Draft PWS.pdf

DRAFT

B.3 PERFORMANCE WORK STATEMENT

1. BACKGROUND

1.1. The U.S. Department of Veterans Affairs (VA) is seeking a Contractor to assist with the provision of housing placement and case management services through the U.S. Department of Housing and Urban Development

(HUD) – VA Supportive Housing (VASH) program. The program is a partnership between HUD and VA to place and maintain homeless Veterans in permanent, community-based housing using HUD Section 8

Housing Choice Vouchers (HCV) that are paired with ongoing VA case management services. Many of these

Veterans have co-morbid conditions that include serious mental illnesses, substance use disorders, and other serious medical conditions. VA intends to engage a Contractor to provide housing placement services in the in

San Francisco County, along with ongoing case management services to HUD-VASH eligible Veterans and their families.

1.2. The Contractor shall meet all requirements in accordance with VHA Directive 1162.05 (2) “Housing and

Urban Development Department of Veterans Affairs Supportive Housing Program”. The Contractor shall be responsible for maintaining compliance with this Directive at all times and shall be responsive to all future updated Handbooks and/or Directives. This Directive can be found at https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=5437

1.3. The target population for this contract is Veterans that demonstrate the most need or vulnerability based on their unique clinical and/or psychosocial circumstances. Veteran eligibility and prioritization are outlined in

Directive 1162.05 (2).

1.4. Through this contract initiative, Contractor(s) will support Veterans in obtaining housing while simultaneously providing case management and supportive services to assist Veterans in maintaining housing.

1.5. The purpose of this contract is to enter into an Indefinite Delivery, Indefinite Quantity (IDIQ) firm fixed-price contract with a community partner (Contractor) who will provide housing search and placement, case management, and supportive services to Veteran beneficiaries as specified herein. All services shall be provided in accordance with the terms, conditions and provisions of this contract for five ordering periods from the date of award. The Contractor shall provide all labor, supervision, supplies, and materials necessary to carry out the task specified in this Performance Work Statement (PWS). Performance will occur at the

Contractor’s location and the San Francisco County area, unless otherwise required by work requirements listed in the PWS, or otherwise specified by the task orders issued under this contract.

1.6. The following contract implementation checklist is provided as a guide to meeting the terms outlined in the

Performance Work Statement. Potential Contractors should be aware that there may be variation among and between VA medical centers in the steps needed to complete these tasks, and that items identified here may be subject to change based on evolving local, regional or national requirements.

1.7. The Contractor shall not commence performance on the resulting tasks order in the awarded contract until the

Contracting Officer (CO) has conducted a kickoff meeting within 30 days or has advised the contractor that a kickoff meeting has been waived.

1.8. The Contracting Officer’s Representative (COR) will evaluate all deliverables submitted. The COR is responsible for certifying invoices for payment only for deliverables received and deemed acceptable by the

COR. A Quality Assurance Surveillance Plan (QASP) will be used by the COR to measure performance success and/or failure. VA Liaisons will be identified by the San Francisco VA Health Care System HUD-

VASH program. They will act as the clinical liaison for all Veteran related issues in conjunction with the

COR between the Contractor and the VA homeless team. They will provide clinical oversight but will not https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=5437 provide direct clinical supervision. Multiple CORs may be appointed to handle administrative, clinical or other duties as assigned. At some facilities, the COR and HUD-VASH Liaison roles may be filled by a single individual.

1.9. Projected Quantities / Units – San Francisco VA Health Care System seeks a Contractor to receive up to 125

HUD-VASH vouchers (clients) distributed over Acuity Levels 2-5. Case Manager caseloads are projected at approximately one (1) case manager to 25 VASH clients. Caseload ratios will fluctuate depending on level of acuity distributed on the caseload. Services will be invoiced per an all-including “unit rate” per face-to-face clinical encounter (home visit). Encounters (home visits) are defined to include a documented, face-to-face contact between a Veteran Client and a Contracted Case Manager provider who exercises independent judgment in the provision of services to the individual. To be included as an encounter, services rendered must be documented.

2. GENERAL REQUIREMENTS

2.1. The Contractor shall be able to provide services to HUD-VASH eligible Veterans/Veteran families for whom such care is specifically authorized by the referring VAMC. Contractor shall perform the following tasks:

2.1.1. The Contractor is recommended to use a case management team approach whenever possible which may include a mix of mental health and addiction treatment professionals, social workers, nurses, psychologist, housing specialists, and peer specialists to meet the clinical needs of

Veterans served.

2.1.2. The Contractor shall provide case management support.

2.1.3. The Contractor shall comply with HUD-VASH San Francisco VA Health Care System policy and

HOMES policies and procedures regarding documentation and evaluation standards for Veterans receiving services under this contract.

2.1.4. While most services will be provided in the community or a Veteran’s home, the team will visit

Veterans if hospitalized or incarcerated and will also accompany Veterans to clinics, emergency visits, or other appointments as needed.

2.1.5. When Veterans have achieved housing stability, the focus of the service support changes to support for maintaining housing, community integration, and other goals as defined by the

Veteran.

2.1.6. Discuss with VA liaison before discharge to ensure it complies with the VA discharge SOP.

2.1.7. The Contractor shall be able to provide full staffing as outlined in task and deliverables within 120 days of contract award either through existing staff or new hires.

2.1.8. The Contractor shall participate in and coordinate with the VA COR and/or VA Clinical Liaison

(VA HUD-VASH Supervisor or Designee) during weekly case conferences regarding updates and changes in the Veteran’s care plans to foster a collaborative relationship with the VA and

Contractor in meeting the Veteran’s needs. Case conferencing may be done in person or by telephonic conference calls as determined by the VA COR/Liaison.

2.1.9. The Contractor shall meet the same performance measures set forth for the VA by the VHA

Homeless Program Office located in the technical manual “Performance Measures and

Metrics”, this requirement shall include any subsequent updates and/or revisions. This includes the responsibility to update all required HOMES documentation within three (3) business days.

2.1.10. The Contractor shall work with the Veteran on obtaining housing, maintaining housing, strengthening independent living skills including independence in transportation, budgeting, and employment and/or assistance obtaining appropriate VA and non-VA benefits.

2.1.11. The Contractor shall make all communications with the VA regarding this contract via the VA

COR/Liaison.

2.2. The Contractor shall submit a staffing plan for approval to the VA Liaison/COR, that includes information about how supervision will be provided, upon award and as changes may occur. The contractor will know the local community and its homeless services. The contractor will have relationships with local agencies/providers.

3. STAFFING

3.1. Contractor shall provide identification of staff to work directly with referred Veterans as outlined in the

Performance Work Statement and their achievement of VA security and credentialing procedures including:

3.1.1. Security/background investigation via National Agency Check with Written Inquiries (NACI) and a Special Agreement Check (SAC) which includes electronic fingerprinting for case managers and their supervisor working with Veterans. In order to complete this background check, the

Contractor must provide staff member’s date of birth, social security number, hair color, eye color, home address, phone number, and email addresses. U.S Citizenship or legal resident status will be verified as part of this process.

3.1.2. For case managers and their supervisor to perform under this contract, they must complete the credentialing process through the VA’s VetPro system. VetPro is necessary for all licensed, registered or certified clinical staff members (e.g. SW, RN, LPMHC). Staff must be cleared through VetPro based on their current status and may not perform work at a lower level than their education status while awaiting VetPro clearance. Information will be provided by San Francisco

VA Health Care System HUD-VASH Program for staff to begin this process online. A Federal

Personal Identification Card will also be issued; this requires an in person visit to the San

Francisco VA Health Care System Human Resources Department for verification of documents and photographs of the individual staff member.

3.1.3. Completion of the VA’s online Information Security and Privacy combined Awareness Training

Course and the Privacy Policy Awareness Training Course in the VA’s Talent Management

System (TMS) is required for all staff and their supervisor working directly with Veterans under this contract. The Privacy Awareness Training requirement may be fulfilled under additional privacy awareness training options. In order to complete online VA Privacy and Information

Security Training, Contractor staff must set up a VA Employee Education System account. This can be done online. This requirement is in addition to any other training that may be required of the Contractor(s) and any sub-contractor(s).

3.1.4. The Contracting team shall participate in continuing education related training including suicide prevention, trauma informed care, motivational interviewing, relapse prevention, supported employment, and supported education, offered through TMS, HUD-VASH staff meetings/trainings, and other forums.

3.1.5. Contractor personnel shall maintain an active standing with the licensing boards in their respective profession in accordance with the below requirements:

3.1.5.1. Basic Life Support (BLS) certification meeting local standards is required for all technical and professional staff;

3.1.5.2. Maintain compliance with state reporting requirements.

3.2. In addition to meeting all the task and deliverables for HUD-VASH case management contained herein, the

Contractor shall also provide the following:

3.2.1. A Mental Health provider at the highest level of their professional license to practice independently in their state (i.e., a Licensed Independent Practitioner (LIP)) as the Case

Management Team Clinical Supervisor, who shall oversee case management activities to meet the clinical needs of Veterans served and make home visits consistent with the Social Work

Treatment Plan.

3.2.2. Appropriate number of Case Managers to carry the task provided in the PWS for each Veteran receiving service under this contract.

3.2.3. The Case Management Team Supervisor and Case Managers must be full time employees and full time to this HUD-VASH contract.

3.3. Staffing responsibilities are described as follows:

3.3.1. The clinical supervisors’ schedule must permit regular and ongoing supervision of case management personnel during clinic business hours for the purposes of clinical oversight, documentation and crisis management. The licensed independent practitioner must be available for team conferences as requested by the local VA medical center HUD-VASH program. In addition, he/she must ensure appropriate supervision of any non-clinical/non-licensed Contractor staff providing related supportive services to Veterans to ensure quality of care, such as peer support specialists, vocational service counselors, etc. The licensed independent practitioner must have an active, current, unrestricted license.

3.3.2. Case Managers will have a minimum of a Masters degree from an accredited institution in the social sciences or family therapy

3.3.3. Other staff may include Housing Specialists, Certified Substance Abuse Counselors, Registered

Nurses, Licensed Vocational Nurses, Licensed Practical nurses, and/or Peer Support Specialists

4. DOCUMENTATION

4.1. The Contractor must complete Homeless Operations Management and Evaluation (HOMES) documentation, consistent with the HOMES policies, and Electronic Health Record (EHR) documentation, in accordance with national and local policies. This EHR documentation may include, but not be limited to: changes to admission, housing, voucher, or employment status, encounter documentation, screening/admission notes, release of information forms, housing service agreements, suicide risk assessments, Advanced Directive

Discussions, discharge notes and safety plans. Contractor shall document encounters using the Subjective, Objective Assessment Plan (SOAP) format for all clinical notes and ensure all encounters are entered within

72 hours of service in accordance with national and local policies. In addition to documenting contact with the Veteran, the Contractor shall also document in the HER evidence of collateral contacts with individuals and agencies engaged to support the Veteran’s housing and recovery needs.

4.2. The Contractor will comply with additional documentation and/or data reporting as required by San Francisco

VA Health Care System based on changing or subsequent local, VISN, or national HUD-VASH requirements.

Additional required documentation includes but is not limited to initial and annual Psychosocial Assessment, Social Work Treatment Plan, Patient Health Questionnaire-9, Columbia Suicide Severity Rating Scale-

Screener, Columbia Suicide Severity Rating Scale- Comprehensive, and Behavioral Contract.

4.3. An approved, assigned licensed independent clinical provider must sign off on all notes if the staff member providing direct services to the Veteran is not independently licensed.

4.4. Any signed documentation shall be scanned into the electronic medical record via the VA medical records office. The Contractor shall maintain compliance with local policies and procedures regarding documentation requirements and timelines.

5. REFERALS AND ADMISSIONS

5.1. Referrals and admissions to HUD-VASH may be conducted by the VA and/or by the Contractor.

5.1.1. Referrals and admissions to HUD-VASH are conducted by the VA. Once admitted, HUD-VASH

Veterans are referred to the Contractor for case management services.

6. CONTRACTOR CASE MANAGEMENT TEAM DUTIES

6.1. The Contractor shall have procedures in place to ensure Veterans have access to case management services

Monday – Friday during normal tours of duty.

6.2. Contractor shall ensure that sufficient staff are available to provide services to meet the documented needs of the Veterans and the VHA performance standards as referenced above, as well as the ability to make home and community visits consistent with the level of care each Veteran is being treated at in addition to the following:

6.2.1. Ensure consistency of team services to enhance staff ability to engage and form relationships with Veterans and provide consistent and highly skilled interventions in keeping with highest level professional standards.

6.2.2. Review and update the HUD-VASH Social Work Treatment Plan with the Veteran at admission, annually or as clinically indicated, and document the review and any changes to the plan in the VA medical record.

6.3. Contractor shall perform the following Case Management duties:

6.3.1. Engage the Veteran in the HUD-VASH process and perform assessment, counseling, and case management of identified Veterans who are at risk, provide psychosocial assessments to identify treatment needs which affect Veteran’s adjustment to their environment, and establish treatment goals with the primary purpose of obtaining and maintaining housing.

6.3.2. Actively involving the Veteran and their family or significant others in coordination with the team members, based on the psychosocial assessments, develop HUD-VASH Social Work Treatment Plans with the Veteran using his/her language whenever possible, ensuring he/she has a copy of the plan including goals for clinical treatment and discharge from case management; The initial HUD-VASH Social Work Treatment Plan must be completed within 30 day of the initial psychosocial assessment per HUD-VASH case Management policy/HUD-VASH Directive..

6.3.3. Contractor shall integrate Social Work Treatment Planning with relevant VA health and mental health services. Contractor shall refer as needed to VA Medical Facilities, VA Regional Offices, and community-based agencies for a variety of services that may include health care, entitlements, vocational assistance, education, recreation, and any other needed assistance.

6.3.4. Utilize counseling strategies to include crisis intervention and Motivational Interviewing including both short- and long-term services working toward long-term goal of housing stability and discharge from HUD-

VASH.

6.3.5. Screen each Veteran for suicidal and homicidal risk per local and national policy or procedure. This screening shall be documented in progress notes, suicide risk assessments, and safety plans as appropriate per local and national policy. Contractor shall document the aforementioned in the VA medical record. If the

Veteran is a danger to him/herself or others, the Contractor shall take immediate steps to provide appropriate intervention. Crisis management shall be coordinated and executed consistent with local standards by the contractor and shall be reported to the VA COR/Liaison and other VA staff, including the local Suicide

Prevention Coordinator.

6.3.6. Facilitate the Veteran’s involvement in therapeutic and work restoration programs, as well as supporting team-based interventions across the Veteran’s individual treatment team and advocating on behalf of the

Veteran.

6.3.7. Contractors shall provide and/or coordinate direct mental health and substance abuse counseling within their scope of practice and assist in securing available VA services using tele-mental health services when appropriate. The Contractor shall also facilitate the Veteran’s involvement in therapeutic and work restoration programs, such as Homeless Veterans Community Employment Services (HVCES), as appropriate.

6.3.8. The Contractor is encouraged to pursue case management graduation to independence, when clinically appropriate. The VA may assign additional Veterans to the Contractor for case management services to replace those Veterans who have graduated from the program. Assignment of additional Veterans for case management services is not guaranteed and will be dependent upon the demand for such services and the

VA’s needs at that time.

6.3.9. All electronic communication completed by contracted staff related to HUD-VASH case management duties must be conducted from that staff member’s official VA e-mail address and must include a signature block that identifies their status as a VA HUD-VASH contractor; Signature block shall have the case manager’s

National Provider Identifier (NPI) number.

7. CONTRACTOR HOUSING PLACEMENT AND STABILIZATION DUTIES

7.1. The Contractor shall perform Housing Placement & Stabilization Duties that include:

7.1.1. Assist veteran and family members being housed with the veteran in securing vital documents, such as a DD-214, a birth certificate, a social security card, income verification, etc. required to obtain a HUD-VASH housing voucher

7.1.2. Accompany Veteran to any public housing authority appointments including annual certifications, briefings, and interim appointments. Contractor shall assist Veteran in completing and submitting

PHA and other Federal, local and state entitlement program paperwork (e.g. Social Security, SNAP benefits, utility assistance, etc.)

7.1.3. Advise any potential landlords that the contractor shall be providing assistance and case management services to the Veteran in order to help the Veteran remain successfully housed.

Advocate with landlords on behalf of the Veteran to maintain a lease. Contractor shall ensure that the Veteran has completed the VA release of information so communication between the landlord, Contractor, and VA COR/Liaison can occur as needed.

7.1.4. Verify whether the Veteran is paying rent and utility bills in a timely manner and provide budgeting/money management assistance as needed.

7.1.5. Evaluate and assist the Veteran with budgeting education to promote the ability to manage expenses including those related to housing while also assisting the Veteran with locating both community and Government resources (i.e. Social Security benefits, disability compensation, local food banks, clothing and furniture donations) as needed.

7.1.6. Assist the Veteran in making calls to utility providers to ask questions and resolve issues

(including restoring, turning on, turning off or transferring utilities),

7.1.7. Assist Veteran in increasing income by applying for all eligible benefits, both VA and non-VA, including Veteran’s Benefits Administration (VBA), Social Security Administration (SSA), and pursuing employment opportunities.

7.1.8. Contractor shall provide life skills education and assistance to Veterans in accordance with VHA

Directive 1162.05 (2) and local policies

8. CASE MANAGEMENT VISITS

8.1. Case Management visits to Veterans shall be conducted in accordance with the HUD-VASH Directive and local Standard Operating Procedures.

8.2. The Contractor shall visit each Veteran face-to-face at the intervals required by the HUD-VASH Directive and local Standard Operating Procedures. Face-to-face visits shall be conducted in accordance with local behavioral health and safety flags in the Veteran’s home, at the Contractor agency, or a place mutually agreed upon by the Veteran and Case Manager. Phone contacts, while an acceptable way to communicate with the

Veteran, are not considered visits in meeting the minimum visit requirements for any acuity level. In the event the Contractor is unable to locate the Veteran for the required number of visits, the Contractor shall follow

SFVA SWS Policy “Procedures for Unsuccessful Home Visits.”

8.3. Home visits to HUD-VASH apartments verify whether Veterans reside in healthy residences. Appropriate support and education will be given to Veterans who are not maintaining a hygienic residence.

8.4. Contractor shall adhere to transition between case management stages and discharge criteria consistent with national policy and local VAMC Standard Operating Procedures.

8.5. The Contractor shall demonstrate diligent efforts to provide services based on the presenting needs and acuity level designation. When the designated Case Management Stage and corresponding minimum visit requirement for an enrolled Veteran changes, the Contractor shall notify the VA COR and Clinical Liaison, as required by the HUD-VASH Directive and local Standard Operating Procedures.

8.6. The Contractor shall re-assess any Veterans who do not meet the goals and objectives outlined in their HUD-

VASH Social Work Treatment Plan to determine any barriers to housing stability. The Contractor’s Case

Manager shall work with the Veteran to eliminate any barriers, which may involve engagement issues, continued active use of substances, serious mental illness (SMI), or a history of violence. The case manager is expected to continue efforts to engage the Veteran, unless there is a risk to the safety of the Case Manager.

Contractor shall consult with VA COR/Liaison when Veterans present a safety risk to the case manager and follow local policies and procedures regarding disruptive behavior reporting and compliance with CRPS flags.

8.6.1. These efforts might require using Motivational Interviewing Techniques to assist the Veteran in redefining goals and making needed changes to the HUD-VASH Social Work Treatment Plan.

The Contractor should consult with facility Mental Health leadership, police service, or other VA program staff such as SUD programs, VA Disruptive Behavior Committee Members, or other homeless programs for assistance in determining alternative clinical treatment approaches.

8.7. In the event the Veteran is at risk of eviction, the Contractor shall schedule a case conference with the VA

Liaison, Contractor, and Veteran to try and prevent eviction from happening. The Case Manger should always initiate appropriate consultation with the VA Liaison and VA COR on adverse events to determine the next course of action.

8.8. There are five basic levels of case management: Intensive, Stabilization, Maintenance, Preparation for

Discharge and Graduation/Independence.

8.8.1. Acuity Level 5 – Intensive. The HUD-VASH Case Management team works with the Veteran to obtain clinical stability. At a minimum, weekly home visits are required, but even more frequent interactions may be needed.

8.8.2. Acuity Level 4 – Stabilization. At this stage, Veterans are more adept at managing their housing responsibilities and their physical, mental health, and substance use disorders are more stable as the Veteran works on addressing those issues that are most likely to lead to housing instability. At least twice a month home visits are required, with additional interactions as needed.

8.8.3. Acuity Level 3 - Maintenance. Case management services ensure that needed treatment, support, and mentoring assistance continue after placement in housing. Home visits need to occur at least every month, once the Veteran demonstrates stability, independence, and improved coping skill use and recovery. Other interactions, such as phone calls, may be indicated.

8.8.4. Acuity Level 2 - Preparation for Discharge. Veterans who have functioned at a very independent level for at least one year and sustained a low acuity level may be considered for this phase to practice and plan for discharge from HUD-VASH. Case management can be provided in the home, community, or at the medical center. During this phase, contacts are to occur at least quarterly and the focus of case management would address steps towards graduation from case management, and/or discharge

8.8.5. Acuity Level 1 - Graduation/Independence. Graduation is for Veterans who no longer need the case management services in HUD-VASH, and thus, the Veteran is not required to participate in case management. A Veteran is discharged from HUD-VASH when he/she is no longer participating in case management. If the Veteran is retaining the HUD-VASH voucher for financial purposes only, he or she is considered in graduation status.

9. TRANSPORATION

9.1. Contractor shall work with Veterans to foster independence in transportation and a sense of self-determination.

9.2. The Contractor shall make every effort to connect the Veteran with existing public transportation networks or other community provided transportation. In cases where the Veteran is unable to access or use existing public transportation networks or other community provided transportation, the Contractor shall provide transportation for the Veterans to attend appointments at the VA, SSA, PHA, benefits agencies, landlords etc. Transportation may include bus passes, transit cards, contractor-owned or operated vehicles, subsidized transportation services, and other identified needed services and entitlements.

9.3. Contractor shall accompany Veterans to medical appointments, meetings, and other appointments as deemed necessary based on the assessment completed by a member of the case management team.

10. VOUCHER RECONCILIATION WITH THE PHA

10.1. At least quarterly, the contractor will reconcile data with the COR/Liaison to determine that status of all

HUD-VASH vouchers. This includes any vouchers that are being used by Veterans who have graduated from the program. When the designated Case Management Stage and corresponding minimum visit requirement for an enrolled Veteran changes, the Contractor shall notify the VA COR and Clinical Liaison, as required by the HUD-VASH Directive and local Standard Operating Procedures.

11. CONTRACTOR DISCHARGE REQUIREMENTS

11.1. Veterans may be discharged from HUD-VASH for a variety of reasons and need discharge plans developed in collaboration with the Veteran to transition the Veteran’s services back to the VA whenever possible. The

Contractor shall document in the VA medical record a discharge plan, a minimum of one month prior to a

Veteran’s discharge date. The discharge plan shall be shared with the Veteran and shall include all the required elements as defined in national and local policies. In limited situations this may not be possible.

11.1.1. When Veterans have accomplished their goals, no longer need case management services, and have reintegrated into the community, Veterans will be graduated from the case management portion of HUD-VASH and retain the HUD-VASH voucher as long as they remain financially eligible. All such discharges from case management will occur after the Veteran’s case management services have been transferred back to the VA for after care services. Prior to the

Veteran’s case management transfer to the VA; the Contractor will initiate a case conference meeting with the Contractor staff, VA Liaison/COR, and Veteran. When a Veteran transfers to another HUD-VASH site, collaboration with the receiving site and Veteran to develop a transition plan will be documented in the EHR

11.1.2. When a Veteran voluntarily leaves the HUD-VASH program such as if the Veteran chooses non-

VASH housing or is unhappy with the program, the contractor will collaborate with the Veteran on a discharge plan. Whenever possible, prior to the Veteran’s discharge, the Contractor will initiate a case conference meeting with the Contractor staff, VA Liaison/COR, and Veteran

11.1.3. When a Veteran is discharged involuntarily, every effort will be made by the contractor to develop a discharge plan with the Veteran prior to discharge and initiate a case conference meeting with the Contractor staff, VA COR/Liaison, and the Veteran.

11.1.4. When a Veteran is no longer financially eligible for HUD-VASH, the Contractor shall document a discharge plan transitioning services back to the VA in the EHR and give a copy to the

Veteran,

11.1.5. When a Veteran is being discharged because the Veteran cannot be located, a discharge plan cannot be developed with input from the Veteran. The contractor should note this in the EHR

11.1.6. When a Veteran is too ill to continue participating in the program, the Veteran should be discharged upon transition to the appropriate level of care. There should be a warm hand-off to the new care team and it should be documented in the EHR

11.1.7. A Veteran who dies is discharged from HUD-VASH.

11.2. If a Veteran leaves the program without prior notice or case consulting, the VA COR and Liaison should be notified immediately

11.3. When a Veteran is discharged from HUD-VASH, the contractor must document this in the EHR per local policy and in HOMES.

NOTE: Non-compliance with HUD-VASH does not necessarily lead to the loss of the HUD-VASH voucher.

PHA rescinds the HUD-VASH voucher if the Veteran no longer meets or is non-compliant with PHA requirements. The Veteran will receive written notification from PHA of this action.

12. VOUCHER PORTING

12.1. The Contractor shall provide services for two types of porting vouchers. One being within the VA catchment area, meaning the veteran can live within the jurisdiction of another PHA within the referring VAMC catchment area if the contractor can still provide case management; the other is outside of the VAMC catchment area.

12.2. If a Veteran chooses to re-locate to another VAMC catchment area, the Contractor shall schedule a case conference with the VA Liaison. The VA Liaison will then determine if the new VAMC has a new HUD-

VASH case management slot and if the new PHA has an available HUD-VASH voucher. HUD-VASH staff at the receiving VAMC must agree that they can and will provide case management services to the Veteran.

The Contractor shall continue to provide case management services until such time as transfer is completed.

12.2.1. Once the porting transfer has been completed the Contractor shall complete a contractor closing documentation note in the electronic health record and exit in HOMES indicating that the

Veteran is no longer part of the San Francisco VA Health Care System HUD-VASH program.

13. CONTRACTOR REPORTING REQUIREMENTS

13.1. Contractor shall submit a quarterly tracking sheet derived from the HOMES OR7 Report and delivered in that format approved by the COR/Liaison that provides status updates for Veterans receiving services under this contract regarding change in level of care, milestones met, employment/benefits, potential discharges, case management interventions, and other fields as approved by the COR. This is also to verify that services have been provided according to the needs of the Veteran

13.2. The Contractor shall follow local incident reporting procedures and notify VA of any negative incident occurring with the Veteran within twenty-four (24) hours of being informed or aware of the incident.

Contractor shall complete a written incident report within 24 hours of notification. The Contractor shall provide documentation, as required by the VA COR describing the incident, analysis of cause and effect, and corrective action taken. Reportable incidents include:

13.2.1. Death

13.2.2. Fire

13.2.3. Drug/police raid

13.2.4. Suicide/suicide attempt

13.2.5. 911 call to police, fire, paramedics, or other

13.2.6. Severe medical illness/emergency

13.2.7. Severe psychiatric illness emergency

13.2.8. Sexual assault

13.2.9. Act of violence by Veteran against others

13.2.10. Abusive behavior by Veteran against staff

13.2.11. Acts of violence by others against Veteran

13.2.12. Abusive behavior by staff against Veteran

13.2.13. Accident

13.2.14. Medication problems or adverse drug reactions

13.3. The Contractor shall provide quarterly written status reports of quarterly internal audits to ensure quality assurance of case management services to the VA COR/Liaison which will include the number of Veterans receiving case management services and at what acuity level, as well as which PHA they are housed under, along with the name and contact information of the Case Manager assigned to each Veteran.

13.4. The Contractor shall document the overall effectiveness of the case management services provided to the

Veteran as outlined in the QASP.

13.5. Annual Collaboration Report (ACR): The contractor shall submit a ACR to the COR and the CO by

November 1st of each year, which describes the following for the most recent fiscal year (October 1st to

September 30th) for the year covered by the report:

13.5.1. The services and assistance provided to Veterans as part of the contract;

13.5.2. The process by which Veterans were referred to the entity for such services and assistance;

13.5.3. The specific goals jointly set by the contractor and VA for the provision of services and assistance and whether the entity achieved such goals; and

13.5.4. The average length of time taken by a Veteran who received services as part of the contract to successfully obtain suitable housing and the average retention rate of such a Veteran in such housing.

The content described in this report is required by P.L. 112-154, Title III, §304, as amended by P.L. 116-

315, Title IV, § 4207(a), P.L. 117-328, Div. U, Title I, § 306; codified at 38 U.S.C. § 2041 Note.

14. RECORDS

14.1. The Contractor shall maintain all Veteran records in accordance with The Joint Commission and/or

Commission on Accreditation of Rehabilitation Facilities (CARF) standards. The Contractor is subject to all

Federal, State, and local statutes regarding confidentiality of patient information. The VA shall be provided access to all records in the Contractor’s facility regarding the care of Veterans under this contract.

14.2. The Contractor personnel who obtain access to hardware or media which may manipulate or store records revealing treatment for drug or alcohol abuse, sickle cell anemia, or infection with HIV, medical quality assurance records, or any other sensitive information as defined by the VA shall not access such records unless absolutely necessary to perform their contractual duties. Any individual who has access to this data shall disclose such information to no one, including other employees of the Contractor not involved with the performance of the particular contractual duty for which access is necessary.

14.2.1. Contractor shall not use Government IT equipment and/or Government records to create or maintain any records that are not specifically tied to or authorized by the contract.

14.2.2. Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected by the

Freedom of Information Act.

14.2.3. Contractor shall not create or maintain any records containing any Government Agency records that are not specifically required or authorized by the contract.

14.2.4. The Contractor shall not dispose of any records created while performing services under this contract without the prior written consent of the Contracting Officer. The Contractor shall put in place procedures to prevent the alienation or unauthorized destruction of records, including all forms of mutilation. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C 2701. Records may not be removed from the legal custody of the Agency or destroyed without regard to the provisions of the agency records schedules.

14.2.5. The Contractor shall obtain the Contracting Officer’s approval prior to engaging in any contractual relationship in support of this contract requiring the disclosure of information, documentary material, and/or records generated under, or relating to this contract. The

Contractor (and any sub-contractor) shall abide by Government and VA guidance for protecting sensitive and proprietary information.

15. FACILITIES

15.1. The Contractor shall have adequate and appropriate space available at the Contractor location for the VA staff to conduct meetings with Veterans and contracted staff members under contract care contracted staff members to conduct meetings with Veterans under contracted care.

15.2. The Contractor facility shall meet the following:

15.2.1. Conforms to the Life Safety Code, National Fire Protection Association (NFPA) #101 standards:

http://www.nfpa.org/aboutthecodes/AboutTheCodes.asp?DocNum=101&cookie%5Ftest=1

15.2.2. If applicable, the Contractor shall possess a valid Business License/Certification for the state of

California.

15.2.3. If applicable, the Contractor facility shall have a current Certificate of Occupancy permit or license as required by the authority that has jurisdiction to issue and must adhere to all applicable local, state, and federal laws.

15.2.4. The Contractor’s facility shall be wheelchair accessible

15.2.5. The Contractor shall be in compliance with Americans with Disabilities Act Guidelines for

Buildings and Facilities. http://www.access-board.gov/adaag/html/adaag.htm

15.2.6. The Contractor’s facility where services are to be provided shall be within the catchment areas of the San Francisco VA Health Care System.

16. STANDARD OF CONDUCT

16.1. The Government reserves the right to refuse acceptance of Contractor personnel whose personal or professional conduct jeopardizes the Veteran care. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, abuse, dereliction or negligence in performing directed tasks, or other abuse, or other conduct resulting in formal complaints by the Veteran, COR or VA staff. Contractor staff shall maintain professional boundaries with Veteran. Contractor staff shall under no circumstances engage in sexual activities or sexual contact with Veterans or their family members, even if such contact is consensual.

Contractor and Contractor staff shall under no circumstances engage in any monetary transactions either in the form of lending or borrowing of money or purchasing goods with the Veteran. Contractor and

Contractor staff shall under no circumstances take unfair advantage of any professional relationship or exploit Veteran or their family members to further their personal, religious, political, or business interests.

Contractor staff should not engage in relationships with Veterans or their family members in whom there is http://www.nfpa.org/aboutthecodes/AboutTheCodes.asp?DocNum=101&cookie%5Ftest=1 file:///U:/My%20Documents/Contracting%20Docs/Medical%20Sharing/(691)%20GLA/HUDVASH%2017/%20http:/www.access-board.gov/adaag/html/adaag.htm a risk of exploitation or potential harm to the Veteran or Veteran family. Contractor is responsible for taking steps to protect Veterans and their family members and is responsible for setting clear, appropriate, and culturally sensitive boundaries.

16.2. Complaints concerning Contractor personnel’s conduct with Government employees or Veteran patients shall be dealt with by the Contractor and COR. The Contracting Officer is the final authority on validating complaints. If Contractor personnel are involved and named in a validated 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. The final arbiter on questions of acceptability is the Contracting Officer. In the event the Government refuses acceptance of services of Contractor personnel, the Contractor shall immediately provide replacement personnel that are acceptable to the Contracting

Officer. The cost of removing and replacing such personnel shall be borne solely by the Contractor.

17. SUBCONTRACTORS

17.1. The Contractor shall be a direct provider of case management and supportive housing. Subcontractors are not permitted under the contract..

18. SUBSTITUTION OF PERSONNEL

18.1. The Contractor shall utilize the personnel named in its proposal to perform the services required under this contract. In the event that any of the personnel named in the proposal are unable to perform the duties of this contract, for any reason such as death, illness, or resignation from the contractor’s employ, the contractor shall promptly submit to the Contracting Officer and COR, in writing, a detailed explanation of the circumstances necessitating the substitution. The Contractor shall submit this request in writing, along with a resume for the proposed substitute, and any other information that may be needed to approve or disapprove the proposed substitution. Any substitution of personnel shall occur without any increase to the contract price and without delay in the performance or delivery of services to the Government.

18.2. The Government shall have the right to require replacement of any contractor or subcontractor employee assigned to work on this contract, if the employee is determined not to possess the experience, education, credentials or ability required under the contract, or if said employee is for any other reason found to be unsuitable to perform the work required by the contract. The replacement shall meet the Personnel requirements stated in the contract. In the event the Government requires replacement of Contractor or subcontractor personnel, the Contractor shall immediately provide replacement personnel that are acceptable to the Contracting Officer. The cost of removing and replacing such personnel shall be borne solely by the

Contractor.

19. CONTRACTOR LIASON

19.1. The Contractor shall identify a point of contact for the management of billing of this contract who will work directly with the VA COR on the billing matters of this contract. This person shall have full authority to act for the Contractor on all matters relating to the daily operation of this contract. The person filling this role may be personnel performing under this contract. An alternate may be designated, but the Contractor shall identify, in writing, those times when the alternate shall act as the liaison.

Contractor Liaison: _______________________________

Phone Number: __________________________________

Fax Number: ____________________________________

Email Address: __________________________________

20. ALCOHOL/DRUG SCREENING

20.1. Contractor is responsible for ensuring their employees are not using alcohol or illegal drugs, while performing work under this contract, and are subject to random alcohol/drug testing performed by the

Contractor. Contractor shall perform alcohol/ drug testing when there is a reasonable suspicion that an employee is using or is impaired by alcohol or illegal drugs while on duty. Reasonable suspicion of alcohol/drug use or impairment includes, but is not limited, to the following:

20.1.1. Observable phenomena, such as direct observation of drug use, possession or the physical symptoms of being under the influence of a drug;

20.1.2. A pattern of abnormal conduct or erratic behavior;

20.1.3. Arrest or conviction for a drug related offense or the identification of a Contractor physician as the focus of a criminal investigation into illegal drug possession, use, or trafficking;

20.1.4. Information provided either by reliable and credible sources or independently corroborated;

20.1.5. Newly discovered evidence that the contract personnel has tampered with a previous drug test.

21. PATIENT SENSITIVITY

The Contractor shall respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships. The Contractor shall respect the cultural and personal values, beliefs, and preferences of each Veteran.

22. HEALTH REQUIREMENTS

22.1. The Contractor certifies that all personnel providing services under this contract have received the following testing/immunizations within the past year and shall maintain coverage during the contract period:

22.1.1. Tuberculosis Testing – the PPD test or radiological exam shall be repeated annually.

22.1.2. Immunizations – for purposes of infection control, all contractor personnel shall take required immunizations and any health action required by generally accepted public health standards and any immunizations necessitated by any outbreaks in the area/community. Contract personnel shall not be allowed to perform duty until immunization documentation is provided to the COR.

22.1.3. Health Restrictions – Contractor personnel shall have not health or physical disability restrictions which shall interfere with the performance of duties.

22.2. As a condition of employment Occupational Safety and Health Administration (OSHA) requires that all contract personnel who shall have occupational exposure to blood, other body fluids, or other potentially infectious materials, shall receive Hepatitis B vaccine, sign a voluntary declination or have documented proof of immunity to Hepatitis B infection. The immunization shall be the responsibility of the Contractor at no cost to the Government.

22.3. The Contractor’s personnel having patient contact or exposure to biological or pathological specimens shall be immunized against, be granted an immunization waiver or have documented proof of immunity to:

rubella, mumps, polio and Hepatitis B. In addition, The Contractor’s personnel shall be free of infectious diseases (to include active Tuberculosis and Viral Hepatitis) that might reasonably be expected to place other workers, patients or the public at risk.

22.4. The Contractor shall provide the Government with all the information necessary to ensure that Government records are maintained correctly and in compliance with The Joint Commission (TJC), OSHA and the

Center for Disease Control health records requirements, for each individual Contractor employee.

23. ORDERING ACTIVITIES

23.1. VA shall designate a Contracting Officer Representative (COR) to monitor the contract performance and assist in contract administration. A delegation of authority letter delineating the responsibilities and limitations of the COR shall be provided to the Contractor. Any commitments of changes, which affect the price, quantity, authority to amend or render a decision on questions of the fact in dispute and related contract administration problems are duties of the Contracting Officer and cannot be delegated.

23.2. The Contractor shall not accept any instructions issued by any other person(s) other than the Contracting

Officer or the COR acting within the limits of his/her authority. Only those services specified herein are authorized. Before performing any service that is not specified in this PWS, the Contractor shall first get approval from the Contracting Officer. Changes to the Contract may be made only in writing by the

Contracting Officer.

24. SITE INSPECTION

The VA shall have the right to conduct an inspection of Contractor’s office facility(s) anytime during the period of performance. The Contractor shall permit on-site visits by the VA to assure compliance with the contract requirements. Contractor shall make all records accessible for review by VA staff upon request.

25. EMERGENCY PLAN

It is agreed that the Contractor shall notify the VA COR immediately when they become aware that a medical emergency or hospitalization of a Veteran provided case management services under this contract has occurred.