S02 - 36C26220R0146 - HCHV VASDHS CERS - 8-Beds - Solicitation - Complete Final.pdf

PAGE 1 OF 101 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. DUNS: DUNS+4:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

36C26220R0146 06-19-2020

Rafael Cervantes 562 766 2281 07-20-2020

@ 1:00PM PST

36C262

Department of Veterans Affairs

Network Contracting Office 22

4811 Airport Plaza Drive

Suite 600

Long Beach CA 90815

X

623220

$16.5 Million

N/A

X

VA San Diego Healthcare System (VASDHS)

7410 Mission Valley Rd

San Diego, CA 92108

36C262

Department of Veterans Affairs

Network Contracting Office 22

4811 Airport Plaza Drive

Suite 600

Long Beach CA 90815

TBA

Department of Veterans Affairs

Financial Services Center

P.O. Box 149971 http://www.tungsten-network.com/

Austin TX 78714-9971

See CONTINUATION Page

HCHV - Safe Haven Program – Transitional Housing

VA San Diego Healthcare System (VASDHS)

Please see Schedule of Service and Price

See CONTINUATION Page

X X

X 1

Michael Kahyai

Contracting Officer

36C26220R0146

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 NOTIFICATION TO OFFERORS

B.3 SCHEDULE OF SERVICE AND PRICE

B.4 STATEMENT OF WORK

B.5 IT CONTRACT SECURITY/VA INFORMATION AND INFORMATION SYSTEM

SECURITY/PRIVACY

SECTION C - CONTRACT CLAUSES

C.1 52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR PERSONNEL

(JAN 2011)

C.2 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION

SYSTEMS (JUN 2016)

C.3 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (OCT 2018)

………………………………………………………………………………………………46

C.4 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (OCT 2020)

C.5 52.216-18 ORDERING (OCT 1995)

C.6 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.7 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.8 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.9 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

C.10 52.224-1 PRIVACY ACT NOTIFICATION (APR 1984)

C.11 52.224-2 PRIVACY ACT (APR 1984)

C.12 52.228-5 INSURANCE—WORK ON A GOVERNMENT INSTALLATION (JAN 1997) .. 62

C.13 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR 1984) . 62

C.14 52.237-3 CONTINUITY OF SERVICES (JAN 1991)

C.15 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.16 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV

2018) ………………………………………………………………………………………………63

C.17 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(OCT 2019)

C.18 VAAR 852.237-74 NON-DISCRIMINATION IN SERVICE DELIVERY (OCT2019)

(End of clause)

C.19 VAAR 852.270-1 REPRESENTATIVES OF CONTRACTING OFFICERS (JAN 2008) ... 66

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

1. ATTACHMENTS

2. PRICE WORKSHEET

3. PRE-AWARD SURVEY CHECKLIST

4. CONTRACTOR CERTIFICATION: IMMIGRATION AND NATIONALITY ACT OF

1952—AS AMENDED

SECTION E - SOLICITATION PROVISIONS

E.1 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.2 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (JUN 2020)

E.3 ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS— COMMERCIAL

ITEMS

E.4 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014)

E.5 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL

ITEMS (JUN 2020)

E.6 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998)

………………………………………………………………………………………………96

E.7 52.216-1 TYPE OF CONTRACT (APR 1984)

E.8 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.9 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND

VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (DEC 2019)

E.10 VAAR 852.209-70 ORGANIZATIONAL CONFLICTS OF INTEREST (JAN 2008)

E.11 VAAR 852.215-70 SERVICE-DISABLED VETERAN-OWNED AND VETERAN-

OWNED SMALL BUSINESS EVALUATION FACTORS (OCT 2019)

E.12 VAAR 852.215-72 NOTICE OF INTENT TO RE-SOLICIT (OCT 2019)

E.13 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION

(OCT 2018)

E.14 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.15 VAAR 852.273-70 LATE OFFERS (JAN 2003)

E.16 VAAR 852.273-74 AWARD WITHOUT EXCHANGES (JAN 2003)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT: Department of Veterans Affairs, Network Contracting Office -22

Michael Kahyai, Contracting Officer

4811 Airport Plaza Drive Suite 600, Long Beach, CA 90815

Telephone number: (951) 601-4540

Email: michael.kahyai@va.gov

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

[X] 52.232-33, Payment by Electronic Funds Transfer—System For Award

Management, or

[ ] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Monthly

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

• Tungsten e-Invoice Setup Information: 1-877-489-6135

• Tungsten e-Invoice email: VA.Registration@Tungsten-Network.com

• FSC e-Invoice Contact Information: 1-877-353-9791

• FSC e-Invoice email: vafsccshd@va.gov

VA’s Electronic Invoice Presentment and Payment System:

(See Web site at and submit invoices to: www.OB10.com (TUNGSTEN NETWORK) Register at: 877-752-0900 (Option #2) mailto:VA.Registration@Tungsten-Network.com mailto:vafsccshd@va.gov http://www.ob10.com/

5. ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the

Solicitation numbered and dated as follows: 36C26220R0146

AMENDMENT NO DATE

B.2 NOTIFICATION TO OFFERORS

1. Authority: This is a solicitation for commercial items prepared in accordance with the format in Federal

Acquisition Regulation (FAR) Part 12, “Acquisition of Commercial Items” and FAR Part 13, "Simplified

Acquisition Procedures,” as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; 36C26220R0146 is being requested, and a written solicitation document will not be issued.

2. This solicitation is a "request for proposals (RFP),". The solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2020-06.

3. The VA San Diego Healthcare System (VASDHS) at 7410 Mission Valley Rd, San Diego, CA 92108 is seeking to rapidly stabilize Veterans’ medical, mental health, substance abuse and other psychosocial problems by partnering with one (1) Contractor to assist with General Harm Reduction Program (GHRP) model of care through the Health Care for Homeless Veterans (HCHV) – Safe Haven Transitional

Housing program.

4. The VA’s requirement is to place eight (8) Veterans in a community based HCHV-Safe Haven

Transitional Housing facilities offering a safe and secure environment that supports their goals for recovery from homelessness. The Contractor shall provide safe housing for male and female Veterans at any given time, based on the needs of the community. The Contractor is required to propose a facility that will be capable of allocating a maximum of eight (8) beds per day to Veteran patients. The facility is expected to accommodate up to eight (8) Veterans. VA and Contractor may mutually agree to assign

Veterans, up to a maximum of eight (8) Veterans, to the Contractor’s facility, at the same price per bed per day currently in effect as shown in the Price Schedule.

1. Offeror shall state in their proposal, at the time of proposal submission, how many veterans they can accommodate at one time and state the address of the proposed facility.

2. Failure to provide address of the proposed facility at the time of proposal submission will result in the proposing contractor to be removed from consideration for award.

3. Failure to provide an address of the proposed facility that is within a 40-mile radius of the

Department of Veterans Affairs San Diego Healthcare System (VASDHS) located at 3350

La Jolla Village Dr., San Diego, CA 92161 and be within the United States at the time of proposal submission will result in the proposing contractor to be removed from consideration for award.

5. It is the Government’s intent to make an indefinite delivery/indefinite quantity (IDIQ) award in response to this solicitation.

6. Offerors shall complete and return all information designated in the enclosed FAR clause 52.212-1, Instructions to Offerors – Commercial Items, paragraph (b) Submission of offers, and the Addendum to

FAR clause 52.212- 1, prior to the time specified in block 8 of standard form (SF) 1449 to be considered for award. Offerors shall also respond to each special standard of responsibility listed in the enclosed FAR clause 52.212-2, Evaluation—Commercial Items. Failure to do so may preclude the offeror from consideration for award.

7. TECHNICAL INQUIRES: Direct all technical inquiries via email to the Administrative Contract

Specialist (CS), Rafael Cervantes at rafael.cervantes@va.gov not later than 06/26/2020 1:00 PM PST. An amendment will be posted to https://beta.sam.gov/ to address any questions received on or about

07/03/2020. The Contractor shall acknowledge an amendment in section 5 above.

8. DUNS NUMBER: Provide the Dun and Bradstreet Number assigned to your business in the space provided below; (refer to FAR provision 52.212-1, Instructions to Offerors – Commercial Items):

8.1.

9. Post-Award Teleconference. The awarded Contractor(s) shall participate in a post-award orientation teleconference to review the contract requirements, start-up plan, and other contract management procedures.

B.3 SCHEDULE OF SERVICE AND PRICE

This is an indefinite delivery, indefinite quantity, (IDIQ) fixed-price contract. Prices in this schedule represent an all-inclusive rate including labor, incidental costs, overhead, and insurance premium payments for applicable insurance coverage. Costs not incorporated into the contractor’s price will not be reimbursed by the

Government.

The guaranteed minimum amount for this contact is $2,000.00. The maximum aggregate value of the orders that can be placed under this contract is $3,000,000.00. The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum amount.

**The previous option year pricing will apply to any extension pursuant to FAR 52.217-8

Each Contract Year is based on a 12 months calendar year.**

Base Year:

Period of Performance Months 1-12 (Actual dates

TBD)

ITEM

NO.

DESCRIPTION Estimated Bed

Quantity

UNIT Unit Price Per Day

1 Daily Room & Board / VASDHS

HCHV-Safe Haven (in accordance with the Statement of Work)

8 Beds

Estimated Base Year Amount $ mailto:rafael.cervantes@va.gov https://beta.sam.gov/

Option Year I:

DESCRIPTION Estimated Bed the Statement of Work)

Estimated Option Year I Amount $

Option Year II:

DESCRIPTION Estimated Bed

1 Daily Room & Board / VASDHS HCHV-

Safe Haven (in accordance with the

Statement of Work)

Estimated Option Year II Amount $

Option Year III:

DESCRIPTION Estimated Bed

1 Daily Room & Board / VASDHS

HCHV-Safe Haven (in accordance with the Statement of Work)

Estimated Option Year III Amount $

Option Year IV:

DESCRIPTION Estimated Bed the Statement of Work)

Estimated Option Year IV Amount $

Estimated Value - Base Year $

Estimated Value - Option Year One (1) $

Estimated Value - Option Year Two (2) $

Estimated Value - Option Year Three (3) $

Estimated Value - Option Year Four (4) $

Estimated Total Value $

B.4 STATEMENT OF WORK

Health Care for Homeless Veterans (HCHV) - Safe Haven Program – Transitional Housing

STATEMENT OF WORK

1. Background:

1.1 The Contractor shall provide the Department of Veterans Affairs San Diego Healthcare System

(VASDHS), 3350 La Jolla Village Dr., San Diego, CA 92161, with Health Care for Homeless

Veterans (HCHV) – Safe Haven program with Transitional Housing services for eight (8) homeless Veterans using the General Harm Reduction Program (GHRP) model of care – for male and female Veterans. GHRP is a model of care that meets the individuals where they are at when determining an appropriate intervention to decrease substance use and improve health.

This model of care does not stress abstinence unless this is the active desire of the client in receipt of services. The Harm Reduction philosophy hopes to encourage safer practices in regard to substance use such as; using clean needles, practicing safe sex. Additionally, the model of care will utilize of harm reduction techniques with medical and mental health care, encouraging

Veterans to access care and treatment without making it a mandate, attempting to increase safety and access to care while limiting harm. Any type of theoretical and evidenced based practice that helps reduce harm to an individual is considered harm reduction and is designed to establish trust and motivate the Veteran to engage in services whether immediately or in the future.

1.2. Harm reduction in a transitional housing environment focuses on having highly trained staff that are able to understand the difference between abstinence-based substance abuse treatment and reduction of substance use and engagement in mental health and medical care. The Veteran will be required to work with case management staff to develop a plan of care that will effectively help him or her move toward permanent housing. Individuals in a transitional housing harm reduction program will not be discharged for being intoxicated, continued substance use, or an inability to comply with psychiatric medication treatment.

1.3 The HCHV-Safe Haven Program is an essential and critical part of the Veterans Health

Administration (VHA) and is vital for providing a gateway to VA and community supportive service for homeless Veterans eligible for VA Healthcare. The Contractor shall provide a secure, appropriately monitored, temporary placement for those Veterans needing emergency residential placement within a 40-mile radius of the Department of Veterans Affairs San Diego Healthcare

System (VASDHS) located at 3350 La Jolla Village Dr., San Diego, CA 92161 and be within the

United States and the state of California. The Contractor shall also provide transportation services which are crucial to ensure that Veterans are able to check into VASDHS and return to temporary residential placement with minimal barriers. Veteran's length of stay within the Safe Haven program shall not exceed 180 days, unless otherwise clinically indicated and approved by VA staff.

(Please refer to page 7, section 5.D of HCHV Handbook). Care will include monthly visits by a

VHA representative.

1.4. Required services include case management, temporary housing and supportive services as appropriate. The contractor shall provide all facilities, labor, supervision, supplies, materials, and assistance with transportation.

1.5. Period of Performance: The period of performance for this contract will be for a Base Year plus four (4) Option Years.

1.6. Contract Type: Firm Fixed Price Indefinite Delivery / Indefinite Quantity.

1.7. Place of Performance: Work shall be performed at the contractor’s facility within a 40-mile radius of the Department of Veterans Affairs San Diego Healthcare System (VASDHS) located at 3350 La Jolla Village Dr., San Diego, CA 92161 and be within the United States.

1.8. Government Furnished Property: Government furnished property will not be provided to the Contractor. All equipment and furnishings required for the Contractor to provide the required services shall be provided by the Contractor.

1.9. Contract Award Meeting: The Contractor shall not commence performance on the tasks in the award Statement of Work until the Contracting Officer has conducted a kick-off meeting or has advised the Contractor that a kick-off meeting is waved.

2. General Responsibilities:

The Contractor Shall:

2.1. Be expected to provide expedient residential placement that enhances the stability of

Veteran services by the HCHV program within ninety (90) days of the contract award date.

2.2. The Contractor will ensure the following:

2.2.1. Participants are monitored 24 hours a day, 7 days a week to include all national, religious, and federal holidays.

2.2.2. There is sufficient personnel to assure security

2.2.3. Staffing will be available on-site 24 hours a day, 7 days a week, 365 days a year including all national, federal, and religious holidays.

2.2.4. The facility has adequate wheelchair accessibility.

2.2.5. Planning and coordinating all activities associated with providing safe and appropriate residential care.

2.3 The Contractor's facility shall have a current occupancy permit or license, as required by the authority that has jurisdiction to issue such. The Contractor shall be expected to provide transportation services, which may include assisting in accessing public conveyances such as buses, to and from the VA San Diego, due to the Safe Haven residential facility being located off VA grounds. The Contractor shall adhere to all applicable local, state, and federal laws.

2.4 The Contractor shall meet all requirements in accordance with the VHA Handbook

1162.09, “Healthcare for Homeless Veterans (HCHV) Program,” including the document found in the appendix, Contracted Provider Inspection Form, (VA Form 10-10115a).

The Contractor shall be responsible for maintaining compliance with these documents at all times and shall be responsive to future updated handbooks, directives, and/or inspection forms. This Handbook can be found on-line at:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3006

3. Safe Haven Transitional Housing Services:

3.1. Contractor services will be furnished to beneficiaries for whom such care is specifically authorized by the VA, and are considered homeless or chronically homeless as defined by sections 38 U.S.C 2002(1) and section 103(a) of the McKinney-Vento Homeless Assistance

Act, 42 U.S.C. 11302(a) (Please refer to HCHV Handbook Section 3). Veteran participants may have serious mental health illness as defined by the VA and/or substance abuse issues.

The Contractor shall provide Safe Haven residential care services under the GHRP model of care as described below:

3.1.1. Provide a Safe Haven facility that will offer 24-hour staffing. The facility will provide semi-private quarters that allow for participants to remain in the facility any time of the day or night. Target population served will include the hard-to-reach homeless Veterans who are on the streets and have been unable or unwilling to participate in VA funded services. The

Contractor shall provide supportive housing services as an alternative to shelter care.

3.1.2. Supportive services provided will assist the homeless Veterans link to resources to increase income, obtain vocational training and/or employment, and to reduce or stop risky behaviors. Substance use will not be permitted on the facility premises however, continued use of substances and/or relapses will not be used as a sole condition for admission, continued stay, and/or discharge from placement. Program rules that address substance use should outline ways that help homeless Veterans manage their addictions and health without abstinence of substances being the only measurement of success. A highly Individualized Service Plans

(ISP) will be unique to each Veteran's needs as well as the level of participation required from each resident in the program.

3.1.3 If Serving female Veterans, the Contractor will provide separate and secure quarters and bathrooms to ensure the safety of the participants and they must have access to female clinical staff (whether from the HCHV contracted provider, the VA, or other community partners) for gender specific treatment and supportive services as needed. Special emphasis on privacy and security should be noted in mixed-gender facilities. Please refer to VHA Handbook 1162.09 for additional information regarding gender specific care provisions.

3.2. It is understood that the type of participant to be cared for under this contract will require care and services above the level of room and board. Absences up to 72 hours may be permitted with VA approval in advance. Any unexcused or AWOL absences may not be reimbursable. Examples of approved absences that would warrant VA reimbursement https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3006 include requirement of higher levels of care for medical or mental health purposes, or other absences that support clinical care. Unexcused absences less than 72 hours will not be a basis for discharge alone. Care will include but is not limited to:

3.2.1. A supervised alcohol/drug free environment

3.2.2. Supportive social services

3.2.3. Structured group activities

3.2.4. Physical activities

3.2.5. Individual and group counseling in collaboration with VA program resources 3.2.6.

Basic Health and Personal Hygiene maintenance, including supplies as necessary

3.2.7. Locked storage of medications

4. Veteran Code of Conduct:

4.1. The Contractor shall develop a code of conduct to be followed by program residents while receiving services under this contract or while on facility premises. The code of conduct should be reviewed and approved by the VA Safe Haven Liaison and provided in writing to program

Veterans upon admission. At minimum, the following acts are not permissible:

4.1.1. Acts or threats of violence to other participants, employees or the general public

4.1.2. The carrying of firearms, knives, or other weapons, including those that are concealed.

4.1.3. Use of intoxicating liquors, narcotics, or controlled substances of any kind on the premises of the program

5. Referral/Discharge & Coordination of Care:

5.1. The Contractor agrees to accept referrals of and provide all services in this contract, to any person determined to be eligible by his/her designee, regardless of the race, color, religion, sex, or national origin of the person for whom such services are ordered.

5.2. All Veterans who are referred for services will have a letter of acceptance/referral from the VA with the date and Veteran's identifying information. That letter will be documented in the

Veteran's chart for record keeping

5.3 All Veterans who are referred will receive medical care by a VA facility/medical center while being provided services authorized by this contract. The VA will not reimburse outside medical providers for any services rendered to any participating Veterans under this contract.

5.4. Orders, request, or changes in the referral process shall only be made by the VA COR/ Safe Haven

Liaison, or authorized party specified by the HCHV Coordinator. Under no circumstances shall there be any deviation by any other party. In addition, the Contractor shall make no deviation and is responsible for providing direction to its staff.

5.5. 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.

5.6. Coordination of care provided by the VHA staff and Contractor for individual Veterans shall be maintained as such:

5.6.1. Contractor shall maintain a daily census.

5.6.2. Case Managers shall make face to face contact, document Veteran's progress, care plan, observations, etc. a minimum of once weekly.

5.6.3. Contractor shall document ongoing communication as it pertains to Veteran participation as needed.

5.6.4. Contractor shall document discharge plans developed by the Veteran and VA staff.

5.6.5. Contractor shall participate in case consultations with VHA staff as needed.

5.6.6. Discharge planning will be coordinated in collaboration with assigned VHA staff and/or liaison. All unplanned exits shall be reported to the VHA staff member and/or liaison immediately i.e. AWOL, death, arrest, or entry to hospital. 5.6.7.

Relapse and unexcused absences will not be a basis for discharge alone.

5.7. Discharging a Veteran participant to the streets without coordinated services through the assigned VHA staff member/liaison and/or appropriate placement will not be permitted unless for reasons such as:

5.7.1. Acts or threats of violence to other participants, employees or the general public.

5.7.2. The carrying of firearms, knives, or other weapons, including those that are concealed.

6. Staff Qualifications:

6.1. Program Manager (Supervisor) shall have a Master's Degree from an accredited

University in any of the social sciences or human services field and two (2) years of experience working in social services.

6.2 Clinical Supervisor shall have a Master's Degree from an accredited University in any of the social sciences fields and shall be licensed in the State of California to practice mental health at the highest level of licensure. The Program Manager may practice as the Clinical

Supervisor, provided that the Program Manager meets both requirements.

6.3. Case Managers shall have a Master's Degree from an accredited University in any of the social sciences or human services field and two (2) years of experience working in social services.

6.4. Counselors shall have one (1) year of related experience in mental health and/or substance abuse counseling and should be accredited or licensed in accordance with their respective fields.

6.5. Resident Assistants and/or Resident Managers shall have one (1) year of experience working in residential facilities that treat patients with mental health and/or substance use issues.

6.6. All staff that have direct contact with patients shall be certified in Basic Life Support (BLS) or

CPR, provided by the contractor.

7. Staffing:

7.1. Program Manager shall be responsible for contract performance. The Program Manager shall have full authority to act for the Contractor on all matters relating to the daily operation of this contract. That employee may be a health care provider performing under this contract. An alternate may be designated, but the Contractor shall identify, in writing, those times when the alternate shall act as the liaison. At minimum, the Program Manager or his/her staff designee shall be available on duty or on-call for emergencies 24 hours a day, 7 days a week, 365 days a year. Responsibilities include but are not limited to:

7.1.1. Management of the contract

7.1.2. Ensures supportive services are conducive to each Veteran's needs

7.1.3. Ensures timeliness of billing

7.1.4. Ensures timely submission of required documentation to the VA

7.1.5. Coordinating for annual inspection of services with VA staff

7.1.6. Current Basic Life Support (BLS) or CPR completed and in current standing for all employees, provided by contractor.

7.2. The Contractor shall provide an appropriate number of qualified staff to carry out the policies, responsibilities, and to ensure the safety of Veteran participants in the program 24 hours a day, 7 days a week, 365 days of the year. The Contractor shall ensure that employees meet and maintain the qualifications needed to perform their duties to service the identified Veteran population.

7.3. During the provision of service, the minimum staffing ratios and health-related requirements shall be as follows:

7.4. Case Managers:

7.4.1. The Case Manager staffing ratio will not exceed 10:1 (10 Veteran clients to 1

Case Manager)

7.4.2. Case Managers shall be present in the facility at minimum during normal business hours of Monday — Friday 8:00am — 4:30pm

7.4.3. Program will be staffed with the appropriate number of Case Managers as required to provide for and meet the staffing ratio and quality of care standards based on VA, state, and federal licensing, and the Joint Commission guidelines.

7.4.4. Any time there is only one Case Manager on duty on the premises, the Program

Manager shall be on call and capable of responding within 30 minutes.

7.5. Counselors:

7.5.1. Shall assist Case Managers in providing supportive and therapeutic services to

Veteran participants.

7.5.2. Counselors shall be present at the facility at minimum during normal business hours of

Monday — Friday 8:00am — 4:30pm to provide individual and group counseling sessions.

7.5.3. Any time there is only a Counselor on duty on the premises, a Case Manager, or the

Program Manager shall be on call and capable of responding within 30 minutes

7.6. Resident Assistants or Resident Managers-

7.6.1. Contractor will provide a 24-hour staffed transitional residence with a reasonable ratio of staff-to-Veterans in order to ensure the provision of adequate safety and oversight of all participants. The Contractor will provide a staffing plan to the VA Liaison/COR for approval to ensure that Residential Assistants or Managers can provide basic supervision of milieu in evenings and overnights and provide for safety of those in the facility in an emergency, helping to evacuate the building if needed, check in residents who return to the premises late, responding to emergencies, or other events as they occur. VA retains the right to require the Contractor to provide additional residential staffing to address safety issues, as identified.

7.6.2. Any time there is only a Resident Assistant or Resident Manager on duty on the premises, the Program Manager or designee shall be on call and capable of responding within 30 minutes.

7.6.3. Staff behavior and interaction with residents shall convey an attitude of genuine concern, caring, and respect.

7.6.4. Contractor shall ensure that employees meet and maintain the qualifications needed to perform their duties, and serve the identified Veteran population in accordance with this contract.

7.7. Staff members on duty shall be awake at all times.

7.8. All staff will have the appropriate training, including:

7.8.1. Monitoring and safety procedures

7.8.2. Medication distribution in accordance with written policies developed by the

Tech Contractor

7.83. Communication with Program staff where applicable

8. Admission:

The Contractor shall be responsible for same day admissions and assessing Veterans, including initial and ongoing assessments. The care planning process shall include coordination supervision, evaluating the care and services provided, and discharge planning.

9. General Supportive Services:

9.1. Supportive services shall be provided as outlined in the Plan of Care administered by trained program staff. This plan shall be developed in conjunction with and monitored by the VA

Liaison/COR. Additionally; the plan will be reviewed by VA program staff on a monthly basis and modified as needed.

9.2. The Contractor shall be responsible for admitting and assessing Veterans, including initial and ongoing assessments. The care planning process shall include coordination, supervision, and evaluating the care and services provided and discharge planning.

9.3. The Contractor will encourage the Veteran to work towards transitional or permanent housing within (180) days of admission. The discharge planning process shall begin within 30 days of admission.

9.4. 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 services

9.5. Infraction of rules should be used as opportunities for engagement.

9.6. Inebriated individuals shall be kept as separate as possible from other Safe Haven program residents and be closely observed and physically checked during the first 12 hours. Contractor shall develop and maintain a written protocol as to how staff will be expected to respond under these circumstances based on staffing capabilities of the program. Close observation and physical checks shall continue beyond the initial 12 hour period for as long as the individual appears inebriated. Documentation and VA notification of such within twenty-four (24) hours is required.

9.7. In all cases relating to signs of withdrawal and/or acts of violence, Contractor staff shall contact the local emergency response system, then follow up with immediate VA notification via email or telephone call to the COR. Follow-up written incident reports shall be submitted within 24 business hours to the COR.

9.8. The Program Manager shall ensure the therapeutic and rehabilitative needs of each individual Veteran are met in accordance with an Individual Service Plan (ISP).

9.9. The ISP shall be developed by the Case Manager or Program Manager with the participation of the Veteran and shall remain consistent with the low-demand program goals.

9.10. Case Managers shall attempt to meet with each Veteran individually on a weekly basis and document each Veteran's progress in the case notes. Progress notes should, at minimum, include the following:

9.10.1. Veteran's progress towards one or more goals, including housing, in the Veteran's ISP;

9.10.2. New issues or problems that affect the Veteran's ISP goals; or

9.10.3. Types of support provided by the program or other appropriate healthcare providers.

9.10.4 Assessment of risk factors, including harm to self or others.

9.11. Veterans shall be provided with opportunities to participate in spiritual worship, counseling, treatment, social skill enhancement, and be provided with education regarding the process of illness and recovery.

9.12. Activities shall be designed to meet the goals and objectives for increased social responsibility, self-motivation, and integration into the larger community. Such activities may include:

9.12.1. Individual and/or group counseling

9.12.2. Social skills training, vocational counseling, and physical activities as appropriate

9.12.3. Supportive social services in collaboration with VA staff and/or other community contract resources

9.12.4. Assistance with housing needs and resources

10. Facility Qualifications:

10.1. The facility shall conform to the Life Safety Code, National Fire Protection

Association (NFPA) #101 standards intp://www.nfpa.org/codes-and-standards/ail-codes-and- standards/list-of-cocies-and-standards?mode=code&code=101

10.2. The Contractor shall possess a valid Business License/Certification for the state of California.

10.3. The Contractor shall have a current Certificate of Occupancy permit license as required by the authority that has jurisdiction to issue for facility location and shall adhere to all applicable local, state, and federal laws.

10.4. The facility shall be wheelchair accessible and in compliance with the Americans with

Disabilities Act guidelines for buildings and facilities haps://www.access-board.gov/guidelines-and- standards/builclings-and-sites/about-the-ada-standards/ada-standards.

10.5. The facility shall have access to public transportation that is within reasonable walking distance.

http://www.nfpa.org/codes-and-standards/ail-codes-and-standards/list-of-cocies-and-standards?mode=code&code=101 http://www.nfpa.org/codes-and-standards/ail-codes-and-standards/list-of-cocies-and-standards?mode=code&code=101 http://www.nfpa.org/codes-and-standards/ail-codes-and-standards/list-of-cocies-and-standards?mode=code&code=101 http://www.nfpa.org/codes-and-standards/ail-codes-and-standards/list-of-cocies-and-standards?mode=code&code=101 http://www.access-board.gov/guidelines-and-standards/builclings-and-sites/about-the-ada-standards/ada-standards http://www.access-board.gov/guidelines-and-standards/builclings-and-sites/about-the-ada-standards/ada-standards http://www.access-board.gov/guidelines-and-standards/builclings-and-sites/about-the-ada-standards/ada-standards http://www.access-board.gov/guidelines-and-standards/builclings-and-sites/about-the-ada-standards/ada-standards

10.6. The facility where services are to be provided shall be within a 40-mile radius and within the catchment area of the Department of Veterans Affairs (VA) San Diego

Healthcare System (VASDHS), located at 3350 La Jolla Village Dr San Diego CA

92161.

11. Contractor Facility:

11.1. The term "facilities" shall include, but is not limited to rooms, sections, eating areas, entrances, hallways, etc. It is agreed that the VHA will have the right to inspection of the facility by authorized representative(s) designated by the VHA to determine whether acceptable standards are maintained, and that adequate care is being rendered. The Contractor shall ensure the following:

11.2. One single bed per occupant with proper bedding, to include fitted sheets, blankets, and pillows

11.2.1. Adequate and secured storage space for clothing and personal properties.

11.2.2. Efficient lighting,

11.2.3. Linen and towels.

11.2.4. Signs that identify female only rooms/restrooms.

11.3. On-site adequate laundry facilities.

11.3.1. Veteran residents shall be required to do their own laundry, but Contractor shall provide any supplies needed to do so. Supplies shall include but are not limited to:

11.3.1.1. Tokens, coins, or funds to operate all machines

11.3.1.32. Adequate amounts of laundry detergent (hypo-allergenic detergent may be required for medical reasons as prescribed)

11.4. Restrooms and showers shall be provided with signs that designate men's facility separate from women's facility.

11.4.1. All toilets, hand washing, and bathing facilities shall be maintained in a safe, fully functional, and sanitary condition. Additional equipment, aids, and/or conveniences shall be provided in facilities for accommodating American Disabilities Act (ADA) standards.

11.4.2. Contractor will provide all toiletries at no additional cost; i.e. toilet paper, sanitary napkins/tampons, shampoo/conditioner, bath soaps, shaving equipment, facial tissues, toothpaste/brushes, hair combs and brushes.

11.5. Contractor will provide all kitchen supplies, utensils required to prepare and consume food and drinks.

11.6. Contractor shall be responsible to ensure that the facility is maintained clean, free of dirt/grime, mold, bed bugs, or other hazardous substances and damage.

11.7. Contractor shall take full responsibility for the Veteran's well-being and safety once the individual enters the facility.

11.8. Indoor recreation/lounging common areas shall be provided with the following equipment:

11.8.1. Chairs

11.8.2. Reading materials; i.e. books, magazines, and newspapers

11.8.3. Other types of entertainment, activities, and/or games that may be deemed appropriate

11.9. Designated smoking areas shall be provided in accordance with the laws of the State of

California and/or additional local and county laws.

11.10. The Contractor shall provide telephone service on site, free of local use charges.

11.11. Emergency exits shall be marked with sufficient lighting in case of emergency.

11.12. Evacuation plans shall be posted in common areas.

11.13. Facility shall be equipped with first aid, fire extinguishers that are fully charged and non-expired, and fire/carbon alarms.

11.14. A space for Veterans who enter the facility inebriated shall be kept separately from other participants in the program until they have been cleared by facility staff to enter the general participant population. This may require having a space (i.e., Safe Room) where the Veteran can sleep separately from the other participants in the program. Veterans sleeping separately due to intoxication must be closely monitored (a minimum of every 15 minutes) and all interventions and Veteran response to the interventions should be documented.

11.15. Contractor shall provide a designated ongoing space and supplies necessary to allow

VHA staff and internal agency staff to conduct Veteran participant group meetings.

11.16. Contractor shall provide a designated, office space on an ongoing schedule to allow for VHA staff to meet privately or semi-privately with Veteran participants. At minimum the space shall include:

11.16.1. At least two chairs

11.16.2. Small table or desk

11.16.3. Be handicap accessible

11.17. The Government will not incur any cost associated with the contractor providing, repairing, or replacing inadequate or faulty equipment.

12. Records:

12.1. The Contractor is a VHA contractor and shall assist in the provision of healthcare to patients seeking such care from or through VHA. As such, the Contractor is considered as being part of the department healthcare activity. The Contractor is considered to be a VHA contractor for purposes of the Privacy Act, Title 5 U.S.C. 552a, further, for the purpose of VHA records access and patient confidentiality. The Contractor is considered to be a VHA contractor for the provisions of Title 38 U.S.0 5701, 5705, and 7362. Therefore, the Contractor will only have access to patient medical records including patient records pertaining to drug and alcohol abuse, HIV, and sickle cell anemia, to the extent necessary to perform its contractual responsibilities. The Contractor is subject to the same penalties and liabilities for unauthorized disclosures of any records as VHA. The Contractor and any subcontractors shall adhere to the provisions of Public Law 104191, Health Insurance Portability and Accountability ACT

(HIPAA) of 1996. This includes both the HIPAA Privacy and Security Rules published by the

Department of Health and Human Services protected health information covered by entities.

The covered entity component of the Department of Veteran Affairs is the Veterans Health

Administration Business Associate Agree (BAA). Contractor shall be responsible for maintaining the following:

12.1.1. Contractor shall be responsible for the development of any necessary forms,

12.1.2. Contractor shall maintain a file for each Veteran admitted to the program.

12.1.3. Contractor will keep all Veteran files behind two locks at all times.

12.1.4. Information will be provided following Veteran consent and completion of VA authorization to release information form.

12.1.5. Contractor will not have access to VA computerized electronic systems.

12.1.6. All Veteran files shall contain VHA referral, discharge, and any other forms related to coordination of care.

12.1.7. All Veteran files shall contain demographic information sufficient to identify the

Veteran participant and to satisfy data collection needs of the program and funding agencies. Files shall include the following, but is not limited to:

12.1.7.1. Veteran identifier (i.e., name, number, etc.)

12.1.7.2. Date of Birth

12.1.7.3. Sex

12.1.7.4. Race/ethnic backgrounds

12.1.7.5. Address (if applicable)

12.1.7.6. Telephone number (if applicable)

12.1.7.7. Next of kin or emergency contact (including phone number and consent of kin)

12.1.7.8. VA verification of homelessness letter

12.1.7.9. Date of admission/readmission

12.1.7.10. Admission agreement

12.1.7.11. Authorization to release information, including VA Information (ROI) on

VA form 10-5345, or most recent version of said form

12.1.7.12. Referral source and reason for referral

12.1.7.13. Veteran rights document

12.1.7.14. Medical referrals and clearances as needed

12.1.7.15. Correspondence with or regarding the Veteran Affairs

12.1.7.16. Discussions and actions to reengage Veteran for not complying with program rules and requirements

12.1.7.17. Any type of supportive services provided to Veteran, i.e. resources and referrals, additional transportation, clothing assistance etc.

12.1.7.18. Medications should be documented in records and/or incidences of medication non-compliance

12.1.7.19. Major incidents involving Veterans will be documented with incident reports and any follow up and/or outcomes

12.1.8. It is agreed that the VA may readily have access to all medical records concerning the Veterans care in the facility.

12.1.9. Contractor shall notify assigned VA COR/Liaison or designee within 24 hours of any

AWOL, death, or unanticipated discharge telephonically

12.1.10. Upon discharge or death of a patient, medical records on all VA beneficiaries will be retained by the facility for a period of at least three (3) years following termination of VA care. However, upon termination or completion of contract; the

Contractor will surrender medical records on all VA beneficiaries to the VA

COR/Liaison or designee.

12.1.11. Periodic reports will be provided to the VA (i.e., Fiscal Accountability) as required.

13. Reports:

13.1. The Contractor shall notify the assigned VHA Staff/Liaison/COR immediately of any medical emergency. If hospitalization of a Veteran is required, it is agreed that readmission will be evaluated by appropriate VA staff.

13.2. In the event a Veteran participant dies, the Contractor shall promptly notify the VHA

Staff/Liaison/COR immediately and will immediately assemble, inventory, and safeguard the patient's personal effects. Any fund deposits and effects left by the Veteran upon the premises of the facility shall be delivered by the Contractor for making disposition of funds and effects left by Veterans; unless the beneficiary dies without leaving a will, heirs, or next of kin capable of inheriting. When deposition has been made the itemized inventory, with a notation as to the disposition of funds, will be immediately forwarded to the VHA office. Should the deceased Veteran leave no will, heirs, or next of kin; his/her personal property and funds, wherever located, vests and becomes the property of the United States in trust. In these cases the facility will forward inventory of any such property and funds in its possession to the appropriate VA office and will hold them (except articles of clothing necessary for proper burial) under safeguard until instructions are received from VHA concerning disposition.

13.3. Contractor shall notify VHA staff immediately upon any changes to participant's health. The

Contractor shall also contact local emergency services as needed during afterhours and weekends.

13.4. The COR/VA Liaison shall monitor the services provided. Contractor shall cooperate with all

VHA staff assigned to this contract, in providing information and answering questions in a timely manner when requested. Contractor shall refer complaints received directly from the customer(s) to the VHA staff/Liaison/COR. All complaints received by the VHA staff/Liaison/COR and forwarded to the Contractor shall be investigated promptly. After investigation and disposition, Contractor shall respond to the VHA staff/Liaison/COR within five (5) business days after receipt of the complaint by the Contractor. VHA staff/Liaison/COR will be provided with all information regarding complaints.

14. Medications:

14.1. Any medications that the Veteran brings into the contractor's facility or is prescribed while in the care of that facility will be managed in accordance with the following:

14.1.1. Contractor shall have a written policy statement regarding the use of prescribed medications. Such a policy shall not necessarily preclude the licit use of prescribed medications.

14.1.2. Medications including controlled substances shall be properly stored and controlled in a locked storage unit.

14.1.3. The proper issuance upon orders from physicians shall be provided by the VA and recorded in the Veteran's chart.

14.1.4. All medication will be self-administered by the Veteran.

14.1.5. Contractor shall provide patient services for Veterans as requested Sunday through Saturday and recognized holidays.

14.1.6. Contractor shall maintain an updated list of all medications within Veteran's chart and document efforts to obtain releases of information to coordinate care with medical providers prescribing these medications.

14.1.7. Contractor shall maintain updated medication records for Veteran participants who stay in the program more than 30 days.

15. Dietary Services:

15.1. The VHA will have the right to inspect the facility by an authorized representative(s)designated by the VHA to determine whether acceptable standards are maintained and that adequate care is being rendered. Dietary services shall include the following:

15.1.1. Three (3) meals shall be served; breakfast, lunch and dinner; with no more than an

8 hour time span between each meal.

15.1.2. In between meals, at least two (2) snacks shall be served to all Veterans unless limited by dietary restrictions prescribed by a medical provider.

15.1.3. Food preparation, serving, and storage shall be in accordance with California

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