19AQMM19R0035-A001.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

1. CONTRACT ID CODE RATING

2. AMENDMENT/MODIFICATION NO.

3. EFFECTIVE DATE

01/18/2019

4. REQUISITION/PURCHASE REQ. NO. 5. PROJECT NO. (If applicable)

LMAQMCODE

OFFICE OF ACQUISITION MANAGEMENT

(A/LM/AQM)

PO BOX 9115, ROSSLYN STATION

US DEPARTMENT OF STATE

ARLINGTON, VA 22219

Alexander D. Warsaw

NAME

703-516-1965

TEL.

warsawad@state.gov

EMAIL

6. ISSUED BY CODE7. ADMINISTERED BY (If other than Item 6)

9A. AMENDMENT OF SOLICITATION NO.

19AQMM19R0035

CONTACT DUNS

CODE FACILITY CODE

8. NAME AND ADDRESS OF CONTRACTOR (No., street, country, state and ZIP Code) (X)

X 9B. DATED (SEE ITEM 11)

01/18/2019

10A. MODIFICATION OF CONTRACT/ORDER NO.

10B. DATED (SEE ITEM 13)

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X XThe above numbered solicitation is amended as set forth in item 14. The hour and date specified for receipt of Offers is extended, is not extended, 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 items 8 and 15, and returning ____copies of the amendment;(b)By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT 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 telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM ONLY APPLIES TO MODIFICATION OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

CHECK ONE A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

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

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. Release Questions and Answers in attachment 2, Q&A.

All other terms and conditions remain unchanged and in full effect.

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

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

Alexander D. Warsaw

(Signature of person authorized to sign)

15B. CONTRACTOR/OFFEROR 15C. DATE SIGNED

By (Signature of Contracting Officer)

16B. UNITED STATES OF AMERICA 16C. DATE SIGNED

01/18/2019

NSN 7540-01-152-8070

Previous edition unusable

STANDARD FORM 30 (REV. 10-83)

Prescribed by GSA FAR (48 CFR) 53.243

19AQMM19R0035

Attachment 2 - Questions Answers

19AQMM19R0035

Solicitation Reference (i.e., Section and Page Number) Technical Question(s) Technical Answers Price Question(s) Price Answers

SOO: Page 11; Section 1, Section C - Contract Objectives states "Minimum Threshold – (20) units of O-negative packed red blood cells" AND SOO: Page 32; Section 1- Solicitation/Contract Form; H.32 Performance Management; in the Quality Assuarnce Martrix it states: "The Contractor shallprovide all staff, equip-ment, supplies, and facilit-ies necessary to ship, re-ceive, inspect, store, anddispose of at least 20 unitsof packed red blood cells. All blood products shall bescreened for communicablediseases and managed inaccordance with AABB (American Association ofBlood Banks)"

Can you clarify that a mixed blood supply of minimum 10 units o-negative would be an acceptable solution? All blood will be Type O. At least 10 units will be Type O, Rh negative.

SOO: Page 11; Section 1; Section C; Contract Objectives under Primary Care it states: "with dedicated work space, logistics, and support staff for both a contract medical provider and a Government medical provider"

Can you clarify the responsibility for the Government medical provider by the medical provider? Is it expected to only provide space and/or logistics, or will the chosen medical provider also be clinically and operationally responsible for the Government medical provider as well?

This is a requirement for work space and shared support from existing ancillary staff. The Contractor will not provide oversight or supervision.

SOO: Page 12; Section 1; Deliverables in Proposal and Throughout Execution; point b) states: "Levels of Service By Service Line.

Within the medical support requirement, the Government has a requirement for services thatshall be segregated into Service Lines. Service Lines include, but are not limited to, Primary Care, Dental Care, Occupational Health,Urgent/Emergency Medical Care, Surgical Services (inclusive of Pre-Operative, Operative, and Post-Operative Care), Critical CareMedicine, Ground Emergency Medical Transport, Laboratory Services (inclusive of blood bank and diagnostic laboratory testing) andDiagnostic Imaging. For each Service Line, the Performance Work Statement shall detail the level of support provided in satisfactionof the Government’s objectives, including the procedures performed, time-flow analysis, and identified operational constraints im-posed by the geographic location of this requirement."

Nowhere in the Contract Objectives summarised on Page 11:

Section 1; Section C or elsewhere in the SOW does it require the provision of dental services. Please can you clarify if this is a requirement.

The provision of emergency dental care, including, at a minimum, diagnostic imaging, tooth extraction, temporary and permanent fillings, and temporary repair of existing prosthedontic devices.

Not addressed in Solicitation Do all doctors and nurses have to be American licensed?

The Government does not require health care providers be licensed in the United States. The Contractor is required to provide acceptable evidence of medical education, licensure, and current specialty qualification (for physicians) under a recognized national authority, including evidence of prime source verification of credentials provided by provider candidates. To further clarify, medical education shall be deemed acceptable when completed in the United States or through an international medical university accredited by the Educational Commission for Foreign Medical Graduates (www.ecfmg.org).

Not addressed in Solicitation Do all doctors have to be board certified?

Physicians must be a graduate of a recognized medical university accredited by the Educational Consortium for Foreign Medical Graduates, licensed by a recognized national authority, and hold current qualifications by a recognized national authority to provide medical services in the specialty contemplated under this contract.

Section C, Statement of Objective, Deliverables in Proposal and Throughout Execution, Annex D, Pharmaceutical Formulary.

When medications or supplies are used, who covers the reimbursement or cost?

This is a firm fixed price capitated contract for health care services.

The Contractor bears all associated costs for services rendered under that Firm Fixed Price for a covered individual.

Not addressed in Solicitation Is security provided by the State Department or the medical services provider?

Outside the security measures afforded to all residents of the International Campus, the Contractor is responsible for the safety and security of its personnel.

Not addressed in Solicitation Where do medical staff live? Is this provided free of charge?

Containerized housing unit?

The Contractor is responsible for making all logistical and life support arrangements necessary to support personnel performing services under this contract. All costs are to be incorporated into the Firm Fixed Unit Price for health care services.

Attachment 2 - Questions Answers

19AQMM19R0035

Section C, Statement of Objective, Contract Objectives, “In achieving the project objectives, Contractor shall: “Secure suitable physical space on the International Compound within the grounds of the Aden Adde International Airport.”

What size area is reserved for the clinic and medical area? Is this space provided by the State Department or does the medical provider have to procure?

The Government shall not provide physical space or any material support to the Contractor performing under this contract. The Contractor, and not the Government, is responsible for secure physical space within the confines of the International Campus on the Aden Adde International Airport.

Not addressed in Solicitation Is the medical service provider or State Department providing/coordinating medical casualty evacuation? Is there a third party provider in place?

The Contractor shall provide all medical resuscitative services and ground transportation from the clinical space to a designated ramp on the flight line of the Aden Adde International Airport.

The Government shall arrange for air ambulance transport from Mogadishu.

Section C, Statement of Objective, Contract Objectives, Page 11:

“Surgical Resuscitative Services, including peri-operative care.

Minimum threshold – One damage control general surgical case at a time with a 30 minute turnaround and three cases per day.

The contract request mentions three surgical cases per day. Are these to be scheduled or elective surgeries? Is there an expectation of general surgical services for routine operative cases? Is there only an expectation of surgical care of trauma?

The Objective is clear as written - the Contractor shall be capable of performing three successive unscheduled damage control surgical resuscitations without resupply.

Section C, Statement of Objective, Contract Objectives, Page 11:

“Laboratory Support. Minimum threshold – Basic blood chemistry, hematology, blood bank type and screen, ….”

For more advanced laboratory services, will State Department facilities be used? This is mainly for routine and primary care labs in non-acute setting.

The Government shall not provide clinical facilities or capabilities supporting performance under this contract. Contractors shall be self supporting and self sufficient.

Not addressed in Solicitation Will State Department doctors be over-reading radiology images?

Is there a requirement to have images send electronically to State Department physicians?

All clinical records are considered deliverable on demand as proof of acceptable performance under this contract. The Contractor shall not rely upon Government "over-read" of diagnostic imaging, and will instead make all decisions and bear all liability for clinical decisions independently. Any liability associated with clinical decisions made by the Government, and any clinical action directed by the Government, shall be born by the Government.

Not addressed in Solicitation Is there a specific electronic medical record being used that we are expected to interface with? How does the State Department want to receive medical records of treatment?

Medical records shall be transmitted in either pdf (written records) or jpeg (clinical and diagnostic images).

Not addressed in Solicitation Will the facilities have access to potable water or should water purification plans including storage be made?

The Contractor shall bear all responsibility for physical infrastructure, including physical space and all necessary utilities within the International Campus of the Aden Adde International Airport.

Section C, Statement of Objective, Contract Objectives, Advanced Life Support ground transport: “Paramedic-level ground transportation within the Mogadishu International Airport perimeter.” “Limited Diagnostic Imaging: Portable plain film x-ray and bedside ultrasound.”

Will the State Department provide equipment, including but not limited to x-ray, ambulance, sterilization equipment, fixtures, et al?

The Government shall not provide physical space or any material support to the Contractor performing under this contract. The Contractor, and not the Government, is responsible for secure physical space within the confines of the International Campus on the Aden Adde International Airport, all logistical support and supply chain management, and all equipment and supplies necessary to perform under this contract under the Firm Fixed Price CLIN structure.

Proposal Due Date, February 4 Would you please consider short extension of proposal due date given the complexity to plan in Somalia context?

No extension shall be granted. This requirement was posted through FedBizOps under a Sources Sought notice 19AQMM19R0020 in November, 2018, without significant change in the requirement scope or place of performance.

Standard Form 1449, 19, Schedule of Supplies/Services, CLIN 0001, et al: “This is a firm fixed price CLIN to be priced per unit. A “unit” is defined as a calendar month of services for a single identifiable person eligible for non-surgical health care services.”

Section B.3 Minimum and Maximum Quantities Under Each and All Task Orders: “…the Government may place a maximum of 600 individuals or $4,500,000 per individual task order.”

Section C, Statement of Objective, Contract Objectives, Page 11, first full paragraph: “…Provide medical support and care to a population of up to 600 personnel living and working…”

In B.2, the Government has established a minimum monthly contract cost of $75,000, inclusive of all costs and fees. There is no established minimum number of units outside that established threshold dollar value, although the anticipated population at risk at the outset of performance is expected to be 25 personnel. In the unlikely event that the Government requires services for more than 600 personnel in a given month, the full range of remedies available to both the Government and the Contractor under the FAR remain available.

Is the Offeror to assume an eligible patient panel of 600 for pricing purposes? Will the Offeror have the opportunity to re-price if the State Department increases the number of eligible patients above 600? If not, what is the initial patient panel so that we can determine level of staff, etc.?