Inactive

This sources sought notice is for the DC VAMC to determine the availability of potential sources and their size classification relative to NAICS Code 624190 -Other Individual and Family Services, havi... This sources sought notice is for the DC VAMC to determine the availability of potential sources and their size classification relative to NAICS Code 624190 -Other Individual and Family Services, having the skills and capabilities necessary to provide case management services in accordance with the attached SOW. All interested vendors are invited to provide information to contribute to this market survey/sources sought including, commercial market information. This is not a solicitation announcement. No award will be made from this source sought. Interested Vendors please provide requested information by email to vanessa.jacobs@va.gov by 3 :00pm EST March 31, 2020. Provide only the requested information below. REQUESTED INFORMATION BUSINESS SIZE AND SOCIO-ECONOMIC STATUS: (a) Indicate whether your business is large or small (b) If small, indicate if your firm your firm is a certified Service-Disabled Veteran Owned Small Business (SDVOSB) or Veteran Owned Small Business (VOSB) (c) Include the DUNS number of your firm. (d) Provide your firms FSS or GSA Contract number if applicable. STATEMENT OF WORK (SOW) OBJECTIVE: The contractor shall provide the Washington DC Department of Veterans Affairs Medical Center (DC-VAMC) community based Housing and Urban Development-VA Supportive Housing (HUD-VASH) case management services to include but not limited to linking Veterans and their families who are homeless or at risk of becoming homeless to appropriate services based on needs assessment, as well as assisting them in obtaining housing and attain self-sufficiency, in accordance with all terms, conditions, provisions and requirements listed herein. The period of performance for these services is one year, with four option years. BACKGROUND Ending homelessness among Veterans and their families have been one of Veterans Affairs Administration initiative. The DC VAMC has a goal of ending homelessness among Veterans by having a housing placement when every Veteran who desires housing can be placed. We recognized that a cookie cutter approach to housing and serving the homeless population is defeating. Therefore, to fulfill the Zero Tolerance goal, the DC VA Medical Center partnered with a community service provider to provide HUD-VASH Case Management Services, utilizing the Housing First Model. The program provided in home case management services and housing support to the most vulnerable formally homeless Veterans. This partnership has been in place for the past ten years and has been extremely successful in housing and keeping some of the hardest to engage population housed. This program has had zero recidivism over the last ten years. As a result, the DC VA Medical Center has opted to maintain this service through contracting as the current contract will expire August 2020. As a result of the benefits of this model to the Government, the DC VA Medical Center is seeking to partner with a community agency (or agencies) to provide HUD-VASH case management services to homeless Veterans in Northern Virginia (Alexandria City, Arlington County, Fairfax County, Loudoun County, and Prince William County) who might or might not be medically vulnerable requiring intensive HUD-VASH case management services. Additionally, we are seeking an additional community provider to provide said services ( for the medically vulnerable) in Montgomery and Prince George s County, Maryland. The Health Care for Homeless Veterans (HCHV) Contracted HUD-VASH Case Management Service is an opportunity to meet Veterans and their families where there are ; employing a housing first model to rapidly reduce Veteran homelessness to those who present with various vulnerabilities to include but not limited to serious medical and mental illness, co-occurring and substance use disorder. The DC VAMC recognizes that there are services that a community provider is able to make available to veterans that the VA might not have or able to provide, additionally, there are veterans who would rather be served by a community provider whom they are familiar with rather than the VA. Therefore, The DC VAM will leverage its partnership through contracting with other Community and or State agencies by making available HUD-VASH case management services for consumers of vouchers awarded in Northern Virginia and 25 medically vulnerable HUD-VASH voucher recipients requiring intensive case management residing in Montgomery and Prince George s County Maryland. These consumer Veterans must be selected through the Coordinated Entry process, referred by the VA, or agency outreach efforts, meet the VA and HUD definition for homeless and or chronically homeless as authorized in 38 U.S.C. 2002(1) and The McKinney-Vento Homeless Assistance Act, as amended by S. 896 The Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act of 2009. NOTE: see http://www.hudhre.info/hearth/. and eligible for Veteran Health Administration (VHA) services. The HUD-VASH Program is described in the VHA Handbook 1162.05. Please click on the following link for more details. http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2040). The program s goal will be for a HUD-VASH case management clinical team to assist homeless veterans to achieve housing stability by providing services such as outreach and engagement, securing housing, and intensive long-term case management. DESCRIPTION/SPECIFICATION/WORK STATEMENT DC VAMC is seeking Contractors to assist with providing HUD-VASH Case Management Services in a team fashion to homeless or at risk of becoming homeless Veterans and their families. Many of these Veterans have multiple conditions that make it difficult for them to navigate the system and advocate for their needs successfully. These conditions may include mental illness, substance use disorders, and other serious medical conditions. Many have been in and out of shelters or living on the streets for years. DC VAMC intends to utilize the services of the Contractor to provide HUD-VASH Case Management Services with a housing first approach to homeless Veterans and their families referred by the VA Medical Centers, Coordinated Entry from any jurisdiction served by the medical center or identified by the outreach efforts of the HUD-VASH Team. The Contractor shall furnish services to the beneficiaries for whom such care is specifically authorized by the VA. It is understood that the type of Veteran to be cared for under this contract may require intensive case management services over and above the level of linking to services and stable housing. The Contractor shall furnish each Veteran authorized care under this contract with the following basic services Needs Assessment and coordination of services Linkage to resources based on needs Intensive Case Management Services determined to be needed by the Veteran and his/her family in a plan developed by the Contractor with consultation from the Veteran and the HCHV staff and/or other appropriate service providers. Appropriate housing placement as determined by the Contractor, HCHV Team, the Veteran and his/her family. Services which the contractor and their Clinicians must be able to furnish or ensure the Veterans has access to but are not limited to, include: Collaboration with the HCHV staff that will provide supportive services with admission and discharge from the program. Coordination of structured group activities as appropriate examples include group therapy, social skills training, Alcoholics Anonymous, Narcotics Anonymous, vocational counseling, and physical activities as appropriate. Provide supportive counseling and advocacy for Veterans. Individual professional counseling, including counseling on self-care skills, adaptive coping skills and, as appropriate, vocational rehabilitation counseling and physical activities where appropriate. Assistance to develop responsible living patterns and to achieve a more adaptive level of psychological functioning, upgraded social skills, and improved personal relationships. Support for an alcohol/drug abuse-free lifestyle. Assistance to gain knowledge of the recovery process. Manage a caseload of minimum 25 clients and maintain case file Conducts comprehensive assessments to collect functional, environmental, psychosocial, financial, employment, housing, educational, and basic acute and chronic medical needs information as appropriate for Veterans and their families to develop a case plan. Develop support systems to meet client needs by identifying and coordinating a variety of available services necessary to maintain independent living, and, when possible, self-sufficiency and family stabilization. Refer clients to available therapeutic, social service, educational and medical resources within the VA-DCHCS when appropriate. Conduct crisis intervention as necessary, and daily street and shelter outreach as needed to connect with referred Veterans. Document in Computerized Patient Record System, CPRS all services provided to each Veteran and his/her family on a daily/weekly/ monthly basis, outlining type, quality and effectiveness of services provided. Document in Homeless Operation Management Engagement System HOMES Veterans housing and employment progress. The cost for service established by this contract shall include the services listed in this document and all services and supplies normally provided to other clients by the agency without extra charge. The Contractor shall employ trained professional staff to carry out the requirements of the contract. This may include but not limited to; Licensed Registered Nurses, Licensed Clinical Social Workers, Peer Support and Addiction Specialist. There shall be an identified professional specifically assigned to the contract who shall be the point of contact for the HCHV staff and Contracting Officer Representative. The Contractor shall make available documentary information required for the VA to conduct utilization review audits for the mandated national evaluation study as required by section 2 of Public Law 100-6; to verify quality of care for Veterans, to assure confidentiality of Veteran record information, and to determine the completeness and accuracy of financial records. The Contractor shall collaborate with the Veteran and HCHV staff to conduct treatment and discharge planning reflecting a team assessment of health, social and vocational needs and the involvement of Veteran's family and appropriate community resources in resolving problems and setting goals. The Contractor shall coordinate transportation services for the veteran to get to scheduled appointments or services, such as, medical and employment to name a few. It is recommended that services be provided no more than 50 miles from the VA. The Contractor shall comply with the VA Veteran's Bill of Rights as set forth in section 17.34a, title 38, Code of Federal Regulations. The Contractor shall assist in preparing reports, maintaining records and databases to track referrals, acceptances, denials, discharges, and follow-up post discharge. The Contractor shall provide monthly invoices in a timely manner, no later than the tenth day of the month, in order to receive timely compensation for the services identified in the contract. The contractor shall provide office hours at the VA Community Resources and Referral Center (CRRC) as needed. Contractor shall attend HCHV monthly meetings as well as regular scheduled national calls as appropriate. SCOPE The agency HUD-VASH program shall be modeled on the standards set in the VHA Handbook 1162.05 and with the same level of efficiency as other similar programs currently operated by the agency. The Program is expected to include the following elements: The HUD-VASH Clinical Team should include Independent Licensed Clinical Social Workers (hereinafter SW ) or Registered Nurses (hereinafter RN ), or Licensed Professional Counselor as well as Case Managers and a Coordinator/Clinical Supervisor with experience that demonstrates advanced practice skills and judgment. All HUD-VASH case managers will be subjected to a full background check. They must complete privacy, HIPAA and security training upon appointment and yearly thereafter for the life of the contract. This will enable the HUD-VASH agency staff to receive and maintain network access. Each staff person will also have to create a Virtual Private Net (VPN) account in order to receive remote access to the VA-MC network. In addition, all clinical staff or person designated to maintain the Homeless Operation Management and Evaluation System (HOMES), must compete HOMES training and all other Veterans Affairs Health Care for Homeless Veteran, (VA-HCHV) required trainings. This will enable them to complete required documentation directly into the VA Computerized Patient Record System (CPRS) as well as all the HOMES required forms in a timely fashion. The HUD-VASH agency team will accept referrals from the Coordinated Entry team in their jurisdiction, as well as, VAMC HCHV Program. These referrals are for veterans that reside in the jurisdiction served by contract agency who have been deemed the most vulnerable based on their Vulnerability Index-Service Prioritization Determination Assessment Tool (VI-SPDAT) assessment. Agency serving Montgomery County and Prince Georges County will be assigned those Veterans with high acuity and medically fragile. The HUD-VASH Clinical Team should work under the direction of a Program Supervisor and or Supervisory Social Worker who is Licensed at the independent level, (Licensed Clinical Social Worker or RN Mental Health Clinicians) with prior experience in working with chronically homeless population, preferably with experience working with homeless veterans. The HUD-VASH Clinical Team shall work in concert with the Washington DC VA Medical Center HUD/VASH Program and will be held to the same guidelines as outlined in the VHA Handbook 1162.05, (see attachment A), that establishes procedures for the United States (U.S.) Department of Housing and Urban Development (HUD) and the U.S. Department of Veterans Affairs Supported Housing (VASH) Program and sets forth the national authority and responsibilities for the Department of Veterans Affairs (VA) portion of administration, monitoring, and oversight of these services. The DC VAMC Contracting Officer Representative, COR, will provide support to the HUD-VASH Clinical Team by assuring that the HUD-VASH Clinical Team: Is trained on VA HOMES and CPRS and all policies and procedures as set forth in the VHA HUD-VASH Handbook 1162.05 Ensure documentation is uniformed among the team and meet HIPAA and VA Privacy and Security guidelines. Ensure understanding and implementation of applicable VA guidelines and HUD/VASH policies. Assist the HUD-VASH Clinical Team with connecting Veterans to needed VA services. (v) Act as the Mental Health Coordinator for Veterans in this program, as needed. Ensure all HOMES documentation is completed in a timely manner, as outlined in the VHA HUD-VASH Handbook 116.05. Assist the HUD-VASH Team in implementing protocols for discharging Veterans from case management. The HUD-VASH Clinical Team is administratively responsible for managing and developing the clinical program and shall be accountable for clinical program effectiveness and implementing modification of services with VA approval, as needed. The HUD-VASH Clinical Team shall complete HOMES assessment, admissions and discharges as required. They shall complete timely services agreement, on a bi-annual basis for each Veteran assigned to the program and provide in home case management visits as needed; minimum once per month. It is the expectation that all interaction with a Veteran shall be documented in CPRS within 24 hours. Likewise all HOMES admission and discharge must be completed in HOMES within 24 hours of the occurrence as outlined in the VHA Handbook 1162.09, found here: http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3006 . Additionally, the contractor will be required to document encounters in their local HMIS system as required by the Continuum of Care. The HUD-VASH Agency must be an active participant in the local Continuum of Care (CoC) and be involved in the Coordinated Entry process to match veterans with the appropriate housing. The HUD-VASH Clinical Team shall collaborate with VA providers to connect Veterans to appropriate specialized treatment services for complex physical and/or mental illness. The HUD-VASH Clinical Team shall have the capacity to or have access to a complete psychosocial assessment of the Veteran to identify mental health, medical and social problems and work to connect the veteran to appropriate treatment services. Some of these services could be social and therapeutic groups, family therapy, individual therapy, Assertive Community Treatment Team, Alcohol Anonymous or and Narcotics Anonymous. Veterans with Substance Use Disorder (SUDs) are some of the most vulnerable of the homeless population served by the HUD-VASH Program and are not required to be sober as a criterion to housing. Therefore, the HUD-VASH Clinical Team shall coordinate treatment services with the DC VAMC and or community-based substance abuse treatment programs for said Veteran as needed. The HUD-VASH agency must provide copies of resumes, clinical licenses and other credentials as necessary for all staff prior to them being assigned to the HUD-VASH Program.VA will review the disciplines and credentials of all staff persons prior to assignment to program to ensure they meet the VA minimum requirements for staff. Each staff must complete the VA background check prior to being assigned to the contract. It is mandatory that a licensed independent clinical social worker is a member of the HUD-VASH VASH team. Case management services shall be provided by any of the following disciplines at a bachelor s level and minimum five years or Master level without a license and two years experience or with a license and 1-year experience doing case management or related field: professional counselors, social worker, psychology or nursing, as well as peer support. The HUD-VASH agency in collaboration with the VA HCHV staff shall develop a protocol with triggers for assessment by the licensed independent social worker for the case managers to follow at each visit. Although case management services do not have to be provided by independent licensed mental health professional, all assessments and crisis interventions must be conducted by an Independent Licensed Mental Health Professional. The HUD-VASH Clinical Team shall participate in VA treatment meeting upon request and or when related to a Veteran being served by their team. And all case managers on the HUD-VASH staff must complete a Critical Time Intervention (CTI) training within 90 days of being assigned to the VA-VASH Program. The HUD-VASH Clinical Team shall provide age-specific care appropriate to the cognitive, emotional, cultural and chronological maturation needs of the veterans. They will be expected to demonstrate knowledge of changes associated with aging and principles of growth and development relevant to the adult and geriatric age groups; can assess and interpret data about the veteran's status; and be able to identify age-specific needs and provide the appropriate care based upon the age-related factors. The HUD-VASH Clinical Team shall perform duties independently and be supervised by the HUD-VASH supervisor. The HUD-VASH Clinical Team shall be accountable to the Contracting Officer Representative in the areas of service, staffing, reports and documentation per this contract. The HUD-VASH Clinical Team shall be responsible for providing services to the literally homeless and chronically homeless veterans to include: Outreach and engagement, admission to HUD-VASH Program Completion of the local Public Housing Authority (PHA) housing application Submitting of referral to the local Public Housing Authority (PHA) Apartment search and lease-up Coordinating care with the VA medical facility Money management Skill development Conduct home visit at least once per month Conduct one-on-one and group meeting with individual case management, based on client need The HUD-VASH case management team must monitor the Veteran s progress and intervenes, if indicated, to ensure that the Veteran remains housed. The HUD-VASH case management team shall follow the DC VAMC HUD-VASH Protocol for Discharging Veterans successfully form case management. (see Attach B) as well VHA HUD-VASH Handbook 1162.05 p.29 on ending case management services . NOTE: Non-compliance with HUD-VASH does not necessarily lead to loss of the section 8 Housing Choice Voucher (HCV). PHA rescinds the HCV if the Veteran no longer meets or is non-compliant with PHA requirements. The Veteran will receive written notification from PHA on said action. The HUD-VASH Clinical Team shall conduct the program in accordance with the policies and procedures outlined in the VHA HUD/VASH Handbook 1162.05 and 1162.09 The HUD-VASH Clinical Team shall consistently demonstrate good customer services skills, including: communicating with and treating internal and external customers (veterans, their representatives, visitors, and all VA staff) in a courteous, tactful, and respectful manner. providing customers with consistent information according to established policies and procedures; and handling conflict and problem in dealing with the Veterans, constructively and appropriately. STAFF TRAINING It is essential that all staff complete annual ethics training as required by respective professional licensure or credentialing boards, with an emphasis on dual relationships and conflicts of interest. It is mandatory that the HUD-VASH team completes all required VA training on an annual basis to maintain access to the network and CPRS: VA Privacy Training Cyber Security Training VA Compliance Business and Integrity Training (CBI) Fire and Safety Training Infection Control policy and Procedures Emergency Preparedness / Disaster Policy and Procedures The HUD-VASH case management team must participating in program specific conference calls and broadcasts such as: Monthly 1-hour conference call hosted by the HUD-VASH National Program office where policy, trends, and resources, as well as site-specific issues and new program ideas are addressed in this forum. Viewing of available HUD-VASH satellite broadcasts, PowerPoint presentations, and attendance at national and regional HUD-VASH and other homeless conferences are encouraged, as time and funding permits. All new case managers must compete all required training within 90 days of initial start date. Training must include: CTI Assertive Community Treatment Motivational Interviewing Housing First, Low-Demand Model of care Suicide Prevention Clinical approaches relevant to the population CASE MANAGER RESPONSIBILITIES The Case Manager team is responsible for: Screening and completing a brief assessment to ensure appropriateness of placement into the program. Assessing Veterans through comprehensive psychosocial evaluations to determine case management needs and recovery goals. Providing access to appropriate treatment and supportive case management services to potential HUD-VASH Program participants. NOTE: This can be done individually or in groups. Employing Motivational Interviewing approaches to promote Veteran follow through with referral for preventive care and treatment of medical conditions, substance use and dependence, other mental health conditions, and problematic health behaviors (e.g., problematic substance use, tobacco use, unsafe sexual practices). Helping the Veteran obtain the voucher from PHA. Providing housing search assistance to HUD-VASH participants with rental vouchers. Making regular home visits to assess Veterans housing stability, social connection and recovery, and acting as a liaison with other VA and community resources, landlords, and PHA. Regular re-assessment and revision of treatment plans are done as needed. Ensuring coverage of caseload during absences and identifying the POC. Reviewing agreements between Section 8 HCV landlords, PHAs, and VA in establishing appropriate referral sites for HUD-VASH placements. Performing site visits of HUD-VASH apartments to ensure that Veterans reside in safe environments in compliance with local housing codes. Meeting regularly with landlords and PHA officials to ensure the availability of Section 8 HCV eligible housing stock. Collecting and submitting HUD-VASH Program evaluation data on Veteran family participants in HOMES. Ensuring that there is no conflict of interest in dealings with Veterans, landlords, or other entities by adhering to professional ethical guidelines. It is essential that all staff complete annual ethics training, to include conflicts of interest, provided as indicated in staff training. SPECIAL CONTRACT REQUIREMENTS There will be multiple awards to serve the areas previously mentioned Northern Virginia, Montgomery County & Prince Georges County respectfully. The Contractor shall notify the authorizing VA staff immediately when a medical emergency occurs that requires hospitalization of any Veteran receiving care at VA expense. If hospitalization of a non-emergency nature is required, it is agreed that admission to a VA hospital shall be accomplished consistent with VA eligibility criteria, as determined by Medical Administration Service. The HUD-VASH Agency shall develop and submit to the VA designee Standard Operating Procedures (SOP) for the HUD-VASH program based on contract requirements and policies and procedures outlined in the VHA Handbook 1162.05 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2040) for approval. Once approved it is expected that the HUD-VASH staff assigned to the program will conduct business according to standards outlined is said document. The HUD-VASH clinical team shall compete bi-annual satisfaction surveys with all Veterans admitted to the program. The survey shall be anonymous, the results shall be computed, summarized and forwarded to designated VA staff by the July 10th and January 10th each year for the life of the agreement. The HUD-VASH Clinical Team shall be expected to protect printed and electronic files containing sensitive data in accordance with the provisions of the Privacy Act of 1974 and other applicable laws, Federal Regulations, VA statutes and policy, and VHA policy. The Team must protect data from unauthorized release, loss, alteration, or unauthorized deletion. The Team must follow applicable regulation and instruction regarding access to computerized files, release of access codes, etc. (See Attachment C) HUD-VASH staff can only disclose or release information from VHA records only with the prior signed authorization of the individual or other legal authority as outlined in VA HANDBOOK 6500.6., VHA Directive 1605.01, as well as HIMS/ROI (see attachment D) All disclosures must be covered by or listed in the Information Bulletin (IB) 10-163, VA Notice of Privacy Practices. Any individually-identifiable information related to VHA treatment of drug abuse, alcoholism, sickle cell anemia, and testing or treatment for HIV has special protection under 38 U.S.C. Section 7332. The information can only be disclosed as authorized by 38 U.S.C. 7332, and the implementing VA regulations at 38 CFR 1.460 1.496. The contractor and their personnel shall be subject to the same Federal laws, regulations, standards, and VA policies as VA personnel regarding information and information system security. These include but are not limited to Federal Information Security Management Act (FISMA), Appendix III of OMB Circular A-130, and guidance and standards available from the Department of Commerce s National Institute of Standards & Technology (NIST). This also includes the use of common security configurations available from NIST s web site at http://checklists.nist.gov. To ensure that appropriate security controls are in place, contractors must follow the procedures set forth in VA Information and Information System Security/Privacy Requirements for IT Contracts located at the following web site http://www.iprm.oit.va.gov. The HUD-VASH Team shall appropriately use word processing software to execute office automation functions such as storing and retrieving electronic documents and files; activating printers; inserting and deleting text, formatting letters, reports, and memoranda; and transmitting and receiving e-mail. The HUD-VASH Team shall always practice safety. The team shall: Practice appropriate use of equipment and supplies. Maintain safe, orderly work areas, report any safety hazards, accidents and injuries to self or patients, fill out appropriate VA accident forms, and follow Life Safety Management (fire protection) procedures. Review hazardous materials/Material Safety Data Sheets (MSDS). Follow Emergency Preparedness plans; and follow security policies/procedures. Comply with federal, state and local environmental and other requirements preventing pollution, minimizing waste, and conserving cultural and natural resources. Demonstrate infection control practices for disease prevention (i.e. hand washing, universal precautions isolation procedures), including annual TB testing. The Contractor shall notify the authorizing VA staff immediately when a medical emergency occurs that requires hospitalization of any Veteran receiving care under this contract. If hospitalization of a non-emergency nature is required, it is agreed that admission to a VA hospital shall be accomplished consistent with VA eligibility criteria, as determined by Medical Administration Service. In the event of a beneficiary receiving services under the HUD-VASH Case Management Team contract dies, the contracted agency shall promptly notify the VA staff authorizing services and immediately assemble, inventory, and safeguard the Veteran's personal effects. The funds, deposits, and effects left by the Veterans shall be delivered by the agency to the person or persons entitled thereto under the laws currently governing the contracted facility for making disposition of funds and effects left by Veterans, unless the beneficiary died without leaving a will, heirs, or next of kin capable of inheriting. When disposition has been made, the itemized inventory with a notification as to the disposition of the funds and effects will be immediately forwarded to the VA office. Should a deceased Veteran leave no will, heirs, or next of kin, his or her personal property and funds wherever located vests in and becomes the property of the United States in trust. In these cases, the contracted agency shall forward an inventory and any such property and funds in its possession to the appropriate VA office and will hold them (except articles of clothing necessary for a proper burial) under safeguard until instructions are received from the VA concerning disposition. The Contracted Agency shall inform the VA's Point of Contact (POC) first by phone and then in writing when they are unable to contact a veteran assigned to the program; within 72 hours. Disengagement of the Veteran and his/her family from services provided by the contracted agency in excess of seven (7) business days must be documented and the appropriate efforts made to reengage the Veteran, not to exceed 60 days. At which time, the appropriate Housing Authority must be notified. Management of program dropout will be an element of the quality assurance review of this program. Inspections and auditing of the contractors files, work environment must be made yearly by the COR as necessary to assure the agency provides quality care in a safe, respectful and confidential manner. As site visits are accomplished by VA program staff personnel, attention will be directed to the adequacy of Veterans' records and meeting area for...

Inactive

This sources sought notice is for the DC VAMC to determine the availability of potential sources and their size classification relative to NAICS Code 541611 having the skills and capabilities necessar... This sources sought notice is for the DC VAMC to determine the availability of potential sources and their size classification relative to NAICS Code 541611 having the skills and capabilities necessary to provide case management services in accordance with the attached SOW. All interested vendors are invited to provide information to contribute to this market survey/sources sought including, commercial market information. This is not a solicitation announcement. No award will be made from this source sought. Interested Vendors please provide requested information by email to vanessa.jacobs@va.gov by 12:00pm EST March 24, 2020. Provide only the requested information below. REQUESTED INFORMATION BUSINESS SIZE AND SOCIO-ECONOMIC STATUS: (a) Indicate whether your business is large or small (b) If small, indicate if your firm your firm is a certified Service-Disabled Veteran Owned Small Business (SDVOSB) or Veteran Owned Small Business (VOSB) (c) Include the DUNS number of your firm. (d) Provide your firms FSS or GSA Contract number if applicable. STATEMENT OF WORK (SOW) OBJECTIVE: The contractor shall provide the Washington DC Department of Veterans Affairs Medical Center (DC-VAMC) community based Housing and Urban Development-VA Supportive Housing (HUD-VASH) case management services to include but not limited to linking Veterans and their families who are homeless or at risk of becoming homeless to appropriate services based on needs assessment, as well as assisting them in obtaining housing and attain self-sufficiency, in accordance with all terms, conditions, provisions and requirements listed herein. The period of performance for these services is one year, with four option years. BACKGROUND Ending homelessness among Veterans and their families have been one of Veterans Affairs Administration initiative. The DC VAMC has a goal of ending homelessness among Veterans by having a housing placement when every Veteran who desires housing can be placed. We recognized that a cookie cutter approach to housing and serving the homeless population is defeating. Therefore, to fulfill the Zero Tolerance goal, the DC VA Medical Center partnered with a community service provider to provide HUD-VASH Case Management Services, utilizing the Housing First Model. The program provided in home case management services and housing support to the most vulnerable formally homeless Veterans. This partnership has been in place for the past ten years and has been extremely successful in housing and keeping some of the hardest to engage population housed. This program has had zero recidivism over the last ten years. As a result, the DC VA Medical Center has opted to maintain this service through contracting as the current contract will expire August 2020. As a result of the benefits of this model to the Government, the DC VA Medical Center is seeking to partner with a community agency (or agencies) to provide HUD-VASH case management services to homeless Veterans in Northern Virginia (Alexandria City, Arlington County, Fairfax County, Loudoun County, and Prince William County) who might or might not be medically vulnerable requiring intensive HUD-VASH case management services. Additionally, we are seeking an additional community provider to provide said services ( for the medically vulnerable) in Montgomery and Prince George s County, Maryland. The Health Care for Homeless Veterans (HCHV) Contracted HUD-VASH Case Management Service is an opportunity to meet Veterans and their families where there are ; employing a housing first model to rapidly reduce Veteran homelessness to those who present with various vulnerabilities to include but not limited to serious medical and mental illness, co-occurring and substance use disorder. The DC VAMC recognizes that there are services that a community provider is able to make available to veterans that the VA might not have or able to provide, additionally, there are veterans who would rather be served by a community provider whom they are familiar with rather than the VA. Therefore, The DC VAM will leverage its partnership through contracting with other Community and or State agencies by making available HUD-VASH case management services for consumers of vouchers awarded in Northern Virginia and 25 medically vulnerable HUD-VASH voucher recipients requiring intensive case management residing in Montgomery and Prince George s County Maryland. These consumer Veterans must be selected through the Coordinated Entry process, referred by the VA, or agency outreach efforts, meet the VA and HUD definition for homeless and or chronically homeless as authorized in 38 U.S.C. 2002(1) and The McKinney-Vento Homeless Assistance Act, as amended by S. 896 The Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act of 2009. NOTE: see http://www.hudhre.info/hearth/. and eligible for Veteran Health Administration (VHA) services. The HUD-VASH Program is described in the VHA Handbook 1162.05. Please click on the following link for more details. http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2040). The program s goal will be for a HUD-VASH case management clinical team to assist homeless veterans to achieve housing stability by providing services such as outreach and engagement, securing housing, and intensive long-term case management. DESCRIPTION/SPECIFICATION/WORK STATEMENT DC VAMC is seeking Contractors to assist with providing HUD-VASH Case Management Services in a team fashion to homeless or at risk of becoming homeless Veterans and their families. Many of these Veterans have multiple conditions that make it difficult for them to navigate the system and advocate for their needs successfully. These conditions may include mental illness, substance use disorders, and other serious medical conditions. Many have been in and out of shelters or living on the streets for years. DC VAMC intends to utilize the services of the Contractor to provide HUD-VASH Case Management Services with a housing first approach to homeless Veterans and their families referred by the VA Medical Centers, Coordinated Entry from any jurisdiction served by the medical center or identified by the outreach efforts of the HUD-VASH Team. The Contractor shall furnish services to the beneficiaries for whom such care is specifically authorized by the VA. It is understood that the type of Veteran to be cared for under this contract may require intensive case management services over and above the level of linking to services and stable housing. The Contractor shall furnish each Veteran authorized care under this contract with the following basic services Needs Assessment and coordination of services Linkage to resources based on needs Intensive Case Management Services determined to be needed by the Veteran and his/her family in a plan developed by the Contractor with consultation from the Veteran and the HCHV staff and/or other appropriate service providers. Appropriate housing placement as determined by the Contractor, HCHV Team, the Veteran and his/her family. Services which the contractor and their Clinicians must be able to furnish or ensure the Veterans has access to but are not limited to, include: Collaboration with the HCHV staff that will provide supportive services with admission and discharge from the program. Coordination of structured group activities as appropriate examples include group therapy, social skills training, Alcoholics Anonymous, Narcotics Anonymous, vocational counseling, and physical activities as appropriate. Provide supportive counseling and advocacy for Veterans. Individual professional counseling, including counseling on self-care skills, adaptive coping skills and, as appropriate, vocational rehabilitation counseling and physical activities where appropriate. Assistance to develop responsible living patterns and to achieve a more adaptive level of psychological functioning, upgraded social skills, and improved personal relationships. Support for an alcohol/drug abuse-free lifestyle. Assistance to gain knowledge of the recovery process. Manage a caseload of minimum 25 clients and maintain case file Conducts comprehensive assessments to collect functional, environmental, psychosocial, financial, employment, housing, educational, and basic acute and chronic medical needs information as appropriate for Veterans and their families to develop a case plan. Develop support systems to meet client needs by identifying and coordinating a variety of available services necessary to maintain independent living, and, when possible, self-sufficiency and family stabilization. Refer clients to available therapeutic, social service, educational and medical resources within the VA-DCHCS when appropriate. Conduct crisis intervention as necessary, and daily street and shelter outreach as needed to connect with referred Veterans. Document in Computerized Patient Record System, CPRS all services provided to each Veteran and his/her family on a daily/weekly/ monthly basis, outlining type, quality and effectiveness of services provided. Document in Homeless Operation Management Engagement System HOMES Veterans housing and employment progress. The cost for service established by this contract shall include the services listed in this document and all services and supplies normally provided to other clients by the agency without extra charge. The Contractor shall employ trained professional staff to carry out the requirements of the contract. This may include but not limited to; Licensed Registered Nurses, Licensed Clinical Social Workers, Peer Support and Addiction Specialist. There shall be an identified professional specifically assigned to the contract who shall be the point of contact for the HCHV staff and Contracting Officer Representative. The Contractor shall make available documentary information required for the VA to conduct utilization review audits for the mandated national evaluation study as required by section 2 of Public Law 100-6; to verify quality of care for Veterans, to assure confidentiality of Veteran record information, and to determine the completeness and accuracy of financial records. The Contractor shall collaborate with the Veteran and HCHV staff to conduct treatment and discharge planning reflecting a team assessment of health, social and vocational needs and the involvement of Veteran's family and appropriate community resources in resolving problems and setting goals. The Contractor shall coordinate transportation services for the veteran to get to scheduled appointments or services, such as, medical and employment to name a few. It is recommended that services be provided no more than 50 miles from the VA. The Contractor shall comply with the VA Veteran's Bill of Rights as set forth in section 17.34a, title 38, Code of Federal Regulations. The Contractor shall assist in preparing reports, maintaining records and databases to track referrals, acceptances, denials, discharges, and follow-up post discharge. The Contractor shall provide monthly invoices in a timely manner, no later than the tenth day of the month, in order to receive timely compensation for the services identified in the contract. The contractor shall provide office hours at the VA Community Resources and Referral Center (CRRC) as needed. Contractor shall attend HCHV monthly meetings as well as regular scheduled national calls as appropriate. SCOPE The agency HUD-VASH program shall be modeled on the standards set in the VHA Handbook 1162.05 and with the same level of efficiency as other similar programs currently operated by the agency. The Program is expected to include the following elements: The HUD-VASH Clinical Team should include Independent Licensed Clinical Social Workers (hereinafter SW ) or Registered Nurses (hereinafter RN ), or Licensed Professional Counselor as well as Case Managers and a Coordinator/Clinical Supervisor with experience that demonstrates advanced practice skills and judgment. All HUD-VASH case managers will be subjected to a full background check. They must complete privacy, HIPAA and security training upon appointment and yearly thereafter for the life of the contract. This will enable the HUD-VASH agency staff to receive and maintain network access. Each staff person will also have to create a Virtual Private Net (VPN) account in order to receive remote access to the VA-MC network. In addition, all clinical staff or person designated to maintain the Homeless Operation Management and Evaluation System (HOMES), must compete HOMES training and all other Veterans Affairs Health Care for Homeless Veteran, (VA-HCHV) required trainings. This will enable them to complete required documentation directly into the VA Computerized Patient Record System (CPRS) as well as all the HOMES required forms in a timely fashion. The HUD-VASH agency team will accept referrals from the Coordinated Entry team in their jurisdiction, as well as, VAMC HCHV Program. These referrals are for veterans that reside in the jurisdiction served by contract agency who have been deemed the most vulnerable based on their Vulnerability Index-Service Prioritization Determination Assessment Tool (VI-SPDAT) assessment. Agency serving Montgomery County and Prince Georges County will be assigned those Veterans with high acuity and medically fragile. The HUD-VASH Clinical Team should work under the direction of a Program Supervisor and or Supervisory Social Worker who is Licensed at the independent level, (Licensed Clinical Social Worker or RN Mental Health Clinicians) with prior experience in working with chronically homeless population, preferably with experience working with homeless veterans. The HUD-VASH Clinical Team shall work in concert with the Washington DC VA Medical Center HUD/VASH Program and will be held to the same guidelines as outlined in the VHA Handbook 1162.05, (see attachment A), that establishes procedures for the United States (U.S.) Department of Housing and Urban Development (HUD) and the U.S. Department of Veterans Affairs Supported Housing (VASH) Program and sets forth the national authority and responsibilities for the Department of Veterans Affairs (VA) portion of administration, monitoring, and oversight of these services. The DC VAMC Contracting Officer Representative, COR, will provide support to the HUD-VASH Clinical Team by assuring that the HUD-VASH Clinical Team: Is trained on VA HOMES and CPRS and all policies and procedures as set forth in the VHA HUD-VASH Handbook 1162.05 Ensure documentation is uniformed among the team and meet HIPAA and VA Privacy and Security guidelines. Ensure understanding and implementation of applicable VA guidelines and HUD/VASH policies. Assist the HUD-VASH Clinical Team with connecting Veterans to needed VA services. (v) Act as the Mental Health Coordinator for Veterans in this program, as needed. Ensure all HOMES documentation is completed in a timely manner, as outlined in the VHA HUD-VASH Handbook 116.05. Assist the HUD-VASH Team in implementing protocols for discharging Veterans from case management. The HUD-VASH Clinical Team is administratively responsible for managing and developing the clinical program and shall be accountable for clinical program effectiveness and implementing modification of services with VA approval, as needed. The HUD-VASH Clinical Team shall complete HOMES assessment, admissions and discharges as required. They shall complete timely services agreement, on a bi-annual basis for each Veteran assigned to the program and provide in home case management visits as needed; minimum once per month. It is the expectation that all interaction with a Veteran shall be documented in CPRS within 24 hours. Likewise all HOMES admission and discharge must be completed in HOMES within 24 hours of the occurrence as outlined in the VHA Handbook 1162.09, found here: http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3006 . Additionally, the contractor will be required to document encounters in their local HMIS system as required by the Continuum of Care. The HUD-VASH Agency must be an active participant in the local Continuum of Care (CoC) and be involved in the Coordinated Entry process to match veterans with the appropriate housing. The HUD-VASH Clinical Team shall collaborate with VA providers to connect Veterans to appropriate specialized treatment services for complex physical and/or mental illness. The HUD-VASH Clinical Team shall have the capacity to or have access to a complete psychosocial assessment of the Veteran to identify mental health, medical and social problems and work to connect the veteran to appropriate treatment services. Some of these services could be social and therapeutic groups, family therapy, individual therapy, Assertive Community Treatment Team, Alcohol Anonymous or and Narcotics Anonymous. Veterans with Substance Use Disorder (SUDs) are some of the most vulnerable of the homeless population served by the HUD-VASH Program and are not required to be sober as a criterion to housing. Therefore, the HUD-VASH Clinical Team shall coordinate treatment services with the DC VAMC and or community-based substance abuse treatment programs for said Veteran as needed. The HUD-VASH agency must provide copies of resumes, clinical licenses and other credentials as necessary for all staff prior to them being assigned to the HUD-VASH Program.VA will review the disciplines and credentials of all staff persons prior to assignment to program to ensure they meet the VA minimum requirements for staff. Each staff must complete the VA background check prior to being assigned to the contract. It is mandatory that a licensed independent clinical social worker is a member of the HUD-VASH VASH team. Case management services shall be provided by any of the following disciplines at a bachelor s level and minimum five years or Master level without a license and two years experience or with a license and 1-year experience doing case management or related field: professional counselors, social worker, psychology or nursing, as well as peer support. The HUD-VASH agency in collaboration with the VA HCHV staff shall develop a protocol with triggers for assessment by the licensed independent social worker for the case managers to follow at each visit. Although case management services do not have to be provided by independent licensed mental health professional, all assessments and crisis interventions must be conducted by an Independent Licensed Mental Health Professional. The HUD-VASH Clinical Team shall participate in VA treatment meeting upon request and or when related to a Veteran being served by their team. And all case managers on the HUD-VASH staff must complete a Critical Time Intervention (CTI) training within 90 days of being assigned to the VA-VASH Program. The HUD-VASH Clinical Team shall provide age-specific care appropriate to the cognitive, emotional, cultural and chronological maturation needs of the veterans. They will be expected to demonstrate knowledge of changes associated with aging and principles of growth and development relevant to the adult and geriatric age groups; can assess and interpret data about the veteran's status; and be able to identify age-specific needs and provide the appropriate care based upon the age-related factors. The HUD-VASH Clinical Team shall perform duties independently and be supervised by the HUD-VASH supervisor. The HUD-VASH Clinical Team shall be accountable to the Contracting Officer Representative in the areas of service, staffing, reports and documentation per this contract. The HUD-VASH Clinical Team shall be responsible for providing services to the literally homeless and chronically homeless veterans to include: Outreach and engagement, admission to HUD-VASH Program Completion of the local Public Housing Authority (PHA) housing application Submitting of referral to the local Public Housing Authority (PHA) Apartment search and lease-up Coordinating care with the VA medical facility Money management Skill development Conduct home visit at least once per month Conduct one-on-one and group meeting with individual case management, based on client need The HUD-VASH case management team must monitor the Veteran s progress and intervenes, if indicated, to ensure that the Veteran remains housed. The HUD-VASH case management team shall follow the DC VAMC HUD-VASH Protocol for Discharging Veterans successfully form case management. (see Attach B) as well VHA HUD-VASH Handbook 1162.05 p.29 on ending case management services . NOTE: Non-compliance with HUD-VASH does not necessarily lead to loss of the section 8 Housing Choice Voucher (HCV). PHA rescinds the HCV if the Veteran no longer meets or is non-compliant with PHA requirements. The Veteran will receive written notification from PHA on said action. The HUD-VASH Clinical Team shall conduct the program in accordance with the policies and procedures outlined in the VHA HUD/VASH Handbook 1162.05 and 1162.09 The HUD-VASH Clinical Team shall consistently demonstrate good customer services skills, including: communicating with and treating internal and external customers (veterans, their representatives, visitors, and all VA staff) in a courteous, tactful, and respectful manner. providing customers with consistent information according to established policies and procedures; and handling conflict and problem in dealing with the Veterans, constructively and appropriately. STAFF TRAINING It is essential that all staff complete annual ethics training as required by respective professional licensure or credentialing boards, with an emphasis on dual relationships and conflicts of interest. It is mandatory that the HUD-VASH team completes all required VA training on an annual basis to maintain access to the network and CPRS: VA Privacy Training Cyber Security Training VA Compliance Business and Integrity Training (CBI) Fire and Safety Training Infection Control policy and Procedures Emergency Preparedness / Disaster Policy and Procedures The HUD-VASH case management team must participating in program specific conference calls and broadcasts such as: Monthly 1-hour conference call hosted by the HUD-VASH National Program office where policy, trends, and resources, as well as site-specific issues and new program ideas are addressed in this forum. Viewing of available HUD-VASH satellite broadcasts, PowerPoint presentations, and attendance at national and regional HUD-VASH and other homeless conferences are encouraged, as time and funding permits. All new case managers must compete all required training within 90 days of initial start date. Training must include: CTI Assertive Community Treatment Motivational Interviewing Housing First, Low-Demand Model of care Suicide Prevention Clinical approaches relevant to the population CASE MANAGER RESPONSIBILITIES The Case Manager team is responsible for: Screening and completing a brief assessment to ensure appropriateness of placement into the program. Assessing Veterans through comprehensive psychosocial evaluations to determine case management needs and recovery goals. Providing access to appropriate treatment and supportive case management services to potential HUD-VASH Program participants. NOTE: This can be done individually or in groups. Employing Motivational Interviewing approaches to promote Veteran follow through with referral for preventive care and treatment of medical conditions, substance use and dependence, other mental health conditions, and problematic health behaviors (e.g., problematic substance use, tobacco use, unsafe sexual practices). Helping the Veteran obtain the voucher from PHA. Providing housing search assistance to HUD-VASH participants with rental vouchers. Making regular home visits to assess Veterans housing stability, social connection and recovery, and acting as a liaison with other VA and community resources, landlords, and PHA. Regular re-assessment and revision of treatment plans are done as needed. Ensuring coverage of caseload during absences and identifying the POC. Reviewing agreements between Section 8 HCV landlords, PHAs, and VA in establishing appropriate referral sites for HUD-VASH placements. Performing site visits of HUD-VASH apartments to ensure that Veterans reside in safe environments in compliance with local housing codes. Meeting regularly with landlords and PHA officials to ensure the availability of Section 8 HCV eligible housing stock. Collecting and submitting HUD-VASH Program evaluation data on Veteran family participants in HOMES. Ensuring that there is no conflict of interest in dealings with Veterans, landlords, or other entities by adhering to professional ethical guidelines. It is essential that all staff complete annual ethics training, to include conflicts of interest, provided as indicated in staff training. SPECIAL CONTRACT REQUIREMENTS There will be multiple awards to serve the areas previously mentioned Northern Virginia, Montgomery County & Prince Georges County respectfully. The Contractor shall notify the authorizing VA staff immediately when a medical emergency occurs that requires hospitalization of any Veteran receiving care at VA expense. If hospitalization of a non-emergency nature is required, it is agreed that admission to a VA hospital shall be accomplished consistent with VA eligibility criteria, as determined by Medical Administration Service. The HUD-VASH Agency shall develop and submit to the VA designee Standard Operating Procedures (SOP) for the HUD-VASH program based on contract requirements and policies and procedures outlined in the VHA Handbook 1162.05 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2040) for approval. Once approved it is expected that the HUD-VASH staff assigned to the program will conduct business according to standards outlined is said document. The HUD-VASH clinical team shall compete bi-annual satisfaction surveys with all Veterans admitted to the program. The survey shall be anonymous, the results shall be computed, summarized and forwarded to designated VA staff by the July 10th and January 10th each year for the life of the agreement. The HUD-VASH Clinical Team shall be expected to protect printed and electronic files containing sensitive data in accordance with the provisions of the Privacy Act of 1974 and other applicable laws, Federal Regulations, VA statutes and policy, and VHA policy. The Team must protect data from unauthorized release, loss, alteration, or unauthorized deletion. The Team must follow applicable regulation and instruction regarding access to computerized files, release of access codes, etc. (See Attachment C) HUD-VASH staff can only disclose or release information from VHA records only with the prior signed authorization of the individual or other legal authority as outlined in VA HANDBOOK 6500.6., VHA Directive 1605.01, as well as HIMS/ROI (see attachment D) All disclosures must be covered by or listed in the Information Bulletin (IB) 10-163, VA Notice of Privacy Practices. Any individually-identifiable information related to VHA treatment of drug abuse, alcoholism, sickle cell anemia, and testing or treatment for HIV has special protection under 38 U.S.C. Section 7332. The information can only be disclosed as authorized by 38 U.S.C. 7332, and the implementing VA regulations at 38 CFR 1.460 1.496. The contractor and their personnel shall be subject to the same Federal laws, regulations, standards, and VA policies as VA personnel regarding information and information system security. These include but are not limited to Federal Information Security Management Act (FISMA), Appendix III of OMB Circular A-130, and guidance and standards available from the Department of Commerce s National Institute of Standards & Technology (NIST). This also includes the use of common security configurations available from NIST s web site at http://checklists.nist.gov. To ensure that appropriate security controls are in place, contractors must follow the procedures set forth in VA Information and Information System Security/Privacy Requirements for IT Contracts located at the following web site http://www.iprm.oit.va.gov. The HUD-VASH Team shall appropriately use word processing software to execute office automation functions such as storing and retrieving electronic documents and files; activating printers; inserting and deleting text, formatting letters, reports, and memoranda; and transmitting and receiving e-mail. The HUD-VASH Team shall always practice safety. The team shall: Practice appropriate use of equipment and supplies. Maintain safe, orderly work areas, report any safety hazards, accidents and injuries to self or patients, fill out appropriate VA accident forms, and follow Life Safety Management (fire protection) procedures. Review hazardous materials/Material Safety Data Sheets (MSDS). Follow Emergency Preparedness plans; and follow security policies/procedures. Comply with federal, state and local environmental and other requirements preventing pollution, minimizing waste, and conserving cultural and natural resources. Demonstrate infection control practices for disease prevention (i.e. hand washing, universal precautions isolation procedures), including annual TB testing. The Contractor shall notify the authorizing VA staff immediately when a medical emergency occurs that requires hospitalization of any Veteran receiving care under this contract. If hospitalization of a non-emergency nature is required, it is agreed that admission to a VA hospital shall be accomplished consistent with VA eligibility criteria, as determined by Medical Administration Service. In the event of a beneficiary receiving services under the HUD-VASH Case Management Team contract dies, the contracted agency shall promptly notify the VA staff authorizing services and immediately assemble, inventory, and safeguard the Veteran's personal effects. The funds, deposits, and effects left by the Veterans shall be delivered by the agency to the person or persons entitled thereto under the laws currently governing the contracted facility for making disposition of funds and effects left by Veterans, unless the beneficiary died without leaving a will, heirs, or next of kin capable of inheriting. When disposition has been made, the itemized inventory with a notification as to the disposition of the funds and effects will be immediately forwarded to the VA office. Should a deceased Veteran leave no will, heirs, or next of kin, his or her personal property and funds wherever located vests in and becomes the property of the United States in trust. In these cases, the contracted agency shall forward an inventory and any such property and funds in its possession to the appropriate VA office and will hold them (except articles of clothing necessary for a proper burial) under safeguard until instructions are received from the VA concerning disposition. The Contracted Agency shall inform the VA's Point of Contact (POC) first by phone and then in writing when they are unable to contact a veteran assigned to the program; within 72 hours. Disengagement of the Veteran and his/her family from services provided by the contracted agency in excess of seven (7) business days must be documented and the appropriate efforts made to reengage the Veteran, not to exceed 60 days. At which time, the appropriate Housing Authority must be notified. Management of program dropout will be an element of the quality assurance review of this program. Inspections and auditing of the contractors files, work environment must be made yearly by the COR as necessary to assure the agency provides quality care in a safe, respectful and confidential manner. As site visits are accomplished by VA program staff personnel, attention will be directed to the adequacy of Veterans' records and meeting area for sufficient level of privacy. The Contr...