Attachment 1 - PWS Readjustment Counseling_FY21_Final.pdf

PERFORMANCE WORK STATEMENT

1. GENERAL. This is a non-personal services contract to provide readjustment counseling services to eligible veterans located in the following cities of Alabama: Eufaula, Blakely, Abbeville, Ozark, Enterprise, and the city of

Dothan. These services are performed for the Columbus Vet Center, 2601 Cross Country Drive, Condominium B-2, Suite 200, Columbus, GA 31906. Services shall be performed at the contractor’s facility, which shall be located in Dothan, AL. The Government shall not exercise any supervision or control over the contract service providers performing the services herein. Such contract service providers shall be accountable solely to the Contractor who, in turn is responsible to the Government.

1.1. SCOPE

1.1.1. Description of Services/Introduction: The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items and non-personal services necessary to perform readjustment counseling services as defined in the Performance Work Statement except for those items specified as government furnished property and services. The contractor shall perform to the standards in this contract.

1.1.2. Background: The contractor shall furnish readjustment counseling services to eligible veterans referred by

Vet Center staff members or professional staff members of VA psychiatry, Social Work, Psychology or Nursing

Services. Readjustment counseling for purposes of this contract is counseling by social workers, psychologist, psychiatrist or other qualified counselors individually or in groups, specifically directed at social, psychological or behavioral difficulties specifically related to the post-war readjustment to civilian life. Such difficulties may interfere with a veteran’s job performance, educational pursuits, family and other interpersonal relations, or overall ability to cope with daily life.

1.1.3. Eligibility for Contracted Readjustment Counseling Services

1.1.3.1. Eligibility will be determined by the Vet Center staff in accordance with Vet Center policy.

1.1.3.2. Eligibility for readjustment counseling services is limited to war zone veterans who were discharged under honorable conditions. Individuals with other than honorable, but more than dishonorable discharge may also be eligible as determined by the VA (see 38 CFR, Section 3.12). Modalities include therapy sessions whose central purpose is the post-war readjustment of the following conflicts:

• World War II - 7 Dec 1941 to 31 Dec 1946

• Korean War - 27 Jun 1950 to 31 Jan 1955

• Vietnam War – 28 Feb 1961 to 7 May 1975

• Lebanon – 25 Aug 1982 to 26 Feb 1984

• Grenada – 23 Oct 1983 to 21 Nov 1983

• Panama – 20 Dec 1980 to 31 Jan 1990

• Persian Gulf War – 2 Aug 1990 and ending by Presidential proclamation or law

• Somalia – 17 Sept 1992 and ending by Presidential proclamation or law

• Republic of Yugoslavia, including Kosovo and Bosnia and Operations Joint Endeavor, Joint

Guard and Joint Forge – 20 Nov 1991 and ending by Presidential proclamation or law

• Global War on Terrorism – 11 Sept 2001 and ending by Presidential proclamation or law

1.1.3.3. Eligible veterans must also have been discharged under honorable conditions or with a character of service for which basic eligibility to receive VA benefits has been established through adjudicative decision by VA (e.g. in the case of veterans possessing Undesirable Discharges, Bad Conduct Discharges, or General Discharges Under

Other Than Honorable Conditions).

1.1.3.4. Veterans possessing a Dishonorable Discharge are not eligible for services provided under this program.

1.1.4. Description of Work: Modalities to readjustment counseling include individual (1 hour) sessions, group (1.5 hour) therapy, and family/couple (1.5 hours) therapy sessions. The services do not include general mental health services, but only provides readjustment counseling for psychosocial difficulties related to post-war readjustment from military duty, for example:

• Exposure to combat-related war trauma

• Exposure to other aspects of war zone stress

• Post-traumatic stress disorder (as defined by DSM-IV-TR) and/or other war-related social and psychological difficulties.

• Stressor unique to military duty for eligible veterans

• Psychological concern over a possible service-connected condition

• Substance abuse connected with military duty and/or post-war homecoming and readjustment

• Difficult post-war experiences, including disrupted homecoming and unsuccessful re-entry into civilian roles

• Concern over possible Agent Orange, biological or chemical agent exposure or ramifications thereof

• Generalized alienation from society manifested by lack of expectable familial, educational and/or vocational activities

• Psychosocial difficulties related to type of military discharge for other than a dishonorable discharge

Basic Services. Duties and responsibilities of contractor included, but are not limited to:

• Contractor shall provide readjustment counseling services to eligible veterans referred by COR or designee in accordance with the requirements of the contract and VA authorization form (VAF 10-5565b).

• Face-to-face, in-person visits are the only visits authorized. In the event of natural disasters or unprecedented events, the contractor must request in writing and receive written approval from

Readjustment Counseling Service, District 2, District Director, or Deputy District Director to conduct visits other than face-to-face, in-person visits (i.e. telehealth, videoconferencing, telephone, etc.) . When granted, approvals are valid for 120 days or the duration of the event as determined by the approving authority.

• Contractor shall schedule the initial veteran counseling session within three (3) working days from the time he-she receives the authorization.

• The duration of counseling sessions for billing purposes will be in accordance with applicable contract requirements.

• Contractors shall maintain counseling records which comply with the Privacy Act and are clinically accurate, up-to-date and complete.

• Contractor shall provide in writing an initial comprehensive psychosocial assessment to the COR no later than the completion of three initial visits. An updated counseling plan will be submitted to the COR one

(1) week prior to completion of each authorized block of visits thereafter which addresses continuing need for readjustment counseling. Coordination of the counseling plans by the COR must occur in a timely manner (one (1) week prior to authorization of subsequent blocks of sessions) so that there will be no disruption in the continuation of readjustment counseling.

• All bills must be submitted monthly in arrears no later than five (5) working days of the following month.

Reimbursement will be made only for authorized in-person counseling sessions. Reimbursement will be made for authorized in-person face-to-face counseling sessions unless Contractor has requested in writing and received written approval in writing from Readjustment Counseling Service, District 2, District

Director, or Deputy District Director.

• Contractor shall conduct periodic evaluation of the quality and effectiveness of services provided as stipulated in the contract mechanism.

• Contractor shall make every effort to prioritize group counseling in the provision of services to referred veterans with readjustment problems.

• Contractor shall ensure the physical security of records and prevention of disclosure of the records, reports, or other private information regarding clients except with the client’s informed written consent. Exceptions to this will be under guidance from the COR, and the Chief of the hospital at the VA support facility.

• At the completion of each individual or group counseling session, the contractor shall document on the

Service Verification form the name of the client, counselor’s name and professional degree, and length of session. This verification form will be presented to the client of his/her signature. A separate composite verification form is to be completed for each veteran for each month, and attached to the monthly bill submitted to the hospital through the COR.

• The contractor shall make a follow-up contact within 60 days after the last contact with the client and document it in the client’s folder.

• The contractor shall complete a closing summary and place client files in inactive status after 90 days of inactivity unless there is documented clinical reason to keep the file active. A closing summary which spells out the degree of success (or lack thereof) treatment plan/goals and prognosis will be completed and a copy forwarded to the COR.

• The contractor must also submit justification to the COR for clients that require extensions beyond 12 months of services.

• The request for an extension of services will have an assessment section with the era of the veteran followed by concise case summary information; an evaluation section that describes more specifically the key symptoms and ongoing issues of the veteran and a plan section that states the type of treatment modality with client goals/outcomes that the provider has formulated with the veteran. The veteran will subsequently be interviewed by the COR in person or over the telephone to assess continuing clinical need.

Recommendation for authorizations extending beyond one year will be submitted by the COR to the

Regional Management Office (RMO) for approval.

• Contractor shall report and submit for approval, any proposed changes in personnel providing services under this contract, to the Contract Officer through the COR.

Contractors are specifically prohibited from the following:

• Commercial advertising of their services for problems not directly related to war-zone veterans under this contract program in such a way as to indicate of imply VA endorsement or promotion of services;

• Providing general mental health services for problems not directly related to war-zone military service and post-military readjustment;

• Billing for physical examinations, prescriptions and/or dispensing medication, other medical treatment, telephone calls with veterans or significant others, consultation between contract counselor and other individuals, veterans’ travel, veterans not keeping appointments (no-shows), or services not specifically authorized in the contract mechanism or the VA referral form (10-5565b);

• Referring to themselves as “Vet Centers” “Outreach Centers”, “Readjustment Counseling Centers”, Veterans Outreach Program”, or similarly misleading the public regarding the nature of their relationship to the VA;

• Contractor shall not actively outreach or solicit clients and;

• Contractor shall refrain at all times from personal, financial, or business relationships with clients, family members or significant others of such clients or former clients insofar as such personal relationships might compromise the professional neutrality and effectiveness of the counseling relationship. Contractor shall adhere to the professional standards of their relevant licensing body.

The provision of medications and physical examinations are not being considered a component of readjustment counseling, and therefore, will not be provided under this contract mechanism. Nonetheless contractor shall have the capability through referral to arrange for needed physical examinations, prescription medications and/or medical treatment. Veteran consumers should be advised that VA will not reimburse through this service for physical examinations, drugs, or other medical treatments. In all such cases, VA medical facilities should be the priority referral for the veteran’s medical care. When this is not feasible due to geographical distance, VA Fee Basis providers should also be considered. The contract provider should coordinate with the COR for assistance in facilitating referrals to VA medical providers.

1.2. QUALIFICATIONS: The contractor shall obtain all necessary licenses and/or permits required to perform this work. The contractor shall maintain or require all health-care providers performing under this contract to maintain, during the term of this contract, professional liability insurance issued by a responsible insurance carrier of not less than the following amount (s) per specialty per occurrence: $1,000,000.00. At least one Licensed Marriage and

Family Therapist, or one Licensed Professional Counselor, or one Licensed Clinical Master’s Social Worker must be on the offeror’s core staff. In lieu of the latter, the offeror must have a mental health-related master’s level counselor and have a Psychiatrist, Psychiatric Clinical Nurse Specialist serving as a consultant who is on call during regular working hours or is otherwise available.

1.3. HOURS OF PERFORMANCE:

1.3.1. The contractor is responsible for conducting business, between the hours of 8:00 a.m. and 4:30 p.m. Monday thru Friday except Federal holidays or when the Government facility is closed due to local or national emergencies, administrative closings, or similar Government-directed facility closings. For other than firm fixed price contracts, the contractor shall not be reimbursed when the government facility is closed for the above reasons. The Contractor must at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within the

PWS when the Government facility is not closed for the above reasons. When hiring personnel, the Contractor shall keep in mind that the stability and continuity of the workforce are essential. The ten holidays observed by the

Federal Government are: New Year’s Day, Martin Luther King’s Birthday, President Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving, Christmas and any other day specifically declared by the President of the United States to be a national holiday.

1.3.2. The Contractor shall provide counselors for groups during non-work hours to include evenings, nights, weekends and holidays.

1.4. CONTRACTOR FACILITIES AND PERSONNEL SERVICES:

1.4.1. The Contractor shall furnish all supplies, equipment, facilities and services required to perform work under this contract. The Government provides no services, facilities, utilities, equipment, or materials.

1.4.2. Location: Contractor and Service providers submitting offers in response to this request for proposal (RFP) shall be physically located within the geographic boundaries/county for which the contract services will be provided.

The contractor/service providers shall be located in and provide services in Dothan, Alabama.

1.4.3. Facility: It is the responsibility of the Contractor to properly maintain its facility/facilities and the VA shall have no responsibility for paying or reimbursing the Contractor for such expenses. The contract facility must:

-be in compliance with existing standards of Federal, State and local safety and fire codes

-be equipped with operational air conditioning /heating systems

-be kept clean and free of dirt, grime, mold, or other hazardous substances and damaged item/s that noticeably detract from the overall appearance.

-be handicap accessible

1.4.4. Contractor Personnel: The Contractor shall be responsible for protecting the personnel furnishing services under this contract. To carry out this responsibility, the Contractor shall provide the following for these personnel:

workers compensation, professional liability insurance, health examinations, income tax withholdings, and social security payments.

1.4.4.1. The parties agree that the Contractor, its employees, agents and subcontractors shall not be considered VA employees for any purpose and will be considered employees of the Contractor. The responsibility for any leave, including any sick leave, professional development or vacation time, is the responsibility of the contractor. The

Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered (e.g., professional judgments, diagnosis for specific treatment).

1.5. MONITORING:

1.5.1. The Contractor agrees to attend any post award conference convened by the contracting activity or contract administration office in accordance with Federal Acquisition Regulation Subpart 42.5. The contracting officer, Contracting Officers Representation (COR) and other Government personnel, as appropriate may meet periodically with the contractor to review the contractor’s performance. At these meetings the contracting officer will apprise the contractor of how the government views the contractor’s performance and the contractor shall apprise the

Government of problems, if any being experienced. Appropriate action shall be taken to solve outstanding issues.

These meetings shall be at no additional cost to the government.

The (COR) will be identified by separate letter. The COR monitors all technical aspects of the contract and assists in contract administration. The COR is authorized to perform the following functions: assure that the Contract performs the technical requirements of the contract; perform inspections necessary in connection with contract performance; maintain written and oral communications with the Contractor concerning technical aspects of the contract; issue written interpretations of technical requirements, including government drawings, designs, specifications; monitor Contractor’s performance and notifies both the Contracting Officer and Contractor of any deficiencies. A letter of designation issued to the COR, especially with regard to changes in cost or price, estimates or changes in delivery dates. The COR is not authorized to change any of the terms and conditions of the resulting order.

A Quality Assurance Surveillance Plan (QASP)-The QASP (see section D) shall be used to monitor performance and quality of all services provided under this contract. The Contractor shall perform at an Acceptable Quality

Levels (AQL) and performance will be measured against the performance standards identified in the below

Performance Requirements Summary Matrix.

Measures PWS

Reference

Performan ce

Requireme nt

Standard Acceptable

Quality Level

Surveillance

Method

Incentive Disincentive/

Deduct

Qualifications of

Key Personnel

1.2. All contract

personnel shall have current board certification and/or applicable licenses

All personnel maintain required credentials

100% Compliance

Periodic

Inspection

Favorable contactor performance evaluation.

Exercise of option periods.

Unfavorable contractor performance evaluation.

Removal from contract until such time the contract personnel meets qualification standard.

Contractor

Facility

1.4.3. Facility is

adequate to meet the criteria for providing services to the veterans;

plan includes private and confidential group and individual counseling areas. Area is easily accessible to the physically challenged.

All contract personnel perform within their scope of practice/privileges

100% of the time

100% Compliance Favorable contactor performance evaluation.

Exercise of option periods.

Unfavorable contractor performance evaluation.

Patient Access 1.1.4. Initial counseling sessions are scheduled within 3 working days from the date the contractor receives authorization

Contractor adheres to requirements of

PWS

90% Periodic

Sampling/

Periodic

Inspection

Favorable contactor performance evaluation.

Exercise of option periods.

Unfavorable contractor performance evaluation

Clinical

Documentation

1.1.4. Client records

are maintained in a structured format and

Contractor adheres to requirements of

PWS

100% Periodic

Sampling/

Periodic

Inspection

Favorable contactor performance evaluation.

Exercise of option

Unfavorable contractor performance evaluation contain assessment and counseling plans.

periods.

Clinical

Documentation

1.1.4. Follow-up

contact is made within

60 days after the last contact with the client and is documented in the client file

Contractor adheres to requirements of

PWS

80%. Periodic

Sampling/

Periodic

Inspection

Favorable contactor performance evaluation.

Exercise of option periods.

Unfavorable contractor performance evaluation.

Removal from contract until such time the contract physician (s) meet qualification standard.

Privacy and

Confidentiality

1.6.2. Contractor is

aware of all laws, regulations, policies and procedures relating to

Privacy, Confidentialit y and HIPAA and complies with all standards

Zero breaches of privacy or confidentiality

All contractor personnel will comply with all laws, regulations, policies and procedures relating to Privacy, Confidentiality and

HIPAA

100%

Compliance/

Periodic

Sampling

Favorable contactor performance evaluation.

Exercise of option periods.

Immediate removal from contract

1.6. RECORD KEEPING

1.6.1. The COR will define the exact counseling record information to be included by the contract provider upon each veteran counseling session(s).

1. A verification form, a created VA and provided form to the contractor, is to be completed by each veteran for each therapy session. The verification form with the clients’ original signature will be attached to the monthly bill/invoice submitted to the COR.

2. The Contractor shall secure a signed acknowledgment of services from each client and for each visit for which they are invoicing the VA. The verification form must include the following: Name of client/veteran

a. Name of the counselor, professional degree, and title

b. Date of service

c. Length of treatment

d. Treatment modality (Individual, Family, or Group)

e. Original client/veteran signature

3. Provide only those services identified on the VA referral form.

4. Client numbers and records for significant others, will be maintained in the name of the veteran;

however, counseling case notes/progress notes on visits by significant others shall be maintained as discrete and separate from the veteran’s notes for continuity of notation, and so they can be easily extracted, if a request for the veteran’s counseling record is made.

1.6.2. Contractor shall maintain accurate and complete counseling records, which comply with the confidentiality requirements of Public Law 93-282 and the Privacy Act of 1974, Public Law 93-579, and HIPPA Privacy

Rules. Contractor shall ensure the physical security of records and the prevention of disclosure of the records, reports, or other private information of clients except with the client's informed, written consent.

1. Contractors and all who are authorized to provide services shall register, attend and provide a completion certificate for the following courses:

a. VA Privacy and Information Security Awareness and Rules of Behavior.

b. Privacy and HIPPA Focused Training.

* All training is available via the VA Talent Management System (TMS) at https://www.tms.va.gov

1.6.3. Counseling records are considered the property of the VA. Within one year following client case closing from contract provider services, the Contractor shall turn the client folder over to the authorizing Vet Center, or contact the Regional Manager of the Vet Center to determine to which Vet Center the folder should be sent.

1.6.4. The same procedures will apply when the contract between the VA and the Contractor terminates/expires/or is not renewed.

1.7. CONTRACTOR FURNISHED PROPERTY

1.7.1. Contractor Furnished Items and Services. The Contractor shall furnish all necessary items and services required to perform this contract in accordance with the terms of this PWS.

1.8. BILLING and PAYMENTS

1.8.1. Invoice requirements and supporting documentation: Supporting documentation and invoice must be submitted no later than the 20th workday of the month. Subsequent changes or corrections shall be submitted by separate invoice. In addition to information required for submission of a “proper” invoice in accordance with FAR 52.212-4 (g), all invoices must include:

1.8.1.1. Name and Address of Contractor

1.8.1.2. Invoice Date and Invoice Number

1.8.1.3. Contract Number and Purchase/Task Order Number

1.8.1.4. Date of Service

1.8.1.5. Type of Session

1.8.1.6. Hourly Rate

1.8.1.7. Quantity of hours

1.8.1.8. Total price

1.8.2. Vendor Electronic Invoice Submission Methods

Invoices will be electronically submitted to the Tungsten website at https://www.tungsten-network.com/us/support/ Tungsten direct vendor support number is 877-489-6135 for VA contracts. The

VA-FSC pays all associated transaction fees for VA orders. During Implementation (technical set-up)

Tungsten will confirm your Tax Payer ID Number with the VA-FSC. This process can take up to 5 business days to complete to ensure your invoice is automatically routed to your Certifying Official for approval and payment. To successfully submit an invoice to VA-FSC please review “How to Create an

Invoice” within the how to guides. All invoices submitted through Tungsten to the VA-FSC should mirror your current submission of Invoice, with the following items required. Clarification of additional requirements should be confirmed with your Certifying Official (your CO or buyer). The VA-FSC requires specific information in compliance with the Prompt Pay Act and Business Requirements. For additional information, please contact:

Tungsten Support

Phone: 1-877-489-6135

Website: https://www.tungsten-network.com/us/support/

Department of Veterans Affairs Financial Service Center

Phone: 1-877-353-9791 Email: vafscched@va.gov

1.8.3. Payment will be made monthly in arrears for services rendered after receipt of a proper invoice.

1.8.4. Payments in full/no billing VA beneficiaries: The Contractor shall accept payment for services rendered under this contract as payment in full. VA beneficiaries shall not under any circumstances be charged nor their insurance companies charged for services rendered by the Contractor, even if VA does not pay for those services. This provision shall survive the termination or ending of the contract.

https://www.tungsten-network.com/us/support/ https://www.tungsten-network.com/us/support/ https://www.tungsten-network.com/us/support/ mailto:vafscched@va.gov

1.8.4.1. To the extent that the Veteran desires services which are not a VA benefit or covered under the terms of this contract, the Contractor must notify the Veteran that there will be a charge for such service and that the

VA will not be responsible for payment.

1.8.4.2. The Contractor shall not bill, charge, collect a deposit from, seek compensation, remuneration, or reimbursement from, or have any recourse against, any person or entity other than VA for services provided pursuant to this contract. It shall be considered fraudulent for the Contractor to bill other third-party insurance sources (including Medicare) for services rendered to Veteran enrollees under this contract.

2. 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.

3. DESIGNATION OF CONTRACTING OFFICER’S REPRESENTATIVE: A VA Medical center representative of the Contracting Officer shall be designated to represent the Contracting Officer in furnishing technical guidance and advice regarding the work being performed under this task order. The foregoing is not to be construed as authorization to interpret or furnish advice or information to the Contractor relative to the financial or legal aspects of the task order. Enforcement of these segments is vested and is the sole responsibility of the Central

Alabama Veterans Healthcare System Contracting Officer.

4. KEY PERSONNEL AND TEMPORARY EMERGENCY SUBSTITUTIONS:

4.1 The Contractor shall assign key personnel that will perform under this contract. Attach separate sheet if necessary.

NAME/SPECIALTY Available Start Date

4.2 It is the responsibility of the contractor to ensure that all vacancies are staffed within a 30- day timeframe.

The contractor shall provide a written quality control plan regarding staffing this requirement continuously throughout the life of this task order to include personnel substitutions and temporary emergency substitutions

5. READJUSTMENT COUNSELING SERVICE (RCS) CONTRACT FEE QUALITY REVIEW

5. 1 The Contractor shall comply with all items listed in the Readjustment Counseling Service (RCS) Contract

Fee Quality Review Forms.

5.2 To ensure compliance with the items listed in the Readjustment Counseling Service Contract Fee Quality

Review Forms the COR and the Regional Management Office will, independent of each other, conduct quality review assessment of the contract. The COR is responsible for providing the Contractor with the Readjustment

Counseling Service (RCS) Contract Quality Review Forms prior to conducting the assessments.

6. CONTRACTOR SECURITY REQUIREMENTS (VA HANDBOOK 6500.6):