PERFORMANCE of WORK STATEMENT for mh resid fac.pdf

PERFORMANCE of WORK STATEMENT Residential Housing For Veterans in the Outpatient Substance Use

Disorder Treatment Program

1. SCOPE

The contractor shall provide all equipment, materials, supplies, food, recreational supplies, internet/Wi-Fi capabilities, PC/laptop/tablet, labor, training, supervision, and transportation necessary to provide residential housing necessary to support the Substance Use Disorder (SUD) Treatment Program(s) administered by the Veterans Health Care System of the Ozarks (VHSO), located in Fayetteville, Arkansas, and its Community-Based Outpatient Clinics (CBOCs) in complete and strict accordance with the resulting contract and all attachments thereto. The contract will be a 5-year IDC award.

2. GENERAL

Fayetteville, AR: These requirements consist of providing residential beds per Paragraph 5 below; random drug testing; and all other associated support services as outlined elsewhere in this Performance Work Statement (PWS). All services shall be provided by a residential facility, located within a 100-mile radius of the VHSO campus, located at 1100 N. College Ave., Fayetteville, AR. The age range of the Veterans may be between 18 and 75 years of age, with the majority being in the 25–50-year-old range, with a primarily male population. Females will normally make up, but not be limited to 10% or less of the Veterans in this program.

Springfield, MO: These requirements consist of providing residential beds per Paragraph 5 below; random drug testing; and all other associated support services as outlined elsewhere in this Performance Work Statement (PWS). All services shall be provided by a residential facility, located within a 100-mile radius of the CBOC campus, located at 1850 West Republic Rd., Springfield, MO 65807. The age range of the Veterans may be between 18 and 75 years of age, with the majority being in the 25–50-year-old range, with a primarily male population. Females will normally make up, but not be limited to 10% or less of the Veterans in this program.

3. CONTRACTOR QUALIFICATIONS (all locations) All contractor/subcontractor employees providing services under this contract shall meet all federal, state, and local certification requirements required for the types of services they provide.

Samples of certification include, but are not limited to:

• To become a Certified Medical Technician (CMT), applicants shall first complete an approved CNA training course. CMT training consists of at least 60 classroom hours of instruction and a minimum or 8-hours of clinical practice under the direct supervision of an instructor. After completion, a CMT will be able assist licensed practical nurses or registered professional nurses in administration of nonparental medications. As evidenced by certificate submission to Contracting Officer (CO) or Contracting Officer’s Representative (COR) (100%).

• Level I Medication Aide, shall complete an approved curriculum of a least 16 hours in order to qualify to administer medications in residential care facilities and assisted living facilities. As evidenced by certificate submission to CO/COR (100%).

• Licensed Administrators manage licensed long-term care facilities, including facilities offering skilled care, intermediate care, assisted living and residential care. They oversee staff, ensure that regulations are followed and monitor the facility’s financial stability. Administrators shall be licensed by the Board of Nursing Home https://health.mo.gov/safety/cnaregistry/index.php https://health.mo.gov/safety/cnaregistry/index.php

Administrators. Applications and renewals for a nursing home administrator or residential care/assisted living administrator license are made through the Board of Nursing Home Administrators. As evidenced by certificate submission to CO/COR (100%).

• Proof of the appropriate certification(s) shall be provided to the CO/COR upon request.

As evidenced by certificate submission to CO/COR (100%).

• Contractor staff shall receive training, and regular supervision. If new to residential care, staff shall not provide independent supervision of Veterans. Training as defined by contractor. No more than one validated patient safety complaint per quarter. COR will validate complaints.

4. TRANSPORTATION (all locations) The contractor shall provide required transportation between the contractor’s facility and the VHSO, Monday through Friday. Transportation may be by contractor owned/operated vehicles or by other properly licensed public transportation serving both locations. Copy of valid Driver’s License will be provided to COR for each driver. All current regulations must be followed.

5. HOUSING

(a) Availability:

Beds shall be made available as follows:

Fayetteville, AR:

(i) PRIMARY BEDS - 14 beds shall be reserved daily.

(ii) TRANSISTIONAL BEDS - 6 additional beds shall be available as needed for transition. These beds may only be utilized when all 14 beds identified in 5(a)(i) are full.

Springfield, MO:

(i) PRIMARY BEDS - 10 beds shall be reserved daily.

(ii) TRANSISTIONAL BEDS - 6 additional beds shall be available as needed for transition. These beds may only be utilized when all 10 beds identified in 5(a)(i) are full.

(b) General Facility Requirements (all locations):

(i) All areas of the facility to be utilized by Veterans shall be adequately heated and cooled with working plumbing as evidenced by Direct Observation (DO) during Environment of Care (EOC) Rounds and temperature logs with temperatures between 65-80. Logs will be provided to COR weekly.

(ii) This is a co-ed treatment program, separate sleeping quarters for male and female Veterans are required as evidenced by DO during EOC Rounds.

(iii) Both indoor and outdoor lounge and recreational activity areas shall be available, onsite, to Veterans as evidenced by DO during EOC Rounds.

(iv) The facility to be utilized by Veterans shall have one bathroom, one bedroom and lounge area that is Americans with Disabilities Act (ADA) Compliant as evidence by site inspection.

(v) Rooms shall have space for number for Veterans assigned to room as evidenced by DO during EOC Rounds.

(vi) Facility shall accept or make special temporary accommodations for Veterans who are medically stable but are in need of having no physical contact with others for up to 120 hours or as mandated by CDC as evidenced by acceptance as needed and confirmation of temporary accommodations as required by COR.

(vii) Facility shall provide clean 2 hand towels, 2 face flannels and 2 bath towels for each Veteran. Towels shall be in good shape (not worn, no holes, etc.). as evidenced by DO during EOC Rounds.

https://health.mo.gov/information/boards/bnha/index.php

(viii) Facility shall provide PC/laptop/tablet with internet/Wi-Fi connection that can be connect to large screen monitor/TV for Veterans to attend weekday VA required programming when weather or pandemic/medical outbreaks prohibit Veterans to travel to VHSO so they may gather safely in groups and maintain safe social distancing as evidenced by DO during EOC Rounds.

(ix) The residential facility shall be responsible for the quarterly deep cleaning of the facility and Veterans shall not be required to do this as evidenced by DO during EOC Rounds.

(c) Room Standards (all locations):

As a minimum, each residential room shall be equipped as follows:

(i) Clean, sanitary mattresses with the ability to wash the mattress cover. Contractor shall clean frequently as needed to maintain proper sanitary conditions as evidenced by DO during EOC Rounds.

(ii) A new pillow, with pillow cover, shall be supplied for every Veteran. This may be taken with him/her when he/she leaves the residential facility. Adequate blankets and bedding shall be made available. Bedding shall not have any holes and be in good shape (not worn, no holes, etc.) as evidenced by DO during EOC Rounds.

(iii) The carpet shall be kept clean and without trip hazard or replaced, if necessary, as evidenced by DO during EOC Rounds.

(iv) Secure container for each Veteran shall be provided for each Veteran to secure his/her personal belongings as evidenced by DO during EOC Rounds.

(d) Residential Common Areas (all locations):

As a minimum, common areas shall include the following:

(i) Shower stalls with non-slip floors, stable shower seat, and properly secured handrails to help prevent falls shall be available as evidenced by DO during EOC Rounds.

(ii) Indoor lounge area with TV, DVD player and an assortment of appropriate movies (no extreme violence, no “x” rated adult movies). As a minimum, accessories in such areas (couches, chairs, carpet, refrigerator, stove, microwave, etc.) shall be kept clean or replaced, if necessary, as evidenced by DO during EOC Rounds.

(iii) Veterans shall be roomed separately from other residential occupants as evidenced by DO during EOC Rounds.

(iv) Transgender Veterans are given the designated space they identify as preferable as evidenced by DO during EOC Rounds.

(e) Payment (all locations):

(i) Payment for beds identified in Section 5(a)(i) shall be made monthly for the number of bed days utilized as evidenced by IPPS submissions.

(ii) Payment for the beds identified in Sections 5(a)(ii) thru 5(a)(iv) shall be made monthly for the number of bed days utilized as evidenced by IPPS submissions.

6. DIETARY (all locations)

(a) The contractor shall provide each Veteran with a morning and evening meal, Monday

– Friday, and three (3) meals a day on weekends/holidays/when required to isolate for those Veterans that do not have a pass to go home as evidenced by DO during EOC Rounds.

(b) Nutritious meals, drinks and snacks shall be available throughout each Veteran’s treatment rotation. This shall include:

(1) Fresh fruits (i.e., apples, oranges, bananas, grapes, melons, peaches, pears, berries, etc.) as evidenced by DO during EOC Rounds.

(2) Fresh, frozen, or canned vegetables (i.e., carrots, celery, broccoli, cauliflower, lettuce/leafy greens, peppers, tomatoes, sweet & white potatoes, etc.) as evidenced by DO during EOC Rounds.

(3) Proteins (i.e., chicken, beef, pork, turkey, nuts, beans/peas, eggs, fish, soy, etc.)

(4) Dairy (i.e., milk, butter, yogurt, cheese, etc.) as evidenced by DO during EOC

Rounds.

(5) Grains (i.e., rice, oatmeal, popcorn, etc.) as evidenced by DO during EOC

Rounds.

(c) The contractor shall develop a nutritious meal plan, including snacks and drinks, and have the plan approved by a registered dietitian in accordance with the special dietary requirements as indicated on the initial intake assessment as evidenced by meal plans made available upon request.

(d) Sanitary procedures shall be followed by all contractor/subcontractor staff in preparing and serving all food items. Sanitary procedures shall be established and maintained for washing hands, washing dishes, cleaning equipment and work areas, and for proper waste disposal, in accordance with state Department of Health regulations applicable to the location of the contractor’s facility(s) as evidenced by DO during EOC Rounds.

7. LAUNDRY (all locations)

The contractor shall furnish, at minimum, 3 operable washing machines and dryers that can adequately accommodate the laundry for 18 Veterans within any 24-hr. period. Veterans shall be responsible for doing their own laundry. The contractor shall provide laundry soap and dryer sheets/fabric softener as evidenced by DO during EOC Rounds.

8. SPECIFIC TASKS (all locations) The contractor shall be in compliance with the following at all times:

(a) The contractor, their personnel, and their subcontractors shall be subject to the Federal laws, regulations, standards, and VA Directives and Handbooks regarding information and information system security as delineated in this contract.

a. Completion of the VA Privacy and Information Security Awareness and Rules of Behavior (VA10176) will satisfy the annual privacy requirement for all employees and contractors.

i. VA Privacy and Information Security Awareness Training and Rules of Behavior (VA10176) as evidenced by course completion certificates submitted annually to CO/COR.

(b) Always provide a minimum of 2 employees on-site to monitor Veterans as monitored by validated Veteran reports. No more than one validated patient complaint per quarter. CO/COR will validate complaints.

(c) Perform safety/bed checks between the hours of 10 pm to 6 am with no fewer than 3 checks while Veterans are present to ensure all Veterans are present not engaging in unauthorized or hazardous activities and are uninjured. Any abnormalities from these checks will be documented and faxed/emailed to the SUD Director and CO/COR immediately or no later than 7:30 am the next business day (not to exceed 12 hours). Verbal report should be given to VHSO SUD clinical staff at the earliest available time of any issues indicative of possible risk as evidenced by check logs.

(d) Emergency protocol in place for nearest medical facility or call 911 if required as evidenced by DO during EOC Rounds.

(e) Advise the CO/COR and SUD Director of any missing or safety compromised Veterans immediately (not to exceed 12 hours) as evidenced by DO of reporting.

(f) All criminal conduct/behavior shall be reported to appropriate authorities immediately. SUD Director and CO/COR need to be made aware as soon as possible after the reporting as evidenced by DO of reporting.

(g) Comply with all local, state, and federal regulations applicable to each contractor facility utilized in performance of this contract. Report to the CO/COR, within 5 working days, all local, state, and/or federal inspection findings with contractor’s response and a corrective action plan for each identified concern. If identified findings have not been corrected within15 working days, a subsequent corrective action plan, with timeframes for resolution shall be submitted and approved by the CO/COR and the SUD Director by COB on the 15th day. Copies of ALL inspections are required to be maintained on file at the facility and provided to the CO/COR within 5 business days of request as evidenced by DO of reporting.

(h) VHSO will be allowed inspection access as evidenced by DO of rounds.

(i) Immediately address conditions rendering the facility unlivable or unsafe due to unforeseen events, insect infestations, catastrophes, and/or acts of God (I.e., foundational, or structural deficiencies, faulty HVAC system, flood, any other catastrophic event at the facility, etc.) and provide alternate arrangements or interventional remedies. A contingency action plan shall be submitted to the VHSO SUD Director and COR for approval immediately after ensuring all Veterans are safe and accounted for as evidenced by DO of reporting. Plan to be submitted within 30 days after award.

(j) Conduct and document quarterly fire drills and fire inspections, as evidenced by documentation provided to the CO/COR within 5 working days of each occurrence as evidenced by DO of reporting.

(k) Provide documentation of pest inspections conducted not less than bi-annually as evidenced by documentation provided to the CO/COR. If pest infestation has been identified or reported, the contractor shall provide documentation of appropriate treatment, and follow-up inspections confirming elimination of the infestation via written report or documentation from pest control company as evidenced by documentation provided to the CO/COR.

(l) If a female is in the program, they shall have access to a private/secure bedroom and bath that males cannot use during their stay in the residential facility to include any male staff members as evidenced by DO of reporting.

(m) All staff shall show respect towards each other and Veterans and shall refrain from any action that may be perceived as sexual harassment, bullying intimidating, or threatening. No more than one validated patient complaint per quarter. CO/COR will validate complaints.

(n) Staff shall monitor for behavioral changes and shall report anything of concern or suspicion to VA treatment team the next business day or immediately. No more than one validated patient complaint per quarter. CO/COR will validate complaints.

9. THERAPEUTIC AND REHABILITATIVE SERVICES (all locations)

The contractor shall provide an environment that is conducive to the recovery of each Veteran. This plan shall be developed by the VA Intensive Outpatient Substance Abuse Treatment Team. The facility shall:

(a) Provide an Environment conducive to recovery – no alcohol or other illegal drugs allowed on the premises as evidenced by DO of rounds and rounding logs sent to SUD Director and CO/COR.

(b) Provide or make available Self-help like recovery meetings, (Celebrate Recovery (CR), Alcoholics Anonymous (AA), Narcotics Anonymous (NA) etc.) 4-5 times per week, on-site, or the contractor shall provide transportation to and from such meetings in the community. A contractor staff member shall escort each Veteran to and from all off-site meetings. No more than one validated patient complaint per quarter. CO/COR will validate complaints.

(c) Make available suitable healthy activities – walking, jogging, basketball, horseshoes, fishing, frisbee, etc., when weather permits. Board games, cards, checkers, puzzles, craft kits, etc., for days when weather is inclement. Individual decks of cards, small puzzles, books for reading, coloring books, craft kits for when quarantined due to illness/pandemic. No more than one validated patient complaint per quarter.

CO/COR will validate complaints.

(d) Provide instructions and assistance with personal hygiene routines as needed. No more than one validated patient complaint per quarter. CO/COR will validate complaints.

(e) Provide supervision of medication administration. Each Veteran will administer his/her own medications. This shall be documented in Medical Administration Record (MAR) for each Veteran. The minimum qualification of staff providing such supervision of these processes and documentation is Nurse (RN/LPN/CNA). Any controlled substances shall be under double lock with only contractor personnel having access to the key(s)/combination(s). Pill counts should be immediately conducted if there are any indications of misuse of medication and reported as soon as possible to SUD Director and CO/COR as evidenced by DO during EOC Rounds and Controlled Substance log.

(f) Ensure all contractor/subcontractor staff members are active in a recovery process that includes a lifestyle that is free from drug and alcohol abuse as evidenced by DO during EOC Rounds.

(g) Provide informal counseling by staff that encourages the self-help like recovery meetings, (CR/AA/NA & etc.) and encourages each Veteran to learn to take responsibility for his/her own actions as evidenced by DO during EOC Rounds.

(h) Random drug screens shall be conducted regularly or when there is suspicion of drug/alcohol use and sent to a certified laboratory. Positive tests shall be reported to the SUD Director immediately, but no later than 18 hours after receipt of the test report as evidenced by DO during EOC Rounds and lab reports.

(i) Residential Staff shall conduct themselves professionally and engage in collaborative communications with clinical treatment team as evidenced by DO.

(j) Ensure regular monitoring of Veterans, room searches, and common areas including the grounds outside the house evidenced by DO during EOC Rounds.

(k) Infection prevention procedures will be followed as recommended by CDC and the State Department of Health evidenced by DO during EOC Rounds.

10. RESIDENT CONDUCT AND BEHAVIOR (all locations)

All residential facility rules shall be followed by all Veterans. In addition to the general rules of the facility, the facility shall ensure all Veterans comply with the following:

(a) Hygiene Requirements:

i. Summer – bath/shower daily.

ii. Winter – bath/shower, at least every other day.

(b) Each Veteran should have at least two changes of clothes. These clothes shall not be worn more than two days between washings.

(c) No shirts/hats/belts/buckles depicting images, advertisements or logos of alcohol products, marijuana, or other illicit drugs or violent or obscene language, or inappropriate sexual images as evidenced by DO while at VA for programming.

(d) All Veterans shall show respect towards each other and staff as evidence by no validated complaints.

(e) Leaving the residential facility – Each Veteran shall notify staff before leaving the facility as evidenced by DO.

(f) Violence / Destruction of Property / Property Theft / sexual harassment / bullying – contractor has the right to prosecute as evidenced by reports from contractor staff.

(g) Although it is routine in facilities of this type to have recovery patients do “daily chores” as a part of their recovery process, this should not be taken as what would serve as “deep cleaning” (i.e., dust fans, moldings, windowsills, under furniture, sanitize trash cans, etc.) as evidence by no validated patient complaints.

11. RESIDENTAL ACTIVITIES (all locations)

The contactor/facility, as a minimum shall provide the following activities:

(a) Week-end activities - at least (2) two per weekend (including a self-help recovery group) shall be scheduled as evidenced by a monthly schedule of activities given to the CO/COR and SUD Director.

(b) Have safe and clean both indoor and outdoor space including, recreational activities, and the availability of safe exercise equipment. Exercise equipment may consist of hand weights (i.e., 3-pound, 5-pound, 8 pound and 10 pound), stationary bike, yoga mat, jump rope, core stability ball, and resistance bands as evidenced by DO during EOC Rounds.

12. MEDICAL NEEDS (all locations)

(c) Veterans will bring their medications with them to the residential facility and these medications shall be locked in a secure location. Veterans are not to store unauthorized medications or supplements anywhere outside the designated locked contract facility cabinets. Veterans may set up their own medication planner, under the supervision of a contractor RN/LPN, with accuracy and security being extremely important. Veterans shall be medically stable when they enter the 28-day treatment program. The contractor RN/LPN shall have experience in assessing various stages of withdrawal, and assessing other medical symptoms, along with the ability to determine if the Veteran requires immediate medical attention beyond that provided by the contractor’s facility. The contractor shall provide a minimum of two residential staff members per shift for safety purposes. At least one on-site staff member per shift shall be Life Support (BLS) certified evidenced by DO during EOC Rounds.

13. RETURN TO USE PROTOCOL (all locations) Collaboration with clinical treatment team for best clinical outcome. Any behaviors, which are considered inappropriate in the supervised residential care, shall be referred to the treatment team for collaborative treatment plan review as evidenced by DO.

14. EMERGENCY/RISK MANAGEMENT (all locations) The contractor shall take all necessary measures to prevent and deal with any safety concerns, bug infestations (beg bugs, lice etc.) on a continued basis. Advise the CO/COR of all corrective action being taken or that has been taken to deal with safety or infestation.

All measures shall be done in accordance with state Department of Health as evidenced by Contract Discrepancy Reports (CRDs).

The contractor shall take all measures to immediately resolve issues concerning safety, infestations, infection outbreaks, heat/AC, and plumbing failures. The contractor shall contact the SUD Director and CO/COR immediately with an outlined plan of how the Veterans shall be taken care of by the contractor until the issues can be resolved. Plan of action shall be communicated to CO/COR and SUD Director within 24 hours as evidenced by CDRs.

15. INSPECTIONS

COR and/or back-up COR shall do unscheduled monthly site visits at all locations to investigate for any safety issues or contract violations are present as evidenced by COR rounding logs.

16. INSPECTION REPORTING: Provide to the COR, within 5 working days of the inspection, all local, state, and/or federal inspection reports. Reports with findings shall include contractor’s response and a corrective action plan for each identified concern. If identified findings have not been corrected within 15 working days, a subsequent corrective action plan as evidenced by CDRs.

(End of Performance Work Statement)