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Contract Opportunity

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SOURCES SOUGHT FOR COLUMBIA VA HEALTH CARE SYSTEM MEDICAL RECUPERATIVE (RESPITE) CARE.

This is a Sources Sought announcement only. This is not a solicitation announcement for proposals and no contract will be awarded from this announcement. No reimbursement will be made for any costs associated with providing information in response to this announcement or any follow-up information requests. No telephone calls will be accepted requesting a bid package or solicitation because there is no bid package or solicitation available.

Through the HCHV program, VA provides supportive services to Veterans and facilitates their access to a broad range of medical, mental health, and rehabilitative services. The purpose of this sources sought is to obtain information to determine if a small business set aside can be used, from small business for the surrounding areas within 50 miles of the Columbia VA s Medical Center that can provide temporary housing and supportive services in a community-based setting to Veterans with special needs who are experiencing homelessness.

This notice is specifically searching for quality Medical Recuperative (Respite) Care and housing services for the most vulnerable and at-risk homeless Veterans and provide a safe, healthy, and secure setting to promote their rehabilitation goals and discharge to permanent housing. Services will be provided to VHA healthcare-eligible Veterans who may be discharging from the VA Medical Center or preparing for planned medical procedures, requiring stabilization prior to and after hospitalization. The contractor will be required to provide a low-barrier therapeutic and rehabilitative milieu and attendant services to address medical rehabilitation, while targeting the underlying factors contributing to homelessness. The contractor will not be required to provide detoxification or other acute level treatment.
The North American Industry Classification System (NAICS) Code is 623220. The applicable size standard is $19 million.

The scope of the proposed FSC G004 Social-Social Rehabilitation.
In order to be eligible to respond as an SDVOSB or VOSB, a firm must be certified at: Veteran Small Business Certification (sba.gov)
An active registration in System for Awardee Management (SAM) is also required. Registration is available at www.sam.gov.

In an effort to collaborate and improve the clarity of the contractual requirements, the Government is providing a Performance Work Statement (PWS). Issuance of the PWS does not constitute an official RFQ, nor restrict the Government's acquisition methodology.

The information obtained through this notice will be utilized exclusively as market research for acquisition planning purposes for the future solicitation of a Firm-Fixed Price (FFP) Contract for Medical Sharing Service. Interested sources are invited to respond to the Sources Sought." No reimbursement will be made for any costs associated with providing information in response to this announcement and any follow-up information requests. Respondents will not be notified of the results of the evaluation. However, will utilize the information for acquisition planning purposes. All data received in response to this Sources Sought Notice marked or designated, as corporate or proprietary information will be fully protected from release outside the Government. Please respond to this Sources Sought announcement no later than 2:00 p.m. HST on December 7, 2023. Â NO TELEPHONE CALLS OR FACSIMILES WILL BE ACCEPTED. Responses received after the deadline or without the required information will not be considered. Â Since this is a Sources Sought announcement only, evaluation letters will be not be issued to any respondent.
Responses to this sources sought notice MUST contain the following information:
(1) Company name and address, point of contact with phone number, and DUNS number;
(2) Documentation that clearly demonstrates the firm s capability of MEDICAL RECUPERATIVE (RESPITE) CARE services with specific relevance to the description of the requirement indicated above (including references with current point of contact and phone number);
(3) Proof of registration in the Veteran Small Business Certification (sba.gov) website (if applicable).
Responses to this notice must be made via e-mail to Willaim.Prenzler@va.gov. Responses may be submitted as attachments, or contained in the body of the e-mail, and must be clearly marked SOURCES SOUGHT RESPONSE MEDICAL RECUPERATIVE (RESPITE) CARE, Columbia VA Health Care System" in the subject line and document header.
As a reminder this is a Sources Sought announcement only, evaluation letters will be not be issued to any respondent, nor will the Government be required to pay for any costs incurred for responses submitted.
Columbia VA Health Care System
PERFORMANCE WORK STATEMENT
Medical Recuperative (Respite) Care

Purpose.

The Department of Veteran Affairs (VA) Medical Center in Columbia, South Carolina has a requirement for a contractor to provide services as part of its community-based Health Care for Homeless Veterans (HCHV) program. The HCHV program s Contract Residential Services (CRS) target and prioritize Veterans experiencing homelessness, that are transitioning from literal street homelessness, being discharged from institutions and are in need of medical respite, and those who recently became homeless and require safe and stable living arrangements with medical assistance while they seek permanent housing.

BACKGROUND.

Through the HCHV program, VA provides supportive services to Veterans and facilitates their access to a broad range of medical, mental health, and rehabilitative services. The purpose of this solicitation is to obtain offers from contracting agencies in surrounding areas within 50 miles of the Columbia VA s Medical Center that can provide temporary housing and supportive services in a community-based setting to Veterans with special needs who are experiencing homelessness.

This notice is specifically soliciting for quality Medical Recuperative (Respite) Care and housing services for the most vulnerable and at-risk homeless Veterans and provide a safe, healthy, and secure setting to promote their rehabilitation goals and discharge to permanent housing. Services will be provided to VHA healthcare-eligible Veterans who may be discharging from the VA Medical Center or preparing for planned medical procedures, requiring stabilization prior to and after hospitalization. The contractor will be required to provide a low-barrier therapeutic and rehabilitative milieu and attendant services to address medical rehabilitation, while targeting the underlying factors contributing to homelessness. The contractor will not be required to provide detoxification or other acute level treatment.

PERIOD OF PERFORMANCE

Period of performance is based upon award date with 4 option years.
Base year
Date of award though first year
Option Year 1
Year 2
Option Year 2
Year 3
Option Year 3
Year 4
Option Year 4
Year 5
Room and Board shall be accessible to the Veterans admitted to the program seven (7) days a week and twenty-four (24) hours per day.
SERVICES TO BE PROVIDED

GENERAL RESPONSIBILITIES: The contractor will provide sufficient facilities to accommodate five (5) Veterans with residential placement which will involve:

Room and Board shall be provided to the Veterans admitted to the program seven (7) days a week and twenty-four (24) hours per day. At least three (3) nutritious meals, seven (7) days a week will be provided for the Veteran.
Registered Nurse on-site for no less than ten (10) hours per week. Additional hours may be necessary, commensurate with the needs of each Veteran.
Twenty-four (24) hours a day, seven (7) days a week, medication management.
Twenty-four (24) hours a day, seven (7) days a week residential staffing on-site.
Additional miscellaneous staffing structure for meeting this level of care, (i.e., nutrition, security, facilities, etc.) must be submitted with offers.

The contracted Recuperative Care Program will offer services to male, female, transgender and non-binary Veterans who require recuperative medical care stabilization due to sickness, injury preparation for and/or recovery from inpatient hospital care. It is understood that Veterans to be served under this contract will require care and services above the level of room and board.

Absences of any Veteran from the facility in excess of seventy two (72) consecutive hours will not be reimbursable except with prior approval of the designated Contracting Officer s Representative (COR).
Negative drug screens will not be a requirement for admission.

Recuperative Medical Care: The contractor shall provide Veterans with recuperative medical and mental healthcare in accordance with the plan of care developed by the VA referring healthcare providers. The contractor will provide an on-site registered nurse (RN), licensed by the state of South Carolina and in good standing with their licensing board, no less than ten (10) hours per week assigned only to Veterans enrolled under this contract during that period. Additional hours may be necessary, commensurate with the needs of each Veteran.

The RN will provide education and assistance with medication management and treatment compliance within the scope of practice for nursing. The RN will support coordination of care with VA providers and the VA CRS Liaison to ensure for continuity of care. Veterans will also receive health education in areas such as sleep, nutrition, coping with chronic illnesses and pain management. The RN will monitor vital signs and follow up with VA medical staff as appropriate. Veterans will be assisted with the use of VA telehealth as needed.

All Veterans will be referred for follow up to the VA for Primary Care and Mental Health appointments and contractors will support Veterans in making initial and subsequent follow up appointments. Efforts will be made for Veterans who are identified to be highly acute. Efforts will be documented in the Veterans Individualized Care Plan (ICP) and reviewed in case-consultation with the VA Liaison at least monthly.

CRITICAL INCIDENT REPORTING: All critical incidents will be reported as soon as possible and no later than twenty-four (24) hours. This includes the following:
Falls with injury
Assault (to Veteran or Staff)
Elderly/Dependent Adult Abuse or Neglect
Sexual Assault
Fire (Veteran Involved)
Medical/Psychiatric Emergency (911 Calls)
Hospitalization
Suicide or Suicide Attempt
Homicide
Death
Infectious Control (COVID-19, TB, etc.)
Active Substance Abuse
Observation/ Possession of Weapons
On-site arrest of a Veteran by law enforcement

DOCUMENTATION: An individual case record will be created for each referred Veteran. Case records shall be maintained in security and confidence as required by the Confidentiality of Alcohol and Drug Abuse Patient Records (42 CFR part 2) and the Confidentiality of Certain Medical Records (38 USC 7332). Case records and data normally maintained and included in a medical record as a function of compliance with State or community licensing standards will be made available on a need-to-know basis to appropriate Department of Veterans Affairs staff members involved with the treatment program of the Veterans concerned. The contractor shall comply with applicable requirements of the Confidentiality of Alcohol and Drug Abuse Patient Records (42 CFR Part II) and the Confidentiality of Certain Medical Records (38 USC 7332). The files shall include:

Reasons for referral
All essential identifying data relevant to the resident and with weekly progress reports or notes, and documentation of any case management interventions or patient care conferences
Medication Management/Monitoring- Copies of any medical prescriptions issued by physicians, including orders, if any, for medications to be taken. Contractor must be in compliance with HCHV inspection requirements.
Nursing, Case management, and Mental Health notes written in a professional manner (i.e. SMART, SOAP, SNAP) will include the following: 1) A written and comprehensive Assessment, 2) Individual Care Plan 3) Financial Plan, 3) Discharge Plan, 4) documented progress and activity towards identified goals.
Final discharge summaries on each resident who leaves the program, to include reasons for leaving, the resident s future plans, and follow-up locator information.
Extension approval if relevant
Waivers as appropriate
RULES, POLICIES AND PROCEDURES: The contractor shall have reasonable rules governing day-to-day life and activities in the facility. Such rules clearly inform Veterans of the obligations upon which their continued participation in the program depends and the consequences for non-compliance. Veterans will be provided a copy of the rules at intake or upon Veterans request. In addition, Contractor will post the rules in a location readily accessible to clients and visitors. These rules must include detailed Patient Rights and the procedures that the Contractor has in place to protect the Veterans rights and dignity. Veterans must be permitted to exercise these rights without fear of reprisal. If requested, Contractors must reasonably accommodate Veterans whose compliance with program rules is limited by the Veterans physical or mental disabilities, in accordance with the Americans with Disabilities Act, the Federal Fair Housing Amendments Act, Section 504 of the Rehabilitation Act, including those requirements covering reasonable accommodations for disabilities and the use of assistance animals, Â and the California Fair Employment and Housing Act of 1973 and all other applicable State or Federal laws. Contractor must equally apply all rules, policies and procedures to Veterans, unless a Veteran has asked for a reasonable accommodation due to his/her disability.
ADDITIONAL CONTRACT REQUIREMENTS
PERSONNEL: The Contractor will employ sufficient personnel to carry out the policies, contract responsibilities, and the program for the facility. There must be, at a minimum, one (1) staff member on duty on the premises or residing at the facility and available for emergencies twenty-four (24) hours a day, seven (7) days a week. In addition, there is an expectation that there is an administrative/clinical Designee that will be available for consultation for emergencies twenty-four (24) hours a day, seven (7) days a week. The Contractor shall assign personnel that by education, training and when required, certification or licensure qualified to provide the Basic Services and Supplemental Services required by this Statement of Work.
REFERRALS, ADMISSIONS AND ELIGIBILITY:
The VA is responsible for determining eligibility of Veterans prior to acceptance by the Contractor for services. After receipt of a Release of Information (ROI), a written pre-approval from VA Staff is required (hard copy, fax or e-mail are acceptable) and shall be provided to the contractor for each Veteran referred for services under the contract. If there is an urgent need to admit a Veteran and VA Staff is not available to provide a written approval in a timely manner a verbal approval is acceptable. Any admissions that occur without written/verbal approval must be verified by VA Staff within twenty (24) business hours in order for the contractor to receive payment for time spent prior to approval (e.g. admission after hours or during the weekend). Written documentation of eligibility verification, signed by an authorized VA Staff, shall be obtained by the contractor as soon as possible for each Veteran referred for services under the contract for inclusion in the Veterans program file.

It is understood that the Contractor will not be paid for care provided to a referred Veteran beyond the period authorized in the referral, unless an extension of the authorization is provided in writing by the VA.

The initial stay for a Veteran should be no longer than ninety (90) calendar days. Any extension of the stay after ninety (90) calendar days must be authorized by the VA Liaison or designee, provided that there is clear clinical indication and availability of funds. Approvals for extensions must be stored in the Veteran s chart.

It is understood that the type of Veterans to be cared for under this contract will require care and treatment services over and above the level of room and board. It is also understood that Veterans may need more intensive case management than the general population. The level of intensity of services required will be part of an ongoing conversation with the VA Liaison. To be eligible for placement in contract beds, all Veterans must be homeless or at imminent risk of becoming homeless and be eligible and registered for VHA services. While special population contracts are intended for Veterans with special needs, a formal diagnosis is not required for the Veteran to participate in the program. Veterans should be independent in Activities of Daily Living (ADLs) as an eligibility requirement. CRS services are not a substitute for long-term care or skilled nursing care. Contractors are encouraged to provide housing and or services to special Veteran populations, such as but not limited to the following: medically compromised Veterans, Veterans with sex offender status, seriously mentally ill Veterans, Veterans who have abused drugs or alcohol for many years, and/or Veterans who have been involved with the legal system.

DENIAL OF SERVICES: Veterans cannot be denied entry to HCHV Contracted Residential Services based solely upon length of current abstinence from alcohol or non-prescribed controlled substances, the number of previous treatment episodes, the time interval since the last program entry, the use of prescribed controlled substances, disability, income, gender, or legal history. This includes a Veterans status of being a victim of Intimate Partner Violence (IPV) and as such cannot be considered during the screening process. The screening process must consider each of these special circumstances and determine whether the program can meet the individual Veteran's needs while maintaining the program's safety, security, and integrity. All contractors must employ a harm reduction approach.

ABSENCES AND CANCELLATION: The contractor shall notify the VA of unauthorized absences by a referred Veteran from the facility within twenty-four (24) hours of Veterans absence. Should a Veteran absent himself/herself from the contractor s facility in an unauthorized manner, payment for services for that Veteran shall be continued for a maximum period of twenty-four (24) hours, provided there is a documented active outreach attempt on the part of the contractor s staff to return the Veteran to the facility and there is a reasonable belief that the Veteran will return. Management of program dropout rate will be an element of quality assurance review of this program.

VA reserves the right to remove any or all Veterans from the facility at any time, without additional cost, when it is determined to be in the best interest of the VA or the Veteran. This includes discharge from facility for ongoing bed bug infestation.

The Contractor shall notify the authorizing VA facility immediately when a medical emergency occurs that requires hospitalization of a referred Veteran. It is agreed that the Veteran will be admitted to the appropriate VA facility. When such admission is not feasible because of the nature of the emergency, it is agreed that hospitalization in a non-federal facility is acceptable. If hospitalization of a non-emergent nature is required, it is agreed that admission to the appropriate VA facility will be accomplished promptly. The contractor will make arrangements for admission and support the Veteran with any transportation issues that may arise to address the emergency.

The Contractor shall notify the authorizing VA Liaison or designee immediately of any incidents involving Veterans residing in the Contract Emergency Residential program. The Contractor shall notify the VA Liaison by telephone during the business hours of 7:30am and 4:30 pm. For all incidents that occur after normal business hours, the Contractor should notify the VA Liaison the following business day. The Contractor shall provide the VA Liaison and the COR with a copy of the incident report within twenty-four (24) business hours. The contractor shall maintain a copy of the incident report in the Veteran s case record. Please see above in Basic Services for details regarding what constitutes Critical Incident Reporting.

CONTRACTOR STAFF CONDUCT/COMPLAINTS HANDLING: Contractor personnel shall be expected to treat referred Veterans with dignity and respect and abides by standards of conduct mirroring those prescribed by current federal personnel regulations. The contractor shall comply with the VA Patient's Bill of Rights as set forth in 38 CFR 17.34a (copy available upon request).

The VA reserves the right to exclude contractor staff members from providing services to Veterans under this contract based on breaches of conduct, including conduct that jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction, or negligence in performing directed tasks, or other conduct resulting in formal complaints by Veterans or other Staff members to designated Government representatives. The contractor and Contracting Officer s Representative 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.

BASIC RIGHTS AND PROTECTION AGAINST DISCRIMINATION: 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 protect the rights and dignity of the individual or family served in all phases of service delivery. At a minimum, providers must afford each Veteran the following rights and protections. Clients must be permitted to exercise these rights without fear of reprisal.

Veterans are entitled to enjoy a safe and healthful environment in the program.

Veterans are entitled to be treated in a manner that respects their dignity, privacy and individuality.

Veterans with disabilities are entitled to reasonable accommodations under fair housing laws when such accommodations are necessary because of their disability.

Veterans are entitled to reasonable privacy and confidential treatment of personal, social, financial, medical, and behavioral/mental health records, except as necessary to further treatment, information and referral services and in compliance with the resident s consent to release information.

Veterans are entitled to the full exercise of their civil, constitutional, and legal rights.

Veterans shall have on-going opportunities to voice opinions, to participate in program operation and programming, and to make suggestions regarding programming and rules.

Veterans rights must be protected against all forms of discrimination, including those based on race, religious creed, color, national origin, ancestry, language, disability (physical or mental health), medical condition, marital status, familial status, age, gender expression, sexual orientation, source of income, or political affiliation.

Veterans shall receive a written policy indicating that harassment of residents and staff on the basis of race, religious creed, color, national origin, ancestry, language, disability (physical or mental health), medical condition, marital status, familial status, age, gender expression, sexual orientation, source of income, or political affiliation shall not be condoned nor tolerated.

All Veterans shall have access to sleeping accommodations and bathroom facilities based on their gender of identification/expression, regardless of physical characteristics or gender conformity. People who do not clearly identify as male or female should have access to whichever sleeping and/or bathroom accommodation helps them feel safest. Where there are single-use showers and bathrooms in the facility designated for residents, transgender residents will be informed about them and welcomed, but not required to use them in lieu of shared facilities. It is the Contractors responsibility to promote a safe environment for transgender and non-binary clients amongst the general population.

Programs must post these policies in a conspicuous place and in appropriate languages. All policies and procedures will be in writing and subject to review by the VA.

REASONABLE ACCOMODATION: Contractor must respect and reasonably accommodate personal and cultural differences associated with race, religious creed, color, national origin, ancestry, language, disability (physical or mental health), medical condition, marital status, familial status, age, gender expression, sexual orientation, source of income, or political affiliation. At no point shall program access be denied because of an individual s disability. Information learned about the client s disability from the assessment will not be used as grounds for discharge or other punishment and will be used to guide client to appropriate services. Moreover, a program may not apply different rules to individuals because of their disabilities, unless the different rules are a result of granting a reasonable accommodation request made by an individual with a disability. The Contractor shall not ask questions about a client s disability, including the nature and severity of the disability or the treatment, symptoms, and medications related to the disability. A Veteran is not obligated to reveal that s/he has a disability prior to admission. Veterans with disabilities are entitled to reasonable accommodations. If a Veteran requests a change in a program s policy or procedure as an accommodation of his/her disability, the program should grant the accommodation when the accommodation is both reasonable and necessary because of the individual s disability. Such an accommodation request must be considered during any stage in the provision of a program, including at intake, during services, and during discharge proceedings. When a reasonable accommodation request is made, the program supervisor may request verification of the individual s disability. The Contractor is required to develop a written policy for their process for reasonable accommodations within thirty (30) calendar days of the award of this contract. This will include: 1) All requests for reasonable accommodation, 2) details of all steps taken to accommodate a Veteran s request for reasonable accommodation, and 3) any explanation for denial of services and/or accommodation, and 4) any appropriate referrals to Veterans who are denied accommodation. All explanations are to be written on formal letterhead from program management to the Veteran and Liaison at the time of denial for services or accommodation. Contractor will be aware that violation of the Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act and Fair Housing Laws may result in stopping admissions and/or termination of contract for convenience.

TRANSPORTATION: The Contractor shall assist with transportation for Veterans to scheduled medical, dental and mental health appointments at VA medical facilities, as related to their recuperative needs. Wheelchair transportation shall be accessible and meet the guidelines of the American with Disabilities Act (ADA). Motor vehicles used for transport shall be maintained in a safe operating condition and only drivers who are licensed and insured for the type of vehicle operated shall be permitted to transport Veterans. When clinically appropriate, contractor may arrange for ride share or public transportation services.

FACILITY: It is the responsibility of the Contractor to properly maintain its facilities and the VA shall have no responsibility for paying or reimbursing the Contractor for such expenses.

The contract facility must:

Pass VA National Fire Protection Act (NFPA) inspection within sixty (60) calendar days of the award of this contract if they have not been previously awarded a contract. Contract will be terminated for convenience if facility does not pass NFPA inspection within sixty (60) calendar days.
Have a current occupancy permit issued by the local and state governments in the jurisdiction where the facility is located.
Be in compliance with existing standards of NFPA, State and local safety codes, and/or State health and sanitation codes.
Where applicable, be licensed under state or local authority.
Where applicable, be accredited by the state.
Be equipped with operational air conditioning /heating systems
Be kept clean and free of dirt, grime, mold, or other hazardous substances and damages that could noticeably detract from the overall appearance.
Be equipped with first aid equipment and an evacuation plan in case of emergency.
Have windows and doors that can be opened and closed in accordance with manufacturer standards and have procedures for evaluation of Veterans on floors above ground level.
Have an aggressive on-going plan to address bed bug infestation. This policy must be a part of your written response to this solicitation. On-going bed bug infestation will be grounds for immediate discharge of Veterans from the facility.

The Contractor facility must meet fire safety requirements, as follows:

The building must meet the requirements of the applicable residential occupancy chapters of the current version of NFPA 101, National Fire Protection Association's Life Safety Code. Any equivalencies or variances must be approved by VAPAHCS Director
All residents in the facility must be mentally and physically capable of leaving the building, unaided, in the event of an emergency
Fire exit drills must be held at least quarterly. Residents must be instructed in evacuation procedures. A written fire plan for evacuation in the event of fire shall be developed and reviewed annually. The plan shall outline the duties, responsibilities and actions to be taken by the staff and residents in the event of a fire emergency. The plan shall be implemented during fire exit drills.
A written policy regarding tobacco smoking in the facility shall be established and enforced.
NFPA 10 Portable fire extinguishers shall be installed at the facility and NFPA will be used as guidance in selection and location requirements of fire extinguishers.
Requirements for fire protection equipment and systems shall be in accordance with NFPA 101. All fire protection systems and equipment, such as the fire alarm system, smoke detectors, and portable extinguishers, shall be inspected, tested and maintained in accordance with the applicable NFPA fire codes and the results documented.
The annual inspection by a VA team required shall include a fire and safety inspection conducted at the facility unless a review of past Department of Veterans Affairs inspections or inspections made by the local authorities indicates that a fire and safety inspection would not be necessary, in which case the fire and safety inspection may be waived by the VA.

INSPECTION OF FACILITY AND PROGRAM: Prior to the award of a contract and annually during the contract term, a multidisciplinary VA team consisting of a social worker, dietitian, a representative of the VA Police, a Facilities Management Safety Officer, Nursing, and/or other subject matter experts as determined necessary by the medical center Director, VA Liaison, or designee shall conduct a survey of the contractor s facilities. Inspections ensure that housing and services provided are in accordance with the contract, and any applicable local, state, and federal requirements. Contractors must be in compliance with VHA Directive 1162.04 and any future updates or versions of that Directive. Inspections ensure that food, shelter, and therapeutic services provided meet quality care standards in a safe environment.

Inspections may also be carried out at such other times as deemed necessary by the Department of Veterans Affairs:
Unannounced visits by the VA Liaison shall occur quarterly and will monitor the following: (1) A visual safety and sanitation inspection of the facility including meal preparation areas, fire exits, sleeping areas and medication storage. Any safety or sanitation deficiency must be addressed immediately. (2) Review of the contract provider s emergency and disaster plans to ensure they are up to date, and that staff are trained in the procedures outlined in the plans. (3) An audit of Veteran s clinical records selected randomly to ensure documentation of case management services and that other services are being provided as required by the contract terms. (4) Review of any Veteran complaints to ensure that these have been resolved in a fair, impartial and consistent manner. (5) The report and any issues that were found along with the resolution must be kept in the COR Administrative File for that program.
Unannounced nutrition inspection will occur bi-annually.
Cursory environmental reviews will occur when the VA Liaison or designee is on-site at the facility.

The Contractor will be advised of the findings of the inspection team. If deficiencies are noted during any inspection, the Contractor will be given a reasonable time (typically thirty (30) calendar days) to take corrective action and to 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 within a reasonable time will be reported 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 discontinue plans to award a contract, or to discharge or transfer patients and to terminate the existing contract, as appropriate.

The inspection of the Contractor facilities will include inspection for conformity to the current Life Safety Code and will also include the following:

General observation of residents to determine if they maintain an acceptable level of personal hygiene and grooming.
Assessment of whether the facility meets applicable fire, safety and sanitation standards.
Determining whether the facility is in attractive surroundings conducive to social interaction and the fullest development of the resident's rehabilitative potential.
Observation of facility operations to see if appropriate organized activity programs are available during working hours (including evenings) and degree to which a high level of activity is observed in the facility, such as individual professional counseling, physical activities, assistance with health and personal hygiene.
Seeking evidence of facility-community interaction, 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.
Observation of staff behavior and interaction with residents to determine if they convey an attitude of genuine concern and caring.
Inspecting the types of meals and other nutrition provided to residents to see if appetizing, nutritionally adequate meals are provided in a setting, which encourages social interaction and if nutritious snacks between meals and bedtime are available for those requiring or desiring additional food, when it is not medically contraindicated.
Making a spot check of Veterans records to ensure accuracy with respect to Veterans length of stay and services provided to the Veterans.

All Department of Veterans Affairs reports of inspection of residential facilities furnishing treatment and rehabilitation services to eligible Veterans shall, to the extent possible, be made available to all government agencies charged with the responsibility of licensing or otherwise regulating or inspecting such institutions.

EMERGENCY PROCEDURES: Contractor will train all staff on emergency procedures and have written protocols that are posted to guide staff response to crises including, but not limited to, physical injury, resident suicide attempts, overdoses, and domestic or other violence. Contractors will have at least one (1) designated paid staff on site at all times who has had training and orientation on emergency procedures. Contractor will promptly and appropriately respond to the medical/psychiatric problems of clients and staff. There will be first aid equipment and supplies for medical emergencies and natural disasters available at all times. These supplies must be checked regularly to ensure they are up-to-date and their location in the facility must be clearly marked and stored in accordance with rules and regulations. Contractor will have all emergency contact numbers posted in the milieu. In the event of an evacuation, lock-down, or shelter-in-pace order, contractor must track the location of each Veteran and report to the VA Liaison the location and status of each Veteran as soon as possible and no later than twenty-four (24) hours.

Universal precaution practices are used by Contractor to prevent transmission of diseases and are implemented under the presumption that blood and body fluids from any source are to be considered potentially infectious. Supplies necessary for maintaining universal precautions, such as sharps containers, must be available.

BILLING: 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 or supplies normally provided other residents by the facility without extra charge. Payments made by the VA under this contract shall constitute the TOTAL cost of care and housing of the homeless Veterans. Payment is authorized starting from the first (1st) day of admission and does not include the day of discharge.

The Department of Veterans Affairs (VA) will pay per diem up to a maximum of forty-eight (48) consecutive hours for the unscheduled absence or ninety-six (96) hours for the scheduled absence of a Veteran under the following conditions:

Scheduled Absences. To receive payment, the absence must:
Be pre-planned, consistent with and support the Veteran s individual service plan (e.g., family reunification, short term medical, substance use disorder (SUD) or psychiatric treatment).
Have the reason documented in the individual Veteran s case file, treatment record, or service plan.
Not result in the bed being filled by the Contractor.
Not be for a break or vacation from treatment.
Not be used for extended educational or employment circumstances.
Not be used to create more than four (4) consecutive days of absence.

Unscheduled Absences. To receive payment for an unscheduled absence:
The provider must have evidence of active outreach to locate and re-engage the Veteran and document the steps taken in the Veterans individual case file, treatment record, or service plan.
The provider may not fill the bed.
The Veteran must be discharged from the HCHV CRS program if not located within forty-eight (48) hours.

Inpatient Hospitalization. HCHV medical recuperative care or geriatric care programs also serve a specific subset of Veterans with complex needs. The per diem payment may be made to a medical recuperative or geriatric care provider if a Veteran requires inpatient medical or psychiatric treatment for a period of up to seven (7) calendar days. The provider may not fill the bed during this time and should maintain contact with the Veteran, VA Liaison, VA and VA inpatient staff if authorized.

Ineligible Veteran. When a Veteran is admitted to a HCHV CRS program and found to be ineligible for HCHV CRS, VA will pay for a maximum of four (4) calendar days from the day of admission to allow the provider and HCHV CRS Liaison time to locate and arrange alternate placement.
The Contractor will submit billing to Austin Payment Center by the seventh (7th ) of every month. Failure to make timely invoice submissions will be cause for a request for a corrective action and if invoicing issues continue to arise it will be grounds for termination for convenience.

The Contractor shall be expected to utilize sign-in/out logs for the purpose of verifying a Veteran s attendance in the program daily. These logs are to be submitted to the VA Liaison monthly, along with invoices, to ensure accuracy of billing. All absences will be clearly documented on the monthly attendance log including reason for any excused absence (e.g. medical needs). No payment will be made without the daily sign-in logs/ bed roster to be verified by VA Staff.

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