DRAFT PERFORMANCE WORK STATEMENT VACIHCS.pdf

SCHEDULE OF SERVICES

It is VHA policy that VA medical facilities establish contracts with community-based organizations that provide residential rehabilitative and therapeutic services to eligible Veterans who are experiencing episodes of homelessness. The Department of Veterans Affairs (VA) Central Iowa Health Care System (VA-CIHCS) located in Des Moines, Iowa has a need for contractors to provide emergency/ transitional residential housing services as part of its community based Health Care for Homeless Veterans (HCHV) program within Polk County, located in central Iowa. The goal of the HCHV program is to remove homeless Veterans from the street or habitation unfit for Veterans and place them in community-based, residential environments with sufficient therapeutic services to meet the needs of those Veterans. The Department of Veterans Affairs (VA) Central Iowa Health Care System (VA-CIHCS) will prioritize the locations and services of the HCHV CERS programs to complement any deficit in available programs or services within VA-CIHCS catchment area.. The Contractor shall furnish all personnel and resources to provide community based transitional residential beds to eligible beneficiaries of the VA-CIHCS Health Care for Homeless Veterans (HCHV) program. The services shall be provided for both female and male Veterans.

Contract Emergency Residential Services (CERS) programs target and prioritize homeless Veterans who require safe and stable living arrangements while they seek permanent housing. This includes Veterans transitioning from literal street homelessness, Veterans being discharged from institutions who are homeless, including those in need of short-term medical respite or recuperative care, and Veterans who recently became homeless. CERS programs, either directly or through linkages with community and other VA services, provide time-limited services such as supporting mental health stabilization, SUD treatment services, enhancement of independent living skills, vocational training and employment services. Emphasis is placed on referral and placement in permanent housing or longer-term residential programs utilizing VA and community resources. Lengths of stay in CERS typically range from 30 to 90 days with the option for the VA to extend time based on clinical need. {Veterans who are homeless and eligible for VA health care may be eligible for CERS program.}

Through the HCHV program, VA provides case management services to Veterans and facilitates their access to a broad range of medical, mental health, and rehabilitative services. The purpose of this solicitation is to obtain proposals from contractors that can provide the services to Veterans as required by this Performance Work Statement (PWS). The contractor shall be required to provide therapeutic and rehabilitative services, but will not be required to provide detoxification or other medical or hospital treatment as those services will be provided by the VA at VA/ VA approved facilities.

Place of Performance: Services shall be provided at the vendor transitional residential housing site located within Polk County, Iowa with nearby access to the city DART bus line and/or other transportation services provided or coordinated by the contractor.

• CLIN 0001, 1001, 2001, 3001, 4001 (Emergency/ Transitional Residential Housing Services):

Emergency/ Transitional Residential Housing Services for eligible Veterans in support of the VA- CIHCS HCHV program. Services are provided on demand by referral, with same day access to placement. Referrals may be made at any time 24 hours a day, 7 days a week, 365 days a year (to include Holidays). The service is provided on a bed cost per day basis (this cost includes services described in para: 2). It is estimated the demand for services will be up to 5 beds per day, 140-155 beds per month, 1825 beds per year.

Period of Performance: Base Period/ Year: 01 January, 2026 to 31 December, 2026

DRAFT

-Performance Work Statement for Emergency/ Transitional Residential Housing Services

1. GENERAL:

1.1. Services Provided: The Contractor shall provide emergency/ transitional residential housing services in support of the VA community based Health Care for Homeless Veterans (HCHV) program within Polk County, located in central Iowa.

1.2. Place of Performance: Services shall be provided at the vendor transitional residential housing site located within the city limits of Des Moines, Iowa.

1.3. Authority: The HCHV Program is authorized by 38 U.S.C. 2031 and 38 CFR Part 63

1.4. Policy/Handbooks: the contractor shall be subject to the following policies, including any subsequent updates during the period of performance:

1.4.1. VHA Directive 1162.04 Health Care for Homeless Veterans Contract Residential Services Program

1.4.2. VHA Directive 1162.09 Health Care for Homeless Veterans (HCHV) Program (also adapted from VHA Directive 1501 VHA Homeless Programs)

1.4.3. VHA Directive 1663 Health Care Resources Contracting – Buying, Title 38 U.S.C. 8153

1.4.4. VHA Handbook 1907.01 Health Information Management and Health Records, as amended

1.4.5. Privacy Act of 1974 (5 U.S.C. 552a) – as amended

1.4.6. VHA Publications - The HCHV CRS Inspection Packet (VA Form 10-10115a), as amended

1.4.7. McKinney-Vento Homeless Assistance Act

1.4.8. VHA Directive 1192 Seasonal Influenza Prevention Program

1.5. Definitions/Acronyms- Terms used in this contract shall be interpreted as follows unless the context expressly requires a different construction and/or interpretation. In case of a conflict in language between the Definitions and other sections of this contract, the language in this section shall govern.

1.5.1. BLS: Basic Life Support

1.5.2. Case Management: Arranging, coordinating, or providing direct clinical services and support; referring and providing linkages to VA and non-VA resources, providing crisis management services and monitoring; and intervening and advocating on behalf of Veterans to support transportation, credit, legal, and other needs.

1.5.3. CDC: Centers for Disease Control and Prevention

1.5.4. CDR: Contract Discrepency Report

1.5.5. CERS/ CRS: Contract Emergency Residential Services/ Contracted Residential Services

1.5.6. CMS: Centers for Medicare and Medicaid Services

1.5.7. Contracting Officer (CO) – The person executing this contract on behalf of the Government with the authority to enter into and administer contracts and make related determinations and findings.

1.5.8. Contracting Officer’s Representative (COR) – A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken.

1.5.9. COS: Chief of Staff

1.5.10. CPARS: Contractor Performance Assessment Reporting System

1.5.11. EHR: Electronic Health Record - electronic health record system used by the VA.

1.5.12. HCHV: Homeless Health Care for Veterans

1.5.13. HHS: Department of Health and Human Services

1.5.14. HIPAA: Health Insurance Portability and Accountability Act

1.5.15. HMIS: Homeless Management information System. A database used to confidentially aggregate data on homeless populations in the United States.

1.5.16. HOMES: Homeless Operations Management and Evaluation System (internal VA system for collecting intake, progress, and outcome information for homeless Veterans)

1.5.17. Homeless: The HCHV Program follows the definition of “homeless” in 38 U.S.C. 2002(1) and section 103(a) of the McKinney-Vento Homeless Assistance Act, 42 U.S.C. 11302(a). NOTE: The term “homeless" or "homeless individual" does not include any individual imprisoned or otherwise detained pursuant to an Act of Congress or a state law.

1.5.18. ISO: Information Security Officer

1.5.19. IVH: Iowa Veterans Home, state run facility located in Marshalltown, Iowa

1.5.20. Medical Emergency - a sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably result in:

Permanently placing a patient's health in jeopardy, causing other serious medical consequences, Causing impairments to body functions, or Causing serious or permanent dysfunction of any body-organ or part.

1.5.21. NCO 23: Network Contract Office 23, supports contract requirements for VA-CIHCS.

1.5.22. POP: Period of Performance

1.5.23. PWS: Performance Work Statement

1.5.24. QA/QI: Quality Assurance/Quality Improvement

1.5.25. QM/PI: Quality Management/Performance Improvement

1.5.26. QASP: Quality Assurance Surveillance Plan

1.5.27. VA-CIHCS: Veterans Affairs-Central Iowa Health Care System

1.5.28. Veterans Health Administration (VHA): The central office for administration of the VA medical centers through throughout the United States. The VHA is located in Washington, D.C.

1.5.29. Veterans Integrated Services Network (VISN) : The regional oversight for the VA medical centers.

The Des Moines VA (VA-CIHCS) falls under VISN 23 out of Minneapolis, MN.

1.5.30. VSO: Veteran Service Organization

2. SERVICES PROVIDED BY THE CONTRACTOR:

2.1. Basic Services The contractor shall furnish each Veteran referred for care by VA under this contract with the following basic services. All services provided by the contractor shall be included at the unit price.

2.1.1. Housing – Housing Available for Rapid Placement. The contractor shall be responsible for identifying sufficient residential capacity to place Veterans in community-based residences with the ability to place a Veteran on the same day of a referral from VA. Identification of suitable residential placement requires sufficient contractor personnel to assure Veterans’ security and staffing available on-site twenty-four hours a day, seven days per week, with Veterans admitted to CERS program having onsite accessibility 24 hours per day, 7 days per week.

2.1.2. Room and Board - Room and board shall include a bed and other furnishings such as a dresser, storage, designated secured space, and personal linens (towels and bed sheets). The contractor is responsible for providing a sanitary food preparation area, supply food sufficient for at least 3 nutritious meals daily for 7 days per week, and snacks of nourishing quality (examples include fruits, vegetables, protein sources), between meals and at bedtime. This is to include alternative meals or food supplies for Veterans with dietary restrictions if medically indicated and reasonable accommodation for Veterans with cultural/religious preferences around food.

2.1.3. Laundry Facilities – Laundry facilities for residents to do their own laundry or to have laundry done for them.

2.2. Therapeutic and Rehabilitative Services - The Contractor shall provide therapeutic and rehabilitative services for each Veteran referred for emergency/ transitional residential services in order to address housing needs based on the care plan developed by the contractor, the Veteran and the VA Homeless Program Coordinator/ CERS Liaison/designee and documented in Veteran’s case record. Services which the contractor must be able to furnish shall include:

2.2.1. Collaboration - Collaboration with the VA program staff that will provide supportive psychosocial services.

2.2.2. Supportive Services - Staff will provide supportive services such as short term motivational or encouragement sessions or problem solving talks to help Veterans adjust to the setting and be motivated to continue with treatment goals.

2.2.3. Case Management - Individual case management services to monitor Veterans progress towards individual Care plan goals and discharge plan. Case management involves arranging, coordinating, or providing directl clinic services and support; referring and providing linkage to the VA and non-VA resources, providing case management services and monitoring; and intervening and advocating on behalf of Veterans to support transportation, credit, legal, and other needs.

Case manager will provide brief counseling on self-care skills, adaptive coping skills in collaboration with VA programs and community resources. Case manager will assist Veteran to overcome obstacles that impede their progress towards their identified goals.

2.2.4. Life Skills - Assistance to develop responsible living patterns, to maintain an acceptable level of personal hygiene and grooming, and to achieve a more adaptive level of psychosocial functioning, upgraded social skills, and improved personal relationships.

2.2.5. Support Substance Free Living Environment - Support for an alcohol and/or drug abuse-free lifestyle provided in an environment conducive to social interaction and the fullest development of the resident’s rehabilitative potential.

2.2.6. Resources for Mental Health and Substance Use Disorder Issues - Assistance to gain and to apply knowledge of the illness and recovery process in an environment supportive of recovery models.

2.2.7. Community Interaction - A program that promotes community interaction.

2.3. Care and Discharge Planning - The contractor shall develop treatment care plan with the Veteran and provide care planning coordination and discharge planning that addresses the Veteran’s needs, which may include health, social, vocational, and housing needs. Contractor will insure the involvement of the Veteran, VA staff, and appropriate community resources for resolving problems and setting goals.

2.4. Case Record - An individual case record will be created for each referred Veteran. Case records shall be maintained in security and confidence as required by the Confidentiality of Alcohol and Drug Abuse Patient Records (42 CFR Part 2) and the Confidentiality of Certain Medical Records (38 USC 7332). Case records and data normally maintained and included in a medical record as a function of compliance with state or community licensing standards will be made available on a need to know basis to appropriate VA staff members involved with the treatment program of the Veterans concerned.

2.5. Confidentiality - The contractor shall comply with applicable requirements of the Confidentiality of Alcohol and Drug Abuse Patient Records (42 CFR Part 2) and the Confidentiality of Certain Medical Records (38 USC 7332).

2.6. Transportation - The contractor shall assist the Veterans with local transportation to scheduled meetings and appointments. 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.

3. REFERRALS/ ABSENCES AND CANCELLATIONS:

3.1. Referrals

3.1.1. VA is responsible for determining eligibility of Veterans referred for the HCHV – CERS program. .

A written referral (hard copy, fax, or e-mail are acceptable) signed by an authorized VA ordering officer shall be provided to the contractor for each Veteran referred for services under the contract.

Efforts will be made by VA to verify eligibility within one business day of CERS admission and contractor will be informed of VA approval of Veteran’s admission to CERS program. In the event a Veteran is admitted to HCHV CERS program and is subsequently found ineligible for the program, immediate alternative placement will need to be made. (See also, Section 3.2 regarding payments.)

3.1.2. A list of authorized VA ordering officials for the contract shall be provided to the contractor upon award of the contract. Ordering officials may be added or deleted from the list during the term of the contract at the discretion of VA Contracting Officer. The contractor shall be provided an updated list of authorized VA ordering officials whenever such changes are made.

3.1.3. Referrals can be made to the contractor 24/7 by authorized VA Personnel/ Ordering officials.

3.1.4. It is understood that the contractor will not be paid for care provided to a referred Veteran beyond the period authorized in the referral, unless an extension of the authorization is provided in writing by VA.

3.1.5. The initial referral period for a Veteran may be up to ninety (90) days, depending upon the needs of the Veteran as mutually determined by the Veteran, the contractor’s staff, and VA Homeless Program Coordinator/CERS Liaison or VA designee. An extension of the referral period up to a total of six months may be authorized by the VA Homeless Program Coordinator/CERS Liaison or VA designee, provided that funding is available. Treatment periods in excess of six months for individual Veterans must be authorized by the VA Director, Homeless Program Coordinator, CERS Liaison or VA designee.

3.2. Absences and Cancellation Protocols and Payments

3.2.1. Unscheduled Absences: The contractor shall notify the VA immediately upon awareness of an unauthorized absence by a CERS admitted Veteran from the facility. Should a Veteran absent himself or herself from the contractor’s facility in an unauthorized manner, payment for services for that Veteran shall be continued for a maximum period of two days, provided there is an active outreach attempt on the part of the contractor’s staff to locate and re-engage the Veteran to return the Veteran to the facility and there is a reasonable belief that the Veteran will return. These engagement attempts must be documented in the Veteran individual case file/treatment record.

Absences of the Veteran from the facility in excess of two days will not be reimbursable unless authorized in advance by the VA Homeless Program Coordinator/ CERS Liaison or VA COR/CO.

3.2.2. Scheduled Absences: To receive payment, the absence must be pre-planned, consistent with and support the Veteran’s individual service plan (for example, family reunification, short-term medical, substance use disorder/SUD or psychiatric treatment.)

3.2.2.1. The reason for the absence must be documented in the individual Veteran’s case file/treatment record.

3.2.2.2. The absence must not result in the bed being filled by the contractor

3.2.2.3. The absence must not be for a break or vacation from treatment

3.2.2.4. The absence must not be used for extended education or employment circumstances

3.2.2.5. The absence must not be used to create more than 4 consecutive days of absence and must be approved by the Homeless Program Coordinator/CERS Liaison or VA COR/CO or VA Designee.

3.2.3. Inpatient Hospitalization: The per diem rate may be paid to the contractor for a Veteran in the CERS program for a period of up to 7 days while a CERS Veteran is hospitalized as an inpatient for medical or psychiatric treatment if approved by the VA CERS Liaison, Homeless Program Coordinator, COR/CO, or VA Designee. The provider shall not fill the bed during this time and shall maintain communication with the CERS Liaison/Homeless Program Coordinator/VA Designee and the Veteran if authorized. Final determination of approved absences and extensions are made by the VA.

3.2.4. Ineligible Veterans. When a Veteran is admitted to a HCHV CERS program and found to be ineligible for HCHV CERS, VA shall pay for a maximum of 4 days from the day of admission to allow the contractor and HCHV CERS Liaison time to locate and arrange alternate placement.

3.2.5. VA reserves the right to remove any or all Veterans from the facility at any time, without additional cost, when it is determined to be in the best interest of the VA or the Veteran.

3.2.6. The contractor shall notify the authorizing VA facility immediately when a medical emergency occurs that requires hospitalization of a referred Veteran. It is agreed that the Veteran will be admitted to the appropriate VA facility. When such admission is not feasible because of the nature of the emergency, it is agreed that hospitalization in a non-federal hospital may be accomplished provided that VA authorization is obtained. If hospitalization of a non-emergency nature is required, it is agreed that admission to the appropriate VA/ VA approved facility will be accomplished promptly.

3.2.7. Contractor will notify the VA through VA Liaison or Liaison’s Designee or Administrator on Duty (AOD) of any negative critical incident occurring with a Veteran residing in the residential program, as soon as possible, but not later than 24 hours of being informed or made aware of the incident.

Contractor will complete written incident report within 48 hours of notification of the incident and submit report to the VA Liaison/COR. Incidents include but are not limited to: death; fire;

drug/police raid; suicide/suicide attempt; 911 call (police/fire department/paramedics/other);

severe medical illness/emergency; severe psychiatric illness/emergency; sexual assault; act of violence by Veteran against other(s); abusive behavior by Veteran against staff; act of violence by other(s) against Veteran; abusive behavior by staff against Veteran; accident; medication problems or adverse drug reactions, or other untoward events. The contractor shall maintain a copy of the incident report in the Veteran’s case record.

3.3. Hours of Operation

3.3.1. The contractor will provide residential housing services 24/7 to referred eligible Veterans.

Referrals can be made 24/7 by VA Personnel/ Ordering Officials per paragraph 2.1.1. and 3.1.

4. VETERANS RIGHTS/ SAFETY/ ENVIRONMENT OF CARE:

4.1. Veteran Rights

4.1.1. Care provided shall respect and integrate the Veteran’s beliefs, values, and cultural influences.

4.1.2. Protection of Veteran rights is of highest priority. The contractor shall not require or force any

Veteran to attend any program that the Veteran does not agree to attend, but may offer a program or class that the Veteran may choose to attend.

4.1.3. Veteran privacy and confidentiality shall be maintained at all times.

4.1.4. Veteran complaints which cannot be resolved by the contractor shall be referred to the VA Patient Advocate. The COR will provide the VA Patient Advocate’s contact information to the Veteran and/or the contractor who shall provide that information to Veterans.

4.2. Veteran Safety

4.2.1. Facilities shall meet the Life and Safety code standards of the National Fire Protection (NFPA). If the contracted facility does not meet safety standards, the Veterans shall be removed and housed elsewhere at the cost of the contractor until the facility meets the safety standards. Code is found at www.nfpa.org.

4.2.2. The contracted facility shall meet the Iowa Public Health Standards (http://www.idph.state.ia.us/mphi/standards.asp), quality management safety standards held by NFPA 101-2012 relating to Existing Hotel Dormitories Facilities (Chapter 29) and New Hotel Dormitories Facilities (Chapter 28). Code is found at www.nfpa.org.

4.2.3. The contractor shall inform VA of any safety citations received. The contractor shall inform the VA COR in writing within three business days after the citation is received and a corrective action plan developed in writing and submitted with the notice. The contractor has thirty calendar days to remediate the concerns. If that is not possible the contractor shall notify the VA COR in writing with anticipated date of remediation of citation issues.

4.2.4. Veteran safety shall be a primary focus of the contractor.

4.2.5. The contractor shall post emergency and disaster plans with written protocols to guide staff response to crises including, but not limited to, manmade and natural disasters, episodes of infectious diseases, physical injury, program participants suicide or suicide attempts, overdoses, and assaults and other violent acts. Contractor staff shall be trained on emergency procedures and protocols.

4.2.6. The contractor shall notify the VA of any critical incidents of Veteran death, accident, injury, infection or adverse drug reaction related to indicated medications, supplies, or equipment as soon as possible, but not later than 24 hours of being informed or made aware of the incident.

4.2.7. Every effort shall be made by the contractor to prevent medication errors, falls, and Veteran injury.

4.2.8. The VA shall determine when a Root Cause Analysis (RCA) is required of the contractor.

4.2.9. The contractor shall conduct all RCAs according to VAHCS policy, and within established timeframes. Root Cause Analysis processes will be defined and provided by the COR at the time a RCA is needed and the contractor shall follow the VA timeframes given.

4.2.10. Completed RCAs shall be provided to the VA CO and COR. Timeframes for completion will be supplied by the VA COR at the time the RCA is identified based on the issue identified in the RCA.

4.3. Environment of Care

4.3.1. The contractor shall maintain a safe and clean environment in the facility at all times.

4.3.2. All significant problems related to VA Veteran care shall be reported verbally and in writing to the

VA COR within one business day.

4.3.3. Environmental safety shall be the responsibility of the contractor, who will provide snow removal, cleaning services, building upkeep, lighting, signage, security, electricity services, ventilation, heating, and air conditioning.

4.3.4. Building should be in good repair. Good repair definition would be no water leaks or problems, free of pests (insects or rodents), toilets, sinks, and showers in working condition, free of mold or other allergens, building structurally sound, well lit hallways, able to be inspected by VA safety and pass inspection. If the Veteran’s living quarters are not in good repair and unable to be fixed within 72 hours, the VA may require, at the discretion of the CO/COR, an equivalent alternative room to be provided to the Veteran in a safe living environment while awaiting completion of the repairs.

4.4. Medications and Prescriptions

4.4.1 Storage, labeling, and monitoring of medications at the contract facility should follow the Iowa Department of Public Health Section 155.21(18) requirements for residential level of care. Safety protocols shall be followed by the contractor for Veterans who reside in an individual apartment and store and self-administer their own medications.

5. CONTRACTOR CONDUCT AND COMPLAINTS HANDLING:

5.1. Contractor personnel shall be expected to treat referred Veterans with dignity and respect and abide by standards of conduct mirroring those prescribed by current federal personnel regulations. The contractor shall comply with the VA Patient's Bill of Rights as set forth in 38 CFR 17.34a (copy available upon request).

5.2. VA reserves the right to exclude contractor staff members from providing services to Veterans under this contract based on breaches of conduct, including conduct that jeopardizes Veteran care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, Veteran abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by Veterans or other staff members to designated Government representatives. The Contractor and Contracting Officer’s Representative shall deal with issues raised concerning contractor personnel conduct. The Contracting Officer shall be the final arbiter on questions of acceptability and in validating complaints.

5.3. The contractor shall have an identified grievance process to address Veteran complaints within

72 hours from contractor’s program/ facility management or within 24 hours if VA or contractor determine the grievance to be emergent. Complaints and steps taken by the contractor to resolve the Veteran’s complaints will be made available to the COR/CERS Liaison upon request.

5.4. Veterans complaints about the quality of care received from the contractor shall be reported by the contractor to the COR within twenty-four hours of the complaint received by the contractor..

6. CONTRACTOR FACILITY AND INSPECTION:

6.1. Contractor Facility

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

6.1.1.1. Have a current occupancy permit issued by the local and state governments in the jurisdiction where the facility is located.

6.1.1.2. Be in compliance with existing standards of State safety codes and local, and/or State health and sanitation codes.

6.1.1.3. Be licensed under State or local authority.

6.1.1.4. Where applicable, be accredited by the State.

6.1.1.5. Be equipped with operational air conditioning and heating systems.

6.1.1.6. Be kept clean free of dirt, grime, mold, or other hazardous substances and damages that noticeably detracts from the overall appearance.

6.1.1.7. Be equipped with first aid equipment and an evacuation plan in case of emergency.

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

6.2. Fire Safety

6.2.1. The contractor facility must meet fire safety requirements, as follows:

6.2.1.1. The building must meet the requirements of the applicable residential occupancy chapters of the current version of NFPA 101, National Fire Protection Association's Life Safety Code. Any equivalencies or variances must be approved by the appropriate Veterans Health Administration Veterans Integrated Service Network (VISN) Director.

6.2.1.2. All residents in the facility must be mentally and physically capable of leaving the building, unaided, in the event of an emergency.

6.2.1.3. Fire exit drills must be held at least quarterly. Residents must be instructed in evacuation procedures when the primary and/or secondary exits are blocked. A written fire plan for evacuation in the event of fire shall be developed and reviewed annually. The plan shall outline the duties, responsibilities, and actions to be taken by the staff and residents in the event of a fire emergency. This plan shall be implemented during fire exit drills.

6.2.1.4. A written policy regarding tobacco smoking at the facility shall be established and enforced.

6.2.1.5. Portable fire extinguishers shall be installed at the facility. Use NFPA 10, Portable Fire Extinguishers, as guidance in selection and location requirements of extinguishers.

6.2.1.6. Requirements for fire protection equipment and systems shall be in accordance with

NFPA 101. All fire protection systems and equipment, such as the fire alarm system, smoke detectors, and portable extinguishers, shall be inspected, tested and maintained in accordance with the applicable NFPA fire codes and the results documented.

6.2.1.7. The annual inspection by a VA team shall include a fire and safety inspection conducted at the facility. If a review of past VA inspections or inspections made by the local authorities indicates that a fire and safety inspection would not be necessary, the fire and safety inspection may be waived by the VA.

6.3. Inspection of the the Facility and Program

6.3.1. Prior to the award of a contract, a multidisciplinary VA team consisting of a social worker, dietitian, registered nurse, a representative of the VA Police, and a Facilities Management Safety Officer, and other subject matter experts as determined necessary by the VA Director or HCHV Coordinator shall conduct a survey of the contractor’s facilities to be used to provide Veterans food, shelter, and therapeutic services to assure the facility provides quality care in a safe environment. Inspections will be carried out annually during the contract term prior to exercising an option, and may also be carried out at such other times as deemed necessary by the Department of Veterans Affairs in announced or unannounced site visits.

6.3.2. 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 to take corrective action and to notify the CO that the corrections have been made; typically thirty calendar days in sum. Failure by the contractor to take corrective action within a reasonable time will be reported to the VA CO.

If corrections are not made to the satisfaction of the VA, the CO will consult with the appropriate officials so that suitable arrangements can be made to discharge or transfer Veterans, and to terminate the existing contract, as appropriate. No additional funds will be made available for capital improvements under this contract.

6.3.3. The Contractor is required to ensure the facility used for this contract meets the Americans with Disabilities Act (ADA) guidelines for accessible accommodations for Veterans with physical limitations or impairments. This is also referred to as “Architectural Barriers Act compliant.” At least five to seven percent of a facility’s HCHV Contract Residential Care beds must meet ADA accessibility requirements, to include entrances/exits, bathroom facilities, and common areas.

Veterans must not be segregated from the rest of the facility due to physical disability; they must have full access to the services and supports at the facility.

6.3.4. The contracted facility must be licensed as required for the particular setting under State or Federal authority, and must meet all applicable local, state, and/or Federal requirements concerning licensing and health/occupancy codes. Copies of valid licenses must be provided to the VA at the time of pre-inspection and for all annual inspection reviews. Where applicable, the facility must have a current occupancy permit issued by the authority having jurisdiction.

6.3.5. The inspection of the contractor facilities will include inspection for conformity to the current Life Safety Code as described in paragraph 6, and will also include the following:

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

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

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

6.3.5.4. 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, assistance with health and personal hygiene.

6.3.5.5. 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.

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

6.3.5.7. 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.

6.3.5.8. Making a spot check of veterans’ records to ensure accuracy with respect to veterans’ length of stay and services provided to the veterans.

6.3.6. 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.

6.3.7. Men and women must have separate facilities. The facility must have male and female residential rooms or sections that are securely segregated or restricted to ensure safety and privacy. If the facility cannot accommodate both male and female Veterans at one location, the provider must make available equivalent facilities and services for the opposite gender that meet the terms of the contract for facilities and services.

7. IMPLEMENTATION AND TIMELINE:

7.1. The contracted facility and associated onsite services are expected to pass inspection and become fully operational within forty-five calendar days from the date of contract award. The contractor shall demonstrate successful completion of the required tasks, and be approved by VA, prior to receiving Veteran referrals and invoicing for payment.

8. CONTRACTOR PERSONNEL RESPONSIBILITIES:

8.1. Personnel/ Key Personnel

8.1.1. The contractor shall employ sufficient personnel to carry out the policies, responsibilities, and the program for the facility. There must be, at a minimum, at least one administrative staff member, or designee of equivalent professional capability, on duty on the premises or residing at the facility and available for emergencies twenty-four hours a day, seven days a week.

8.1.2. During the first ninety calendar days of performance, the contractor shall make no substitutions of key personnel unless the substitution is necessitated by illness, death, or termination of employment. The contractor shall notify the VA Contracting Officer Representative (COR), in writing within five calendar days after the occurrence of any of these events and provide resumes for the substitute key personnel.

8.1.3. For temporary substitutions where the key person will not be reporting to work for three consecutive work days or more, the contractor shall provide a qualified replacement for the key person. This substitute shall have comparable qualifications to the key person.

8.1.4. The contractor is to have a contingency plan in place to be utilized if personnel leave the contractor's employment or are unable to continue performance in accordance with the terms and conditions of the resulting contract.

8.1.5. VA reserves the right to refuse or revoke acceptance of key personnel if personal or professional conduct or lack of skills, training, or qualifications jeopardizes Veteran care or interferes with the regular and ordinary operation of the facility. Breaches of conduct may include, but are not limited to, intoxication or debilitations resulting from drug use, theft, Veteran abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by Veterans or other staff members to designated VA personnel. The contractor and VA COR shall handle the issues raised concerning contract personnel's conduct. The final arbiter on questions of acceptability is the VA Contracting Officer.

8.1.6. The VA COR shall resolve complaints concerning contractor relations with VA personnel or Veterans. The VA COR has authority on validating complaints. In the event that the contractor is involved and named in a validated Veteran complaint, the VA reserves the right to refuse acceptance of the services of such personnel. This does not preclude refusal in the event of incidents involving physical or verbal abuse.

8.2. Qualifications of Personnel

8.2.1. Contractor personnel who perform services under this contract that require a license shall be licensed in the State of Iowa. All license(s) held by the personnel working on this contract will be full and unrestricted as well as current and in effect licenses. Such licenses shall be subject to review by the VA COR. Current copies of all licenses shall be provided to the VA upon request.

8.2.2. The contractor shall assign to this contract, personnel that by education and training and, when required, certification or licensure, are qualified to provide the services as denoted in the PWS.

The contractor provides staffing of key personnel for this contract; however, VA shall have final approval of personnel assigned to the contract by the contractor, primarily regarding the case manager assigned. Personnel assigned as case manager shall have a Bachelor or higher degree in Human Services or related field. Related professional experience in providing services in homelessness, case management, therapy, and social services shall also be considered by VA

CO/COR.

8.2.3. Contractor personnel shall provide evidence of qualifications as required by this contract for all employees utilized to perform the services.

8.2.4. VA reserves the right to have any contractor personnel removed from performing under this contract upon written documentation from the VA CO regarding one or more incidents of medical incompetency, physical or mental impairment, or abusive nature with staff or Veterans which will put Veterans or staff as risk.

8.2.5. VA reserves the right to have contractor personnel removed from performing under this contract for sexual harassment of any Veterans and/or VA personnel.

8.2.6. The contractor shall provide a list of all employees to be utilized in the performance of this contract upon request. As employees leave the contractor’s employment and new employees are added to the roster of employees performing services under this contract, the contractor shall provide updated rosters of employees to VA as requested.

8.2.7. The qualifications of such personnel shall also be subject to review by the VA CO and COR if the need arises.

8.2.8. All contractor staff providing services to Veterans under this contract shall undergo and pass the appropriate background investigation per contracted agency requirements. The contracted agency is responsible for all fees associated with obtaining appropriate background checks.

8.3. Personnel Policy - The contractor shall assume full responsibility for the protection of its personnel furnishing services under the contract. To carry this out, the contractor shall provide the following for these personnel.

8.3.1. Worker's Compensation

8.3.2. Professional liability insurance

8.3.3. Health examinations

8.3.4. Income tax withholding

8.3.5. Social Security payments

8.4. Management, Supervision, and Training

8.4.1. The contractor shall be responsible for supervising the daily services provided under this contract.

8.4.2. The contracted agency shall have written policies and procedures regarding staff credentials.

8.5. Contractor Training and Employee Health

8.5.1. The VA is mandated by a number of internal and external accreditation and reviewing organizations to train or orient VA employees in specific subjects. It will be the contractor’s responsibility to provide or afford mandated training/orientation to employees assigned to provide the contracted services to the Veterans. The contractor must provide evidence or certification of the training or orientation to the VA COR. The following training/orientation issues presently exist within VA and must be satisfied within the timeframe and frequency specified. Staff shall be trained and oriented within 30 days of hire. The contractor shall provide at minimum, the following trainings to contract key personnel:.

8.5.1.1. Veteran Privacy/ Confidentiality/ HIPAA and Information Security training

8.5.1.2. Safety/Emergency Response Action Plan

8.5.2. Additionally, VA must comply with National Institute of Health directives as it relates to physical examinations, vaccinations, and inoculations. The contractor shall ensure that each contracted employee meets the prerequisite and yearly employment preventative health screenings. When physical examinations, vaccinations, or innoculations are required, all screenings shall be at the expense of the contractor and documentation of completion of these items shall be provided to the VA CO/COR upon request. The contractor shall furnish the VA COR proof that contract employees have received the following:

8.5.2.1. Preventative health screening/testing/vaccinations as required by Occupational Safety and Health (OSHA), CDC, Departments of Public Health and/or VA..

8.5.2.2. Pandemic guidance per local, state, and National; Centers for Disease Control (CDC).

8.5.2.3. All related documentation, such as completed competency checklists or educational training records, shall be maintained by the contractor and available for VAHCS review upon request.

8.5.3. VA Required Contractor Training.

9. QUALITY MANAGEMENT MONITORING:

9.1. It is the expectation that the performance of contracted services will meet basic principles of risk reduction, safety, staff competence, and performance improvement. VA retains the right of oversight of quality and safety of services provided through the contract. Methods of oversight shall include but not be limited to:

9.1.1 The contractor shall ensure that all services provided by the contractor’s licensed individuals are within the scope of their privileges and credentials.

9.1.2 The contractor shall provide documents such as policies and procedures to demonstrate compliance with State Residential Licensing related to credentialing and privileging, competency assessment and initial and ongoing training for staff provision of care, treatment and/or services performed.

9.1.3 The contractor shall provide documents such as policies and procedures to demonstrate prevention and management of safety risks; and, upon request, reports of incidents involving care, treatment and/or services of VA Veterans.

9.2. In the event that contracted services do not meet quality and/or safety expectations, the best remedy will be implemented by the VA COR or CO, to include but not limited to a targeted and time limited performance improvement plan and/or renegotiation of the contract terms or termination of the contract in collaboration with the Contracting Officer.

9.3. VA, at its sole option, will monitor the professional care and administrative management of services provided to VA beneficiaries under this contract, through one or any combination of the following methods; reviews of state agencies reports, onsite inspection of the residential care facility by VA staff, and/or onsite monitoring of VA Veterans. It is agreed that the residential care facility shall provide VA with copies of all state agency reports when requested, and cooperate fully with VA's quality improvement-quality assurance program functions relating to this contract, including VA's onsite inspection and monitoring. The VA Contracting Officer shall make all final determinations as to the contractor's reasonable cooperation with VA and compliance with these requirements.

9.4. Monitoring of contractor’s performance shall be done by the VA Contracting Officer’s

Representative (COR). Incidents of contractor noncompliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.

9.5. Upon award, a Quality Assurance Surveillance Plan will be signed by the CO, COR, and contractor outlining the evaluation criteria to ensure the contractor is aware of the management and quality criteria required to meet the terms of the contract (refer to attachment titled “Quality Assurance Surveillance Plan – HCHV Program”).

9.6. Frequency of Measurement: During contract performance the COR will periodically analyze whether the negotiated frequency of surveillance is appropriate for the work being performed.

10. RECORD KEEPING/ DOCUMENTATION:

10.1. The VA shall establish and maintain a record keeping system that will record the services performed by the contractor's employee(s). Any incidents of contractor non-compliance as evidence by the monitoring procedures shall be forwarded immediately to the COR/CO.

10.2. Documentation of bed days utilized/services performed shall be reviewed prior to certifying payment. The VA shall pay for bed days utilized/services actually performed, and in strict accordance with the contract. Billable bed days starts the day of admission, with no payment for the day of discharge. Contract monitoring and record-keeping procedures shall be sufficient to ensure proper payment and allow audit verification that services were provided.

11. CONTRACTOR RESPONSIBILITIES:

11.1. PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY

IMPROVEMENT (QI)

11.1.1. Quality Management/Quality Assurance Surveillance: Contract personnel shall be subject to Quality Management measures, such as Environment of Care (EOC) rounds, CERS inspection checklists, and periodic direct observation inspection. Methods of Surveillance: Environment of Care (EOC) rounds, CERS inspection checklists (P01_Att-1_HCHV CERS Inspection_DEC2024, as amended, Form 10-10116a), and periodic direct observation inspection. Contractor performance will be monitored by the government using the standards as outlined in this Performance Work Statement (PWS) and methods of surveillance detailed in the Quality Assurance Surveillance Plan (QASP). The QASP shall be attached to the resultant contract and shall define the methods and frequency of surveillance conducted.

11.1.2. Veteran Complaints: The CO will resolve complaints concerning Contractor relations with the Government employees or Veterans. The CO is final authority on validating complaints. In the event that The Contractor is involved and named in a validated Veteran complaint, the Government reserves the right to refuse acceptance of the services of such personnel. This does not preclude refusal in the event of incidents involving physical or verbal abuse.

11.1.3. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. The CO and COR shall deal with issues raised concerning Contractor’s conduct. The final arbiter on questions of acceptability is the CO.

11.1.4. Performance Standards:

11.1.4.1. Measure: Key Personnel Qualifications and Training (para. 5.2, 6.3, 8.1, 8.2, 8.5, 9.1, 11.1.3, 11.1.4.1) Performance…