Loren Data's SAM Daily™

FBO DAILY - FEDBIZOPPS ISSUE OF APRIL 11, 2015 FBO #4886
DOCUMENT

G -- Loma Linda Homeless Safe Haven - Attachment

Notice Date

4/9/2015
 

Notice Type

Attachment
 

NAICS

624229 — Other Community Housing Services
 

Contracting Office

Department of Veterans Affairs;Network Contracting Office 22;4811 Airport Plaza Drive;Suite 600;Long Beach CA 90815
 

ZIP Code

90815
 

Solicitation Number

VA26215R0701
 

Response Due

5/11/2015
 

Archive Date

7/10/2015
 

Point of Contact

Shavon Bogan
 

E-Mail Address

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Small Business Set-Aside

N/A
 

Description

1. Background Through the Health Care for Homeless Veterans Program (HCHV), the VA provides case management services to Veterans and facilitates their access to a broad range of medical, mental health and rehabilitative services. HCHV's goal is to engage homeless Veterans in treatment and facilitate their placement into a safe and secure environment that supports their rehabilitation goals. The HCHV - Safe Haven Contract Program is an essential and critical part of the Veterans Health Administration (VHA) and is vital for providing a gateway to VA and community supportive service for homeless Veterans eligible for VA Healthcare. The goal of this contract is to provide a secure, appropriately monitored, temporary placement for those Veterans needing emergency residential placement near the VA Loma Linda campus. Program transportation is crucial to ensure that Veterans are able to check into VA Loma Linda and return to temporary residential placement with minimal barriers. Veteran's length of stay within Safe Haven program should not exceed 180 day stay with monthly visits by VHA representative. The purpose of this contract is to enter into a Firm fixed-Price Contract with a community provider (contractor) who will provide transitional housing services to Veterans for the VA Loma Linda Healthcare System as specified herein. All services shall be provided in accordance with the terms and conditions, and provisions of this solicitation for a period of one year from the date of award with the Government's option to exercise four (4), one (1) year option periods. The contractor shall provide all facilities, labor, supervision, supplies, materials and transportation (where needed) as required in this solicitation and resulting contract. The goal of this HCHV Safe Haven is to temporarily house Veterans while appointments, services and referrals are in process to secure placement within VHA community based transitional housing programs or return to their residence. 2. Statement of Work The Contractor shall be expected to provide same day residential placement that enhances the stability of Veterans services by HCHV within sixty (60) days of award date. The Contractor will ensure the following; a) that participants are monitored 24 hours a day, 7 days a week to include all National, Religious, and Federal holidays; b) sufficient personnel to assure security; c) staffing available on-site24 hours a day, 7 days a week, 365 days a year including all national, federal, and religious holidays; d) wheelchair accessibility; e) planning and coordinating all activities associated with providing safe and appropriate residential care. The Contractor's facility must have a current occupancy permit or license, as required by the authority that has jurisdiction to issue such. The Contractor shall be expected to provide transportation to and from VA Loma Linda, due to Safe Haven being located off VA grounds. The Contractor must adhere to all applicable local, state and federal laws. 3. Safe Haven Housing Services: Contractor services will be furnished to beneficiaries for whom such care is specifically authorized by the Department of Veteran Affairs (VA), and are considered homeless or chronically homeless. Veteran participants may have serious mental health illness as defined by the VA or substance abuse issues. Contractor will provide Safe Haven residential care services under a Harm Reduction model of care as described: (1)Provide a Safe Haven facility that will offer 24-hour staffing. The facility will provide semi-private quarters that allow for participants to remain in the facility any time of the day. Target population served will include the hard-to-reach homeless Veterans who are on the streets and have been unable or unwilling to participate in VA funded services. Contractor shall provide supportive housing services as an alternative to shelter care. If serving female Veterans, will provide separate and secure quarters to ensure the safety of the participants. (2)Supportive services provided will assist homeless Veterans link to resources to increase income, obtain vocational training and/or employment, and to reduce or stop risky behaviors. Substance use will not be permitted on contractor premises however, continued use of substances and/or relapses will not be used as a sole condition for admission, continued stay, and/or discharge from placement. Program rules that address substance use should be outlined in ways that help homeless Veterans manage their addictions and health without abstinence of substance use being the only means measurement of success. Highly Individualized Service Plans (ISP) will be unique to each Veterans needs as well as the level of participation required form each resident in the program. It is understood that the type of participant to be cared for under this contract will require care and services above the level of room and board. The per diem rate established will be an all-inclusive rate. Upon VA approval absences up to 24 hours may be permitted, unexcused or AWOL absences in excess of 24 hours will not be reimbursable. Unexcused absences less than 48 hours will not be a basis for discharge alone. Care will include, but is not limited to: a.Supervised alcohol /drug free environment b.Supportive social services c.Structured group activities d.Physical activities e.Individual and group counseling in collaboration with VA program resources f.Basic Health and Personal Hygiene maintenance; including supplies as necessary g.Storage and monitoring of medications 4. Veteran Code of Conduct The contractor shall develop a Code of Conduct to be followed by program residents while receiving services under this contract or wile on facility premises. The Code of Conduct should be reviewed and approved by the VA Safe Haven Liaison and provided in writing to program Veterans upon admission. At minimum, the following acts are not permissible; (1)Acts or threats of violence to self, other participants, employees or the general public (2)The carrying of pistols, firearms or other concealed weapons (3)Gambling in any form (4)Use of intoxicating liquors, narcotics, or controlled substances of any kind on premises of program 5. Referral/Discharge & Coordination of Care The facility agrees to accept referrals of and to provide all services in this contract, for any person determined eligible by his/her designee, regardless of the race, color, religion, sex, or national origin of the person for whom such services are ordered. 1)All Veterans who are referred for services will have a letter of acceptance/referral from the VA with date and Veteran's identifying information. a.That letter will be documented in the Veterans chart for record keeping. 2)All Veterans who are referred will receive medical care by a VA facility/medical center while being provided services authorized by this contract. a.The VA will not reimburse outside medical providers for any services rendered to participating Veterans under this contract. 3)Orders, requests, or changes in the referral process shall only be made by the VA COR/VA Safe Haven liaison, or authorized party specified by the HCHV Coordinator. Under no circumstances shall there be any deviation by any other party. In addition, Contractor shall make no deviation and is responsible for providing direction to its staff. 4)VA reserves the right to remove any or all Veteran from the facility at any time without additional cost, when it is determined to be in the best interest of the VA or the Veteran. 5)Coordination of care provided by VHA staff and contractor for individual Veterans shall be maintained as such: a.Contractor shall maintain daily census. b.Contractor shall document Veterans progress, care plan, observations etc. minimum 2x weekly. c.Contractor shall document ongoing communications as it pertains to Veteran participant as needed. d.Contractor shall document discharge plans developed by Veteran and VA staff. e.Contractor shall participate in case consultations with VHA staff as needed. f.Discharge planning will be coordinated by an assigned VHA staff and/or Liaison. All unplanned exits must be reported to the VHA staff/Liaison immediately i.e., AWOL, death or entry to hospital. g.Relapse and unexcused absences will not be a basis for discharge alone. 6)Discharging a Veteran participant to the streets without coordinated services through the assigned VHA staff/Liaison and/or appropriate placement will not be permitted unless for reason such as: i.Acts or threats of violence to self, other participant, employees or general public. ii.The carrying of pistols, firearms or concealed weapons. 6. Staffing The Contractor shall designate one (1) employee who shall be responsible for the performance of the work under this contract. The liaison shall have full authority to act for the Contractor on all matters relating to the daily operation of this contract. That employee may be a health care provider performing under this contract. An alternate may be designated, but the Contractor shall identify, in writing, those times when the alternate shall act as that employee. In addition, the Contractor must adhere to all applicable local, state, and federal laws. At minimum, there must be a (1) full-time administrative staff member or his/her staff designee on duty or on-call available for emergencies 24 hours a day, 7 days a week, 365 days a year. Responsibilities include but are not limited to: a. Management of the contract b.Ensures fidelity of services c.Ensures timeliness of billing d.Ensures timely submission of required documentation to VA e.Coordinating for annual inspection of services with VA staff f.Program will be staffed with the appropriate number of licensed healthcare professionals in accordance with the contract to provide for and meet standards based on state guidelines g.Current Basic Life Support (BLS) completed and current standing. The Contractor must provide an appropriate number of qualified staff to carry out the policies, responsibilities, and ensure the safety of Veteran participants in the program 24 hours a day/7days a week/365 days of the year. The Contractor shall ensure that employees meet and maintain the qualifications needed to perform their duties to service the identified Veteran population. 7. Direct Care/Paraprofessional Staff 1)During the provision of service, the minimum staffing ratios and health-related requirements shall be as follows: Staffing ratio will not exceed 20:2 (20 clients to 2 staff members). 2)Program will be staffed with the appropriate number of qualified healthcare professionals in accordance with the contract to provide for and meet the standards based on VA, State and federal licensing, and the Joint Commission guidelines 3)Contractor will provide a 24-hour staffed transitional residence with proper staff ratio for day and night supervision adequate for the safety and oversight of all participants a.At least one staff member on duty must be a direct care provider. 4)Any time there is only one direct care staff person on duty on the premises, another direct care staff person shall be on call and capable of responding within 30 minutes. 5)Staff behavior and interaction with residents convey an attitude of genuine concern and caring and respect. 6)Contractor shall ensure that employees meet and maintain the qualifications needed to perform their duties, and serve the identified Veteran population in accordance with this contract 7)Staff members on duty must be awake at all times. 8)Monitoring staff will have the appropriate training, included but not limited to: a.Monitor of safety b.Facilitate medication distribution c.Communication with Program staff where applicable 8. Supportive Housing Services Shall be provided in accordance with a plan of care and a trained program staff, Supervision shall be provided in accordance with VA policy and regulations: 1)The Contractor shall be responsible for admitting and assessing Veterans, including initial and ongoing assessments. The care-planning process shall include coordination, supervision, and evaluating the care and services provided and discharge planning. 2)The Contractor will encourage veteran to work towards transitional or permanent housing within 60 days of admission. 3)The Contractor will offer a low-demand environment with a minimum set of rules designed to re-establish trust in the chronically homeless Veteran and engage the Veteran in needed services. a.At minimum, once monthly random Urine Analysis (UA) screening will be required, and all positive results will be relayed to the VA liaison. b.Infraction of rules should be used as opportunities for engagement. 4)The Contractor shall provide telephone service on site free of local use charges. 5)Emergency exits must be marked with sufficient lighting in case of emergency. 6)Evacuation plans must be posted in common areas. 7)Facility shall be equipped with first aid, fire extinguishers fully charged non-expired, and fire/carbon alarms. 8)Veterans who enter the program inebriated shall be kept separately from other participants in the program until they have been cleared to enter the general participant population. This may require having a "safe room" where the Veteran can sleep separate from the other participants in the program. a)Inebriated individuals shall be closely observed and physically checked at least every 30 minutes during the first 12 hours. Close observation and physical checks shall continue beyond the initial 12 hour period for as long as the individual appears inebriated. Documentation and VA notification of such is required. b)In all cases relating to signs of withdrawal and/or acts of violence contact the local emergency response system then follow up with a phone call to the assigned liaison. 9)The Contractor's case management team shall meet the therapeutic and rehabilitative needs of each individual Veteran in accordance with a highly Individual Service Plan (ISP). 10)The ISP shall be developed by the qualified staff with the participation of the Veteran and shall remain consistent with the low-demand program goals. 11)Staff shall document each Veteran's progress on a weekly basis. Progress notes should include the following: a.Veteran's progress towards one or more goals in the Veteran's ISP; b.New issues or problems that affect the Veteran's ISP; or c.Types of support provided by the program or other appropriate healthcare providers. 12)Veterans shall be provided with opportunities to participate in spiritual worship, counseling, treatment, social skill enhancement, and knowledge of the process of illness and recovery. 13)Activities shall be designed to meet the goals and objectives for increased social responsibility, self-motivation, and integration into the larger community. Such activities may include: a.Individual/group counseling b.Social skills training, vocational counseling and physical activities as appropriate c.Supportive social services, in collaboration with VA staff and/or other community contract resources d.Assistance with housing needs and resources 9. Facility Maintenance and Supplies The term "facilities" shall include, but is not limited to rooms, sections, eating areas, entrances etc. It is agreed that VHA will have the right to inspection of the facility by an authorized representative(s) designated by the VHA to determine whether acceptable standards are maintained and that adequate care is being rendered. The Contractor shall ensure the following: a.One single bed per occupant with proper bedding; i.e., fitted sheets, blankets, pillows; b. Adequate and secured storage space for clothing and personal properties c.Efficient lighting; d.Linen and towels; e.Signs that identify female only rooms/restrooms; f.On-site adequate laundry facilities; (1) Veteran residents shall be required to do their own laundry but Contractor shall provide any supplies needed to do so. Supplies shall include but are not limited to: i. Tokens, coins, or funds to operate all machines; ii.Adequate amounts of laundry detergent Hypo-allergenic detergent may be required for medical reasons as prescribed. g.Restrooms and showers shall be provided with signs that designate men's facility separate from the female's facility. h.All toilets, hand washing, and bathing facilities shall be maintained in safe, fully functional, and sanitary condition. Additional equipment, aids, and/or conveniences shall be provided in facilities for accommodating American Disabilities Act (ADA) standards; i.Contractor will provide all toiletries at no additional cost; i.e., toilet paper, sanitary napkins, shampoo/conditioner, bath soaps, shaving equipment, facial tissues, toothpaste/brushes, combs/brush; j.Contractor will provide all kitchen supplies, utensils required to prepare and consume foods and drinks; k.Contractor shall be responsible to ensure that the facility is maintained clean, free of dirt/grime, mold, bed bugs or other hazardous substances and damage; l.Contactor shall take full responsibility for the Veterans well-being and safety once the individual enters the facility; m.Indoor recreation/lounging areas shall be provided with the following equipment: a.Chairs b.Reading materials; i.e. books, magazines, and newspapers c.Other types of entertainment, activities, and/or games that may be deemed appropriate. n.Designated smoking areas shall be provided in accordance with the laws of The State of California and/or additional local County law; o.Contractor shall provide a designated ongoing space and supply necessary to allow VHA staff and internal agency staff to conduct Veteran participant group meetings. p.Contractor shall provide a designated office space on an ongoing schedule to allow for VHA staff to meet privately to semi privately with Veteran participants. At minimum that space shall include: 1)At least two chairs 2)Small table or desk 3)Be handicap accessible q.VA Loma Linda will not incur any cost associated with the contractor providing, repairing, or replacing inadequate or faulty equipment. 10. Records The Contractor is a VHA contractor and shall assist in the provision of health care to patients seeking such care from or through VHA. As such, the Contractor is considered as being part of the department health care activity. The Contractor is considered to be a VHA contractor for purposes of the Privacy Act, Title 5 U.S.C. 552a, further, for the purpose of VHA records access and patient confidentiality. Contract is considered to be a VA contractor for the following provisions: Title 38 U.S.C. 5701, 5705 and 7362. Therefore, the Contractor will not have access, as would other appropriate components of VHA, to patient medical records including patient records pertaining to drug and alcohol abuse, HIV, and sickle cell anemia, to the extent necessary to perform its contractual responsibilities. The Contractor is subject to the same penalties and liabilities for unauthorized disclosures of any records as VHA. Contractors and any subcontractors must adhere to the provisions of Public law 104-191, Health Insurance Portability and Accountability (HIPAA) act of 1996. This includes both the HIPAA Privacy and Security Rules published by the Department of Health and Human Services protected health information by covered entities. The covered entity component of the Department of Veteran Affairs is the Veterans Health Administration Business Associate Agree (BAA). Contractor shall be responsible for maintaining the following: a.Contractor shall be responsible for the development of any necessary forms. b.Contractor shall maintain a file for each Veteran admitted to the program. c.Contractor will keep all Veteran files behind two locks at all times. d.Information will be provided following Veteran consent and completion of VA authorization to release information form. e.Contractor will not have access to VA computerized electronic systems. f.All Veteran files shall contain VHA referral, discharge and any other forms related to coordination of care. g.All Veteran files shall contain demographic information sufficient to identify the Veteran participant and to satisfy data collection needs of the program and funding agencies, to include but not limited to: 1)Veteran identifier (i.e., name, number, etc.); 2)Date of Birth; 3)Sex; 4)Race/ethnic backgrounds; 5)Address; 6)Telephone number; 7)Next of kin or emergency contact (include phone number and consent of kin); 8)VA verification of homelessness letter; 9)Date(s) of admission (i.e., new/readmission, etc.); 10)Admission agreement; 11)Authorization to release information, including, VA release of information (ROI) on most current VA form 10-5345; 12)Referral source and reason for referral; 13)Veteran rights document; 14)Medical referrals and clearances as needed; 15)Correspondence with or regarding the Veteran; 16)Discussions and actions to reengage Veteran for not complying with program rules and requirements; 17)Any type of supportive service(s) provided to Veteran i.e., personal hygiene, laundry, resource and referral, additional transportation service, clothing assistance etc. 18)Medications should be documented in records and/or incidences of medication noncompliance; 19)Major incidents involving Veterans will be documented with incident reports and any follow up/outcomes. h.It is agreed that the VA may readily have access to all medical records concerning the Veterans care in the facility. i.Contractor shall notify assigned VA COR/Liaison or designee within 24 hours of AWOL, Death or unanticipated discharge telephonically or Contractor shall fax information to 909.422.3186. j.Upon discharge or death of a patient, medical records on all VA beneficiaries will be retained by the facility for a period of at least three (3) years following termination of care at VHA expense. However, upon termination or completion of contract; the Contractor will surrender medical records on all VA beneficiaries to the VA COR/Liaison or designee k.Periodic reports will be provided to the VA (i.e., Fiscal Accountability) as required 11. Reports The Contractor shall notify the assigned VHA staff/Liaison/COR immediately of any medical emergency. If hospitalization of a Veteran is required, it is agreed that readmission will be evaluated by appropriate VA staff. In the event a Veteran participant dies, the Contractor shall promptly notify the VHA staff/Liaison/COR immediately and immediately assemble, inventory, and safeguard the patient's personal effects. Any fund deposits and effects left by the Veteran upon the premises of the facility shall be delivered by the Contractor 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 notation as to the disposition of funds, will be immediately forwarded to the VHA office. Should a deceased Veteran leave no will, heirs of next of kin, his/her personal property and funds, wherever located, vests and becomes the property of the United States in trust. In these cases the facility will forward an inventory of any such property and funds in its possession to the appropriate VA office and will hold them (except articles of clothing necessary for proper burial) under safeguard until instructions are received from the VHA concerning disposition. Contractor shall notify VHA staff immediately upon any changes to participants' health: Contractor shall contact local emergency services as needed during afterhours and weekends. The COR/VA Liaison shall monitor the services provided. Contractor shall cooperate with all VHA staff assigned to this contract, in providing information and answering questions in a timely manner when requested. Contractor shall refer complaints received directly from the customer(s) to the VHA staff/Liaison/COR. All complaints received by the VHA staff/Liaison/COR and forwarded to the Contractor shall be investigated promptly. After investigation and disposition, Contractor shall respond to the VHA staff/Liaison/COR within five (5) business days after receipt of the complaint by the Contractor. VHA staff/Liaison/COR will be provided with all information regarding complaints. 12. Medications Any medications that the Veteran brings into the contractor's facility or is prescribed while in the care of that facility will be managed in accordance with the following: a)Contractor shall have a written policy statement regarding the use of prescribed medications. Such a policy shall not necessarily preclude the licit use of prescribed medications. b)Medications including controlled substances shall be properly stored and controlled in a double locked storage unit. c)The proper issuance upon orders from physicians shall be provided by the VA and recorded in the Veteran's chart. The Veteran will initial that document upon self-administering medication to verify the count of medication. d)All medication will be self-administered by the Veteran. e)Contractor shall provide patient services for Veterans as requested Sunday through Saturday and recognized Holidays. f)Contractor shall maintain daily medication log. g)Contractor shall maintain updated medication records for Veteran participants who stay in the program more than 30 days. 13. Dietary Services The VHA will have the right to inspect the facility by an authorized representative(s) designated by the VHA to determine whether acceptable standards are maintained and that adequate care is being rendered. Dietary services shall include the following: a.Three (3) meals shall be served; breakfast, lunch and dinner; with no more than an 8 hour time span between each meal. b.In between meals, at least two (2) snacks shall be served to all Veterans unless limited by dietary restrictions prescribed by a medical provider. c.Food preparation, serving, and storage shall be in accordance with California Department of Public Health. http://www.cdph.ca.gov/programsPages/FDB%20Food%20Safety%20Program.aspx d.Sanitary procedures shall be established and maintained for washing dishes, cleaning equipment, and work areas and for proper waste disposal. e.Menus shall be written at least on week in advance and copies of the menus as served shall be dated and kept on file for at least 30 days; and shall be made available for review by the Veteran and/or VA staff. f.Some Veterans may have medical recommendations for specialized diets (i.e., cardiac, low sodium, or diabetic diets). The Contractor shall accommodate the individualized dietary needs of Veterans Residents, as specified by their medical providers. g.The dietary needs of all Veterans shall be met in accordance with sound nutrition consistent with USDA standards. USDA dietary guidelines may be found at: http://www.cnpp.usda.gov/dietaryguidelines.htm 14. Transportation Services The Contractor shall be required to provide transportation to and from VA Loma Linda Medical Center and outpatient clinics for Veterans participants only. The VHA will have the right to inspect any vehicles utilized for the transportation of Veterans by an authorized representative(s) designated by the VHA to determine whether safe operating conditions are being maintained. Transportation services are to be provided as follows: a.The manufacturer's rated seating capacity of the Contractor's vehicles shall not be exceeded; b.Motor vehicles shall be maintained in a safe operating condition, registered, and fully insured; c.Only drivers licensed and insured for the type of vehicle operated shall be permitted to transport Veterans; d.Emergency safety kits shall be maintained in the vehicle and updated on a quarterly basis at minimum; records of such shall be maintained for review; e.Motor vehicles shall be equipped with appropriate fire extinguishers. 15. Qualifications 1)Staffing: a.Case Manger i.Bachelor of Art (BA)/Bachelors of Science (BS) degree from an accredited university b.Counseling Staff i.Bachelor of Art (BA)/Bachelors of Science (BS) from an accredited university. c.All technical and professional staff shall be certified in Basic Life Support (BLS). 2)Facilities: This will be used to determine if the Contractor's facility meets the required safety, licensing, and health codes/certifications. For this factor, proposals shall provide proof of conformance to the following requirements: a.Contractor's facility conforms to the Life Safety Code, National Fire Protection Association (NFPA) #101 standards: http://www.nfpa.org/abouthecodes/AboutTheCodes.asp?DocNum=101&cookie%Ftest=1 b.Contractor shall possess a valid Business License/Certification for the state where contract performance shall occur; (i.e.) California c.Contractor facility must have current Certificate of Occupancy permit or license as required by the authority that has jurisdiction to issue and must adhere to all applicable local, state, and federal laws d.Contractor's facility shall be wheelchair accessible. e.Contractor must be in compliance with Americans with Disabilities Act Guidelines for Buildings and Facilities. http://www.access-board.gov/adaag/html/adaag.htm. f.Facility shall conform to the Safe Haven Model and shall not have more than 25 residents in the facility g.Contractor's facility shall have access to public transportation and it must be within reasonable walking distance h.Contractor's facility where services are to be provided shall be within the catchment areas of the VALLHS. 16. Standard of Conduct The Government reserves the right to refuse acceptance of contract personnel whose personal or professional conduct jeopardizes the Veteran care. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, abuse, dereliction or negligence in performing directed tasks, or other abuse, or other conduct resulting in formal complaints by the Veteran, COR or VA staff. Contractor shall maintain professional boundaries with Veteran. Contractor staff shall under no circumstances engage in sexual activities or sexual contact with Veterans or their family members, whether such contact is consensual or forced. Contractor and Contractor staff shall under no circumstances engage in any monetary transactions either in the form of lending or borrowing of money or purchasing goods with the Veteran. Contractor and Contractor staff shall under no circumstances take unfair advantage of any professional relationship or exploit Veteran or their family members to further their personal, religious, political, or business interests. Contractor staff should not engage in dual or multiple relationships with Veterans or their family members in which there is a risk of exploitation or potential harm to the Veteran or Veteran family. Contractor is responsible for taking steps to protect Veterans and their family members and is responsible for setting clear, appropriate, and culturally sensitive boundaries. Standards for conduct shall mirror those prescribed by current Federal Personnel Regulations. A review current Federal Personnel Regulations can be found at http://www.opm.gov/hr_practitioners/lawsregulations. Complaints concerning contract personnel's conduct with Government employees or Veteran patients shall be dealt with by the Contractor and COR. The Contracting Officer is the final authority on validating complaints. In the event that Contractor personnel are involved and named in a validated complaint, the Government reserves the right to refuse acceptance of the services of such personnel. This does not preclude refusal in the event of incidents involving physical or verbal abuse. The final arbiter on questions of acceptability is the Contracting Officer. 17. Subcontractors All individuals that provide services under this contract and are not employees of the Contractor will be regarded as Subcontractors. The Contractor shall be responsible and accountable for the quality of care delivered by any and all of its Subcontractors. The Contractor shall be responsible for strict compliance of all contract terms and conditions without regard to who provides the service. The parties agree that the Contractors, its employees, agents and subcontractors shall not be considered VA employees. Please reference clause "Limitation on Subcontracting" included in section C of this solicitation. 18. Substitution of Personnel The Contractor shall utilize the personnel named in its proposal to perform the services required under this contract. In the event that any of the personnel named in the proposal are unable to perform the duties of this contract, for any reason such as death, illness, resignation from the contractor's employ, the contractor shall promptly submit to the Contracting Officer and COR, in writing, a detailed explanation of the circumstances necessitating the substitution. The Contractor shall submit this request in writing, along with a resume for the proposed substitute, and any other information that may be needed to approve or disapprove the proposed substitution. Any substitution of personnel shall occur without any increase to the contract price and without delay in the performance or delivery of services to the Government. The Government shall have the right to require replacement of any contractor or subcontractor employee assigned to work on this contract, if the employee is determined not to possess the experience, education, credentials or ability required under the contract, or if said employee is for any other reason found to be unsuitable to perform the work required by the contract. The replacement shall meet the Personnel requirements stated in the contract.
 

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