This is a SOURCES SOUGHT ANNOUNCEMENT ONLY. The purpose of this Sources Sought announcement is for market research to make appropriate acquisition decisions. It is neither a solicitation announcement nor a request for proposals or quotes. The Government is not obligated to nor will it pay for or reimburse any costs associated with responding to this Sources Sought synopsis request. This notice shall not be construed as a commitment by the Government to issue a solicitation or ultimately award of a contract, nor does it restrict the Government to a particular acquisition approach. Any inquiries are to be made in writing by email to the point of contact, Stephanie Martin, Contract Specialist. Responses to this notice shall be sent by email to [email protected] by the due date and time of 03-02-2021 by 4:30 p.m. PST. Description of requirement and submittal requirements are below. Description: The Contractor shall provide HCHV-CERS Residential Treatment services to VA beneficiaries (homeless veterans) for whom such care is specifically authorized by the San Francisco VA Medical Center. All performance shall be in accordance with the Performance Work Statement (PWS). Period of Performance: Tentative dates of 06-01-2021 through 05-31-2026 The Government requests capability statements, pricing, and comments from interested businesses regarding the requirements described above. Responsible sources are encouraged to submit a response to this notice with a statement of interest on company letterhead. At a minimum, the following information shall be provided: Company Name; Company Mailing Address; Point(s) of Contact including telephone number(s) & email address(es); Socio-Economic (i.e. Small/Large Business, HUBZone, Service-Disabled Veteran Owned, 8(a), etc.) as it relates to NAICS Code 624221 DUNS Number Additional information and/or comments. 2 Schedule of Services CLIN Description Qty Unit Total Unit Total Cost 1001 Provide 15 beds per day to homeless veterans in the San Francisco, CA catchment area (15 Beds x 365 Day = 5475 ) 5,475 DY           Total for Ordering Period One:   CLIN Description Qty Unit Total Unit Total Cost 2001 Provide 15 beds per day to homeless veterans in the San Francisco, CA catchment area (15 Beds x 365 Day = 5475) 5,475 DY           Total for Ordering Period Two:   CLIN Description Qty Unit Total Unit Total Cost 3001 Provide 15 beds per day to homeless veterans in the San Francisco, CA catchment area (15 Beds x 366 Day = 5490) 5,490 DY           Total for Ordering Period Three:   CLIN Description Qty Unit Total Cost Total Cost 4001 Provide 15 beds per day to homeless veterans in the San Francisco, CA catchment area (15 Beds x 365 Day = 5475) 5,475 DY           Total for Ordering Period Four:   CLIN Description Qty Unit Total Unit Total Cost 5001 Provide 15 beds per day to homeless veterans in the San Francisco, CA catchment area (15 Beds x 365 Day = 5475) 5,475 DY         Total for Ordering Period Five:         Grand Total for All Ordering Periods :   SAN FRANCISCO VA HEALTH CARE SYSTEM HEALTH CARE FOR HOMELESS VETERANS (HCHV) CONTRACTED EMERGENCY RESIDENTIAL SERVICES (CERS) RESIDENTIAL TREATMENT BACKGROUND Ending homelessness among Veterans by 2015 was established as a national priority by the Department of Veterans Affairs Secretary, Eric Shinseki, in November 2009 at the National Summit on Ending Veterans Homelessness. In June 2010, the U.S. Interagency Council on Homelessness (USICH) released Opening Doors: Federal Strategic Plan to Prevent and End Homelessness, which is fully aligned with this goal. Eliminating Veteran Homelessness remains one of three Agency Priority Goals for 2014-2015 in VA s 2014-2020 Strategic Plan. 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 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. PROGRAM DESCRIPTION DRAFT The HCHV CERS Program exists to provide a means of removing homeless Veterans from the street or habitation unfit for humans and placing them in community-based, residential environments with sufficient supportive services to meet their basic needs and ultimately, facilitate the improvement of their overall health status and housing situation. HCHV CERS Program characteristics: Targets and prioritizes homeless Veterans who are eligible for VA health care, and are transitioning from chronic literal street homelessness, Veterans being discharged from institutions (including those being discharged from psychiatric inpatient care settings), and Veterans who recently became homeless and require safe and stable living arrangements while they seek permanent housing Seeks to reduce barriers to immediate placement Does not require any length of sobriety or abstinence from alcohol or other drugs as a condition of admission Provides safe, secure housing as well as supportive services Lengths of Stay typically range from 30 to 90 days with the option to extend based on clinical need. Veterans are expected to meaningfully engage their case managers and available Programming Emphasis is placed on achieving placement in permanent housing or longer-term residential programs that offer paths to increased housing stabilization at the time of program exit and reducing negative exits due to rule violations or other avoidable circumstances. House Rules and ExpectationsDRAFT Rules focus on staff and resident safety: No buying or selling of alcohol or drugs in the facility No dealing or use of illicit drugs in the facility No sexual activity between residents No violence or threats of violence Honor nightly curfew When possible, infractions are to be used to engage residents, not simply as grounds for service termination. Negative discharges will be monitored as a measure of program quality. Veterans are expected to engage programming and maintain communication with case managers at all times around matters relating to admission, stay, and treatment Admission Practices Staff will assist residents with admission forms and eligibility determination with VA Facility works to reduce barriers to admission: Accepts referrals throughout day if possible Flexibility with admission processes Admission Criteria Homeless Veteran Eligible for VA Health Care Overview of Types of Services Available to Residents Safe, Secure housing (includes laundry and restroom facilities) Three daily nutritious meals Case Management and Care Coordination Services Vocational Services Benefits Services Enhancement of Independent Living Skills Permanent/ Transitional housing search support Support for mental health stabilization Substance Use Disorder treatment services PERFORMANCE WORK STATEMENT OBJECTIVE The Contractor shall provide residential treatment services for homeless Veterans in accordance with the HCHV CERS model requirements. Services are expected to involve a 24-hour-a-day/7-days-a-week therapeutic community and evidence-based recovery program offering supportive, secure housing to homeless Veterans, many of whom may also be dealing with mental illness and/or substance use disorders. The program places an expectation on the Veteran to engage in supportive case management services and recommended treatment and on the Contractor to provide expertise and guidance towards improving housing stability and addressing individual factors contributing to each Veteran s homelessness to ensure their transition from homelessness to permanent, stable housing and encourage ongoing engagement with aftercare and relapse prevention services upon discharge. Contractors must comply with all HCHV CERS requirements as identified below. HCHV CERS PROVIDER QUALIFICATIONS & CAPABILITY REQUIREMENTS DRAFT Capable of performing outreach or otherwise identifying and referring to the contract program homeless Veterans with mental illness and/or substance use disorders and a desire to pursue recovery by entering a residential treatment program; Capable of providing secure, separate housing and bathroom accommodations for males and females; common use of kitchen facilities and dining rooms is acceptable; Capable of providing services twenty-four (24) hours a day for Veteran placements lasting up to ninety (90) days per Veteran. Extensions beyond initial ninety (90) days should be authorized in writing by VA Liaison; extensions beyond six (6) months must be prior- approved by the Social Work Service Contract Coordinator/ COR; Capable of providing three daily nutritious meals and reasonable accommodation for special dietary needs; Capable of offering a means for clients to wash their own clothes or otherwise tend to laundry; Capable of providing secure, appropriate storage for both Veteran belongings and medication; Capable of providing quality case management and treatment services that utilize a Recovery Model approach that includes elements of motivational interviewing, harm reduction, and critical time intervention; Capable of maintaining a minimum of one staff member on site at all times to ensure appropriate response to matters involving Veteran safety; Capable of providing a working phone line and ensuring reasonably prompt communication with the VA is possible at all times; DIRECT VETERAN CLINICAL SERVICES: 60% of time involves direct service to Veterans Occupancy: The Contractor will be responsible for ensuring that a minimally acceptable level of 80% occupancy of HCHV CERS funded beds is maintained at all times through independent outreach efforts as well as by collaboration with VA. C.3.2 Care Planning: Contractor will engage the Veteran in a collaborative assessment of needs, including barriers to stable housing, and create an initial plan of care to address those concerns within 14 days of admission. This plan is to be updated as needed throughout the Veteran s episode of care. DRAFT Case Management: Contractor will provide individual case management meetings at least three (3) times per month (preferably once per week) that focus, at a minimum, on: housing search and stabilization, increasing income, any necessary coordination of ongoing participation in care provided by VA/community medical and/or mental health care providers, and ongoing discharge planning. Medication Monitoring: Contractor is expected to provide a means of securely and properly storing all medications brought into the program for Veteran use. Contractor shall ensure there are appropriate policies and procedures that support the safe storage of medications for Veteran participants. This storage can be provided to the Veteran to secure his or her medications, or central storage may be provided by the Contractor. Veterans may self-administer medications, but storage should ensure that no other program participants are able to access an individual Veteran s medications. Any suspicion or concern for misuse is to be reported to VA Liaison and/or COR immediately by following incident reporting protocol. Exits to Independent Housing: The Contractor is expected to promote a focus on achieving stable, permanent housing for all Veterans referred for care; exits to permanent housing will be monitored as an indicator of overall program quality utilizing data provided by the VHA Support Service Center s Homeless Service Scorecard. The target values for exits to this type of housing are established by VHA Homeless Program Office on an annual basis at the start of each fiscal year (e.g., FY20 target value for Exits to Permanent Housing is 55% or more) and can vary from year to year. Target values for Exits to Permanent Housing will be communicated by VA HCHV Liaison and/or COR to Contractor at the start of each fiscal year. Negative Exits: The Contractor is expected to facilitate Veteran completion of the HCHV CERS Program to the maximum extent possible, while still maintaining program integrity and safety; Negative Exits, which shall be defined as discharges involving Veterans being asked to leave the program due to rule violation or otherwise leaving the program without consulting program staff in any way, shall be monitored on a continuous basis utilizing data provided by the VHA Support Service Center s Homeless Service Scorecard. The target values for Negative Exits are established by VHA Homeless Program Office on an annual basis at the start of each fiscal year (e.g., FY20 target value for Negative Exits is 20% or less) and can vary from year to year. Target values for Negative Exits will be communicated by VA HCHV Liaison and/or COR to Contractor at the start of each fiscal year. DRAFT C3.7. Mental Health and Substance Use Disorder Treatment: Contractor will be expected to provide evidence-based practices that support the Veteran in gaining and applying knowledge of the recovery process to his/her life using a Harm Reduction approach and to provide referral for additional treatment and/or aftercare supports as needed to promote and facilitate the Veteran s recovery efforts and successful exit to permanent housing. ADMINISTRATIVE SERVICES: 40% of time does not involve direct service to Veterans Determination of Eligibility, Referrals and Admissions: VA is responsible for determining Veteran eligibility for placement in program prior to admission by the Contractor for services. The Contractor is responsible for obtaining confirmation of Veteran eligibility for placement into program prior to admission of each Veteran referred under this contract. To be eligible for HCHV Contracted Residential Services, all Veterans must meet the requirements of 38 U.S.C. 2031(a) and 38 CRF 63.3, i.e., Veterans in this program must be homeless or at imminent risk of homelessness within 14 days of application for services and be eligible and registered for VA health care at SFVAHCS. Failure to establish eligibility prior to admission may result in denial of payment for services provided to ineligible Veterans. A list of authorized VA ordering personnel including primary identified VA Liaison shall be made available to Contractor upon award of the contract. VA employees may be added or deleted from this list during the term of the contract at the discretion of VA. Contractor shall not deviate from the list of individuals authorized to approve admissions without an updated list. Referral constitutes authorization of an initial service period of up to 90 days (unless otherwise specified). Release of Information: Contractor shall ensure that a signed VA Release of Information (ROI) (VA Form 10-5345) is obtained for any Veteran being admitted to the contract program and placed into the individual Veteran s case record. It is essential that Veterans permit communication between VA and Contractor through an appropriate ROI to ensure safe and effective treatment of each Veteran. Veterans who refuse to allow this communication about their treatment needs and ongoing care will need to receive services elsewhere. DRAFT Individual Case Records: The Contractor will maintain an individual case record for each referred Veteran. Case records must be maintained in security and confidence as required by the Confidentiality of Alcohol and Drug Abuse Patient Records (42 CFR part II) and the Confidentiality of Certain Medical Records (38 USC 7332), and in accordance with the Health Insurance Portability and Accountability Act (HIPAA: Pub. Law. 104 191). Records should contain at a minimum: Reason for referral; pertinent demographic information; copies of any medical prescriptions/orders issued by physicians; case management/treatment notes; any critical incident reports; a final summary that include reason(s) for leaving, the Veteran s known future plans, and follow-up locator information, if available; and any and all information needed to meet clinical requirements of annual HCHV Residential Services Program inspections. Homeless Management Information System (HMIS) Data Reporting: Veterans served through VA s HCHV CERS 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. Daily Census Sign-In Sheet: The Contractor is responsible for collecting Veteran participant signatures on a daily census sign-in sheet to verify attendance in the program. This information is to be provided to the VA Liaison, COR, or other designee at a frequency to be designated by VA that is no less than once weekly and up to daily with weekend or holiday sign-in sheets to be provided on the next business day in order to ensure effective monitoring of bed utilization. Incident Reporting: The Contractor shall notify the VA immediately when any adverse critical incident involving a Veteran admitted to the program occurs. Critical Incidents shall include: Falls Elderly/Dependent Adult Abuse or Neglect Sexual Assault Fire (Veteran Involved) Medical or Mental Health Emergency (911 Calls) Hospitalization Suicidal ideation or suicide attempt Homicidal ideation Physical Assault (involving Veteran participants and/or other program participants/staff) Observation/ Possession of Weapons Infectious Disease Control Concerns (e.g., Bed Bugs, TB, Scabies, Norovirus) Active Substance Use Death During regular business hours, VA Liaison, HCHV Coordinator/Supervisor and/or COR shall be contacted immediately by phone to report such an incident; if the incident occurs outside of regular business hours (Monday-Friday 8:00AM-4:30PM), Contractor shall notify VA Liaison, HCHV Coordinator/Supervisor and/or COR at the start of the following business day. Should Contractor require immediate after-hours VA support/intervention, Contractor shall notify the SFVAHCS Administrator on Duty (AOD) by calling the local VA facility. A written report to the VA Liaison and/or COR should follow the initial VA notification within 24 business hours. The report should list known precipitating factors or triggers. Contractor shall maintain a copy of all critical incident reports in the involved Veteran s individual case record. DRAFT Extension Requests: It is understood that Contractor will not be paid for care provided to a Veteran participant beyond the initial authorized period unless an extension of authorization is provided in writing by the VA. Contractor is responsible for ensuring that all requests for extension of services beyond the initially authorized service period of 90 days are reviewed in advance and approved in writing by the VA Liaison, COR, or other designee before reaching the Veteran participant s 90th day. Extension requests must include clinical reasoning and a targeted housing plan to justify approval; extension requests will be individualized to Veteran needs and approved in writing increments of no more than 30 days at a time. Only extraordinary circumstances will be considered in order to extend service periods in excess of six (6) months, and all requests for extension exceeding six (6) months from date of admission must be approved in writing by VA Liaison and COR or designee. Contractor shall be available to complete VA extension approvals through CHANGES system as needed without interruption to Veteran care and within one business day of VA correspondence related to extension authorization. Satisfaction Surveys: When requested, the Contractor will be responsible for administering, collecting, and delivering to VA Liaison a survey of the Veterans experience in the program. This survey will be the primary tool for reporting Veteran satisfaction data in VA specialized homeless programs; it is to be administered to and collected from any Veterans who have resided in the program for at least thirty (30) days. Admission and Discharge Reporting: The Contractor is responsible for notifying the identified VA Liaison (or designee) within 24 business hours that an admission or discharge has occurred and for providing a written report of admission or discharge within 48 business hours that contains the specific data required by the Northeast Program Evaluation Center (NEPEC) for documentation in the Homeless Operations and Management Evaluation System (HOMES). The written report of discharge shall also contain a brief discharge summary that includes but is not limited to: date of exit, type of exit (positive vs. negative), Veteran s perception of exit and agreement with exit, status of treatment goals at time of exit, aftercare plan, Veteran s agreement with aftercare plan, housing status at exit and future contact information. Absences and Cancellation: Contractor shall notify VA Liaison, COR or designee immediately or during the next available business hours of all Veteran absences from the facility. Absences of Veteran from the facility in excess of 48 consecutive hours will not be reimbursed except those with prior approval of VA Liaison, COR or designee. DRAFT Should an enrolled Veteran 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 consecutive days provided there is a documented 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 Veteran will return. Management of Negative Exits will be an element of quality assurance review of this program. Contractor may consider providing an authorized absence (or pass ) for purposes that are expected to further the recovery goals of a Veteran, e.g., job-related absences, family visits, housing searches, medical. All requests for passes must be documented in writing in the Veteran s individual case record. Contractor shall notify VA Liaison, COR or designee in writing of all Veteran requests for passes prior to start, preferably 24-48 hours, of any absence from program authorized by Contractor and include reason for pass and contact/location information while Veteran is absent. Authorized absences shall not exceed 48 hours in any given month for any single Veteran unless otherwise approved by Contractor and VA Liaison, COR, or designee. Payment will not be made for absences over 48 hours. Contractor can maintain enrollment of a Veteran without payment beyond the approved 48-hour absence at Contractor s discretion and in consultation with VA Liaison, COR or designee. However, the Veteran must be discharged if absent for more than 14 days. Contractor cannot receive payment of per diem while Veteran is placed in another VA-contracted bed such as detox. 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 Veteran or VA. Contractor shall issue late passes for Veteran participants to enter program site after standard curfew time if/when Contractor and/or VA determines that a late pass is indicated. Indication for late pass issuance may include but is not limited to alternative work schedules or returns from medical appointments, procedures, or emergency/inpatient admissions. If a Veteran returns to program past curfew without a late pass, Contractor shall allow Veteran to enter program after curfew for the night and shall not use curfew immediately and automatically as grounds for service suspension ( overnight outs ) or termination but as a means for clinical engagement. DELIVERABLES Reserved STAFFING AND SERVICE PLAN: The Contractor shall provide a detailed staffing and service plan. Plan should demonstrate that sufficient professional personnel are employed to carry out the policies, responsibilities, and services required under this contract. The Contractor must identify each person functioning as Key Personnel under this contract and provide the VA with a description of the services to be provided by each person. The Contractor shall assign to this contract personnel that by education and/or training (and, when required, certification or licensure) are qualified to provide the services required by this PWS. Contractor may be required to supply a resume(s) summarizing relevant skills and experience of any/all key personnel upon request. Minimum Key Personnel requirements are as follows: DRAFT One administrative staff member, or designee of equivalent professional capability (with the authority to make decisions regarding the facility and residents, or with contact information for an offsite administrator in case of emergency), on duty on the premises or providing awake supervision of residents and staff 24 hours a day, 7 days a week. One professionally credentialed clinical supervisor full-time onsite to provide treatment and clinical services. Sufficient case management/counseling personnel to maintain the therapeutic milieu and provide direct services to Veterans residents. VA recommends staffing ratio of a minimum of one full-time dedicated case manager per 20 Veterans. Exceptions may be granted in writing by VA. Case managers must have sufficient training and experience working with individuals experiencing homelessness; training and experience working with individuals who have chronic medical, mental health and/or substance use problems is highly desirable. Staff working with Veteran participants shall be able to assess, anticipate, and effectively refer Veterans experiencing crises for additional support when needed. At least one staff or security member with CPR certification on site and available in an emergency during each shift, 24 hours per day. The Contractor shall provide resumes for any proposed substitutions of Key Personnel, at least 15 days prior to proposed date of substitution. The Contracting Officer shall notify the Contractor within fifteen (15) calendar days after receipt of all required information if the VA is able to accept the proposed substitute Key Personnel. Temporary substitutions of Key Personnel shall be permitted in accordance with the Contractor s contingency plan. The Contractor s contingency plan to be utilized if personnel leave Contractor s employment or are unable to continue performance in accordance with the terms and conditions of the resulting contract should be submitted to CO as a part of proposal package. The CO is the ultimate authority on acceptable length for temporary substitution of key personnel. The VA reserves the right to refuse or revoke acceptance of any Key Personnel if personal or professional conduct, or lack of required skills or experience, jeopardizes patient care or interferes with the regular and ordinary operation of the facility and the HCHV CERS Program. DRAFT DOCUMENTATION OF SUPPORTIVE SERVICES: The Contractor shall provide written documentation constituted by the individual Veteran case record that verifies the provision of all supportive services required under this contract for each Veteran participant. CARE PLAN: The written plan of care shall be completed and entered into the individual Veteran case record no later than day 14 days after being admitted to the program. CRITICAL INCIDENT REPORTS: Written critical incident reports must be submitted to the VA Liaison within 24 business hours (VA Liaison/COR to be notified immediately or as soon as possible at start of following business day when incidents occur; AOD to be contacted if immediate VA intervention/support is needed afterhours). EXTENSION REQUESTS: Written requests for extension are due prior to the 90th day when it is anticipated the Veteran will require additional time beyond the initially authorized service period, and prior to the expiration of the initial and any and all subsequent future extension authorizations. ADMISSION AND DISCHARGE REPORTS: The HOMES Entry and Exit forms and the brief discharge summary shall be completed and submitted to the VA Liaison and/or COR or designee within 48 business hours of admission or discharge (VA Liaison to be notified within 24 business hours of admission or discharge). SATISFACTION SURVEYS: When Veteran participant surveys/questionnaires (e.g., uSPEQ, Chaleng) are provided by VA to the Contractor to give to Veterans, completed surveys are to be returned to VA Liaison at the end of each designated survey month. DAILY CENSUS SIGN-IN SHEET: The daily census sign-in sheet shall be provided to the VA Liaison, COR and/or designee at a frequency designated by VA that is no less than once weekly and up to daily with weekend or holiday sign-in sheets to be provided on the next business day. NOTIFICATION OF ABSENCES: Contractor shall notify VA Liaison, COR or designee immediately or during next available business hours of all unauthorized Veteran absences from the Contractor facility. Contractor shall notify VA Liaison, COR, or designee in writing of all Veteran requests for passes prior to start, preferably 24-48 hours, of any absence from program authorized by Contractor. DRAFT INVOICES: Unless specifically excluded in this contract, the per diem rate established will include all services listed in this document and all services or supplies normally provided to other residents of the facility at no extra charge. Payments made by VA under this contract shall constitute total cost of care and housing for the homeless Veterans enrolled in this program. The monthly invoice is computed at the per diem rate multiplied by the total number of beds occupied by Veterans at midnight each night of the given month and does not include day of discharge. Invoices shall first be submitted to the VA Liaison, COR, or designee for approval by the 5th of the month immediately following the billing period in question. Once approved, invoices are to be submitted through the Tungsten Network (Electronic Invoicing System) by the 10th of the month immediately following the billing period in question; all electronic invoices submitted shall be accompanied by the invoice pre-approved by VA Liaison, COR, or designee for reference of the certifying official. (For additional information, Reference: VAAR 852.273-72 Electronic Submission of Payments pg. 23. and FAR 52.232-33 Payments by Electronic Funds Transfer System for Award Management pg.27.). QUARTERLY PERFORMANCE REPORT: Upon request, the Contractor shall provide the COR with a written report detailing program data and activities on a quarterly basis. The report should contain, at minimum, the following information: Total Number of Veterans Served Occupancy rate Percent of Veterans discharged to permanent housing Percent of negative discharges (i.e. discharges due to rule violation, failure to comply with program requirements, or unexpected discharges without prior consultation with staff). Other information the contractor feels pertinent, such as: quality improvement projects, changes in staffing or business practices, systems or resource concerns, etc. DELIVERABLE TIMETABLE Deliverables Due Dates D.1. Reserved Removed D.2. STAFFING AND SERVICE PLAN Due upon solicitation close date D.3. DOCUMENTATION OF SUPPORTIVE SERVICES: Due upon request with minimum of quarterly reviews to be completed by VA D.4. CARE PLAN Due in Veteran case record by day 14; due to VA upon request D.5. CRITICAL INCIDENT REPORTS Due within 24 business hours of a critical adverse event involving a Veteran DRAFT D.6. EXTENSION REQUESTS Due prior to the expiration of any authorized period of service D.7. ADMISSION AND DISCHARGE REPORTS Due within 48 business hours of Veteran admission or discharge D.8. SATISFACTION SURVEYS Due at the end of each monthly service period when requested D.9. DAILY CENSUS SIGN-IN SHEET Due to VA Liaison/COR/designee at frequency designated by VA at least weekly and up to daily D.10. NOTIFICATION OF ABSENCES Due to VA Liaison/COR/designee immediately or during next available business hours if absence is unauthorized; if authorized, then due prior to start of absence, preferably 24-48 hours D.11. INVOICES Due to VA Liaison by the 5th of the month immediately following the billing period in question; due in Tungsten Network (electronic billing system) by the 10th of the month immediately following the billing period in question. D.12. QUARTERLY PERFORMANCE REPORT Due to VA Liaison/COR/designee by the 15th of the month following the end of each FY quarter upon request CONDUCT 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. Local law enforcement and/or fire departments should be contacted for assistance and intervention as appropriate and indicated by any given circumstances. The Contractor shall also notify the VA Liaison, AOD, or COR immediately of any high-risk situations involving Veterans with suicidal and/or homicidal threats or ideation, episodes of physical or sexual violence, sexual activities, safety concerns, or activities involving illegal substances so that appropriate response may be coordinated. In the event of a medical or psychiatric emergency, it is agreed that every effort will be made to facilitate Veteran access to local VA Medical Center for care. If a VA Medical Center is not available in the vicinity or is otherwise inconveniently located, the Contractor will advise the VA Liaison or AOD of the facility to which the Veteran has been admitted. The Contractor will also be expected to assist Veteran s requiring non-urgent services with accessing appropriate care from a VA or community facility, as appropriate. COMPLAINTS/GRIEVANCE PROCEDURES Contractor must have an internal grievance process that Veterans can use to resolve conflicts within the program. Contractor must have written policies and procedures for resolving grievances including a statement regarding the client s right to request reasonable accommodation and must post them in a conspicuous place that is accessible to program participants. Each Veteran shall receive a copy of the grievance policies and procedures upon intake and upon receiving a warning or notice of discharge. DRAFT Contractor shall refer grievances received directly from Veterans to the identified VA Liaison, COR or designee within 48 hours of complaint. All grievances received by the VA Liaison, COR or designee will be immediately forwarded to the Contractor and shall be investigated promptly. After investigation and clarification of disposition, Contractor shall respond to the VA Liaison or COR within five (5) business days or less with proposed resolution or plan for corrective action. The Contracting Officer (CO) shall be notified in instances where the proposed course of action or response does not appear sufficient to resolve any given complaint. VA Liaison and COR or designee will monitor the services being provided in this contract program. Contractor is expected to cooperate with VA Staff and COR by providing information and answering questions in a timely manner when requested. Contractor will be subject to a Contract Discrepancy Report (CDR) anytime unacceptable contract performance is determined to be critical in nature and requires formal corrective action through report of contract discrepancy to CO. Failure to perform duties herein will have Contractor be subject to contract termination. TRAVEL The Contractor is expected to assist Veterans with arranging local transportation to scheduled meetings and appointments. The contractor is expected to help Veterans understand and learn how to utilize public transportation; this includes providing access to information and clarifying instructions necessary to effectively utilize public transit systems. If contractor and VA staff both determine that public transportation is not available, adequate, or appropriate for any Veteran, the contractor will be expected to assist the Veteran with identifying potential alternative modes of transport, however, under no circumstances is the contractor expected to provide transportation to a Veteran directly. FACILITIES General Requirements: 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: J.1.1 Where applicable, 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 State safety codes and local, and/or State health and sanitation codes. Meet the requirements of the Americans with Disabilities Act (ADA) (Public Law 100-336, 42 USC 12101-12213) pertaining to handicapped accessibility in effect on the date of contract award. Where applicable, be licensed under State or local authority. Where applicable, be accredited by the State. Be equipped with operational air conditioning/heating systems needed to maintain temperature allowed under applicable housing codes DRAFT Be kept clean free of dirt, grime, mold, or other hazardous substances and damaged 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. Have an aggressive ongoing plan to address bed bug infestation. This policy must be a part of your written response to this solicitation. Ongoing bed bug infestation will be grounds for immediate discharge of Veterans from the facility Fire Safety Requirements: 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 SFVAHCS Director. Fire exit drills must be held at least quarterly. Program participants must be instructed in evacuation procedures when the primary and/or secondary exits are blocked. 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. This plan shall be implemented during fire exit drills. A written policy regarding tobacco smoking in the facility shall be established and enforced. J.2.4. Portable fire extinguishers shall be installed at the facility. Use NFPA 10, Portable Fire Extinguishers, as guidance in selection and location requirements of 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. Inspection: Prior to the award of any contract and annually thereafter during any subsequent contracted performance periods, a multidisciplinary VA team consisting of a social worker, dietitian or nutrition and food service professional, nursing staff, VA Police, and a Safety and Occupational Health Specialist, as well as any other subject matter experts determined necessary by the medical center director, COR, HCHV Coordinator, or VA Liaison, shall conduct a survey of the Contractor s facilities to be used to provide Veterans food, shelter, and clinical services to assure the facility provides acceptable level quality care in a safe environment. Additional inspections may also be carried out, announced or unannounced, at any other time as deemed necessary by VA. DRAFT 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 amount of time (typically 30 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 the reasonable time provided will be reported to the VA Contracting Officer. If corrections are not made to the satisfaction of the VA, the Contracting Officer will be notified, and shall be the final arbiter on the necessary resulting consequences and action. The inspection of the Contractor facilities will include inspection for conformity to the current Life Safety Code as described in paragraph 5, 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 waking 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. DRAFT 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 inspection findings for residential facilities furnishing treatment and rehabilitative services to eligible Veterans shall, to the extent necessary, be made available to all government agencies charged with the responsibility of licensing or otherwise regulating or inspecting such institutions. CERTIFICATION & ACCREDITATION REQUIREMENTS The C&A requirements do not apply, and a Security Accreditation Package is not required.

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