C03 36C26125D0050 Fully Executed.pdf

31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT)

Maricela Berrones-Gauger

Contracting Officer

30c. DATE SIGNED

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

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

1. REQUISITION NO. PAGE 1 OF 58

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

36C26125D0050 09-30-2025 07-11-2025

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

Austin Mitts | Austin.Mitts@va.gov

b. TELEPHONE NO. (No Collect Calls)

559-225-6100 x 6584

8. OFFER DUE DATE/LOCAL

TIME 08-01-2025

10:00am PDT

9. ISSUED BY CODE

Department of Veterans Affairs

Network Contracting Office 21

00261

10. THIS ACQUISITION IS

SMALL BUSINESS

X UNRESTRICTED OR SET ASIDE: % FOR:

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

NAICS: 624221

SIZE STANDARD:

$13.5 Million

SMALL BUSINESS 8(A)

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

N/A

14. METHOD OF SOLICITATION

X RFQ IFB RFP

15. DELIVER TO CODE

"See Performance Work Statement"

16. ADMINISTERED BY CODE

Department of Veterans Affairs

Network Contracting Office 21

00261

17a. CONTRACTOR/OFFEROR CODE 39FM0 FACILITY CODE

IHS, THE INSTITUTE FOR HUMAN SERVICES, INC.

BIG BAND BASH A BENEFIT FOR IHS

650 IWILEI RD STE 202

HONOLULU HI 96817

18a. PAYMENT WILL BE MADE BY CODE

Department of Veterans Affairs

Financial Services Center

P.O. Box 149971

Austin TX 78714-9971

PHONE: FAX:

TELEPHONE NO. UEI:EHNWN2KMTMQ1

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

EFT:

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

SEE ADDENDUM

19.

ITEM NO.

20. See CONTINUATION Page

SCHEDULE OF SUPPLIES/SERVICES

Contractor shall provide HCHV Contracted Emergency

Residential Services for the VA Pacific Islands Health Care

System.

IDIQ Period of Performance 09/30/2025 - 09/29/2030

Ordering Period 1: 09/30/2025 - 09/29/2026

Ordering Period 2: 09/30/2026 - 09/29/2027

Ordering Period 3: 09/30/2027 - 09/29/2028

Ordering Period 4: 09/30/2028 - 09/29/2029

Ordering Period 5: 09/30/2029 - 09/29/2030

Point of Contact is Austin Mitts

Email: Austin.Mitts@va.gov

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

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

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

$0.00

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE ARE NOT ATTACHED.

ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN 1

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

29. AWARD OF CONTRACT: REF. OFFER

DATED . YOUR OFFER ON SOLICITATION

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

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) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 1449 (REV. NOV 2021)

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

X

X

Constance Mitchell, Executive Director 9/12/2025 mailto:Austin.Mitts@va.gov mailto:Austin.Mitts@va.gov

36C26125D0050

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (NOV 2023)

C.2 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.3 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION

SYSTEMS (NOV 2021)

C.4 52.216-18 ORDERING (AUG 2020)

C.5 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.6 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.7 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.8 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR 1984)

C.9 VAAR 852.201-70 CONTRACTING OFFICER'S REPRESENTATIVE (DEC 2022)

C.10 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.11 VAAR 852.215-70 SERVICE-DISABLED VETERAN-OWNED AND VETERAN-

OWNED SMALL BUSINESS EVALUATION FACTORS (JAN 2023) (DEVIATION)

C.12 VAAR 852.215-71 EVALUATION FACTOR COMMITMENTS (OCT 2019)

C.13 852.222-71, COMPLIANCE WITH EXECUTIVE ORDER 13899. (DEVIATION) (APR

2025)

C.14 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV

2018) 46

C.15 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(OCT 2019)

C.16 VAAR 852.237-74 NON-DISCRIMINATION IN SERVICE DELIVERY (OCT 2019)

C.17 VAAR 852.237-75 KEY PERSONNEL (OCT 2019)

C.18 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020) .49

C.19 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (JAN 2025) (DEVIATION FEB 2025)

C.20 MANDATORY WRITTEN DISCLOSURES

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR:

Kanui Bell

(808) 447-2839

KanuiB@ihshawaii.org

b. GOVERNMENT: Contracting Officer 36C261

Department of Veterans Affairs Network

Contracting Office 21

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

[X] 52.232-33, Payment by Electronic Funds Transfer—System For Award

Management, or

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [x] Monthly in arrears

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment

Requests.

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the

Solicitation numbered and dated as follows:

AMENDMENT NO DATE

36C26125Q0602 0001 07/11/2025 mailto:KanuiB@ihshawaii.org

B.2 PRICE/COST SCHEDULE

The guaranteed minimum award amount for this contract is $1,000.00. The maximum aggregate value of orders that can be placed under this contract is $1,700,000.00. The Government does not guarantee that it will place any orders under this contract more than the guaranteed minimum award amount. Estimated quantity as indicated on this schedule does not limit nor does it guarantee the number of units to any specific number of units at any time. The number of units being utilize may vary from day to day. The total number of units per period shall not be exceeded unless authorized in writing by a warranted, VA

Contracting Officer

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

1001 2,190.00 DY $85.500000 $187,245.00

HCHV Contract Emergency Residential Services (CERS)

Provide 6 beds per day to Homeless Veterans on a per diem basis in accordance with the PWS

6 beds x 365 day = 2,190 days

Contract Period: Ordering Period 1

POP Begin: 09-30-2025 POP End: 09-29-2026

PRINCIPAL NAICS CODE: 624221 - Temporary Shelters

PRODUCT/SERVICE CODE: G099 - Social - Other

MANUFACTURER PART NUMBER (MPN): N/A

2001 2,190.00 DY $89.780000 $196,618.20

HCHV Contract Emergency Residential Services (CERS)

Provide 6 beds per day to Homeless Veterans on a per diem basis in accordance with the PWS

6 beds x 365 day = 2,190 days

Contract Period: Ordering Period 2

POP Begin: 09-30-2026 POP End: 09-29-2027

PRINCIPAL NAICS CODE: 624221 - Temporary Shelters

3001 2,196.00 DY $94.260000 $206,994.96

Provide 6 beds per day to Homeless Veterans on a per diem basis in accordance with the PWS

6 beds x 366 day = 2,196 days

Contract Period: Ordering Period 3

POP Begin: 09-30-2027 POP End: 09-29-2028

PRINCIPAL NAICS CODE: 624221 - Temporary Shelters

4001 2,190.00 DY $98.980000

Provide 6 beds per day to Homeless Veterans on a per diem basis in accordance with the PWS

6 beds x 365 day = 2,190 days

Contract Period: Ordering Period 4

POP Begin: 09-30-2028 POP End: 09-29-2029

PRINCIPAL NAICS CODE: 624221 - Temporary Shelters

PRODUCT/SERVICE CODE: G099 - Social - Other

MANUFACTURER PART NUMBER (MPN): N/A

$216,766.20

5001 2,190.00 DY $103.930000

HCHV Contract Emergency Residential Services (CERS)

Provide 6 beds per day to Homeless Veterans on a per diem basis in accordance with the PWS

6 beds x 365 day = 2,190 days

Contract Period: Ordering Period 5

POP Begin: 09-30-2029

POP End: 09-29-2030

PRINCIPAL NAICS CODE: 624221 - Temporary Shelters

PRODUCT/SERVICE CODE: G099 - Social - Other

MANUFACTURER PART NUMBER (MPN): N/A

$227,606.70

GRAND

TOTAL

$1,035,231.06

B.3 PERFORMANCE WORK STATEMENT

Performance Work Statement

VA Pacific Islands Health Care System (VAPIHCS)

Health Care for Homeless Veterans

HCHV CONTRACTED RESIDENTIAL SERVICES (CRS)

Emergency Housing

A. GENERAL

1.1 Services Required: The Department of Veteran Affairs Pacific Health Care System (VAPIHCS) through the Health Care for Homeless Veterans (HCHV) Emergency Contract Housing program provides care, treatment and rehabilitative services to homeless Veterans in the Pacific Region. The services provided to eligible homeless Veterans include outreach, case management and housing services. It is the purpose of this program to provide these Veterans a safe residential setting for a temporary period while addressing their immediate needs by accessing appropriate resources and supports with the goal to obtain permanent housing and end their homelessness.

To provide the care, treatment and rehabilitative services required, the VA HCHV program contracts with agencies and/or organizations (Contractors) to stabilize the Veterans’ needed medical, mental health, substance abuse and other psychosocial problems so that the Veteran can transition into permanent housing or other appropriate housing. Since these Veterans may have co-morbid conditions which may include serious mental illnesses, substance abuse disorders, and other serious medical conditions, the

Contractor is required to possess an understanding of these challenges and general skills to support the

Veterans to address these issues.

1.2 Authority: The Department of Veterans Affairs established Health Care for Homeless Veterans

(HCHV), in accordance with 38 U.S.C. 501, and 2031. The Department of Veterans Affairs is implementing programs to end homelessness for Veterans and this program’s purpose is consistent with that effort through the provision of immediate short term housing for homeless Veterans.

1.3 Definitions: Definition of Homelessness: It is the responsibility of the VA HCHV program to determine homeless status of program applicants. The HCHV Program follows the definition of

“homeless” as authorized in 24 U.S.C. 576.2

1.3.1. Veteran: A Veteran is, for the purpose of HCHV Emergency Contract Housing, a person who served in the active military, naval, or air service and who was discharged or released under conditions other than dishonorable and is eligible for VA Health Care as determined by the local VA

Medical Center.

1.3.2. Contracting Officer (CO):The CO is a VA employee who is assigned responsibility for the VA contract. The CO role is to ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms and shall safeguard the interests of the United States in the contractual relationship. The CO is the only person authorized to approve changes or modify any of the requirements of this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration as only the Contracting Officer is authorized to make commitments or issue changes that shall affect price, quantity or quality of performance of this contract.

The CO shall also assure that the Contractor receives impartial, fair, and equitable treatment under this contract. The CO is ultimately responsible for the final determination of the adequacy of the Contractor’s performance.

Assigned CO: Network Contracting Office (NCO) 21 Contracting Officers Organization or

Agency: Department of Veterans Affairs, VISN 21 Contracting

1.3.3. Contracting Officer’s Technical Liaison (COR):The COR is responsible for technical administration of the contract as outlined in the COR Delegation of Authority issued by the CO.

The COR shall assure proper Government surveillance of the Contractor’s performance and keep the CO informed of such. The COR shall keep a quality assurance file. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf.

1.3.4. VA Contracted Housing Liaison (Liaisons):The Liaison is the HCHV staff assigned responsibility for program eligibility determination and admission authorization for homeless Veteran’s entry into the contracted program. The Liaison is the primary contact for the program regarding the

Veterans served and provides general oversight and program assistance as needed.

1.3.5 Quality Assurance Surveillance Plan (QASP):The QASP is part of the contract and identifies the specific performance indicators and standards to be achieved by the Contractor as outlined in the

Performance Work Statement (PWS). The QASP review will be completed periodically by the COR and

Contractor’s performance reported to the CO.

1.3.5.a.The QASP monitors the specific performance indicators and will be completed through an onsite visit, announced or unannounced, or through other means available to the COR. Any issues identified will be forwarded to the Contractor for correction.

1.3.6 General Monitoring – Announced or unannounced on-site monitoring will also occur by

Emergency Housing Liaisons (Liaisons) and will include review of general service performance and the environment for health and safety. Any issues identified will also be forwarded to the Contractor for correction.

1.3.7 Key Personnel: Employees of the Contractor that are essential to the work being performed under this contract.

2.0 CONTRACTOR RESPONSIBILITIES: The U.S. Department of Veterans Affairs (VA) requires a Contractor to provide emergency residential and case management services through the Health Care for

Homeless Veterans (HCHV) program. This contract is designed to serve homeless Veterans in need of immediate placement in a safe environment with onsite support service.

2.1 Population to be Served

VA Eligible, Locally Registered and Approved to entry program services: This site will serve

Veterans who served in the US Military and determined eligible for VA benefits and services and registered at the local VA serving the local catchment area. All eligible Veterans must be approved by the

VA Liaison per the identified process prior to program admittance. Veterans must also be independent in their Activities of Daily Living (ADLs) and

Independent Daily Living skills (IDLs) unless it is determined by the VA Liaison that the program has the capability and capacity to serve those who have limitations in these areas. This would include environmental and staffing supports and program services.

Program acceptance of Veterans who have been convicted of a sexual offence will be made on a case by case basis. This consideration will include, but not be limited to, the nature of the offense, the composition of the house including vulnerability of other Veterans at the site, the community at large, the Contractor’s policy of acceptance of individuals with this conviction and the post discharge permanent housing plan for the Veteran. Veteran would be required to register their location per Megan’s Law.

Veterans who have been convicted of an Arson offense will not be approved for program entry. In addition, Veterans will not be served if at the discretion of the VA Liaison in collaboration with the

Contractor it is determined that a Veteran’s past and current behavior may have a significant negative impact on the program and other residents.

2.1.1 Location of Services: The identified site for performance will occur at the Contractor’s VA approved location in Urban Honolulu on Oahu, Hawaii. The site must also be accessible by local public or Contractor-provided transportation to the local VA facility and community resources and services.

2.1.2 Homeless or at Risk: To be eligible for Emergency Housing services under this contract the

Veteran must be homeless or at imminent risk of becoming homeless. A required initial homeless clinical assessment will be completed by a VA Liaison to verify homelessness or at risk.

2.1.3 Primary target populations: The primary target populations are Veterans who are homeless or chronically homeless and may present with mental health support needs, substance abuse disorders and/or in need of a short-term medical recovery.

2.1.4 Number to be serviced under this contract: The number of Veterans served will be determined by site characteristic but will be limited to no more than 6 Veterans at one time at this site. If

Contractor’s environment allows and if there are under-utilized funds in the contract as a result of bed vacancies, authorization may be given to over serve this 6 limit.

2.1.5 Length of Stay: The duration of a Veteran’s stay is targeted to be no longer than 90 days unless specifically authorized by the VA Emergency Housing Liaison for an extension. This extension is required to be documented and reasons for this extension identified.

2.1.6 Hours of Service to be Provided: 24 hours/7 days/ 365 (Leap Year 366 days) per year including State, Territory and Federal Holidays.

2.1.7 Service Outcome: The service outcome of emergency contracted housing services is to stabilize the homeless Veteran, secure appropriate resources and supports, and secure permanent or other appropriate housing for their future. Permanent housing is the primary desired residential outcome for all

Veterans participating in this program.

2.1.8 Care, Treatment and Rehabilitative Services: The Contractor shall furnish care, treatment and rehabilitative services in accordance with Section 2.7 Program Service of this PWS.

2.2 Site Characteristics

2.2.1 Type of Housing to be provided: It is preferred that the number of beds allow that the housing unit be in single family detached houses within the community. However other housing types are acceptable such as apartments or units within a shelter or congregate living facility. Environment should provide for adequate bedroom, dining and a common area equipped with adequate seating and entertainment options. An outside common seating area for residents is desired, but not required. The site should also have the capacity to provide shelter to a spouse or partner in a Veteran’s immediate household (no children or minor dependents).

2.2.2 Accessibility: Housing are to be accessible from the street and where possible wheelchair accessible or ramped for home access. If possible, doorways shall be of enough width to accommodate wheelchairs or at minimum walkers. A fully ADA compliant environment is preferred but not required.

2.2.3 Bedroom and bathroom space must be appropriate and be of enough size as determined by

VHA. Single bedrooms of adequate size shall accommodate no more than 2 beneficiaries, unless specifically authorized by VHA.

2.2.4 New Contracts/Site Relocations – For new contracts the Contractor will secure an appropriate site for the performance of the contract, promptly comply with VA site and other inspection requirements and be operational to accept Veteran residents within 90 days from the date of the contract. This 90-day operational requirement also applies to sites which have had to relocate during the term of the contract. If a new location and/or Contractor is bidding is seeking a site to fulfill the requirements of the solicitation, the disclosure of this must be identified in BOLD print on the Solicitation response.

2.2.5 Sub-Contracting – If the Contractor will be subcontracting any part of their proposed Contractor such as site utilization and/or services including case management, a fully executed Memorandum of

Understanding (MOU) or sub-contract agreement with that entity must be submitted with the

Solicitation response. This MOU must detail the expectation and role of the sub-contracting agency in providing the services under this contract and the role of the Contractor to supervise the services being provided.

2.2.6 Control of Site: Contractors must have site control of the residential care site through ownership or a valid property lease which must be provided with the Solicitation response.

2.2.7 Site Approval: The Contractor’s identified site of service approved by VA will be the location for services to be provided to Veterans under this contract. Any additional sites will require a VA pre-inspection and authorization prior to the provision of services.

2.2.8 Site Maintenance: It is the responsibility of the Contractor to properly develop and/or maintain its facilities and the VA shall have no responsibility for paying or reimbursing the Contractor for such expenses.

2.2.9 Occupancy Permit: If new, contract site must have a current occupancy permit issued by the local and State governments in the jurisdiction where the site is located or a statement from the appropriate city or state office stating there is not a need for an occupancy Permit.

2.2.10 Follow existing standards of State safety codes and local, and/or State Health and sanitation codes.

2.2.11 Where applicable, be licensed under State or local authority.

2.2.12 Where applicable, be accredited by the State.

2.2.13 Be equipped with operational air conditioning/heating systems if required for habitation at the discretion of the VA facilities inspector at the site’s pre-inspection.

2.2.14 Be kept clean free of insects including bedbugs and rodents, free of dirt, grime, mold, or other hazardous substances and damage that noticeably detracts from the overall appearance.

2.2.15 Showers and toilets will be maintained clean and sanitary.

2.2.16 Be equipped with first aid, fire safety equipment and an evacuation plan in case of emergency.

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

2.3 Environment Supports: In the housing environment the following must be provided:

2.3.1 Each resident shall be provided with a single bed, frame and bed linens, including blankets as needed. Specially designed zippered bed bug mattress covers which enclose the mattress and box springs (or an equivalent preventative measure approved by VA) must be in place to reduce the infestation of bed bugs. If the bed bug mattress covers are torn or if zipper is not closing properly the cover must be replaced.

2.3.2 Hygiene products to include towels, wash cloths, soap, deodorant, toothpaste and toothbrushes, as needed.

2.3.3 Bathrooms (toilets, basins, showers and bathroom hygiene supplies) will be located within a reasonable distance on the same floor of the living space.

2.3.4 A space for personal belongings off the floor such as closets, dressers or wardrobes for clothing and effects shall be provided in the resident’s room.

2.3.5 A place for the resident to secure (lock) valuable personal items and medications which cannot be removed by other guests.

2.3.6 Privacy shall be provided to the resident.

2.3.7 Rooms shall be accessible to the Veteran 7 days a week and 24 hours per day. Veterans will have access to their assigned bed during this time except, where necessary, a specific defined period of no more than 2 hours daily for staff to clean the room or bed area.

2.3.8 Veteran sleeping environment shall be maintained in a preventative manner to assure that it is in good repair, clean, free of noise during normal nighttime sleep hours and free of insects and/or rodents.

A written plan will be in place and followed in a timely manner to rid the environment of insects and/or rodents if an infestation is identified.

2.4 Meals: The Contractor shall provide nutritious meals. Food shall be prepared, served and stored under sanitary conditions. The following shall be provided:

2.4.1 Unless deemed inappropriate for the site by VA, the site shall provide storage space in an onsite refrigerator for Veterans to store personal food, if refrigeration is required.

2.4.2 The site shall establish and maintain sanitary procedures for washing dishes, cleaning equipment and work areas and disposing of waste.

2.4.3 At least three (3) nutritious meals or their equivalent shall be served daily at regular times. These meals will follow a weekly posted menu and substitutions of menu items will be at a minimum. A dairy item must be available or upon request for the Veterans for each meal and noted on the on the menu.

2.4.4 Contractor will provide alternative meals 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.

2.5 Laundry: Laundry facilities shall be available on site for residents to do their wash and dry laundry at no charge.

2.6 Transportation: The Contractor shall assist the Veteran to their scheduled VA or community meetings and medical appointments through the provision of Contractor provided transportation or secure public transportation through the provision of bus passes, taxi vouchers, or payments to private services, such as Uber. The site shall post a weekly transportation schedule to the VA Clinic and the mode of transportation. If reliable public transportation is not available within a reasonable distance

(1/4 mile) or the Veteran is unable walk to the bus stop location, the agency shall establish a schedule to transport residents which addresses their meeting or medical appointments. In addition transportation should be available to local community services such as food markets, retail or dining services. If the

Veteran has ambulation difficulties and unable to access public transportation, then the Contractor shall assist Veteran with coordinating their enrollment to appointments and community access through acquisition of community transportation services for the disabled.

2.7 Program Service

The following outlines the services required of the Contractor to address the care, treatment and rehabilitative services expectation under this contract. Additional Contractor developed and implemented supports to address these expectations must be in place. VA may complement the non-VA community-based provider’s program with added treatment services through VA outpatient programs but should not be the sole supports available.

2.7.1 Outreach Plan: The Contractor must have a formal plan of action to engage in community outreach to identify homeless Veterans who may be eligible and in need of contracted emergency housing services. This Outreach Plan must be submitted to the COR upon request and will be review periodically for acceptability. If the Contractor identifies through their outreach a Veteran who may qualify for the contracted bed, the Contractor will utilize the VA referral process to determine acceptance of the Veteran into the program. This process identifies specific non-acceptance issues and/or behaviors which may place the Veteran or others at risk. Additionally, the contractor shall accept homeless Veterans directly identified by the VA Emergency Housing Liaison who have signed a Release of Information (ROI) and are eligible for Emergency Housing. In all situations, the VA Liaison or their assigned has the sole determination if a Veteran is accepted into a contracted bed at the site. It is expected that the Contractor actively engage in outreach so the occupancy of contracted beds be maintained at a minimum rate of 80% or higher as determined by VA during any given quarter.

Objective #1 – Contractor will maintain minimum acceptable level of occupancy of 80% through collaboration with VA and their demonstrated independent outreach efforts. See

QASP- Contractor Performance Standard #1.

If an increase in the percentage of occupancy is required by VA Central Office (VACO), the revised expectation will be conveyed to the Contractor by the COR. Occupancy will be reviewed quarterly as part of ongoing Quality Assurance Surveillance Plan (QASP) efforts. If this rate is not consistently achieved a corrective action plan may be required depending on factors affecting the occupancy shortfall.

2.7.2 Entry Assessment and Admission: Entry into services can be either through Veteran self-referral to the VA or through the outreach efforts of the Contractor. If the Contractor identifies a homeless individual as potentially qualified to receive services, the Contractor shall obtain from the

Veteran a VA Release of Information (ROI) and follow the identified process to request the Veteran’s

VA eligibility with the VA Liaison or their assigned to assure the Veteran is registered for VA benefits and services. Similarly, if the Veteran presents to the VA, VA staff will obtain ROI from veteran to coordinate services with the Contractor. If the Veteran is eligible, the Contractor shall coordinate with the Liaison to establish a time for the Liaison to complete the Clinical Interview. Formal entry into services will not occur without the completion of this Interview. Admission must be established on the same day of referral. If the Clinical Interview cannot take place on the same day of referral, Contractor must ensure a temporary same-day placement until formal admission can be established.

Objective #2 -Contractor will follow the established VA protocol for the eligibility documentation, including arranging a Clinical Interview where requested, and promptly complete and return documentation for eligibility determination and program acceptance for HCHV Emergency

Housing Service. See QASP -Contractor Performance Standard #2.

The VA Liaison is responsible for determining eligibility of Veterans prior to admission to Contractor’s bed. A list of VA staff authorized to approve admissions under the contract shall be provided to the

Contractor. Acceptance of billing is conditional upon the eligibility and admission approval of the VA

Liaison. In addition, the current HCHV identified process for eligibility determination includes the VA

Liaison clinical assessment and the Participation Agreement, and VA Rights sent by the Liaison to the

Contractor for Veteran signature and return emailed to the VA Liaison. If the Veteran is denied eligibility/admission to the program, the contractor must provide an explanation of their decision in writing with copies maintain in a file by the Contractor. If the Veteran is accepted into the program the

VA Liaison shall fax or send by secure email a completed VA Eligibility and Enrollment into Emergency

Housing Services to the Contractor acknowledging the Veteran’s date of acceptance. The Contractor shall maintain these documents in a secure case management file.

Objective #3- Contractor will maintain a comprehensive case management file. See QASP -

Contractor Performance Standard #3. The Contractor may also utilize admission and other forms specific to their agency requirements.

Training and updates on the processes and all referenced VA forms will be provided to the

Contractor by the VA Emergency Housing Liaison or COR.

2.7.3 Case Management: The Contractor shall assign a case manager as the primary contact for the

Veteran and this role shall not conflict with other duties such as also being the primary residence rules and compliance staff person. This case manager will, in conjunction with the program participant based on their Inventory of Needs, develop a Housing Support Plan (HSP) which outlines the general services and supports needed and prioritized. This document will also identify the Veteran’s Resource

Acquisition and their Discharge Plan upon leaving the program. This plan will be created, implemented and submitted to VA Liaison within 7 days of admission. The HSP should identify the shared responsibility of the case manager and the Veteran in achieving the goals identified. The level of achieving the identified goals depend greatly on the Veteran’s desires, wishes, priorities and their motivation. The role of the Case Manager is to be proactive in their efforts to secure the necessary supports identified, including permanent housing.

For Veterans eligible for the VA HUD-VASH program, Contractor case management staff, as the secondary case managers, shall develop a Collaboration Plan with the Veteran and the VA HUD-VASH social worker to identify and support the efforts to secure needed documents and other resource to facilitate and expedite the Veteran’s move into permanent housing. This Plan will be consistent with the

HUD-VASH Housing Plan, a copy of which will be maintained in the Contractor’s file. This

Collaboration Plan shall be updated and submitted monthly as part of the progress note for the Veteran to the HCHV Social Worker.

Objective #4- Contractor will complete a comprehensive assessment of the Veteran’s needs and develop a Housing Support Plan with the Veteran to be submitted to VA with 7 days of admission.

See QASP - Contractor Performance Standard #4. The case manager shall meet with the Veteran a minimum of 3 or more times per month to review progress and where needed modify the HSP.

Objective #5 – Contractor will submit a Monthly Housing Support Summary which documents 3 or more meetings with the Veteran per month and outlines the specific actions taken by the Case

Manager and Veteran to achieve the goals identified in their Housing Support Plan. See QASP -

Contractor Performance Standard #5.

Communication with VA on the status of the Veteran in achieving their identified goals in the HSP is essential. This provides an opportunity for VA staff to assist as needed in resolving barriers, challenges or issues which may interfere with the Veteran’s successful move into permanent housing. While informal contact will be maintained between VA and site case managers, formal communication will be submitted by the case manager through end of the month summaries (progress notes) of the efforts of both the Veteran and the site case manager with the identified HSP goals.

The case management provided should include but not be limited to the following:

2.7.3.1 Housing Assistance: Provide direct and ongoing assistance to support the Veteran’s access to permanent housing. All efforts to engage Veteran regarding housing plans, options and resources shall be clearly documented. The Case Manager will refer the Veteran to the HUD-VASH program and if ineligible for this program, seek housing options under the City and County Section 8 or other available assisted living voucher systems. Mere communication with Veteran regarding housing without subsequent Contractor staff action and follow-up, shall not on its own meet the above requirement. Contractor shall meet the current Permanent Housing Metrics established by

VA Central Office (VACO). This metric shall be communicated by the COR as revisions to the required

% of Veterans who enter Permanent Housing is established by VACO.

2.7.3.2 Resource Acquisition: The Case Manager will provide direct and ongoing assistance to support the Veteran accessing eligible financial and supportive programs i.e. SS, SSDI, General

Assistance, Food Stamps, VA service-connected benefits, SSVF, employment, etc. and assist application preparation and/or transportation to benefit site. Veteran must also be screened for Medicaid eligibility and an application submitted even though Veteran’s health care is provided by VA.

Documentation of all referrals and outcomes must be noted in the Veteran’s monthly progress note.

Eligible Veterans should be encouraged to seek employment services by having Veteran contact VA or

Community resources. As part of the Housing Support Plan the case manager shall develop with the

Veteran a Financial Plan and Budget which reflects employment and non-employment resources and income and what is needed to secure housing.

Objective #6 – Contractor will provide Veterans direct and ongoing assistance to support the Veteran’s access of housing options, financial and supportive programs such as SS, SSDI, General Assistance, Medicaid, etc. and document this activity in the Monthly Summary submitted to VA. See QASP -Contractor Performance Standard #6.

2.7.3.3 Recovery Assistance: Provide referral, support and encouragement for the Veteran’s attendance at PTSD and substance programs provided by Contractor, VA or at other programs.

Transportation for Veterans to access these services will be required of the Contractor.

2.7.3.4 Medical and Mental Health Assistance: Case management will support and encourage the

Veteran’s attendance at medical and mental health programs at the Contractors program or VA through scheduling or providing Contractor transportation as needed per 2.6. Medication management is not required by the Contractor unless it is policy for the Contractor’s organization. The Veteran may manage their physician non-narcotic prescribed and over the counter medication, but they must be properly stored and secured. If not in conflict with a general site ban on the use of all narcotics including those prescribed by their physician, the site must have a specific policy for physician prescribed narcotics to assure that their use follows physician orders.

2.7.3.5 Relationship Assistance: Where appropriate case management will support the Veteran to connect with peers and their family.

2.7.3.6 VA Coordination and Veteran’s status: The Case Manager with communicate with the VA

Liaison through regular scheduled contacts which address the Veteran’s progress in the goals identified in the Housing Support Plan or on issues that may arise. The Program will submit a monthly summary of the case management activities and Veteran’s progress toward the goals outlined in the HSP. In addition, if a Veteran is or has been identified as HUD-VASH eligible the Collaboration Plan is to be updated and submitted as the Veteran’s progress note.

Objective #7 – Contractor will submit to VA a monthly summary which describes the activities and status of the efforts of both the Veteran and the site case manager in achieving the Veteran’s goals identified in the Housing Support Plan. See QASP – Contractor

Performance Standard #7.

2.7.3.7 Discharge Planning: Develop with the Veteran a Discharge Plan to identify the type of housing the Veteran will transition to at the time of their discharge. This Discharge Plan shall be prepared no later than 7 days after admission. In addition, the program will inform the VA Liaison within 24 business hours of the Veteran’s discharge whether planned or unplanned. The Contractor shall also submit a final progress summary note including reasons for resident leaving, their future and their progress to achieving their established goals along with the Exit Summary for Contracted Housing to the VA Liaison within 36 business hours of discharge.

Objective #8 – Contractor will submit to VA a completed Exit Summary for Contracted Housing within 36 business hours of the Veteran’s departure or discharge from Emergency Housing. See

QASP – Contractor Performance Standard #8.

Discharges will be characterized as follows:

a. Positive Discharge: A positive discharge is when the Veteran has been successfully placed in permanent housing either individually or with family or friends. The Contractor will work to target that

55% or more of Veteran discharges are positive with the Veterans moving into permanent housing.

Objective #9 – Contractor will achieve the VA Central Office (VACO) metric which requires that

55%* or more Veterans are discharged to permanent housing.

*Percentage may be revised by VA Central Office. See QASP -Contractor Performance

Standard #9)

a. If a revision (increase) in the target percentage expectation is identified by VA Central Office, this revised expectation will be conveyed to the Contractor by the COR. The percentage of Positive

Discharges will be reviewed quarterly as part of ongoing Quality Assurance Surveillance Plan (QASP) efforts. If this rate is not consistently achieved, a corrective action plan may be required depending on factors affecting the positive discharge shortfall.

b. Administrative/Neutral Discharge: The Veteran has been transferred to an alternate level of care with concurrence from the VA Liaison for medical, mental health, or substance abuse treatment to better meet the Veteran’s clinical needs.

c. Negative Discharge: A negative discharges is when a) the Veteran is absent from the program site and his whereabouts are unknown and or unwilling to return; b) the Veteran has had an episode of violence or has threatened violence against staff or other residents and must be discharged to maintain the safety of the site; c) the Veteran’s substance use on site creates a serious issue for the Veteran and others, d) the Veteran’s length of stay has exceeded 90 days from the date of admission and the VA

Liaison has not approved continuation. The target for negative discharges of Veterans is 20% or less and the Contractor will work to achieve this target.

Objective #10 – Contractor will achieve the VA Central Office (VACO) metric which requires that

20%* or less of Veterans leave services through a negative discharge.

*Percentage may be revised by VA Central Office. See QASP -Contractor Performance

Standard #10.

2.7.3.8 Incident Reporting: The Program shall notify the VA Liaison within 4 business hours of any critical incident involving the death, suicide/suicide attempt, fire (Veteran involved) or sexual or physical assault of a Veteran residing in the residential program.

The Contractor shall provide the VA Liaison with a copy of the incident report within 24 business hours.

For all other incidents, program shall notify the VA Liaison within 4 business hours of the incident and submit to VA staff an incident report within 48 business hours. Examples of other incidents include

(though not limited to) falls, abuse or neglect, hospitalization, infection control (Bed Bugs, TB, etc.)

active substance abuse and possession of weapons.

2.7.3.9 Length of Stay: Case managers are to assist Veterans to demonstrate progress toward their goals outlined in the Housing Support Plan. Veteran stays are reviewed by the Emergency Housing

Liaison and the case manager for progress after 14 days and continued stays are limited to 90 days unless specifically authorized by the VA Emergency Housing Liaison for an extension.

Any extension of this time may not occur without written prior approval from the VA Emergency

Housing Liaison. The VA Liaison will not approve per diem for lengths of stay exceeding 90 days from the date of admission unless:

I. The Veteran has demonstrated reasonable progress and there are circumstances that are barriers to the Veteran’s placement in housing; and/or

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

III. The VA Liaison has been appropriately advised of these efforts well in advance of the

90-day limit; and

IV. The VA Liaison concurs that the Veteran will continue to derive benefits from a continued stay at the contracted site.

Objective #11 – Contractor will limit the Veteran’s stay in Emergency Housing to 90 days unless authorized in writing by a VA Emergency Housing Liaison. See QASP - Contractor Performance

Standard #12.

2.7.3.10 Occupancy: It is expected that the Contractor beds will be maintained at an average minimum of 80% occupancy as calculated based upon number of bed nights available per quarter. If a revision

(increase) in the target percentage expectation is identified by VA Central Office, this revised expectation will be conveyed to the Contractor by the COR. The Occupancy percentage will be reviewed quarterly as part of ongoing Quality Assurance Surveillance Plan (QASP) efforts. If this rate is not consistently achieved, a corrective action plan may be required depending on factors affecting the negative discharges.

2.7.3.11 Provision of Structured Group Activities: It is expected that the site develop and provided structured group activities for Veteran participation. This should occur at minimum twice a month. These group activities can be at the specific site or where appropriate at a central location. Activities may include computer access and training, social skills training, financial workshops including VA benefit acquisition, and life skills training. Other meeting may include Alcoholics Anonymous, Narcotics

Anonymous, or vocational counseling.

Objective #12 – Contractor will provide or provide access to structured group activities no less than twice per month and document the attendance at the specific group activity in their submitted

Monthly Housing Support Plan.

See QASP – Contractor Performance Standard #13

2.7.3.12 Daily Schedules of Program and Community Services: It is expected that the site develop and display a daily schedule. This schedule should include both routine activities for the day/week and the availability of Contractor provided program service at the specific site or central site such as structured group activities including computer access and training, social skills training, financial workshops, and life skills training. In addition it should identify and provide access to recreation and leisure activities and upcoming events in the community. The program should support the Veteran’s active participation in activities which enhance their lives and supports a sense of positive movement toward housing independence. Where necessary transportation for these activities would be expected to be provided or arranged by the Contractor .

3.0 Contractor Staff Requirements

3.1 Qualifications: The Contractor shall assign to this contract, personnel that by education and training and, when required, certification or licensure, and are qualified to provide the Services required by this

Statement of Work (SOW).

3.2 Ratios: The Contractor needs to provide sufficient number of trained staffs to carry the policies, responsibilities and services of the program. These staffs must be physically present to ensure that the

Veterans are provided a safe, secure, confidential and a structured environment that address their needs.

This should include:

3.2.1 Case Managers - Each Veteran has an assigned primary case manager responsible for coordinating services specified in the contract. The case manager to Veteran ratio is 1:15 or fewer cases;

however, consideration will be given by the VA to the staffing characteristics of each site. This case manager may not be assigned other duties in addition to this primary role unless specifically authorized by the VA HCHV program. The name and their organizational F.T.E. assignment as a case manager must be provided to VA on request to assure adequate staffing.

Objective #13 – Contractor will have an adequate number of qualified, designated case managers whose primary role is to assist their assigned Veterans at the site(s). See QASP – Contractor

Performance Standard #14

3.2.2 On-site Staffing – A qualified designated staff person will be on duty at the approved site 24 hours a day, 7 days per week. The role and authority of this person must be identified and consistent with the site-specific policies and procedures to address emergencies as they arise.

Objective #14 – Contractor will have a designed qualified staff person on duty at the approved site

24 hours per day, 7 days a week. See QASP – Contract Performance Standard #15

3.2.3 Administrative Staff -There must be at least one administrative staff member identified and able to be contacted within one hour of any emergency or situation occurring with the authority to make decisions regarding the site and residents. The name and contact number of this administrative staff person and a sequence of other administrative contacts must be posted on site and available to the on-site staff and residents.

3.2.4. That when a VA inspection team evaluates the Contracted site the team is consistently assured that staff can provide the services required under the terms of the contract.

3.3 Training: The Contractor shall assign to this contract personnel who will receive initial and periodic training. An annual training report will be submitted to the COR upon request.

Training required:

3.3.1 Possess current certification in Basic Life Safety (BLS for Healthcare Providers including

CPR and AED). Frequency per BLS Safety requirements.

3.3.2 Have received training on alcohol and substance use and familiarity with current treatment programs.

3.3.3 Have received training related to Military Sexual Trauma and PTSD, the characteristics of the disorders and triggers, and awareness of treatment approaches.

3.3.4 Have received training related to general mental health disorders, their characteristics, use of medications, and awareness of treatment approaches.

3.3.5 Have received training in maintaining client privacy and confidentiality in all verbal and written communications and interactions.

3.3.6 Adhere to the provisions of Public Law 104-191, Health Insurance Portability and

Accountability Act (HIPAA) of 1996. This includes both the Privacy and Security Rules published by the Department of Health and Human Services (HHS) regarding the use and disclosure of protected health information. Privacy training shall be completed annually.

3.3.7 Have training on Bloodborne Pathogen/Infection Control Procedures.

3.3.8 Employees involved in patient care shall complete the VA Privacy and Security Training in

TMS at https://www.tms.va.gov/learning/user/SelfRegistrationUserSelection

3.3.9 Have training on Crisis Prevention/ Intervention Training.

3.3.10 Have training on Emergency Disaster Preparedness and Policy Reviews

3.3.11 Have training on…