36C24218R0013-0001000.docx

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2.

AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE

OF PAGES

10A. MODIFICATION OF

CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

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:

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

E. IMPORTANT:

is extended,

(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 electronic communication 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 is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV.

11/2016) is required to sign this document and return ___________ copies to the issuing office.

is not, 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 ITE M 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES

SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR

43.103(b).

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 r eference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS

ENTERED INTO

PURSUANT TO AUTHORITY OF:

D. OTHER

BY

Contractor

16C. DATE SIGNED

14.

DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

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

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

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

11. THIS ITEM ONLY APPLIES TO AMENDMENTS

OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer) 08-10-2018 Department of Veterans Affairs Network Contracting Office 02 1304 Buckley Road Suite 101 Syracuse NY 13212 Department of Veterans Affairs Network Contracting Office 02 1304 Buckley Road Suite 101 Syracuse NY 13212 To all Offerors/Bidders

36C24218R0013 07-18-2018

X X X Tuesday August 28, 2018 3:00 PM EST This amendment addresses questions received through 8/10/2018.

In addition, the following changes are made to the performance Work Statement.

Section 4.6.12.1 "Clinical Pharmacy Services": Delete paragraph and r eplace with following:

"Clinical pharmacy services are provided by the VA via telepharmacy.

Delete paragraph 4.7.7 Clinical Pharmacist (VA Staff):

RESPONSE DUE DATE IS CHANGED TO 3:00 PM EST ON AUGUST 28, 2018.

All other terms and conditions remain unchanged.

Allan Preston Contracting Officer

CONTINUATION PAGE

1. QUESTION: In section 2.6 specialty care staffing states “the following specialty staffing shall be provided by the contractor.” However, Section 2.6.1 Podiatry states, “VA to Provide” Who is responsible for providing the podiatrist? And, will the contractor need to provide space at the clinic for podiatry services?

ANSWER: VA provides podiatry services at main facility

2. QUESTION: In section 2.6 specialty care staffing states “the following specialty staffing shall be provided by the contractor.” However, in Section 2.6.4. General and Specialty Mental Health Staffing States, “VA to provide General and Specialty mental health staffing.” Will the contractor need to provide any mental health staffing? If so, can contract mental health staff utilize the VA mental health consultation rooms?

ANSWER: Contractor does not provide Mental Health Staffing.

3. QUESTION In section 4.6.17.6 it states “Contractor’s shall 1) set up the clinic’s main number with an auto-attendant greeting with an option 7 transferring calls to the Veterans Crisis Line. Caller’s not selecting Option 7 will then be transferred to a “live person.” However, Section 4.7.20.2.1. states the VA will be responsible for, “providing PC workstations, software, primary telecommunications lines and networking equipment required to access the VISTA system.” Is the VA providing the phones throughout the clinic or is that a contractor responsibility?

ANSWER: Contractor Responsibility

4. QUESTION: The solicitation calls for a “minimum of 3 exam rooms and 1 exam/consultation room per PACT teamlet.” Is the VA looking for 3 exams rooms and 1 dedicated consult per team or 2 exam rooms and 1 exam room that is an exam/consult space?

5. ANSWER 2 exam rooms and 1 exam room that is an exam/consult space.

6. QUESTION: Total Estimated Patients enrolled/assigned to site: 1500” Question – will the Government please provide the most current billable/enrollment figures?

ANSWER: Billable for month of June 1432

7. QUESTION: Will the new contractor inherit the patient’s last vesting visit and be allowed to bill for one year from that date upon contract award?

ANSWER: The Contractor will be provided a list of all enrolled patients at the beginning of the contract. Contractor will be able to bill for these patients immediately. In order to remain enrolled in the clinic, patient must be seen within 12 months of their last visit.

8. QUESTION: 2.10 Training (ACLS/BLS/VA Mandatory) Is ACLS required for CBOC staff?

ANSWER: ACLS is not required

9. QUESTION: 4.6.6 Laboratory Services - Is the Contractor responsible for securing and paying for the lab courier service?

ANSWER: yes, refer to 4.6.6

10. QUESTION: 4.6.6.3 Ancillary Testing (Point of Care and Waived Testing)

a. 4.6.6.3.5 Is the Contractor responsible for maintaining and repairing the Point of Care Testing equipment?

b. 4.6.6.3.6 Please advise what fecal occult blood test kits the VA uses.

c. 4.6.6.3.12 Please advise the type of credentials/education required for the hematology/coagulation lab tech working in the CBOC? Typically, lab techs do not have a Medical Technologist certification.

ANSWER:

a. Contractor is responsible for maintaining the instruments. Ancillary testing staff will arrange for repair or replacement of instrumentation.

b. Hemoccult ICT

c. Point of care testing for hematology/coagulation would be done on a waived testing system and therefore can be performed by any who is properly trained and documented by the Ancillary Testing Coordinator.

11. QUESTION: 4.6.10 Pharmacy Services (Prescription Fulfillment)

a. Please provide a comprehensive list of the vaccines and medications that the Contractor is required to supply in the CBOC.

b. Do you have the approximate cost of vaccines and medications used at the CBOC in the last year?

c. Please provide number of each type of vaccine provided last year.

d. Will there be a pixus medication dispenser at the CBOC? If so, who will be responsible for the medications in the pixus?

e. Is the Contractor required to provide the 10 day emergent medications for the CBOC patients?

ANSWER:

a. All vaccines recommended by CDC/ACIP for adult should be made available to the veterans at the CBOCs. Attached is a list of vaccines provided to the CBOC by the VA and will now be supplied by the Contractor. Please Note – for the time frame for the data pull clinics were utilizing Zostavax and have since converted to Shingrix.

b. We are providing the vaccines and the quantities provided. VA pricing is much different than those on the open market.

c. See Attachment

d. No there will not be a Pyxis medical dispenser at the CBOC.

e. VA will pay for all urgent/emergent medications or supplies filled by the VA contracted pharmacy that meets criteria.

12. QUESTION: 4.6.12 Clinical Pharmacy Services - Will the VA CPS be working in the capacity of a provider? If so, please advise if the CPS will require 1:3 ancillary staff to assist the CPS.

ANSWER: The VA will be providing a CPS to working the capacity of a provider, however they will not be on site. These services will be provided via telehealth. The CPS would require the same ancillary support as other telehealth clinics.

13. QUESTION: 4.4.15.3 Can the clerical support for VA Mental Health providers be one of the PACT clerical support, or does this have to be a full time dedicated employee?

ANSWER: The staff can be one of the PACT support staff however, they must be trained in MH scheduling rules and regulations and abide by the rules and regulations, which are different than the Primary Care scheduling rules and regulations.

14. QUESTION: 4.6.17.4 Telephone Access to Clinical Care - Is the Contractor required to supply the telephones for the CBOC?

ANSWER: See Question 3 above

15. QUESTION: Will the government be doing site visits prior to award? If so, how much advance notice will the contractor be given?

ANSWER: See section E “ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS--COMMERCIAL ITEMS”, “Specific Instructions” “Part II” “Section (c).

If a site visit will be conducted, the contractor will be given approximately 48 hours advanced notice.

16. QUESTION: How many VA staffed personnel will be providing services at the CBOC? Please list by job title and number of days per month.

ANSWER: Mental Health Staff at Auburn:

Psychologist – 1.0 FTE Mon – Fri (18/19 days per month) at Auburn location Psychiatrist - .60 FTE Mon/Tue/Fri (12 day per month) at Auburn location Telehealth Psychiatrist/Resident - .1 FTE Mon/Tues both ½ days (4 days per month) Telehealth Psychologist - .075 FTE Fri am (2 days per month or 4 ½ partial days per month) Telehealth Social Worker - .075 FTE Fri pm (2 days per month or 4 ½ partial days per month)

17. QUESTION: Are existing employees under a collective bargaining agreement?

ANSWER: Unknown

18. QUESTION: Does the current PC floorplan meet the requirements of the RFP or does the VA require the PACT design of Onstage/Offstage?

ANSWER: The current floorplan does not meet the current PACT guidelines. The VA requires the onstage/offstate design elements listed in the PACT Manual. The contractor is responsible for providing adequate space to meet the requirements in the solicitation and resulting contract. The space requirements in the current solicitation are different than the previous requirement.

19. QUESTION: Will the VA give scoring preference to clinics designed with an Onstage/Offstage floor plan.

ANSWER: Contractor is required to meet the space requirements in the solicitation. Anything above and beyond that will be reviewed by the evaluation team and may be scored higher

20. QUESTION: What is the veteran population in the catchment area by zip code?

ANSWER: See attachment D.9 in the solicitation.

21. QUESTION: Please explain why the VA believes the enrollment at the clinic will increase while VetPop shows a declining Veteran population in the catchment area. Please indicate which zip codes or counties the VA expects to grow during the life of the contract.

ANSWER: To project the expected number of enrollees for this CBOC for the years 2017-2020, the current enrollees were used as the base number. Enrollee projections for the counties most closely associated with this CBOC were determined for the years 2017-2020 using the actual number of patients seen in the past two years. The rate of growth was determined by comparing two consecutive years. The resulting percentage was then applied to the current number of enrollees to determine future enrollees. To project the expected number of users, the number of current, known users (approximately 1400) was compared to the number of enrollees according to the VSSC for the same time period. That “conversion” factor was applied to the projected number of enrollees determined above to obtain the projected number of users. The number of new users was estimated based on current enrollment trends for this CBOC.

22. QUESTION: What is the current invoiced enrollment of the clinic? Current PCCM enrollment?

ANSWER: See Question 6 above

23. QUESTION: The RFP asks for 3 exam rooms and a consultation room for each team. There are only 1 ½ Pact teams currently with 1509 veterans assigned. Can one of the 3 exam rooms be exam/consultation room?

ANSWER: See question 4 above

24. QUESTION: What offices are needed for VA staffed employees at the clinic?

ANSWER: Refer to 4.7 “Space Requirements”

25. QUESTION: When we submit the contract can we submit electronically & is there specific forms that are in one document being this document we are working on is 246 ANSWER: Proposals are not to be submitted electronically. See Section E for instructions on submitting offers.

26. QUESTION: Are there worksheets for determining our costs and our elements of our Price Proposal? Specifically, we are looking for guidance on calculating our quantity, unit, unit price and amount for the base year and the following 4 years. This corresponds to what we have to fill in for Form 1449 (items 19-24) which is the “cover sheet” (page 1).

27. ANSWER: There are no worksheets provided for determining costs.

28. QUESTION: Are there templates available for the Technical Proposal as well as the Narrative section or any guidance in terms of items to include and format? This required document submission is listed on page 134 (section E Instructions) ANSWER: No templates are available. A sample format for a subcontracting plan is included in section D.

29. QUESTION: In section B.3-Schedule of Expenses of the Solicitation/Contract application document do we have to use the Estimated Quantity that is listed or can we use the number of Veterans whom our clinic currently provides services for?

30. ANSWER: Estimated Quantity

31. QUESTION: In submitting our application – do we have to return to the Syracuse VA office section such as B4, C and E, that do not require information, or signatures from the applicant?

ANSWER: Yes

32. QUESTION: For section D.6- Subcontracting Model and section D-12 – Past Performance Evaluation, do we need to submit any form of attestation, or documentation, if we do not plan on sub-contracting any services with our application?

ANSWER: Past Performance form is located in the RFP as Attachment D.12. Refer to Factor 2, sub-factor B. “Reference”.

A subcontracting plan is required in accordance with Federal Acquisition Regulation 52.219-8 and 52.219-9 and Department of Veterans Affairs Acquisition Regulation 852.219-9. Any proposed subcontracting plans must be submitted with initial offers. If during performance the subcontractor becomes ineligible to provide services, the Contractor must notify the VA immediately.

The subcontracting goals are as follows: Small Business- 17%; Small Disadvantaged Business -5%; Veteran-Owned Small Business-7%; Women-Owned Small Business-5%; Service-Disabled Veteran-Owned Small Business-5%; and HUBZone Small Business-3%.

Refer to Section B – Continuation of SF 1449 Blocks numbers 13, 14, 15 and 16.

Attachment One Vaccines previously provided by VA for use in the Clinic.