D4.4_Request for Extension of Per Diem Form.docx

This is a Request for Extension of Per Diem Form used by the VA Grant and Per Diem Program to manage extensions of transitional housing services for veterans beyond their initial authorized period. The form establishes a formal protocol requiring contractors to submit written extension requests to the VA Grant and Per Diem Program Manager/Contracting Officer Representative (COR) for approval. Contractors must provide comprehensive justification including the veteran's need for continued services, steps already taken to secure permanent housing, identified barriers to housing placement, and mitigation strategies to address those barriers.

The extension request requires contractors to document a detailed action plan with specific timelines for implementation during the extension period and provide a minimum of two alternative housing plans. Additionally, contractors must confirm the veteran's agreement with the proposed plan. This structured documentation ensures that per diem funding extensions are granted only when justified by documented need and supported by concrete housing transition strategies, maintaining accountability in the delivery of transitional housing services under the VA Greater Los Angeles Healthcare System's 30-bed Safe Haven program.