Active

Contract Opportunity

Procurement Technical Assistance Centers (PTACs) are an official government contracting resource for small businesses. Find your local PTAC (opens in new window) for free government expertise related to contract opportunities.

Department of Veterans Affairs
Veterans Health Administration (VHA)Sources Sought Notice to Obtain a qualified vendor
to provide HEALTH CARE FOR HOMELESS VETERANS (HCHV) CONTRACTED RESIDENTIAL SERVICES (CRS) at the Central Western MA HCS

This is a Sources Sought notice and not a request for quotes. This request is solely for the purpose of conducting market research to enhance VHA s understanding of your company s offered services and capabilities. The Government will not pay any costs for responses submitted in response to this Source Sought Notice.

This Sources Sought notice provides an opportunity for respondents to submit their capability and availability to provide the requirement described below. Vendors are being invited to submit information relative to their potential to fulfill this requirement, in the form of a capability response that addresses the specific requirement identified in this Sources Sought.

The Veterans Health Administration (VHA) is seeking to obtain a qualified vendor to HEALTH CARE FOR HOMELESS VETERANS (HCHV) CONTRACTED RESIDENTIAL SERVICES (CRS) at the Central Western MA HCS per the general requirements below. The standard shall be of quality; meeting or exceeding those outlined in the general statement of work as described below.

Refer to the Performance Work Statement section below for the requested requirement description. This Sources Sought is to facilitate the Contracting Officer s review of the market base, for acquisition planning, size determination, and procurement strategy.

Please provide:

QUALIFICATION INFORMATION:
Company / Institute Name:
Point of Contact:
Address:
Phone Number:
E-mail Address:
Unique Entity Identifier (UEI) #:
CAGE Code:

A statement as to whether your company is large or small business under the applicable NAICS code according to the appropriate size standard. Also indicate if you are: a non-profit entity, small, disadvantaged business, Section 8(a) small business, woman-owned small business, service-disabled veteran-owned small business, or a HUBZone small business.

VA Central Western Massachusetts Health Care System
Mental Health Service Line
FY 2022-2027 Performance Work Statement for
HEALTH CARE FOR HOMELESS VETERANS (HCHV)
CONTRACTED RESIDENTIAL SERVICES (CRS)

BACKGROUND

The Health Care for Homeless Veterans (HCHV) program is an essential and critical part of VHA. It provides a gateway to the VA and community-based supportive services for the homeless. The program utilizes Contracted Residential Services (CRS) in community locations to engage homeless Veterans.

A.1. Basic Admission Criteria
A.1.1. Veteran is homeless.

A.1.2. Veteran is eligible for VA Health Care.
PROGRAM DESCRIPTION

HCHV CRS Programs exists to provide a means of helping homeless Veterans get off the streets and find more suitable habitation. CRS programs work to help Veterans get into community-based, residential environments with sufficient supportive services to meet their basic needs. The goal is to ultimately facilitate the improvement of their overall health status and housing situation. Programs operates in accordance with HCHV Program Federal Regulations 38 CFR 63 and are partners with the VA in the mission of ending homelessness among Veterans.

B.1. Foundational Rules and Expectations for Participation
B.1.1. 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

B.1.2. When possible, infractions are to be used to engage residents, not simply as grounds for
service termination. Profanity does not in and of itself constitute abuse and shall not
exclusively be considered grounds for discharge. Any actual or threatened violence
may be grounds for discharge.

B.1.3. Veterans are expected to engage programming and maintain communication with Case
Managers while in the CRS Program.

B.2. Admission Practices
B.2.1. Veterans who are eligible may be, but are not limited to:
transitioning from chronic street homelessness.
discharging from institutions (hospitals, jails, etc.) (see Probationary/Provisional Plan p. 16)
recently homeless due to fleeing domestic violence, being in a place not meant for human habitation, such as an abandoned building, a vehicle, or a residence that is no longer meeting inspection and code or facing condemnation according to a governmental entity.
Eviction or foreclosure of the residence. Every attempt will be made by the contractor, Veteran, and/or referrer to secure documentation of such as part of referral process.
The VA Liaison will be available for collaboration with contractor staff to ensure
appropriateness and eligibility for Veteran to be in CRS. It is understood that payment for Veterans
admitted without an initial determination of eligibility may not be authorized if the Veteran is found
to be ineligible.
B.2.1.i. Staff will ensure that a case manager has met with a Veteran within 72 hours of
admission.
B.2.1.ii. Staff will ensure that a Veteran is routed to VA Liaison for an intake within 72
hours of admission, so that GPD intake by VA Liaison can take place within 7
days of admission to CRS Program.

B.2.2. Contractor works to reduce barriers to admission:
Accept referrals Monday through Friday during business hours at a minimum.
Respond to sources of referrals with acceptance or decline of Veteran referred to CRS within 72 hours of receipt of referral form before coordination with Veteran to enter the program. Acceptance or decline of Veteran within 24-48 hours is preferred.

B.2.3. B.2.3. There will not be a certain timeframe prior to admission that a Veteran must be free of
drugs or alcohol so long as a Veteran is medically stable to be in CRS. Detoxification
services are not expected of the CRS Program. In cases of high recidivism or
unsuitability for the CPRS Program environment on account of continuous substance
use/abuse, the contractor reserves the right to decline admission with recommendations
to the Veteran and/or referrer for what interventions would be needed to
establish an episode of stay at the CPRS Program. Also see Probationary/Provisional
Plan on page 16.

B.2.4. For those Veterans referred or who are on the street, in places not meant for
habitation, or staying in vehicles, the admissions and intake committee will coordinate for the
Veteran to receive a prioritized determination regarding their referral to CRS.

B.2.5. The CRS Program admissions and intake staff reserve the right to decline admission to a
Veteran who is found to be inappropriate for the CRS Program. However, every attempt should
be made to accommodate the Veteran. It is the expectation of the VA that if a Veteran is denied
admission to the CRS Program, the admission and intake staff will provide the Veteran with
alternate resources and services for homeless Veterans to the referrer.
B.2.6. The admitted Veteran will be provided with a copy of the Resident Handbook or other
documentation that outlines at a minimum rules, regulations, responsibilities, and expectations
of the Veteran and the Contractor.

B.2.7. While recidivism is discouraged, there is no limitation to the number of times that a Veteran can
be accepted into the CRS Program after leaving the program. Veterans who are former
participants can be rereferred and readmitted so long as they are otherwise meeting eligibility
criteria. Every attempt to address what will be different during additional episodes of stay will
be taken with the Veteran in order to secure permanent housing and minimize length of stay at
the CRS Program.
B.2.7.i. CRS Program staff and VA Liaison will be expected to monitor and coordinate
efforts in helping Veteran on a regularly scheduled basis (i.e. monthly) who return
multiple times to the CRS Program due to difficulties with remaining permanently
housed. Case Manager-Liaison-Veteran meetings may be a medium for addressing this.

B.2.8. See sample Monitoring High Risk Veterans Policy (p. 17) regarding Veterans with histories of
or current suicidal behaviors or ideation upon admission, which could be implemented as is or
edited per the needs or indications of the VA and contractor. Liaisons will provide existing Safety
Plans completed by such Veterans to the Contractor for their records.

B.3. Types of Services Provided by Contractors Case Managers

B.3.1. Screenings or Referrals for Benefits. Vets with limited or no income will have challenges to
obtaining permanent housing. CRS staff assess for and refer to appropriate agencies those Vets
who may qualify for:
military service-connected compensable conditions
qualify for disability insurance or supplemental security income
qualify for retirement pensions
Veterans-specific or public cash assistance programs
SNAP benefits
health insurance
one-time-only financial assistance programs that would provide Veterans with first and/or last month s rent, security deposits, moving expenses coverage, payment of fees and/or fines to obtain IDs and other documentation to appropriate organizations and agencies
As needed and appropriate, Veteran s should also be referred to
legal services
criminal justice system services
credit counseling and/or debt consolidation agencies

B.3.2. Enhancement of independent living and social skills via regularly scheduled programming (this list is not all-inclusive of possibilities):
12-step program groups,
computer and literacy classes,
social and life skills trainings,
financial aid and budgeting workshops,
vocational and/or credit counseling
legal services to address identity fraud, child support, and/or benefits & entitlements, etc.
peer and mentor support
access to health fairs, local community events
recreational and leisure activity opportunities

B.3.3. Permanent or transitional housing search support, which may include:
providing Veterans with contact information for such places they wish to pursue for relocation purposes or permanent residence
conducting housing readiness evaluation to determine gaps in being able to complete housing applications
hands-on coordination with agencies and providers to assist Vet in exiting the CRS to another location.
assessing for whether a Veteran needs referral to retirement or rest homes, assisted living facilities, etc.
applying for local or regional GPD transitional housing programs. GPD programs may be most appropriate for Veterans with complex barriers to obtaining permanent housing, and who are going to a longer period of support than what the CRS Program can accommodate.

B.3.4. Case Managers utilize the following approaches to engaging Veterans:
recovery-oriented and harm reduction
motivational interviewing, and/or
critical time intervention.

B.3.5. Case management staff will have contact with Veterans, at least every other week, to engage
with them about completion of goal-oriented tasks related to meeting basic and health needs
and addressing barriers to obtaining permanent housing. Weekly contact is preferred and
encouraged during the first/initial month of the Veterans stay.

B.3.6. Case managers should have some experience working in social service or health care fields.
Work history with people who have chronic medical, mental health and substance abuse
problems is highly desirable. Staff working with Veterans should be able to assess, anticipate,
and effectively refer Veterans experiencing crises for additional support as appropriate. This
list is not all-inclusive of offerings and opportunities to be considered by contractor for training
purposes, but contractor should be able to avail case management staff to such training:
crisis intervention
cultural sensitivity
sexual harassment
sensitivity to wider issues of homelessness
harm reduction philosophy
laws regarding the ADA, fair housing, mandated reporting
de-escalation techniques
B.3.7. Case managers will ensure that Veterans are safe and healthy within their scope of practice.
They will refer Veteran to appropriate mental and medical health providers as necessary.
HCHV CRS PROVIDER QUALIFICATIONS & CAPABILITY REQUIREMENTS

Contractor must comply with all HCHV CRS Program requirements as identified below.

C.1.1. Possess capacity for performing outreach or otherwise identifying and referring
homeless Veterans to the HCHV CRS Program. Accept Veterans in to the CRS Program
regardless of what geographical location they may come from. Maintain sites within the
catchment area of CWM VA HCS: Franklin, Hampden, Hampshire, Berkshire, and/or
Worcester Counties.

C.1.2. Capable of providing secure, separate housing and bathroom accommodations for both
males and females.

C.1.3. Capable of routing, referring, or summoning assistance for Veterans to get to emergency
and urgent care services per a stated policy 24/7/365 that is accessible to Contractor
designees or staff who may be point persons for when emergencies or urgencies arise at
Contractors locations.
C.1.3.i. information on how to access designees for emergencies or urgencies
will be posted in common spaces for all CRS participants to be aware of
if need arises
C.1.3.ii. during intake process, attention will be made to ensure that Veterans are
aware of emergency and urgency reporting procedures and where to
access help with emergent or urgent situations

C.1.4. Contractor will ensure that Veterans basic needs are met:
provide three daily nutritiously balanced meals and an evening snack and reasonable accommodation for special dietary needs (gluten or lactose intolerance, diabetic) in a setting that encourages socialization and possesses waste disposal and sanitization systems
offer a means for Veterans to wash their own clothes or otherwise tend to laundry on a weekly basis, providing cleaning products if needed
provide secure, appropriate storage for both Veterans belongings and medication.
storage should ensure that no other residents are able to access an individual Veterans medications
maintain a food pantry or shelf so that Veterans with food insecurity have readily available non-perishable options. Keep set times and days for when food pantry or shelf is accessible to Veterans.
maintain a clothing shelf operation or provide access to one off-site so that Veterans with cold weather clothing needs can receive provisions as needed
clean, sanitary, and safe common and sleeping spaces to include desk chairs, beds, dressers, etc.
provide linens, bedding, and toiletries as needed
for those Veterans who vacate the premises, retaining belongings for a minimum of 72 hours, in the event that the Veteran returns to retrieve them.
Provide access to a working phone line for the Veteran to be able to conduct communications until an independent mobile device is secured for the Veteran
provide monitoring, assessment, and guidance for Veterans who are high risk for suicide or have history of homicidal, violent, or suicidal ideation. Should staff at any time observe a Veteran express homicidal or suicidal ideation, appropriate referrals to mental health providers will be made for evaluation. VA HCHV Liaison and Suicide Prevention Coordinator will be notified just as high-risk flag Veterans admitted to the Contractor s facility will be identified to the Case Management Staff. Completion of any safety plans either by VA or Contractor personnel with the Veteran will be part of Contractor s clinical documentation. Veterans with violent and/or homicidal ideation or actions may be discharged from CRS for safety reasons at any time. (See sample VA-Contractor High Risk Veteran Monitoring policy, p.17).

C.1.5. Capable of providing transportation services
to assist Veterans with arranging local transportation to scheduled meetings and appointments.
to help Veterans understand and learn how to utilize public transportation, including access to information and clarifying instructions necessary to effectively utilize public transit systems.
to assist the Veteran with identifying potential alternative modes of transport if public transportation is not available, adequate, or appropriate for a Veteran.
directly to Veterans, have designated contractor drivers will possess valid driver s licenses to complete and a formal process that Veterans can be educated about to initiate scheduling of such transportation.
D. HCHV CRS PROVIDER ADMINISTRATIVE ROLES, RESPONSIBILITIES, & DUTIES

D.1.1. Occupancy: The contractor will be responsible for ensuring that a minimally acceptable level
occupancy as defined in the Quality Assurance Surveillance Plan (QASP).

D.1.2. Exits to Permanent Housing: The contractor is expected to promote a focus on achieving
Stable 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 rate for exits to this type of
housing will be 55% or higher.

D.1.3. Negative Exits: The contractor is expected to facilitate Veteran completion of the HCHV
CRS 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 rate for these types
of exits will be 20% or less.
Per diem funds assist homeless veterans by helping to offset operating costs to ensure the availability of supportive housing and service centers tasked with furnishing outreach, rehabilitative services, vocational counseling and training, and transitional housing assistance. Code of Federal Regulations 38 § 61.30.

D.1.4. Release of Information: The contractor shall ensure that a signed VA Release of Information
(ROI) is obtained for any Veteran being admitted to HCHV CRS and that it is placed into the
individual case record so that it s also available to VA Liaison.

D.1.5. 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 (Veteran, family, employment, and education status)
copies of any medical prescriptions/orders issued by physicians
case management and progress notes that include specific service duration and outcome as well as referrals
any critical incident reports
a final summary that includes reason(s) for leaving (Exit Form)
the Veteran s known after care plans and location upon exiting, if available.
Case Notes should be titled according to content and relate to the Veterans goals as identified in
their service plans. Intake Notes should indicate the Veterans
strengths,
needs,
abilities, and
preferences
Case managers should document attempts to engage Veteran, even if unsuccessful in doing so.
D.1.5.i.: Individual Service Plans. an initial written plan shall be completed and entered into
the case record no later than 3 days after program admission and should be updated
monthly. The individual service plan should include goals that address:
Establishing permanent housing
Increasing income or skill level
Supporting self-determination and -preferences
Goals identified in the individual service plans are to be
Time-specific
Measurable
Behavioral

D.1.6. Homeless Management Information System (HMIS) Data Reporting: Veterans served
through VA s HCHV CRS program must have client level data entered in the local
Continuum of Care (CoC) s HMIS.

D.1.7. Daily Census: The contractor is responsible for knowing Veterans status with the Program.
Rosters or census documents as to which Veterans are in the Program are to be given to the
VA Liaison daily Monday through Friday to ensure effective monitoring of bed utilization.
The contractor will identify on the daily census which contract a Veteran is under.

D.1.8. Incident Reporting: The contractor shall notify the VA immediately when any adverse
critical incident involving a Veteran admitted to the program occurs or when any staff becomes
aware of a critical incident having occurred. VA Liaison has operable cellular and office phone
where messages can be left as well as email capacity. Critical incidents are often those that
necessitate 9-1-1 calls or the summoning of police and may also involve Contractor staff.
Critical Incidents include:
Elderly/Dependent Adult Abuse or Neglect
Sexual Assault
Fire (Veteran Involved)
Medical or Mental Health Emergency
Suicidal ideation or attempt
Homicidal ideation or attempt
Physical Assault that results in significant injury
Significant Property Damage due to a Violent Act
Death
Significant Infectious Control Concerns (TB, etc.)
Observation/Possession of Weapons
Illegal Activity (prostitution, etc.)
Medication-related incident (stealing, selling, etc.)

If an incident occurs after hours, the local VA Facility Administrator on Duty (AOD) is to
be notified by telephone. VA or local police and/or EMTs are to be called as warranted
by the provider to ensure the safety and health of any parties involved with a critical incident.
Residential staff should follow emergency plan protocol as established by the Contractor.
D.1.8.i. Documentation. the critical incident should be documented via the Contractor s
incident report form within 24 hours of the critical incident occurring so that it is
available for viewing by the VA Liaison within 24 hours. Contractor shall
maintain a copy of all critical incident reports in the involved Veteran s
individual case record.

D.1.9. Length of Stay & Extension Requests: Generally speaking, Veterans remain under HCHV
CRS for a total of 180 days. The contractor is responsible for coordinating with the VA
Liaison about Veterans in need of extensions under contract beyond the initially authorized
service period. This coordination will include discussion about justifications and lengths of
extension. VA Liaison will document justification of extension granted in the Veteran s VA
chart.

D.1.10. Discharge Reporting: The contractor is responsible for notifying the VA Liaison
within 24 business hrs. via the daily census of Veterans exits and for providing a written
exit form that contains the specific data required by the Northeast Program
Evaluation Center (NEPEC) for documentation of discharge in the Homeless Operations and
Management Evaluation System (HOMES). The Exit Form should be available to Liaisons
within 3 business days of the Veteran s discharge from the HCHV CRS.

D.1.11. HMIS & CoC. The Contractor is expected to have access to and participate in the Homeless
Management Information System (HMIS) and the local Continuum of Care for purposes of
outreach.
DELIVERABLES

E.1. QUALITY CONTROL BUSINESS PLAN: The contractor shall submit a Quality Control
Business Plan that supports the program objectives and associated tasks. The CO shall review
and comment as necessary to ensure that contract goals are met.

E.2. STAFFING AND SERVICE PLAN: The contractor shall provide a detailed staffing and
service plan. Plan should demonstrate that enough 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
their position description
their credentials, education level, certificates held
their resumes
There are to be at a minimum the following key personnel:
contact information for an offsite administrator who can make decisions and take action pertaining to the CRS Program residents and sites in case of emergency available 24 hours a day, 7 days a week
contact information for and availability of residential staff and/or other designees for Veterans to access in the event of urgent or emergent concerns and events 24 hours a day, 7 days per week
At a minimum, designated staff have training in
blood borne pathogens and infection prevention and
medication monitoring or administration (whichever is applicable)
The contractor shall provide resumes for any proposed substitutions of key personnel, at least 15 days prior to the date the substitution is to occur. 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 CRS Program.

E.3. ADMINISTRATIVE DOCUMENTATION REQUIREMENTS INVOICES: The monthly
invoice is computed at the daily rate multiplied by the total number of beds occupied by Veterans
at midnight each night of the given month. Invoices should first be submitted to the VA Liaison
for approval and signature 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 should be accompanied by invoice bearing VA Liaison signature
for reference of 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.).

E.4. QUARTERLY PERFORMANCE REPORT: The VA Liaison shall provide the contractor
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.
This information will be reviewed with the contractor. Corrective actions will be taken to address not meeting performance measures of the contract by the contractor. A detailed action plan concerning steps to be taken to address performance measures will be completed by contractor and provided within 14 days of the VA Liaison.

DELIVERABLE TIME TABLE
Deliverables
Due Dates
QUALITY CONTROL BUSINESS PLAN
Current professional liability insurance documentation
Due upon solicitation close date
STAFFING AND SERVICE PLAN
- key personnel position descriptions
- resumes, certifications, licenses & credential documentation of each key personnel staff person
- CPR &/or First Aid certificates for those certified
- employee manual or handbook
- training and continuing education offerings, policies regarding staff training and education
- resident staff, peer leader/mentor/committee or other designees handbook(s)
- contingency and/or strategic plan
- emergency, health, and safety management plans and policies
Due upon solicitation close date
DOCUMENTATION OF SUPPORTIVE SERVICES:
- operational manual, to include (unless a separate document is provided):
bed bug policy
fire drill policy
service to transgender persons policy [to be aligned with VHA Directive 1341(2) 5/23/18]
- residential handbook, to include:
tobacco use policy
non-discrimination policy
grievance policy
- listing of group and class offerings, ongoing recreational opportunities
Due upon solicitation close date
INDIVIDUAL SERVICE/TREATMENT PLAN
Made available to VA Liaison in Veteran case record within 3 days of Veteran s enrollment in CRS
CRITICAL INCIDENT REPORTS
Reported by electronic or telephone medium immediately.
Documentation made available to VA Liaison within 24 business hours
EXIT FORMS
Due within 48 business hours of Veteran discharge
DAILY CENSUS

Due (business) daily
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.
(IF PREVIOUSLY AWARDED CONTRACTS BY VA) MOST RECENT DOCUMENT OF INSPECTION RESULTS
Due upon solicitation close date

F. ABSENCES AND CANCELLATION

F.1. The Contractor shall notify VAMC of any absences from the facility. Should a Veteran absent
himself/herself in an unauthorized manner (i.e. going AWOL), payment for services for that
Veteran to the contract facility would be continued for a maximum period of 48 hours.
Passes/scheduled absences can only be covered up to 4 days. For instance, if a Veteran is going
for residential treatment that lasts 28 days, the Veteran must be discharged from the CRS by the
fourth day and reason for exit must be documented in the contractor s health record system.
Management of Negative Exits will be an element of quality assurance review of this program.

F.2. The 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, etc.). All requests for passes must be documented in writing in the
Veterans individual case record.

F.3. 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.
G. CONDUCT

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 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.

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 remain in the program and not be involuntarily removed without reasonable notice, good cause, and just procedures.
All program clients are entitled to just and standardized procedures for determining eligibility, admissions, sanctions and discharges, and resolving grievances.
Veterans are entitled to reasonable privacy and confidential treatment of personal, social, financial, medical, mental, and behavioral health records, except as necessary to further treatment, information and referral services and in compliance with the resident s consent to release information, however bed/room checks policy should also be in place with Veteran s fully aware of what that entails.
Veterans are entitled to the full exercise of their civil, constitutional, and legal rights.
Veterans will 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, sexual preference, source of income, or political affiliation.
A written policy indicating that harassment of clients 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, sexual preference, source of income, or political affiliation will not be condoned nor tolerated should be part of the Resident Handbook that the Veteran receives.
Contractors will develop a written policy for transgender clients that provides for safe, secure, and dignified case management as well as accommodate the special requirements needed for privacy. 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 told about them and welcome to use them, but not required. It is the Contractors responsibility to promote a safe environment for transgender clients amongst the general population in accordance with VHA Directive 1341(2) 5/23/18.
H. COMPLAINTS
The identified VA Liaison will monitor the services being provided in all HCHV CRS Facilities. The contractor is expected to cooperate with VA Staff and COR by providing information and answering questions in a timely manner when requested. Contractor shall refer complaints received directly from Veterans to the identified VA Liaison within 48 hours of complaint. All complaints received by the VA Liaison that of a life-threatening manner to a Veteran, will be immediately forwarded to the contractor and shall be investigated promptly. After investigation and clarification of disposition, the contractor shall respond to the VA Liaison within five (5) working days or less with proposed resolution or plan for corrective action. The CO shall be notified in instances where the proposed course of action or response does not appear sufficient to resolve any given complaint.

The resident handbook, given at the time of intake/admission, will include a grievance policy so that Veterans may know how to address in a step-by-step process format - concerns and complaints concerning the CRS Program and their stay at the shelter.
FACILITIES

The residential locations must be within the counties of Worcester, Franklin, Berkshire,
Hampden and/or Hampshire. The Contractor may have more than one physical plant in
which Veterans will domicile while participating in the CRS.

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 work environment may require a combination of settings from personnel s personal sedentary office to shared space in the residential care setting. The work is typically preformed in an adequately lighted and climate-controlled facility. Work may require occasional travel for transport assistance, case management activities, and/or treatment consultation.

I.1. 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:
I.1.1. Have a current occupancy permit issued by the local and state governments in the
jurisdiction where the facility is located.

I.1.2. comply with existing standards of State safety codes and local, and/or State health
and sanitation codes.

I.1.3. 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.

I.1.4. Where applicable, be licensed under State or local authority.

I.1.5. Where applicable, be accredited by the State.

I.1.6. Be equipped with operational air conditioning/heating systems

I.1.7. Be kept clean free of dirt, grime, mold, or other hazardous substances and damaged
noticeably detract from the overall appearance.

I.1.8. Be equipped with first aid equipment and an evacuation plan in case of emergency.

I.1.9. Have windows and doors that can be opened and closed in accordance with manufacturer
standards. It is strongly recommended that windows on non-ground floors not be openable
beyond 3 inches.

I.2.1. Fire Safety Requirements:

I.2.1. 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 VANCHCS Director

I.2.2. Fire drills must be held 6 times a year. Residents 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.

I.2.3. 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.

J. INSPECTIONS

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 or mental health clinician for clinical review purposes,
dietitian or nutrition and food service professional, who will also conduct twice annual
unannounced inspections
nursing or pharmacy staff,
VA Police,
a Safety and Occupational Health Specialist and
any other subject matter experts the VA medical center director deems necessary
Inspectors will survey 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.

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.

Cursory environmental reviews will be conducted and based upon observations by VA Liaison(s).
These reviews will be recorded. Any grossly apparent infractions will be addressed with subject matter experts and the Contractor. In accordance with VHA Directive 1162.04 dated 2.22.22, a minimum of four unannounced inspections by a CRS Liaison and/or Contracting Officer Technical Representative will occur annually.

A VA CRS Inspection Form template is available from the VA Liaison upon the Contractor s request.

J.1.1. Life Safety Code. 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:
J.1.2. General observation of residents to determine if they maintain an acceptable level of personal hygiene and grooming.
J.1.2. Assessment of whether the facility meets applicable fire, safety and sanitation standards.
J.1.3. Determining whether the facility is in attractive surroundings conducive to social interaction and the fullest development of the resident's rehabilitative potential.
J.1.4. 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.
J.1.5. 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.
J.1.6. Observation of staff behavior and interaction with residents for appropriateness and effectiveness. Observation of staff s ability to share their knowledge base about the residential facility programming and their roles and responsibilities.
J.1.7. 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.
J.1.8. A clinical review of Veterans records to ensure accuracy with respect to services provided to the Veterans. (Also see Deliverable Time Table for when documentation of certain items should be inputted to the Veterans records.)
J.1.9. Those documents listed in Deliverable Time Table will be requested at the time of inspection. It is highly recommended that all documents listed under Deliverables are reviewed for accuracy and updating annually.
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 as well as the VA Integrated Services Network (VISN) and VA Central Office (VACO).
PROBATIONARY/PROVISIONAL PLAN
A CWM VA HCS A&D or 4U/L staff member sends over a referral form on a Vet to HCHV CRS Program. On the referral form, referrer
indicates that this Veteran is contraindicated for not meeting the CRS Program s eligibility requirements due to x, y, z reasons, but would like for the CRS Program staff to consider Veteran for a minimal stay with possibility for extension at the request and approval of the VA HCHV Liaison.
details what has been or would be put in place by the referrer including an appointment with the HCHV Liaison upon admission to the CRS Program
to start the process of discharge from CRS and
ensure structure to minimize contraindications.
In some cases, where it may not be known that a Veteran is contraindicated from CRS
Facility by the referrer, CRS Program staff would communicate suggestions and
recommendations for a probationary/provisional plan to the referrer. Rereferral would
then be possible.

CRS Program staff are STRONGLY encouraged to report to Liaisons when such referrals are received for consultation purposes.

CRS Program gets back to referrer and indicates that for Veteran to come to be accepted, a, b, and c would need to be in place and/or understood by referrer and Veteran beforehand. The CRS Program reserves the right to still not accept a Veteran to the Facility even if a probationary/provisional plan is set up.

Referrer would confirm being able to have a, b, and c set up and drafts the probationary/provisional plan. The referred Veteran is aware of and in agreement with it before going to CRS Program. It is the referring staff who inform the Veteran in writing of this probationary/provisional plan and provide a copy to CRS Program staff.

CRS Program staff are STRONGLY encouraged to report to Liaisons when such admission occurs for follow-up and collaboration purposes.

Liaisons make note of Veteran s ID and appointments and watch CRS Program census for who assigned Case Manager is for identified Veteran.

Liaison who completes intake on Veteran makes additional appointments if they are not already set up with Veteran as part of the plan and begins working with Veteran and CRS Program case manager on alternate living arrangements for Veteran. Liaison continues to coordinate and monitor efforts to expedite discharge or help Veteran with complying to plan by communicating with CRS Program case manager.

At any point in time for any infraction or breach in the probational/provisional plan for admission to the CRS Program, the Veteran can be dismissed by CRS Program staff. In such instances, the case manager or other staff should notify the Liaison, who was working with the Veteran on compliance with the probationary/provisional plan.

MONITORING HIGH-RISK VETERANS POLICY
High risk veterans will first be identified during referral process by intake coordinator.
Veteran referred will be screened by designated staff prior to admission.
Veteran may be screened by contractor/vendor s mental health clinician prior to admission if deemed necessary for safety and manageability purposes.
Upon admission, Veterans will receive intake from staff.
if there is any question of immediate risk, mental health clinician, senior or supervisory case manager, or EMTs will be summoned for further urgent or emergent evaluation and determination of action steps.
if there is not immediate risk, a safety plan will be drafted and provided to Veteran.
staff will e-mail using last initial/last four to an identified e-mail group*
place an alert in Veteran s chart (shows as a red flag in electronic chart) if;
Veteran admits suicidal / homicidal ideation or thoughts within six months
admits to suicide attempt within one year
(Veteran can be flagged without meeting above criteria if there are previous multiple suicide attempts or an extensive history of suicidal/homicidal ideation)
VA Liaisons meet with all admitted Veterans for an intake within three days of arrival.
VA Liaison will notify CRS if an admission has a High Risk Flag in the VA chart
If the Veteran is found to be currently at moderate/high risk, the liaison will:
Develop a Safety Plan with the Veteran
Provide a copy of the Veteran s Safety Plan and documented assessment and history of suicidal intent and behavior via secure fax.
Send an e-mail using last initial/last four to an identified e-mail group
high risk veterans are monitored regularly and checked-in with by CRS Program staff
CRS Program staff are regularly trained on managing high risk behaviors
At any time, if CRS program staff become concerned about a Veteran s increasing stressors/level of risk, identified CRS Program staff will:
send an e-mail using last initial/last four to the identified e-mail group re: concern
if applicable, send Veteran to an urgent or acute care medical facility or the CWM VA HCS sick call or A&D staff for assessment if there is any immediate self-harm intent or behavior
likewise, VA Liaisons will notify via e-mail group of any Vets at CRS Program who present to A&D, sick call, or other facility with suicidal ideation.
status review of Veterans with high risk flags will be a standing VA Liaison and CRS Program staff collaborative meeting agenda item.
In the event a Veteran goes AWOL from CRS facility and has a High Risk Flag, CRS Program supervisory or senior case management staff or mental health clinician will alert all members of the e-mail group.
Weekend coverage: Prior to the weekend, VA liaisons will alert CRS Program designee(s) of any high-risk flag Veteran following a VA chart review of that week s contact w/ VA
In the event one of these identified Veterans goes AWOL over the weekend, CRS Program designees (i.e. resident staff, others at the physical site) will inform senior or supervisory case management staff and/or mental health clinician of Veteran s AWOL
Upon being notified, senior or supervisory case management staff or mental health clinician will send an email to the VA doctor on call (NHMAOD@va.gov) that a high risk Veteran has gone AWOL, notify VA police, and alert the below providers via e-mail.

*E-mail group: may consist of multiple VA and CRS Program staff as determined collaboratively by the Liaison/COR and CRS Program leadership. may include but does not have to be limited to: CRS Program senior or supervisory case management staff or mental health clinician, VA Liaison, VA Police, VA AOD, VA Suicide Prevention Coordinator, VA Liaison s supervisor or counterpart Liaisons

Attachments/Links