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HCHV Respite NMVAHCS Health Care for Homeless Veterans-Respite for New Mexico VA Health Care System


Arizona, United States
Government : Military
RFP
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This is a SOURCES SOUGHT ANNOUNCEMENT ONLY. It is neither a solicitation announcement nor a request for proposals or quotes and does not obligate the Government to award a contract. Requests for a solicitation will not receive a response. Responses to this sources sought must be in writing. The purpose of this sources sought announcement is for market research to make appropriate acquisition decisions and to gain knowledge of potential qualified Service Disabled Veteran Owned Small Businesses, Veteran Owned Small Businesses, 8(a), HubZone, other Small and Large Businesses interested and capable of providing the services described below. Documentation of technical expertise must be presented in sufficient detail for the Government to determine that your company possesses the necessary functional area expertise and experience to compete for this acquisition.

Important information: 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 a contract, nor does it restrict the Government to a particular acquisition approach. The Government will in no way be bound to this information if any solicitation is issued. If response by Service Disabled Veteran Owned Small Business firms proves inadequate, an alternate set-aside or full and open competition may be determined. The North American Classification System (NAICS) code for this acquisition is 623220 ($15).

Notice to potential offerors: All offerors who provide goods or services to the United States Federal Government must be registered in the System for Award Management (SAM) at www.sam.gov and complete Online Representations and Certifications Application (ORCA). All interested Offerors should submit information by e-mail, mail or ground carrier to: Southern AZ VA HealthCare System, 3601 S. 6th Avenue, Tucson, AZ 85743 or by e-mail to Lillian.Sepulveda@va.gov. All information submissions to be marked Attn: L. Danielle Sepulveda, Contracting Officer (9-90C) and should be received no later than 12:00 pm Pacific Time on January 12, 2017. After review of the responses to this announcement, the Government intends to proceed with the acquisition and a subsequent solicitation will be published.

Responses to this notice shall include the following:
(a) company name
(b) address
(c) point of contact
(d) phone, fax, and email of point of contact
(e) DUNS number
(f) Cage Code
(g) Tax ID Number
(h) If respondent is VOSB or SDVOSB, respondent is to provide proof of www.vetbiz.gov certification. In addition, SDVOSB/VOSB Contractors are asked to acknowledge that they understand the limitations on sub-contracting pursuant to FAR 52.219-14, Limitations on Sub-Contracting, which will be included in the impending solicitation. Furthermore SDVOSB/VOSB contractors are asked to respond that they are capable of providing the requested services keeping within the parameters of this clause
(i)If an Offeror proposes to use any subcontractors, joint ventures, or teaming arrangements the Offeror shall include the percentage and type of work the subcontractor will accomplish to include their certifications. (Any subcontractors, joint ventures, or teaming partners shall have the required certifications as described in the sources sought notice) and
(j) must provide a capability statement that addresses the organizations qualifications and ability to perform as a contractor for the work described below.

DRAFT STATEMENT OF WORK
Health Care for Homeless Veterans Program
Medical Respite


Objectives:
Provide Medical Respite residential care that allows homeless individuals the opportunity to rest in a safe environment while accessing medical care and other supportive services
Clinical Assessment to provide determination of strengths, needs abilities and preference of each Veteran
Initiation of case management to plan and coordinate the homeless Veteran s care

Scope: HCHV Services address the cause and effects of homelessness in a community-based setting that provides direct services in a safe environment that supports recovery and meets the needs of homeless Veterans. Services include short-term residential treatment to Veterans who need an immediate housing placement as they seek permanent housing and/or additional care and services. HCHV services may be responsible for the direct provision of case management and additional care and services. Additional care and services may include, but are not limited to, vocational training and skills development, and mental health and/or Substance Use Disorder (SUD) counseling.

Special Qualifications: The contractor shall ensure all employees possess and maintain current professional certification as described below during the execution of this contract. Contractor shall ensure the following staff performing services under this contract have the following qualifications and meet the following staffing ratios: 1:20.
Housing Manager High School Graduation or G.E.D. with a minimum of one year experience providing administrative services in an organization serving clients with social service needs.
Clinical Supervisor - licensed in the State of New Mexico with one of the following: Licensed Professional Counselor, Licensed Marriage and Family Therapist, Licensed Independent Substance Abuse Counselor, Licensed Master of Social Worker or Licensed Clinical Social Worker.
Case Manager - High School Graduation or G.E.D. and training with a minimum of one year experience working with homeless individuals with chronic medical, mental health and substance abuse problems and be able to assess and anticipate crises.

CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES:

General: The Contractor shall furnish all supplies, equipment, facilities and services required to perform work under this contract that are not listed under Section 3 of this PWS.

Provide Treatment Services and Documentation of Services. Contractor shall provide the Contracted Emergency Residential Services described in the Performance Work Statement as outlined below.

Contracted Emergency Residential Services (CERS)-

Residential Care Facilities: The Contractor shall have site control of the residential care facility through ownership or valid lease. VA will conduct an inspection that Contractor sites must pass prior to contract award and annually 60 days prior to an option period being exercised. VA reserves the right to inspect any facility and associated services at any time under the terms of this contract.
Contractor shall ensure its facilities are licensed as required for the particular setting and meet all applicable local, state, and Federal requirements concerning licensing and health codes. Contractor shall provide copies of valid licenses to the VA at the time of pre-inspection and during annual inspection reviews. Where applicable, the facility must have a current occupancy permit issued by the authority having jurisdiction.
Contractor shall meet all the standards referenced in the Health Care for Homeless Veteran (HCHV) Contracted Provider Inspection Form provided in ATTACHMENT 2 which is incorporated herein by reference.
Contractor shall ensure its facilities meet the following standards:
NFPA 101: Life Safety Code. This code can be located at http://www.nfpa.org/aboutthecodes/AboutTheCodes.asp?DocNum=101# or within the published NFPA 101: Life Safety Code, 2012 edition
Americans with Disabilities Act (ADA) to include facility safety and accessibility requirements of the disabled, see www.ada.gov. This also includes meeting standards for certified service dogs in the facility, see current standards at www.ada.gov/service_animals_2010.htm. Service Dog owner is responsible for supervision, care and feeding of animal.
Contractors shall provide the following to each Veteran referred and admitted to the Contract Residential Care facility:
Sleeping accommodations that are safe and accessible to Homeless Veterans, particularly of vulnerable target populations such as the geriatric community that may have issues with things such as climbing stairs and ladders, along with a designated single standing bed with a mattress that is used exclusively by the individual Veteran from the time of admission to the time of discharge. This bed must be situated in a room that affords the Veteran safety, privacy and security.
Appropriate linens/bedding for the bed including a pillow.
A night stand for personal effects.
Closet space sufficient to hang clothing.
A Chest of Drawers with sufficient drawer space to hold Veteran clothing/personal effects.
A safe and securely locked place for each Veteran to store his/her belongings that is readily accessible to the Veteran (such as a locking closet, a locking armoire, a locker, etc.). This securely locked space must be of sufficient size to contain a 17 laptop and/or other valuables/ medications. The locked space must also be permanently mounted in the facility so as not be easily removed from the facility.
Laundry facilities (including detergent and dryer sheets/fabric softener) for Veterans to do their own laundry or laundry services provided as part of the Veteran s stay in the residential care program (at no cost to the Veteran).
Contractor shall provide appropriate safety and security in all common areas, such as lounges, laundry rooms, shared kitchens, group rooms, entrances and exits, and hallways, through active monitoring. Monitoring may be done through video surveillance or frequent security staff observation (1-2 hour checks for staff observation). No video surveillance in private areas such as bathrooms or sleeping areas.
Sanitary procedures shall be established by the Contractor. Veterans are to be taught such procedures and encouraged to follow them. Many Homeless Veterans need to be taught how to successfully keep their own residence clean after successful transition to stable housing. Contractor shall encourage Veterans to engage in the cleaning and upkeep of the facility. Such encouragement should be limited to Veteran s clinical abilities. The Contractors staff is responsible for ensuring a clean and sanitary living environment. The VA COR may perform random checks to ensure cleanliness.
Contractors shall provide a safe and sober environment for all Veterans. These policies and procedures must be communicated to Veterans both verbally and in writing in a manner that is understandable to them upon admission to the facility. This communication must be documented in the Veteran s record by the Contractor. The following situations are to be enforced and addressed with the Veteran:
Suspected or known drug or alcohol use or relapse by one or more Veterans;
On-site contraband, weapons (including props or souvenirs that appear to be weapons), drugs, alcohol, or related paraphernalia ;
On-site drug or alcohol testing methods (i.e., urine drug screens, breathalyzers, etc.) and frequency;
Safe prescription medication storage and handling, including specific provisions for prescribed controlled substances;
Safe prescription medication access, including specific provisions for safe disposal of medications and syringes;
Assertive monitoring of controlled substances, including but not limited to signing in medications after receipt from pharmacy with an observed pill count by Contractor staff when clinically warranted; staff observation and recording of taking of controlled substances and other medications by Veterans when clinically warranted;
Room inspections and daily bed checks of Veterans residing in the program, including methods and frequency. Daily tracking and documentation of Veteran s presence in the program at least once daily. If a Veteran has not been confirmed present in any one 24 hour period, the Contractor shall notify the COR immediately;
Grievance process to address Veteran complaints with time frames for responses from the Contractor s program/facility management;
Veteran abandonment of belongings in the facility, including time frames and procedures for disposal
Process to elicit Veteran satisfaction with the facility and onsite services, including information collection methods and frequency, and process for utilizing the information for continual performance improvement purposes.
Contractor shall provide Veterans three meals a day, seven days a week, or the means to purchase and prepare their own meals. These meals must meet USDA suggested nutritional guidelines or other medically directed requirements and the facilities/equipment to prepare three meals daily, that encourages social interaction. Meals provided by Contractor which are traditionally served hot should be served at an appropriate temperature. Contractors shall ensure that all food, whether purchased by Veterans or provided by Contractor, is stored, handled and served in a safe and sanitary manner that meets accepted industry standards and guidelines. Contractor staff shall assess Veterans who are preparing their own meals to ensure food is being handled and stored in a safe manner.

The VA has particular concern for chronically homeless Veterans, many of whom are either undernourished or have developed poor eating habits or both, because of extended homelessness, chronic medical, mental health or substance abuse disorders. The Contractor shall ensure such Veterans are getting adequate nutrition.
Contractor shall maintain a printed menu. Contractor shall provide a VA dietitian or the COR access to these menus at any time.
1.The Contractor shall develop a process to elicit Veteran feedback for the snacks and meals provided by the Contractor. The process will include information collection methods and frequency, and a process for utilizing the information for continual performance improvement purposes.
2. The VA dietitian or the COR may assess Veterans feedback with Contractor provided meals and snacks to determine the Contractor s success in meeting the requirement to provide satisfying and nutritious meals during annual facility inspection or at any point during the contract period.

Contractor shall document all clinical information in accordance with CARF Standards as outlined in 5.2 Treatment Services and Documentation of Services.

Veterans may be discharged from HCHV Contract Residential Care programs for positive, negative or administrative reasons. The date of discharge must be approved by the COR for billing purposes. The Contractor shall provide discharge planning and referrals for each Veteran, regardless of character of discharge from the facility, to appropriate community resources and services based upon a team assessment of health, social and vocational needs and the involvement of Veterans families as appropriate. Discharges will be accomplished in collaboration with the COR to ensure appropriate resources are offered to Veteran. Veterans who engage in an episode of violence or threaten violence against staff or other Veterans must be discharged immediately to maintain the safety of the facility.

Discharges will be characterized as follows:

Positive Discharge a.) the Veteran has been successfully placed as anticipated in transitional or permanent housing, or reunited with family, and has met the goals of his/her Individual Service Plan within 90 days or less; b.) the Veteran has been successfully placed as anticipated in transitional or permanent housing, or reunited with family, and has met the goals of his/her Individual Service Plan in greater than 90 days from the date of admission and the COR has approved continuation of fixed daily charge for payment. This information applies to Veterans approved to stay beyond 90 days as clinically warranted. The performance goal is 50% or greater of all Veterans admitted to the program will be Positive Discharge

Administrative Discharge the Veteran has been transferred to an alternate level of care with concurrence from the COR for medical, mental health, or substance abuse treatment to better meet the Veteran s clinical needs. The performance goal is no more than 20% of all Veterans admitted to the program.

Negative Discharge a.) the Veterans whereabouts are unknown; b.) the Veteran has had an episode of violence or has threatened violence against staff or other Veterans and must be discharged to maintain the safety of the facility; c.) the Veteran has had more than one episode of drug use at the facility, has failed to engage in or accept treatment alternatives, and must be discharged to maintain a safe and sober environment at the facility; d.) the Veteran s length of stay has exceeded 180 days from the date of admission and the COR has not approved continuation of treatment. The performance goal is no more than 30% of all Veterans admitted to the program.

Unacceptable Discharge a.) the Veteran is discharged to a homeless shelter or drop in setting after a length of stay greater than seven (7) days from the date of admission unless there is concurrence from the COR that there is no other alternative due to circumstances beyond the Contractor s control; b.) the Veteran is discharged to the streets at any point in time after the date of admission under any circumstances. The performance goal is zero (0) occurrences.

Special Care Provisions for Female Veterans: Contractor shall give special attention to meeting the unique treatment needs of homeless women Veterans. These needs often may include assistance with managing sexual trauma, eating disorders, interpersonal violence, and caring for dependents while in treatment.

Contractor shall ensure that women Veterans have access to female clinical staff (whether from the Contractor, VA or other community partner) for additional gender-specific treatment and/or supportive services as needed.

Contractor shall maintain and adjust environments to support the safety, security, privacy and services for women Veterans. Contractor shall place special emphasis on privacy and security in mixed-gender facilities. Veteran residents have a right to be treated with dignity in a humane environment that affords them both reasonable protections from harm and appropriate privacy with regard to their personal needs. The Contractor shall ensure that the living environments include:
Residential room and board in an environment that promotes a lifestyle free of sexual discrimination.
An environment conducive to social interaction, supportive of recovery models and the fullest development of the resident's rehabilitative potential regardless of gender or sexual orientation.
If housed with males provide separate and secure bathroom arrangements to ensure an acceptable level of privacy for personal hygiene and grooming.

Medication Storage and Monitoring: Contractor shall provide appropriate space and security for the storage of medications. Contractor shall ensure there are appropriate policies and procedures that support the safe storage of medications for Veteran residents. This storage can be provided to the Veteran to secure his or her medications, or central storage can be provided by the Contractor.

Contractor shall have written procedures that address storage while providing access to medications and safe disposal of medications and syringes. Contractor shall ensure that Veterans residing in the program are educated about these procedures and the importance of safely storing their medications.

PART 5
SPECIFIC TASKS
SPECIFIC TASKS: Contractor shall perform the following tasks:

Obtain a Release of Information (ROI) from Veteran for any information requested by outside parties during the Veterans participation in the program if applicable.

Ensure all documentation is in accordance with the current CARF standards-.

Provide Clinical Assessments within seven days of admission to determine strengths, needs, abilities and preferences of each Veteran and/or services to include:
History of homelessness
Mental health history
Physical health history
Substance use history
Social history
Education, vocation, and income history
Legal history
Strengths and Needs
Abilities and Preferences
Barriers/Vulnerabilities
Military History
Trauma History

Provide on-site drug or alcohol testing methods (i.e., urine drug screens, breathalyzers), when clinically appropriate or when requested by the COR.

Provide Case Management to plan and coordinate the homeless Veteran s care. At a minimum Case Management Services will include the following:
Working toward the rapid placement of the Veteran in a safe setting, with an emphasis on utilizing housing first approaches wherever possible.
Arranging, coordinating, and/or providing direct clinical services (enrollment, assessment, treatment plan, reassessment) and support.
Using Recovery Model principles.

Provide the following clinical skills/interventions in an individual or group setting as appropriate: Cognitive Behavioral Therapy (CBT), CBT skills, Mind Body Stress Reduction (MBSR), MBSR skills, Motivational Interviewing, and Psychoeducational tools, sober living skills, psychotropic medication education, or other clinically relevant interventions to assist Veterans in managing negative mental health symptoms. The goal in utilizing the above skills/interventions is to provide an environment in which Veterans can successfully transition into stable permanent housing after the Veteran has reduced the impact of negative mental health symptoms and improved their ability to successfully live independently.

Provide Treatment Services and Documentation of Services provided in Veteran s record: Address the needs of special populations which may include women, OEF/OIF/OND,SMI, and chronically homeless.

Provide routine updates to the Initial Treatment Plan developed in conjunction with the NMVAHCS Housing First Program. Individual treatment plan shall include specific goals, measurable objectives, targeted dates for completion, a designated responsible individual for addressing each goal. Plans may include goals that:
Improve the Veteran s safety
Assist the Veteran s overall physical and mental status and promote a healthy lifestyle
Instill hope
Increase employability or increase income, or improve income management
Improve the Veteran s overall quality of life
Improve the Veteran s self-esteem, self-efficacy, and independence
Assist the Veteran in achieving an optimal level of psychosocial functioning
Provide support services aimed at the prevention of homelessness

Provide progress notes that document the following:
Progress toward the Veteran s goals
Veteran s participation in treatment
Services provided
Changes to treatment or service plan

Provide program exit summary upon termination from the program for each episode of care. Medical care and services provided, and recommendations for follow-up care, shall be documented in this exit summary, which shall include at minimum:
Date of Exit
Type of Exit
Veteran s perception of exit and agreement with exit
Status of Treatment goals at time of exit
Aftercare plan

Provide incident report in writing to the COR by close of business on the day of the incident and a phone call immediately for any of the following:
Death;
Fire;
Drug/police raid;
Suicide/suicide attempt;
911 calls (police / fire dept. / paramedics / other);
Drug overdose;
Severe medical illness / emergency;
Severe psychiatric illness / emergency;
Sexual assault, harassment or attempt;
Act of violence or abusive behavior by Veteran against other(s) or staff;
Act of violence or abusive behavior by staff against Veteran;
Accident with or without injury involving staff or Veteran(s);
Medication problems or adverse drug reactions;
Or any other clinical relevant incidents.
Provide Treatment Planning: Individual treatment plans are developed through a joint effort of the Veteran, the Contractor, and the COR. Treatment plans shall be developed for each Veteran based on input from COR staff assessments, other VA clinical data, and the Veteran. The COR is expected to utilize the Mental Health Treatment Suite for the documentation of treatment plans in Computerized Patient Record System. NOTE: If clinically indicated and if staffing is available, interdisciplinary planning must be provided by the treatment team. HCHV program staff must monitor the quality of care provided by the contract facility through regular visits to the facility. This is accomplished with the weekly treatment group meetings discussed in 1.14 .

Provide Treatment Services: Contractor shall provide therapeutic and rehabilitative services as described in the Performance Work Statement and in the Individual treatment plan. In some cases, VA may complement the Contractor s program with added treatment services such as participation in VA Outpatient programs (e.g., CWT, Incentive Therapy, Mental Health Clinic, SUD treatment).

Provide Exit/Discharge from Contract Residential Services: Exit or discharge planning for each Veteran starts at the time of admission into the Contracted program. Exit planning is for the Veteran to identify personal needs for obtaining housing, continuing recovery, care, treatment, and services after exit. Exit planning is addressed at each interdisciplinary treatment team meeting with the Veteran. Length of Stay is variable based on progress towards goals, objectives, and time frames listed in the treatment plan. The timing of transition to the community is negotiated between the Veteran and the team. Contractor s staff are responsible for ensuring that access barriers to continuing outpatient care (e.g., distance, transportation, scheduling) are reduced or eliminated.

Veterans may end participation in HCHV Contract Residential Services for any of the following reasons:
The Veteran has accomplished the goals as defined in the treatment plan and is prepared for community integration with identified resources after exit.
The Veteran requires treatment beyond program resources and is to transition to another level of care.
The Veteran has failed to adhere to the rules and the regulations of the program.
The treatment environment does not meet the Veteran s expectations or needs.
The Veteran requests to leave before treatment goals are met.
The Veteran has a personal emergency necessitating exit.

There are circumstances when the treatment team may make a clinical decision to discharge a Veteran prior to program completion. These circumstances include:
The Veteran exhibits dangerous and/or threatening behavior;
The Veteran exhibits a pattern of relapse or unauthorized use of an addictive substance and a lack of engagement in treatment services.
The Veteran refuses to engage in treatment planning.
The Veteran has achieved maximum benefit from treatment in the program.
The Veteran refuses to allow communication between VA and the Contractor that is necessary to ensure the safe and effective coordination of care.

Whether the Veteran ends participation in the program, has completed the program, or is in the process of being discharged by the Contractor, the Contractor shall ensure the following occurs:
The Veteran is involved in the exit planning process.
The Veteran is provided clear information regarding exit.
Continuity of VA and non-VA services for medical and mental health needs are arranged. The HCHV program staff is included in decisions regarding the setting and frequency of ongoing treatment and community recovery activities.
The treatment team will follow-up with the Veteran post-discharge to facilitate access to continuing aftercare services.
An assessment of the Veteran s dangerousness and overall mental health stability is made by the treatment team and appropriate action taken, according to the Contractor s policy.
If the Veteran does not have permanent housing, the Contractor shall provide information that facilitates arrangements for transitional or temporary housing.
The Contractor shall inform HCHV program staff of the Veteran s exit within 24 hours.

If a Veteran refuses to participate in exit planning or if a Veteran drops out of treatment without seeing or contacting Contractor s staff, the Contractor shall notify the HCHV program staff, and assess the level of risk. If the Veteran is deemed to be an immediate danger to him or herself or others, the Contractor shall call the Veteran Crisis line (800-273-8255) for assistance. If safety concerns persist, local 911 should be called.

PART 6
APPLICABLE PUBLICATIONS

APPLICABLE PUBLICATIONS (CURRENT EDITIONS)

6.1. The Contractor shall abide by the following regulations, publications, manuals, and local policies and procedures which are made part of this contract and are incorporated herein by reference.
Commission on Accreditation of Rehabilitation Facilities, CARF International
VHA HANDBOOK 1162.09 Health Care for Homeless Veterans Program
VHA HANDBOOK 1162.01 GRANT AND PER DIEM PROGRAM

Lillian D Sepulveda
Contracting Officer
520-629-4614

Contracting Officer's email

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