DRAFT PERFORMANCE WORK STATEMENT.pdf

DRAFT PERFORMANCE BASED STATEMENT OF WORK

CONTRACT EMERGENCY RESIDENTIAL SERVICES BEDS: Women’s program

1. PURPOSE.

1.1. The Department of Veterans Affairs has been providing direct and specialized services for homeless Veterans for over 25 years. The Secretary of the VA has set a zero-tolerance policy for homelessness within the Veteran population since 2009. The plan to end homelessness among Veterans includes planned increases to the capacity of existing programs and an increase in services offered to Veterans. New models of care not previously offered by The Veteran Health Administration are also being implemented.

1.2. The Department of Veterans Affairs Medical Center- West Los Angeles requires contractors to provide transitional housing services as part of its community-based Health Care for Homeless Veterans (HCHV) program. The HCHV Program, an essential and critical part of Veterans Healthcare Administration is vital for providing a gateway to GLA and community supportive services for eligible Veterans who are homeless. This emergency transitional housing program is designed to address the needs of the most vulnerable and at-risk homeless Veterans.

It targets and prioritizes Veterans experiencing homelessness and are transitioning from literal street homelessness, being discharged from institutions, and/or who recently became homeless and require safe and stable living arrangements while they seek permanent housing. HCHV’s goal is to engage homeless Veterans in treatment and place them in a safe, sober and secure, emergency transitional housing that supports their rehabilitation goals. The model under the HCHV Contracted Residential Services (CRS) used for this contract will be:

1.2.1. Contract Emergency Residential Services (CERS) programs target and prioritize homeless Veterans transitioning from literal street homelessness, Veterans being discharged from psychiatric and inpatient hospitalizations and Veterans who recently became homeless and require safe and stable living arrangements while they seek permanent housing. Lengths of stay in CERS typically range from 30 to 90 days with the option to extend based on clinical need.

1.3. The purpose of this solicitation is to obtain offers from Contractors who can provide housing, and supportive services to up to 20 Homeless Female Veterans. This emergency transitional housing contract will be known as “CERS-Women’s program” and is located in WLA catchment area, within a 25 miles RADIUS of the WLA campus.

Contractor shall offer a safe and secure environment that supports their goals for recovery from homelessness. Awards may be based on residential capacity to place Veterans in safe environmental residency. Maximum number of beds funded will not exceed 10950 bed days of care per year. The Contractor will be required to provide an on-demand, low-barrier therapeutic and rehabilitative milieu and attendant services targeting the underlying factors contributing to homelessness.

2. GENERAL CONTRACT REQUIREMENTS.

2.1. Contractors are urged in the strongest terms to carefully review the requirements outlined in the Statement of Work to ensure that all criteria within can be met as required and in a timely fashion. This contract is independent from any past similar contracts awarded and should be reviewed and seen as separate and distinguished. Once awarded, the Contractor accepts and understands, the fully executed contract is a requirement of the VA and shall not be altered or manipulated without fully executed contract modification(s).

2.2. Same Day Access: Veterans may access transitional housing programs via VA consults from the HCHV Liaison, or directly to the program by their outreach efforts and/or through referrals from the community. The program will target Veterans who are engaged in care through a collaborative partnership among the VAGLAHS, the Los Angeles Coordinated Entry System Service Providers, Los Angeles Homeless Services Authority, and other Veteran-specific programs that target homeless Veterans.

2.2.1. Programs will be expected to complete intake and SAME DAY admissions for those veterans approved as eligible for placement by the COR/HCHV liaison or their designee or through direct referrals. The Contractor shall ensure their internal admission process and procedures allow for SAME DAY placement of accepted Veterans into an available bed. Admission shall occur up to 9 pm during workdays (Monday – Friday, with the exception of federal holidays) and to 7 pm on weekends.

2.2.1.1. The Contractor will offer beds on the SAME DAY the referral is made by the designated liaisons or from direct referrals or eligible referring sources.

2.2.1.2. HCHV CRS staff will confirm eligibility prior to referral submission, during the work week and the contract’s staff will complete a SQUARES review for all direct referrals.

2.2.1.3. The Contractor must place Veterans into available beds on the same day of the approved admission whether liaison or direct referred, if referrals are made before 7pm, and space is available.

2.3 Criteria & Eligibility: The Contractor shall provide services to Veterans who are VA healthcare eligible and experiencing homelessness or at risk of becoming homeless, i.e., received an eviction or no longer able to reside at their existing housing situation.

2.3.1 Be determined to be homeless based upon the McKinney-Vento Homeless

Assistance Act definition by the local VA medical center HCHV program. See Reference section.

2.3.2 Be eligible for VA healthcare as determined by the local VA medical center and and/by the program using Squares.

2.3.2.1 A Veteran must be homeless and eligible for VA Health Care in order to be considered for admission to any HCHV CRS Program. Authorized VA Liaison or designee shall be ultimately responsible for determining Veteran eligibility and approval for placement into a HCHV CRS Bed; failure to establish VA approval for admission by the next business day may result in a denial of payment for services provided.

2.3.3 Veterans must be able to:

2.3.3.1 Actively engage in case management services on a weekly basis.

2.3.3.2 Actively engage in housing search.

2.3.3.3 Secure permanent house.

2.3.3.4 Be ADL independent.

2.4 Referred: Veterans are referred to the Contractor by VAGLAHS staff, other community agencies, the Contactor’s outreach efforts or Veteran self-referrals. The referrals will be based on the Veteran’s demonstrated need for case management and supportive services to stabilize their mental health, substance abuse, medical and/or other co-occurring serious psychosocial issues before expediently transitioning into secure and permanent housing. The environment of a CERS program considers those Veterans who need a jump start to get back on their feet. The environments are similar to shelters, with the added benefit of programming and case management. Veterans must actively participate in their discharge planning and be willing to seek permanent housing for placement consideration,

2.4.1 During the work week M-F 8-330. Both the VA HCHV CRS Liaison(s) and the program shall receive consults (VA referrals)/direct referrals and will complete the admission process for same day admission if veteran meets the listed criteria and eligibility clauses and their admission is not deemed unsafe for their milieu.

For after hours (330pm to 9pm), during the work week M-F and weekends, the program will continue to complete direct or community referrals. Program will be responsible to complete healthcare eligibility checks for placement. Programs to accept Veterans referred who meet the criteria and eligibility clause, and their admission is not deemed unsafe for their milieu.

2.4.2 When a veteran is accepted for placement:

2.4.2.1 For HCHV Consults: the HCHV CRS liaison will ensure a suicide Risk

Assessment (CSSR) is documented in the CPRS record.

2.4.2.2 For Program Direct Referrals: the HCHV CRS liaison will be responsible in documenting the CSSR when meeting with the Veteran for their admission.

2.4.3 Outreach: Contract staff shall engage in Outreach services, including street outreach efforts, and assist homeless Veterans in seeking housing placement, treatment and supportive services which is a key element of this contract.

2.4.3.1 Outreach shall not include Contractor’s efforts towards “in-reaching” of services established from or by the VA ie: the welcome center or other VA departments or other VA resources and housing programs.

2.5 Contractor shall utilize the Housing First approach, with reduced barriers for program entry. Veterans cannot be denied entry into a HCHV CRS program based solely upon length of current abstinence from alcohol or non-prescribed controlled substances, illegal substances, the number of previous treatment episodes, the time interval since the last program entry, the use of prescribed controlled substances, legal history or behavioral flag. See Denial of Services section.

2.5.1 Accepts referrals (via VA, Community Partner, or Veteran) throughout the day, evening to at least 7:00 p.m., Monday – Friday, with the exception of federal holidays, and weekends.

2.6 The Contractor shall rapidly house female Veterans requiring residential services and treatment at the VAGLAHS, addressing mental health, substance abuse and other psychosocial problems. Veterans must be ADL independent. Ultimately, the goal is for Veterans to actively search for and obtain permanent housing within 90 days under this CERS contract.

2.7 Liaison: A VAGLAHS HCHV Liaison/COR will be assigned to the Contractor who shall act as the clinical liaison between the Contractor and VAGLAHS.

2.7.1 The Contractor shall provide a private, nonshared office with adequate space for the VAGLAHS HCHV Liaison to meet with the Veterans.

2.7.2 VA HCHV Liaison will present to the program 3-5 days per week.

2.7.3 For Community location/site, the contractor shall provide parking for the HCHV

CRS Liaison(s).

2.8 The Contractor will not be required to provide detoxification or other hospital level treatment.

2.9 This emergency transitional housing will be used exclusively for single Female.

3. PERIOD OF PERFORMANCE. The period of performance for this contract will be for a Base year PLUS four (4) Option Years.

4. CONTRACT TYPE. Firm Fixed Price Indefinite Delivery/Indefinite Quality (IDIQ).

5. PLACE OF PERFORMANCE. The program location is crucial to ensure that Veterans can attend appointments scheduled in various VAGLAHS clinics or to local community providers and return to transitional housing with minimal barriers.

Space allotted for sleeping, eating, case management, and clinical services shall be within a 25 mile RADIUS of the WLA-VA campus; 11301 Wilshire Blvd LA, CA 90073.

Regardless of location, the Contractor will be required to attend frequent in person or virtual meetings with the WLA VA located at 11301 Wilshire Blvd., Los Angeles, CA 90073

6. GOVERNMENT FURNISHED PROPERTY. Government furnished property will not be provided to the Contractor. All equipment and furniture required by the Contractor to fulfill this contract will be provided at their expense.

7. CONTRACT AWARD MEETING. The Contractor shall not commence performance on the tasks in the awarded Statement of Work until the Contracting Officer or representative has conducted a kick-off meeting or has advised the Contractor that a kick-off meeting is waived.

Program should be fully operational within 30 days but not to exceed 90 days of kick off meeting or its waiver.

A list of authorized GLA Staff for the contract shall be provided to the Contractor upon award of the contract. GLA Staff may be added or deleted from the list during the term of the contract at the discretion of GLA HCHV CRS Section Chief or Supervisor. The Contractor shall be provided an updated list of authorized GLA Staff whenever such changes are made.

8. INSPECTION OF FACILITY AND PROGRAM: Prior to the award of a contract and annually during the contract term, a multidisciplinary GLA team consisting of a Clinical social work team, dietitian, a representative of the GLA Police, a Facilities Management Safety Officer, Nursing and/or other subject matter experts as determined necessary by the medical center director or HCHV Coordinator, shall conduct an inspection of the Contractor’s facilities to evaluate the Veteran’s food, shelter, safety, medication procedures and therapeutic services to assure the facility provides quality care in a safe and sober environment. Inspections may also be carried out at such other times as deemed necessary by the Department of Veterans Affairs.

Implementation of Timeline:

The contract facility and associated onsite services must pass an initial inspection completed by VA staff and become fully operational within 30 days but not to exceed 90 days from the date of contract award.

Contractor shall demonstrate successful completion of the following tasks, validated by VA inspection prior to receiving Veteran referrals and invoicing for payment:

Task Timeline Identify all staff required per the Statement of Work/Performance Work Statement and have them in place and available to provide the full range of case management and onsite services to Veterans.

Within 30 days but not to exceed 90 days of contract award or sooner

Identify a safe physical environment in a clinically appropriate setting for services to occur according to the SOW/PWS.

Within 30 days but not to exceed 90 days after the contract award

Must have all ex: twenty (20) beds fully operational and available for services to occur according to the SOW/PWS.

Within 30 days but not to exceed 90 days after the contract award

Contractors are obligated to participate and adhere to the HCHV inspection season. Contractors will address and resolve all deficiencies found during the inspections before the season is complete or during ad hoc visits over the term of the contract. Contracting will be notified if any vendor is not in compliance. For any deficiencies, a Corrective Action Plan (CAP) will also be expected and resolved in a timely fashion as instructed by the HCHV CRS Liaison inspecting team. Facility inspections will be conducted at least annually but may be inspected more frequently.

8.1. The Contractor will be advised of the findings of the inspection team. If deficiencies are noted during any inspection, the Contractor will be given a reasonable time (30 days) to take corrective action and provide evidence to the inspection team CAP is monitored by.

Additionally, the HCHV liaison will notify the Contracting Officer that the corrections have been made. For the initial inspection, a contract will not be able to admit Veterans until noted deficiencies have been eliminated.

Failure by the Contractor to take corrective action within a reasonable time (30 days) will be reported to the GLA Contracting Officer. If corrections are not made to the satisfaction of the GLA, the Contracting Officer will consult with the appropriate officials so that suitable arrangements can be made to discontinue plans to award a contract, or to discharge or transfer patients and to terminate the existing contract, as appropriate.

8.2. The inspection of the Contractor’s facilities will include inspection for conformity to the current Life Safety Code, and will also include the following:

8.2.1. General observation of residents to determine if they maintain an acceptable level of personal hygiene and grooming.

8.2.2. Assessment of whether the facility meets applicable fire, safety and sanitation standards.

8.2.3. Determining whether the facility is in attractive surroundings conducive to social interaction and the fullest development of the resident's rehabilitative potential.

8.2.4. Observation of facility operations to see if appropriate organized activity programs are available during waking hours (including evenings) and degree to which a high level of activity is observed in the facility, such as individual professional counseling, physical activities, promotion of health and personal hygiene.

8.2.5. Seeking evidence of facility-community interaction, 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.

8.2.6. Observation of staff behavior and interaction with residents to determine if they convey an attitude of genuine concern and caring.

8.2.7. Inspecting the types of meals and other nutrition provided to residents to see if appetizing, nutritionally adequate meals are provided in a setting, which encourages social interaction and if nutritious snacks between meals and bedtime are available for those requiring or desiring additional food, when it is not medically contraindicated.

8.2.8. Conducting random review of Veterans’ records to ensure accuracy with respect to Veterans’ length of stay and services provided to the Veterans.

8.3 All Department of Veterans Affairs reports of inspection of residential facilities furnishing, treatment and rehabilitation services to eligible Veterans shall, to the extent possible, be made available to all government agencies charged with the responsibility of licensing or otherwise regulating or inspecting such institutions.

8.4 All residential facilities must have an approved/passed initial inspection prior to Veteran admission to the awarded HCHV CRS program.

9. CONTRACT MONITORING. The COR or the VAGLAHS HCHV Liaison or their designee will monitor the Contractor's performance. Performance deficiencies or poor performance identified during the term of the contract will be addressed with the Contractor. If determined appropriate, the Contracting Officer, COR and/or other VA staff members shall meet with representatives of the Contractor to review performance and resolve issues; Corrective Action Plans may be required. See also Performance Measures section.

10. METHOD OF INSPECTION AND ACCEPTANCE. The Contracting Officer’s Representative (COR) will evaluate all deliverables submitted. The COR or their representative is responsible for certifying invoices for payment only for deliverables received and deemed acceptable by the COR. The COR will evaluate the performance of the contract through quarterly and annual performance reviews. Failure to comply with the SOW could potentially lead to negative performance evaluation findings which could lead to premature contract termination if not corrected through a CAP.

11. SERVICES TO BE PROVIDED

11.1. Residential Services: The Contractor shall provide housing and supportive services to female Veterans under this contract which is required to ensure the safety and privacy of these Veterans.

TASK 1: HOUSING AVAILABLE FOR RAPID PLACEMENT

The Contractor will be responsible for identifying sufficient residential capacity to safely support the placement of single female Veterans. This service will include:

11.1.1. Timeliness of Response-

HCHV CRS Consults: consult shall be opened by the liaison and responded to per the VA SOP.

Direct referrals: program staff, shall resolve direct contact immediately and return calls, if appropriate, within 2 hours, to the referral source. Any call received from the VA, between the hours of 8-330, shall be deferred to complete an HCHV CRS consult.

11.1.2. Veterans shall be offered same day admission.

11.1.3. Sufficient personnel to assure security, see Staff section.

11.1.4. Staffing available 24 hours a day, 7 days per week, including holidays and weekends.

11.1.5. The facility must allow Veteran to receive mail. The mail will be kept secure until pick-up for Veteran. (At times, Veterans will need to receive medications by mail and/or important documents- all which ensure successful transition to permanent housing). The Contractor must demonstrate practice to ensure Veterans access to mail including medications in a secure manner, see Medication section also.

11.2. Subsistence:

The Contractor shall provide all food and beverages for Veterans residing at the facility including three (3) meals per day and snacks. The Contractor shall maintain a clean and comfortable environment of care that includes subsistence meeting the following conditions:

11.2.1 Meals that meet the nutrition and dietary guidelines of the United States

Department of Agriculture found at: https://www.choosemyplate.gov/ .

11.2.2 Nutritious snacks between meals and at bedtime shall be available for those requiring or desiring additional food when it is not medically contradicted. All food shall be stored, handled and served in a safe and sanitary manner that meets accepted industry standards and guidelines.

11.2.3 Contractor shall also provide reasonable accommodations for fulfilling special dietary needs, such as kosher, diabetic, allergies, medically indicated, vegetarian (including vegetarian preferences). Contractor will ensure Veterans eating such an alternate diet are provided with complete nutrition.

11.2.4 The Contractor shall provide meals. The Contractor will be responsible to ensure food is stored as per requirements of Nutrition with regards to proper heating and refrigeration (warmer(s)/ice box or refrigeration units).

11.2.5 The Contractor shall provide tables and chairs, all eating utensils, cups, plates, bowls, and napkins. Contractor shall also provide trash receptacles and trash bags in the dining area and dispose of the trash after all meals .

12 Facilities Requirements.

12.1 A safe, secure, and readily available place for each Veteran to store belongings (e.g., a locking closet, a locking armoire, a wall or outside locker) chairs, tables, and locks if necessary.

12.2 Linens including sheets, pillowcases, towels, blankets, and pillows. The Contractor shall provide clean linens during a weekly linen exchange for all Veterans. Contractor shall have spare linens to replace linens requiring cleaning between regularly schedule cleaning days.

Routine linen cleaning shall not be conducted onsite.

12.3 Access to laundry facilities and supplies free of charge and adequate for residents to do their own laundry or to have laundry done at minimum one time per week. If providing on-site shared laundry: A laundry facility will include at least 1 washer and 1 dryer for every 10 Veterans provided on-site. Laundry service to include water, electricity, etc., shall be provided at no cost to authorized Veterans.

12.3.1 The Contractor will be fully responsible for the unit’s maintenance, upkeep, and care. The Contractor shall provide adequate amounts of laundry detergent. Hypo-allergenic detergent may be required for medical reasons as prescribed.

12.3.2 If equipment breaks down, the Contractor shall provide alternate weekly arrangements at community laundry facilities until in house services are operable.

Contractor will be required to provide transportation for any Veteran in need to and from.

12.4 The Contractor shall provide health and personal hygiene supplies for Veterans throughout their stay (i.e., dental products, hair products, soap and shave products, deodorant products, minor first aid products feminine products).

12.5 Contractor shall maintain a clean and comfortable environment of care that meets the conditions stated herein. Contractor shall bear all costs associated with ensuring compliance with these requirements. Contractor must ensure that it has sufficient operating funds to maintain the facility according to the requirements of this contract.

12.6 Room inspections, including methods and frequency.

12.6.1 Regular room checks shall occur with a strong focus on maintaining a safe environment that promotes the wellbeing of all residents. Increased room checks and safety planning for Veterans determined to be high-risk is required with supporting documentation.

13 SAFE ROOM:

13.1 The Contractor shall:

13.1.1 Have a “Safe Room” for Veterans who enter the program inebriated or exhibiting or engaging in behaviors requiring their separation from the general population.

Those Veterans shall be kept separate from the other Veterans to allow for sobering/quiet time until they have been cleared to return to the general population of the Contracted Residential Service Program.

13.1.2 Ask inebriated Veterans who enter the program to provide a UA or breathalyzer for documentation purposes. If the Veteran refuses to provide the UA, the Contractor shall not refuse services to the Veteran.

13.1.3 Determine if the Veteran is in need of immediate emergency services for medical attention. If medical attention is required, the Contractor shall call 911 and contact the COR/HCHV Liaison. If after hours, an email shall be sent for notification.

Program shall complete a VA Incident Report and forward to the HCHV CRS Liaison, see Critical Incident Report section.

13.1.4 Place the Veteran in the Safe Room if determined that the Veteran is not in need of immediate medical attention.

13.1.5 Monitor Veterans who are placed in the “Safe Room.” Veterans shall be physically checked every 30 minutes during the first 12 hours. Close observation and physical checks shall continue beyond the initial 12-hour period for as long as the Veteran appears inebriated. Documentation of physical checks should be maintained with a brief description of Contractors observations in the Veteran’s record. As needed, the Contractor shall conduct a re-assessment, urinalysis and/or breathalyzer to determine appropriateness of Veteran returning to the general population of the Contracted Residential Service Program.

13.1.6 Contact the local emergency response system then follow up with a phone call to the assigned COR/HCHV liaison in all cases relating to signs of withdrawal and/or acts of violence.

13.1.7 For admissions purposes, the safe room shall not be used as an assessment or bridge setting for same day admitted Veterans.

13.1.8 The safe room shall be furnished with the following:

13.1.8.1 One single bed per occupant.

13.1.8.2 Proper bedding, i.e., fitted sheets, blankets, pillows.

13.1.8.3 Immediate accessibility to restrooms facilities.

13.1.8.4 Immediate accessibility to staff in case of emergency.

14 Janitorial Services. The contractor shall manage daily cleanliness of the entire temporary housing facility, including bathroom, shower, dining facilities, sleeping areas, and all common areas. The Contractor shall also ensure the outside of the facility, at least 30 feet perimeter, is kept clean and free from debris. The Contractor shall provide daily trash removal from the trash receptacles inside and outside the facility. The Contractor shall empty trash receptacles when they are full regardless of when daily trash service is scheduled. The contractor shall provide cleaning supplies to accomplish daily cleanliness; the COR will inspect the facility for cleanliness and report deficiencies to the Contractor and VAGLAHS.

15 Transportation. The contractor shall provide transportation for Veterans to attend appointments at or off campus of the VA Medical Center (including local VA clinic or community providers) , and appointments for potential housing placements, benefits agencies, and meetings with landlords. The Contractor will be expected to help the Veteran access public transportation, including providing information and instructions necessary to enable Veterans to utilize public transportation. Transportation may include assistance in obtaining Metro-cards, bus fare, or local subsidized transportation services such as Access, Lyft, etc., however if not in place or until in place, the Contractor is responsible for providing transportation service. If GLA staff determines that adequate public transportation is not available or appropriate for a Veteran, the Contractor shall arrange for alternative transport by car or taxi at Contractor’s expense.

TASK 2: THERAPEUTIC AND REHABILITATIVE SERVICES:

16 Therapeutic and Rehabilitative Services: Each Veteran will have an Individualized Service

Plan (ISP) emphasizing goals established by the Veteran with input from the Contractor and GLA liaison (or Designee). Therapeutic and rehabilitative services will be stated in the plan of care.

Services which the Contractor must be able to furnish or provide the following:

16.1 Group Activities: Contractor will be responsible for planning and coordinating all activities associated with providing safe and appropriate residential care. This includes, but is not limited to, the elements described in the upcoming paragraph and any associated expenses shall be the Contractor’s responsibility. Groups shall be provided regardless of Veterans participation.

Structured group activities, as appropriate, shall occur at least FOUR 4- times per month

– examples include group therapy, life skills training, social skills training, financial workshops, Alcoholics Anonymous, Narcotics Anonymous, vocational counseling, and physical activities as appropriate.

Should a Veteran have mental health, medical, family and/or employment obligations which directly conflicts with this requirement, alternate group activities will be arranged and/or the Contractor will clearly document efforts made to accommodate the Veteran.

Contractor will coordinate provision of group activities with VA HCHV Liaison. Groups shall have sign in logs and brochures or other materials of what was discussed; these should be saved for liaison review.

Contractor shall facilitate a “House Meeting” once per month. For the purposes of this contract “House Meetings,” (or GLA Housing Resource Groups) may not be counted as a structured group activity as these should have a therapeutic value and facilitation shall be the responsibility of the Contractor. Also, the house meeting will be converted to a monthly newsletter/flyer to include what would have been the updates and information provided during the monthly House meetings to the Veterans in the event of a pandemic or social distancing is required and shall be distributed to the Veterans.

16.2 GLA Coordination: Collaboration and coordination with GLA program staff, as needed, will include coordination of supportive psychosocial services and housing. In particular, coordinated efforts must be made with the GLA Liaison around medical, mental health, admission and discharge needs.

16.3 Case Management: This will include structured individual case management, at minimum, weekly including counseling on self-care skills, adaptive coping skills, financial planning, permanent housing search, written care plan, referral for financial benefits. Additional counseling may include professional and vocational rehabilitation counseling in collaboration with GLA programs and community resources.

Discharge planning shall begin at time of admission and reviewed at least monthly.

A thorough written Individualized Service Plan (ISP) will also be developed within one week of admission for each Veteran placed in residential services and shall be updated every 30days thereafter to discharge.

ISPs are developed through a joint effort with the Veteran, the contracted provider, and the HCHV staff. ISPs must be developed for each Veteran by the Veteran in collaboration with and based upon input from HCHV program staff assessments, and other GLA clinical data. ISPs will reflect SMART goals.

In addition, special attention will be made to address High Suicide Risk (HSR) Veterans as identified by GLA Liaison, GLA Mental Health Staff, or contracted case manager.

16.3.1 On a weekly basis, the contracted case manager will be required to update the

GLA Liaison on Veteran progress and/or safety concerns for HSR Veterans.

16.3.2 Contracted case manager will review the HSR Safety Plans with the Veteran on a bi-weekly basis. HSR Safety plan reviews and a copy of the Veteran’s Safety Plan will be documented in the chart.

16.4 All Veterans will be referred to GLA for Primary Care and Mental Health appointments and Contractors will support Veterans in making initial and subsequent appointments.

Efforts will be documented in the Veteran’s program records and reviewed by the GLA Liaison at least monthly. If the Veteran refuses such referral, the Contractor shall assist the Veteran with appropriate community-based services and documentation efforts and appointments within the Veteran’s Client Record.

16.4.1 All Contractors will provide proper documentation verifying services and case management efforts by all team members including, but not limited to housing, benefit and employment specialists, and program management staff.

16.4.1.1 There will be an expectation that notes are written professionally in a format that utilizes the clear settings of goals and documents progress towards those goals.

16.5 The Contractor shall provide treatment and discharge planning reflecting a team assessment of health, social and vocational needs and the involvement of the Veteran, the VA staff and appropriate community resources in resolving problems and setting goals.

16.6 Case Conference: The Contractor is expected to provide HCHV staff with regular reports on changes in Veteran’s status, including all changes and observations concerning the Veteran’s needs, monthly or as needed basis.

16.7 Permanent Housing Search: Programs are required to provide Veterans with direct and ongoing assistance in achieving permanent housing. Permanent Housing is a primary goal of the HCHV CRS contracts, therefore plans for Veterans’ transition to permanent housing placements must be clearly reflected in each ISP and in weekly case management notes.

16.7.1 As part of this plan, Veterans’ housing history and needs must be assessed through a formal and thorough Housing Assessment completed within 3 business days of program admission. Housing Assessments must identify Veterans’ housing history, strengths (i.e. positive prior rental history), and barriers (i.e. Unlawful Detainers).

16.7.2 Should Veteran refuse to engage with program staff regarding plans for permanent housing transition, motivational interviewing and other therapeutic techniques will be used to address Veteran’s ambivalence.

16.7.3 All efforts to engage Veteran regarding housing plans, options, and resources shall be clearly documented and include any therapeutic techniques utilized. Contractor staff must provide direct assistance to Veterans in developing permanent housing plans and accessing appropriate housing resources. It is expected that as part of their housing plan, Veterans will be co-enrolled in either HUD-VA Supported

Housing (HUD-VASH) or Supported Services for Veteran Families (SSVF)/Rapid Rehousing services.

16.7.3.1 These services shall be provided weekly through one-to-one case management. Examples of expected housing services include:

1) assistance obtaining and reviewing Veteran’s free credit report, identifying housing strengths and/or barriers associated with current credit status.

2) Creating a Tenant Portfolio with Veteran that contains all relevant documents required in the rental process, including a completed sample rental application for Veteran, income verification documents, identification, applicable subsidies, etc.

3) Reviewing affordable housing rental options and Permanent Supportive Housing (PSH) program offerings and assisting Veterans with making appropriate rental inquiries and submitting completed rental applications.

4) Conducting regular and individualized housing advocacy efforts, including transportation, assistance scheduling, meeting, and communicating with property managers and landlords, and engage in troubleshooting where rental barriers or denials occur in the housing search process and

5) exploring housing options in all areas including low-rent areas.

16.7.4 All housing efforts by Contractor shall be documented clearly and presented to

GLA Liaison upon request.

16.7.5 Mere communication with Veterans regarding housing, without subsequent

Contractor staff action and follow-up, shall not on its own meet the above requirements.

16.8 Financial Planning: Referral to and follow up on all potential financial resources the

Veteran may be eligible for (e.g., SSI, SSDI, Food Stamps, NSC pension, GA, etc.).

16.8.1 Case Managers will document all structured activities that support Veteran in developing a short- and long-term plan to understand and address their current financial situation and how to improve it. Financial planning efforts may be accomplished in group but preferably through one-on-one case management services.

16.8.1.1 At minimum four financial planning activities appropriate to the

Veterans individual circumstance must be documented monthly.

16.8.1.2 Veterans with no income, shall be referred to DPSS for GR and food stamps immediately but no less than 2 weeks of admission.

16.8.1.3 Veterans with no income or limited income or by preference, CM shall explore their interest in increasing their income through employment, or benefits claims (SSI/SSDI and/or SC/NSC).

16.8.1.3.1 If a Veteran is ineligible for employment, the CM shall initiate a claim for benefits with the Veteran immediately but no less than 30 days from their admission.

16.9 Employment Services: Referral to all relevant employment opportunities the Veteran is eligible for and interested in, Case managers will document all structured activities that support Veteran in applying for employment as appropriate based on needs of Veteran as identified in the assessment.

16.10 Recovery: Support for an alcohol/drug abuse-free lifestyle provided in an environment conducive to social interaction and the fullest development of the resident’s rehabilitative potential. Assistance to gain and to apply knowledge of the recovery process in an environment supportive of recovery models including a focus on Harm Reduction rather than strict abstinence and supportive of a Housing First approach. Pursuant to these principles, drug testing may not be used to discharge or discipline a Veteran but may be used as a clinical intervention to modify behavior.

16.11 Critical Incidents: The Contractor shall notify the authorizing GLA facility immediately of any incidents involving Veterans residing in the Contract Residential Services program.

16.11.1 The Contractor shall notify the authorizing GLA facility immediately but no later than within 24 business hours when a medical emergency occurs that requires hospitalization of an admitted Veteran. It is agreed the Veteran will be admitted to the appropriate GLA facility. When such admission is not feasible because of the nature of the emergency, it is agreed that hospitalization in a non-federal facility is acceptable. If hospitalization of a non-emergent nature is required, it is agreed that admission to the appropriate GLA facility will be accomplished promptly. The Contractor will make arrangements for admission and support the Veteran with any transportation issues that may arise.

16.11.1.1 The Contractor shall notify the VA HCHV Liaison by telephone during the hours of 8:00am and 4:30pm. For all incidents that occur after normal business hours, the Contractor should notify the liaison(s) the following business day. The Contractor shall provide the GLA liaison(s) and the COR with a copy of the incident report within 24 business hours or next business day.

16.11.2 Critical Incident & Incident Reporting- All incidents will be reported within 24 business hours. The Contractor shall complete the incident form and forward, in an encrypted email, to the assigned liaison or their designee. The form should have details as to what occurred and what were the interventions.

Reportable incidences can include the following:

16.11.2.1 Falls

16.11.2.2 Assault (to Veteran or Staff)/Fights

16.11.2.3 Elderly/Dependent Adult Abuse or Neglect

16.11.2.4 Sexual Assault

16.11.2.5 Fire (Veteran Involved)

16.11.2.6 Medical/Psychiatric Emergency (911 Calls)

16.11.2.7 Hospitalization

16.11.2.8 Suicide or Suicide Attempt

16.11.2.9 Homicide

16.11.2.10 Death

16.11.2.11 Infectious Control (TB, etc.)

16.11.3 Death- In the event a Veteran residing in the HCHV program under this contract dies, the Contractor will promptly notify the VA Liaison authorizing admission and immediately assemble, inventory, and safeguard the Veteran’s personal effects. The funds, deposits, and effects left by Veterans upon the premises of the facility shall be delivered by the director or manager of the facility to the person or persons entitled thereto under the laws currently governing the facility for making disposition of funds and effects left by Veterans unless the beneficiary died without leaving a will, heirs, or next of kin capable of inheriting.

When disposition has been made, the itemized inventory with a notation as to the disposition has been made, they will be immediately forwarded to the VA Liaison.

Property and funds wherever located vests in and becomes property of the United States in trust. In these cases, the facility will forward an inventory of any such property and funds in its possession to the appropriate VA office and will hold them (except articles of clothing necessary for proper burial) under safeguard until instructions are received from the VA concerning disposition.

16.11.4The Contractor shall maintain a copy of any incident report in the Veteran’s case record. Please see above in reporting for details regarding what constitutes a Critical Incident or Incident.

16.12 Medication Management: Medications that a Veteran brings into the facility or is prescribed while in the care of the Contractor shall be managed in accordance with the following:

16.12.1 Medications and narcotics shall be properly stored, controlled, issued, and recorded in compliance with physician’s orders. Contractor shall establish procedures for insuring Veterans confidentiality in the storage of and keeping of records concerning medication. Medications that a Veteran brings into the facility or is prescribed while in the care of the Contractor shall be managed in accordance with the following:

16.12.1.1 All medications shall be surrendered to the program (for storage and maintenance, unless clinically indicated to be) carried on the Veteran’s person. All controlled substances shall be surrendered/stored by the program.

16.12.1.2 Medications including but not limited to controlled substances shall be properly stored and controlled in a double locked storage unit, unless clinically indicated to be carried on the Veteran’s person.

16.12.1.3 Contractor shall provide a centralized area to store medications and maintain logs for all received medications stored by the program on behalf of Veterans.

16.12.1.4 Contractor shall have a written policy regarding the use of prescribed medications by program’s Veterans. Such policy shall not preclude the illicit use of prescribed medications.

16.12.1.5 All medication will be self-administered by the Veteran and monitored by program staff during posted hours and as prescribed by physician’s orders. Veteran will initial the Contractor’s medications log upon self-administering medication to verify the count of medication.

16.12.1.6 Contractor shall include in their policy, measures taken for Veterans who are prescribed medication(s) but will be gone during posted hours.

16.12.1.7 Contractor shall maintain copies of any medical prescriptions issued by VA physicians or VA providers licensed to prescribe medications or community providers, including orders, if any, for medications to be taken.

TASK 3: DELIVERY OF SUPPORT SERVICES

17. Referrals, Admissions and Eligibility: Contractor must utilize an admission process that includes written eligibility criteria that is fair, objective, and compliant with applicable State and Federal laws.

Contractor will provide verbal and written notification that is readily accessible to all individuals, upon request, of reasons for non-acceptance. Notification of reasons for non-acceptance is not required to be given to those denied service/housing because of bed unavailability. The eligibility information must be made available to clients at intake and staff must provide answers to questions about the admission criteria and process.

17.1 The VA is responsible for determining eligibility and admission of Veterans during the work week, however contracted staff shall perform SQUARES to determine eligibility for all direct referrals. For direct and community referrals, the program is responsible for printing the SQUARES search result and storing it in the Veteran’s chart if deemed eligible for admission. Release of Information (ROIs) can be verbal and can be completed once the Veteran presents to the program if admitted. TB test can be addressed post admission, if not ordered prior.

Any admissions that occur without eligibility approval, i.e., after hours or weekends must be verified by GLA Staff within 24 business hours or the next business day in order for the Contractor to receive payment for time spent prior to approval (e.g., admission after hours or during the weekend).

17.2 Admissions Process: During the admissions process, GLA CERS program staff will determine eligibility and appropriateness for placement into this HCHV housing program during appropriate hours. Contractor staff will be notified of an accepted Veteran and notification of their arrival.

However, all Contractor staff shall register with SQUARES to determine eligibility for any direct and community referrals. If the Contractor subsequently determines the Veteran is not suitable for the available level of care offered in the transitional housing environment, the Contractor will notify the referring staff to continue their placement search for the referred Veteran immediately but no less than within 2 hours. The

Contractor shall make every effort to minimize access barriers into the program; flags or multiple program admissions/discharges shall not be reasons to not consider Veteran placement acceptance.

17.3 Denial of Services: If a bed is available, Veterans cannot be denied entry by the Contractor if the Veteran has been approved and deemed eligible by HCHV CRS liaison staff, unless the veteran requires care above and beyond the scope of program practice.

17.3.1 Veterans cannot be denied entry into this contract transitional housing program for flag concerns or multiple admission/discharges to THP.

17.3.2 Acceptance of treatment cannot be a condition of admission or continued stay.

17.4 Placement considerations. Infractions of rules should be used as opportunities for engagement.

17.4.1 Contractor shall train their staff in providing flexible, respectful responses to infractions of rules.

17.4.2 Assertive engagement by the staff with Veterans regarding these problems is the preferred course of action to deal with the common problems of the Safe Haven model/facility.

17.4.3 Suspected or known drug or alcohol use or relapse by one or more residents should be addressed with interventions based on the Safe Haven model.

17.5 On-site contraband, weapons, drug, or alcohol related paraphernalia (i.e.: found alcohol, drugs, drug “works,” etc.) should be confiscated and addressed with interventions based on the Safe Haven model, which shall include either reporting to the VAPD for discarding procedures (such as bottles/drugs and paraphernalia) or storing (i.e.: items that could be used as a weapon such as a screwdriver) in a locked/safe place where Veterans can retrieve it upon their discharge. Veteran’s may store contraband in the community.

17.6 Admission Denials tracker: For all placement denials from direct and community referrals, the program shall forward a denial tracker spreadsheet to the HCHV supervisor weekly, Monday by 9am. It shall include Veteran’s Name, last four, date of referral, time of referral, date of admission, date of denial, reason for denial (veteran denied placement, unable to contract veteran, program denied), if program denied specify reason. If for higher level of care, this should be explained/described, see reference section.

17.7 The Contractor will maintain and securely share with the HCHV Liaison or designee, a daily census by 9am and provide any required discharge forms within 24 hours.

17.8 The Contractor shall forward the daily bed count by 9am to the GLA designed staff.

17.8.1 The program, when forwarding the daily bed count will add accurate admission count and pending status numbers to ensure all parties are aware of open beds for referrals when forwarding the above information.

PROGRAM INFORMATION

BEDS AVAILABLE AS OF:

today’s date

NOTES

PROGRAM NAME: ADD

PROGRAM CODE: ADD

BEDS STATUS:

TOTAL Max Capacity: total awarded beds

TOTAL Occupied: total current admitted veterans

Pending Admissions: number of veterans approved for placement, but have not presented for admission.

Enter gender served and indicate whether Single or Family:

male/female single/family

CAPACITY FOR SAME-DAY ADMISSION: (capacity – (total occupied+ pending)) indicate number here Screenings: # 0 Discharges: # 0

Provide any specifics and details for the program.

17.9 Extensions: It is understood the Contractor will not be paid for care provided to an admitted Veteran beyond the period authorized in the admission unless an extension of the authorization is provided in writing to the HCHV CRS Liaison, and the extension is approved.

17.9.1 If a Veteran’s stay goes beyond the initial 90 days, any extension must be authorized by the HCHV liaison, The Contractor shall work with Veterans to find permanent housing suitable for the Veteran within 90 days from the date of admission. Contractors may not bill for per diem for Veterans whose length of stay exceeds 90 days from the date of admission without prior approval from the VAGLAHS HCHV Liaison and provided there is clear clinical indication and availability of funds. Only extraordinary circumstances will be considered in order to extend services.

17.9.2 The VAGLAHS HCHV Liaison will not approve per diem for lengths of stay beyond 90 days from the date of admission unless:

17.9.2.1 There are extenuating clinical circumstances beyond the Contractor’s control that are barriers to the Veteran’s placement in housing.

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