AMENDMENT 0001_12639522Q0200.pdf

(x)

12639522Q0200 x x copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted ; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGEMENT TO BE

RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR

OFFER. If by virtue of this amendment you desire to change an offer already submitted , such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

x

APHIS-MN-126395

MINNEAPOLIS MN 55401

SUITE410

250 MARQUETTE AVE

USDA APHIS

07/22/20220001

13. THIS ITEM ONLY APPLIES TO MODIFICATION OF CONTRACTS/ORDERS. IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

12. ACCOUNTING AND APPROPRIATION DATA (If required) is not extended.is extended, Items 8 and 15, and returning

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended , by one of the following methods: (a) By completing

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

FACILITY CODE CODE

10B. DATED (SEE ITEM 13)

10A. MODIFICATION OF CONTRACT/ORDER NO.

9B. DATED (SEE ITEM 11)

9A. AMENDMENT OF SOLICITATION NO.

CODE

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code)

7. ADMINISTERED BY (If other than Item 6)CODE 6. ISSUED BY

PAGE OF PAGES

4. REQUISITION/PURCHASE REQ. NO.3. EFFECTIVE DATE2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO. (If applicable)

1. CONTRACT ID CODE

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

06/27/2022

CHECK ONE A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority) appropriation data, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

E. IMPORTANT: Contractor is not is required to sign this document and return __________________ copies to the issuing office.

ORDER NO. IN ITEM 10A.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

The purpose of this Amendment is to:

1. Extend the required response date/time to July 29, 2022 by 5 p.m. ET.

2. Replace the Pricing Schedule with the attached revised version.

3. Revise the Performance Work Statement.

4. Incorporate Responses to Questions.

SEE CONTINUATION PAGES FOR DETAILS

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)15A. NAME AND TITLE OF SIGNER (Type or print)

15C. DATE SIGNED 16B. UNITED STATES OF AMERICA 15B. CONTRACTOR/OFFEROR 16C. DATE SIGNED

(Signature of person authorized to sign) (Signature of Contracting Officer)

STANDARD FORM 30 (REV. 11/2016)

Prescribed by GSA FAR (48 CFR) 53.243

Previous edition unusable

Except as provided herein, all terms and conditions of the document referenced in Item 9 A or 10A, as heretofore changed, remains unchanged and in full force and effect .

AMENDMENT 0001 – 12639522Q0200

PRICING SCHEDULE

Line item quantities below are estimates for evaluation purposes only. Contract and Task Order minimum and maximum amounts are specified in the following clauses: 52.216‐19 “Order Limitations” and 452.216‐73 “Minimum and Maximum Contract Amounts”.

ITEM DESCRIPTION EST. QTY UNIT UNIT PRICE TOTAL

BASE PERIOD (Date of Award through 09/03/2023)

0001 Onsite Mid‐level Provider 52 WK __________ __________

0002 After Hours Mid‐Level Provider Telephonic 52 WK __________ __________ Consultation Line

0003 On‐Call CMA/Physician consultation Line 52 WK __________ __________

0004 Actual CMA/Physician consultation 520 HR __________ __________

0005 Offsite Radiological Test: 25 EA __________ __________ 1‐view Medical test

0006 Offsite Radiological Test: 2‐view 25 EA __________ __________ medical test

0007 Radiological B Reader Interpretation 25 EA __________ __________

OPTION PERIOD 1 (9/4/2023 – 09/03/2024) EST. QTY UNIT UNIT PRICE TOTAL

1001 Onsite Mid‐level Provider 52 WK __________ __________

1002 After Hours Mid‐Level Provider Telephonic 52 WK __________ __________ Consultation Line

1003 On‐Call CMA/Physician consultation Line 52 WK __________ __________

1004 Actual CMA/Physician consultation 520 HR __________ __________

1005 Offsite Radiological Test: 25 EA __________ __________ 1‐view Medical test

1006 Offsite Radiological Test: 2‐view 25 EA __________ __________ medical test

1007 Radiological B Reader Interpretation 25 EA __________ __________

(CONTINUED)

OPTION PERIOD 2 (9/4/2024 – 09/03/2025) EST. QTY UNIT UNIT PRICE TOTAL

2001 Onsite Mid‐level Provider 52 WK __________ __________

2002 After Hours Mid‐Level Provider Telephonic 52 WK __________ __________ Consultation Line

2003 On‐Call CMA/Physician consultation Line 52 WK __________ __________

2004 Actual CMA/Physician consultation 520 HR __________ __________

2005 Offsite Radiological Test: 25 EA __________ __________ 1‐view Medical test

2006 Offsite Radiological Test: 2‐view 25 EA __________ __________ medical test

2007 Radiological B Reader Interpretation 25 EA __________ __________

OPTION PERIOD 3 (9/4/2025 – 09/03/2026) EST. QTY UNIT UNIT PRICE TOTAL

3001 Onsite Mid‐level Provider 52 WK __________ __________

3002 After Hours Mid‐Level Provider Telephonic 52 WK __________ __________ Consultation Line

3003 On‐Call CMA/Physician consultation line 52 WK __________ __________

3004 Actual CMA/Physician consultation 520 HR __________ __________

3005 Offsite Radiological Test: 25 EA __________ __________ 1‐view Medical test

3006 Offsite Radiological Test: 2‐view 25 EA __________ __________ medical test

3007 Radiological B Reader Interpretation 25 EA __________ __________

(CONTINUED)

OPTION PERIOD 4 (9/4/2026 – 09/03/2027)

4001 Onsite Mid‐level Provider 52 WK __________ __________

4002 After Hours Mid‐Level Provider Telephonic 52 WK __________ __________ Consultation Line

4003 On‐Call CMA/Physician consultation line 52 WK __________ __________ availability

4004 Actual CMA/Physician consultation 520 HR __________ __________

4005 Offsite Radiological Test: 25 EA __________ __________ 1‐view Medical test

4006 Offsite Radiological Test: 2‐view 25 EA __________ __________ medical test

4007 Radiological B Reader Interpretation 25 EA __________ __________

TOTAL AMOUNT (BASE PERIOD AND OPTION YEARS 1 – 4) __________

SF30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

The Performance Work Statement, Sections 3.1, 3.4, and 4.8 are revised (additions underlined, deletions strike‐through):

3.1 Task Two: After Hours Mid-Level Provider Telephonic Consultation Line

The Contractor shall provide a mid‐level provider to provide unrestricted telephonic medical consultation services on an as‐needed basis including nights and weekends with minimum availability required:

Sunday 12:00 a.m.‐ Monday 6:00 a.m.

Monday 6:00 p.m. – Tuesday 6:00 a.m.

Tuesday 6:00 p.m. – Wednesday 6:00 a.m.

Wednesday 6:00 p.m. – Thursday 6 a.m.

Thursday 6:00 p.m. – Friday 6:00 a.m.

Friday 6:00 p.m. – Saturday 6:00 a.m.

Saturday 12:00 6:00 a.m. – Saturday 11:59 pm

Services shall be provided on a regular recurring weekly basis throughout the base period and each option period, including Federal Holidays. A phone number must be made available to USDA during the post‐award, kick‐off meeting between USDA COR (or their designated authority) and the Vendor.

3.4 Task Four: Radiography Services

Contractor shall provide radiologic services under this contract at offsite location within 20miles of NBAF. Contracted Radiological services must be able to provide posteroanterior (PA) (1‐view) only and posteroanterior (PA) and lateral (LAT) (2‐view) as requested by USDA.

This medical test must be performed by a board‐certified radiologist or radiology technician as permitted within their scope of practice following Kansas state law. Test interpretation is requested and will be performed by a board‐certified radiologist as permitted within their scope of practice following Kansas State Law.

B Reader Interpretation of Chest Xrays may be ordered separately and in addition to standard test interpretation included with radiological tests. Chest X‐ray shall be interpreted and classified according to the International Labour Office (ILO) International Classification of Radiographs of Pneumoconioses by a NIOSH‐certified B Reader. Unit of measurement for payment for B Reader Interpretation services is “per interpretation” and is a standalone item.

B Reader Interpretation Services shall be ordered through task orders on an as‐needed basis.

The USDA COR (or their designated authority) will authorize, coordinate, and schedule appointments with the Contractor. The Contractor shall complete these appointments, and all the requested associated medical examination and/or testing, within two (2) business days from the exam date after request by the USDA, unless otherwise mutually agreed upon, and following applicable Federal, State, and local laws and regulations. Contractor shall provide a copy of the radiologist’s chest radiography interpretation report/letter with date and radiologist reviewer’s signature to the COR or designee.

The contractor is not required to perform radiography services on federal holidays.

4.8 Government Furnished Equipment, Information, Materials and Services

The Government will provide the following on‐site equipment and items for on‐ site visits:

stethoscope, sphygmomanometer, thermometer with probe covers, pulse oximeter, height and weight scale, otoscope with specula, ophthalmoscope, reflex hammer, examination table, examination gloves, handwashing station, and cleaning supplies. The Government will employ approximately two Registered Nurses that will provide services within their scope of practice onsite including but not limited to Spirometry (PFT), Audiometry, Vision screening, EKG’s First Aid, Vaccinations, and Phlebotomy.

The Government will make examination rooms available as needed. The Contractor shall specify in the response to the solicitation any other requirements needed to successfully perform the required services requested in this statement of work. Unless otherwise agreed by the parties, Government‐furnished resources will be provided only during normal business hours at the designated work site.

RESPONSES TO QUESTIONS

Question #1: 2.0 Scope, page 11

The Contractor shall provide professional medical services to approximately 450 workers. The pricing sheet shows no increase over the 4 year period for estimated quantity of work performed. Please confirm if the number of workers is expected to remain flat over this period.

If an increase is expected, can expected growth be provided? How will any adjustment to work hours or pricing be handled with the Contractor over the 4 year period if applicable?

What are scheduled shift times for workers at NBAF? How many workers per shift?

Response: The contractor shall provide services to approximately 450 workers throughout the contract period of performance.

See Section 4.8, Government Furnished Equipment, Information, Materials and Services:

“The Government will employ approximately two Registered Nurses that will provide services within their scope of practice onsite including but not limited to Spirometry (PFT), Audiometry, Vision screening, EKG’s First Aid, Vaccinations, and Phlebotomy.”

Scheduled shift times for federal workers are not available.

Question #2: 3.1 Onsite Mid‐Level Provider. Page 18

Please confirm that the 20 hours per week is inclusive of documentation and administrative work.

Response: Yes. See Section 3.1.2, Appointment Coordination. “If no appointments are scheduled for the time when the Contractor is on‐site (or between appointments), then the Contractor shall review diagnostic and laboratory results, provide medical recommendations based on current, evidence‐based medical guidelines for consultation requests by the USDA and/or USDA personnel, and/or any other service described in this section.”

Question #3: 3.1.5 Onsite Occupational Examinations, Page 19‐20

Please confirm that all testing, except for CXR, done on site by the NBAF nurses.

Response: The required onsite occupational examination services are specified in Section 3.1.5, Onsite Occupational Examinations.

Question #4: 3.2 After hours Mid‐Level Provider Telephonic Consultation Line, Page

Regarding the After-hours call for APP schedule:

There is overlap in the telephonic consult timing between Saturday 12 am and 6 am.

Was this by design or error?

Response:

See Amendment 0001 which incorporates the corrected schedule.

Question #5: 3.3 On Call CMA /Physician, Page 24‐25

Considering the expansive call coverage for the CMA as described, is there an option to have a secondary board certified physician in occupational health help cover some of the call hours on a routine schedule?

Response: Yes, with prior approval from the Contracting Officer. See Section 2.2, Contractor Key Personnel and clause 452.237-74 Key Personnel.

Question #6: 3.3 On Call CMA /Physician, Page 24‐25

Is there access for CMA to come onsite for site visits, consults with Mid-Level, etc.?

Is the CMA allowed to come onsite outside of scheduled Mid-Level hours?

Response: Onsite visits are not required or specified for CMA/Physician services.

Onsite visits may arranged on an as-needed basis with prior written approval from the Contracting Officer.

Question #7: 3.3.1 Program Consultation, Page 24‐25

The CMA is required to perform Program Consultation for broad areas as described.

Please confirm the time required to perform these duties are included in the annual estimate of 520 hours reflected on the Pricing Schedule and shall not exceed this limit.

Response: Correct. See Section 3.3.3.2, Payment for Actual CMA/Physician Program and Medical Consultation Hours. “Actual Consultation time shall be paid on an hourly basis in minimum 0.25 hour increments. Payment for actual consultation hours worked shall not to exceed the total estimated quantity of hours established for the base period and each option period. The contractor’s invoice shall include a detailed breakdown of the actual Physician (CMA) hours worked.”

Question #8: 3.3.1 Program Consultation, Page 24‐25

May Contractor review OHMS matrix for Medical surveillance? A review will be necessary to understand needs and provisions.

Response: Yes. See Section 3.3.1 Program Consultation.

“… The Contractor shall periodically review the NBAF Occupational Health Plan and provide medical recommendations on occupational health services, policies, and procedures as requested by the COR or other designated authority. The National Bio and Agro‐ Defense Facility (NBAF) will utilize a basic hazard‐specific OHMS Medical Matrix intended to standardize the components and requirements for the medical surveillance, monitoring, and certification programs conducted on campus. The CMA shall assist as needed with maintaining, directing, and revising the OHMS Medical Matrix including individual program elements, as needed and/or as requested by the USDA.”

Question #9: 3.3.2 Medical Consultation. Page 25

Will the CMA have access to be onsite or is remote telephonic vs. video consulting available?

Response:

See Section 3.3, Task Three: On Call Competent Medical Authority (CMA)/Physician. “The Physician (CMA) shall provide verbal recommendations and/or advice for cases presented under consultation and provide a written statement or opinion to the USDA within 24 hours of consultation or the next business day, or as otherwise mutually agreed upon by both parties. The CMA will have a cell phone available for communication at all times and the number will be provided to the COR during the post award kick‐off meeting.”

On‐Call CMA/Physician services shall be performed at the contractor’s facility, or at the contractor’s remote location as specified. (See Section 1.2 Place of Performance).

Question #10: 3.3.2 Medical Consultation. Page 25

Does the Mid‐Level determine the “as‐needed” basis for the physician consult or someone else?

Response:

See Section 3.3, Task Three: On‐Call Competent Medical Authority (CMA)/Physician. “The contractor Physician (CMA) shall be available on‐call (non‐restricted) from 6:00 a.m. and 6:00 p.m., Monday to Friday (60 hours per week) including Federal Holidays, to provide medical consultation services as requested by the COR (or their designated authority).”

Question #11: 3.4 Radiography Services Confirm if the Contractor is required to sub-contract for professional radiology services if the Contractor does not directly employ radiology physicians. If so, confirm if the pricing schedule for radiological testing is required to include both the technical and professional components for each type of test. Or, is an independent radiologist able to bill directly for their professional services?

Response:

The prime contractor is responsible for decisions to subcontract. The prime contractor retains legal and management responsibility for overall contract performance.

See Amendment 0001 for changes to Section 3.4, Task Four: Radiography Services. Refer to unit of measurement for payment for radiography tests and B Reader Interpretation.

Question #12: 4.2 Invoice Requirements, Page 27 Please confirm if the IPP invoicing system is required for all billings, including invoices for both professional and technical radiology services.

Response: Correct.

Question #13: 4.3.1.1 Key Areas, Page 27 There is reference to patient satisfaction surveys. Please confirm if the Contractor is responsible for the patient survey administration and reporting process.

Response: The contractor is not responsible for patient survey administration/reporting.

Please provide detailed exam requirements/injuries/exposure types to identify additional equipment/resources needed.

Response:

See Amendment 0001, which removes the following statement: “The Contractor shall specify in the response to the solicitation any other requirements needed to successfully perform the required services requested in this statement of work.”

Question #15: 4.10 Project/Program Manager, Page 33 This section describes the requirement to have a Project/Program Manager to oversee compliance and daily administration. The Pricing Schedule does not include a section or estimate for this administrative time.

Please confirm if the cost of hours worked by this position are reimbursed under the arrangement. In other words, is compensation available for this position? If yes, how should this time be reflected on the pricing schedule?

Response: This is a firm-fixed-price contract. The unit prices shall include all costs associated with furnishing and delivering all materials and performing all work in a complete and acceptable manner. Costs should be included in the Pricing Schedule item(s) with which that cost is most closely associated. (See Section 1.3 Contract Type.)

Question #16: 4.11 Quality Assurance, Page 33‐34 The Contractor shall provide a Quality Assurance Manager for oversight of the quality of performance. Is this responsibility part of the Program Manager role or another position?

Response: The contract does not require that the roles of the Quality Assurance Manager and Program Manager must be assigned to two different people.

Question # 17: Pricing Exhibit, page 3

Item 0006 describes a Lateral (LAT) (2 view) radiological test. However, the source documents describe the two view exam being comprised of an AP (anteriorposterior view and a Lateral view) .

Can you confirm that 0006 pricing is referring to a 2-view radiological test that would include an AP view and a LAT view?

Response: See Amendment 0001, which revises the line item description for the 1-view and 2-view medical tests.

Response: See Amendment 0001 which adds B Reader interpretation.