18A.)

Under the authority of Public Law 104-262 and 38 USC 8153, the Contractor agrees to provide Health Care Resources in accordance with the terms and conditions stated herein, to furnish to and at the VA Nebraska-Western Iowa Health Care System, the services and prices specified in the Sections B.2 (Schedule) and B.3 (PWS).

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR: (include name, address, phone, and email contact information).

b. GOVERNMENT: Matthew Dale, Contracting Officer Department of Veterans Affairs Network Contracting Office (NCO) 23 316 N. Robert St. STE 506 St. Paul MN 55101 651-293-3010 Matthew.Dale3@va.gov

c. Contractor and Government points of contact can be changed by written notification to the other party. Notification will be placed in the Contract file and will not require a modification to the Contract.

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor should be mailed to the following address (Contractor fill in address information below if different than administration address above):

3. INVOICES: Invoices shall be submitted monthly in arrears. See B.3 PWS Section 11, page 20, Invoicing and Payment.

4. Type of Contract:

Per-procedure, fixed price, indefinite delivery indefinite quantity purchase order under the authority of VAAR 873 and FAR 13.5.

mailto:Matthew.Dale3@va.gov

B.2 Schedule The Contractor shall furnish all personnel to provide services necessary to services as detailed in the B.3 Performance Work Statement (PWS) to eligible beneficiaries in support of the VA Nebraska-Western Iowa Health Care System’s Health Care for Homeless Veterans (HCHV) program. The HCHV strives to remove homeless Veterans from the street or from habitation unfit for Veterans and place them in community-based residential environments with sufficient therapeutic services to meet the Veterans’ needs.

Place of Performance: Omaha, Nebraska.

Pricing Instructions: Offerors- please provide all-inclusive rate per Veteran per day in the Unit Price section and multiply by ten for proposed total estimate for each period of performance. Lastly, combine the totals for your proposed base period total estimated cost with the option year estimates to provide a total proposed estimate for all periods of performance.

Period of Performance: 01 August 2022 to 31 July 2023 with four option periods of one year each.

Omaha Nebraska HCHV Homeless Shelter and Support Services Base Period of Performance: 01 August 2022 to 31 July 2023

LIN Description Estimated Quantity

Unit Price

Estimated Total Price for Base Period

Omaha Veteran Transitional Housing and Services – estimated 20 beds per day, every day.

Includes all services listed in the PWS at section B.3.

20 beds / day

Option Year 1: 01 August 2023 to 31 July 2024

LIN Description Estimated Quantity

Unit Price

Estimated Total Price for OY 1

Omaha Veteran Transitional Housing and Services – estimated 20 beds per day, every day.

Includes all services listed in the PWS at section B.3.

Total estimated price for all periods of performance: $ Minimum Contract Value: $10,000.00 Maximum Contract Value: 1.5 times value of successful offeror’s estimated total pricing, to be finalized prior to award.

Omaha Nebraska HCHV Homeless Shelter and Support Services Option Year 2: 01 August 2024 to 31 July 2025

LIN Description Estimated Quantity

Unit Price

Estimated Total Price for OY 2

Omaha Veteran Transitional Housing and Services – estimated 20 beds per day, every day.

Includes all services listed in the PWS at section B.3.

Option Year 3: 01 August 2025 to 31 July 2026

LIN Description Estimated Quantity

Unit Price

Estimated Total Price for OY 3

Omaha Veteran Transitional Housing and Services – estimated 20 beds per day, every day.

Includes all services listed in the PWS at section B.3.

Option Year 4: 01 August 2026 to 31 July 2027

LIN Description Estimated Quantity

Unit Price

Estimated Total Price for OY 4

Omaha Veteran Transitional Housing and Services – estimated 20 beds per day, every day.

Includes all services listed in the PWS at section B.3.

B.3 Performance Work Statement

A. Purpose

The core mission of the HCHV program is to reduce homelessness among Veterans by conducting outreach to those who are the most vulnerable and who are not currently receiving VA services and then engaging them in treatment and rehabilitation via VA programs and non-VA community programs that provide prevention and support services. The Department of Veterans Affairs NWI Health Care System in Omaha, NE requires contractors to provide services as part of its Health care of Homeless Veterans (HCHV) program. The contracted services allows for the HCHV program to remove homeless Veterans suffering from serious mental illness, substance abuse disorder and/or moderate medical needs from the street or habitation unfit for Veterans and place them in community-based, residential environments with sufficient therapeutic services to meet the needs of those Veterans to move towards obtaining permanent housing in accordance with 38 U.S.C. 2013 (a).

38CFR 63.3. The Contracted Emergency Residential Program is outlined in the HCHV Program Handbook 1162.09.

B. Background

Through the HCHV program, the Department of Veterans Affairs (VA) provides case management services to Veterans and facilitates their access to a broad range of medical, mental health, and rehabilitative services. This requirement is for the acquisition of services for veterans from a contractor who can provide care, treatment and rehabilitative services, including services focusing on securing permanent housing in community-based treatment facilities offering a safe and secure environment that supports individualized rehabilitation goals in Omaha, NE. The contractor is expected to target and prioritize homeless veterans transitioning from literal street homelessness, veterans discharged from institutions, veterans required to register on a sexual offense registry, Veterans in need of medical respite and Veterans who recently became homeless and require safe and stable living arrangements while seeking permanent housing. Veterans must meet the following criteria:

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

• Are determined to be homeless based on the McKinney-Vento Act definitions(see Reference section for details) by the local VA medical center HCHV program; and

• Are suffering from a mental health and/or substance abuse disorder.

The contractor will be required to provide therapeutic and rehabilitative services, including services to assist veteran in securing permanent housing, but will not be required to provide detoxification or other hospital level treatment. Those services will be provided by the VA at VA facilities. VA my complement the non-VA community-based provider’s program with added treatment services such as participation in VA outpatient programs.

C. Required Services

1. Basic Services: The Contractor is required to be accessible to Veterans for admit to that program 24 hours a day, 7 days a week. The contractor shall furnish each Veteran referred for care under this contract with the following basic services:

a. Room and Board: Room and Board to include a bed and other furnishing such as a dresser, storage, and personal linens(towels, pillows, blankets and bed sheets). In addition, room and board will include a place for the Veteran to secure personal valuables and belongings in a locked storage space within the Veteran’s room or locked storage space within the facility the Veteran will have access to 24/7. The Contractor will allow Veteran to store personal belongings for at least 72 hours after formal HCHV discharge.

b. Nutrition: At least three nutritious meals, 7 days a week will be provided for the Veteran. In addition, there will be availability of snacks of nourishing quality (e.g. fruits, vegetables, protein sources, etc.), between meals and bedtime for those requiring or desiring additional food, even when it is not medically indicated. There will not be more than a 14 hour span between evening meal and breakfast of the following day. Contractor will provide alternative meals for Veterans with dietary restrictions if medically indicated (e.g. diabetic, renal and soft mechanical diets) and reasonable accommodation for Veterans with cultural/religious preferences around food (e.g. Kosher, Sikh, etc.). Food shall be prepared, served and stored under sanitary conditions. The facility shall provide storage space in an onsite refrigerator for Veterans to store and freely access personal food. The facility shall establish and maintain sanitary procedures for washing dishes, cleaning equipment and work areas, and disposing of waste.

c. Laundry Facilities: Laundry facilities and necessary detergent free of charge and adequate for residents to do their own laundry or to have laundry done at minimum one time per week.

d. Medication Storage and Monitoring: Contractor shall provide appropriate space and security for the storage of medications. Appropriate policies and procedures that support the safe storage of medications for Veteran residents should be determined by the type of house setting. A locked storage device can be provided to the Veteran to secure the Veteran’s medications or central storage can be provided by the HCHV Contracted Residential Program.

The Contractor will have written procedures that address medication storage while providing access to medications and safe disposal of medications and syringes. Veterans residing in the program should be educated about these procedures and the importance of safely storing their medications. The Contractor will have procedures related to medication monitoring for Veterans requiring this service.

The contractor will keep an up to date individual record of all medications, including prescription and non-prescription medications used by participants. Contractors will establish written policy for review of medications for expiration dates or deterioration.

The contractor will demonstrate provider staff responsible for monitoring of medications are familiar with medications stocked; have knowledge of/or access to information (e.g. current physician’s desk reference or other resource) that includes indications, side effects, interactions and potential allergic reactions.

Medications and narcotics shall be properly stored, controlled, issued and recorded in compliance with physician’s orders. Contractor shall establish procedures for insuring Veterans confidentiality in the storage of and keeping of records concerning medication.

Medication Assisted Treatment (MAT) cannot be used to rule out Veterans participation in an HCHV Program. This includes prescribed use of Vicodin, morphine, methadone, oxygen, etc.

Reasonable accommodation for individuals in MAT is required provided the requested accommodation does not require major financial or administrative commitments that would be considered an “undue burden.” Examples of reasonable accommodations include:

i. Arranging for the individual to take medication at their clinic, physician’s office, or another off-site location – when consistent with the individual’s treatment plan.

ii. Storing an individual’s MAT medication in a lock box in the program and having the individual be personally responsible for it.

iii. Arranging to have the housing facility keep MAT medications in a locked cabinet (Copies of Inspection Packet requirements relating to medication management are available upon request).

e. Therapeutic and Rehabilitative Services: Therapeutic and Rehabilitative Services determined to be needed by each individual Veteran referred for treatment as stated in the treatment plan developed by the Contractor, with input from the Veteran and the VA Homeless program Coordinator(or designee). Services required of the Contractor must be able to furnish shall include:

i. Group Activities: Structured group activities, as appropriate, shall occur weekly – examples include group therapy, life skills training, social skills training, financial workshops, Alcoholics Anonymous, Narcotics Anonymous, vocational counseling and physical activities as appropriate. Should a Veteran have mental health, medical, family and/or employment obligations which directly conflicts with this requirement alternate group activates will be arranged and/or the Contractor will clearly document efforts made to accommodate the Veteran.

ii. VA Coordination: Collaboration and coordination with VA program staff, as needed, will include coordination of supportive psychosocial services. In particular, coordinated efforts must be made with the Liaison around medical, mental health, admission and discharge needs.

iii. Life Skills: Assistance to develop responsible living patterns, to maintain an acceptable level of personal hygiene and grooming, and to achieve a more adaptive level of psychosocial functioning, upgraded social skills, improved tenancy skills and improved personal relationships.

v. Recovery: Support for an alcohol/drug abuse-free lifestyle provided in an environment conducive to social interaction and the fullest development of the resident’s rehabilitative potential. Assistance to gain and to apply knowledge of the recovery process in an environment supportive of recovery models including a focus on Harm Reduction rather than strict abstinence and supportive of a Housing First approach.

Pursuant to these principles, drug testing may not be used to discharge or discipline a Veteran but may be used as a clinical intervention to modify behavior. An environment that is free from drugs and alcohol, encouragement from staff and peers to practice learned skills within the facility and opportunities for Veterans to practice learned skills in the community.

vi. Increased Income: Provide education on means and methods to increase Veteran income through a variety of avenues such as SSI, NSC pension, GA and employment opportunities. Assist Veteran in completing necessary steps to file for increased income opportunities. Case Managers will document education sessions and referrals.

vii. Employment Services: Referral to all relevant employment opportunities the Veteran is eligible for and interested in, Case managers will document all structured activities that support Veteran in applying for employment as appropriate based on needs of Veteran as identified in the assessment.

viii. Financial Planning: Referral to and follow up on all potential financial resources the Veteran may be eligible for (e.g. SSI, SSDI, Food Stamps, NSC pension, GA, etc.).

Case Managers will document all structured activities that support Veteran in developing a short and long term plan to understand and address their current financial situation and how to improve it. Financial planning efforts may be accomplished in group but preferably through one on one case management services.

ix. Permanent Housing Search: Programs are required to provide Veterans with direct and ongoing assistance in achieving permanent housing. As a primary goal of the HCHV program, plans for Veterans’ transition to permanent housing placements must be clearly reflected in each Individual Care Plan and in weekly case management notes.

Housing Assessments must identify Veterans’ housing history, strengths (i.e. positive prior rental history), and barriers (i.e. Unlawful Detainers). Should Veteran refuse to engage with program staff regarding plans for permanent housing transition, motivational interviewing and other therapeutic techniques will be used to address Veteran ambivalence. All efforts to engage Veteran regarding housing plans, options, and resources shall be clearly documented and include any therapeutic techniques utilized.

Contractor staff must provide direct assistance to Veterans in developing permanent housing plans and accessing appropriate housing resources. Examples of expected housing services include: All housing efforts by Contractor shall be documented clearly and presented to HCHV Liaison upon request. Mere communication with Veterans regarding housing, without subsequent Contractor staff action and follow-up, shall not on its own meet the above requirements.

x. Case Management: structured individual case management, at minimum, weekly including counseling on self-care skills, adaptive coping skills, financial planning, permanent housing search, written care plan, referral for financial benefits. Additional counseling may include, professional and vocational rehabilitation counseling in collaboration with VA programs and community resources.

In addition, special attention will be made to address High Suicide Risk (HSR) Veterans as identified by the VA Liaison, VA Mental Health Staff and/or the contracted Case Manager. On a weekly basis the contracted case manager will be required to update the VA Liaison on Veteran progress and/or safety concerns for HSR Veterans. Contracted case manager will review the HSR Safety Plans with the Veteran on a bi-weekly basis.

HSR Safety plan reviews and a copy of the Veteran’s Safety Plan will be documented in the chart. All Veterans will be referred to VA for Primary Care and Mental Health appointments and Contractors will support Veterans in making initial and subsequent appointments.

Efforts will be documented by Contractor and reviewed by the HCHV Liaison at least monthly. All Contractors will provide proper documentation verifying services and case management efforts by all team members including, but not limited to housing, benefit and employment specialists, and program management staff. There will be an expectation that notes are written professionally in a format that utilizes the clear settings of goals and documents progress towards those goals (e.g. SNAP, SOAP, or SMART notes).

The Contractor will act as primary in providing participants case management services to all participants. VA HCHV Program Coordinator or designee will provide case management services as secondary in collaboration with the Contractor.

xi. Discharge Planning: Securing permanent housing will be the primary discharge goal for every Veteran. All Veterans must have a discharge plan which integrates items included in Paragraph viii above. Compliance with all VA regulations regarding discharges and timeliness of reporting discharges is required by Contractor. Case Managers will provide assistance with discharge planning for every Veteran and report all discharges. Paperwork required for discharging a Veteran from any HCHV program is required via fax within 24 business hours from known discharge. Housing needs will be assessed upon acceptance into the program and resources will be coordinated for discharge to a successful community placement throughout the duration of the Veteran’s stay.

A negative discharge for undesirable behavior is a committee decision that must include the VA Liaison prior to discharge. All Veterans scheduled for discharge based on behavior must meet with the treatment team and work with team to determine most therapeutic option for Veteran. This does not include violations for safety reasons or verbal abuse.

Please note: Profanity does not in and of itself constitute abuse and shall not exclusively be considered grounds for discharge. Any and all actual or threatened violence will be grounds for discharge. Veterans may be discharged for safety reasons at any time. All negative discharges will be subject to a full team debriefing, including VA Liaison, to look for opportunities missed to intervene sooner. All discharges are subject to the Contractors grievance procedures and must allow clients the opportunity to be represented by the VA Liaison in the grievance process. Reasonable efforts must be made to coordinate with the Liaison in order to schedule an appeal.

f. Grievance Procedures: Programs must have an internal grievance process that Veterans can use to resolve conflicts within the program. Programs must have written policies and procedures for resolving grievances, including a statement regarding the client’s right to request reasonable accommodation, and must post them in a place conspicuous and be accessible to clients. In addition, each client shall receive a copy of the grievance policies and procedures, upon intake and upon receiving a warning or discharge notice.

g. Intake Packets: All Veterans must receive an intake packet within 72 business hours which includes, at minimum, the following information:

1. Description of the Contractor’s Services

2. Grievance Policy

3. Emergency Procedures

4. Patient Rights and Reasonable Accommodation

h. Performance Measures: HCHV performance measures and requirements set forward in this solicitation must be met in order to receive the highest past performance rating. VA Liaison will review performance metrics at minimum quarterly with Contractor. These include the following:

• Veterans discharged into permanent housing- 55% and above

• Veterans negatively discharged from program; at or below 20%

i. Emergency/Disaster Plans: Contractor will have emergency and disaster plans with written protocols that are posted to guide staff response to crises including, but not limited to, manmade and natural disasters, episodes of infectious diseases, physical injury, program participants suicide or suicide attempts, overdoses, and domestic or other violence. All contractor’s staff are trained on emergency procedures and protocols.

j. Outreach: Contractor will be responsible to engage in outreach in the community both independently and in collaboration with VA and/or Metro Area Continuum of Care for Homeless (MACCH). Contractors will maintain occupancy by engaging in outreach services and will be knowledgeable about outreach best practices generally accepted in the community.

k. Nondiscrimination: Contractor shall comply with the principles listed in 38 CFR 17.707(b) to provide housing and supportive services in a manner that is free from religious discrimination.

2. Supplemental Services: All services will be provided at no additional charge to the stated daily fixed fee, except for those services specifically stated below to be Supplemental Services.

None

3. Number of Veterans to be Covered by Contract: Contractor will provide services to cover a capacity of 20 Veterans at any given time.

D. Additional Contract Requirements

1. Personnel: The Contractor will employ sufficient personnel to carry out the policies, contract responsibilities, and the program for the facility. Case management staff must have appropriate and commensurate coverage for staff using authorized and unauthorized leave (e.g. holidays, sick leave, family care, etc.). In addition, there is an expectation that there is an administrative/clinical Designee that will be available for consultation for emergencies 24 hours a day, 7 days a week.

The Contractor shall assign personnel that by education, training and when required, certification or licensure qualified to provide the Basic Services and Supplemental Services required by this SOW. Contractor must have a policy prohibiting staff from establishing sexual relationships with program clients.

a. Staff Training: Contractor will provide at least one staff person on-site at all times who has had training and orientation on the following topics. Staff shall receive and document—at a minimum—one-time training per year on these subjects.

CPR

First Aid Crisis intervention Cultural sensitivity Sexual harassment Universal Precautions (disease transmission prevention) Adult abuse/neglect reporting laws Harm Reduction philosophy Suicide Prevention Medication management State and Federal Fair Housing Law and ADA Requirements Conflict resolution De-escalation techniques

2. Referrals:

a. The VA is responsible for determining eligibility of Veterans prior to referral to the

Contractor for treatment. A written referral (hard copy, fax or secure e-mail are acceptable) signed by an authorized VA ordering officer shall be provided to the Contractor for each Veteran referred for services under the contract.

b. A list of authorized VA ordering officials for the contract shall be provided to the Contractor upon award of the contract. Ordering officials may be added or deleted from the list during the term of the contract at the discretion of VA Contracting Officer. The Contractor shall be provided an updated list of authorized VA ordering officials whenever such changes are made.

c. It is understood that the Contractor will not be paid for care provided to a referred Veteran beyond the period authorized in the referral, unless an extension of the authorization is provided in writing by the VA.

d. The initial referral period of a Veteran may be up to 60 days, depending upon the needs of the Veteran as mutually determined by the Veteran, the contractor’s staff, and the VA Homeless Program Coordinator or designee. An extension of the referral period up to a total of 6 months may be authorized by the VA Homeless Program Coordinator or designee, provided that funding is available. Treatment period in excess of 6 months for individual Veterans must be authorized by the VA Homeless Program Coordinator or designee. Any change that affects the active terms of the contract must be coordinated through the VA COR and Contracting Officer or authorized ordering official.

e. All referral requests will be processed by the Contractor and a decision to accept or not accept made within (2) business days of receipt. The Contractor will provide the VA Homeless Program Coordinator or designee in writing(hard copy, fax or secure e-mail are acceptable) the referral decision.

3. Absences and Cancellation:

a. VHA Directive 1162.04 Appendix C (dated February 22, 2022) details the process in which determinations are made regarding potential payments to Contractor for absent Veterans. No payments for absences of any kind will be authorized beyond what is authorized in this Appendix. See Attachment 8 for the full text of the Appendix.

b. VA reserves the right to remove any or all Veterans from the facility at any time, without additional cost, when it is determined to be in the best interest of the VA or the Veteran.

c. The Contractor shall notify the authorizing VA facility immediately when a medical emergency occurs that requires hospitalization of a referred Veteran.

i. It is agreed that the Veteran will be admitted to the appropriate VA facility.

ii. When such admission is not feasible because of the nature of the emergency, it is agreed that hospitalization in a non-federal hospital may be accomplished provided that VA authorization is obtained.

iii. If hospitalization of anon-emergency nature is required it is agreed that admission to the appreciate VA facility will be accomplished promptly.

d. The Contractor shall notify the authorizing VA facility immediately of any incidents involving Veterans residing in the residential program.

i. The contractor shall notify the VA HCHV Program Coordinator by telephone during the hours of 8:00 am and 4:30 pm.

ii. For all incidents that occur after normal business hours, the Contractor should notify the Administrator on Duty (AOD).

iii. The Contractor shall provide the HCHV Program Coordinator and the VA COR with a copy of the incident report within 24 hours.

iv. The Contractor shall maintain a copy of the incident report in the Veteran’s case record.

e. The Contractor will complete a written incident report within 24 hours of notification.

Incidents include but are not limited to:

i. death; fire; drug/police raid; suicide/suicide attempts;

ii. 911 call(police/fire dept./paramedics/other);severe medical illness/emergency;

iii. severe psychiatric illness/emergency;

iv. sexual assault;

v. act of violence by Veteran against other(s);

vi. abusive behavior by Veteran against staff;

vii. act of violence by other(s) against Veteran;

viii. abusive behavior by staff against Veteran;

ix. accident; medication problems or adverse drug reactions;

x. or other untoward events.

4. Rules, Policies, and Procedures:

The Contractor shall have reasonable rules governing day-to-day life and activities in the facility.

Such rules clearly inform Veterans of the obligations upon which their continued participation in the program depends and the consequences for non-compliance. Veterans will be provided a copy of the rules at intake or upon Veterans request.

In addition, Contractor will post the rules in a location readily accessible to clients and visitors.

These rules must include detailed Patient Rights and the procedures that the Contractor has in place to protect the Veterans rights and dignity. Veterans must be permitted to exercise these rights without fear of reprisal.

If requested, Contractors must reasonably accommodate Veterans whose compliance with program rules is limited by the Veterans’ physical or mental disabilities, in accordance with the

Americans with Disabilities Act, the Federal Fair Housing Amendments Act, Section 504 of the Rehabilitation Act, including those requirements covering reasonable accommodations for disabilities and the use of assistance animals, and all other applicable State or Federal laws.

Contractor must equally apply all rules, policies and procedures to Veterans, unless a Veteran has asked for a reasonable accommodation due to his/her disability.

5. Contractor Staff Conduct/Complaints Handling:

a. The Contractor personnel shall be expected to treat referred Veterans with dignity and respect as outlined in the VA Patient’s Bill of Rights as set forth in 38 CFR 17.34a. See exhibit A.

Patient Bill of Rights.

b. The Contractor will maintain a written grievance process to address Veteran complaints with time frames for responses from the Contractor’s management. This document will be made available to the COR at the COR’s request.

c. The VA reserves the right to exclude Contractor staff members from providing services to Veterans under this contract based on breaches of conduct, including conduct that jeopardize patient care of interferes with the regular and ordinary operation of the facility.

i. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks or other conduct resulting in formal complaints by Veterans or other staff members to designated Government representatives.

ii. The Contractor and COR shall deal with issues raised concerning contractor personnel conduct. The Contracting Officer shall be the final arbiter on questions of acceptability and in validating complaints.

6. Transportation: The Contractor shall assist the Veterans with local transportation to scheduled meetings and appointments. The Contractor will be expected to help the Veteran access public transportation, including providing information and instructions necessary to enable Veterans to utilize public transportation. If VA staff determines that adequate public transportation is not available or appropriate for a Veteran, the Contractor shall arrange for alternative transport by car. The Contractor shall develop a policy for how transportation will be managed for Veterans.

Since Veterans without income cannot be responsible for the cost of transportation, the Contractor will be responsible for providing transportation by linking Veteran to transportation and/or providing transportation for activities needed to achieve goals in a treatment plan.

7. Records and Reports:

a. As VA exercises contract oversight, attention will be directed to the adequacy of Veteran’s records.

b. Site visits by VA staff will periodically include a spot check of records to ensure contractor invoices accurately reflect the Veteran’s length of stay.

c. The Contractor will be responsible for the following onsite records and reports:

i. Daily sign-in sheets signed by program Veterans, to document and verify Veteran’s presence at the facility for billing purposes.

ii. Daily sign-in sheets must be completed clearly, accurately and thoroughly with full signatures and monitored so as to provide a full accounting of Veteran’s stay and services received for billing and audit purposes.

iii. These sign-in sheets will be hand delivered and/or faxed a minimum of weekly to HCHV Program Coordinator or designee for review.

iv. In the event one or more Veterans refuses to sign the daily sign-in sheets due to documented mental health problems, an alternative method of verification may be developed on a case by case basis in collaboration with the HCHV Program Coordinator or designee, subject to final approval by the VA COR.

d. Contractor shall maintain an individual clinical record on each Veteran out-placed under this contract. The Contractor must as required by the Confidentiality of Alcohol and Drug Abuse Patient Records (42 CFR part 2) and the Confidentiality of Certain Medical Records (38 USC 7332).

e. All case records will be maintained with security and confidentiality and will be made available on a need-to-know basis to appropriate staff members involved with the treatment program of the Veterans concerned.

f. Individual clinical records will contain the following:

i. An initial biopsychosocial assessment completed within two (2) weeks of program admission and will include but not be limited to:

a) verification of Veteran status,

b) all identifying data relevant to the Veteran and his/her family, including medical problems and medications,

c) mental health problems and medications,

d) substance use history, housing history and preferences,

e) income supports or benefits,

f) education,

g) marketable skills and licenses,

h) employment history/vocational issues,

i) information relating to the Veteran’s admission including reason for referral,

j) the targeted goals for constructive changes which are to be attained during the residential rehabilitation episode,

k) and the anticipated length of stay, if known.

g. An initial Individual Service Plan completed within two (2) weeks of program admission signed by the Veteran. The Individual Service Plan must contain the following

a) barriers,

b) service needs,

c) strengths,

d) specific services provided including duration and outcomes,

e) documentation of referrals,

f) and benefits to be achieved due to program participation.

h. The Contractor is expected to provide a written copy of the Individual Service Plan to the

Program Coordinator or designee within (2) business days of the Veteran signing the document. The plan must specifically include but will not be limited to:

a) Provisions for Veteran placement into an appropriate transitional or permanent housing placement within 60-90 days of admission to the HCHV Contract Residential Care facility, but no more than 180 days.

b) 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.

c) Provisions for the stabilization and/or treatment of biopsychosocial issues and stressors. This may include provisions of care within the contracted facility, connections to VA medical and mental health care, and/or referrals and connections to community based resources.

d) Relevant Releases of Information to communicate and coordinate Veteran’s treatment with VA and other community based service providers.

e) Progress notes for each case management encounter to include information regarding progress toward meeting the Individual Service Plan goals, and

f) Documentation of Veteran participation in onsite daily structured activities and groups.

i. Updated Individual Service Plans every thirty (30) days from the date of the initial plan, to include any measures of movement toward rehabilitation goals, with particular focus on the attainment of community based housing. The Contractor must provide a written copy of the updated Individual Service Plan to the HCHV Program Coordinator or designee within (3) business days.

j. A final discharge summary on each Veteran who leaves the program regardless of character of discharge, to include a description of beneficial changes realized during the residential period, reasons for leaving, the Veteran’s future plans, after-care referrals and connections, and follow up locator information.

k. Contractors will have written policies and procedures in place to address how intoxicated or impaired participants will be identified and managed.

i. Contractors will have written process of how staff are educated on the policies and procedures addressing intoxicated or impaired participants.

l. Contractors will be expected to enter data into a Homeless Management Information System (HMIS) web-based software application and bed totals in the Homeless Inventory Count.

i. This data will consist of information on the Veterans served and types of supportive services provided by contractors.

ii. Contractors must treat the data for activities funded by the VA HCHV Contract Residential Care program separately from that of activities funded by other programs.

iii. Contractor will be required to export client-level data for activities funded by the VA HCHV Contract Residential Care program to VA on a regular basis.

m. Contractors must treat the data for activities funded by the VA HCHV Contract Residential Care program separately from that of activities funded by other programs. Contractor will be required to export client-level data for activities funded by the VA HCHV Contract Residential Care program to VA on a regular basis.

n. The Contractor will be expected to participate in the Omaha Continuum of Care for the Homeless via entering data as stated above and any other activities focused on meeting the needs of Veterans and meeting the criteria and benchmarks for maintaining the declaration of Ending Veteran Homelessness.

o. The Contractor will participate independently or in collaboration with VA/Omaha community resources to engage in Outreach efforts to engage hard to reach chronically homeless Veterans.

p. Quarterly Reporting: During the duration of the contract the contracted provider representative or designee and VA HCHV Program Coordinator or designee will meet quarterly to review contracted provider’s performance on the applicable VA metrics including the QASP. The Contractor shall provide the Liaison with a written report of program activities on a Quarterly basis in accordance with the QASP. The report should contain, at minimum, the following information:

i. Total Number of Veterans Served

ii. Data from QASP compliance tool

iii. Program Completion Rates

iv. Outcomes (e.g. # or % of veterans discharged to independent housing, increased income/benefits, occupancy, etc.)

v. Other pertinent information, such as: quality improvement projects, changes in staffing or business practices, systems or resource concerns, etc.

8. Facility:

a. It is the responsibility of the Contractor to properly maintain its facilities, and the VA shall have no responsibility for paying or reimbursing the Contractor for such expenses. The Contract facility must:

i. Have a current occupancy permit issued by the local and state governments in the jurisdiction where the facility is located.

ii. Be in compliance with existing standard of State safety codes and local, and/or State health and sanitation codes.

iii. Be licensed under State or local authority.

iv. Where applicable, be accredited by the State.

v. Be equipped with operational air condition/heating systems.

vi. Be kept clean free of dirt, grime, mod or other hazardous substances and damage noticeably detracting from the overall appearance.

vii. Be equipped with first aid equipment and an evacuation pan in case of emergency.

viii. Has a written disaster plan that has been coordinated with the Emergency Management Entity Responsible for the Locality in which the project resides. The disaster plan encompasses natural and manmade disasters. This would include a Covid-19 response plan which shall include all requirements as governed by local, State and Federal government mandates.

ix. Have windows and doors that can be opened and closed in accordance with manufacturer standards.

b. The Contractor facility must meet fire safety requirements, as follows:

i. The building must meet the requirements of the applicable residential occupancy chapters of the current version of NFPA 101, National Fire Protection Association’s Life Safety Code.

a) Any equivalencies or variances must be approved by the appropriate Veterans Health Administration Veterans Integrated Service Network (VISN) Director.

ii. All residents in the facility must be mentally and physically capable of leaving the building, unaided, in the event of an emergency.

iii. Fire exit drills must be held at least quarterly.

a) Residents must be instructed in evacuation procedures when the primary and/or secondary exits are blocked.

iv. A written fire plan for evacuation in the event of fire shall be developed and reviewed annually.

a) The plan shall outline the duties, responsibilities and actions to be taken by the staff and residents in the event of a fire emergency.

b) This plan shall be implemented during fire exit drills.

v. A written policy regarding tobacco smoking in the facility shall be established and enforced.

vi. Portable fire extinguishers shall be installed at the facility. Use NFPA 10, Portable Fire Extinguishers, as guidance in selection and location requirements of extinguishers.

vii. Requirements for fire protection equipment and systems shall be in accordance with NFPA 101. All fire protection systems and equipment, such as the fire alarm system, smoke detectors, and portable extinguishers, shall be inspected, tested and maintained in accordance with the applicable NFPA fire codes and the results documented.

viii. The annual inspection by a VA team required by paragraph 7 shall include a fire and safety inspection conducted at the facility unless a review of past Department of Veterans Affairs inspections or inspections made by the local authorities indicates that a fire and safety inspection would not be necessary, in which case the fire an safety inspection may be waived by the VA.

9. Inspection of Facility and Program:

a. Prior to the award of a contract and annually during the contract term, a multidisciplinary VA team shall conduct an inspection of the Contractor’s facilities.

b. This team will consist of the following members:

i. a social worker,

ii. dietician,

iii. registered nurse,

iv. representative of the VA Police and a VA Facilities Management Safety Officer,

v. and other subject matter experts as determined necessary by the medical center director or HCHV Program Coordinator.

c. This team will inspect Contractor’s facilities used to provide Veterans food, shelter, and therapeutic services and verify whether the facility provides quality care in a safe environment.

d. Inspections may also be carried out at such other times as deemed necessary by the Department of Veterans Affairs.

e. The Contractor will be advised of the findings of the inspection.

f. If deficiencies are noted during any inspection, the Contractor will be given a reasonable time t take corrective action and to notify the Contracting Officer that the corrections have been made.

g. A contract will not be awarded until noted deficiencies have been eliminated.

h. Failure by the Contractor to take corrective action within a reasonable time will be reported to the VA Contracting Officer.

i. If corrections are not made to the satisfaction of the VA, the Contracting Officer will consult with the appropriate officials so that suitable arrangements can be made to discontinue plans to award a contract, or to discharge of transfer patients and to terminate the existing contract, as appropriate.

j. The inspection of the Contractor facilities will include inspection for conformity to the current Life Safety Code as described in paragraph above, and will also include the following:

i. General observation of residents to determine if they maintain an acceptable level of personal hygiene and grooming.

ii. Assessment of whether the facility meets applicable fire, safety and sanitation standards.

iii. Determining whether the facility is in attractive surroundings conducive to social interaction and the fullest development of the resident’s…