G--Safe-Haven HCHV Residential Housing and Case Management Services for the Bronx VAMC.

The VA has been providing direct and specialized services for homeless Veterans for over 25 years. As part of the VA Plan to End Homelessness among Veterans announced in late 2009, the Veterans Health Administration (VHA) has increased capacity of existing programs and services offered to program participants. VA efforts to meet the needs of the most vulnerable homeless Veterans have led to innovative program models and new evidence based approaches within its homeless programs. Recent national trends in service provision for the homeless outside of the VA system include the utilization of Safe Havens as an alternative to shelter care or as a placement after unsuccessful discharge from an inpatient or residential treatment program due to relapse-related issues. A Safe Haven is a form of treatment housing that serves hard-to-reach homeless persons with severe mental illnesses and/or substance use disorders that are on the streets and have been unable or unwilling to participate in more traditional treatment services. It is a low demand model of service delivery that allows clients to engage in treatment and services at their own pace. Because VA is limited by current grant authorities and existing program structures and practices and cannot fund harm-reduction treatment models, VA has been unable to provide the types of services focused on shelter diversion and early stabilization in community-based environments and has been criticized by outside organizations for not having this component of the continuum of care. The Department of Veterans Affairs (VA) efforts to end homelessness among Veterans has focused on enhancing current homeless service capacity as well as developing new programs and initiatives in concert with community and federal partners. The intent of this contract is for the James J. Peters VA Medical Center, Bronx, New York (aka, Bronx VA ), to engage a community provider to offer homeless Veterans services through a Safe Haven model of residential care. Under the contract authority of VA s Healthcare for Homeless Veterans (HCHV) Contract Residential Care programs, the Bronx VA will solicit community organizations to provide Safe Haven services as a specialty model. This model of HCHV Contract Residential Care will offer services up to 40 street homeless Veterans under the HCHV Contract Residential Care program enhanced by the services as defined in the Tasks and Deliverables. These services must be put forth in the solicitation. Significant deviation from these services can dilute the model as prescribed, and thus disrupt ongoing program evaluation and fidelity studies. The VA National Center on Homelessness among Veterans ( the Center ) provides ongoing support for program development for both providers and VA staff. Additionally, the Center has formulated the evaluation protocol and program fidelity measures which must be adhered to by the selected Contractor and the Bronx VA. The Bronx VA will contract for up to 40 beds and associated services through procedures in line with their own business practices and contracting services. Entities that are interested in providing Veterans these services should be aware that although this contract seeks services for the Bronx VA, HCHV is a national program serving Veterans throughout the country. This program has become one of the largest VA interventions to assist homeless Veterans. It is also the first specialized homeless program developed by the VA. It represents one of VA s most significant efforts to achieve the President s goal of ending homelessness among Veterans. The Safe Haven program model has been developed by VA in a number of other high priority cities and continues to be highly monitored. This contract for Safe Haven residential care will serve up to 40 street homeless Veterans in need of immediate placement in a safe environment with onsite treatment services. Many of these Veterans have co-morbid conditions that include serious mental illnesses, substance abuse disorders, and other serious medical conditions. The goal of the HCHV Contract Residential Care Program is to rapidly stabilize Veterans medical, mental health, substance abuse and other psychosocial problems in order to place Veterans in other appropriate permanent housing as quickly as possible within 90 to 180 days, but no more than 270 days from the date of admission. VA intends to engage a Contractor to provide rapid placement of VA-referred Veterans in a safe, residential treatment setting while addressing Veterans complex needs through on-site treatment case management services using a Safe Haven model. This housing must meet the criteria established both by HCHV clinical staff and VA fire and safety officials. Contractors are urged in the strongest terms to carefully review the requirements outlined in the Performance Work Statement to ensure that all facilities fire and safety and treatment services criteria can be met in a timely way. This contract is intended for a community based contractor currently operating a Safe Haven residential care program with on-site treatment services and demonstrated experience serving street homeless Veterans in conjunction with the New York City Department of Homeless services contracted street outreach teams in the five boroughs of New York City and the Bronx VA Medical Center whereby this contract provides supplemental funding for Veterans to receive immediate placement and enhanced on-site clinical services designed to address Veterans unique and population specific needs. VA will consider proposals for new residential treatment programs if it can be determined that the contractor can meet all of the terms of the Performance Work Statement within the required time frames. VA places a great deal of emphasis on the responsibility and accountability of contractors receiving VA funds through the HCHV Contract Residential Care program. VA has procedures in place to monitor facilities and treatment services provided to homeless Veterans as well as outcomes associated with the services provided in HCHV Contract Residential Care programs and the Safe Haven model programs. The target population for HCHV Contract Residential Care Safe Haven is street homeless, seriously mentally ill Veterans, Veterans with chronic substance abuse disorders and/or serious medical problems and complex needs. To be eligible for the HCHV Contract Residential Care Safe Haven program, Veterans must: Be eligible for VA health care as determined by the local VA medical center Be determined to be chronically street homeless based on McKinney-Vento / HEARTH Act definitions by the local VA medical center HCHV program [see Reference section for additional information] Be assessed by the HCHV program at the VA medical center to have serious mental health, substance abuse, medical and/or other serious psychosocial conditions or stressors that makes the Veteran highly vulnerable with a high likelihood of death due to homelessness, and has been unable or unwilling to participate in more traditional treatment services. HCHV Contract Residential Care Safe Haven Veterans are referred to the contractor based on a demonstrated need for case management and treatment services to stabilize their mental health, substance abuse, medical and/or other co-occurring serious psychosocial issues in order to secure transitional or permanent housing as quickly as possible. In the Bronx, the program will target Veterans who are engaged in care through a collaborative partnership among the Bronx VA, the New York City Department of Homeless Services contracted street outreach teams, and the selected Safe Haven provider. This contract will only be awarded to one contractor with a facility in the Bronx that meets the requirements outlined in the Tasks and Deliverables. A VA Liaison to the contractor will be identified by the homeless program leadership at the Bronx VA. She/he will act as the clinical liaison for all client related issues between the Contractor and the Bronx VA homeless team. She/he will provide clinical oversight. She/he will not provide direct clinical supervision. Clinical oversight refers to a working relationship between VA liaisons and the Contractor in which the VA liaisons ensure compliance with the tasks and associated deliverables in this Performance Work Statement, as well as ensuring the safety and quality of care provided to Veterans. In providing clinical oversight, VA liaisons may also serve as consultants to the Contractor in enhancing safe and effective person-centered care in complex situations to meet the needs of Veterans in conjunction with VA regulations, requirements, and guidelines. Clinical supervision refers to regular structured meetings whose primary purpose is to assess the skills and performance of individual practitioners and foster practitioner progress in the expertise of planning work, diagnosis, and therapeutic intervention. Clinical supervision is a structured process focused on staff professional growth and learning to develop knowledge, skills, competence, and capabilities in a therapeutic milieu. While there is arguably overlap between clinical oversight and clinical supervision, VA expects the selected Contractor to have the staffing and expertise to execute the tasks and associated deliverables associated with this Performance Work Statement without reliance or undue burden on VA liaisons to provide support that would reasonably be considered clinical supervision. The Contractor is expected to provide routine, ongoing clinical supervision to its staff working on this contract. The VA Liaison will provide clinical oversight in the manner described. Contractor will have general liability insurance coverage of $5 Million to $10 Million to cover employee malfeasance. PERIOD OF PERFORMANCE: The period of performance for this contract will be for a Base Year plus four (4) Option Years. CONTRACT TYPE: Firm Fixed Rate. PLACE OF PERFORMANCE: Work will be performed at the contractor s facility in the Bronx, New York. Government furnished workspace will not be provided for this effort. However, the contractor will be required to attend frequent meetings and planning sessions at the Bronx VA medical center. GOVERNMENT FURNISHED PROPERTY: Government furnished property will not be provided to the Contractor. All equipment required by the Contractor will provided at their expense.