Department of Veterans Affairs Homeless Providers Grant and Per Diem Program

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Department of Veterans AffairsHomeless
Providers Grant and Per Diem Program

• 2008 New Awardees Training ConferencePart 4

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Department of Veterans AffairsHomeless
Providers Grant and Per Diem Program

• Jeffrey L. Quarles, MRC, LICDC
• Clinical Manager

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Health and Safety Management

• Practices that support quality services in GPD
  Programs

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Successful Health and Safety Practices

• These practices are focused on creating a
  healthy, safe and clean environment for
  veterans, visitors, and staff
• Minimize negative consequences from incidents,
  reduce future risk

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Successful Health and Safety Practices

• Risk Assessment
• Plans, Policies and Procedures
• Staff Training

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Risk Assessment

• Identifying potential hazards and emergencies
  that the organization could face and addressing
  them with internal plans, policies and procedures
• Fire
• Natural disasters
• Utility outages
• Medical/psychiatric emergencies
• Violent or threatening behavior
• Intentionally unsafe acts

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Plans, Policies and Procedures

• Developing plans to manage emergencies for the
  organization
• Developing procedures to ensure clear and
  consistent response by staff, to emergencies or
  incidents and reinforce practices that prevent
  occurrences
• VA will review plans and policies to ensure the
  health and safety of veterans being served

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Plans, Policies and Procedures

• Involve VA in the development of policies and
  procedures, when applicable, to ensure good
  communication, consistent and effective response
  by all parties involved.

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Staff Training

• Training to ensure persons follow plans/policies.
• Emergency drills
• Consider doing training with VA staff when
  applicable.
• Staff in-services
• First aid/CPR
• Responses to threatening behavior
• Maintaining professional boundaries
• Incident reporting

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Special Reporting Circumstances-VAMC Expectations

• Medical centers must incorporate GPD-Funded
  Programs into a critical incident reporting
  procedure
• Policies and procedures must be consistent with
  the VHA National Patient Safety Improvement
  Handbook 1050.1
• Have a conversation with your GPD Liaison about
  how this process will work with your local VA

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What type of situations are reported to the GPD
Office by VA staff?

• Sentinel Events an unexpected occurrence
  involving serious physical or psychological
  injury or risk thereof (JCAHO)
• Suicide
• Drug Overdose
• Serious Injury/Death
• Intentional Unsafe Acts as it pertains to
  residents in the GPD program
• Criminal Act
• Purposefully unsafe act
• Act related to alcohol or drug impaired staff
• Events of alleged abuse/exploitation of a veteran

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Department of Veterans AffairsHomeless
Providers Grant and Per Diem ProgramGPD
Regulations

• Guy Liedke, Ph.D
• Program Specialist

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Overview

• 38 CFR 61.1 61.82
• Important Sections of CFR
• Definitions
• Site Control
• Per Diem
• Agreement and Funding Actions
• Program Changes
• Financial Management
• Recovery Provisions / Disposition
• General Operation Requirements

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Definitions

• 38 CFR 61.1
• Important Definitions
• Veteran
• Homeless
• Operating Costs
• Fee
• Rent

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Site Control

• 38 CFR 61.17
• - Draw Funds
• Rehabilitation and New Construction
• Exception is acquisition
• -Appropriate use VA Funding
• Grantee of Record
• Ensure a Viable Project

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Per Diem

• 38 CFR 61.30 61.33
• Payment Requirements
• Initial and Annual Inspection Compliance
• VA must refer the homeless veteran or
• VA must authorize the provision of
  housing or service
• Per Diem Calculation
• 100 of the cost of care minus any other sources
  of income
• Service Centers are 1/8 the rate per hour

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Agreement Funding Actions

• 38 CFR 61.61
• Requirements
• MOA for both Capital and Per Diem
• Obligate Funding
• No Capital Revisions after Obligation
• Enforcement of Compliance
• No concurrent receipt of per diem for both
  service center and housing by provider
• No more than 100 cost of care for per diem and
  special need grants combined

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Program Changes

• 38 CFR 61.62
• Requirements
• Significant Change
• In site or sites
• Additions or Deletions of activities or beds
• Change in Grantee Leadership or Address
• Funding Mix
• Budget Revisions
• Construction Changes

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Inspections

• 38 CFR 61.65
• Requirements
• VA may inspect at any time as are deemed
  necessary to determine compliance
• Authority to inspect carries no authority over
  the management or control of the provider
• Compliance / Payment

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Financial Management

• 38 CFR 61.66
• Requirements
• Comply with Single Audit Act of 1996
• Follow Generally Accepted Accounting Principles
• Determine Actual Costs
• Meet Appropriate OMB Circular for Cost Principles
  
• A-122
• A- 87

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Recovery Provisions

• 38 CFR 61.67
• Requirements
• 3 years from date of award to operation
• 5 years from date of award funds to treasury
• Non-Performance
• Sub- Standard Performance
• Withhold
• Suspend
• Recover
• Letter of Indebtedness

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General Operation Requirements

• 38 CFR 61.80
• Requirements
• Life Safety Code / ADA
• Space Environment
• Structural Integrity
• Clinical Compliance
• Sober Environment
• 24-7 Supervision

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Department of Veterans AffairsHomeless
Providers Grant and Per Diem Program

• Interactive Exercise

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Department of Veterans AffairsHomeless
Providers Grant and Per Diem Program

• Susan Langer, MSW, LCSW
• Mike Lamb, MPA, LCSW
• Project Development Specialists

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Capital Development Process Flow
Awardee submits documentation HHS Direct
Deposit Sign-up VA ACH Vendor/Miscellaneous Pa
yment form
GPD Field Office sends out grant award
letter/ package
Project receives Facility Management approval
Pre-Disbursement Review conducted by local VA
medical center
Project nearing completion provider notifies
GPD Field Office in writing 90 days prior to end
of project renovation or new construction
Provider begins drawing down Capital funds
GPD Field Office request formal assignment of
liaison .
Provider submits paperwork to GPD Field Office
for Per Diem Rate Determination
GPD Liaison facilitates initial project inspection
MOA signed by provider and local VA medical center
Local VA medical center Director approves
project inspection
NHC reviews inspection package and forwards to
GPD Field Office
GPD Field Office issues Per Diem Action Sheet
project is officially activated
Provider admits homeless veterans to project
site and initiates supportive services
Note Providers should review the GPD Providers
Webpage, Capital Grant Recipient Guide, and
participate on applicable monthly
conference calls throughout lifecycle of Capital
grant
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Department of Veterans AffairsHomeless
Providers Grant and Per Diem Program

• Q A Panel Discussion
• GPD Field Office Staff

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CLOSING REMARKS

• ROGER CASEY, Ph.D, LCSW

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CONTACT INFORMATION GPD Field Office10770 N.
46th Street, Suite C-200Tampa, Florida
33617(Toll free) Office 1-877-332-0334Fax
1-877-332-0335

• Susan Langer Office 1-303-504-3561
• Email susan.langer_at_va.gov
• Mike Lamb Office 1-202-461-6079
• Email mike.lamb_at_va.gov

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Three Soldiers, Vietnam Veterans Memorial,
Washington, D.C.