Question and Responses.pdf

United States Forest Washington Office 201 14th St, SW Department of Service Procurement & Washington, DC 20250 Agriculture Property Services

Acuity_QUESTIONS-RFP12318722R0011_05242022 1 of 1

Note: When submitting questions via e-mail, please reference the RFQ Number/Name in the Subject Line. Questions not submitted on this Form via email will not be answered.

ATTACHMENT I – PRE-QUOTE QUESTION FORM

Notice of Opportunity (NOO)/Request for Quote (RFQ) 12318722R0011

US Forest Service Medical Qualifications for Wildland Firefighters

Question # Attachment Section or

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# Description / Question / Comment

1 General

For project planning, can the gov’t provide the volume of exams by location? Pages 6-7 of PWS --4.0 Deliverable/Schedule under “Objective” identifies the number of personnel by regional roll-out. See below for a breakdown of exams by region.

2 RFP

Schedule of Items/Price Schedule

2-6

Can administrative support costs inclusive of scheduling and network maintenance personnel be included in Base Item #8?

Yes

3 RFP Data Rights - General 27

The contractor uses internal systems to track and manage the exam process, please confirm that data rights section of the RFP does not apply to contractor owned systems.

While the government maintains unlimited data rights, the Contractor’s internal systems fall under restricted computer software. Please reference FAR 52.227-14 Rights in Data-General.

4 General

Can the Contractor use internal systems to electronically schedule and track the exam authorization process and its progress to enable an accurate and timely billing of medical providers? Yes, as long as it is HIPAA compliant and adheres to the standards of the Privacy Act of 1974 for any sensitive data it contains.

5 General

Does eMedical have a scheduling component? No. eMedical tracks when a specific employee last had an AME or an OF-178 exam, for the purpose of informing that employee to the appropriate next step in the process (i.e. if an employee went https://sam.gov/opp/6b1b6cc0cd224b898de9f12a6835a101/review

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# Description / Question / Comment through an AME this year, eMedical documents that process so the employee knows to go through the self-certification process next year) but the system does not automatically direct an employee or schedule any portion of the process. Once the employee completes their appropriate questionnaire in eMedical, the system auto-generates an email with instructions on how to proceed. For those employees needing the AME, the email would supply instructions for scheduling an exam through the contractor or through a supervisor, depending on the situation.

6 PWS Sect 3.0, #8 5

How does the contractor track exams within the eMedical system for quality purposes?

The contractor does not track the exams within eMedical. The eMedical system tracks what process employees last went through, what phase of the process employees are in on an individual basis, and it stores the exam content for the RMO’s to review. The contractor may track exams through whatever outside process they determine necessary.

7 General

For tracking purposes will the client provide rosters of all eligible employees that can participate in the exam program? When an employee is ready for their exam, the employee or other gov’t representative will contact the contractor with names and locations of employees needing exams.

Because of the number of AME’s, on-going new hires, the movement of employees between different locations, and the number of unanticipated exams for the OF-178, it is not possible to provide an accurate roster of all eligible employees in advance and at one time.

8 General Based on the contractor staffing approach, would the gov’t provide access to eMedical

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# Description / Question / Comment for support staff? The gov’t can provide limited access to eMedical for support staff.

The access would be restricted to the ability as assist MP’s with technical issues (i.e.

password resets) but will not be able to access any kind of employee pii/phi.

9 General To provide the Gov’t with the best possible solution would the gov’t consider an extension of the proposal due date? Yes

Please submit this Pre-Quote Question Form to: drackus.thomas@usda.gov by the deadline of 22 May 2022.

Regional breakdown of the number arduous-qualified employees (those needing AME’s) from 2021 data:

Region 1: 2651 Region 2: 1684 Region 3: 2040 Region 4: 2313 Region 5: 6110 Region 6: 3481 Region 8: 1747 Region 9: 1323 Region 10: 161 mailto:drackus.thomas@usda.gov

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1 RFP Subfactor 1.4 Project Plan 9

In the Project Plan will the gov’t consider 90 day ramp up for Phase I? The program will go live with the developers in August for Regions 8,9, 10 and smokejumpers and there is no way to gradually phase this process in, other than regionally, so no the gov’t is unable to phase it in.

2 General FAR Clauses

Will the gov’t consider FAR flow downs being excluded from contracts with the medical provider network? FAR Clauses will apply to the Contractor/subcontractor.

There will be no exclusions, the Contractor will be responsible for ensuring subcontractor adhere to the FAR clauses Terms and Conditions.

3 PWS 11.0 Section 508 9

3.Will the gov’t consider adding a new user type to the eMedical system for assigned/designated contractor personnel that would allow collection of paper exams forms from the providers and a contractor designee then input the data directly into eMedical on behalf of the MP. With the understanding this would only be utilized in the event a provider clinic does not have the technology capability, or they are unwilling to submit electronically.

Yes, the gov’t is open to considering this idea.

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# Description / Question / Comment

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Acuity_QUESTIONS-RFP12318722R0011_05172022 1 of 2

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1 RFP

Schedule of Items/Price Schedule

Is all labor to be performed to be included in Base Item # 8? The CPM and alternate will be included under Base Item #8

RFP

PWS

Key Personnel

RFP

pg

PWS

pg 4

The RFP lists key personnel as the Contract Program Manager (CPM) and at least 1 Alternate CPM, however the PWS lists Key personnel as CPM, at least 1 Alternate CPM and 1 Deputy PM. Would the gov’t please clarify which is correct? The RFP is correct.

A DPM is not a required position but may be useful and is a recommendation.

3 PWS Pg 4

Please clarify the statement of one DPM per region, is it the governments intend to have a separate DPM per region? The government currently has Regional contacts that may be utilized but has no specific position related to this contract. The DPM is a non-required position that may be useful as this will be a regional roll-out

4 PWS

Appendix A –

Arduous Medical Exam

Under the Arduous Medical Exam, a Peak Flow is listed as a component of the Exam.

Would the government consider a spirometry tracing test instead? Yes, if it remains within the same price range.

5 PWS 4.0 Table 6

The Table references a QASP, does the gov’t intend to provide this document for proposal purposes? Yes the gov’t will post an amendment that includes the QASP

6 General

Upon contract award will the awardee receive a list of the current medical providers using eMedical? Yes, the gov’t has maintained a database of physicians who have previously used eMedical in the

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# Description / Question / Comment past and it will be provided to the contractor.

7 PWS

RFP

11.0 Section 508

508 Compliance

Since the government is directing the use of the USDA’s eMedical system, does Section 508 compliance apply to this procurement?

Yes, the eMedical system is Section 508 compliant

8 General

Would the government consider an extension of two weeks for proposal submission? An extension could potentially set-back the implementation of the AMP but if multiple interested parties request it then, yes, it would be considered.

9 Attachment 5 Entire Spreadsheet

Does the government expect to have a MP provider with 50 road miles of every address listed in Attachment 5? Yes, the expectation is to either have a MP within 50 miles of every station listed -or- an alternate plan in place for providing those same services when a clinic/MP cannot be located.

10 General

Would the government consider any alternative method to completing exams directly into eMedical? No, the system is already in development and will be ready to use August 1, 2022. Currently the gov’t also receives efax exam submissions and having an alternative method becomes problematic to track.

11 General

Would the government consider an Industry Day with perspective vendors to provide a better understanding of the requirements and government expectations of the end result of the program? No, but we will continue to accept and respond to questions as well as post the responses as an amendment to assist in knowledge-sharing.

12 RFP Data Rights – General 28

Would the government make an exception to obtain the contracting officer's approval prior to engaging in any contractual relationship (sub-contractor) in support of

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# Description / Question / Comment this contract for the Contractors medical network? Yes, the contractor will be responsible for procuring and managing the services of MP’s, including the use of sub-contractors, as long as the contract has no violations.

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Paragraph Page # Description / Question / Comment

1 General

We typically see chest x-rays ordered as medically indicated due to history of past positive PPD. Who determines when medically indicated items (chest x-ray, EKG etc.) are required? If USDA, please provide guidelines for medical indications for applicable components (examples: age specific, gender specific etc.). The provider completing the exam will determine if a chest x-ray is indicated based on their knowledge of the patient’s history and their physical exam. A history of a positive PPD would be one of many possible reasons a provider would order the exam. The USDA would not be ordering an exam.

2 General Is a b-read required for x-rays? Unless required by the patient’s condition (e.g.: asbestos exposure), no.

3 General

How many providers are registered with eMedical? Approximately 1800 medical providers have entered exam results into eMedical.

4 General

If a further evaluation is required after USDA medical review, does USDA order additional exams from the contractor provider network.

(i.e., EKG)? No, if a further evaluation is needed after FS medical review, this will be performed by the employee’s PCP.

5 General

There is a long list of physician forms on the eMedical resource site (re: Asthma, Psych, Diabetes etc.), does USDA expect contractor MPs to complete these forms as medically indicated as part of this contract? No, these forms are not related to AMEs or OF-178 exams. They are designed for employees with

Paragraph Page # Description / Question / Comment waivers relating to the listed conditions and not the responsibility of the contractor’s MP to complete. If so, are these completed during the initial exam?

6 General

Will the contractor have the opp1ortunity to make recommendations for changes to supporting documentation on the eMedical resource site (i.e., Guidance to the medical provider)?The contractor is welcome to offer suggestions but will not have authority to make any changes directly.

7 General

Our medical tracking system includes an examinee portal and a client portal. These portals allow the government to upload rosters of exam authorizations and to facilitate scheduling at the convenience of the examinee.

We also use this system for exam tracking and automated invoicing and payments. We often times have integrations with our client and/or government systems for ease of security of data transmission. Would the government be interested in seeing a demonstration and discuss the potential to create integrations with eMedical? Not at this time.

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QUESTIONS+FORM+-+RFP12318722R0011. v3. 5.20.22

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# Description / Question / Comment

1 Attachment 1 –

PWS

3.0 Technical

Requirements/Tasks 6

Under Number 11: Ensure MP’s accurately input exam results into eMedical system and submit to MQP for review by RMO’s:

Would it be acceptable for the contractor to have the geographically dispersed medical providers send the completed exams to a central location, and for a qualified MP from the contractor’s team to review and input all exam results into eMedical?

Yes, the MP that performs exams does not need to be the one to input the results (typically most MP’s do not have time to do each one) so long as the person who does input the results abides by pii and confidentiality agreements/requirements (often that means administrative office personnel). Therefore, if the contractor would prefer to have a designated individual for this task, that is fine. The designated individual does not need to evaluate or review exams (aside from ensuring all relevant and required information is complete) as that is the job of the FS RMO.

2 NA NA NA

Would a 2-3 week extension be possible.

An extension could potentially set-back the implementation of the AMP but if multiple interested parties request it then, yes, it would be considered.

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# Description / Question / Comment

3 NA NA NA

Is there an incumbent for this work? If so, what is the contract number?

There is no incumbent for this work. This is a new process being implemented and has not been contracted before. Prior to this, exams were performed on an as-needed basis, and it was the employee’s responsibility to identify, schedule, pay for exams and ensure they were input into the system by the MP.

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QUESTIONS+FORM+-+RFP12318722R0011RD-QTC

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# Description / Question / Comment

1 RFP Section v 2 – 6

The Schedule of Items/Price Schedule for Base Year and all Option Years have a line item for Program Manager with an estimated quantity of 12. It is assumed the quantity is referring to the 12 months of salary for a Program Manager inclusive of all fringe benefits. Is this correct? If not, please clarify. Yes, it reflects 12 months of salary with benefits

2 RFP Section v 2 – 6

With regard to remote Arduous Medical Exams (AME), i.e. 51-100 miles and 101-200 miles, it is assumed that AMEs performed outside the 50 road mile radius will be billed to the corresponding line item based on actual road miles for the examinee. Is this correct? If not please clarify. Yes, that is correct

3 RFP & Attachment

1 – PWS

RFP: N/A

PWS – 2.0

RFP:

PWS:

Regarding Key Personnel, contractor is to assign as key personnel a Contract Program Manager (CPM) and at least one Alternate. The PWS states Key Personnel to include CPM, at least one Alternate CPM and one Deputy Program manager assigned for each identified Forest Service Region. It is assumed that the government only requires a CPM and on Alternate CPM as Key Personnel. Is this correct? If not please clarify. Yes, this is correct. The DPM is recommended as a regional point of contact but not required. The CPM + alternate are required positions.

4 Attachment 1 –

PWS 2.0 3

Are there any clearances required for one to access the eMedical system? Only as a system administrator.

Medical Providers access the system using a username/password. The CPM and alternate will have limited administrator privileges, enough to assist MP’s if they get locked out of accounts or forget

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# Description / Question / Comment usernames/passwords. These limited permissions will require the use of a government furnished computer and LincPass for access and a basic background check may be required to obtain those items.

5 Attachment 1 –

PWS 3.0 (#7) 5

It is assumed that the contractor will be able to easily discern the type of examination, i.e. AMP or OF-178, at the time Wildland fire personnel is requesting exam scheduling. Is this correct? If not, how will the contractor be able to determine the type of exam necessary? The contractor will be contacted by local USFS representative with the necessary information to schedule the exams. They will likely compile modules of firefighters, 5-25 at a time, for scheduling at or around the same time for ease of scheduling. At that time they will indicate which exams are needed. More than 90% of exams will be AME’s.

6 Attachment 1 –

PWS

3.0 (#11) & 13.0

6 &

Contractor is responsible to “ensure MP’s accurately input exam results into eMedical system and submit to MQP for review by RMO’s.” Additionally, Performance Requirement Measures require compliance with using eMedical to “input, store and track exam results in agreement with PWS 3.8.”

In order to be compliant with these tasks contractor personnel will need to have access to eMedical. Will contractor personnel have access to eMedical?

The contractors will not have that kind of access to eMedical. They will not need to input, store or track exam results themselves so much as they will need to ensure the utilization of the system by MP’s by assisting the MP’s in creating accounts and following-up with them to confirm exams results were input into the system.

7 Attachment 1 –

PWS

4.0 (#4, 5, 6, 7) 6-7

Based on the schedule for Key Deliverables, multiple regions will be phased in based on an implementation due date. For Regions that have a later implementation date, e.g. Region 6 by January 1, 2023, how are AMEs currently being performed for these Regions? AME’s don’t currently exist, it is a new process the USFS will be implementing over the next few years. The existing system is the HSQ with an OF-178 exam and only a

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# Description / Question / Comment small percentage of fire personnel are currently sent through that exam process (<10%). Those that require an OF-178 exam must locate MP’s, educate them on how to use eMedical, and pay for exams on their own.

Is there incumbent contractor(s)? No If yes, who are the incumbents.

If the USFS is currently using local MPs to perform examinations, will these MPs be shared with the contractor after award? The USFS has maintained a database of MP’s who have previously used eMedical and that database will be available to the contractor upon award.

8 Attachment 1 –

PWS

4.0 (#4, 5, 6, 7) 6-7

Based on the implementation dates for Regions, does the government anticipate a backlog of AMEs that need to be performed? No, the purpose of rolling out the new process gradually is to prevent backlogs by keeping the number of people going through the system at a manageable number. Fire personnel are unable to perform their duties until their exam is completed, entered, reviewed and cleared. A backlog could create serious consequences with respect to personnel responding to fires if they are stuck in the system.

9 Attachment 1 – Appendix A 1 & 2 11

Please provide historical data, e.g. past three years, on the ratio of AME and OF-178 exams performed annually. No one currently gets AME’s, it is a new process being implemented this year. Reference documentation below for more info on current/past process and #’s

Attachment 2 – AMP Exam Form &

Attachment 3

OF178

N/A

The examinee is expected to complete the exam forms prior to date of examination in eMedical. How can the contractor verify that the forms are completed prior to the appointment? The employee completes the form electronically and then receives a unique code via email that they must present to the MP. Additionally, supervisors and other USFS staff are included in the emails that indicate when an employee has completed their paperwork. Contractor will not need to verify this information, the USFS staff will notify the contractor

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# Description / Question / Comment know when the module of employees have finished their paperwork and are ready for their exams.

Response to Question #9:

The Forest Service (FS) Fire Medical Qualifications Program (MQP) oversees the medical screening of all fire personnel with positions requiring fitness qualifications. When fully implemented, this program will have two pathways, one for “light” or “moderate” fitness levels (current HSQ Process) and one for “arduous” fitness levels (AMP). FS employees seeking medical clearance to take the WCT will use eMedical to initiate the medical clearance process, complete the AMP or HSQ form and, if necessary, any additional exam forms and waiver requests. eMedical serves about 25,000 USFS employees and Administratively Determined (AD) casual employees that are taking the WCT annually. Of that, approximately 20,000 USFS employees/AD’s hold a qualification that requires the “Arduous” WCT.

The current system, in use since approximately 2015, requires employees taking any level of the WCT (light, moderate, arduous) to complete the HSQ. Currently those forms are individually reviewed by the local HSQ Coordinator and, depending on the responses supplied by the employee, the employee may be sent for an exam by a physician, nurse practitioner, or physician assistant for further review. Approximately 8% of employees provide a qualifying response on their HSQ which triggers an exam. Once the medical provider completes that initial exam, the USFS Reviewing Medical Officer determines if a waiver can be granted and the employee generally does not need another full exam in the future unless there is a change in their medical conditions.

When the USFS implements the AMP, starting as a regional roll-out in 2022, every employee who holds an “arduous” fire qualification will have an initial exam, and then every three years thereafter, including a thorough health screening questionnaire. The alternate 2 years will require a shorter questionnaire and a blood pressure check conducted by a forest or module-level EMT but no exam. Moderate and light qualifications will continue to use the existing HSQ, getting exams on an as-needed basis.