Doc. 02. Performance Work Statement (PWS).pdf

PERFORMANCE WORK STATEMENT (PWS)

PROJECT TITLE: Influx Care Facility (ICF) Site in Fort Bliss, Texas

DEPARTMENT: U.S. Department of Health and Human Services (HHS) Administration for Children and Families (ACF)

Office of Refugee Resettlement (ORR)

1.0 BACKGROUND

The U.S. Department of Health and Human Services (HHS), Administration for Children and Families (ACF), Office of Refugee Resettlement (ORR) is responsible for the care and placement of Unaccompanied Children (UC) transferred from the Department of Homeland Security (DHS). In accordance with the Homeland Security Act of 2002 and the Trafficking Victim Protection Reauthorization Act (TVPRA) of 2008, ORR is responsible for providing care and custody of all UC who have been referred by DHS within seventy-two (72) hours of apprehension. ORR has worked to increase permanent bed capacity in State-Licensed Care Facilities to align with increased referrals year over year since the passage of the TVPRA.

Unfortunately, due to shifting and unpredictable patterns of migration, ORR has experienced several periods when UC referrals far exceed available bedspace capacity leading to significant and lengthy backups along the Southwest Border of the United States (U.S.). This includes an historic increase in Fiscal Year (FY) 2021 when ORR received over 100,000 UC referrals in less than six (6) months posing significant child safety hazards. To better prepare for future surges, ORR has a need for Influx Care Facility (ICF) Sites across the country to augment its permanent bed capacity. These ICF Sites allow ORR to accept referrals from U.S. Border Patrol more expeditiously and limit the time UC spends in the Border Patrol Facility.

2.0 PURPOSE AND OBJECTIVES

The purpose of this Performance Work Statement (PWS) is to specify ORR’s requirements for the provision and operation of ICF Sites and related services throughout the continental U.S. Under this PWS, the Contractor(s) shall provide:

a) Facilities and Infrastructure necessary to safely house UC when capacity in ORR’s network of state-licensed beds has been exceeded.

b) Direct Care of UC including all personnel, services, and resources necessary to provide for the care and supervision of UC housed at the ICF.

Prime Contractor capabilities, experience, subcontractor base, community network, and expertise related to the provision of safe and appropriate care and support of UC, and/or similarly situated at-risk minor populations are critical to the success of this effort.

Policy and Reference Documents

ICF Site operations shall be conducted in accordance (IAW) with the following:

• ORR Policy Guide, Children entering the United States Unaccompanied: https://www.acf.hhs.gov/orr/policy-guidance/children-entering-united-states-unaccompanied

• Policy for Influx Care Facilities (See Section 7 of ORR Policy Guide referenced in Section 1.3.1.1 above):

https://www.acf.hhs.gov/orr/policy-guidance/children-entering-united-states-unaccompanied-section-7#7.1 https://www.acf.hhs.gov/orr/policy-guidance/children-entering-united-states-unaccompanied https://www.acf.hhs.gov/orr/policy-guidance/children-entering-united-states-unaccompanied https://www.acf.hhs.gov/orr/policy-guidance/children-entering-united-states-unaccompanied-section-7#7.1

• ORR Field Guidance containing updates to ICF standards: https://www.acf.hhs.gov/orr/policy-guidance/uc-program-field-guidance

• ORR Key Documents: https://www.acf.hhs.gov/orr/policy-guidance/unaccompanied-children-program

• The Contractor shall comply with ORR Policy related to preventing, detecting, and responding to sexual abuse and harassment in accordance with ORR’s Zero Tolerance Policy (See Section 4.5.3 of ORR Policy Guide referenced in Section 1.3.1.1 above): https://www.acf.hhs.gov/orr/policy-guidance/children-entering-united-states-unaccompanied-section-4).

• UC Manual and Procedures (UC MAP) provides procedures that operationalize ORR policy. The UC MAP is accessed through ORR’s online case management system which will become available for Contractor access after award.

Performance Requirements are based upon policy, regulations, and guidelines. The Contractor is responsible for staying up to date with policy and regulatory changes and should adapt to the evolving nature of the working environment. The Contractor shall notify the Contracting Officer’s Representative (COR) in the event of any significant discrepancies.

Type of Contract

The Federal Government intends to award an Indefinite-Delivery Indefinite Quantity (IDIQ) Contract type in accordance with Federal Acquisition Regulation (FAR) 16.504.

Period of Performance

The Period of Performance for this requirement shall consist of a Base Period of three (3) months from the date of Contract Award and three (3) three (3) month Option Periods.

Overview of Required Services (Flores and Adherence to ORR Policy)

The Contractor shall provide and operate an ICF Site and provide all services, resources, equipment, and staff necessary for operations. The scope of services under this effort includes providing the care, housing, and supervision of UC ranging from 13 to 17 years of age in ORR custody until such time as the

UC can be released to an ORR approved and vetted sponsor, the UC is transferred to another ORR facility, or the UC is transferred as directed by the Government.

NOTE: The population of ICFs will generally be limited to UC aged 13 to 17. However, the Contractor may be required to house minors under the age of 13 who are part of a sibling or family group at the direction of ORR. All services provided to UC must be tailored to the unique needs of UC and equal to their age, gender, level of development, and other demographics such as country of origin, language spoken, etc. Factors other than age are considered when assigning UC to an ICF. These factors are provided in ORR Policy Guide Section 7.2.1.

The ICF Site shall comply with all applicable state child welfare laws and regulations and all state and local building, fire, health, and safety codes. ICF Site must deliver services in a manner that is sensitive to the age, culture, native language, and needs of each UC. Under the terms of the Flores Settlement

Agreement (FA), the ICF Site must provide the following services for each UC:

https://www.acf.hhs.gov/orr/policy-guidance/uc-program-field-guidance https://www.acf.hhs.gov/orr/policy-guidance/uc-program-field-guidance https://www.acf.hhs.gov/orr/policy-guidance/unaccompanied-children-program https://www.acf.hhs.gov/orr/policy-guidance/children-entering-united-states-unaccompanied-section-4 https://www.acf.hhs.gov/orr/policy-guidance/children-entering-united-states-unaccompanied-section-4

• Proper physical care and maintenance, including suitable living accommodations, food, appropriate clothing, and personal grooming items.

• Appropriate routine medical and dental care, family planning services, including pregnancy tests and comprehensive information about and access to medical reproductive health services and emergency contraception, and emergency health care services.

• A complete initial medical examination (including screenings for infectious diseases) within 48 hours of admission, excluding weekends and holidays, unless the UC was recently examined at another ORR care provider facility.

• Appropriate immunizations as recommended by the Advisory Committee on Immunization Practices’ Child and Adolescent Immunization Schedule and approved by HHS’ Centers for Disease Control and Prevention.

• Administration of prescribed medication and special diets.

• Appropriate mental health interventions when necessary.

• An individualized needs assessment, which includes the various initial intake forms, collection of essential data relating to the identification and history of the child and his or her family, identification of the UC’s special needs including any specific problems which appear to require immediate intervention, an educational assessment and plan, and an assessment of family relationships and interaction with adults, peers, and authority figures.

• A statement of religious preference and practice.

• An assessment of the UCʼs personal goals, strengths, and weaknesses.

• Identifying information regarding immediate family members, relatives, godparents, or friends who may be residing in the United States and may be able to assist in connecting the child with family members.

• Educational services appropriate to the UCʼs level of development and communication skills in a structured classroom setting Monday through Friday for six (6) hours per day, which concentrates primarily on the development of basic academic competencies, and secondarily on English Language Training. The educational program shall include instruction and other reading materials in primary native languages. Basic academic areas should include Science, Social Studies, Math, Reading, Writing, and Physical Education. The program must provide UC with appropriate reading materials in languages other than English for use during leisure time.

• Activities according to a recreation and leisure time plan that includes daily outdoor activity (weather permitting) with at least one (1) hour per day of large muscle activity and one (1) hour per day of structured leisure time activities (that should not include time spent watching television). Activities should be increased to a total of three (3) hours on days when school is not in session.

• At least one (1) individual counseling session per week conducted by trained social work staff with the specific objective of reviewing the child’s progress, establishing new short-term objectives, and addressing both the developmental and crisis-related needs of each child.

• Group counseling sessions shall be administered at least twice a week. Sessions are usually informal and take place with all UC present. The sessions give new children the opportunity to get acquainted with staff, other children, and the rules of the program. It is an open forum where everyone gets a chance to speak and engage with staff and their peers. Daily program management is discussed, and decisions are made about recreational and other activities. The sessions allow staff and UC to discuss whatever is on their minds and to resolve problems.

• Acculturation and adaptation services, which include information regarding the development of social and interpersonal skills which contribute to those abilities necessary to live independently and responsibly.

• Access to religious services of the UC’s choice. If attempts are made to obtain religious services of the UC preference cannot be obtained, he/she will not be required to attend services provided as an alternative.

• Visitation and contact with family members (regardless of their immigration status), is structured to encourage visitation. The staff must respect the child’s privacy while reasonably preventing the unauthorized release of the UC.

• A reasonable right to privacy, which includes the right to wear his or her own clothes when available, retain a private space in the residential facility, group, or foster home for the storage of personal belongings, talk privately on the phone, and visit privately with guests, as permitted by the house rules and regulations, receive, and send uncensored mail unless there is a reasonable belief that the mail contains contraband.

• Services designed to identify relatives in the United States as well as in foreign countries and assistance in obtaining legal guardianship when necessary for the release of the unaccompanied child.

• A comprehensive orientation regarding program intent, services, rules (written and verbal), expectations, and the availability of legal assistance.

• Legal services information, including the availability of free legal assistance, the right to be represented by counsel at no expense to the Government, the right to a removal hearing before an Immigration Judge, the right to apply for asylum or to request voluntary departure in lieu of deportation. This information is included in the Legal Resource Guide for Unaccompanied Alien Children.

• The defined and priced requirements under this Contract shall be measured in terms of facility capacity for UC general population beds, facility capacity for UC medical isolation/quarantine beds, staffing support for UC general population beds, staffing support for UC medical isolation/quarantine beds, and one-time Demobilization/Site Reclamation/Restoration.

• The Contractor will maintain sufficient personnel, supplies, housing, medical, medication, and services necessary to always accommodate the minimum and maximum staffed capacity as determined by ORR. For the site at Pecos, Texas, this will range between Warm Status and 2,940

UC.

• The Contractor shall maintain and operate UC housing areas in a manner that promotes child safety and that adheres to child welfare practices. The Contractor will provide sufficient staffing, in accordance with ORR mandated ratios, and provide line of sight supervision of UC (both waking and sleeping hours). While the use of bunk beds is authorized, their use shall be employed only as needed to accommodate greater numbers of children and not impede the ability of staff to maintain a line of sight of UC.

• The Contractor shall use staffing plans (including the use of standing posts and deploying staff beyond minimum ratios) when the facility design/layout may make the direct line of sight supervision challenging. The Contractor shall make recommendations for housing UC in a manner that achieves these goals for approval by COR. In addition, the Contractor is encouraged to conduct outreach and partner with local non-governmental and community-based organizations to the greatest extent possible.

• The Contractor shall house UC in compliance with ORR Policy according to an assessment of the youth’s gender identity and housing preference, health and safety needs, and State and Local licensing standards. For the purposes of this Contract, “area” is defined as a separate residential housing unit where sight and sound separation are maintained. The Contractor shall abide by all ORR mandated staffing ratios, as detailed in ORR Policy Guide, Children Entering the United States Unaccompanied, https://www.acf.hhs.gov/orr/policy-guidance/children-entering-united-states-unaccompanied-section-7 as of the date of execution of this Contract. The Contractor is responsible for monitoring the ORR regulations for updates and shall always ensure compliance.

• The Contractor shall provide all staffing necessary to accommodate the ORR-stated capacity of the ICF Site, taking into consideration demographics of the UC, as well as the medical status of the

UC.

• At all times, the Contractor shall maintain and operate the ICF Site in a manner that promotes child safety and that adheres to child welfare practices, as mandated in ORR policy.

https://www.acf.hhs.gov/orr/policy-guidance/children-entering-united-states-unaccompanied-section-7 https://www.acf.hhs.gov/orr/policy-guidance/children-entering-united-states-unaccompanied-section-7

• The Contractor shall use creative solutions to maintain a line-of-sight supervision while physically segmenting children into smaller groups, including but not limited to temporary partitions and other devices approved by the COR prior to implementation. As part of the services provided by the Contractor under the terms of the Contract, and with the approval of the COR, the Contractor is encouraged to bring in services from the community to support UC programs, such as visits from local organizations, cultural activities, and sports/recreation organizations. Costs for these services shall not be passed on to the Government without the explicit pre-approval of the Contracting Officer (CO), in writing.

3.0 SCOPE OF SERVICES

The Contractor shall provide all facilities, resources, staff, and services necessary to operate the ICF Site in Fort Bliss, Texas. The scope of services under this effort includes the temporary care, housing, and supervision of UC in ORR custody until such time as the UC can be released to an ORR approved/vetted sponsor, the UC is transferred to another ORR facility, or the UC is transferred as directed by the Federal Government. The Contractor shall provide all services necessary to meet the needs of UC placed at Fort Bliss, Texas including providing care, housing, line of sight supervision, case management, medical services, behavioral health services, facility management/operation services, as well as a survey tool approved by the COR.

The defined and priced requirements under this contract shall be measured in terms of Facility Capacity for UC General Population Beds, Facility Capacity for UC Medical Isolation/Quarantine Beds, Staffing Support for UC General Population Beds, Staffing Support for UC Medical Isolation/Quarantine Beds, and one time Demobilization/Site Reclamation/Restoration.

The Contractor shall provide all facilities-related infrastructure, materials, supplies, and resources necessary to accommodate up to 5,000 UC General Population Beds for UC aged from 13 to 17 years of age under the existing facility footprint of the Fort Bliss ICF Site. Changes to the facility footprint or tent operational status requires the written approval of the Contracting Officer (CO). At all times during the period of performance of this contract, all twenty-five (25) tents (inclusive of dormitory areas, facilities support, and storage) that comprise the facility footprint shall be fully operational and available for use, at the sole discretion of the Federal Government.

The Contractor shall house UC according to demographics that adhere to ORR Policy for age and sex with male and female UC housed in separate areas. For the purposes of this contract, “area” is defined as a separate tent where site and sound separation are maintained. The Contractor shall abide by all ORR mandated staffing ratios, as detailed as of the date of this contract in ORR Policy: https://www.acf.hhs.gov/sites/default/files/documents/orr/FG- 13%20EIS%20Instructions%20and%20Standards%202021%2004%2030.pdf

Warm Status

Warm Status means an ICF Site has scaled down to zero (0) UC on site, but the Contractor must be fully prepared to reactivate the operations to accept up to 500 children at the ICF Site within one (1) week of notification by the CO (verbal or written). Warm status refers to maintaining standing facilities in good working order (e.g., maintaining critical infrastructure) to accommodate an increase of Staffed Capacity upon direction by the CO. Examples of achieving Warm Status include, but are not limited to, rearranging the footprint, or repurposing existing structures for other ORR-mission activities and/or temporarily taking HVAC and other relevant systems offline (if not required for ORR activities), etc. The Contractor shall maintain personnel sufficient to 1) Maintain Warm Status, 2) Plan for Ramp-Up, and 3) Transition from Warm Status to fully operational within one (1) week.

https://www.acf.hhs.gov/sites/default/files/documents/orr/FG-13%20EIS%20Instructions%20and%20Standards%202021%2004%2030.pdf https://www.acf.hhs.gov/sites/default/files/documents/orr/FG-13%20EIS%20Instructions%20and%20Standards%202021%2004%2030.pdf https://www.acf.hhs.gov/sites/default/files/documents/orr/FG-13%20EIS%20Instructions%20and%20Standards%202021%2004%2030.pdf

At the request of the Federal Government, the Contractor shall ramp-up or ramp-down Staffed Bed Capacity in increments of 500 in the following manner:

RAMP-UP:

BASE STAFFED BED CAPACITY RAMP-UP INCREMENT NEW STAFFED BED CAPACITY

WARM STATUS 500 500

500 500 1,000

1,000 500 1,500

1,500 500 2,000

2,000 500 2,500

2,500 500 3,000

3,000 500 3,500

3,500 500 4,000

4,000 500 4,500

4,500 500 5,000

RAMP-DOWN:

BASE STAFFED BED CAPACITY RAMP-UP INCREMENT NEW STAFFED BED CAPACITY

5,000 500 4,500

4,500 500 4,000

4,000 500 3,500

3,500 500 3,000

3,000 500 2,500

2,500 500 2,000

2,000 500 1,500

1,500 500 1,000

1,000 500 500

500 500 WARM STATUS

The defined requirements under this Contract shall be measured in terms of Beds of Capacity and Staffed Beds. Beds of Capacity means the beds are onsite, but the staffing and services will require a ramp-up to be fully useful and considered into Staffed Beds. Staffed Beds means the staffing and services as required in the Contract are readily available for immediate occupation of a UC in a bed. The transition from Beds of Capacity to Staffed Beds will be at the Government’s request via Contract Modification.

RAMP-UP/RAMP-DOWN NOTICES:

NOTICES: The CO shall provide ramp-up and ramp-down notices in writing to the Contractor. A Contract Modification will be executed (by a warranted Contracting Officer) and the funds associated with the ramp-up or ramp-down requirement shall be added to the Contract. Fund totals/obligation amounts shall be based on the date that the ramp-up or ramp-down time-period ends.

RAMP-UP: The CO shall provide the Contractor with a seven (7) day notice in writing when a ramp-up requirement is identified.

RAMP-DOWN: The CO shall provide the Contractor with a seven (7) day notice in writing when a ramp-down requirement is identified.

PAYMENT TERMS AND CONDITIONS:

• RAMP-UP – Payment shall commence at the end of the ramp-up period. When the Contractor receives a seven (7) day ramp-up notice in writing, payment shall commence on the eighth day going forward when Staffed Bed Capacity is increased.

• RAMP-DOWN – Payment shall commence at the end of the ramp-down period. When the Contractor receives a seven (7) day ramp-down notice in writing, payment shall occur on the eighth (8) day going forward when Staffed Bed Capacity is reduced.

PRICING – Each Contract Modification issued for a ramp-up or ramp-down notice shall include the Period of Performance associated with the request. To facilitate this structure, the Contractor shall provide pricing at a daily rate for ramp-up and ramp-down period.

NOTE: ORR reserves the right to pull a tent from General Population and designate it as a medical isolation tent to address a surge in UC capacity.

Soft-Tent Capacity and Construction

Under the terms of this PWS, UC will be housed in existing soft-sided tents (structures) currently constructed and maintained at the Fort Bliss ICF Site. The Contractor shall maximize the amount of available square footage per UC to the maximum extent practicable within the preferred and maximum tent capacities, as directed by the COR. The Contractor shall abide by ORR policies, procedures, and field guidance regarding bed placement and the housing of UC, including those UC who are determined to be COVID-19 positive or requiring medical isolation or quarantine due to medical conditions.

Under the existing facility footprint of the Fort Bliss ICF Site, the capacity of each soft-sided tent structure shall be limited to a preferred capacity of 300 beds per soft-sided tent structure, with a maximum capacity of 650 beds per soft-sided tent structure as directed by the COR, unless there is a Contract Modification that specifically changes the preferred and maximum capacity per soft-sided tent structure. Single beds are required under this Contract unless otherwise directed by the CO in writing. Should the UC count (also referred to as “census”) in a tent exceed 400 beds and/or the COR authorized the use of bunk beds, the Contractor shall, only with the written authorization of the CO, utilize bunk beds that conform to the following requirements:

• Each bunk bed must allow enough space in between the top and bottom bunk and the top bunk and the ceiling to allow the assigned UC to sit upright without the UC’s head touching the top bunk or ceiling.

• Each bunk bed must be equipped with a securely attached ladder capable of supporting an average weight an average weight employee (adult).

• Each bunk bed that has a bottom bunk that is more than thirty (30) inches above the floor (including the mattress), must be equipped with securely attached safety bedrails along the lengths of the bed on each side with a means to allow a UC to get in and out of bed. Bunk beds securely attached to a wall may use the wall as one of the required safety bedrails. The top of safety bedrails must be at least five inches above the top of the mattress. For both the top and bottom bunk, the safety bedrails and the mattress support under the mattress must not present an entrapment or other hazard.

• Openings in the safety bedrails and openings between ladder rungs must not have openings that can entrap a child's body or body part. Openings must measure less than 3 ½ inches or more than 9 inches to prevent a child's body or body part from being entrapped.

• Each bunk bed must be spaced to provide adequate walk space on at least one side and one end of each bed.

• Each bunk beds must be spaced in a way that allows line of site supervision of UC.

At all times, the Contractor shall maintain and operate the Fort Bliss ICF Site and UC housing areas in a manner that promotes child safety and that adheres to child welfare practices, as mandated in ORR policy.

The Contractor shall provide sufficient staffing, in accordance with ORR mandated ratios, always to provide line of sight supervision of UC both during waking and sleeping hours. The Contractor shall implement strategies and other devices to reduce noise in UC housing areas, to the extent practicable and at the direction of the COR. This may include partitions and other dividers that do not impede line of sight supervision, and as approved by the COR.

The Contractor is encouraged to use creative solutions to maintain line of sight supervision while physically segmenting children into smaller groups, including but not limited to temporary partitions and other devices approved by the COR. The Contractor shall use staffing plans (including the use of standing posts and deploying staff beyond minimum ratios) when the facility design/layout may make line of sight supervision challenging and as needed to maintain line of sight supervision. The Contractor shall make recommendations for bed placement and housing UC in a manner that achieves these goals, subject to approval by the COR. The Contractor is encouraged to conduct outreach and partner with local non-governmental and community-based organizations to the greatest extent possible. As part of the services provided by the Contractor under the terms of the contract, and with the approval of the COR, the Contractor is encouraged to bring in services from the community to support UC program, such as visits from local organizations, cultural activities, and sports/recreation organizations. Costs for these services may not be passed on to the Government without the explicit pre-approval of the CO, in writing.

4.0 OUTCOME

The outcome of this effort is to provide comprehensive services that meet the unique needs of the UC population, including:

• Case Management Services

• Medical Services

• Behavioral Health Services

• Line of Sight Supervision Services

• Facility Management Services

• Survey Tool

• Educational Services

Successful completion of this project will ensure that a full complement of services is provided to UC by a cadre of qualified staff, in a timely manner, and to meet the unique needs of the UC population.

5.0 ASSUMPTIONS/CONSTRAINTS

Although services shall be staffed and rendered in accordance with (IAW) the staffing ratio identified in ORR Field Guidance #13, dated April 30, 2021, the ICF Site is not subject to the minimum staffing ratios required for licensed programs and influx facilities under ORR Policy Guide Section 4.4.1 and ORR Policy Guide 7.7, or to the minimum staffing ratios for Case Management and clinical staff outlined in the standard ORR Cooperative Agreement for licensed programs.

Services provided shall be IAW ACF, ORR Field Guidance #13, Influx Care Facilities (ICF) Instructions and Standards, dated April 30, 2021, and UAC Manual of Procedures (UAC MAP) and UAC Policy Guide dated August 7, 2017. Key documents for the ACF ORR Unaccompanied Children Program can be found at the link:

https://www.acf.hhs.gov/orr/policy-guidance/unaccompanied-children-program#legal

The Contractor is responsible for staying up to date with regulatory and policy changes and should adapt to the evolving nature of the working environment.

Only ICF Site federal personnel, or personnel who have been cleared through a fingerprint-based, federal background check, are permitted to supervise direct care staff. Staff and volunteers who provide direct care must pass public record criminal background checks for deployment at the ICF Site. Additionally, all medical providers must maintain current state licensure, possess clean background checks, and clean child abuse and neglect checks. Staff who will have unsupervised direct access (e.g., physically present) to UC must have an FBI based background check, and child abuse and neglect check (if not waived or modified by ORR). Staff who do not have direct access to children must have a public records criminal background check. ORR will ensure receipt of background checks for ICF Site staff. Staff and volunteers who provide https://www.acf.hhs.gov/orr/policy-guidance/unaccompanied-children-program#legal direct care may not have unsupervised contact with unaccompanied children until all background checks have been completed.

For this document, quarantine refers to separating individuals who were exposed to a contagious disease to see if they become sick. Isolation refers to separating sick individuals with a contagious disease from other individuals.

6.0 PERFORMANCE REQUIREMENTS

Independently, and not as an agent of the Government, the Contractor shall furnish all the necessary services, qualified personnel, material, equipment, and facilities, not otherwise provided by the Government, as needed, to perform the requirements described in this PWS.

The contractor shall provide a comprehensive orientation regarding program intent, services, rules (written and verbal), expectations, and the availability of legal assistance. Legal services shall include information, including the availability of free legal assistance, the right to be represented by counsel at no expense to the government, the right to apply for asylum or to request voluntary departure in lieu of deportation.

The Contractor shall provide turnkey wrap around services for up to Warm Status to 5,000 UC at the ORR Fort Bliss ICF Site location from the date of contract award. Services and staffing can be ramped up to support UC in increments of 500 at a schedule agreeable to the Government. Timeframe for services to start is TBD.

The Contractor shall perform the following tasks and deliver requirements in accordance with stated performance standards.

6.1 CASE MANAGEMENT SERVICES

The Contractor shall provide the following:

• The Contractor and its personnel shall comply with all applicable State child welfare laws and regulations, and all State and local health and safety codes. The Contractor and its care providers shall deliver services in a manner that is sensitive to the age, culture, native language, and needs of each unaccompanied child. The Contractor shall ensure that the personnel they provide have access to language line use/translation services for other such languages as required and directed by ORR.

• COR reserves authority to determine on-site | virtual Case management Ratio.

• The Contractor shall perform initial intake assessments and case management services for triaging and input into the UC database for reporting purposes.

• The Contractor shall develop an individual service plan for the care of each child (per ORR Policy & Guidance Section 3.3).

• The Contractor shall contact and engage potential sponsors to initiate sponsor assessments, including performing background checks, child abuse and neglect checks, and sex offender registry checks in accordance with ORR policies and procedures.

• The Contractor shall make determinations on sponsor suitability by thoroughly vetting the sponsor identity and confirming the validity of government-issued identity documents as required by the field guidance issued for each applicable UC category.

• The Contractor shall engage in the family reunification process and make recommendations for timely reunifications of UC with the verified sponsors as specified as required in the field guidance issued for each applicable UC category.

• The Contractor shall coordinate with ORR care providers, consulates, international bodies, child advocates, third-party coordinators, and U.S. Federal agencies to unify UC with the respective sponsors.

• The Contractor shall provide case information and status updates to UC Case Coordinator and ORR/Federal Field Specialists (FFS) on progress in achieving a safe and timely release to the sponsor and to the UC on the child’s case and provision of services, preferably in-person. The FFS makes the final determination on all release decisions.

• Contractor shall conduct ORR Initial Intake Assessment and provide Language/ Translation services for 75% of UCs within 24 hours of admission.

• Contractor shall ensure that each UC has a single assigned case manager within 24 hours of initial assessment, and that cases are reassigned within 24 hours if a case manager leaves or is unable to continue working a case. Contractor shall maintain a central assignment registry and be able to provide the registry to ORR upon request.

• Contractor shall ensure the UAC Assessment is complete for 75% of UCs within 24 hours of admission.

• Contractor shall ensure Sponsor background checks, abuse and neglect checks, Identification Authentication, and sex offender registry checks are completed for at least 75% of UCs within 10 days of admission to program

• Contractor shall ensure all information is entered into the UC database within 24 hours of collection or update.

• Contractor shall ensure requests for UC transportation for reunification or transfer are submitted to the travel vendor for 75% of UCs within 24 hours of ORR approval for reunification or transfer.

• Contractor shall ensure 100% of case management staff complete all required initial and ongoing trainings provided by ORR or ORR’s training providers. Contractor shall coordinate case management service delivery with any other ORR-designated parties (e.g., federal staff/detailees).

Care providers must ensure that all records are maintained and protected so that confidential information and data are secure and not accessed, used, or disclosed to unauthorized parties or improperly altered.

There must be established administrative and physical controls to prevent unauthorized access to both electronic and paper records. The care provider’s policies and procedures must also address preventing the physical damage or destruction of records. For sensitive unaccompanied alien child’s information pertaining to sexual abuse or clinical records, care providers must implement appropriate controls on the dissemination of such information to ensure that sensitive information is not exploited to the unaccompanied alien child’s detriment by staff or other children or youth.

Case Managers are also responsible for the timely entry of all required information into the ORR database.

For specific timeframes related to assessment of unaccompanied alien children and potential sponsors, reporting, and release:

• The Application for Release

• UAC Assessment and Case Review

• Initial Medical Exam

• Responding to Medical Emergencies

• Assessment for Risk

• Transfer of Physical Custody

• Closing the Case File

All potential sponsors must complete an application for a child to be released to them from ORR custody (the “Family Reunification Application”). Within 24 hours of identification of a potential sponsor for a child or youth, the care provider or the ORR National Call Center sends the sponsor a package with the application and related documents (called the Family Reunification Packet or FRP).

The application package includes the following documents:

• Family Reunification Packet Cover Letter

• Authorization for Release of Information

• Family Reunification Application

• Sponsor Care Agreement

• A flyer with contact information on organizations offering a Legal Orientation Program for Custodians (LOPC) https://www.acf.hhs.gov/orr/resource/children-entering-the-united-states-unaccompanied-section-2#2.2.3 https://www.acf.hhs.gov/orr/resource/children-entering-the-united-states-unaccompanied-section-3#3.3.1 https://www.acf.hhs.gov/orr/resource/children-entering-the-united-states-unaccompanied-section-3#3.4.2 https://www.acf.hhs.gov/orr/resource/children-entering-the-united-states-unaccompanied-section-3#3.4.5 https://www.acf.hhs.gov/orr/resource/children-entering-the-united-states-unaccompanied-section-4#4.8.1 https://www.acf.hhs.gov/orr/resource/children-entering-the-united-states-unaccompanied-section-2#2.8.2 https://www.acf.hhs.gov/orr/resource/children-entering-the-united-states-unaccompanied-section-2#2.8.3

• A flyer with contact information for the UAC Sexual Abuse Hotline

• Fingerprint instructions

• Sponsor Handbook

• Letter of Designation for Care of a Minor (If parent or legal guardian wishes to specify)

• A flyer warning sponsors of potential fraud scheme

NOTE: ORR may direct staff capacity, including but not limited to case managers and youth care workers, to assist with tasks to improve facilities and services at the ORR Fort Bliss ICF Site – or, on a virtual basis, at other ORR facilities.

6 1.1A CASE MANAGEMENT SERVICES STAFFING

The Contractor shall employ case managers based on the appropriate level of need 12-hour shifts during a 7-day work week. Shifts shall be staffed from the hours of 8:00 a.m. – 6:00 p.m. Staff must be able to contact sponsors outside of traditional working hours, and work around sponsors’ schedule. Contractor must establish a schedule that enables each child to meet with their assigned case manager at least once a week (i.e., every 7 calendar days) to discuss the status of their case and offer the child an opportunity to provide information relevant to their case or to ask questions.

• The Contractor shall provide experienced case managers who can augment services currently on-site (if not waived or modified by ORR).

• Experience: 2-5 years of experience in recording case management activities and childcare experience

• Education: Associates degree, degree in social work, or social services

• Skill set: Demonstrated ability to:

• Gather, document, and verify information

• Work alongside an Agency, other contractor, or staff

• Perform duties on-site and off-site

• The Contractor will retain Case Management Leads, of whom at least 25 percent will have a minimum of 1 year of experience with ORR program case management, and a minimum of 2 years of experience in a staff management/supervisory role.

• The Contractor will seek to retain Case Management Supervisors who have a minimum of 3 years of experience with ORR program case management, and a minimum of 5 years of experience in staff management/supervision.

• The contractor will ensure that UC are educated on the process for reporting concerns about their case status through the ICF Site’s pre-existing grievance process. Grievances on case status will be reviewed by the Lead Case Manager or supervisor of the assigned case manager. In accordance with ORR Policy 4.10.1, the child must receive a written response to their grievance regarding their case status within 5 days of receipt. During the initial communication with a sponsor, the sponsor will be educated on the process for reporting concerns about the child’s case status and provided the contact information for the child’s Lead Case Manager or supervisor. The sponsor will be directed to file the grievance with the Lead Case Manager or supervisor. Sponsors who use this process to raise concerns about the child’s release status will receive a response within 5 days of receipt.

The minimum staffing ratio includes:

• Case managers with minimum 50% on site; 1:8 UAC.

• Case management supervisor (1:10 case manager leads)

• Case management lead (1:7 case managers)

• Recommended: Case aide (2 for every 500 UC)

6.1.1.1 TRAINING

The Contractor shall train staff in the following: ORR policies and procedures, ORR interim guidance and operations manual; the Prison Rape Elimination Act Interim Final Rules procedures; the sponsor reunification packet; ORR Database/System of Record; behavioral management and non-violent restraint techniques; cultural competence training; and child-welfare best practices. The Contractor shall request the COR’s approval for all training material developed before its use. All training material developed for the purpose of this contract will be the property of ORR. Training material shall be available in hard and electronic copy.

The Contractor shall prioritize completing ORR-approved training for Youth Care Workers upon notification of award.

The Contractor shall follow procedures consistent with relevant provisions in the ACF ORR Policies and UAC Manual of Procedures (UAC MAP) in administering case management services, including (without limitation) in all initial placements, transfers, screenings, and releases of unaccompanied children. Any substantial departure from the procedures as outlined in the ACF UAC Manual by the Contractor will only be permissible as agreed to in advance between the Contractor and the Government/ORR.

6.1.1.2 SCREENING

The contractor shall provide an appropriate mix of qualified personnel to provide services as described above, unless otherwise noted. The contractor is strongly encouraged to engage bilingual Spanish speaking and other appropriate languages/dialects used by UC of Afghan and Haitian cultures case management providers, to facilitate service to UC who have language and literacy barriers.

6.1.1.3 CREDENTIALING AND VETTING OF PERSONNEL

The terms “credentialed”, and “credentialing” mean having provided, or providing, respectively, documentation that identifies and authenticates personnel, and verifies the qualifications of such personnel, by ensuring that such personnel possess a minimum common level of training, experience, physical and medical fitness, and capability appropriate for a particular position, and commensurate with professional standards for the respective field of practice. The contractor shall:

• Certify that they have validated and vetted the identity of all personnel serving under this contract, and

• Certify that all personnel meet industry (i.e., emergency management, social work, data specialists, program management) standards and qualifications for the position(s) to be filled.

The Contractor shall be responsible for vetting, screening their employees and ensuring there is an appropriate level of trust in the badged employee in compliance with ORR Policy Section 4.3.

(https://www.acf.hhs.gov/orr/policy-guidance/children-entering-united-states-unaccompanied).

6.2 MEDICAL SERVICES

6.2.1 INTAKE HEALTH SCREENING

• The contractor shall coordinate with a CDC-funded entity to provide testing for UC for COVID-19 as per current ORR guidelines. The Contractor will ensure relevant information is included on the Influx Intake Health Screening form.

• The contractor shall set up and operate a screening location where medical personnel will perform COVID-19 screening and testing, obtain a medical history (including dietary restrictions or allergies), and screen to determine acute or chronic issues that require immediate or continuing medical attention.

Contractor shall ensure appropriate medical, emergency dental care, and family planning services are implemented within 60 days of beginning operations.

https://www.acf.hhs.gov/orr/policy-guidance/children-entering-united-states-unaccompanied

6.2.2A MODIFIED HEALTH ASSESSMENT

• For ICF Site facilities in operation <180 days, the contractor shall perform a Modified Health Assessment (MHA) within 48 hours of arrival that includes a medical history, vital signs, allergy history, a review of systems, a physical exam, COVID-19 testing, pregnancy, and influenza testing (as applicable), diagnosis and plan, and administration of required immunizations (see vaccination section). This shall include obtaining a medical history (including dietary restrictions or allergies), and screening for acute or chronic issues that require immediate or continuing medical attention.

• The contractor shall instruct healthcare providers to document their findings on ORR’s Health Assessment form and enter all data from the assessment into the UC Portal and upload documentation within 24 hours of the child’s visit Scanning of records is not sufficient to meet this requirement; information must be documented in the appropriate section of the UC portal.

• The contractor shall perform the initial health assessment twelve (12) hours per day, seven (7) days per week

6.2.2B INITIAL MEDICAL EXAM

• For ICF Site facilities in operation >180 days, the ICF Site will expand and replace the MHA with a complete Initial Medical Exam (IME), in accordance with ORR guidance and policy, by adding the following components to the medical assessment:

• Tuberculosis screening per ORR guidelines

• Risk-based STI screening per ORR guidelines

• Lead screening per ORR guidelines

• All ACIP recommend vaccinations: https://www.cdc.gov/vaccines/schedules/hcp/imz/catchup.html.

• Hearing and vision screening

• Psychosocial risk assessment

• The IME must be appropriately documented in the UC Portal within 24 hours of the child’s examination

• All elements of the IME must be completed within two days of the child’s arrival on site.

• All health-related documentation (e.g., health forms, office notes, hospital discharge summaries, immunizations record, lab results) shall be uploaded to the Files section of health report in the health tab.

https://www.cdc.gov/vaccines/schedules/hcp/imz/catchup.html

** Please note that requirements may be subject to change based on updated ORR guidance, and clinical and epidemiologic conditions.

** Screenings may be requested and performed based on the clinical judgment of the healthcare provider and the child’s individual circumstances

6.2.3 Ongoing Medical Services

• The contractor shall provide ongoing health services that continue past the initial health screening and health assessment/IME, and these services shall include the following: medical history interviews and physical examinations, point-of-care urine pregnancy, medication prescriptions and administration, vaccinations, COVID-19 testing, and other medical treatment consistent with the ORR Medical Services Policy Section 3.4.

• Depending on site-specific conditions, the contractor may choose to provide phlebotomy, mobile imaging, and other point-of-care diagnostic testing (e.g., strep, pregnancy testing) services directly, or sub-contract to an outside vendor for these services.

6.2.3.1 Sick Call

• The contractor shall provide sick call twenty-four (24) hours per day, seven (7) days/week.

• The ICF Site shall operate at the level of a Pediatric Urgent Care to mitigate reliance on local healthcare facilities which are facing higher hospitalization rates due to the COVID-19 Delta variant and entering the busy Fall-Winter respiratory infection season. It is ill-advisable to bring children in COVID-19 isolation to medical facilities (except for extreme emergencies) for minor medical issues.

• The Contractor shall procure supplies and durable medical equipment to manage musculoskeletal injuries (X-rays, splinting/casting) and laceration repairs among other minor injuries. The contractor shall procure point-of-care testing for common communicable diseases (influenza, strep) as well as other conditions (glucose, pregnancy testing)

• The contractor shall arrange for phlebotomy on-site with rapid turn-around on results to prevent unnecessary ER visits. See below regarding CLIA Certificate requirements

6.2.3.2 Emergency Services

• The contractor shall provide all personnel, products, materials, and services required to perform emergency medical assessment and treatment with the goal to stabilize a child prior to being transported to an ER.

• The contractor shall be able to provide emergency services 24/7. Due to variable response times and capabilities of local jurisdictional EMS systems, the contractor shall have at least one ambulance onsite and appropriate emergency staff. Those facilities with 1000 children or more shall have multiple ambulances available. Additionally, any facility that is a significant distance from a local ER shall have an ambulance onsite regardless of the size of the UC population.

• The contractor shall have sufficient operable AEDs located throughout the facility in areas of larger gathering that are routinely tested as per American Heart Association guidelines. Additionally, there shall be several available trauma bags and staff with basic life support training situated in strategic locations around the facility to ensure a timely emergency response.

• The contractor shall conduct routine drills to ensure appropriate, timely, emergency response from onsite providers.

• The contractor shall establish relationships with local EMS, emergency room administration and tertiary facilities to ensure continuity of medical care and streamline communication.

• The contractor shall provide vehicles for non-urgent/emergent transfers of UC to and from healthcare facilities or outpatient clinics.

6.2.3.3 Family Planning Services

• The contractor shall provide family planning services to include comprehensive information about, and access to, medical reproductive health services and emergency contraception as per ORR guidelines or in compliance with GARZA requirements

• The contractor shall test all females 10 years of age and older, or females under 10 years of age who have reached menarche, for pregnancy by conducting a urine pregnancy test on intake.

• The contractor shall ensure that pregnancy screening is conducted before vaccination administration so that…