# Presentation: 096225

## Department of Veterans AffairsHomeless Providers Grant and Per Diem Program

- 2008 New Awardees Training ConferencePart 4

**Notes:**
Greetings and general comments:   Congratulate awardees on their successful grant applications and efforts to move projects to operational status.

## Department of Veterans AffairsHomeless Providers Grant and Per Diem Program

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

## Health and Safety Management

- Practices that support quality services in GPD Programs

## 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

## Successful Health and Safety Practices

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

## 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

## 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

## 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.

## 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

**Notes:**
Plans and policies are only as good as the persons are trained to perform them competently.

## 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

## 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

## Department of Veterans AffairsHomeless Providers Grant and Per Diem ProgramGPD Regulations

- Guy Liedke, Ph.D
-     Program Specialist

## 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

## Definitions

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

## 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

## 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

## 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

## 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

## 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

## 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

## 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

## General Operation Requirements

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

## Department of Veterans AffairsHomeless Providers Grant and Per Diem Program

- Interactive Exercise

**Notes:**
This interactive exercise will involve answering some questions that we prepared for you based on the training to see what you’ve learned. Don’t be shy to answer. We have prizes to give out. We ask that only 1 person from your agency answer a question.

## Department of Veterans AffairsHomeless Providers Grant and Per Diem Program

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

## Capital Development Process Flow

- Awardee submits documentation:
- HHS – Direct Deposit Sign-up;
- VA – ACH Vendor/Miscellaneous
- Payment form

- GPD Field Office sends out
- grant award letter/
- package

- GPD Field Office request
- formal assignment of liaison
- .

- 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

- Project receives Facility
- Management approval

- 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   **

**Notes:**
Summary of items discussed during training conference via process flow chart:  Susan covers ‘GPD Field Office sends out grant award letter” through “Provider submits paperwork to GPD Field Office”, Mike picks up with “GPD Liaison facilities initial project inspection” through “Provider admits homeless veterans to project site.”  if time permits, elaborate on process flow categories as necessary.  

## Department of Veterans AffairsHomeless Providers Grant and Per Diem Program

- Q & A Panel Discussion
-     GPD Field Office Staff

**Notes:**
Introduce GPD Field Staff availability for Q & A.

## CLOSING REMARKS

- ROGER CASEY, Ph.D, LCSW

## CONTACT INFORMATION GPD Field Office10770 N. 46th Street, Suite C-200Tampa, Florida 33617(Toll free) Office: 1-877-332-0334Fax: 1-877-332-0335

- 	Susan Langer – Office: 1-303-504-3561
- 			         Email: susan.langer@va.gov
- 	Mike Lamb – Office: 1-202-461-6079
- 			       Email: mike.lamb@va.gov

## “Three Soldiers”, Vietnam Veterans Memorial, Washington, D.C.

- “Three Soldiers”, Vietnam Veterans Memorial, Washington, D.C.

**Notes:**
We thank you for your dedication in serving our Nation’s Homeless veterans.
We hope that this training conference has been helpful to you. We welcome your feedback and comments.  Please complete the evaluation....