Attachment 1 - Statement of Work - 442 Veteran Lodging Service.doc

VETERAN LODGING SERVICE

For

CHEYENNE VA HEALTH CARE SYSTEM - STATION 442

STATEMENT OF WORK (SOW)

1. Background The Cheyenne VA Medical Center (VAMC), located at 2360 E. Pershing Blvd, Cheyenne WY 82001, has need for off-site lodging for Veterans who travel long distances for their healthcare needs. Lodging is required for authorized Veterans traveling to the Cheyenne VAMC or its Community-Based Outpatient Clinics (CBOCs) for on-site appointments and will be costed to the Cheyenne VAHCS. The contractor shall provide room accommodations to veteran beneficiaries under the following terms and conditions:

2. Specific Tasks

a. Contractor shall provide a minimum of one (1) hotel/lodging.

b. Contracted rooms will be available within ten (10) miles of medical center facilities in ZIP codes Loveland CO, 80538, Fort Collins CO, 80526, And Cheyenne WY, 82001 Greeley CO, 80634.

c. Shall be responsible for providing invoices at the first of every month.

d. Shall be the single point of contact for issues/complaints for the hotel and the Medical Center.

e. Shall monitor hotels for compliance with all safety and health regulations, state and federal.

f. Shall provide a point of contact (POC) for contract management.

g. Additional hotel requirements:

1) A minimum of five (5) rooms per day are required to be reserved for VA veterans.

2) Three (3) of the reserved rooms need to be American with Disabilities Act (ADA) compliant.

3) One (1) of the ADA-compliant rooms should have a roll-in shower, if possible.

4) Hotel shall be within (10) miles of the Medical Centers.

5) Rooms shall be available Sundays through Saturday.

6) All rooms shall be non-smoking rooms.

7) A designated smoking area with proper signage shall be provided.

8) Rooms should have two beds to accommodate a caregiver, as needed.

9) Rooms shall be fully furnished: Bed(s), Telephone, TV, and Refrigerator.

h. A sampling of the rooms shall be inspected before the award of the contract. The Medical Center reserves the right to inspect the rooms on an as-needed basis.

i. All rooms will be charged at the same rate regardless of the time of/or type of room reservation. The VA reserves the right to request additional rooms; however, as part of the competitive process, the contractor must propose as part of the offer, any rates above and beyond the daily room requirement. Room rates shall be calculated at checkout time/date. Late checkouts should be available to the veteran.

3. Performance Monitoring

a. The VA Medical Center shall be responsible for scheduling the veteran’s hotel reservation. It is the medical center’s responsibility to ensure a complete and accurate Non-VA Temporary Lodging and Referral Voucher is provided to the veteran upon lodging clearance.

b. The Lodging Coordinator will ensure they complete the monthly invoice review within 3-5 business days of receipt into their e-mail accounts. Any invoicing discrepancies identified will be referred to the Lodging Management Group that same day. Once the issue is resolved, only then will the approval be for submitting for invoicing will be granted.

c. The VA Medical Center shall be responsible for providing any patient information security/PII training as needed. The C & A requirements do not apply; a Security Accreditation Package is not required. Incidental exposure to protected health information may occur from accessing the work site. Staff will follow all Privacy & Security policies and procedures.

d. The VA Medical Center shall release unreserved rooms back to the hotel by 5 p.m. daily. VA will be responsible for unreleased unused room fees.

e. The VA Medical Center shall have a process in place to handle complaints from the hotels and/or from the veterans. All complaints shall be referred to the contractor.

f. The VA reserves the right to terminate the contract at any time at the convenience of the government.

g. The VA Medical Center shall do a site visit of the offered hotels before the award of the agreement.

h. The Contractor shall guarantee the Medical Center that there shall be no ‘Blackout Dates’ on any reserved rooms.

i. All hotel industry standards for health and safety must be met or exceeded. NFPA, ADA, OSHA, and all city, county, and state ordinances/codes. This shall include all housekeeping regulations.

j. The Veterans upon scheduling an appointment will be informed by CVAHCS staff, to immediately call the assigned hotel/motel to reserve a room. The Contractor will hold a room for the Veteran in accordance with their standard reservation process.

k. If a Veteran cancels their VA appointment but fails to cancel lodging within the specified hotel/motel timeframe, there will be a charge to the Veteran credit card

l. The Contractor shall allow contracted rooms to be occupied only by specific individuals referred by authorized personnel of the CVAHCS. These individuals upon completing lodging clearance at the CVAHCS, will provide a Non-VA Temporary Lodging and Referral Voucher to the hotel/motel front desk staff. This voucher will have specific information related to the current stay to include the veteran’s name date of lodging, number of days authorized, and authorized by initials.

1) Authorized Lodging personnel tour is Monday through Friday (07:30-16:00) and can be reached at (307)778-7552.

2) After hours, weekends and holidays, the Administrative Office of the Day (AOD) can be reached at (307)778-7555.

m. The Veteran is required to contact the hotel before 5 p.m. for any/all late check-ins.

n. All hotel rules regarding pets shall be complied with by the veteran.

4. Security Requirements The Contractor shall comply with the VA Personal Identity Verification procedures identified in the contract that implement Homeland Security Directive-12 (HSPD-12), Office of Management and Budget (OMB) Guidance M-05-24, and Federal Information Processing Standards Publication (FIPS PUB) Number 201.

5. Government-Furnished Equipment (GFE)/Government-Furnished Information (GFI) None.

6. Other Pertinent Information or Special Considerations

a. Extended Stay: Should additional services be requested by the Veteran (extension of stay) outside of the services authorized by the CVAHCS, such services shall be at the expense of the Veteran. If the Veteran is admitted or stays overnight in the VA facility, stays of family members or caregivers in the contracted lodging facility shall be at their own expense.

b. Transportation/Parking: The Veteran shall not be responsible for any parking or shuttle fees.

1) Shuttle service to/and from the medical center is requested.

2) ADA accommodating shuttle if possible.

3) Identify shuttle availability between the hours of 5 PM and 9 AM daily at the offered hotels.

4) After 9 AM on business days (no holidays or weekends) the medical center will provide transportation to and from the hospital.

c. Liability for Damages: Any damage caused by a Veteran will be billed to that individual. The CVAHCS assumes no liability with its lodgers other than the contracted room rate. In the event of damage or disruption, it is the hotel/motel’s prerogative to determine if a Veteran will be a future guest. The CVAHCS will honor this decision. After the hotel/motel management informs the Veteran of not being welcomed back to their facility, the CVAHCS will follow up with a registered letter informing the Veteran of the hotel decision and CVAHCS abiding by that decision. The CVAHCS must be notified within 3 business days when any damages have occurred. The damages shall be documented and submitted to the CVAHCS; to include pictures.

a. Identification of Possible Follow-on Work

None.

b. Identification of Potential Conflicts of Interest (COI) None.

c. Identification of Non-Disclosure Requirements Not applicable.

7. Risk Control Patient Emergency Procedures: In the event of an emergency/non-emergency situation where fire/police/ambulance are called, this information will be communicated to the Lodging Management Group who will inform the SVAHCS lodging coordinator/s. The Contractor shall also be informed.

a. If an emergency, the notification is expected within 2-hours.

b. If a non-emergency, the notification is expected by the close of business, the next day.

8. Place of Performance Hotel/motels within listed areas, and contracted rooms will be available within ten miles of medical center facilities in ZIP codes.

a. Cheyenne WY, 82001

b. Loveland CO, 80538

c. Fort Collins CO, 80526

d. Greeley CO, 80634

9. Period of Performance The Cheyenne Veterans Administration Healthcare System (CVAHCS) period of performance for this Blanket Purchase Agreement (BPA) for Veteran Lodging Services for 5-years.