36C24218R0567-0001000.docx

Solicitation 36C24218R0567, Amendment 00001 Vendor questions received through Noon on 07/24/2018

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) 07-24-2018

NONE

Department of Veterans Affairs 400 Fort Hill Ave.

Canandaigua NY 14424 Department of Veterans Affairs Network Contracting Activity 400 Fort Hill Ave.

Canandaigua NY 14424 To all Offerors/Bidders

36C24218R0567 07-24-2018

X X X X This amendment hereby addresses vendor questions received through Noon on 07/24/2018.

All other terms and conditions remain unchanged.

Allan Preston Contracting Officer

1. QUESTION: On pages 25 paragraph 2.4 of the RFP it outlines Discipline Specific PACT Team Members required for all sites which include Clinical Pharmacy Specialist in paragraph 2.4.1 and Clinical Pharmacy Specialist Anticoagulation in paragraph 2.4.2. Is it acceptable to the VA for one pharmacist to serve as both the anticoagulation and clinical pharmacist?

ANSWER: The VA Anticoagulation Clinic will provide coverage for anticoagulation patients.

2. QUESTION: On page 33 paragraph 2.23 of the RFP references the Ryan Haight Act. Currently the Glens Falls CBOC providers have individual DEA numbers. Is the VA now requiring a facility DEA number?

ANSWER: Yes

3. QUESTION: On page 43 paragraph 4.5.7 of the RFP, it states, “Routine radiology procedures will be provided by the Albany VA Medical Center.” Who will be responsible for urgent x-rays, the Albany VA Medical Center or the Contractor?

ANSWER: Albany VAMC

4. QUESTION: On page 43 paragraph 4.7.10 of the RFP it states, “All equipment attaching to a VA network will be owned by the VA and controlled by the VA.” On pages 77-78 paragraph 4.7.10.1 and 4.7.10.1.5 it states the Contractor shall be responsible for the procurement, installation and maintenance of all printers, copiers, scanners, fax machines, shredders, or other peripheral office equipment and all related and ongoing supplies required to operate the equipment in support of the facility under the specifications of this contract. The VA currently provides printers and scanners connected to the VA network in the Glens Falls CBOC. Will the VA continue to provide these printers and scanners under the new contract?

ANSWER: No

5. QUESTION: On page 44 paragraph 4.5.10 of the RFP it states, “the Contractor will provide all medications (and supplies), including any vaccines that are to be administered to patients in the clinic…” In addition, it states, “urgent/emergent outpatient prescription medications or supplies will be filled via contracted local pharmacy for up to 10 days. VA will provide this contract. All other prescribed medications will be sent to VA pharmacy for filling.” Currently all urgent/emergent medications are provided through the VA’s Pyxis unit in the clinic and all vaccines in the clinic are provided by the VA. Will all vaccines administered to patients in the clinic now be provided by the Contractor at the contractor’s expense? Will all urgent/emergent medications now be filled by the local pharmacy provided at the VA’s expense?

ANSWER: Yes

6. QUESTION: On page 56 paragraph 4.6.15.11.4.15.2. of the RFP it states, “Office-based Buprenorphine Treatment. Buprenorphine can be prescribed as office based treatment in non-specialty settings (e.g., primary care), but only by a “waivered” physician. Buprenorphine is not subject to all the regulations required in officially-identified OTPs, but must be delivered consistent with treatment guidelines and Pharmacy Benefits Management criteria for use.” The Glens Falls CBOC providers are not currently waivered providers, is this a new requirement?

ANSWER: The VA is encouraging primary care providers to learn about buprenorphine treatment and obtaining DEA status to prescribe buprenorphine but it is not yet a requirement.

7. QUESTION: On page 56 paragraph 4.6.15.12.1 of the RFP it states, “To ensure the availability of outreach and referral services to homeless Veterans, all Contractor sites must designate at least one outreach specialist, usually a clinical social worker, to provide services to homeless Veterans.” Will the outreach specialist be provided by the VA?

ANSWER: Yes

8. QUESTION: On page 74 paragraph 4.7.1.2 of the RFP it states, “Primary Care: Minimum of (3) three exam rooms and (1) one exam/consultation room per PACT Teamlet.” Is the VA requiring 3 exam rooms plus one consult/exam room for a total of 4 exam/consult rooms per PACT teamlet, or is the VA requiring a total of 3 exam/consult rooms per PACT teamlet?

ANSWER: Three exam rooms are required per PACT; one room for the LPN, one for the RN, and one for the provider; Refer to 4.7 and link to the PACT Space Module Design Guide at: http://www.cfm.va.gov/til/dGuide/dgPACT.pdf. Each team member should have a room (one for the RN, one for the LPN, one for the provider = 3 rooms); the TCT should also have his/her own room. This room can also be used for consultation. There is some flexibility/overlap in what the room can be used for.

9. QUESTION: On page 75 paragraph 4.7.1.9 it states, “Space should contain a wall mounted drinking fountain.” In other CBOCs operated by the Contractor, the OIG requested that the wall mounted drinking fountains be removed from the CBOCs due to infection control issues. Currently the Glens Falls CBOC utilizes a water cooler. Is it acceptable to the VA to use a water cooler in the Glens Falls CBOC instead of a wall mounted drinking fountain?

ANSWER: Yes

10. QUESTION: On page 121 paragraph C.12 VAAR 852.219-9 VA Small Business Subcontracting Plan Minimum Requirements (Dec 2009) of the RFP it states, “(c) For a commercial plan, the minimum goals for award of subcontracts to service-disabled veteran-owned small business concerns and veteran-owned small businesses shall be at least commensurate with the Department's annual service-disabled veteran-owned small business and veteran-owned small business prime contracting goals for the total value of projected subcontracts to support the sales for the commercial plan.” We have located the FY2017 goals (attached) on the VA website at https://www.va.gov/osdbu/library/accomplishments.asp. However, we did not locate the FY2018 goals on the VA website. Could you please identify what the FY2018 annual SDVOB and VOSB prime contracting goals are for the VA or direct us to where we can find them?

ANSWER: The goals have not changed since 2017 and new goals have not been published.

11. QUESTION: On page 221 Contract List of Reporting Requirements table under List of Key Personnel and Credentials it states, “(See Attachment Number One)”. The attachment to the RFP is the QASP. What attachment is being referenced in the List of Key Personnel?

ANSWER: D.5 KEY PERSONNEL LIST

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

ANSWER: Refer to page 226: Part II, Section 3 - Site Visits: Site visits may be conducted of proposed locations. Provide a point of contact for coordination of site visits. In addition, refer to page 233: Factor 1, Subfactor D: Proposed site must be physically located in the city of Glens Falls, NY. A site visit may be conducted as part of the evaluation process. Include mailing address, street address, city, etc.

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

13. QUESTION: What is the most recent number of billable enrollees?

ANSWER: As of June 2018, there were 3,268 billable enrollees

14. QUESTION: What is the current PM/PM rate at the existing CBOC?

ANSWER: This information must be requested through the Freedom of Information Act (FOIA)

15. QUESTION: Please explain why the VA believes the enrollment at the clinic will remain stable while VetPop shows a declining Veteran population in the catchment area.

ANSWER: The VA anticipates enrollment to remain relatively the same throughout the length of the contract (average of 3,197) as reflected in B.6 Price Schedule and Services, estimated quantities.

16. QUESTION: Please indicate which zip codes or counties the VA expects to grow during the life of the contract.

ANSWER: The primary catchment areas for growth are Warren, Washington and Saratoga Counties

17. QUESTION: Will the contractor or the VA be responsible for paying for POC equipment, validation and supplies?

ANSWER: Refer to 4.5.6.3.; the Contractor is responsible

18. 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: Refer to 4.6.22.2. and 6.2.1.; 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.

19. QUESTION: Would the VA consider beginning the startup period on the day that the protest period has expired as opposed to the date of the contract award?

ANSWER: No

20. 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: One FTE VA employee will be providing services at the CBOC; PACT Social Worker, 5 days per week

21. QUESTION: Please confirm that the courier service costs will be borne by the contractor.

ANSWER: Confirmed

22. QUESTION: Please list all vaccines the contractor will be responsible for supplying under this contract.

ANSWER: Refer to 4.5.10.

23. QUESTION: Page 74 indicates the VA would like exam rooms with 3’6” openings. Please specify if this is the rough opening and the VA means a standard 36” door? If not, please indicate the actual opening of the door once it is installed.

ANSWER: Door opening should be 42” wide (i.e. 3’6”)

24. QUESTION: Does the VA require that exam room doors be swinging doors or sliding doors? If sliding doors, does the VA want both exam room doors to be sliding doors?

ANSWER: It depends upon the layout of the clinic; there is some flexibility with the type of door selected even though the PACT construction manual specifies sliding doors.

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

ANSWER: Unknown

26. 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/offstage design elements listed in the PACT manual.

27. QUESTION: Please confirm the Government requires both three exam rooms and a consultation room for each PACT Team.

ANSWER: See question #8 above

28. QUESTION: In light of the increase incidence of Veteran related violence and prevention of the same, is the government or the contractor responsible for hiring a security guard? Armed or Unarmed?

ANSWER: Refer to sections 4.7.6. - 4.7.8. for safety/security information

29. QUESTION: Is the VA supplying the phones and phone system?

ANSWER: Refer to 4.7.1.; the Contractor is responsible for providing

30. QUESTION: In total, how many group rooms are required for this facility and what are the size requirements?

ANSWER: Refer to 4.7.1.7.

31. QUESTION: How many telemedicine visits can be expected per year?

ANSWER: Current VA guidance is to complete 2% of all visits using Telehealth; for estimating purposes, a single PACT team with 1,200 patients has an annual revisit rate of 2.0 visits per patient. 2.0% of 2,400 = 48 TCT visits per year. Please note, this metric can change as the needs of the VA fluctuate.

32. QUESTION: Is the VA providing Office-based Buprenorphine Treatment/Opioid Treatment Program (OTP) in the clinic? If so, what other requirements will be needed (ex. Secure room, training, staffing, etc.)?

ANSWER: No; none at this time

33. QUESTION: What is the anticipated workload for the outreach specialist for the homeless? Does the government believe additional outreach specialists will be needed?

ANSWER: Refer to 4.6.15.12.1.; no additional outreach specialist anticipated at this time

34. QUESTION: 2.5.2 – says VA shall provide radiology technologist. Please clarify if the VA plans to provide any radiology services at the clinic.

ANSWER: Radiology services will not be provided at the clinic

35. QUESTION: The tele-health technologist provided by the contractor- is this person required to be an LVN or MA? Please clarify.

ANSWER: Refer to 2.5.5. and attachment D.7 Telehealth Operations Manual; the TCT shall be an RN or LPN

36. QUESTION: 4.5.13- Clinical pharmacy services will be provided by the VA pharmacy and in some instances, may be provided by telehealth capabilities. Please clarify who provides the required pharmacist for the clinic-contractor or the VA.

ANSWER: 4.5.13 reads as follows: TELEPHARMACY SUPPORT SERVICES: The Contractor shall provide space for clinical pharmacy telehealth services at the Contractor’s location as appropriate. Clinical pharmacy services will be provided by the Contractor and in some instances, may be provided by telehealth capabilities.

37. QUESTION: Who is responsible for providing anti-coag pharmacist VA or contractor?

ANSWER: See question #1 above

38. QUESTION: 2.5.5 states Telehealth tech 1 FTE per 5000 patients, given the enrollment of 3197 does the VA require a Telehealth tech in clinic five days per week?

ANSWER: Yes