In accordance with FAR Part 10, Market Research, this is a Sources Sought Notice to determine the availability of potential sources/vendors having the skills and capabilities necessary to provide Healthcare for Homeless Veterans (HCHV) Rehabilitative Services for up to 53 single male and up to 4 female homeless veterans with mental illness and/or substance use disorders in a residential program located in Central Ohio, catchment area for a period of one (1) base year, with four, 12-month options, exercisable at the Government s discretion. All interested contractors are invited to respond as this information may be used to determine potential set asides for the above noted services. This Sources Sought Notice is for information and planning purposes only and shall not be construed as a solicitation or as an obligation on the part of the Department of Veterans Affairs (VA). No reimbursement will be made for any costs associated with providing information in response to this Sources Sought or any follow up information. If your company is able to perform these services please respond to the following: Company name and address. Company point of contact name, telephone number and email address. Type of business: Service-Disabled Veteran-Owned Small Business, Veteran-Owned Small business, 8A, HUBZone, Woman-Owned Small Business, etc. All businesses eligible to provide this service are encouraged to reply as this information may be used to determine potential set-asides. UEI number and NAICS Code. Federal Supply Schedule (FSS) Contract, list the GSA Contract Number and relevant SINS. Company website address. Capabilities/Qualifications: A written response providing clear and unambiguous evidence to substantiate the capacity to fulfill this requirement. Description of the capabilities/qualifications/skills your company possesses to perform services described. Do you need to subcontract any portion of work to provide these services stated herein? Past Experience relative to similar requirements. Offer may provide the following information on similar projects for which the responder was a prime contractor. The name, address, and value of each project. The Prime Contract Type, Firm Fixed-Price. The name, telephone and address of the owner of each project. A description of each project and why it is relevant to this requirement. Include difficulties and successes. Your company s role and services provided for each project. Telephone and faxed responses will not be accepted nor responded to. It is requested that the above information be provided no later than June 15, 2023 at 10:00 am EST. Responses should be emailed to Brandi.Holland2@va.gov PART I: GENERAL INFORMATION Background Through the HCHV Program, the VA provides Veterans case management services and facilitates their access to a broad range of medical, mental health, and rehabilitative services. The Contractor shall provide care, rehabilitative services to Homeless Veterans in community-based facilities offering a safe and secure environment that supports their rehabilitation goals. The Contractor shall be required to provide a safe, therapeutic and rehabilitative setting and attendant services. The term residential Program may refer to a variety of housing options including, apartment style housing, group home, or institutional setting. The type of veterans to be cared for under this contract will require care and services over and above the level of room and board. Services to be Provided All veterans placed by VA staff in the facility must be eligible veterans for VA health care as described by the Department of Veterans Affairs guidelines. All veteran residents shall be capable of self-preservation and performance of all ADLs (Activities of Daily Living) independently including bathing, dressing, toileting, feeding, transferring, and continence. In an emergency situation, veteran residents shall have sufficient capacity to recognize physical danger, the judgment that requires to immediate egress from the group residence, the capacity to follow a prescribed route of egress, and have the physical ability to accomplish such egress. Contractor will develop SOP including this information in their admission criteria. Should a Veteran develop a condition post admission in which he/she can no longer perform ADL s independently and/or sufficient capacity to recognize physical danger and the judgment that requires immediate egress, the contractor will work with the VA Liaison to develop and implement a transition plan. Contractor shall provide community-based residential care and rehabilitative services for up to fifty-three (53) homeless male veterans and four (4) female veterans, who may have a mental illness and/or substance use disorder diagnosis, in a residential program. Applicable Documents VHA Handbook 1162.09 Health Care for Homeless Veterans (HCHV) Program (http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3006) VA patient s Bill of Rights, 38 U.S. C 17.34a (http://www.va.gov/health/rights/patientrights.asp) Life Safety Code of the National Fire Protection Agency: NFPA #101 (www.nfpa.org) Confidentiality of Medical Quality Assurance Records: 38 U.S.C. 5701 (http://www.gpo.gov/fdsys/granule/USCODE-2010-title38/USCODE-2010-title38-partIV-chap57-subchapI-sec5701/content-detail.html); and 38 U.S.C. 7332 (http://www.gpo.gov/fdsys/granule/USCODE-2011-title38/USCODE-2011-title38-partV-chap73-subchapIII-sec7332/content-detail.html) Disclosure of Patient Records: Records protected by 38 U.S.C. 5705; its implementing regulations at 38 U.S.C. 17.500-511; VHA Directive 98-016, 4b. (1) (d), 4.6(2)(c) and 4.6(4). These records may be disclosed only as authorized by 38 U.S.C. 5705 and the VA regulations. Disclosure of these records in violation of 5705 is a criminal offense under 38 U.S.C. 5705(e): (http://www.gpo.gov/fdsys/pkg/USCODE-2013-title38/pdf/USCODE-2013-title38-partIV-chap57-subchapI-sec5705.pdf) PART II: WORK REQUIREMENTS Services to be provided: Contractor shall furnish each veteran authorized care under this contract with the following basic services: Contractor shall have a facility obtained (either leased/rented/owned) and made fully operational prior to the effective date of this contract. The facility must pass the life safety inspection prior to any services rendered. The contractor will employ sufficient personnel to carry out the policies, responsibilities, and the program for the facility. There must be, as a minimum, at least one administrative staff member, or designee of equivalent professional capability, on duty on the premises or residing at the house and available for emergencies 24 hours a day, 7 days a week. Veterans may be on physician ordered special diets. Veterans shall have appetizing, nutritional meals provided in a setting that encourages social interaction. Meals shall include three (3) nutritionally adequate meals a day, 7 days a week and availability of nutritious snacks between meals and bedtime for those requiring or desiring additional food, when it is not medically contraindicated. Refrigeration and dry food storage areas are appropriately maintained and monitored. All food areas are clean and free of litter. Current licensures are maintained, if required. If facility is not set up to provide meals 7 days a week, nutritional food must be provided or available at no cost to the Veteran. (This could mean Veterans have access to a food pantry, local food bank, are receiving supplemental nutritional assistance program (SNAP), or the contractor provides the food). For individually prepared meals: appliances must be adequate to safely store and prepare food and are in good working condition (i.e.: stove, refrigerator, dishwasher, etc.) for individually prepared meals. This would also include ensuring that all food preparation areas contain suitable space and equipment to store, prepare, and serve food in a sanitary manner. Cleaning supplies shall be provided to maintain a clean kitchen area. These would include broom, mop, vacuum, cleaning products, dish soap, trash can, trash bags, etc.) Resource information is available to educate veterans with special dietary needs (i.e.: Diabetic, allergies, medically indicated.) This may be accomplished through nutritional education provided directly by the agency or a referral resource within the community. Many veterans are either undernourished or have poor eating habits because of their chronic psychiatric disorders, which could be alcohol/drug abuse related behaviors. Laundry facilities for residents to do their own laundry with no cost to the veterans. Machines shall be maintained and in good condition to ensure availability of service. Dining areas must be comfortable and adequate size to seat the maximum number of residents in the facility. Common living areas must be comfortable and adequate in size to accommodate the maximum number of residents in the facility. The facility shall maintain one functional lavatory (bathing and/or shower facility) for every six people living in the facility. For non-congregate settings, bedrooms shall measure at least 100 square feet for a single room, or an additional 25 square feet for each resident double occupancy room (or in a multi-resident room). Male and female residents shall have secure separate sleeping quarters. Bedrooms shall contain no more than four beds. Floor plan of facility/units shall be available for review and approval prior to award. NOTE: The complex nature of certain residents may dictate the need for single occupancy in a bedroom. Bedrooms shall contain a suitable bed furnished by the facility with, mattress, pillow, sheets/blankets and towels. The facility shall be responsible for laundering the linens and towels at least weekly and keeping them in good condition. Mattresses must be kept in good condition and replaced as needed. The Contractor will offer a low-demand environment meaning Veterans will be offered mental health and substance abuse services but, their participation in these services will not be contingent on their acceptance or continued stay in the facility. A locked cabinet or secured lock box (that cannot be easily removed from the premises) shall be provided for medication and valuables storage. Facility shall have safe and functioning systems for: heating and cooling, hot and cold water, electricity, plumbing, sewage, food preparation (unless food is prepared off site), laundry, artificial and natural light, and ventilation. The residence shall be climate controlled to be heated not below 65 degrees Fahrenheit in the winter and cooled not above 75 degrees Fahrenheit in the summer. All facility areas shall be kept clean and sanitized weekly. Chores may be assigned to veterans, but facility staff must ensure areas are cleaned to sanitary standards. Therapeutic, Rehabilitative, and Recovery Services shall be determined by the individual resident in conjunction with the contracted facility staff and in consultation with the VA Liaison. The Contractor shall develop a service plan with the veteran and include the VA Liaison. Such plans shall be developed based on a psychosocial assessment, completed by contracted facility staff and shall be in compliance with Commission of Accreditation for Rehabilitation Facilities (CARF) standards located at http://www.carf.org/home/ Services which the Contractor shall be able to furnish include: Case management, which shall address self-care skills, adaptive coping skills, mental health service needs, supported employment, in collaboration with VA program or contracted community resources. Case management services shall be provided during day shift hours, Monday through Friday. Collaboration with the VA program staff, which will provide supportive psychosocial services. Assistance to develop responsible living patterns, to maintain an acceptable level of personal hygiene and grooming, and to achieve a more adaptive level of psychosocial functioning, upgraded social skills, and improved personal relationships. A program that promotes community interaction. Monitoring of medications, if instructed and is necessary. 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. The provider shall provide a level of service that does not expel the veteran if he tests positive for drugs or alcohol but provides a recovery focused environment that is supportive and inclusive while the veteran stabilizes with their mental health treatment and medications. Allow Veterans prescribed Suboxone or other antagonist types of medicine that assist with withdrawal and the management of mental health symptoms. Track veteran outcomes upon discharge from services. In collaboration with VA liaison, provide case management 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. Weekly case review of residents involving the contractor, designated VA HCHV Program staff, and COR. The contractor s facility shall have a current occupancy permit or license required by the authority having jurisdiction. The Contractor shall assist the Veterans with local transportation to scheduled meetings and appointments. The Contractor will be expected to help the Veteran access public transportation, including providing information and instructions necessary to enable Veterans to utilize public transportation. Special Care Requirements Imperative Levels of Care Evidence based best practice interventions, for homeless persons, shall be designed to promote a more adaptive level of psychosocial functioning, and to assist VA staff in transitioning veterans into permanent/independent housing. Contractor shall include supportive health care that shall include the instruction and/or information related to personal hygiene to all veterans that may be in need of care. Individual adjustment services including social diversion, recovery focused, recreational and spiritual opportunities. Full attention shall be given to motivation and education of veterans to achieve and maintain independence in the activities of daily living and self-care. Pest Prevention There shall be a Pest Preventative Treatment plan in place; pest preventative treatment plans shall include prevention and remedy methods for the treatment of pests, such as bed bugs, rodents; and shall render prevention/treatment of such pests with pest control industry standard practices. The COR shall monitor the Contractor s facility to ensure compliance with this protocol and successful results. Contractor shall maintain an emergency housing contingency plan in the event of an infestation that renders the facility unfit for habitation. Responsibility and Legal Obligations Contractor and facility staff shall conform to all regulations, Federal, State and local governing the performance of contracted services. The Contractor shall employ sufficient personnel to carry out the policies, responsibilities, and programs of the facility. In residential program facilities/group homes, there must be an administrative staff member or designee of equivalent professional capability on the premises or resides at the house 24-hours a day, seven (7) days a week. When a supervised residential setting is linked to a geographically distinct rehabilitation and/or socialization day program, sufficient professional healthcare personnel must be identified to provide the necessary therapeutic activities and to ensure a meaningful integration. Contractor shall make available to the VA, documentation/information deemed necessary by the VA to conduct utilization review audits for the mandated national evaluation study as required by section 2 of Public Law 110-6; to verify quality of patient care for veterans, to accuracy of financial records. Contractor shall comply with the VA patient s Bill of Rights as set forth in section 17.34a, Title 38, Code of Federal Regulations. Contractor under this program must meet the following VA standards, based on regulations promulgated by Title 38 Code of Federal Regulations (CFR) Section 17.53b Residential Standards Both residential and ambulatory care settings shall meet the following: The standards of the Life Safety Code (National Fire Protection Association (NFPA #101) The fire and safety code imposed by the State law City, State, and Federal requirements concerning licensing and health codes, including construction, fire, maintenance, and sanitation regulations All residential program settings shall meet ADA (Active Daily Activities) requirements (www.ada.gov) All residential program settings must be licensed as required for the particular setting under State or Federal authority Be equipped with operational air conditioning /heating systems Be kept clean free of dirt, grime, mold, or other hazardous substances and damaged noticeably detract from the overall appearance. Be equipped with first aid equipment and an evacuation plan in case of emergency. Have windows and doors that can be opened and closed in accordance with manufacturer standards. Must have a water supply that is free from contamination. Written policies and procedures regarding safety, security, and privacy in which are regularly communicated to participants and staff and routinely enforced. If applicable, this would include separate facility (bathrooms/showers) access for privacy and security given the population served. Has installed staff offices, treatment, group, participant rooms, dorms, shower, and restrooms have locks appropriate for the setting and gender mix. If applicable, separate male and female bathrooms. Has established a procedure for ongoing law enforcement monitoring. Ensures residential supervision with sufficient knowledge of the position is on duty 24 hours a day, 7 days a week; If this supervision is provided by a volunteer or senior resident, a paid staff member is on call for emergencies 24 hours a day, 7 days a week. Ensures documentation of residential supervision training. ensures emergency contacts for medical, law enforcement, fire department, and agency are prominently posted in the facility. Has a system to identify participants who are subject to residency restrictions (e.g., Those are required to register following conviction for a sexual offense) and when appropriate, to communicate with parole or probation authorities to confirm that the placement meets any court-imposed requirements Ensures the facility is safe and secure based on location, population(s) served, and facility structure (This includes ensuring locks are in working order where appropriate) (Note adequate consideration should be given to separation and safety in facilities where multiple genders and/or children are served). Program has adequate policies and procedures which are communicated and enforced to ensure safety, security, and privacy based on location, population(s) served, and facility structure. Ensure interior and exterior locks are in good working order; appropriately located; adequate for the area that is being secured and populations served within the facility. Provides adequate natural or artificial illumination to permit normal indoor activities and to support health and safety of residents. Must also ensure there is sufficient lighting on the perimeter of the facility based on the housing setting (e.g.; rural, industrial, or residential settings). a. Both interior and exterior lights must be checked regularly to make sure they are operating effectively Interior and exterior lights must be in good working order and adequate for the area that is being secured and populations served within the facility Common areas (e.g., laundry, computer labs, break rooms) are appropriately secured, monitored, and lit. Contractor has a written disaster plan that has been coordinated with the emergency management entity responsible for the locality in which the project resides. The disaster plan encompasses natural and manmade disasters Accreditation and Licensing Accreditation by the Commission on Accreditation of Rehabilitation Facilities (CARF) is desirable, but not required. Where applicable, the residential program shall have a current occupancy permit issued by the authority having jurisdiction. Personnel There must be, at a minimum, at least one administrative staff member, or designee of equivalent professional capability, on duty on the premises or residing at the facility and available for emergencies 24 hours a day, 7 days a week. Contractor shall assign to this contract personnel that by education and training (and, when required, certification or licensure) are qualified to provide the Basic Services and Supplemental Services required by this Performance Work Statement (PWS). All staff shall be certified in CPR/Heart Saver, VA Privacy Training, Psychological First Aid and received training on verbal de-escalation. Certificates of completion are to be forwarded to the designated COR by email. All Contractor employees assigned to this contract who create, work with, or otherwise handle records are required to take VHA-provided records management training, Talent Management System (TMS) Item #3873736, Records Management for Records Officers and Liaisons. The Contractor is responsible for confirming training has been completed according to agency policies, including initial training and any annual or refresher training. Key personnel are defined as professional staff, such as: facility Director, program manager, or case manager. Contractor personnel shall be expected to treat referred Veterans with dignity and respect and abide 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 (link provided under definitions). 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 (COR) 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. A Contingency Plan shall include, at minimum, an outline of how the Contractor shall maintain the full day-to-day operations of the program and provide ongoing clinical care to Veterans during periods when temporary substitutions are required and or there are inadequate staffing levels. The Contractor s Contingency Plan to be utilized if personnel leave Contractor s employment or is 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. The Contracting Officer (CO) or Contracting Officer Representative (COR) shall be notified of any temporary substitutions within one (1) business day. Referrals The VA is responsible for determining eligibility of Veterans prior to referral for services. A referral will be facilitated through the coordinated entry process. The contractor will be required to provide a daily census to properly notify the VA of admissions. The contractor will enter all veteran data into the HUD Homeless Management Information System (HMIS). In compliance with local CoC guidance. The Contracting Officer is the only person authorized to approve changes or modify any of the requirements of this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitments or issue changes that shall affect price, quantity or quality of performance of this contract. 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 referral period for a Veteran may be up to 90 days, depending upon the needs of the Veteran as mutually determined by the Veteran, the Contractor s staff, Contracting Officer Representative (COR), and the VA Homeless Program Coordinator or designee. An extension of the referral period up to a total of ninety (90) days may be authorized by the VA Homeless Program Coordinator or designee, provided that funding is available. Service periods in excess of this time for individual Veterans must be authorized by the VA Homeless Program Coordinator or designee through the COR. Contractor shall provide housing and/or services to special Veteran populations (e.g.: medically compromised Veterans, 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). Evidence of Insurance Coverage Before commencing work under the contract, the Contractor shall furnish the Contracting Officer a certification within 30 days indicating that the coverage outlined in this contract has been obtained, and that it may not be changed or cancelled without written notice. Records and Reporting The Contractor shall notify the authorizing VA hospital and VA program liaison immediately when a medical emergency may occur, thus requiring the hospitalization of any resident receiving care at VA expense. It is agreed that the veterans shall be admitted to VA Central Ohio Health Care System facility when feasible. If hospitalization of a non-emergency nature is required, it is agreed that admission to the VA hospital shall be accomplished consistent with eligibility criteria, as determined by VA. Contractor shall notify Health Care for Homeless Veterans (HCHV) program coordinator and COR immediately in the event of a veteran s illness or injury requiring medical care and/or hospitalization, including which hospital veteran was transferred to. Contractor shall also provide a daily occupancy report to HCHV program. In the event of a beneficiary receiving residential services dies, the residential program shall promptly notify the Department of Veterans Affairs office and VA program Liaison, authorizing admission and immediately assemble, inventory, and safeguard the veteran s personal effects. The funds, deposits, and effects left by the deceased veteran at the residential program, shall be delivered by the residential program to the person or persons entitled. The Contractor shall adhere to the laws currently governing the residential program 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 disposition has been made, the itemized inventory with a notation identifying the recipient of the belongings shall be immediately forwarded to the VA office. In the event that no such person is identified, the property and funds shall become the property of the United States in trust. In these cases, the residential program shall forward any property and funds in its possession to the appropriate VA office, and hold them (except articles of clothing necessary for proper burial) under safeguard until instructions are received from the VA concerning disposition. Absences of the Veterans from the residential program in excess of 48 hours will be not reimbursable. The COR shall determine if the absence is unauthorized. If a Veteran referred under this contract is found to be absent in an unauthorized manner, the payment for veteran services would be continued at that contract facility for a maximum period of two (2) days. There should be an active outreach attempt of the facility staff to return the veteran to the residential program, and a strong likelihood that the Veteran will return. Documentation of outreach attempts required to be provided to VA Liaison/COR within 48 hours of veteran s absence. Management of program dropouts (i.e., negative outcomes) will be an element of the quality assurance review of this program. The contractor shall notify the authorizing VA facility immediately of any incidents involving veterans residing in the residential program. The contractor shall notify the VA case manager by telephone during the hours of 8:00am and 4:30pm. For all incidents that occur after normal business hours, the contractor should notify the Administrator on Duty (AOD). The contractor shall provide the HCHV case manager and the COR with a copy of the incident report within 24 hours. The contractor shall maintain a copy of the incident report in the Veteran s case record. Contractor shall maintain an individual clinical record on each veteran placed under this contract. The Contractor shall comply with the requirements of the Confidentiality of certain medical records (38 USC 7332), and (42 CFR, Part II). All case records shall be maintained with such security and confidentiality as required and shall be made available on a need-to-know basis to appropriate staff members involved with the service program of the veterans concerned. In addition to reasons for referral, the clinical record maintained by the contract facility shall include: All essential identifying data relevant to the resident and his/her family, including a psychosocial assessment, completed by facility staff. Service plans shall be completed by facility staff, in collaboration with VA outreach and the HCHV program coordinator, and shall include data relating to the resident s admission, anticipated length of stay, targeted goals and objectives for constructive changes and discharge planning. Service plans must meet CARF regulations whether or not the facility is CARF accredited. Release of Information (ROI) shall be filled out and signed by the Veteran and placed in the file. ROI should be sent to COR within 48 hours of being completed. A summary of all medical prescriptions issued by physicians, including orders, and if any medications need to be taken. Reports of periodic reevaluations by program staff, to include any measures of movement toward rehabilitation goals, with particular focus on the attainment of self-help skills. Final summaries on each resident who leaves the program, which includes a description of beneficial changes found during the residential period, reasons for leaving, the resident s future plans, and follow up locator information. Contractor shall provide a copy of final summary to HCHV Program office and veteran within one month of the veteran leaving the Residential Program. Upon discharge or death of the resident, medical records on all beneficiaries shall be retained by the residential program for a period of at least three (3) years following termination of care. Contractor staff conduct/complaint handling: Contractor personnel shall be expected to treat referred Veterans with dignity and respect and abide 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 Veteran care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, Veteran 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 Technical 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. Confidentiality of Patient Records In performance of this contract, Contractor shall not be considered to be a part of VA for purposes of 5 U.S.C. 552a, 38 U.S.C. 5701 and 7332. Contractor shall obtain needed records from VA only with signed consent by veteran. Records created by Contractor in the course of performing this contract are the property of VA, and shall not be accessed, released, transferred, or destroyed except in accordance with federal law, regulations, and policy. Access to data shall be limited to the minimum necessary for performance of the contract. Contractor shall take steps to ensure that access is limited to those employees who need access to the data to perform the contract. Contractor shall not copy information contained in the system, either by printing to paper or by copying to another digital format, without the express permission of VAAAMC Release of Information Office, except as is necessary to make single copies in the ordinary course of providing Veteran care. Contractor shall not comingle the data from the system with information from other sources. Contractor shall report any unauthorized disclosure of VA information to the VAAAMC Privacy Officer. If this contract is terminated for any reason, Contractor shall provide the VA with all individually-identified VA veteran services records or other information in its possession, as well as any copies made pursuant to paragraph (2), above within seven (7) days of the termination of the contract. Certain information available from the database and other records created by the Contractor under this Contract are medical quality assurance records protected by 38 U.S.C. 5705; its implementing regulations at 38 U.S.C. 17.500-511; VHA Directive 98-016, 4b. (1) (d), 4.6(2)(c) and 4.6(4). These records may be disclosed only as authorized by 38 U.S.C. 5705 and the VA regulations. Disclosure of these records in violation of 5705 is a criminal offense under 38 U.S.C. 5705(e). Contractor shall follow all VA policies regarding the retention of records. In the alternative, Contractor may deliver the records to VA for retention. Any changes in the law or regulations governing the information covered by this contract during the term of this contract shall be deemed to be incorporated into this contract. The Contractor shall educate its employees and Subcontractors of the requirements of this section and shall advise its employees and Subcontractors of any changes as they occur. On the Contractor s request, the VA shall provide trainers who can education the Contractor s employees and Subcontractors, of their obligations under this section. The Contractor shall make its internal policies and practices regarding the safeguarding of medical and/or electronic information available to federal agencies with enforcement authority over the maintenance of those records upon request. Inspection and Acceptance It is agreed that the Department of Veteran Affairs shall have the right to inspect the residential program and all appurtenances by an authorized representative(s) designated by the Department of Veterans Affairs. Prior to the award of a contract and annually during the contract term, a multi-disciplinary team consisting of a social worker, dietitian, nurse, and an engineering service safety officer, shall conduct an initial inspection of the residential program and all appurtenances. Other inspection team members may be included, as needed. Subsequent inspections of the residential program shall be made yearly by a multidisciplinary team including hospital personnel (appointed by the director), to assure that the facility is providing quality care within a safe environment. As VA program personnel accomplish site visits, attention shall be directed to the adequacy of veteran s records. Site visits shall also include a spot check of records to ensure the Contractor invoices accurately reflect the veteran s length of stay. The local Department of Veterans Affairs Medical Center dietitian (member of the inspection team), shall evaluate not only the printed menus, but the veteran s satisfaction with meals, and the actual consumption of food. Three sufficient balanced meals shall be provided by the Contractor where the veteran resides. Government food assistance programs such as food stamps shall not be used for this purpose. Meals must be prepared and served following the State Board of Health, Food, Safety and Sanitation Guidelines. Meals shall be prepared that are nutritionally balanced following USDA guidelines. Contractor shall be advised of the findings of the inspection team. If deficiencies are noted during any inspection, the facility shall be given a reasonable time to take corrective action and to notify the Contracting Officer that the corrections have been made. Facilities must also be made available for random inspections, as applicable. The Department of Veteran Affairs, through the designated Contracting Officer Representative, shall monitor the Contractor s facility to ensure compliance with this contract. Any unsatisfactory conditions noted during an inspection shall be reported in writing to the Department of Veterans Affairs Contracting Officer through the Medical Center Director. If corrections are not made to the satisfaction of the Department of Veterans Affairs, the Contracting Officer shall consult with the appropriate officials to make suitable arrangements to discharge or transfer veterans and terminate the contract. Clinical documentation review: Has policies and procedures to address how intoxicated or impaired participants will be identified and managed. Ensures that project staff are educated on and following policies are procedures regarding how intoxicated or impaired participants will be identified and managed. Ensures residents are provided a clean and sober environment, as evidenced by effective policies and procedures that are communicated to participates and that are consistently followed by staff. Ensures that participants in need of medical or social detox conducted at the same site are clearly separated from the general resident population. Ensures a quarterly technical performance report addressing their ability to meet the goals, objectives, measures, and special needs as set forth in their application is completed by the provider and reviewed quarterly. When necessary, the contractor initiates a corrective action plan (CAP) when accomplishments vary for any of the goals and objectives as stated in the contract. Ensures that the consultation and participation of not less than one homeless veteran or formerly homeless veteran on the board of directors or the equivalent policy making entity. Attempts to involve homeless veterans through employment, volunteer services, or otherwise, in construction, rehabilitation, maintenance, or operation of the program. Ensures the records kept on homeless veterans are kept confidential, including any records of the provision of family violence prevention or treatment services. Ensures that all housing and services provided to participants meet the quality standards outlined in the HCHV handbook. Ensures sustained efforts are made that eligible hard-to-reach persons are served in the facility. This outreach should be targeted toward persons who meet the definition of homelessness in 38 U.S.C. 2002(1). Participant record includes, at a minimum, the following: family status, verification of veteran status, education, employment history, release of information in file, and marketable skills/licenses/credentials. Ensures that an individual service plan is maintained in the case management record for each individual participant. The individual service plan contains an assessment of barriers, service needs, strengths, specific services provided including duration and outcomes, documentation of referrals, and benefits to be achieved as a result of program participation. The Nurse will inspect medication management, monitoring, and individual storage: For medication management, the contractor must: Ensure an up-to-date individual record of all medications, including prescription and non-prescription medications, used by persons served. Organization has written procedures that address storage and handling of medications, safe disposal, and documentation of medication use. As requested, persons served are provided information about resources for advocacy to assist them with being actively involved in making decisions related to the use of medications. As requested, persons served are provided information about training and education regarding medication. Organization documents that are used of all medications by persons served is reviewed on at least an annual basis by a physician or qualified professional licensed to proscribe medications. Organization has written procedures that address administration of medications by personnel, including staff credentials and competencies, documentation of medication administration, and documentation of the use and benefits, or lack thereof, of as needed doses. Organization has written procedures regarding medications that provide for compliance with all applicable laws and regulations pertaining to medications and controlled substances. Organization has documentation or confirmation of informed consent for each medication administered, when possible. Organization has written procedures which integrate any prescribed medications into a person s overall plan, including, if applicable, special dietary needs and restrictions associated with mediation use. Organization procedures ensure the identification, documentation, and required reporting, including to the prescribing professional, any medication reactions or medication errors as appropriate. Organization has written procedures which include actions to the following in case of emergencies related to the use of medications, including ready access to the telephone number to poison control center by both program personnel and participants. For Medication Monitoring: Ensure an up-to-date individual record of all medications, including prescription and non-prescription medications, used by persons served. Organization has written procedures that address storage and handling of medications, safe disposal, and documentation of medication use. All medications are secured in a secured locked area, except when under the direct supervision of appropriate staff. Keys or combinations to locks for the medication area are under the control of authorized staff All medications are periodically checked for expiration dates or deterioration All medications are stored according to manufacturer's recommendations Program staff responsible for monitoring are familiar with all medications stocked including indications, side effects, toxic effects, interactions, and potential allergic reactions Program staff responsible for monitoring are provided orientation, continuing education and training, as appropriate For Individual Storage: Self-administered medications are stored in a safe and secure manner in the resident's room according to the facility's policies and procedures Method of storage cannot be easily removed from the facility (e.g., lock box is secured to a large dresser or the structure of the building) 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 Safety Officer shall inspect the facility for conformity to the current Life Safety Code and submit the findings to the chairperson or liaison of the team. Other members of the team shall focus on an assessment of the quality of life within the residential program, giving particular attention to the following indicators: General observation of residents indicates that they maintain an acceptable level of personal hygiene and grooming. Observation of staff behavior and interaction with residents to determine if they convey an attitude of genuine concern and caring The facility meets applicable fire, safety, and sanitation standards, in attractive surroundings conducive to social interacting, and the fullest development of the resident s rehabilitative potential. The building must meet the requirements of the applicable residential occupancy chapters of the current version of NFPA 101, National Fire Protection Association's Life Safety Code. The building must be structurally sound as to not pose any threat to health and safety of the occupants and so as to protect them from the elements. It also must be in compliant with the Americans with disabilities act and the architectural berries act. Any equivalencies or variances must be approved by the appropriate Veterans Health Administration Veterans Integrated Service Network (VISN) Director. All residents in the facility must be mentally and physically capable of leaving the building, unaided, in the event of an emergency Fire exit drills must be held at least quarterly. Residents must be instructed in evacuation procedures when the primary and/or secondary exits are blocked. A written fire plan for evacuation in the event of fire shall be developed and reviewed annually. The plan shall outline the duties, responsibilities and actions to be taken by the staff and residents in the event of a fire emergency. This plan shall be implemented during fire exit drills. A written policy regarding tobacco smoking in the facility shall be established and enforced. Portable fire extinguishers shall be installed at the facility. Use NFPA 10, Portable Fire Extinguishers, as guidance in selection and location requirements of extinguishers. Requirements for fire protection equipment and systems shall be in accordance with NFPA 101. All fire protection systems and equipment, such as the fire alarm system, smoke detectors, and portable extinguishers, shall be inspected, tested and maintained in accordance with the applicable NFPA fire codes and the results documented. The annual inspection by a VA team required by paragraph 7 shall include a fire and safety inspection conducted at the facility unless a review of past Department of Veterans Affairs inspections or inspections made by the local authorities indicates that a fire and safety inspection would not be necessary, in which case the fire and safety inspection may be waived by the VA. There shall be appropriate organized activity programs during waking hours, including evenings. Examples include individual professional counseling, physical activities, and assistance with health, personal hygiene, employment, and training programs. There is evidence of facility-community interaction. This may be demonstrated by the nature of scheduled activities, or by gathered information about resident flow out of the facility (i.e. community activities, volunteers, local consumer services). Staff behavior and interaction with residents convey an attitude of genuine concern and caring. Interviews by the inspection team members involving veterans participating in the project is applicable in the inspection process. (Note: Any complaints or allegations, made by veterans regarding deficiencies in the project should either, be fully resolved, investigated and determined to be unfounded, or the VAMC and/or contractor should be actively working toward a resolution) All Department of Veterans Affairs reports of inspection of residential facilities furnishing rehabilitation services to eligible veterans shall, to the extent possible, be made available to all government agencies charged with the responsibility of licensing or otherwise regulating or inspecting such institutions. PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY IMPROVEMENT(QI) Quality Management/Quality Assurance Surveillance: Contractor (s) shall be subject to Quality Management measures, such as patient satisfaction surveys, staffing and supportive services, timely completion of records and reports, and Social Work Reviews. Methods of Surveillance: Direct observation shall be performed periodically or through 100% surveillance. There will be periodic inspections to evaluate outcomes on a periodic basis. Inspections may be scheduled Daily, Weekly, Monthly, Quarterly, Annually or unscheduled, as required. There will be progress or status meetings. Contractor performance will be monitored by the government using the standards as outlined in this Performance Work Statement (PWS) and methods of surveillance detailed in the Quality Assurance Surveillance Plan (QASP). Performance Standards: Measure: Emergency Housing Facilities & Management Performance Requirement: (100%) Facility meets fire, safety, Americans with Disabilities Act, licensure, safety and veteran privacy and additional safety for female veterans. Provides sober environment and nutritionally adequate meals Standard: Passing facility inspection and documentation of meeting the performance standards listed above Acceptable Quality Level: (100%) during annual rating period Surveillance Method: Random Inspection of records. VA team Inspection Frequency: Quarterly or Randomly Performance Standards: Measure: Staffing & Supportive Services Performance Requirement: Full-time administrative staff on duty and sufficient case management personnel. The contractor shall provide evidence of site supervision with at least one staff or security member. Coordinated case management to include psychosocial assessment and assist veterans with appointments, paperwork and transportation and structured group activities. Standard: Passing random inspection and documentation of meeting the performance standards listed above Acceptable Quality Level: 95% of randomly selected cases Surveillance Method: Quarterly or Randomly Frequency: Quarterly or Randomly Performance Standards: Measure: Records and Reports Performance Requirement: Daily sign-in sheets signed by veterans. Psychosocial assessment, individual service plan, progress notes for each client, documentation of veteran participation in daily group activities and entry of veteran data into HMIS system Standard: Passing random inspection and documentation of meeting the performance standards listed above Acceptable Quality Level: 100% of randomly selected cases Surveillance Method: Quarterly or Randomly Frequency: Quarterly or Randomly Performance Standards: Mandatory Training Performance Requirement: Contractor shall complete all required training on time per VAMC policy Standard: All (100%) of required training is complete on time by contractor employees(s). Acceptable Quality Level: 100% completions, no deviations. Surveillance Method: Periodic Sampling Frequency: Quarterly or Randomly Performance Standards: Measure: Housing Placement Performance Requirement: In accordance with VA National Performance Monitors 55% exits to permanent housing. Negative exits will not be greater than 20%. HCHV performance measures, targets and data definitions, including metric exceptions are set by the VA HCHV program office and may be adjusted annually. Changes to Targets will be communicated to the HCHV Contractor at the beginning of a new period of performance. Standard: Meeting the performance standards listed above Acceptable Quality Level: +/- 2% of the established target. Surveillance Method: Review of the Homeless Scorecard Frequency: Quarterly M. Census Reporting and Payment DAILY CENSUS: A Daily Veteran Census log sheet broken down by category of bed(s) shall be sent by protected email to the COR daily by 10:00 a.m. to track bed days. Census will reflect the 11:59 census from the previous day. PAYMENTS: It is understood that payment made by the VA under this agreement shall constitute the total cost of the facility care. The facility agrees that no additional charges shall be billed to the beneficiary or his family, either by the facility or any third-party furnishing services or supplies required for such care - unless and until specific prior written authorization is obtained from the VA Central Ohio Healthcare System authorized payment for a specific item. A day is defined as up to the 24-hour period after the veteran is admitted and/or spends the night at the facility, the day of discharge is not counted. N. Billing Unless specifically excluded in this contract, the per diem rate established shall include the services listed in the Performance Work Statement (PWS) and shall also include all services or supplies normally provided other Veterans by the facility without extra charge. Payments made by VA Central Ohio Healthcare System under this contract shall constitute the TOTAL cost of care and housing of the homeless Veterans. If a Veteran is admitted to or discharged from the Program on the same calendar day, payment shall not be authorized. Absences of the Veteran from the Program shall not be reimbursed. The Contractor shall submit electronic invoices by the 10th of every month into the Tungsten System. FSC e-invoice program http://www.fsc.va.gov/einvoice.asp OB10 electronic invoicing system http://www.tungsten-network.com/customer-campaigns/veterans-affairs/ FSC e-Invoice Contact Information: 1-877-353-9791 FSC e-invoice email: vafsccshd@va.gov O. Records Management 1. Contractor shall comply with all applicable records management laws and regulations, as well as National Archives and Records Administration (NARA) records policies, including but not limited to the Federal Records Act (44 U.S.C. chs. 21, 29, 31, 33), NARA regulations at 36 CFR Chapter XII Subchapter B, and those policies associated with the safeguarding of records covered by the Privacy Act of 1974 (5 U.S.C. 552a). These policies include the preservation of all records, regardless of form or characteristics, mode of transmission, or state of completion. 2. In accordance with 36 CFR 1222.32, all data created for Government use and delivered to, or falling under the legal control of, the Government are Federal records subject to the provisions of 44 U.S.C. chapters 21, 29, 31, and 33, the Freedom of Information Act (FOIA) (5 U.S.C. 552), as amended, and the Privacy Act of 1974 (5 U.S.C. 552a), as amended and must be managed and scheduled for disposition only as permitted by statute or regulation. 3. In accordance with 36 CFR 1222.32, Contractor shall maintain all records created for Government use or created in the course of performing the contract and/or delivered to, or under the legal control of the Government and must be managed in accordance with Federal law. Electronic records and associated metadata must be accompanied by sufficient technical documentation to permit understanding and use of the records and data. 4. VA Central Ohio Healthcare Systems and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Records may not be removed from the legal custody of VA Central Ohio Healthcare Systems or destroyed except for in accordance with the provisions of the agency records schedules and with the written concurrence of the Head of the Contracting Activity. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C. 2701. In the event of any unlawful or accidental removal, defacing, alteration, or destruction of records, Contractor must report to VA Central Ohio Healthcare Systems. The agency must report promptly to NARA in accordance with 36 CFR 1230. 5. The Contractor shall immediately notify the appropriate Contracting Officer upon discovery of any inadvertent or unauthorized disclosures of information, data, documentary materials, records or equipment. Disclosure of non-public information is limited to authorized personnel with a need-to-know as described in the [contract vehicle]. The Contractor shall ensure that the appropriate personnel, administrative, technical, and physical safeguards are established to ensure the security and confidentiality of this information, data, documentary material, records and/or equipment is properly protected. The Contractor shall not remove material from Government facilities or systems, or facilities or systems operated or maintained on the Government s behalf, without the express written permission of the Head of the Contracting Activity. When information, data, documentary material, records and/or equipment is no longer required, it shall be returned to VA Central Ohio Healthcare Systems control or the Contractor must hold it until otherwise directed. Items returned to the Government shall be hand carried, mailed, emailed, or securely electronically transmitted to the Contracting Officer or address prescribed in the [contract vehicle]. Destruction of records is EXPRESSLY PROHIBITED unless in accordance with Paragraph (4). 6. The Contractor is required to obtain the Contracting Officer's approval prior to engaging in any contractual relationship (sub-contractor) in support of this contract requiring the disclosure of information, documentary material and/or records generated under, or relating to, contracts. The Contractor (and any sub-contractor) is required to abide by Government and VA Central Ohio Healthcare Systems guidance for protecting sensitive, proprietary information, classified, and controlled unclassified information. 7. The Contractor shall only use Government IT equipment for purposes specifically tied to or authorized by the contract and in accordance with VA Central Ohio Healthcare Systems policy. 8. The Contractor shall not create or maintain any records containing any non-public VA Central Ohio Healthcare Systems information that are not specifically tied to or authorized by the contract. 9. The Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected from public disclosure by an exemption to the Freedom of Information Act. 10. The VA Central Ohio Healthcare Systems owns the rights to all data and records produced as part of this contract. All deliverables under the contract are the property of the U.S. Government for which VA Central Ohio Healthcare Systems shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest. Any Contractor rights in the data or deliverables must be identified as required by FAR 52.227-11 through FAR 52.227-20.
