Q--CONTRACTED EMERGENCY RESIDENTIAL SERVICES (CERS) FOR HOMELESS IN LEBANON, PA.
Department of Veterans Affairs, Network Contracting Office 4 | Published February 3, 2015 - Deadline February 13, 2015
STATEMENT OF WORK: CONTRACTED EMERGENCY RESIDENTIAL SERVICES (CERS) FOR HOMELESS VETERANS
1. Purpose - The Department of Veteran Affairs Medical Center, 1700 South Lincoln Ave, Lebanon, PA 17042, (herein, referred to as the Lebanon VAMC) requires contractors to provide services as part of its Community Based Health Care for Homeless Veterans (HCHV) program, in accordance with VHA Handbook 1162.09. The goal of the HCHV program is to remove homeless Veterans from the street or habitation unfit for Veterans and place them in community-based, residential environments with sufficient therapeutic services to meet the needs of those Veterans.
2. Type of Contract - Indefinite-Delivery/Indefinite-Quantity.
3. The contractor shall provide services to Veterans for whom such care is specifically authorized by the VA. The contractor shall provide residential placement and supportive services sufficient to place up to 25 Veterans under the Health Care for Homeless Veterans (HCHV) program, for the base period of 1 February, 2015 through 30 September, 2015 and two (2) option years, in accordance with all terms and conditions, provisions and requirements listed herein for the all inclusive rate listed above. This rate is inclusive of all services as may be necessary in the treatment of the veteran to include transportation to healthcare appointments and meetings. Unless specifically excluded in this contract, the per diem rate established will include the services listed in this document and will also include all services normally provided other residents by the facility without extra charge. The contractor facility will not be used for detoxification or other hospital level treatment. The contractor facility shall be located within 200 miles of the Lebanon VAMC, within the state of Commonwealth of Pennsylvania.
4. Period of Performance: The period of performance will be for one base period of eight months plus two - one year option periods which allows the Government to unilaterally extend the contract period for twelve (12) months each.
Base Year: February 1, 2015 - September 30, 2015
Option Year 1: October 1, 2015 - September 30, 2016
Option Year 2: October 1, 2016 - September 30, 2017
5. The contractor shall furnish services to Veterans for whom such care is specifically authorized by the VA. It is understood that the type of residents to be cared for under this contract will normally require care and services over and above the level of room and board. Many of these veterans who are homeless or who are at risk for homelessness have co-morbid conditions that include mental illnesses, substance abuse disorders, and/or medical conditions. This contract is designed to serve homeless Veterans in need of immediate placement and/or emergency housing in a safe environment.
6. The contractor shall furnish each Veteran authorized care under this contract with the following basic services:
a. Room and Board, including menus listing three (3) nutritionally adequate meals a day, 7 days a week and the availability of nutritious snacks between meals and at bedtime for those requiring or desiring additional food, when it is not medically contraindicated. Supplemental menus shall be provided for those with dietary restrictions.
Laundry facilities for veterans to do their own laundry or to have laundry done.
c. Therapeutic and Rehabilitative Services determined to be needed by the individual Veteran in a plan developed by the contractor with input from the Veteran and the Lebanon VAMC-HCHV case manager. Services, which the contractor must be able to furnish, include:
i. Structured group activities, including physical activities as appropriate.
ii. Instruction in and assistance with health and personal hygiene
iii. Provision of locked drawers for storage of medication.
iv. Supportive social services, in collaboration with the Lebanon VAMC-HCHV case managers, or other contract resources.
v. Individual professional counseling, by a properly qualified individual who possesses a degree, license, or certification, including counseling on self-care skills and adaptive coping skills.
vi. 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.
vii. Support for an alcohol/drug abuse free lifestyle by maintaining a drug and alcohol free environment.
viii. Assistance in learning, testing and internalizing knowledge of the illness/recovery process for homelessness. Assistance to gain and to apply knowledge of the illness/recovery process in an environment supportive of recovery models.
ix. Assistance with provision of transportation to health care at the Lebanon VAMC and other medical appointments.
7. The contract facility must have a current occupancy permit or license required by the authority having jurisdiction.
8. Unless specifically excluded in this contract, the per diem rate established shall include the services listed herein and will also include all services normally provided other residents by the facility without extra charge.
9. The contractor shall employ sufficient personnel to carry out the policies, responsibilities, and the program for the facility. The Contracted Emergency Residential Services (CERS), at a minimum, shall have an 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. Multiple residential buildings will require additional on-site personnel to ensure each building has 24 hour supervision. In those instances where a supervised residential setting is linked to a geographically distinct rehabilitation and/or socialization day program, sufficient professional counseling personnel must be identified to provide the necessary therapeutic activities and to ensure a meaningful integration of these efforts with those provided in the residential setting. Any professional counseling provided by the contractor shall be performed by a properly qualified individual who has a degree, license, or certification in this skill.
10. The contractor shall make available to the Lebanon VAMC-HCHV staff, documentary information deemed necessary by the Lebanon VAMC to conduct utilization review audits for the mandated national evaluation study as required by the Section 2 of Public Law 100-6; to verify quality of resident care for Veterans, to assure confidentiality of resident record information and to determine the completeness and accuracy of financial records.
11. The contractor shall conduct treatment and discharge planning reflecting a team assessment of health, social, and vocational needs and the involvement of the Veteran, the Lebanon VAMC-HCHV staff, and appropriate community resources in resolving problems and setting goals.
12. 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 (http://www.gpo.gov/fdsys/pkg/CFR-1998-title38-vol1/pdf/CFR-1998-title38-vol1-sec17-707.pdf).
13. Absences shall be managed using the following guidance:
Scheduled/Approved Absences: If the Veteran has left the program and the absence is scheduled, approved and/or deemed in-line with treatment goals, the contractor can only bill for the first 72 hours of the absence.
Unscheduled/Not Approved: If the Veteran has left the program and the absence is not scheduled, approved and/or deemed in-line with treatment goals, the Veteran must be discharged after 24 hours and is considered AWOL (absent without leave). The contractor can bill for the 24-hour period that they held the bed in good faith anticipating the Veteran's return.
Management of program dropout will be an element of Lebanon VAMC quality assurance review of this homeless Veterans' emergency housing program.
14. The facility agrees and warrants that it does not maintain nor provide dual or segregated patient facilities, which are segregated on the basis of race, creed, color or national origin. The facility may neither require such segregated use by written or oral policies nor tolerate such use by local custom. The term "facilities" shall include but not limited to rooms, wards, sections, eating areas, drinking fountains, entrances, etc.
15. The facility agrees to accept referral of and to provide all services specified in this contract for any Veteran regardless of race, color, religion, sex or national origin determined eligible by the Lebanon VAMC-HCHV designee for whom such services are required. In addition the Lebanon VAMC warrants that subcontracting will not be resorted to as a means of circumventing this provision. The contractor agrees to accept referrals and provide services 24 hours per day, seven days per week. The contractor will make available at least one housing unit for females, assuring their privacy and safety, and at least one unit and all common living areas should be handicapped accessible.
16. It is agreed that the Lebanon VAMC-HCHV staff will have complete access to all records concerning the Veteran's care in the facility. It is agreed that duly authorized representatives of the Lebanon VAMC will provide follow-up supervision visits to Veterans placed to assure the continuity of care and to assist in the Veteran's transition back into the community. It is understood that these visits do not substitute nor relieve the contractor in any way of the responsibility for the daily care and treatment of the Veteran. Upon discharge or death of the resident, records on all Veterans will be retained by the facility for a period of at least three years following termination of care. After three years all Veteran's records shall be turned over to the Lebanon VAMC.
17. It is understood that the Veteran may be provided facility care at the expense of the Lebanon VAMC for a period not to exceed that stated in the length of treatment plan contracted, unless an extension of the authorization is provided in writing by the Lebanon VAMC-HCHV staff.
18. The contractor facility shall provide the Veterans with transportation to scheduled meetings and appointments at medical facilities including but not limited to the Lebanon VAMC, and/or the local Community Based Outpatient Clinics (CBOC) at Camp Hill, Lancaster, Berks, York, and Schuylkill, and assistance with information and instructions to Veterans so they can utilize public transportation if that is their preference.
19. The contractor facility shall not accept food stamps or welfare from Veterans.
20. The contractor facility warrants that all applicable fire laws are being complied with and there are no recommendations of fire officials, which have not been resolved.
21. The Lebanon VAMC reserves the right to remove any or all Veteran residents from the facility at any time without additional cost, when it is determined to be in the best interest of the Lebanon VAMC or the Veteran(s).
22. 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 the Code of Federal Regulations, Section 17.34a, Title 38 (http://www.ecfr.gov/cgi-bin/text-idx?SID=a906d8f449f5c95a98d16497790187ce&node=38:220.127.116.11.19.0.175&rgn=div7).
23. It will be the responsibility of the Lebanon VAMC-HCHV case manager to refer all homeless Veterans to the contractor(s). The Veteran's status will be homeless or at risk for homelessness and he/she may have co-morbid conditions that include mental illnesses, substance abuse disorders, and/or medical conditions.
24. Before referring any Veteran, the Lebanon VAMC-HCHV case manager shall have provided the patient with a clinical assessment to include a physical, laboratory studies, and confirmation of co-morbid conditions by Lebanon VAMC clinical staff.
25. All Veterans shall be capable of self-preservation, and in an emergency, 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.
26. Length of stay at Lebanon VAMC cost will be initially authorized for up to 60 days (authorization will not exceed contract performance period), depending upon the needs of the Veteran, as mutually determined by the Veteran, the contractor's residential treatment staff, and VAMC-HCHV case manager.
27. INSPECTION AND ACCEPTANCE
a. It is agreed that the Lebanon VAMC will have the right to inspection of the CERS and all appurtenances by authorized representative(s) designated by the Lebanon VAMC. The contractor will be advised of the finding of the inspection team. If deficiencies are noted during any inspection, the contractor will be given a reasonable time to take corrective action to notify the Contracting Officer that the corrections have been made. A contract will not be awarded until noted deficiencies have been eliminated.
b. Prior to the award of a contract, a multidisciplinary Lebanon VAMC team consisting of a social worker, dietitian, and an engineering service safety officer shall conduct a survey of the contractor's emergency residential center; Contracted Emergency Residential Service centers to be utilized will be restricted to community-based facilities that provide food, shelter, and therapeutic services in a supportive environment.
c. In the cases of complexes of non-VA community facilities, it is imperative that all components of the program be inspected by the Lebanon VAMC team prior to award of the contract as is required for an integrated primary site. Each of the community facilities identified in the complex as contact recipients will also be subject to the requirement for contracting, safety and record keeping described in other parts of this document as applying to the CERS.
d. The Lebanon VAMC Safety Officer will inspect the facility for conformity to the current National Fire Protection Association Life Safety Code (http://www.nfpa.org/codes-and-standards/document-information-pages?mode=code&code=101) and submit findings to the chairperson of the team. The other team members of the team will focus on an assessment of the quality of life within the CERS, giving particular attention to the following factors:
e. General observation of residents indicates that they maintain an acceptable level of personal hygiene and grooming.
f. The facility meets applicable fire, safety and sanitation standards in attractive surroundings conducive to social interaction and the fullest development of the resident's rehabilitative potential.
g. The facility should be in a central location, near public transportation, and near areas, which provide employment.
h. 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.
i. 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.
j. Staff behavior and interaction with Veterans convey an attitude of genuine concern and caring.
k. 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 for room and board is particularly indicated for homeless Veterans. Many of these Veterans are either undernourished or have developed poor eating habits or both, because of their chronic psychiatric disorder, including alcohol/drug abuse behaviors. The local VA Medical Center dietitian may consult with the initial inspection team and the team making subsequent assessments, in evaluating not only the printed menus but also the Veterans' satisfaction with meals and the actual consumption of food offered.
l. 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 to take corrective action to notify the Contracting Officer that the corrections have been made. A contract will not be awarded until noted deficiencies have been eliminated.
m. 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 an inspection of 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 the appropriate officials so that suitable arrangements can be made to discharge or transfer Veteran and to terminate the contract.
o. Subsequent inspections of the CERS must be made yearly by a multidisciplinary team including such VA Medical Center personnel necessary to assure the facility provides quality care in a safe environment. As the VA program personnel accomplish site visits, attention will be directed to the adequacy of veterans' records. Site visits will also include a spot check of records to ensure contractor invoices accurately reflect the veteran's length of stay.