G--FBO Sources Sought for Transitional Housing (Health Care for Homeless Veterans) for John D. Dingell VA Medical Center

SOURCES SOUGHT NOTICE For Transitional Housing (Health Care for Homeless Veteran) for John D. Dingell VAMC This is a Sources Sought Notice. This advertisement is not a solicitation for offers, nor is it a request for quotes. A request for quotes may be issued at a later date. The purpose of this Sources Sought is to conduct market research to determine if responsible sources exist and if there are any businesses capable of providing the requirements. The proposed NAICS Code is 624229, Other Community Housing ($14 Million). The John D. Dingell VA Medical Center (JDDVAMC), in Detroit, Michigan has a need for emergency housing and supportive services as part of its Community Based Health Care for Homeless Veterans (HCHV) program. This is a total need and the VA contemplates making multiple awards (If applicable). The government is interested in sources that can provide some or all of the required services. Interested parties are encouraged to respond with what they can provide (i.e. if you can only support a certain number of beds, please state what you can provide). Prospective offerors shall respond to this Sources Sought no later than 3:00pm (Eastern), Monday, January 30, 2017. Send all replies to Michelle C. Ford at [email protected] Note: This is a Sources Sought Notice only, and is not a request for proposals. No reimbursement will be made for any costs associated with providing information in response to this Sources Sought or any follow up information requests. STATEMENT OF WORK John D. Dingell VA Medical Center -Transitional Housing for Homeless Veterans Wayne, Oakland & Macomb Counties PURPOSE: The John D. Dingell VA Medical Center located in Detroit, MI, requires a contractor who can provide care, treatment and rehabilitative services to homeless veterans with or without a mental health or substance use disorder diagnosis in a community-based treatment facility offering a safe and secure environment that supports their rehabilitation goals. The Contractor will be required to provide therapeutic and rehabilitative services, but will not be required to provide detoxification or other hospital level treatment those services will be provided by the VA at VA facilities. BACKGROUND: The goal of the Healthcare for Homeless Veterans (HCHV) program is to remove homeless Veterans from the street or habitation unfit for Veterans and place them in community-based, residential environments with sufficient therapeutic services to meet the needs of those Veterans. Through the HCHV program, the VA provides case management services to Veterans and facilitates their access to a broad range of medical, mental health, and rehabilitative services. SCOPE: HCHV awards contracts to community-based agencies to provide short-term residential treatment to Veterans who need immediate housing placement as they seek permanent housing and/or additional care and services. The contractor shall provide up to 26 beds, which will include 23 male beds and up to 3 female beds, and furnish services to beneficiaries in Wayne, Oakland and Macomb Counties for whom such care is specifically authorized by the Department of Veterans Affairs (herein called VA). It is understood that the type of patients to be cared for under this contract are authorized VA beneficiaries who are experiencing homelessness, mental illness and/or substance abuse disorder and will normally require care and services over and above the level of room and board. DEFINITIONS: Health Care for Homeless Veterans Program. The Health Care for Homeless Veterans (HCHV) program is an essential and critical part of VHA, providing a gateway to VA and community-based supportive services for eligible Veterans who are homeless. HCHV programs provide outreach services; care, treatment, and rehabilitative services, including case management services; and therapeutic transitional housing assistance under 38 U.S.C. 2032 in conjunction with Work Therapy under 38 U.S.C. 1718. The program uses Contracted Residential Services (see paragraph 5.d.) in community locations to engage homeless Veterans who have been underserved. Many of these Veterans would benefit from mental health and Substance Use Disorder (SUD) treatment but will not avail themselves of these services without the encouragement of outreach workers. Homeless. The HCHV Program follows the definition of homeless in 38 U.S.C. 2002(1) and section 103(a) of the McKinney-Vento Homeless Assistance Act, 42 U.S.C. 11302(a). NOTE: The term homeless" or "homeless individual" does not include any individual imprisoned or otherwise detained pursuant to an Act of Congress or a state law. Homeless Management Information System. The Homeless Management Information System (HMIS) is a computerized data collection tool specifically designed to capture client level information over time on the characteristics and service needs of men, women, and children experiencing homelessness and the services provided to them. HMIS implementations can encompass geographic areas ranging from a single county to an entire state and are administered locally within the community (Continuum of Care) by one lead agency that is responsible for standards and privacy compliance, as well as HUD reporting and other funder required aggregate reporting. Substance Use Disorder Specialist. The Substance Use Disorder (SUD) Specialist is a professional with a Master s degree and an independent license, who is responsible for providing expertise on SUDs to the HCHV and HUD-VASH teams, to other providers within the medical facility, and in the community. The SUD Specialist also provides assessments and treatment to certain high-risk, substance-using homeless Veterans. Supportive Services. Supportive Services encompass a range of services that assist an individual in the transition from the streets or shelters into permanent or permanent supportive housing and that assist persons with living successfully in housing. Examples of supportive services include, but are not limited to: assistance in securing permanent housing; vocational assistance, including mentoring and coaching as well as job placement; income assistance and financial planning; relapse prevention; and social and recreational activities. Veteran. A Veteran, for the purpose of HCHV programs, is a person who served in the active military, naval, or air service, and who was discharged or released under conditions other than dishonorable and is enrolled or eligible for VA health care under 38 CFR 17.36 or 17.37. An eligible veteran must meet the criteria specified in 38 CFR 63.3 to qualify for benefits under the HCHV program. Life Safety Code. The publication, known as NFPA 101, is a consensus standard widely adopted in the United States. It is administered, trademarked, copyrighted, and published by the National Fire Protection Association Health Care For Homeless Veterans (HCHV) Program: VHA Handbook 1162.09 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=3006 VA Patient's Bill of Rights. VA Patient s Bill of Rights as set forth in Section 17.34a, Title 38, Code of Federal Regulations. http://www.ecfr.gov/cgi-bin/text-idx?SID=772b2c7680dcc57290c6fdedcc201093&mc=true&node=se38.1.17_134&rgn=div8 Confidentiality of Alcohol and Drug Abuse Patient Records (42 CFR, Part II). http://www.ecfr.gov/cgi-bin/text-idx?rgn=div5;node=42%3A1.0.1.1.2 Confidentiality of Certain Medical Records (38 USC 7332). https://www.gpo.gov/fdsys/pkg/USCODE-2011-title38/pdf/USCODE-2011-title38-partV-chap73-subchapIII-sec7332.pdf SERVICES TO BE PROVIDED: The contractor shall furnish each veteran authorized care under this contract with the following basic services: A supervised environment which will be staffed on a 24-hour basis; Room and Board; Laundry facilities for residents to do their own laundry; providing laundry detergent and bleach. Therapeutic and Rehabilitative Services determined to be needed by individual veteran patients, in a plan developed by the contractor with consultation by the veteran and the VA case manager. Services which the contractor must be able to furnish include: Structured group activities, including physical activities as appropriate. Instruction in and assistance with health and personal hygiene. Monitoring of medications. Supportive social services, in collaboration with the case managers, VA or other community contract resources. Bio-psychosocial assessment, treatment plan, individual professional counseling, including counseling on self-care skills, adaptive coping skills, vocational rehabilitation counseling and as appropriate discharge planning in collaboration with VA program or contract community resources. Assistance in learning and development of responsible living patterns to achieve a more adaptive level of psychosocial functioning, upgraded social skills, and improved personal relationships. Support for an alcohol/drug abuse-free lifestyle. Assistance in learning, testing, and internalizing knowledge of the illness/recovery process. GENDER SPECIFIC CARE PROVISIONS: The contractor shall identifying sufficient residential capacity to provide up to 23 Veteran beds on any given day, including residential capacity for up to 3 female beds, and furnish services to beneficiaries in Wayne, Oakland and Macomb Counties for whom such care is specifically authorized by the Department of Veterans Affairs (herein called VA). ( ** This section of the requirement only applies to facilities that house female veterans**) Special attention need to be given to meeting the unique needs of homeless women veterans. These needs often include assistance with managing sexual trauma, eating disorders, and interpersonal violence. Women veterans will be receiving clinical care from a VA medical facility. They must have access to female clinical staff for additional gender-specific treatment and/or supportive services as needed. Separate gender living facilities must meet the basic facility requirements for residents. For mixed gender facilities, the living environment of HCHV Contract housing must include:         1. Separate and secure sleeping arrangements (unit or wing) for each gender, 2. Separate and secure bathroom arrangements for each gender, 3. Screening procedures and criteria for sex offenders, and 4. Common areas (lounges, laundry rooms, group rooms) with appropriate security arrangements. HCHV-funded programs shall maintain and adjust environments to support the safety, security, privacy and services for women veterans. Special emphasis on privacy and security should be noted. Veteran residents have a right to be treated with dignity in a humane environment that affords them both reasonable protections from harm and appropriate privacy with regard to their personal needs. The living environments of HCHV Contract Residential Services transitional housing shall include: Residential room and board in an environment that promotes a lifestyle free of sexual discrimination. An environment conducive to social interaction, supportive of recovery models and the fullest development of the resident s rehabilitative potential regardless of gender or sexual orientation. Separate and secure bathroom arrangements to ensure privacy for personal hygiene and grooming. TRANSPORTATION: The contractor shall provide veterans with daily transportation to scheduled meetings and appointments. Transportation is provided once in the morning and afternoon for VA Medical Center appointments. Transportation will also be made available by the transitional housing facility to transport Veterans to local DHS, the Social Security Office, and the Veterans Benefits Administration. Transport for housing searches may be available and coordinated with Program staff. 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. SUPPLEMENTAL SERVICES: Unless specifically excluded in this contract, the per diem rates established will be an all-inclusive rate and will include the services listed in this document. It will also include all services or supplies normally provided to other patients by the facility without extra charge to the VA or its patients. FACILITY: It is the responsibility of the contractor to properly maintain its facilities and the John D. Dingell VA Medical Center shall have no responsibility for paying or reimbursing the contractor for such expenses. The contract facility shall have a current occupancy permit or license required by the authority having jurisdiction. All contract facilities must be licensed under state or federal authority. Both residential and ambulatory care facilities must conform to the standards of the Life Safety Code (National Fire Protection Association #101) and conform to the fire and safety code imposed by the state law which adequately protects residents, and must meet all city, state, and federal requirements concerning licensing and health codes. In all cases, the VA requires a level of safety which conforms to NFPA #101. The contractor shall employ sufficient professional health care personnel to carry out the policies, responsibilities, and programs of the facility. In residential treatment facilities there must be, at minimum, a full time case manager or licensed Bachelor level Social Worker and a full-time 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. The contractor shall make available to the VA, documentary 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 100-6 (http://uscode.house.gov/statutes/pl/100/6.pdf) ; to verify quality of patient care for veterans; to assure confidentiality of patient record information; and to determine the completeness and accuracy of financial records. The contractor shall conduct treatment and discharge planning reflecting a team assessment of health, social and vocational needs and the involvement of residents' families (when available) and appropriate community resources in resolving problems and setting goals. The contractor shall comply with the VA Patient's Bill of Rights as set forth in Section 17.34a, Title 38, of the Code of Federal Regulations. This contract does not require the provider to have JCAHO accreditation however; the contractor shall perform the required work in accordance with JCAHO standards or equivalent. Before commencing work under the contract, the Contractor shall furnish the Contracting Officer with a certification from their insurance company indicating that the coverage outlined in this contract has been obtained and that it may not be changed or canceled without written notice within thirty (30) days to the Contracting Officer. PERSONNEL: The contractor is required to develop and maintain the following documents for each contract employee working on this contract. Credentials and qualification for the job. A current competence assessment checklist (an assessment of knowledge, skills, abilities and behaviors required to perform a job correctly and skillfully; and to provide care for certain patient populations, as appropriate. A current performance evaluation supporting ability of the employee. Documentation of continuing education for the last two years. The contractor shall provide current copies of these records at the time of contract award and annually on the anniversary date of contract award to the VA Contracting Officer Representative (COR), or upon request, for each contractor employee working on this agreement. REQUIRED TRAINING INITIAL/ANNUAL: All contractors who will be working on the contract complete a mandatory training program titled VA Privacy and Information Security Awareness Training and Rules of Behavior. This training is offered through the VA Talent Management System (TMS), a system that offers web-based training to VA employees and its partners. Each contract employee self-enrolls for a profile on the VA TMS by visiting https://www.tms.va.gov/plateau/user/login.jsp. INSPECTION: It is agreed that the VA will have the right to inspect the residential treatment center and all appurtenances by an authorized representative(s) designated by the VA. Prior to the award of a contract and annually during the contract term, a multidisciplinary VA team consisting of a social worker, nurse, dietician, and a safety officer shall conduct a survey of the residential treatment/community health care center. Residential treatment centers to be utilized will be restricted to community based facilities that provide food, shelter, and therapeutic service in a supportive environment. Residential treatment settings shall make documented information available to the VA, as deemed necessary to: Conduct utilization review audits for the mandated national evaluation study, Verify quality of patient care for veterans, Ensure confidentiality of patient record information, and Determine the completeness and accuracy of financial records. In cases of complexes of non-VA community health care facilities, it is imperative that all components of the program be inspected by the VA team prior to award of the contract as is required for an integrated primary site. Each of the community health care facilities identified in the complex as contract recipients will also be subject to the requirements for contracting, safety and record keeping described in other parts of this document as applying to the residential treatment center. The safety officer will inspect the facility for conformity to the current Life Safety Code and submit the findings to the chairperson of the team. The other members of the team will focus on the assessment of the quality of life within the residential treatment facilities, giving particular attention to the following indicators: General observation of residents to determine if they maintain an acceptable level of personal hygiene and grooming. The facility meets applicable fire, safety, and sanitation standards in attractive surroundings conductive to social interaction and the fullest development of the resident's rehabilitative potential. The facility should be in a central location, near public transportation, and near areas which provide employment; also within a 50 mile radius of John D. Dingell VA Medical Center. Appropriate organized activity programs during waking hours (including evenings) reflecting a high level of activity in the facility or in the linked facilities, for example, individual professional counseling, physical activities, assistance with health and personal hygiene. There is evidence of facility-community interaction. This may be demonstrated by the nature of scheduled activities, or by information about resident flow out of the facility (e.g., community activities, volunteers, local consumer services, etc.). Staff behavior and interaction with residents convey an attitude of genuine concern and caring. The contractor will be advised of the finding of the inspection team. If deficiencies are noted during any inspection, the facility will be given a reasonable time (30 days) to take corrective action and notify the Contracting Officer that the corrections have been made. A contract will not be awarded until noted deficiencies have been eliminated. Failure by the contractor to take corrective action with a reasonable time (30 days) will be reported to the VA Contracting Officer. The VA shall monitor the contractor's program and inspect the contractor's facility to ensure compliance with this agreement. Any unsatisfactory conditions noted during the inspection of the contract facility will be reported in writing to the VA Contracting Officer. If corrections are not made to the satisfaction of the VA, the Contracting Officer will consult with John D. Dingell s VA Medical Center s HCHV program manager and/or other officials so that suitable arrangements can be made to discontinue plans to award a contract, or to discharge or transfer patients and to terminate the contract. DIETETIC SERVICES: Patient dietary needs shall be met in accordance with sound medical practice including those who are diabetic. Appetizing, nutritionally adequate meals are provided in a setting which encourages social interaction and nutritious snacks between meals and bedtime are available for those requiring or desiring additional food, when it is not medically contraindicated. The addition of nutritious snacks to the requirements of the rooms and board is particularly indicated for homeless chronically mentally ill patients. Many of these patients are either undernourished or have developed poor eating habits or both, due to their chronic psychiatric disorder, including alcohol/drug abuse behaviors. The local VA dietitian may consult with the initial inspection team and the team making subsequent assessments, in evaluating not only the printed menus but also the patients' satisfaction with meals and the actual consumption of food offered. At least three nutritious meals or their equivalent shall be served daily at regular times with not more than a 14 hour span between evening meal and breakfast of the following day. Between meals and/or bedtime snacks of nourishing quality shall be offered. There shall be evidence that food is prepared, served and stored under sanitary conditions. Sanitary procedures shall be established and maintained for washing dishes, cleaning equipment and work areas, and for proper waste disposal. ABSENCES AND CANCELLATION: Absences including the following: hospitalization, AWOL (absence without leave), day passes, as well as weekend passes of the patient from the residential treatment center in excess of 48 hours will not be reimbursable. The contractor shall notify the Homeless Program Coordinator or designee immediately when a medical emergency occurs which requires hospitalization of any patient receiving care at VA expense. Contractor shall ensure that the veteran will be admitted to the nearest available VA facility when possible. If hospitalization of a non-emergency nature is required, it is agreed that admission to a VA will be accomplished consistent with VA eligibility criteria, as determined by VA policies. The John D. Dingell VA Medical Center reserves the right to remove any or all Veterans from the facility at any time, without additional cost, when it is determined to be in the best interest of the VA and/or the Veteran. This includes discharge from the facility for ongoing bed bug infestation. The contractor shall notify the Homeless Program Coordinator or designee immediately of any incidents involving Veterans residing in the Residential Program. The contractor shall notify the Homeless Program Coordinator or designee 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 Homeless Program Coordinator or designee 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 STAFF CONDUCT/COMPLAINTS 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 (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 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. PATIENT CARE AND RECORDKEEPING: In the event a beneficiary receiving residential treatment center care under this contract dies, the residential treatment center will promptly notify the John D. Dingell VAMC case manager authorizing admission and immediately assemble, inventory, and safeguard the patient's personal effects. The funds, deposits, and effects left by VA patients upon the premises of the residential treatment center shall be delivered by the residential treatment center to the person or persons entitled thereto under the laws currently governing the residential treatment center for making disposition of funds and effects left by patients, 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 of the funds and effects will be immediately forwarded to the John D. Dingell VAMC case manager. Should a deceased patient leave no will, heirs or next of kin, his personal property and funds - wherever located - vests in and becomes the property of the United States in Trust. In these cases the residential treatment center 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. In the event a Veteran passes away at the residential facility, that facility would contact the Wayne County Morgue and arrange for them to pick up the body. Subsequent inspections of the residential treatment center must be made yearly by a multidisciplinary team including such hospital personnel as deemed necessary to assure that the facility provides quality care in a safe environment. As site visits are accomplished by VA program personnel, attention will be directed to the adequacy of the veteran's records. Site visits will also include a spot check of records to ensure contractor invoices accurately reflect the veteran s length of stay. The contractor shall maintain an individual clinical record on each veteran out-placed under this contract. The contractor shall comply with the requirements of the "Confidentiality of Certain Medical Records" (38 USC 7332), and the "Confidentiality of Alcohol and Drug Abuse Patients Records" (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 VA staff members involved with the treatment program of the veterans concerned. In addition to reasons for referral, the clinical record maintained by the contract facility will include: All essential identifying data relevant to the resident and his/her family, including a socio-cultural vocational assessment. Data relating to the resident s admission, to include the targeted goals for constructive changes which are to be attained during the residential rehabilitation episode, and the anticipated length of stay, if known. Copies of any medical prescriptions issued by physicians, including orders, if any, for medications to be taken; Reports of periodic reevaluation by program staff, to include any measures of movement toward rehabilitation goals, with focus on the attainment of self-help skills. Final summaries on each resident who leaves the program, to include a description of beneficial changes realized during the residential period, reasons for leaving, the resident's future plans, and, if possible, follow-up locator information. Upon discharge or death of the patient, medical records on all VA beneficiaries will be retained by the Residential Treatment Center (RTC) for a period of at least three years following termination of care. REFERRAL and OUTREACH PROCESS The VA case manager/treatment team, in collaboration with the existing community homeless case workers, shall identify and refer patients to the contractor. All patients will be homeless including severely mentally disabled veterans to include those with alcohol and/or substance abuse disorders. Before referring any patient, the VA shall have provided the patient with a clinical assessment, with a physical exam and laboratory studies if indicated, and confirmation of chronic mental illness by a VA mental health professional. All patients will be capable of self-preservation, and in an emergency situation, will have sufficient capacity to recognize physical danger, sufficient judgment to recognize when such danger requires immediate egress from the group residence, sufficient capacity to follow a prescribed route of egress, and sufficient physical mobility to accomplish such egress. The contractor shall conduct community outreach to identify homeless veterans for transitional housing. The VA mental health professional will provide a clinical assessment and a physical exam as previously stated. VA will authorize up to six (6) months of care depending upon the needs of the patient as mutually determined by the patient, the VA outreach worker, and the residential treatment staff. STANDARDS/LICENSES The Contracting Officer or his/her designee will notify the Contractor of any noncompliance with the foregoing provisions and the action to be taken. The Contractor shall after receipt of such notice immediately correct the conditions to which attention has been directed. Such notice, when served on the Contractor or his/her representative at the site of the work, shall be deemed sufficient for the purposes aforesaid. If the Contractor fails or refuses to comply promptly, the Contracting Officer may issue an order stopping all or any part of the work and hold the Contractor in default. LEVEL OF CARE The Contractor shall provide a program of therapeutic and rehabilitative mental health services designed to promote a more adaptive level of psycho- social functioning. The Contractor shall provide supportive personal care. The Contractor shall provide individual adjustment services including social divisional, recreational, and spiritual opportunities. The Contractor shall provide sufficient motivation and education of patients to allow patients to achieve and maintain independence in the activities of daily living and self-care. CONTRACT CHANGES/TECHNICAL DIRECTIONS: 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. 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. HOMELESS PROGRAM REPORTING REQUIREMENT: The Contractor shall enter client level data on all Veterans served through VA s HCHV residential contract/emergency housing program. The Contractor shall enter the client level data into the local community Continuum of Care s (CoC) HIS. Data entered must include, at a minimum, the Universal Data Elements from the 2010 HMIS Data Standards.