G--HCHV COTNRACT REQUIREMENT BASE YEAR WITH FOUR (4) ONE (1) YEAR OPTIONS

STATEMENT OF WORK BACKGROUND The Cincinnati Veterans Affairs Medical Center (VAMC) anticipates award of a FIRM FIXED PRICE contract, based on the contents of this solicitation. The goal of this Health Care for Homeless Veterans (HCHV) contract is to remove homeless Veterans from the street or places unfit for human habitation and place them in community-based, residential environments. Through HCHV, VA provides case management and outreach services to Veterans and facilitates their access to a broad range of medical, mental health, and rehabilitative services. The Cincinnati VAMC provides diagnostic and therapeutic services in medicine, surgery, rehabilitation medicine, psychiatry, and skilled nursing home care. This facility also provides homeless services to those men and women Veterans requiring a transition program to aid homeless Veterans. The contractor shall furnish transitional housing for the beneficiaries of the Cincinnati VAMC. Temporary/Emergency Residential Shelter. Provide housing, to include, but not necessarily limited to, beds, restroom, bath and kitchen facilities, and related furnishings. Contractor to provide personal hygiene items, first aid supplies, and laundry detergent. The contractor shall provide services to beneficiaries specifically authorized by the Cincinnati VAMC. The contractor shall also allow a legal spouse, parent of the Veterans minor children, and minor children to inhabit the living area. Each opposite sex family member over the age of 12 shall be provided a private bedroom in the apartment (NOTE: The Cincinnati VAMC shall pay only for the VETERAN, i.e. the per diem will be the same for an individual Veteran as for a spouse/family). The contractor shall provide a minimum of 6 bedrooms, with capacity of at least 12 bedrooms. The vendor must be able to accommodate both male and female Veterans. Except in the case of spouses and families as previously defined, opposite sex clients shall not be housed in the same apartment. The contractor shall provide services to the HCHV program in accordance with all terms and conditions, provisions and requirements listed herein for the sum quoted. This rate is inclusive of all services as may be necessary in the treatment of the patient. Unless specifically excluded in this contract, the per diem rate established will include the services listed in this document. It is understood that the type of patients to be cared for under this contract will normally require care and services over and above the level of room and board as listed in the REQUIREMENTS section of this document. The facility will not be used for detoxification or other hospital level treatment; VAMC will serve as treatment center. REQUIREMENTS The following categories outline the minimum requirements necessary for this contract. Unless otherwise noted, no additional charge shall be made for providing these services. 1) Room and Board: a) Bedroom (1) Uniquely keyed, deadbolt door lock for each bedroom (2) Full size bed or larger (3) Dresser measuring at least 30" X 48" X 12" (4) 1 fitted sheet, 1 flat sheet, 1 blanket, and 2 pillows with pillow cases b) Common Living Room / Dining Room (1) A color television of at least 19" (2) Telephone with ability to place local calls (3) Couch that seats at least 3 (4) A dining table with 4 chairs c) Kitchen and Other Shared Areas (1) Gas or electric range stove and oven (2) Refrigerator and Freezer combination (3) Microwave (4) Minimum other required supplies: Description Quantity Non-disposable Dinner Forks 4 Non-disposable Teaspoons 4 Non-disposable Tablespoons 4 Non-disposable Serrated Knives 4 Large Serving Spoons 2 Metal Spatula 1 Microwavable Cereal Bowl 4 Microwavable Coffee Cups 4 Water Glasses 4 Microwaveable Dinner Plates 4 10" Frying Pan 1 /= 2.5 quarts 1 Baking Sheet / Pizza Pan 1 Casserole Dish >/= 2 quarts 1 Oven Mitts 2 Vacuum Cleaner 1 Broom 1 Dust Pan 1 Mop 1 Mop Bucket 1 Dish Soap 1 Floor Cleaner 1 Dish Towels 2 Dish Drying Rack 1 Dish Cloths 2 All purpose kitchen / bathroom disinfectant 1 d) Bathroom (1) Tub and shower combination (2) Sink with a wall mounted mirror above it (3) At least 2 bath towels and 2 washcloths (4) Toilet and toilet paper (5) Minimum other required supplies Personal Hygiene Shampoo At least 1 Toothbrush 1 / admission / Authorized Veteran Deodorant 1/ admission / Authorized Veteran Toothpaste 1/ admission / Authorized Veteran Bar Soap 1/ admission / Authorized Veteran Disposable Razors 2 / week / Authorized Veteran e) Grocery Allowance (1) $50 per week grocery allowance for each authorized Veteran (included in per diem). (2) Each authorized Veteran shall be transported by the contractor at least weekly to a grocery store to purchase groceries. (a) The Veteran shall be provided with adequate food as directed by the COTR or designee immediately upon admission. The Veteran shall also be taken to the grocery store within 24 hours of admission. f) Shared Laundry (1) A laundry facility to include at least 1 washer and 1 dryer shall be provided on-site for each building. (2) Laundry service to include water, electricity, etc., shall be provided at no cost to authorized Veterans. (a) Laundry detergent shall be provided for each authorized Veteran free of charge and shall not be deducted from the grocery allowance. 2) Program Management a) Services determined to be needed by the individual patient in a plan developed by the contractor with input from the patient and the VAMC HCHV case manager. b) The authorized Veteran shall maintain possession of medications for themselves and their family, as applicable. c) Medication shall be taken through client self-administration. d) Each living unit shall be cleaned and re-stocked for new occupancy within 24 hours of discharge. e) Each living unit shall be maintained in a fully liveable and operable condition. Should any damage or malfunction occur in the unit, the COTR or designee shall be notified immediately. The COTR or designee shall provide direction on an acceptable time-frame for repair and/or replacement. f) If supportive social services are offered, they shall be coordinated with the HCHV case managers. g) The contractor shall assist with arranging transportation for VA Medical Center and other appointments. (1) If the contractor is uncertain about granting requests for travel, the contractor shall contact the assigned HCHV case manager and the case manager will provide guidance. (2) The contractor is expected to provide $100 per Veteran each month in direct transportation assistance (included in per diem) . This shall be provided in the form of a bus token, bus card, taxi fare, gas card or other approved means as approved by the COTR. The COTR may waive this requirement for the Veteran in writing. This shall be immediately available as requested by the Veteran upon admission. h) The contractor shall employ sufficient professional staff and other personnel to carry out the policies and procedures of the program. There will be at a minimum, staff available off-site for emergencies, 24 hours a day, 7 days a week. i) Pre-treatment orientation for Veterans and family that are referred from Cincinnati VAMC. Each Veteran referred to contractor is provided upon admission handbook of rights. j) The contract facility must have a current occupancy permit or license required by the authority having jurisdiction. Unless specifically excluded in this contract, the per diem rate established will include the services listed in the document and will also include all services normally provided other patients by the facility without extra charge. REFERRALS 1) Personnel authorized by the VAMC to order service shall make requests for service via telephone. 2) Orders, requests, and changes shall only be made by the HCHV Coordinator. 3) A list of authorized ordering personnel shall be made available upon award of the contract. Employees may be added or deleted from the list during the term of the contract at the discretion of VAMC. The Service Provider shall be notified to such changes as they occur. ABSENCES AND CANCELLATION 1) The contractor shall notify VAMC of absences from the facility. Absences of the patient from the facility in excess of forty-eight (48) hours will not be reimbursable except with the prior approval of the VAMC coordinator. Should a patient absent himself/herself in an unauthorized manner payment for services for that veteran to the contract facility would be continued for a maximum period of two days provided there is an active outreach attempt on the part of the contract facility staff to return the veteran to the residential treatment program and a strong likelihood that the patient will return. 2) It is understood that the beneficiary may be provided facility care at the contracted amount for a period not to exceed the stated length of treatment plan contracted (generally sixty days), unless an extension of the authorization is provided in writing by the VAMC. 3) VAMC reserves the right to remove any or all patients from the facility at any time without additional cost, when it is determined to be in the best interest of the VAMC or the patient. CONDUCT The Contractor shall make available to the VA, documentation deemed necessary by the VA to conduct utilization review audits to verify quality of patient care for Veterans, to assure confidentiality of care for veterans, to assure confidentiality of patient record information, and to determine the completeness and accuracy of financial records. This may include but is not limited to case notes, sign in/sign out documents, billing records, program rules for patient rights and responsibilities, program policies or standards of practice. The contractor shall conduct treatment and discharge planning reflecting a team assessment of health, social and vocational needs and the involvement of resident and appropriate community resources in resolving problems and setting goals. The contractor shall notify VAMC immediately when a medical emergency occurs requiring re-hospitalization of a patient receiving care at VA expense. It is agreed that the veteran will be readmitted to the appropriate VA facility. When such readmission is not feasible because of the nature of the emergency, it is agreed that hospitalization in a non-federal hospital may be accomplished provided the VAMC authorization is obtained. If hospitalization of a non-emergency nature is required it is agreed that readmission to the VAMC will be accomplished promptly. COMPLAINTS HANDLING The Contracting Officer's Technical Representative (COTR) shall monitor the service provided. Contractor shall cooperate with the COTR in providing information and answering questions in a timely manner when requested. Contractor shall refer complaints received directly from the customer(s) to the COTR. All complaints received by the COTR and forwarded to the Contractor shall be investigated promptly. After investigation and disposition, Contractor shall respond to the COTR within five (5) working days after receipt by the Contractor. FACILITY Facility shall be inspected by VA personnel prior to award and annually thereafter. Facility shall be equipped with operational air conditioning /heating systems. Facility shall be kept clean free of dirt, grime, mold, or other hazardous substances and damaged noticeably detract from the overall appearance. Facility shall be inspected and treated for insects and pests on a quarterly basis. If concerns regarding pest and insect control arise more frequently, the vendor shall communicate these to the COTR or designee. The COTR or designee may request additional inspection(s) and/or treatment(s). Facility shall be equipped with first aid kid, fire extinguisher fully charged non-expired, fire/carbon alarms, evacuation plan in case of emergency. Facility shall have windows and doors that can be opened and closed in accordance with manufacturer standards. VAMC will not incur any cost associated with the contractor providing inadequate or faulty equipment. Facility shall be located in Hamilton County, Ohio, USA. POLICY 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. The facility agrees to accept referral of and to provide all services specified in this contract for any person determined eligible by VAMC, regardless of race, color, religion, sex or national origin of persons for whom such services are ordered. In addition the facility warrants that subcontracting will not be resorted to as a means of circumventing this provision. It is agreed that VAMC readily has access to all records concerning the Veteran's care in the facility. It is agreed that duly authorized representatives of the 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 facility in any way of the responsibility for the daily care and treatment of the Veteran. Upon discharge or death of the patient, records on all VAMC beneficiaries will be retained by the facility for a period of at least three years (or such other length of time as defined from time to time by VAMC) following termination of care. The facility will not accept food stamps or welfare from Veterans. The facility warrants that all applicable fire laws are being complied with and there are no recommendations of fire officials, which have not been resolved. The Contractor shall comply with the VA Patient's Bill of Rights as set forth in Section 17.33, Title 38, Code of Federal Regulations. (copy is available upon request). The VAMC case manager/treatment teams, in collaboration with the existing community homeless care task force workers, shall identify and refer all appropriate patients to the contractor. Before referring any patient, the VAMC shall have provided the contracted agency with a Cincinnati VAMC approved, signed Release of Information (ROI) from the veteran patient as well as that veteran's clinical assessment, physical and laboratory studies, and confirmation of chronic mental illness by a VA staff. Veterans served through VA's HCHV residential contract/emergency housing program must have client level data entered into the local community Continuum of Care's (CoC) HMIS. Data entered must include, at a minimum, the Universal Data Elements from the 2010 HMIS Data Standards. INSPECTION AND ACCEPTANCE It is agreed that the Veterans Affairs will have right to inspection of the residential treatment center and all appurtenances by an authorized representative(s) designated by the Veterans Affairs. Prior to the award of a contract, a multidisciplinary Veterans Affairs team consisting of a social worker, dietitian, registered nurse, and an engineering service 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 services in a supportive environment. 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. 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 through the Medical Center Director. 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 patients and to terminate the contract. Subsequent inspections of the residential treatment center must be made annually by a multidisciplinary team including such VAMC Medical Center personnel as the Director considers 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. SAFETY The COTR will inspect the facility for conformity to the current Life Safety Code and submit his/her findings to the multidisciplinary team The inspection will focus on an assessment of the quality of life within the residential treatment facilities, giving particular attention to the following factors: a. General observation of residents indicates that they maintain an acceptable level of personal hygiene and grooming. b. The facility meets applicable fire, safety and sanitation standards in attractive surroundings conducive to social interaction and the fullest development of the residents' rehabilitative potential. c. The facility should be in a central location, near public transportation, and near areas, which provide employment. d. The facility shall be located in Hamilton County, Ohio, USA. e. 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. f. Staff behavior and interaction with residents convey an attitude of genuine concern and caring. g. Appetizing, nutritionally adequate meals are either provided and nutritious snacks between meals and bedtime are available for those requiring or desiring additional food, when it is not medically contraindicated or a fully operational kitchen and groceries are available for the resident to cook their own meals. The addition of nutritious snacks to the requirements for room and board is particularly indicated for homeless 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 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 patients' satisfaction with meals and the actual consumption of food offered. PAYMENTS a. Payment to the Contractor shall be made monthly, in arrears, per patient upon receipt of a properly prepared invoice. Payment for any leave, including sick leave, holiday, or vacation time, shall be the responsibility of the Contractor. VA will pay only for "fixed daily charge". b. Contractor employee(s) shall be actually performing the services specified in the contract in order to receive reimbursement. c. The Department of Veterans Affairs Financial Service Center (FSC) is the designated agency office for invoice receipt in accordance with the Prompt Payment Act (5 CFR Part 1315). FSC or its designated representative may contact the vendor to provide specific instructions for electronic submission of invoices. The vendor shall be responsible for any associated expenses. FSC may utilize third-party Contractors to facilitate invoice processing. Prior to contact by FSC or its designated representative for electronic invoicing submissions, the vendor shall continue to submit all invoices to FSC at the mailing address below: Payment Address: Department of Veterans Affairs Financial Services Center P.O. Box 149971 Austin, TX 78714-8971 d. Billings rendered by the Contractor to the Program Office for services furnished under the terms of this contract shall be billings in full. Neither the beneficiary his insurer, nor any third party shall be billed. NOTE: Invoices for payment may be rejected if all information required by FAR Clause 52.212-4(g) is not included. Invoices shall include the following information to be considered valid for payment. Invoices without the required information will be returned: Vendor name, invoice number and date Complete purchase order number assigned by the VA facility Name of provider, number of patient days "fixed daily charge". Total dollar amount of invoice