G004--36C24122Q0147 to provide Contract Emergency Residential Services (CERS) for the Manchester VAMC.

1 Department of Veterans Affairs Veterans Health Administration (VHA) Sources Sought Notice Obtain a qualified vendor to provide Contract Emergency Residential Services (CERS) for the Manchester VAMC This is a Sources Sought notice and not a request for quotes. This request is solely for the purpose of conducting market research to enhance VHA s understanding of your company s offered services and capabilities. The Government will not pay any costs for responses submitted in response to this Source Sought Notice. This Sources Sought notice provides an opportunity for respondents to submit their capability and availability to provide the service requirement described below. Vendors are being invited to submit information relative to their potential to fulfill this requirement, in the form of a capability response that addresses the specific requirement identified in this Sources Sought, please ensure that you indicate your DUNS number on your response. The Veterans Health Administration (VHA) is seeking to obtain a qualified vendor to provide Contract Emergency Residential Services (CERS) for the Manchester VAMC per the general requirements below. The standard of services shall be of quality; meeting or exceeding those outlined in the general performance work statement as described below. Refer to the Performance Work Statement section below for the requested service description. This Sources Sought is to facilitate the Contracting Officer s review of the market base, for acquisition planning, size determination, and procurement strategy. Performance Work Statement (PWS) VA Healthcare for Homeless Veterans (HCHV) Contract Emergency Residential Services (CERS) Manchester VA Medical Center 1. The Department of Veteran Affairs, Manchester VAMC hereafter referred to as VA is located at 718 Smyth Rd, Manchester, NH requires Contractor to provide homeless veteran services through a Contracted Emergency Residential Services (CERS) model of residential care at a facility located within the catchment area of the Manchester VAMC. These services, not to exceed 8 Veterans at any one time, are to be provided to homeless Veterans as defined in the Statement of Work (SOW). The VA National Center on Homelessness among Veterans ( the Center ) will provide ongoing training for program development for both contract providers and VA staff. Contractor will be evaluated based on the Center s established evaluation protocol and program fidelity measures. The goal of the CERS program is to provide housing and supportive services to Veterans and facilitate their access to a broad range of medical, mental health, and rehabilitative services. The target population for this CERS program is homeless Veterans with complex needs. Eligibility will be determined by the VA, based on Veteran status; meeting the McKinney-Vento Homeless Assistance Act definition of homelessness (see http://www.hudhre.info/hearth/ for additional information); and an assessment by the VA HCHV program resulting in a determination of making the Veteran highly vulnerable and requiring CERS services. 2. BACKGROUND AND OVERVIEW: The Department of Veteran Affairs (VA) has been providing direct and specialized services for homeless Veterans for nearly 25 years. The Secretary of the VA has set a zero-tolerance policy for homelessness within the Veteran population. As part of the Plan to End Homelessness among Veterans announced in late 2009, the Veterans Health Administration has been increasing both capacity of existing programs and services offered to program participants. The plan calls for utilizing new models of care not previously offered by VA. The VA s Plan to End Veteran Homelessness calls for enhancing current homeless service capacity as well as developing new programs and initiatives in concert with community and federal partners. The goal of the CERS program is to remove homeless Veterans from the street or habitation unfit for Veterans and place them in community-based, residential environments with sufficient therapeutic services to meet the needs of those Veterans. This model will offer services, not to exceed 8 Veterans at any one time, to homeless Veterans under the HCHV Contracted Emergency Residential Services (CERS) program enhanced by the services as defined in the SOW. Rapid stabilization of the Veterans medical, mental health, substance abuse and other psychosocial problems in order to place Veterans in other appropriate transitional or permanent housing within 90 days, without a planned reason for the extension, is an expected outcome of this Contract. If Veteran has stayed maximum length of 90 days, and has determined that he or she will need more time in Contracted Residential Service program, a formal request for a 30-day extension can be made. This request will be made in writing and approved by Contracted Residential Services Program Manager and HCHV Coordinator and/or assigned designee. A maximum of two 30-day extensions can be made during entry in the program. This contract will be awarded to a Contractor having an acceptable facility within 45 miles of the Manchester VAMC, and located in the state of NH. An acceptable facility cannot be co-located with a private business not affiliated with the program and must be free of hazards that could cause potential harm to Veterans or liability to the VA (e.g., pool.) If a business shows interest but has another private business on the premises not affiliated with the program they will not be found capable. The Vendor shall furnish the documents to validate a long-term lease for the premises being used to house the homeless Veterans. Such lease could be for 36 or 48 months. A VA Liaison to the Contractor will be identified by the homeless program leadership at VA. This individual will act as the clinical liaison for all client related issues between the Contractor and VA by providing clinical oversight. The VA Liaison will not provide direct clinical supervision to Contractor staff. The VA Liaison duties will be direct case management with all Veterans in the program. The VA Liaison will also consult with and provide input to the Contractor as needed. The Contractor shall provide all labor, supervision, housing, material and supplies necessary to provide emergency residential placement, treatment and supportive services through the CERS program. Services will be provided on-site at the Contractor s facility, in accordance with all terms conditions, provisions and requirements listed herein. The prices provided in the Price Schedule shall be inclusive of all basic services as may be necessary in the treatment of the Veteran. Basic services shall be as defined in the Statement of Work. 3. IMPLEMENTATION TIMELINE: The contract facility and associated onsite services are expected to pass inspection and become fully operational within 30 days from the date of contract award. Failure to meet the 30-day milestone may result in the contract being terminated. The Contractor will demonstrate successful completion of the following tasks, validated by VA inspection, prior to receiving Veteran referrals and invoicing for payment: a. Site control demonstrated at time of contract award. This may be through ownership or lease. All permits and license will be reviewed. The Contractor is required to ensure that the facility used for this contract meets fire and safety code imposed by the State law, and the Life Safety Code of the National Fire and Protection Association. It is important to note that typically the Life Safety Code is more stringent than local or state codes. No additional funds will be made available for capital improvements under this contract. Applicants also should note that all facilities, unless they are specifically exempted under the Life Safety Code, are required to have an operational sprinkler system. VA will conduct an inspection that Contractor sites must pass prior to contract award. The Contractor is required to ensure the facility used for this contract meets the Americans with Disabilities Act (ADA) guidelines for accessible accommodations for Veterans with physical limitations or impairments. This is also referred to as Architectural Barriers Act compliant. At least 5% 7% of a facility s HCHV Contract Residential Care beds must meet ADA accessibility requirements, to include entrances/exits, bathroom facilities, and common areas. For example, if a Contractor has 20 beds for the HCHV Contract Residential Care program in the facility, two (2) to four (4) of those beds must be accessible to Veterans with physical limitations or impairments. Veterans must not be segregated from the rest of the facility due to physical disability; they must have full access to the services and supports at the facility. Contractor facility must be licensed as required for the particular setting under State or Federal authority, and must meet all applicable local, state, and/or Federal requirements concerning licensing and health/occupancy codes. Copies of valid licenses must be provided to the VA at the time of pre-inspection and for all annual inspection reviews. Where applicable, the facility must have a current occupancy permit issued by the authority having jurisdiction. Supportive services for female Veterans under this contract are required to ensure the safety and privacy of these Veterans. Men and women must have separate bathroom facilities. The facility must have female residential rooms or sections that are securely segregated or restricted from men to ensure safety and privacy. If the facility cannot accommodate both male and female Veterans at one location, the provider must make available equivalent facilities and services for the opposite gender that meet the terms of the contract for facilities and services. b. Pre-Award Inspection of the facility and on-site services conducted by VA contract inspection team. This team is made up of HCHV clinical staff, VA fire and safety officials, nursing, dietetics, and other staff as deemed necessary for facility inspection. Pre-award inspection will be completed within 30 days of proposal submission. Any items requiring corrective action will be communicated to the Contractor in writing within one (1) week of inspection. c. Complete the abatement of all inspection corrective action(s) and pass VA inspection. To be completed within 30 days of pre-award inspection. d. Identify all staff required per the SOW, have them in place and available to provide full range of case management and services to Veterans. To be completed within 30 days of contract award. e. Work will be performed at the Contractor s facility within the geographic limitations outlined above. Government furnished workspace will not be provided for this effort. Government furnished property will not be provided to the Contractor. All equipment required by the Contractor will provided at their expense. The Contractor will be required to attend frequent meetings and planning sessions at VA throughout the term of the contract. f. The Contractor shall not commence performance under this contract until the Contracting Officer has conducted a kick-off meeting or has advised the Contractor that a kick-off meeting is waived. *Per QASP Task 5-7 Veteran Safety, observations and reviews of all treatment records will be conducted in conjunction with the annual inspection. 4. GUIDELINES FOR SERVICES: An institution licensed by the state to provide, on a regular basis, housing and supportive services to Veterans who are homeless or staying in a habitation unfit for human habitation. It is understood that those Veterans cared for under this contract will require care and services over and above the level of room and board. The contractor shall comply with the principles listed in 38 CFR 17.707(b) to provide housing and supportive services in a manner that is free from religious discrimination. The Contractor must communicate policies and procedures to Veterans both verbally and in writing in a manner that is understandable to each Veteran upon admission to the facility, in the form of a written Veteran handbook that is verbally reviewed by the assigned case manager with the Veteran. All updates to any policies and procedures must be reviewed with Veterans with 7 days of revision. This communication must be documented in the Veteran s client record. 5. BASIC SERVICES. The Contractor shall furnish each Veteran referred for care under this contract the following basic services: a. ROOM AND BOARD: Room and Board to include a bed and other furnishings such as a dresser, storage, and personal linens (towels and bed sheets). The bed must be designated for use exclusively by the individual Veteran from the time of admission to the time of discharge. The bed must be situated in a room that affords the Veteran safety, privacy and security. Each Veteran must have a safe and secure place to store their belongings that is readily accessible to the Veteran (such as a locking closet, a locking armoire, a locker, etc.) Meals to include at least 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. The VA has particular concern for chronically homeless Veterans, many of whom are either undernourished or have developed poor eating habits or both, because of chronic medical, mental health or substance abuse disorders. A VA dietitian may assess printed menus as well as Veterans satisfaction with meals and the actual consumption of food offered in determining the Contractor s success in meeting this requirement during annual facility inspection or at any point during the contract period. *Per the QASP Task 2, beds will be made available in a ready state and will be observed through monthly reports from the contractor. b. LAUNDRY FACILITIES: On-site laundry facilities and supplies for Veterans to do their own laundry or to have laundry done. c. INTERNET AND COMPUTER ACCESS: Internet access shall be available to Veterans residing at the facility. Access shall consist of a service/speed rating of at least 10 Megabytes per Second (Mbps) Download, 1Mbps Upload or better. Wireless or other access shall be provided so that it is possible for three (3) or more users to access internet services simultaneously. Facility shall provide hardware (computer(s), printer, etc.) to be utilized. Veterans enrolled at the local community college or taking online courses, should be given priority of usage. The Contractor will be responsible for establishing hours of usage as well as setting any parental controls they deem essential. d. ENVIRONMENT OF CARE SERVICES: The Contractor must provide a clean and comfortable environment of care that is a structurally sound facility; does not pose any threat to the health and safety of the occupants and protects them from the elements. The facility entries and exit locations are capable of being utilized without unauthorized use and provide alternate means of egress in case of fire; every room or space will have natural or mechanical ventilation; be free of pollutants in the air at levels that threaten the health of Veterans; provide a water supply free from contamination; has sufficient sanitary facilities in proper operational condition, allowed to be used in privacy, and are adequate for personal cleanliness and the disposal of human waste. Facility must have adequate heating and or cooling mechanisms that are in proper operating condition; adequate natural or artificial illumination to permit normal indoor activities and to support the health and safety of Veterans; provides sufficient electrical sources to permit use of essential electrical appliance while assuring safety from fire. All housing and equipment will be maintained in a sanitary manner free from pests, insects and vermin and will provide a warm, welcoming, and respectful atmosphere through lighting and décor. Contractor ensures that furniture is well maintained and comfortable. It is the Contractor s responsibility to maintain a clean and comfortable environment that meets these conditions. For example, the Contractor would be responsible for alleviating a bed bug infestation by hiring an exterminator at its own expense. *Per QASP Task 3, an annual inspection and facility review will be conducted prior to exercising the option year. Any recommendations or discrepancies will need to be resolved prior to the exercise of the option year. e. ON-SITE OFFICE SPACE FOR VA LIAISON: The Contractor must provide designated onsite furnished office space to a VA Liaison from VA. The office space must afford the VA Liaison and Veterans privacy and confidentiality when meeting. This space can additionally be used by community providers and other VA staff involved in Veteran care, when appropriate to Veteran s treatment plan. f. TRANSPORTATION: The Contractor will ensure that transportation is available for Veterans to attend medical/mental health appointments, search for transitional or permanent housing and address other care needs. This can be done through provision of bus passes, utilization of cab services or CERS provider facility transportation. These costs will be considered part of the basic services provided. If adequate public transportation is not available or appropriate for a Veteran, the Contractor shall provide round-trip transportation to and from the Manchester VAMC at least once per day for all normally operating business days (Monday through Friday), excluding Holidays. In addition, the Contractor will provide transportation for Veterans who are in need of assistance in getting to the Contracted Emergency Residential Service Program for their initial intake and placement into the program. The VA will be responsible for making transportation arrangements for veterans beyond these requirements. 6. ADDITIONAL CONTRACT REQUIREMENTS: a. The Contractor shall comply with the VA patient s Bill of Rights as set forth in Section 17.34a, Title 38, Code of Federal Regulations. The Contractor is responsible for maintaining Veterans privacy and confidentiality and must have systems in place that protect Veteran s personal identifying information and protected health information. This includes but is not limited to the following: having adequate private office space for Veterans to meet in confidence with their case manager; having secured paper and electronic filing systems to protect clients case records and other documentation; conducting ongoing training of staff about maintaining client privacy and confidentiality in all verbal and written communications and interactions; ensuring that non-clinical/non-case management facility staff have access to Veteran information only as needed in order to meet the service requirements contained in the contract. b. The CERS Contractor shall have the ability to accommodate admissions during business operating hours (Monday through Friday, 8AM to 4:30PM.) c. SUPPORTIVE SERVICES: The Contractor shall provide, in conjunction with the VA, at minimum, the following supportive services to Veterans in the program: (1) Engagement of the Veteran in the service planning process. The VA will conduct psychosocial assessments to identify treatment needs which affect the Veterans adjustment to their environment, and establish treatment goals. The Contractor will cooperate in the development of assessments and counseling strategies to include crisis intervention to address Veteran s behaviors, as needed. The VA and Contractor will conduct high-risk screening, psychosocial assessment and treatment planning, actively involving the Veteran and their family or significant others, in coordination with the team members. (2) The VA and Contractor will collaboratively assess the psychosocial and environmental needs or dysfunction secondary to or exacerbating the social, substance or psychiatric problems, which might contribute to Veterans readjustment challenges in the community. As a collaborative team the VA and Contractor will establish and maintain a therapeutic relationship with the Veteran, staff, and community programs/agencies, and are responsible for collaborating on treatment goals and plans that address identified needs, stressors and problems. (3) Psychosocial assessments and treatment planning will include goals for clinical treatment. The VA and Contractor document psychosocial services and document the overall effectiveness of the services provided. Specifically, the VA and Contractor will collaboratively: (a.) Develop a Treatment Plan with the Veteran consistent with CERS program goals; the plan must specifically include provisions for Veteran placement into an appropriate transitional or permanent housing placement within 90 days of admission to the HCHV Contract Residential Care facility without a planned reason for extension. The housing placement planning must take into account all appropriate and available community based housing options as well as the Veteran s preferences regarding location and housing type. The plan should also be focused on getting the Veteran(s) to accept services that will allow attainment of transitional or permanent housing. (b.) Review the Treatment Plan a minimum every thirty (30) days thereafter in a clinical meeting with the Veteran. (c.) Make changes in plans in consultation with the Veteran. (d.) Screen each Veteran for suicidal and homicidal risk as necessary. If the Veteran is a danger to him/herself or others Contractor will take immediate steps to provide appropriate intervention. Crisis management will focus on immediate safety for the Veteran and CERS Contract staff. The Contractor will follow its established policies and protocols for managing crisis situations. The Contractor will provide said policies and protocols to the VA at the outset of the contract and upon any modification to the policies and protocols. The Contractor will contact the VA and inform of the incident immediately upon safe to do so. (e.) Coordinate monthly case conferences regarding updates and changes in Veterans care plans to foster a collaborative relationship with the VAMC and Contractor in meeting Veterans needs. Case conferencing may be done in person or by telephonic conference calls as determined by VA staff. (f.) Obtain a signed Release of Information from the Veteran for verbal and written communication during the Veteran s length of stay. Obtain relevant Releases of Information to communicate and coordinate Veterans treatment with other community based service providers, as needed. (g.) Assist Veterans in completing housing applications and other benefits paperwork; e.g. Department of Veterans Affairs Compensation and Pension, Service Connection, Social Security forms; as needed. Contractor will assist Veterans in obtaining the needed documentation required for completing applications including but not limited to, birth certificates, driver s license, income verification and any additional information required by housing resources and potential income supports. (5) Contractor will provide transportation to the Manchester VA Monday through Friday as needed for appointments. (6) The Contractor will provide the following onsite therapeutic and rehabilitative services: Health and personal hygiene maintenance; Supportive social services, in collaboration with the VA and other involved community resources. Opportunities for immediate learning and/or development of responsible living with a goal of achieving a more adaptive level of psychosocial functioning; Support for an alcohol and/or drug-free lifestyle; Opportunities for learning, and internalizing knowledge of the illness and/or recovery process; improving social skills; and improving personal relationships; and Opportunities for client participation in community activities, volunteer opportunities, local consumer services, etc. The Contractor will support an alcohol and/or drug-free lifestyle by training its staff in the appropriate use of a breathalyzer and to be aware of the signs and symptoms of substance use. (7) The Contractor shall immediately augment therapeutic and rehabilitative services through onsite service or will provide transportation for Veterans to receive services such as: structured groups and activities to promote social skills building and healthy lifestyles; groups will be offered but are not mandatory. Groups may include emphasis on self-care skills, adaptive coping skills, vocational counseling, in collaboration with the VA Liaison or community resources as appropriate to support the goal of obtaining and maintaining permanent housing. d. Contractor immediately notify VA through the VA Liaison at VA of any negative incident occurring with a Veteran upon being informed or made aware of the incident. Contractor will complete a written incident report within 24 hours of notification. Incidents include but are not limited to: death; fire; drug/police raid; suicide/suicide attempt; 911 call (police/fire dept./paramedics/other); drug overdose; severe medical illness / emergency; severe psychiatric illness / emergency; sexual assault; act of violence by Veteran against other(s); abusive behavior by Veteran against staff; act of violence by other(s) against Veteran; abusive behavior by staff against Veteran; accident; medication problems or adverse drug reactions; or other untoward events. [See Incident Report Form in Reference section.] *Per QASP Task 5 Veteran Safety, observations and reviews of all treatment records will be conducted in conjunction with the annual inspection. e. In the event a Veteran residing in HCHV Contract Residential housing under this contract dies, the Contractor shall promptly notify the VA Liaison authorizing admission and immediately assemble, inventory using established protocol, and safeguard the Veteran s personal effects. The funds, deposits, and effects left by Veterans upon the premises of the facility shall be delivered by the director or manager of the facility to the person or persons entitled thereto under the laws currently governing the facility for making disposition of funds and effects left by Veterans unless the beneficiary died without leaving a will, heirs, or next of kin capable of inheriting. When disposition has been made, the itemized inventory with a notation as to the disposition has been made, they will be immediately forwarded to the VA Liaison. Property and funds wherever located vests in and becomes property of the United States in trust. In these cases, the facility will forward an 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 the VA concerning disposition. 7. STAFFING AND TRAINING: The Contractor shall employ sufficient personnel to carry out the policies, responsibilities, and programs of the facility. There must be, as a minimum, at least one (1) staff member or designee of equivalent professional capability, on duty on the premises and available for emergencies 24 hours a day, seven (7) days a week. The Contractor shall assign to this contract personnel that, by education and training, and when required, certification or licensure, are qualified to provide the services required by this SOW. The Contractor must identify each person functioning as Key Personnel under this contract, and provide the VA a description of the services to be provided by such a person, together with a resume summarizing the person s relevant skills and experience. During the first 90 calendar days of contract performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death, or termination of employment. Within 14 calendar days after substitutions necessitated by situations described above, the Contractor shall provide resumes for the substitute key personnel. For substitutions proposed by the Contractor after the initial 90 calendar day period, the Contractor shall provide resumes for the substitute personnel, together with any other additional information requested by the Contracting Officer at least 15 calendar days before the substitution is to occur. As a minimum: One (1) Full-time employee with a minimum of a bachelor level education in social work or other human services related field. This level of training shall only be required during business hours (Monday-Friday 8:00AM-4:30PM.) Staff on duty must remain awake and available to interact with veterans during their work tour, whether during the day or at night. There should always be one (1) staff member, as a minimum, on duty at any time. d. The Contractor shall provide an initial organizational chart, identifying personnel, their position, and area(s) of responsibility to the Contracting Officer prior to contract award. Any certifications or licensure required will be made available upon request. The Contracting Officer shall notify the Contractor within 15 calendar days after receipt of required information if the VA refuses to accept assigned contract personnel. The Contractor shall be responsible for updating the organization chart as changes in staff occur. The VA reserves the right to refuse or revoke acceptance of personnel if personal or professional conduct, or lack of required skills or experience, jeopardizes Veteran care or interferes with regular and ordinary operation of the facility. e. The Contractor must have a contingency plan to address the replacement or substitution for personnel that leave the Contractor's employment or are unable to provide performance in accordance with the terms and conditions of the resulting contract. f. Contractor staff must maintain professional boundaries with the Veteran at all times while conveying an attitude of genuine concern and caring. g. Contractor staff should under no circumstances engage in sexual activities or sexual contact with Veterans or their family members, whether such contact is consensual or forced. Contractor should under no circumstances take unfair advantage of any professional relationship or exploit Veteran clients or their family members to further their personal, religious, political, or business interests. Contractor staff should not engage in dual or multiple relationships with Veterans or their family members in which there is a risk of exploitation or potential harm to the Veteran or Veteran family. Contractor is responsible for taking steps to protect Veterans and their family members and is responsible for setting clear, appropriate, and culturally sensitive boundaries. *Per QASP Task 1 Clinical Information Return; clinical monitoring and chart reviews will occur in conjunction with the annual inspection. *Per QASP Task 4 Quality Care, an annual inspection and facility review will be conducted prior to exercising the option year to observe training records to determine staff qualifications. *Per QASP Task 8 Veteran Satisfaction, an annual roll-up report that includes qualitative statements from Veterans will be reviewed in conjunction with the annual inspection. 8. ADMISSIONS, LENGTH OF STAY AND DISCHARGES a. Rapidly stabilize Veterans medical, mental health, substance abuse and other psychosocial problems by expediting placement of these Veterans into safe, supportive emergency housing is expected of this contract. After stabilization, veterans should be placed in other appropriate transitional or permanent housing quickly (within 90 days) with no more than 150 days without a planned reason for the extension. The VA Liaison will not approve per diem for lengths of stay exceeding 150 days from the date of admission unless: (1) There are extenuating clinical circumstances beyond the Contractor s control that are barriers to the Veteran s placement in housing; and/or (2) There is documented evidence that the Contractor has exhausted every effort to place the Veteran in housing sooner; and (3) The VA Liaison has been appropriately advised of these efforts well in advance of the 150 day limit; and (4) The VA Liaison concurs that the Veteran will continue to derive therapeutic benefits from a continued stay at the HCHV Contracted Residential Care facility. [See Reference section for Request for Extension of Per Diem form.] b. Veterans will be screened and referred to the Contractor by the VA Liaison. Excepting lack of available beds, the Contractor will be expected to provide immediate admission to housing and services to these Veterans 24 hours per day, seven (7) days per week. The date of admission must be approved by the VA Liaison for billing purposes. If a Veteran presents at the facility during weekends, at night, or a holiday day, the CERS provider may accept the Veterans. However, VA staff has the right of approval or disapproval for payment. Engagement of homeless Veterans in the provision of housing placement, treatment and supportive services is a key element of the HCHV Contract Residential Care program. c. In the event that a Veteran s length of stay exceeds 90 days from the date of admission and there is no approval from the VA Liaison for continued per diem, the Contractor will work in conjunction with VA Liaison to find new housing options. Veterans may be discharged from HCHV Contract Residential Care programs for positive or negative reasons. The date of discharge must be approved by the VA Liaison for billing purposes. The Contractor shall provide discharge planning and referrals for each Veteran, regardless of character of discharge from the facility, to appropriate community resources and services based upon a team assessment of health, social and vocational needs and the involvement of Veterans families as appropriate. Performance and descriptive measures, as established by the Department of Veterans Affairs/National Homeless Program Office, will be shared with the Contractor. The data will be reviewed during Quarterly progress meetings and annually, as needed. Opportunity will be provided for the Contractor to review data and offer feedback and engagement in strategies to improve performance, as necessary. 9. PER DIEM, BED DAY OF CARE, BILLING AND PAYMENT a. The contract vehicle will be an indefinite delivery, indefinite quantity, firm fixed price contract since it is impossible to determine with any certainty the amount of services that will be required under this contract. The period of performance for this contract will be for a base year plus 5 option years. It is understood that no obligation will be incurred by the VA except for services rendered under this contract pursuant to referrals issued by the VA for residential treatment for Veterans. This contract will serve up to 8 homeless Veterans in need of immediate placement in a safe environment with onsite supportive services. b. Per Diem or Bed Day of Care are terms used to define what the VA will pay for the eligible Veteran s stay in a CERS bed and supportive services for each day the Veteran resides at the facility and receives services. Unless specifically excluded in this contract, the Bed Day of Care rate established will include all services listed in this document and will also include the services or supplies normally provided to other clients by the facility without extra charge. It is the Contractor s responsibility to have appropriate systems of verification of services in place to justify invoices and payments. c. The VA can only pay for eligible Veterans (i.e., Veterans whom VA refers to the Contractor, or for whom VA authorizes the provision of services) as determined by the local VA HCHV program. No funding or financial support will be provided for spouses/partners, minors, or other dependent family members the Veteran identifies as part of his/her family. The Contractor will be responsible for any family members that are allowed to reside in the facility with the Veteran and receive supportive services. d. The Contractor may not bill the VA and the VA will not pay per diem for beds that are used by more than one person at a time, such as in shifts. For example, it is not permissible to bill the VA for a bed that was used by an eligible Veteran at night but then given to someone else to sleep in during the day while the eligible Veteran was attending appointments outside of the facility. The Contractor may only bill the VA for bed days of care for authorized Veterans who are actively residing at the facility. In the case of Veteran absences, the following rules will apply: (1) CERS Veterans will be allowed up to three days of absence from the facility per month. The CERS provider will be expected to hold the bed and will be reimbursed for the three days of absence. (2) Longer additional absences of up to seven (7) days per month can be allowed if the absences are consistent with the Veteran s plan of care and have prior written approval of VA Liaison and the COR. e. Although absences from the CERS facility are generally discouraged, it is recognized that providing an environment with a goal of achieving housing stability sometimes requires additional flexibility. 10. Records and Reports: As VA exercises contract oversight, attention will be directed to the adequacy of Veterans records. Site visits by VA staff will periodically include a spot check of records to ensure Contractor invoices accurately reflect the Veteran s length of stay. The Contractor will be responsible for the following onsite records and reports: a. Daily sign-in sheets signed by program Veterans, to document and verify Veterans presence at the facility for billing purposes. Daily sign-in sheets must be completed clearly, accurately and thoroughly with full signatures and monitored so as to provide a full accounting of Veterans stay and services received for billing and audit purposes. In the event one or more Veterans refuses to sign the daily sign-in sheets due to documented mental health problems, an alternative method of verification may be developed on a case by case basis in collaboration with VA COR. b. The Contractor shall maintain an individual clinical record on each Veteran housed under this contract. The Contractor must comply with the requirements of the Confidentiality of certain medical records (38 USC 7332), and (42 CFR, Part II) when appropriate, and shall be part of the contract. All case records will be maintained with such security and confidentiality as required, and will be made available on a need-to-know basis to appropriate staff members involved with the treatment program of the veterans concerned. c. 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. IN THE EVENT THE CONTRACTOR AFFECTS ANY SUCH CHANGE AT THE DIRECTION OF ANY PERSON OTHER THAN THE CONTRACTING OFFICER WITHOUT AUTHORITY, NO ADJUSTMENT SHALL BE MADE IN THE CONTRACT PRICE TO COVER AN INCREASE IN COSTS INCURRED AS A RESULT THEREOF. d. The COR will be responsible for the overall technical administration of this contract as outlined in the COR Delegation of Authority, including monitoring of the Contractor's performance. e. All individual clinical records will contain an initial biopsychosocial assessment completed within two (2) weeks of program admission. The assessment and plan will include but not be limited to: all identifying data relevant to the Veteran and his/her family, including medical problems and medications, mental health problems and medications, substance use history, housing history and preferences, income supports or benefits, employment/vocational issues, information relating to the Veteran s admission including reason for referral, the targeted goals for constructive changes which are to be attained during the residential rehabilitation episode, and the anticipated length of stay, if known. f. An initial ISP completed within two (2) weeks of program admission signed by the Veteran and the VA Liaison. The plan must specifically include but will not be limited to: Provisions for Veteran placement into an appropriate transitional or permanent housing placement within 90 days of admission to the HCHV Contract Residential Care facility. Only with a planned and approved extension would a Veteran be able to remain in the program for up to, but no more than 150 days. The housing placement planning must take into account all appropriate and available community based housing options as well as the Veteran s preferences regarding location and housing type. g. Provisions for the stabilization and/or treatment of biopsychosocial issues and stressors. This may include provisions of care within the contracted facility, connections to VA medical and mental health care, and/or referrals and connections to community based resources. h. Relevant Releases of Information to communicate and coordinate Veterans treatment with VA and other community based service providers. i. Progress notes for each case management encounter to include information regarding progress toward meeting the ISP goals. j. Documentation of Veteran participation in onsite structured activities and groups. k. Updated ISPs every thirty (30) days from the date of the initial plan, to include any measures of movement toward rehabilitation goals, with particular focus on the attainment of community based housing. l. A final discharge summary on each Veteran who leaves the program regardless of character of discharge, to include a description of beneficial changes realized during the residential period, reasons for leaving, the Veteran s future plans, after-care referrals and connections, and follow up locator information. m. Contractors will be expected to enter data into a Homeless Management Information System (HMIS) web-based software application and bed totals in the Homeless Inventory Count (see Reference section). This data will consist of information on the Veterans served and types of supportive services provided by Contractors. Contractors must treat the data for activities funded by the VA HCHV Contract Residential Care program separately from that of activities funded by other programs. Contractors will be required to export client-level data for activities funded by the VA HCHV Contract Residential Care program to VA on a regular basis. 11. VA INFORMATION AND INFORMATION SYSTEM SECURITY/PRIVACY GENERAL a. The Information Technology security requirements for Certification and Accreditation (authorization) requirements do not apply, and a Security Accreditation Package is not required . The Contractor, their personnel, and their subcontractors shall be subject to the Federal laws, regulations, standards, and VA Directives and Handbooks regarding information and information system security as delineated in this contract. 12. SECURITY INCIDENT INVESTIGATION The term security incident means an event that has, or could have, resulted in unauthorized access to, loss or damage to VA assets, or sensitive information, or an action that breaches VA security procedures. The Contractor/subcontractor shall immediately notify the COR and simultaneously, the designated ISO and Privacy Officer for the contract of any known or suspected security/privacy incidents, or any unauthorized disclosure of sensitive information, including that contained in system(s) to which the Contractor/subcontractor has access. To the extent known by the Contractor/subcontractor, the Contractor/subcontractor s notice to VA shall identify the information involved, the circumstances surrounding the incident (including to whom, how, when, and where the VA information or assets were placed at risk or compromised), and any other information that the Contractor/subcontractor considers relevant. With respect to unsecured protected health information, the business associate is deemed to have discovered a data breach when the business associate knew or should have known of a breach of such information. Upon discovery, the business associate must notify the covered entity of the breach. Notifications need to be made in accordance with the executed business associate agreement. In instances of theft or break-in or other criminal activity, the Contractor/subcontractor must concurrently report the incident to the appropriate law enforcement entity (or entities) of jurisdiction, including the VA OIG and Security and Law Enforcement. The Contractor, its employees, and its subcontractors and their employees shall cooperate with VA and any law enforcement authority responsible for the investigation and prosecution of any possible criminal law violation(s) associated with any incident. The Contractor/subcontractor shall cooperate with VA in any civil litigation to recover VA information, obtain monetary or other compensation from a third party for damages arising from any incident, or obtain injunctive relief against any third party arising from, or related to, the incident. QUALITY ASSURANCE PLAN (QAP) Task ID Indicator Standard Acceptable Quality Level Method of Surveillance Incentive Clinical Information Return 1 Deviation from routine care: Clinical information is provided back to Health Care For Homeless Veterans at the authorizing Veterans Affairs Medical Center Information is provided within 72 hours of the event 95% Ongoing clinical monitoring and chart reviews coinciding with yearly facility inspection visits Exercising the Option Year Access 2 Beds availability: Beds will be available in a ready state to accommodate Health Care For Homeless Veterans referrals Empty beds will be ready for occupancy within 24 hours of notification by Health Care for Homeless Veterans 95% This will be observed through monthly reports from the contractor Exercising the Option Year Facility 3 Accreditation of healthcare facility Facility will meet relevant regulatory standards 95% Review during annual inspections of the facility of survey recommendations and corrective actions. Exercising the Option Year Quality Care 4 Staff Qualifications Veteran care staff hired by the contractor will: a) Not be currently participating in Health Care for Homeless Veterans programming 100% Observation and review of training records during annual inspections. Exercising the Option Year