Performance Work Statement_HCHV.docx

PERFORMANCE WORK STATEMENT

Northeast Ohio VA MEDICAL CENTER

CONTRACTED RESIDENTIAL SERVICES (CRS) BEDS

A. PURPOSE.

The VA Northeast Ohio Healthcare System (VANEOHS) requires a contractor to deliver services for homeless veteran services using a “Safe Haven” model of residential care. The facility preferably should be within 3 miles of the VA Community Based Outpatient Clinic (CBOC) in Akron, Ohio (Summit County). These services are part of the community-based Health Care for Homeless Veterans (HCHV) program. The goal of the HCHV program is to remove homeless Veterans from the street or habitation unfit for Veterans and place them in community-based, residential environments with sufficient supportive services to meet their needs and ultimately facilitate the improvement of their housing situation.

B. BACKGROUND.

Ending homelessness among Veterans is a national priority. The goals and plans for achieving this initiative were introduced by the Department of Veterans Affairs Secretary in November 2009 at the National Summit on Ending Veterans Homelessness.

VANEOHS Healthcare for Homeless Veteran (HCHV) Program is an essential and critical part of the VHA and is vital for providing a gateway to VA and community supportive services for eligible Veterans who are homeless. The purpose of this solicitation is to obtain offers from Contractors in Akron, OH who can provide housing and supportive services to Homeless Veterans in community-based Contracted Emergency Residential Services (CERS) facilities offering a safe and secure environment that supports their goals for recovery from homelessness. The Contractor shall be required to provide a therapeutic and rehabilitative milieu and attendant services targeting the underlying factors contributing to homelessness. The Contractor shall not be required to provide detoxification or other hospital level treatment.

C. GUIDELINES FOR SERVICES:

The Contractor must provide a safe environment for all Veterans consistent with the Safe Haven model of housing and services. The Contractor will offer a low-demand environment with a minimum set of rules designed to re-establish trust in the chronically homeless Veteran and engage the Veteran in needed treatment services. Contractor must have written policies and procedures in place that address the following concerns and situations:

· Acceptance of treatment cannot be a condition of admission or continued stay.

· Medication adherence or compliance cannot be a condition of admission or continued stay.

· Abstinence from alcohol or drugs cannot be a condition of admission or continued stay. Infractions of rules should be used as opportunities for engagement.

· Management of suspected or known drug or alcohol use or relapse by one or more Veterans and interventions based on the Safe Haven model including Motivational Interviewing and Harm Reduction.

· On-site contraband, weapons, drug or alcohol related paraphernalia (i.e., found alcohol, drugs, drug “works”, etc.) and utilize interventions based on the Safe Haven model;

· Safe prescription medication storage and handling, including specific provisions for prescribed controlled substances.

· Room inspections, including methods and frequency to be tracked in a log and available for review by VA staff upon request.

· Grievance process to address Veteran complaints with time frames for responses from the Contractor’s program/facility management.

· Client abandonment of belongings in the facility, including time frames and procedures for disposal.

· Process to elicit client satisfaction with the facility and onsite services, including information collection methods and frequency, and process for utilizing the information for continual performance improvement purposes.

· Procedure for medical records request by veteran with specifics regarding re-release of information.

These policies and procedures must be communicated to Veterans both verbally and in writing in a manner that is understandable within 72 business hours of admission to the facility. This communication must be documented in the Veteran’s client record.

House rules and expectations should be kept to a minimum, be simple, and should focus on safety of the Veterans and staff. Most Veterans may have had difficulty in the past adhering to settings where strict rules are applied. The rules should reward positive behavior, be enforceable, relate to the living situation, provide for safety of the Veterans and provide opportunities for engagement. Veterans will not be discharged for the use of alcohol or drugs. Many of the Veterans that this program will target have failed programs in the past for their inability to stay clean and sober. Maintaining housing stability will be the primary goal for each Veteran. To provide for the safety of the Veteran(s), the Contractor must have written policies and procedures in place that clearly indicate the following are prohibited:

· Dealing or use of illicit drugs/alcohol at the facility;

· Buying or selling of alcohol or drugs in the facility;

· Sexual activity between Veterans (including kissing and holding hands);

· Violence or threat of violence toward Veterans or facility staff;

· Destruction of facility property;

· Possession of weapons.

Although rules must be kept simple and demands on the Veterans low, it is required that staff at the facility stay continuously engaged with the Veterans. Policies and procedures for staff should reflect the following: Regular room checks should occur with a strong focus on maintaining a safe environment that promotes the well-being of all Veterans; Staff is trained in providing flexible, respectful responses to infractions of rules; Homeless Veterans will not be discharged for drinking or use of drugs off property, non-compliance with prescribed medication or infractions of house rules that do not constitute a risk to their personal safety or the safety of the facility Veterans or staff; and assertive engagement by the staff with patients regarding these problems is the preferred course of action to deal with these common problems of the Safe Haven facility.

The Contractor must communicate policies and procedures to Veterans both verbally and in writing in a manner that is understandable to each Veteran upon admission to the facility, in the form of a written Veteran handbook that is verbally reviewed by the assigned case manager with the Veteran. All updates to any policies and procedures must be reviewed with Veterans with 7 days of revision. This communication must be documented in the Veteran’s client record.

D. SERVICES TO BE PROVIDED

I. BASIC SERVICES: Safe Haven Low Demand Program Model A Safe Haven Model is a 24-hour/7-days-a-week community based early recovery model of supportive housing that serves hard to reach, hard to engage homeless Veterans with severe mental illness and substance use disorders who are on the streets and have been unable or unwilling to participate in supportive services. The Safe Haven Low Demand Program will provide case management to encourage participation in supportive services. Housing in this program provides private accommodations for up to 12 veterans and allows 24-hour residence for an expected length of stay of up to 6 months (180 days).

The contractor shall provide up to 12 beds, which shall include male beds and/or female beds, and furnish services to beneficiaries in Akron, Ohio and surrounding counties for whom such care is specifically authorized by the Department of Veterans Affairs (herein called VA). The Contractor shall furnish each Veteran who has been approved as eligible by the VA and admitted for care under this contract with the following basic services:

ROOM AND BOARD: Room and Board shall be accessible to the Veteran 7 days a week and 24 hours per day. Accommodations will include a bed and other furnishings such as a dresser, storage locker or designated secured space, and personal linens (towels, pillows, blankets, and bed sheets, etc.). The Contractor shall allow Veteran to store personal belongings for at least 7 days after formal HCHV discharge.

Handicapped accessible rooms shall be available in accordance with the 2010 ADA Standards for Acceptable Design. If the facility is more than one story, there shall be handicapped accessible rooms on the first floor, along with at least one handicapped accessible bathroom with shower. The facility must provide accessibility to reduce barriers into the building, such as handicapped ramps, wider door frames, bath or shower grab bars and handrails.

At least three nutritious meals, 7 days a week shall be provided for the Veteran. In addition, there will be availability of snacks of nourishing quality (e.g., fruits, vegetables, protein sources, etc.), between meals and bedtime for those requiring or desiring additional food, even when it is not medically indicated. There will not be more than a 14-hour span between evening meal and breakfast of the following day. Contractor shall provide alternative meals 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, etc.). Food shall be prepared, served, and stored under sanitary conditions. The facility shall provide storage space in an onsite refrigerator for Veterans to store and freely access personal food.

The facility shall establish and maintain sanitary procedures for washing dishes, cleaning equipment and work areas, and disposing of waste.

a. PRIVACY REQUIREMENTS: The living environments of HCHV Contract housing must include:

(1) Separate and secure sleeping arrangements (unit or wing) for each gender,

(2) Separate and secure bathroom arrangements for each gender,

(3) Screening procedures and criteria for sex offenders (mixed gender facility), and

(4) Common areas (lounges, laundry rooms, group rooms) with appropriate security arrangements.

Additionally, mixed gender facilities that share entrance and common areas (living room, kitchen, dayroom, etc.) must include onsite staffing available 24 hours a day, 7 days per week.

b. GENDER SPECIFIC CARE PROVISIONS: The contractor shall identify sufficient residential capacity to provide up to 12 Veteran beds on any given day, including residential capacity for female beds, and furnish services to beneficiaries in Akron, Ohio and surrounding Counties for whom such care is specifically authorized by the Department of Veterans Affairs.

(**This section of the requirement only applies to facilities that house female Veterans**)

Special attention needs to be given to meeting the unique needs of homeless women Veterans. These needs often include assistance with managing sexual trauma, eating disorders, and interpersonal violence. Women Veterans will be receiving clinical care from a VA medical facility. They must have access to female clinical staff for additional gender-specific treatment and/or supportive services as needed.

Separate gender living facilities must meet the basic facility requirements for residents. For mixed gender facilities, the living environment of HCHV Contract housing must include:

1. Separate and secure sleeping arrangements (unit or wing) for each gender

2. Separate and secure bathroom arrangements for each gender.

3. Screening procedures and criteria for sex offenders.

4. Common areas (lounges, laundry rooms, group rooms) with appropriate security arrangements.

HCHV-funded programs shall maintain and adjust environments to support the safety, security, privacy and services for women Veterans. Special emphasis on privacy and security should be noted. Veteran residents have a right to be treated with dignity in a humane environment that affords them both reasonable protections from harm and appropriate privacy with regard to their personal needs. The living environments of HCHV-Contracted Emergency Residential Services transitional housing shall include:

1. Residential room and board in an environment that promotes a lifestyle free of sexual discrimination.

2. An environment conducive to social interaction, supportive of recovery models and the fullest development of the resident’s rehabilitative potential regardless of gender or sexual orientation.

3. Separate and secure bathroom arrangements to ensure privacy for personal hygiene and grooming.

c. LAUNDRY FACILITIES: Laundry facilities and necessary detergent free of charge and adequate for residents to do their own laundry or to have laundry done at minimum one time per week.

d. SAFE ROOM: Provides a “safe room” where veterans returning to the facility under the influence can relax until they are ready to return to their rooms. This room should provide a television and comfortable seating. A minimum of 30 minute checks will be performed by staff on duty while a Veteran is in the “safe room.” More than one intoxicated Veteran is permitted in the room at a time.

e. INTERNET AND COMPUTER ACCESS: Internet access shall be available to Veterans residing at the facility. Access shall consist of a service/speed rating of at least 10 Megabytes per Second (Mbps) Download, 1Mbps Upload or better. Wireless or other access shall be provided so that it is possible for three (3) or more users to access internet services simultaneously. Facility shall provide hardware (computer(s), printer, etc.) to be utilized. Veterans enrolled at the local community college or taking online courses, should be given priority of usage. The Contractor will be responsible for establishing hours of usage as well as setting any “parental controls” they deem essential.

f. THERAPEUTIC AND REHABILITATIVE SERVICES: Each Veteran will have an Individual Care Plan (ICP) completed by the Contractor with input from the Veteran and the VA HCHV Coordinator (or Designee). Therapeutic and rehabilitative services will be stated in the plan of care. Services which the Contractor must be able to furnish or provide shall be detailed in the QASP and will include:

I. Group Activities: Structured group activities, as appropriate, shall occur two times per month – examples include group therapy, life skills training, social skills training, financial workshops, Alcoholics Anonymous, Narcotics Anonymous, vocational counseling, and physical activities as appropriate. For the purposes of this contract “House Meetings” and VA Housing Resource Groups may not be counted as a structured group activity should have a therapeutic value and facilitation shall be the responsibility of the Contractor. Should a Veteran have mental health, medical, family and/or employment obligations which directly conflicts with this requirement alternate group activates will be arranged and/or the Contractor shall clearly document efforts made to accommodate the Veteran.

II. VA Coordination: Collaboration and coordination with VA program staff, as needed, will include coordination of supportive psychosocial services. In particular, coordinated efforts must be made with the Liaison around medical, mental health, admission and discharge needs.

III. Case Management: A thorough written Individualized Care Plan (ICP) will be developed within 14 business days of admission for each Veteran. This will include structured individual case management, at minimum, weekly including counseling on self-care skills, adaptive coping skills, financial planning, permanent housing search, written care plan, referral for financial benefits. Additional counseling may include professional and vocational rehabilitation counseling in collaboration with VA programs and community resources.

In addition, special attention will be made to address High Suicide Risk (HSR) Veterans as identified by the HCHV Liaison, VA Mental Health Staff and/or the contracted Case Manager. On a weekly basis the contracted case manager will be required to update the HCHV Liaison on Veteran progress and/or safety concerns for HSR Veterans. Contracted case manager will review the HSR Safety Plans with the Veteran on a bi-weekly basis. HSR Safety plan reviews and a copy of the Veteran’s Safety Plan will be documented in the chart.

All Veterans will be referred to VA for Primary Care and Mental Health appointments and Contractors shall support Veterans in making initial and subsequent appointments. Efforts will be documented in the Veterans ICP and reviewed by the HCHV Liaison at least monthly. All Contractors shall provide proper documentation verifying services and case management efforts by all team members including, but not limited to housing, benefit and employment specialists, and program management staff. There will be an expectation that notes are written professionally in a format that utilizes the clear settings of goals and documents progress towards those goals (e.g., SNAP, SOAP, or SMART notes).

IV. Staffing Ratio: Health Care for Homeless Veterans-Contracted Emergency Residential Services (HCHV-CERS) Contracts shall maintain a minimum staffing requirement ratio of one full-time dedicated case manager per every 12 active Veterans. Exceptions may be granted in writing by the VA. Staff is defined as a paid clinically-trained professional capable of providing case management services and does not include interns. The VA requires that case managers working with Veterans do not engage in case management of non-Veteran population unless a waiver has been granted by the VA. Each VA HCHV Liaison will have no more than two Points of Contact (PsOC) per program.

V. Permanent Housing Search: Programs are required to provide Veterans with direct and ongoing assistance in achieving permanent housing. As a primary goal of the HCHV program, plans for Veterans’ transition to permanent housing placements must be clearly reflected in each ICP and in weekly case management notes. Should Veteran refuse to engage with program staff regarding plans for permanent housing transition, motivational interviewing and other therapeutic techniques will be used to address Veteran ambivalence. All efforts to engage Veteran regarding housing plans, options, and resources shall be clearly documented and include any therapeutic techniques utilized.

Contractor staff must provide direct assistance to Veterans in developing permanent housing plans and accessing appropriate housing resources. These services shall be provided weekly through one-to-one case management. Examples of expected housing services include: 1) assistance obtaining and reviewing Veteran’s free credit report, identifying housing strengths and/or barriers associated with current credit status; 2) Creating a Tenant Portfolio with Veteran that contains all relevant documents required in the rental process, including a completed sample rental application for Veteran, income verification documents, identification, applicable subsidies, etc.; 3) Reviewing affordable housing rental options and Permanent Supportive Housing (PSH) program offerings, and assisting Veterans with making appropriate rental inquiries and submitting completed rental applications; 4) Conducting regular and individualized housing advocacy efforts, including transportation, assistance scheduling, meeting, and communicating with property managers and landlords, and engage in troubleshooting where rental barriers or denials occur in the housing search process. All housing efforts by Contractor shall be documented clearly and presented to HCHV Liaison upon request. Mere communication with Veterans regarding housing, without subsequent Contractor staff action and follow-up, shall not on its own meet the above requirements. Sex Offender programs will have increased focus on discharge to stable or permanent housing placements as evidenced in ICP and QASP.

VI. Financial Planning: Referral to and follow up on all potential financial resources the Veteran may be eligible for (e.g., SSI, SSDI, Food Stamps, NSC pension, GA, etc.). Case Managers will document all structured activities that support Veteran in developing a short- and long-term plan to understand and address their current financial situation and how to improve it. Financial planning efforts may be accomplished in group but preferably through one-on-one case management services. At minimum four financial planning activities appropriate to the Veterans’ individual circumstance must be documented monthly.

VII. Employment Services: Referral to all relevant employment opportunities the Veteran is eligible for and interested in, Case Managers will document all structured activities that support Veteran in applying for employment as appropriate based on needs of Veteran as identified in the assessment.

VIII. Recovery: Support for an alcohol/drug abuse-free lifestyle provided in an environment conducive to social interaction and the fullest development of the resident’s rehabilitative potential. Assistance to gain and to apply knowledge of the recovery process in an environment supportive of recovery models including a focus on Harm Reduction rather than strict abstinence and supportive of a Housing First approach. Pursuant to these principles, drug testing may not be used to discharge or discipline a Veteran but may be used as a clinical intervention to modify behavior.

IX. Transportation: The Contractor will ensure that transportation is available for Veterans to attend medical/mental health appointments, search for transitional or permanent housing and address other care needs. This can be done through provision of bus passes, utilization of cab services and/or rideshares, or Safe Haven provider facility transportation. These costs will be considered part of the basic services provided.

X. Occupancy: It is expected that Contractor beds will be maintained at an average minimum of an 75% occupancy rate but at a preferred rate of 85% as calculated based upon number of bed nights available per quarter. If this rate is not consistently attained a Corrective Action Plan (CAP) will be developed by the Contractor as part of the QASP and/or process improvement plan. Adjustments in contract funding may occur through modifications if occupancy is not maintained. Failure to maintain year to date occupancy rate at or above 75% may be grounds for immediate termination for convenience.

XI. Outreach: Contractor shall be responsible to engage in outreach in the community both independently and in collaboration with VA Northeast Ohio Healthcare System HCHV Coordinator or Designee(s) at least two times per month. In addition, clear documentation for outreach activities must be made available to Liaison upon request during the QASP review. Contractors shall maintain occupancy by engaging in outreach services and will be knowledgeable about outreach best practices generally accepted in the community.

XII. Discharge Planning: Securing permanent housing will be the primary discharge goal for every Veteran. All Veterans must have a discharge plan within two weeks of admission. Compliance with all VA regulations regarding discharges and timeliness of reporting discharges is required by Contractor. Case Managers will provide assistance with discharge planning for every Veteran and report all discharges via email within 24 business hours using a secured process (e.g., HOMES ID number). Housing needs will be assessed upon acceptance to the program (within 72 business hours as noted in Paragraph 5) and resources will be coordinated for discharge to a successful community placement throughout the duration of the Veteran’s stay.

A negative discharge for undesirable behavior is a committee decision that must include the HCHV Liaison prior to discharge. All Veterans scheduled for discharge based on behavior must meet with the treatment team and work with team to determine most therapeutic option for Veteran. This does not include violations for safety reasons or verbal abuse. Please note: Profanity does not in and of itself constitute abuse and shall not exclusively be considered grounds for discharge. Any and all actual or threatened violence will be grounds for discharge.

Veterans may be discharged for safety reasons at any time. All negative discharges will be subject to a full team debriefing, including HCHV Liaison, to look for opportunities missed to intervene sooner. All discharges are subject to the Contractors grievance procedures and must allow Veterans the opportunity to be represented by the HCHV Liaison in the grievance process. Reasonable efforts must be made to coordinate with the Liaison in order to schedule an appeal. Lastly, all TQI measures must be met in order to receive the highest past performance rating. These include the following:

· Bed Occupancy > 75%, preferred 85%

· Length of Stay ≤ 180 Days

In addition, VHA National HCHV Program Office performance measures must be met each Fiscal Year (FY) in order to receive the highest performance rating. Of note is that the performance measures target are subject to change annually based on the Technical Manual-Performance Measures Guide. These include the following:

· HCHV1 (Discharge to Independent Housing) – FY26 target is 55% of Veterans Exiting HCHV-CERS Contract bed are Exited to Permanent Housing as reported by VHA HCHV Liaison (metric criteria to be shared by VHA each FY).

· HCHV2 (Discharge with Negative Exits) – FY26 target is no more than 20% of Veterans Exiting from HCHV-CERS Contract bed result in a Negative Exit (defined as Veterans asked to leave because of violation of program rules [excluding exits due to threatened/actual violence to self or others]; failure to comply with program requirements; or left the program without consulting staff) as reported by VHA HCHV Liaison (metric criteria to be shared by VHA each FY).

HCHV performance measures and targets are set by the VA HCHV program office and may be adjusted annually. Changes to Targets will be communicated to the HCHV-CERS Contractor at the beginning of a new Period of Performance. HCHV Liaisons will review HCHV performance measures with the Contractor on a quarterly basis.

XIII. Grievance Procedures: Programs must have an internal grievance process that Veterans can use to resolve conflicts within the program. Programs must have written policies and procedures for resolving grievances, including a statement regarding the Veteran’s right to request reasonable accommodation, and must post them in a place conspicuous and be accessible to Veterans. In addition, each Veteran shall receive a copy of the grievance policies and procedures, upon intake and upon receiving a warning or discharge notice.

XIV. Intake Packets: All Veterans must receive an intake packet within 72 business hours which includes, at minimum, the following information:

1. Description of the Contractors services

2. Grievance Policy

3. Emergency procedures

4. Patient rights and Reasonable Accommodation

XV. Extensions- All extensions beyond 6 months must be approved in writing by HCHV Coordinator or Designee.

XVI. Medication Management: Medications and narcotics shall be properly stored, controlled, issued and recorded in compliance with physician’s orders. Contractor shall establish procedures for insuring Veterans confidentiality in the storage of and keeping of records concerning medication. Medication Assisted Treatment (MAT) cannot be used to rule out Veterans participation in an HCHV Program. This includes prescribed use of Vicodin, morphine, methadone oxygen, etc. Reasonable accommodation for individuals in MAT is required provided the requested accommodation does not require major financial or administrative commitments that would be considered an “undue burden.” Examples of reasonable accommodations include:

i. Arranging for the individual to take medication at their clinic, physician’s office, or another off-site location – when consistent with the individual’s treatment plan.

ii. Storing an individual’s MAT medication in a lock box in the program and having the individual be personally responsible for it.

iii. Arranging to have the housing facility keep MAT medications in a locked cabinet (Copies of Inspection Packet requirements relating to medication management are available upon request).

XVII. Timeliness of Response- Contractor is expected to have a dedicated phone line for VA inquiries and referrals. Return calls from the program are expected within 4 hours during business hours Monday through Friday. This includes calls from VA Staff or the Liaison to the program.

i. Critical Incident Reporting- All critical incidents will be reported within 24 hours. This includes the following:

1. Falls

2. Assault (to Veteran or Staff)

3. Elderly/Dependent Adult Abuse or Neglect

4. Sexual Assault

5. Fire (Veteran Involved)

6. Medical/Psychiatric Emergency (911 Calls)

7. Hospitalization

8. Suicide or Suicide Attempt

9. Homicide

10. Death

11. Infectious Control (TB, etc.)

12. Active Substance Abuse

13. Observation/ Possession of Weapons

E. DOCUMENTATION: The Contractor shall provide treatment and discharge planning reflecting a team assessment of health, social and vocational needs and the involvement of the Veteran, the VA staff and appropriate community resources in resolving problems and setting goals. An individual case record will be created for each referred Veteran. Case records shall be maintained in security and confidence as required by the Confidentiality of Alcohol and Drug Abuse Patient Records (42 CFR part 2) and the Confidentiality of Certain Medical Records (38 USC 7332). Case records and data normally maintained and included in a medical record as a function of compliance with State or community licensing standards will be made available on a need-to-know basis to appropriate Department of Veterans Affairs staff members involved with the treatment program of the Veterans concerned. The Contractor shall comply with applicable requirements of the Confidentiality of Alcohol and Drug Abuse Patient Records (42 CFR Part II) and the Confidentiality of Certain Medical Records (38 USC 7332). The files shall include:

· Reasons for referral

· All essential identifying data relevant to the resident and his/her family including a socio-cultural assessment, weekly progress reports or notes, and documentation of any case management interventions or patient care conferences

· For sites who implement Medication Management/Monitoring- Copies of any medical prescriptions issued by physicians, including orders, if any, for medications to be taken. Contractor must be in compliance with HCHV inspection requirements

· Case management notes written in a professional manner (i.e., SMART, SOAP, SNAP) will include the following: 1) A written and thorough Housing Needs Assessment, 2) Financial Plan, 3) Discharge Plan, and Individual Care Plan with attendant goals and documented activity indicating Veteran and Case Manager is actively working on identified goals.

· QASP Compliance Tool and all attendant supporting documentation demonstrating Contractor compliance with Contract

· Final summaries on each resident who leaves the program, to include reasons for leaving, the resident’s future plans, and follow-up locator information.

· Extension approval if relevant

· Waivers as appropriate

Contractor shall be required to maintain daily sign-in sheets signed by Veterans, psychosocial assessment, Individual Service Plans, progress notes for each Veteran, documentation of Veteran participation in daily group activities, and entry of Veteran data into HMIS system.

Contractors shall agree to participate in the Homeless Management Information System (HMIS) which is a local information technology system used to collect Veteran-level data and data on the provision of housing and services to homeless individuals and families and persons at risk of homelessness. Each Continuum of Care (CoC) is responsible for selecting an HMIS software solution that complies with the U.S. Department of Housing and Urban Development (HUD's) data collection, management, and reporting standards. HMIS Guides and Tools can be accessed using the link below.

https://www.hudexchange.info/programs/hmis/hmis-guides/#hmis-data-and-technical-standards

The Contractor shall comply with the principles listed in 38 CFR 17.707(b) to provide housing and supportive services in a manner that is free from religious discrimination.

F. RULES, POLICIES AND PROCEDURES: The Contractor shall have reasonable rules governing day-to-day life and activities in the facility. Such rules clearly inform Veterans of the obligations upon which their continued participation in the program depends and the consequences for non-compliance. Veterans will be provided with a copy of the rules at intake or upon Veterans request. In addition, Contractor shall post the rules in a location readily accessible to Veterans and visitors. These rules must include detailed Patient Rights and the procedures that the Contractor has in place to protect the Veterans’ rights and dignity. Veterans must be permitted to exercise these rights without fear of reprisal. If requested, Contractors must reasonably accommodate Veterans whose compliance with program rules is limited by the Veterans’ physical or mental disabilities, in accordance with the Americans with Disabilities Act, the Federal Fair Housing Amendments Act, Section 504 of the Rehabilitation Act, including those requirements covering reasonable accommodations for disabilities and the use of assistance animals, and the Michigan Fair Housing And Anti-Discrimination Laws and all other applicable State or Federal laws. Contractor must equally apply all rules, policies and procedures to Veterans, unless a Veteran has asked for a reasonable accommodation due to his/her disability.

G. PROCEDURES FOR NEGATIVE DISCHARGE OR SANCTION: Contractor must post rules in the Veterans Case Manager’s Office and provide Veteran with the rules which specify the reasons or conditions for which a Veteran may be sanctioned or discharged, including those behaviors which constitute gross misconduct and are grounds for immediate discharge from the program and those which would prompt a written warning if violated and potential discharge if violated repeatedly. Contractor shall describe the formal appeal procedures through which Veterans may appeal program regulations, sanctions or discharges. This information must be provided to Veterans in writing upon intake and must be clear and easily understandable by Veterans. This information will include:

· Immediate contact with HCHV Liaison

· Timely due process provisions which should include two warning notices for violations which do not result in immediate discharge prior to issuance of a discharge notice and an opportunity for a case conference after warning is issued to the Veteran

· Notice of, and access to, formal appeal procedures

· Notice of the conditions or process for re-admission to the program.

· Reasonable efforts to provide an appropriate referral to another facility or appropriate level of care as needed

· This does not apply to Veterans who are discharged for danger to self or others

H. ADDITIONAL CONTRACT REQUIREMENTS

The C&A requirements do not apply and a Security Accreditation Package is not required.

I. PERSONNEL: The Contractor shall employ sufficient personnel to carry out the policies, contract responsibilities, and the program for the facility. Case management staff must be clinically-trained to provide the required case management services and must have appropriate and commensurate coverage for staff using authorized and unauthorized leave (e.g., holidays, sick leave, family care, etc.). There must be, at a minimum, two staff members on duty and available for emergencies 24 hours a day, 7 days a week. In addition, there is an expectation that there is an On-Call Coverage Plan submitted each year and/or when changes are required due to change in Contractor’s staffing to the HCHV Liaison and/or administrative/clinical designee that will be available for consultation for emergencies 24 hours a day, 7 days a week. The Contractor shall assign personnel that by education, training and when required, certification or licensure qualified to provide the Basic Services and Supplemental Services required by this PWS.

II. Staff Training: Contractor shall provide at least two staff persons on-site at all times who has had training and orientation on the following topics. Staff shall receive and document—at a minimum—one-time training per year on these subjects.

· CPR

· First Aid

· Crisis intervention

· Cultural sensitivity

· Sexual harassment

· Sensitivity to wider issues of homelessness

· Universal Precautions (disease transmission prevention)

· Adult abuse/neglect reporting laws

· Harm Reduction philosophy

· Suicide Prevention

· Medication management

· State and Federal Fair Housing Law and ADA Requirements

· Conflict resolution

· De-escalation techniques

· Search and Seizure/Probable Cause in the Shelter Setting

Contractor shall perform criminal background checks on all staff members that work with children. Contractors shall agree not to hire Staff who is currently enrolled in a VA Homeless Program or who have ended participation in a VA Homeless Program within the past two years. Contractor must have a policy prohibiting staff from establishing sexual relationships with program Veterans.

The Contractor must identify each person functioning as “Key Personnel” under this contract and provide to the VA a description of the services to be provided by such person, together with a resume summarizing that person’s relevant skills and experience.

During the first ninety (90) calendar days of contract performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death, or termination of employment. Within 14 days after substitutions necessitated by situations described above, the Contractor shall provide resumes for the substitute key personnel. For substitutions proposed by the Contractor after the initial 90 calendar day period, the Contractor shall provide resumes for the substitute personnel, together with any other additional information requested by the Contracting Officer, at least 15 days before the substitution is to occur. The Contracting Officer shall notify the Contractor within fifteen (15) calendar days after receipt of all required information if the VA refuses to accept the substitute key personnel. The VA reserves the right to refuse or revoke acceptance of key personnel if personal or professional conduct, or lack of required skills or experience, jeopardizes patient care or interferes with the regular and ordinary operation of the facility.

Temporary substitutions of key personnel shall be permitted in accordance with the Contractor’s contingency plan. The Contractor’s contingency plan to be utilized if personnel leave Contractor’s employment or are unable to continue performance in accordance with the terms and conditions of the resulting contract must be submitted as part of the Contractor’s offer.

I. REFERRALS, ADMISSIONS AND ELIGIBILITY: Contractor must utilize an admission process that includes written eligibility criteria that is fair, objective, and compliant with applicable State and Federal laws. Contractor will provide verbal and written notification that is readily accessible to all individuals, upon request, of reasons for non-acceptance. Notification of reasons for non-acceptance is not required to be given to those denied service/housing because of bed unavailability. The eligibility information must be made available to Veterans at intake and staff must provide answers to questions about the admission criteria and process. Contractors must have formal appeal procedures through which Veterans may appeal unfavorable admission or eligibility decisions and a copy of the policy for appeals is to be given to the Veteran at screening or intake.

The VA is responsible for determining eligibility of Veterans prior to acceptance by the Contractor for services. After receipt of a Release of Information (ROI) a written pre-approval from VA Staff is required (hard copy, fax or e-mail are acceptable) and shall be provided to the Contractor for each Veteran referred for services under the contract. If there is an urgent need to admit a Veteran and VA Staff is not available to provide a written approval in a timely manner a verbal approval is acceptable. Any admissions that occur without written/verbal approval must be verified by VA Staff within 24 business hours in order for the Contractor to receive payment for time spent prior to approval (e.g., admission after hours or during the weekend). Written documentation of eligibility verification, signed by authorized VA Staff, shall be obtained by the Contractor as soon as possible for each Veteran referred for services under the contract for inclusion in the Veterans program file.

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

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

The initial stay for a Veteran should be no longer than 6 months. Some Veterans may be considered for an extension depending on the needs of the Veteran as mutually determined by the Veteran, the Contractor’s staff, and HCHV Coordinator or Designee. Any extension of the stay after 6 months must be authorized by the VA Homeless Program Manager or Designee, provided that there is clear clinical indication and availability of funds. Only extraordinary circumstances will be considered in order to extend Service periods in excess of 6 months for individual Veterans, and these must be authorized by the Medical Center Director or Designee.

It is understood that the type of Veterans to be cared for under this contract will require care and treatment services over and above the level of room and board. To be eligible for placement in emergency contract beds, all Veterans must be homeless or at imminent risk of becoming homeless and be eligible and registered for VA services. Contractors are encouraged to provide housing and or services to special Veteran populations, such as but not limited to the following: medically compromised Veterans, Veterans with young children, Veterans with sex offender status, seriously mentally ill Veterans, Veterans who have abused drugs or alcohol for many years, and/or Veterans who have been involved with the legal system.

J. DENIAL OF SERVICES: Veterans cannot be denied entry to HCHV Contracted Residential Services 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, disability or legal history. This includes a Veterans status of being a victim of Domestic Violence and as such cannot be considered during the screening process. 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. All Contractors must employ a harm reduction approach.

K. ABSENCES AND CANCELLATION: The Contractor shall notify the VA of unauthorized absences by a referred Veteran from the facility within 24 hours of Veterans absence. Should a Veteran absent himself/herself from the Contractor’s facility in an unauthorized manner, payment for services for that Veteran shall be continued for a maximum period of 24 hours, provided there is a documented active outreach attempt on the part of the Contractor’s staff to return the Veteran to the facility and there is a reasonable belief that the Veteran will return. Management of program dropout rate will be an element of quality assurance review of this program. The CRS Liaison may authorize payment for excused absences up to 72 hours if there is a compelling medical or mental health need and the excused absence is verified a priori.

VA reserves the right to remove any or all Veterans from the facility at any time, without additional cost, when it is determined to be in the best interest of the VA or the Veteran. This includes discharge from facility for ongoing bed bug infestation.

The Contractor shall notify the authorizing VA facility immediately when a medical emergency occurs that requires hospitalization of a referred Veteran. It is agreed that the Veteran will be admitted to the appropriate VA facility. When such admission is not feasible because of the nature of the emergency, it is agreed that hospitalization in a non-federal facility is acceptable. If hospitalization of a non-emergent nature is required, it is agreed that admission to the appropriate VA facility will be accomplished promptly. The Contractor shall make arrangements for admission and support the Veteran with any transportation issues that may arise.

The Contractor shall notify the authorizing VA facility immediately of any incidents involving Veterans residing in the Contract Emergency Residential program. The Contractor shall notify the VA case manager by telephone during the hours of 7:30am and 4pm. For all incidents that occur after normal business hours, the Contractor should notify the HCHV Staff the following business day. The Contractor shall provide the HCHV case manager and the COR with a copy of the incident report within 24 business hours. The Contractor shall maintain a copy of the incident report in the Veteran’s case record. Please see above in Basic Services for details regarding what constitutes Critical Incident Reporting.

L. CONTRACTOR STAFF CONDUCT/COMPLAINTS HANDLING: Contractor personnel shall be expected to treat referred Veterans with dignity and respect and abides by standards of conduct mirroring those prescribed by current federal personnel regulations. The Contractor shall comply with the VA Patient's Bill of Rights as set forth in 38 CFR 17.34a (copy available upon request).

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

M. BASIC RIGHTS AND PROTECTION AGAINST DISCRIMINATION: Contractors must protect the rights and dignity of the individual or family served in all phases of service delivery. At a minimum, providers must afford each Veteran the following rights and protections. Veterans must be permitted to exercise these rights without fear of reprisal.

· Veterans are entitled to enjoy a safe and healthful environment in the program.

· Veterans are entitled to be treated in a manner that respects their dignity, privacy and individuality.

· Veterans with disabilities are entitled to reasonable accommodations under fair housing laws when such accommodations are necessary because of their disability

· Veterans are entitled to remain in the program and not be involuntarily removed without reasonable notice, good cause, and just procedures

· All program Veterans are entitled to just and standardized procedures for determining eligibility, admissions, sanctions and discharges, and resolving grievances

· Veterans are entitled to reasonable privacy and confidential treatment of personal, social, financial, medical, mental, and behavioral health records, except as necessary to further treatment, information and referral services and in compliance with the resident’s consent to release information

· Veterans are entitled to the full exercise of their civil, constitutional, and legal rights

· Veterans will have on-going opportunities to voice opinions, to participate in program operation and programming, and to make suggestions regarding programming and rules.

· Veterans’ rights must be protected against all forms of discrimination, including those based on race, religious creed, color, national origin, ancestry, language, disability (physical or mental health), medical condition, marital status, familial status, age, gender, sexual preference, source of income, or political affiliation

· Veterans will receive a written policy indicating that harassment of Veterans and staff on the basis of race, religious creed, color, national origin, ancestry, language, disability (physical or mental health), medical condition, marital status, familial status, age, gender, sexual preference, source of income, or political affiliation will not be condoned nor tolerated

· Contractors shall develop a written policy for all Veterans that provides for safe, secure and dignified case management as well as accommodate the special requirements needed for privacy. Where there are single-use showers and bathrooms in the facility designated for residents. It is the Contractors responsibility to promote a safe environment for all Veterans amongst the general population.

· Programs must post these policies in a conspicuous place and in appropriate languages.

· All policies and procedures will be in writing and subject to review by the VA

N. REASONABLE ACCOMODATION: Contractor must respect and reasonably accommodate personal and cultural…