668-Statement of Work HCHV-CERS 2024.docx

668-HCHV Contract Emergency Residential Services-transitional housing

STATEMENT OF WORK

A. BACKGROUND

The Veterans Integrated Service Network (VISN) 20 provides a full range of medical services, mental health services and therapeutic housing programs to Veterans in the following VA regions:

Spokane, WA metro area

Additionally, VISN 20’s Network of Community Based Outpatient Clinics (CBOCS) provides primary care services in several outlying areas of the above regions. These facilities provide Transitional Housing to those Veterans requiring an interim step while receiving intensive outpatient services; addressing issues relating to their homelessness, and while waiting to access permanent housing resources and have medical vulnerabilities which prevents them from using other shelter resources in the current area . This transitional housing service will need to accommodate an estimated number of Veterans for room and board. Services shall be provided as Veteran stabilizes and identifies their next steps. Length of stay will range from 30 to 90 days. A Veteran may be extended for additional time on a case by case basis depending on clinically indicated need.

B. REQUIREMENTS:

1. Contractor must pass annual inspections according to HEALTH CARE FOR HOMELESS VETERANS CONTRACTED PROVIDER INSPECTION FORM (VA Form 10-10115a; attached in Section D).

2. This contract is for a Health Care for Homeless Veterans (HCHV) Transitional Housing. The contractor shall provide Transitional Housing for Veterans/Beneficiaries of VISN 20, Spokane, WA metro area. The contract facility must have a current occupancy permit by the authority having jurisdiction.

3. The location for the HCHV Contracted Transitional Housing Facility shall be in an area accessible and within walking distance to public transportation and within a 60-mile radius of VA facility or CBOC within VISN 20, Spokane, WA metro area. The expectation would be that the Veteran would have less than a one-hour bus ride between the residential facility and the VA facility.

4. The contractor shall provide to the VA, Community HCHV, in accordance with all terms and conditions, provisions and requirements listed herein for the sum listed in the Price/Cost Schedule. This rate is inclusive of all services as may be necessary in the services provided to the Veteran. Unless specifically excluded in this contract, the per diem rate established will include the services listed in this document and will also include all services normally provided other patients by the facility without extra charge.

5. The contractor shall furnish services to beneficiaries from whom such care is specifically authorized by VISN 20. It is understood that the type of patients to be cared for under this contract will normally require care and services over and above the level of room and board. Homeless Veterans may exhibit ongoing symptoms of a mental illness such as depression, schizophrenia, post-traumatic stress disorder (PTSD), and/or substance dependencies. The facilities shall not be used for detoxification, medical respite, or other hospital level treatment, as VISN 20 will serve as a treatment center. Veterans will receive all medical, mental health medications from the VA or fee-based providers as requested from the Veteran.

6. The contractor shall focus on the successful completion of residential programming as part of the goal of effectively ending homelessness among Veterans. This will be evidenced by minimizing the number of negative exits/discharges from the housing program. Negative exits are when Veterans are asked to leave the program for rule violations, prior to successful permanent housing placement. A target of 70% or more for Veterans leaving the program with successful permanent housing placement will be the goal.

7. The contractor shall focus on discharging Veterans directly to permanent housing in the community with a target of 35% discharges to permanent housing.

8. The contractor shall furnish each Veteran authorized care under this contract with the following basic services:

a. Residential Room and Board to include bed with linens and bathing facilities.

b. Provide food for three balanced meals daily (two meals shall be available on site by contractor; the third meal can be prepared by Veterans using local resources; or a can be a boxed meal) and snacks daily to each Veteran resident. In order to support recovery plans, Veterans may be allowed to prepare their own meals with on-site supervision.

c. Contractor to provide personal hygiene items, first aid supplies, and storage as needed.

d. Laundry facilities for residents to do their own laundry.

e. Case Management and supportive services determined to be needed by the individual resident will be documented in a plan developed by the contractor with consultation by the Veteran and the VA case manager and/or other appropriate VA staff. Services which the contractor must be able to furnish include:

i. Communication and collaboration with the VA program staff, which will provide supportive psychosocial services.

ii. Linkage and collaboration with VA program and community resources, life skills training including counseling on self-care skills, adaptive coping skills and, as appropriate.

iii. Structured group activities as appropriate – examples include, social skills training, Alcoholics Anonymous, Narcotics Anonymous, and physical activities as appropriate.

iv. Assistance to develop responsible living patterns and to achieve a more adaptive level of psychosocial functioning, upgraded social skills, and improved personal relationships.

v. Support for an alcohol/drug abuse-free lifestyle.

vi. Assistance to gain and to apply knowledge of the illness/recovery process.

f. Access to a locker and/or locked storage area to keep medication and/or valuables.

g. Access to a refrigerator that is used to store medication only (no food storage).

h. Contractor Case Manager will work towards rapid placement of Veteran in a safe appropriate setting; arranging, coordinating, or providing direct clinical services and support; referring or providing linkage to VA medical facilities and other federal, state, local or community based partners. Providing crisis management services and monitoring psychiatric status and stability; and assisting and counseling Veterans with transportation, credit, legal or other needs. Documentation of such services provided must be clear, detailed, and specific to each Veteran.

i. Contractor will provide each Veteran participant, one hour per week of direct face-to-face Case Management contact.

j. VA Liaison will provide oversight of Case Management services provided by contractor. Liaison will review Contractor Case Manager recovery plans, notes, class schedules and content, adverse events and staff Veterans as clinically indicated.

9. Unless specifically excluded in this contract, the per diem rate established will include the services listed in this document and will also include all services or supplies normally provided other patients by the facility without extra charge.

10. The contractor shall employ sufficiently trained staff and other personnel to carry out the policies and procedures of the program. There will be at a minimum, an employee on duty on the premises, or residing at the program and available for emergencies, 24 hours a day, 7 days a week. Contractor shall provide service for Veteran beneficiaries as requested Sunday through Saturday to include recognized Federal Holidays (see below).

New Year’s Day Martin Luther King Jr.’s Birthday President’s Day Memorial Day Juneteenth Independence Day Labor Day Columbus Day Veterans Day Thanksgiving Day Christmas Day

11. The contractor shall make available to the VA, documentary information deemed necessary by the VA to conduct utilization review audits for the mandated national evaluation study as required by Section 2 of Public Law 100-6; to verify quality of care for Veterans, to assure confidentiality of care for Veterans, to assure confidentiality of Veteran record information, and to determine the completeness and accuracy of financial records.

12. The contractor shall collaborate with the VA treatment staff, who will provide treatment services reflecting a team assessment of health, psychosocial and vocational needs and the involvement of Veterans’ families and appropriate community resources in resolving problems and setting goals. The contractor will complete an Individualized Service Plan (ISP) on each Veteran according to VA documentation standards.

13. The 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.

14. ABSENCES AND CANCELLATION

a. The contractor shall notify the authorizing VA of Veteran absences from the facility. Absences of the Veteran from the facility in excess of forty-eight (48) hours will not be reimbursable except those with the prior approval of the VA facility coordinator. Should a Veteran be referred to a residential treatment facility and not present for admission, the contractor should notify the VA facility coordinator immediately to determine next steps. If a Veteran fails to return to their contracted bed, the contractor should notify the VA coordinator immediately. Payment for services for that Veteran to the contract facility would be continued for a maximum period of two days provided while an active outreach attempt on the part of the contract facility staff to return the Veteran to the residential Transitional Housing program if there is a strong likelihood that the patient will return.

b. It is understood that the beneficiary may be provided facility care at the expense of the VA for a period not to exceed of that stated in the length of treatment plan contracted, unless an extension of the authorization is provided in writing by the VA.

c. 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.

15. The contractor shall permit same-day admissions when possible in coordination with the VA facility coordinator

16. The contractor shall not admit or discharge any Veteran without notifying VISN 20 Homeless program staff.

17. If a Veteran is admitted to and discharged from the service facility on the same day, payment will be made for one day.

18. The contractor shall submit to the VA an invoice for services delivered each month, at the applicable per diem rate of per patient so referred and residing in the contractor’s transition services.

19. The contractor shall comply with the VA Patient’s Bill of Rights as set forth in Section 17.34a, Title 38, Code of Federal Regulations.

20. CONDUCT:

The contractor shall notify the authorizing VA facility immediately when a medical emergency occurs requiring hospitalization of a Veteran receiving care at VA expense. 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 the VA authorization is obtained. If hospitalization of a nonemergency nature is required, it is agreed that admission to the VA will be accomplished promptly. The following acts are not permissible by contracting facility staff providing services under this contract or while on facility premises:

a. Use of intoxicating liquors, narcotics or controlled substances of any kind (excluding doctors’ prescriptions which do not impair ability to perform contract) while on duty or reporting for duty while under the influence of liquors, narcotics or controlled substance of any kind (excluding doctors’ prescriptions which do not impair performance).

b. Gambling in any form.

c. Carrying of pistols, firearms, or concealed weapons.

d. Smoking and other uses of tobacco while on duty.

e. Resorting to physical violence to settle a dispute with a fellow employee, customer(s) or the general public while on duty.

f. Spitting in prohibited places or any other unsanitary, offensive, or insensitive practices or behavior.

g. Use of loud, indecent, or profane language and/or making threatening or obscene gestures toward customers or other employees.

h. Engaging customer in a verbal confrontation in an attempt to settle a disagreement.

i. Soliciting or accepting tips from customer, companions, or others at any time.

20. COMPLAINTS HANDLING

The Contracting Officer Representative (COR) shall monitor the service provided. Contractor shall cooperate with the COR in providing information and answering questions in a timely manner when requested. Contractor shall refer complaints received directly from the customer(s) to the COR. All complaints received by the COR and forwarded to the Contractor shall be investigated promptly. After investigation and disposition, Contractor shall respond to the COR within five (5) working days after receipt by the Contractor.

21. TRANSPORTATION

The facility shall assist the Veteran with transportation to scheduled meetings and appointments including information and instructions so that they can utilize public transportation when possible.

22. FACILITY REQUIREMENT

a. Facility shall be equipped with operational air conditioning/heating systems.

b. Facility shall be kept clean free of dirt, grime, mold, or other hazardous substances and damaged noticeably detract from the overall appearance.

c. Facility shall be equipped with first aid kid, fire extinguisher fully charged non-expired, fire/carbon alarms, evacuation plan in case of emergency.

d. Facility shall have windows and doors that can be opened and closed in accordance with manufacturer standards.

e. Lockers and/or locked space with locks for medication storage.

f. Refrigerator for medication storage.

g. VISN 20 will not incur any cost associated with the contractor providing inadequate or faulty equipment.

23. POLICIES

a. It is agreed that the VA readily have access to all records concerning the Veteran's care in the facility. It is agreed that duly authorized representatives of the VA will provide follow-up supervision visits to Veterans placed to assure the continuity of care and to assist in the Veteran's transition. It is understood that these visits do not substitute nor relieve the facility in any way of the responsibility for the daily care and treatment of the Veteran. Upon discharge or death of the patient, records on all VA beneficiaries will be retained by the facility for a period of at least three years following termination of care at VA expense.

b. The facility shall not accept food stamps or welfare from Veterans.

c. The facility warrants that all applicable fire laws are being complied with and there are no recommendations of fire officials, which have not been resolved.

d. Fire exit routes need to be visible/posted in each residential room and common areas.

e. The VA case manager/treatment teams, in collaboration with the existing community homeless care task force workers, shall identify and refer all Veterans to the contractor. Veterans will be homeless and be medically vulnerable and/or fragile (e.g., chronically mentally ill Veterans whose psychiatric disorder is manifested by chronic alcohol or other drug abuse).

f. Before referring any Veteran, the VA shall have provided the contracted agency with a signed Release of Information (ROI) from the Veteran patient as well as that Veteran’s clinical assessment and confirmation of mental health and substance abuse disorders risk factors.

24. INSPECTION AND ACCEPTANCE

a. It is agreed that the Veterans Affairs (VA) will have right to inspection of the residential Transitional Housing properties and all appurtenances by an authorized representative(s) designated by the VA.

b. In the cases of complexes of non-VA community health care facilities, it is imperative that all components of the program be inspected by the VA team prior to award of the contract as is required for an integrated primary site. Each of the community health care facilities identified in the complex as contact recipients will also be subject to the requirement for contracting, safety and record keeping described in other parts of this document as applying to the residential treatment center.

c. The contractor shall be advised of the findings of the inspection team. If deficiencies are noted during any inspection, the facility shall be given a reasonable time to take corrective action to notify the Contracting Officer that the corrections have been made. A contract will not be awarded until noted deficiencies have been eliminated.

d. The VA shall monitor the contractor's program and inspect the contractor's facility to ensure compliance with this agreement. Any unsatisfactory conditions noted during an inspection of contract facility shall be reported in writing to the VA Contracting Officer through the Medical Center Director. 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 discharge or transfer patients and to terminate the contract.

e. Subsequent inspections of the residential treatment center must be made yearly by a multidisciplinary team including such VA Medical Center personnel as the Director considers necessary to assure the facility provides quality care in a safe environment. As the VA program personnel accomplish site visits, attention will be directed to the adequacy of Veterans' records. Site visits will also include a spot check of records to ensure contractor invoices accurately reflect the Veteran's length of stay.

25. SAFETY

a. The COR will inspect the facility for conformity to the current Life Safety Code and submit to the team and will focus on an assessment of the quality of life within the Transitional Housing programs, giving particular attention to the following factors:

i. General observation of residents indicates that they maintain an acceptable level of personal hygiene and grooming.

ii. The facility meets applicable fire, safety and sanitation standards in attractive surroundings conducive to social interaction and the fullest development of the resident's rehabilitative potential.

iii. Appropriate organized activity programs during waking hours (including evenings) reflecting a high level of activity in the facility or in the linked facilities, for example individual physical activities, and assistance with health and personal hygiene.

iv. There is evidence of facility-community interaction. This may be demonstrated by the nature of scheduled activities or by information about resident flow out of the facility, e.g., community activities, volunteers, local consumer services, etc.

v. Staff behavior and interaction with Veterans convey an attitude of genuine concern and caring.

vi. If clinically indicated, Veterans can stay on the property/grounds during waking hours (daylight).

vii. Veterans are not permitted to bring unauthorized guest into the residential Transitional Housing programs without permission.

viii. Appetizing, nutritionally adequate meals are provided in a setting, which encourages social interaction and nutritious snacks between meals and bedtime are available for those requiring or desiring additional food, when it is not medically contraindicated. The addition of nutritious snacks to the requirements for room and board is particularly indicated for homeless patients. Many of these Veterans are either undernourished or have developed poor eating habits or both, because of their chronic psychiatric disorder, including alcohol/drug abuse behaviors. The local VA Medical Center dietitian may consult with the initial inspection team and the team making subsequent assessments, in evaluating not only the printed menus but also the patients' satisfaction with meals and the actual consumption of food offered.

26. INFECTION CONTROL REQUIREMENTS

a. Tests shall be current within the past year.

b. Tuberculosis Testing - All contractor personnel shall provide documentation of a Purified Protein Derivative (PPD) test performed within the past year. In case of a past positive PPD test, a negative chest radiographic report to rule out active tuberculosis shall be provided. The PPD test shall be repeated annually.

c. OSHA Regulation Concerning Occupational Exposure to Bloodborne Pathogens – The contractor shall provide training or a self-study training module to its personnel; provide Hepatitis B vaccination series at no cost to its personnel who elect to receive it; maintain and distribute an exposure determination and control plan to its personnel; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident.

d. VA shall notify the Contractor of any significant communicable disease exposures to its employees as appropriate. The Contractor’s occupational health provider shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel (AJIC 1998; 26:289-354) for disease control. If the employees of the contracting agency suffer a communicable disease, the Contractor shall provide follow up documentation of employee’s clearance to return to the workplace prior to their return.

27. CONFIDENTIALITY OF PATIENT RECORDS

a. The Contractor is a VA contractor and shall assist in the provision of health care to patients seeking such care from or through VA. As such, the Contractor is considered as being part of the Department health care activity. Contractor is considered to be a VA contractor for purposes of the Privacy Act, Title 5 U.S.C. 552a. Further, for the purpose of VA records access and patient confidentiality, Contractor is considered to be a VA contractor for the following provisions: Title 38 U.S.C. 5701, 5705, and 7362. Therefore, Contractor may have access, as would other appropriate components of VA, to patient medical records including patient treatment records pertaining to drug and alcohol abuse, HIV, and sickle cell anemia, to the extent necessary to perform its contractual responsibilities. However, like other components of the Department, and notwithstanding any other provisions of the contract, the Contractor is restricted from making disclosures of VA records, or information contained in such records, to which it may have access, except to the extent that explicit disclosure authority from VA has been received. The Contractor is subject to the same penalties and liabilities for unauthorized disclosures of such records as VA.

b. The records referred to above shall be and remain the property of VA and shall not be removed or transferred from VA except in accordance with U.S.C.551a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records) and federal laws, rules and regulations. Subject to applicable federal confidentiality or privacy laws, the Contractor, or their designated representatives, and designated representatives of federal regulatory agencies having jurisdiction over Contractor, may have access to VA ‘s records, at VA’s place of business on request during normal business hours, to inspect and review and make copies of such records.

28. CONTRACTING WITH PARTIES LISTED ON THE OIG LIST OF EXCLUDED

INDIVIDUALS/ENTITIES

a. In accordance with The Health Insurance Portability and Accountability Act (HIPAA) and the Balanced Budget Act (BBA) of 1977, the Office of Inspector General has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

b. Therefore, all offerors shall review the OIG List of Excluded Individuals/Entities on the OIG web site at www.hhs.gov/oig to ensure that the proposed candidate(s) and/or firm(s) are not listed. Offerors should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) of $10,000 for each item or service furnished during a period that the person or entity was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP’s may also be imposed against health care providers and entities that employ or enter into contracts with excluded individuals or entities to provide items or services to Federal program beneficiaries.

c. By signing the offer/bid, the Contractor certifies that he/she has reviewed the OIG List of Excluded Individuals/Entities and that the proposed candidate(s) and/or firm is not listed as of the date the offer/bid was signed.

29. HIPAA COMPLIANCE

a. Contractors and any subcontractors must adhere to the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPPA) of 1996. This includes both the Privacy and Security Rules published by the Department of Health and Human Services (HHS). As required by HIPPA, HHS has promulgated rules governing the use and disclosure of protected health information by covered entities. The covered entity component of the Department of Veterans Affairs is the Veterans Health Administration Business Associate Agreement (BAA) with the VHA.

b. Business associates must follow VHA privacy policies and practices. All contractor and business associates must receive privacy training annually. For contractors and business associates who do not have access to VHA computer systems, this requirement is met by completing VHA National Privacy Policy training, other VHA approved privacy training or contractor furnished training that meets the requirements of the HHS Standards for Privacy of Individually Identifiable Health Information as determined by VHA. For this contract, the contract project manager will need to be able to show documentation at the annual inspection, that the staff working with Veterans have been educated on the contractors’ privacy rules and regulations and are aware of how to protect sensitive health information. For contractors and business associates who are granted access to the VHA or Department of Veteran Affair grounds, this requirement is met by completing VHA National Privacy Policy training or other VHA approved privacy training. Proof of training is required.

30. CONTRACT ADMINISTRATION DATA

The contracting officer is the only person authorized to approve changes or modify any of the requirements under this contract. The contractor shall communicate with the contracting officer on all matters pertaining to contract administration. Only the contracting officer is authorized to make commitments or issue changes which will affect price, quantity, or quality of performance of this contract.

In the event the contractor effects any such change at the direction of any person other than the contracting officer, the change shall be considered to have been made without authority and no adjustment will be made in the contract price to cover any increase in costs incurred as a result thereof.

31. INVOICING

a. The contractor shall electronically submit an original monthly invoice by the fifteenth (15th) of the month for the previous month’s service. Invoices shall cite applicable item numbers from the schedule of supplies and services. Invoices for one-time services shall be submitted upon the completion of the services. Invoices shall only have item number, quantity and pricing. A separate report will need to be submitted to COR that details patient information.

b. Written deliverables and copies of all correspondence requiring a signature shall be sent to the COR and the CO.

c. The VA Fiscal Service Center (VAFSC) requires the following information for the invoice to be considered valid for payment. Invoices without the required information will be returned:

i. Vendor name, invoice number, and date

ii. Remittance address (address where the payment is to be issued)

iii. Station Number, Purchase Order Number (PO#)

iv. Contract number

v. Itemized description of goods or services, quantity, and unit price

vi. Total dollar amount of invoice

vii. Discount or net terms

d. The VAFSC can accommodate electronic funds transfer (EFT) payments and also maintains an online Vendor Inquiry System that allows vendors direct access to payment status. If you are interested in either of those services, please contact our customer support help desk on the VAFSC Vendor web site at http://www.tungsten-network.com/US/en/veterans-affairs/.

32. PRIVACY LANGUAGE

a. Information made available to the contractor or subcontractor by VA for the performance or administration of this contract or information developed by the contractor/subcontractor in performance or administration of the contract shall be used only for those purposes and shall not be used in any other way without the prior written agreement of the VA. This clause expressly limits the contractor/subcontractor's rights to use data as described in Rights in Data- General, FAR 52.227-14(d) (1).

b. VA information should not be co-mingled, if possible, with any other data on the contractors/subcontractor’s information systems or media storage systems in order to ensure VA requirements related to data protection and media sanitization can be met. If co-mingling must be allowed to meet the requirements of the business need, the contractor must ensure that VA’s information is returned to the VA or destroyed in accordance with VA’s sanitization requirements. VA reserves the right to conduct on-site inspections of contractor and subcontractor IT resources to ensure data security controls, separation of data and job duties, and destruction/media sanitization procedures are in compliance with VA directive requirements.

c. Prior to termination or completion of this contract, contractor/subcontractor must not destroy information received from VA, or gathered/created by the contractor in the course of performing this contract without prior written approval by the VA. Any data destruction done on behalf of VA by a Contractor/subcontractor must be done in accordance with National Archives and Records Administration (NARA) requirements as outlined in VA Directive 6300, Records and Information Management and its Handbook 6300.1 Records Management Procedures, applicable VA Records Control Schedules, and VA Handbook 6500.1, Electronic Media Sanitization. Self-certification by the contractor that the data destruction requirements above have been met must be sent to the VA Contracting Officer within 30 days of termination of the contract.

d. The contractor/subcontractor must receive, gather, store, back up, maintain, use, disclose and dispose of VA information only in compliance with the terms of the contract and applicable Federal and VA information confidentiality and security laws, regulations and policies. If Federal or VA information confidentiality and security laws, regulations and policies become applicable to the VA information or information systems after execution of the contract, or if NIST issues or updates applicable FIPS or Special Publications (SP) after execution of this contract, the parties agree to negotiate in good faith to implement the information confidentiality and security laws, regulations and policies in this contract.

e. The contractor/subcontractor shall not make copies of VA information except as authorized and necessary to perform the terms of the agreement or to preserve electronic information stored on contractor/subcontractor electronic storage media for restoration in case any electronic equipment or data used by the contractor/subcontractor needs to be restored to an operating state. If copies are made for restoration purposes, after the restoration is complete, the copies must be appropriately destroyed.