HCHV Performance Work Statement for VISN 19 -watermarked.pdf

VISN 19

VA ROCKY MOUNTAIN NETWORK

PERFORMANCE WORK STATEMENT

HEALTH CARE FOR HOMELESS VETERANS

CONTRACT RESIDENTIAL SERVICES PROGRAM

1. PURPOSE

This section establishes required operations, oversight, and contractor compliance for Health Care for Homeless Veterans (HCHV) Contract Residential Services (CRS) in accordance with VHA Directive 1162.04(1) and applicable federal statutes and regulations. Contracts must provide care, treatment, or rehabilitation services and cannot be for housing alone, consistent with 38 U.S.C. §2031 and 38 CFR Part 63.

2. BACKGROUND

The U.S. Department of Veterans Affairs (VA), VISN 19 VA Rocky Mountain Network is seeking providers to assist with the provision of short-term emergency residential placement aimed at prevention of homelessness The central goal of the HCHV CRS program is to reduce homelessness among Veterans by conducting outreach and then engaging them in treatment, rehabilitation and other VA programs and non-VA community programs that provide prevention and support services. The contracted service described herein is designed to serve homeless Veterans in need of immediate placement in a safe environment for the following VA Health Care Systems:

A. VA Eastern Colorado Health Care System 1700 North Wheeling Street Aurora, CO 80045

B. VA Montana Health Care System 3687 Veterans Dr.

Helena, MT 59636

C. VA Cheyenne Health Care System 2360 E Pershing Blvd Cheyenne, WY 82001

3. PROGRAM SCOPE

A. This requirement is intended for community-based contractors currently operating residential facilities with demonstrated experience serving homeless individuals. The target population for HCHV CRS is homeless Veterans, particularly in cities along the major interstates and in affluent areas where housing is unaffordable and the wealth gap is most visible.

B. The VA may complement the non-VA community-based provider’s program with added treatment services such as participation in VA outpatient services.

DRAFT

C. VA Contracting Officer Representative (COR) / HCHV CRS Liaison will be assigned to each contractor facility and be identified by the VA medical center HCHV program. They will act as liaison for all client-related issues between the contractor and the VA HCHV team. They will not provide direct supervision.

4. DEFINITIONS

A. Homeless Veteran: The HCHV programs follows the definitions of “homeless Veteran” in 38 U.S.C. §§ 2002(1) and 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.

B. Veteran: A Veteran is, for the purpose of HCHV CRS Program, a person who served in the active military, naval, or air service, and who was discharged or released under conditions other than dishonorable and is enrolled or eligible for VA health care under 38 CRF 17.36 or 17.37. An eligible veteran must meet the criteria specified in 38 CFR 63.3 to qualify for benefits under the HCHV program.

C. Veteran Family: “Veteran family” refers to a Veteran with a household composed of two or more related persons. The term “Veteran family” also includes one or more persons living with the VA health care eligible Veteran who are determined to be important to the Veteran’s care or wellbeing.

D. Per Diem: Means that the VA shall pay for eligible Veteran’s stay in a residential treatment bed and associated treatment services for each day (date of admission is that first day) the Veteran resides at the facility and receives services. Unless specifically excluded in this contract, the rate established shall include the services listed in this document and shall also include the services or supplies normally provided to other patients by the facility without extra charge. It is the contractor’s responsibility to have appropriate systems of verification of services in place to justify invoices and payments.

E. Case Management: Arranging, coordinating, or providing direct services and supports; linkages to VA/non-VA resources; crisis management and monitoring;

and advocacy for transportation, credit, legal, and other needs.

F. Non-VA Community-Based Provider: A community facility providing temporary, short-term housing (generally up to six months), outreach, case management, and rehabilitative services, and basic mental health services as needed.

G. Participant: an eligible veteran for whom VA pays per diem to a non-VA community-based provider under 38 CFR part 63.

H. HCHV CRS Liaison: VA staff designated by the VA medical facility to oversee HCHV CRS operations, inspections, documentation, incident review, and payment requests for absent veterans per directive appendix C.

5. ROLES AND RESPONSIBILITIES

A. Contractor We'll operate the CRS program as specified herein and, in the contract, meet inspection standards, maintain documentation, and cooperate with VA oversight and audits.

B. VA medical facility HCRS CRS Liaison we'll monitor program operations, review inspection packets, verify administrative files, review critical incidents, and coordinate corrective actions.

C. VISN Network Homeless Coordinator will review CRS programs for compliance, ensure initial annual inspections, monitor performance metrics, and initiate corrective actions when needed.

D. HCHV National Program Office will provide oversight, guidance, data reporting, and require corrective action when non-compliance is identified.

6. REQUIREMENTS

A. Location: Contractors with residential facilities will provide HCHV CRS to qualified veterans that are located below:

1. Metro Denver (80012, 80014, 80022, 80033, 80123, 80127, 80202-80239)

2. Fort Collins, CO (80521-80528)

3. Bozeman, MT (59715)

4. Kalispell, MT (59901-59904)

5. Missoula, MT (59801-59812)

Ideally these facilities should be in centralized locations, near public transportation, and near areas that provide employment.

B. Facilities and Services:

1. Inspections: All contractor facilities and associated onsite services shall pass initial inspection per VHA Handbook 1162.04(1) Appendix B, prior to contract award. Veterans cannot be serviced in these facilities until initial inspection has been passed. In addition, contractor facilities must pass an annual VA inspection in accordance with VHA Handbook 1162.04(1) Appendix B. Also, Contractor facilities must operate in compliance with all federal, state, and local laws. The VA reserves the right to re-inspect any facility and associated services at any time under the terms of this contract.

2. Clinical Service Scope: Contractor shall deliver therapeutic rehabilitative services and case management and coordination with VA clinical staff.

3. Staffing: Contractor will employ sufficient professional staff to operate the program with an employee on duty or residing on site and available 24/7.

4. Patient Rights: Contractor will comply with applicable veteran's patient rights provisions referenced in 38 CFR 17.33.

C. Eligibility and Program Entry: To be eligible for HCHV CRS, a Veteran must meet the requirements of 38 U.S.C. 2031(a) and 38 CFR 63.3 and be referred to the location by a VA medical center.

1. The HCHV Coordinator, Social Worker or VA designated employee (case worker) refers eligible patients to the HCHV contractor.

2. Only Veterans authorized by HCHV CRS Liaison will be accepted into the facility under the HCHV CRS program.

3. Veterans shall be screened for entry into HCHV CRS to determine medical and psychiatric stability and their suitability for entry into the facility.

4. Obtain a Release of Information (ROI) from the Veteran allowing communication with the VA regarding the Veteran’s treatment needs and ongoing care.

5. When a Veteran is determined to be ineligible or if the level of care is not appropriate, collaborate with the Veteran and the HCHV CRS Liaison to arrange for provision of care through other VA or community resources.

6. Veterans cannot be denied entry into HCHV CRS based solely upon length of current abstinence from alcohol or non-prescribed controlled substances, the number of previous treatment episodes, the time interval since the last program entry, the use of prescribed controlled substances, or legal history. The screening process must consider each of these special circumstances and determine whether the program can meet the individual Veteran's needs while maintaining the program's safety, security, and integrity.

7. Contractor will ensure their internal admission process and procedures allow for timely, and whenever possible, same-day placement of homeless veterans into available beds.

8. The VA shall only pay for eligible beneficiaries of VISN 19, that is only Veterans whom the VA medical center HCHV personnel refers to the contractor, or for whom the VA medical center HCHV personnel authorizes the provision of services. In the case of contractors providing residential services to Veteran families, the VA shall only pay for the eligible Veteran.

9. The VA pays for each eligible Veteran’s exclusive use of a residential treatment bed within a facility. Therefore, the contractor may not bill the VA, and the VA will not pay for beds that are used by more than one person at a time, such as in shifts.

D. Exit/Discharge from HCHV CRS Program

1. Veterans shall be placed in other permanent housing within 60 to 90 days from the date of admission, but not more than 180 days from the date of admission. Contractors shall not bill for Veterans whose length of stay exceeds 180 days from the date of admission without prior approval from the COR/HCHV CRS Liaison. Extension Requests are due prior to the expiration of any authorized period of service. These requests need to be documented and approved by the COR/HCHV CRS Liaison.

2. If a Veteran’s length of stay exceeds 180 days from the date of admission and there is no approval from the COR/HCHV CRS Liaison, the contractor shall retain the responsibility for finding suitable permanent housing in the community at its own expense prior to the Veteran’s discharge from the program.

3. Veterans may be discharged from HCHV Contract Residential Care programs for positive or negative reasons. The date of discharge shall be approved by the COR/HCHV CRS Liaison for billing purposes. The contractor shall provide discharge planning and referrals for each Veteran, regardless of character of discharge from the facility to appropriate community resources and services based upon a team assessment of health, social and vocational needs and the involvement of Veterans’ families as appropriate.

4. The contractor will inform HCHV CRS Liaison of the Veteran’s exit within 24 hours.

5. Discharges shall be in accordance with VHA Handbook 1162.04(1).

E. Absence and Eligibility: This section outlines the updated requirements for absences and eligibility determinations in accordance with the HCHV CRS Directive. All documentation related to absences, outreach efforts, and eligibility determinations must be maintained by the contractor for verification, billing, and audit purposes. The contractor shall comply with the following provisions:

1. Scheduled Absences: The Department of Veterans Affairs (VA) will reimburse up to 96 consecutive hours per episode of care for a scheduled absence under the following conditions:

• The absence is pre-planned, consistent with, and supports the Veteran’s individual service plan (e.g., family reunification, short-term medical care, substance use disorder (SUD) or psychiatric treatment.

• The reason is documented in the Veteran’s case file, treatment, record, or service plan.

• The bed is not filled by the provider during the absence.

• The absence is not for a break or vacation from treatment.

• The absence is not used for extended educational or employment circumstances.

• The absence does not exceed 4 consecutive days.

2. Unscheduled Absences: VA will reimburse up to 48 consecutive hours for an unscheduled absence under the following conditions:

• The provider has evidence of active outreach to locate and reengage the Veteran and documents these steps in the Veteran’s case file, treatment record, or service plan.

• The bed is not filled by the provider during the absence.

• The Veteran is discharged from the HCHV CRS program if not located within 48 hours.

3. Ineligible Veteran: If a Veteran admitted to the HCHV CRS program is later found ineligible, VA will pay for a maximum of 4 days from the day of admission to allow the provider and HCHV CRS Liaison time to arrange alternate placement.

F. Nutrition: The HCHV CRS contract provider is responsible for providing a sanitary food preparation area, supplying sufficient food for at least three nutritious meals 7 days a week, and snacks of nourishing quality (e.g., fruits, vegetables, protein sources), between meals and bedtime. This is to include alternative meals or food supplies for Veterans with dietary restrictions if medically indicated (e.g., diabetic, renal, and soft mechanical diets) and reasonable accommodation for Veterans with cultural/religious preferences around food (e.g., Kosher, Sikh) and in accordance with VHA 10-10116a HCHV CRS Programs Inspection Packet.

G. Medication Storage and Monitoring: HCHV CRS programs are responsible for providing appropriate space and security for the storage of medications.

Storage can be provided to the Veteran to secure his or her medications or central storage can be provided by the HCHV CRS program. HCHV CRS programs are expected to have written procedures that address storage while providing access to medications and safe disposal of medications and syringes. Veterans residing in the program should be educated about these procedures.

7. RECORDS MANAGEMENT AND DATA

A. The contractor shall provide the COR/ HCHV CRS Liaison with a copy of their staff’s resume and a signed copy of Attachment 4 Contractor Rules of Behavior, for each employee and when a new employee joins the team or as requested.

B. Site visits by VA staff will periodically include a spot check of records to ensure contractor invoices accurately reflect the Veteran’s length of stay. Contractor shall adhere to the Department of Veterans Affairs Records Control Schedule (RCS) 10-1 (https://www.va.gov/vhapublications/rcs10/rcs10-1.pdf) for classification, retention, and disposals of records pertaining to care of veterans utilizing the facility. Contractors should contact COR/HCHV CRS Liaison prior to disposing of any veterans’ records. The contractor shall be responsible for the following records and reports:

1. Daily sign-in sheets signed by program Veterans to document and verify

Veterans presence at the facility for billing purposes. Daily sign-in sheets must be completed clearly, accurately and thoroughly with full printed names/signatures and monitored to provide a full accounting of a Veteran’s stay and treatment services received. Daily sign-in sheets will be made available upon request.

2. Veteran’s Intake, initial Individualized Care Plan (ICP), and Housing Needs

Assessment shall be completed within 72 hours of program admission.

ICPs are developed through a joint effort by the Veteran and the contractor.

The ICP is signed by the Veteran. ICPs shall be developed for each Veteran based on Veteran input and may also include input from HCHV CRS Liaison assessments and other VA clinical data. ICPs will be updated by the contractor every thirty (30) days from the date of the initial plan, to include any measures of movement toward rehabilitation goals, with particular focus on the attainment of community-based housing.

3. A final discharge summary on each Veteran who leaves the program, regardless of character of discharge, will include a description of beneficial changes realized during the residential period, reasons for leaving, the Veteran’s future, after-care referrals and connections, and follow up locator information. A final discharge summary is due within 24 business hours of Veteran’s discharge.

https://www.va.gov/vhapublications/rcs10/rcs10-1.pdf

C. Contractor shall document any incidents in writing and notify the COR/HCHV CRS Liaison of all critical incidents at their facility including death occurring with a Veteran within 24 hours or next business day of being informed or aware of the incident, if not sooner. Once the COR/HCHV CRS Liaison is notified of critical incident, the HCHV CRS Liaison may determine the need for a written report.

D. Contractors shall secure and provide file plans for veterans’ records associated with care. Secure shall mean the contractor has implemented physical measures, policies, and procedures to protect the contracted entity’s electronic and physical records, from natural and environmental hazards, as well as unauthorized intrusion pertaining to veterans. File plan shall include at a minimum “location of file”, “date of admission”, and “date of discharge

8. PERFORMANCE MONITORING AND CORRECTIVE ACTION:

A. A list of performance objectives and performance thresholds that will be verified by the COR/HCHV CRS Liaison will be identified by the PWS at the time of contract award. The performance objectives and performance thresholds represent the minimum acceptable level of performance. The performance objectives represent the most significant tasks to this contract and do not excuse the contractor from performance of other responsibilities identified in the PWS.

B. VA will monitor CRS performance using established metrics, inspections, and audits; the contractor must participate in reviews and implement corrective action plans within VA-specified timeframes when deficiencies are identified.

C. The contractor shall provide the HCHV CRS Liaison with a written report on all program activities on a quarterly basis in accordance with the Quality Assurance Surveillance Plan (QASP). The contractor’s quarterly report should contain, at a minimum, the following information:

a. Total Number of Veterans Served

b. Data from QASP compliance tool

c. Program Completion Rates

d. Outcomes (e.g. # or % of veterans discharged to independent housing, increased income/benefits, occupancy, etc.)

e. Other pertinent information, such as quality improvement projects, changes in staffing or business practices, systems or resources concerns, etc.

These reports shall be maintained by the HCHV CRS Liaison in the contract administrative file, and necessary reports shall be submitted as part of the annual inspection package.