36C24218R0611-0002000.docx
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- Solicitation number
- 36C24218R0611
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This document provides an amendment to a solicitation for outpatient clinic services. It addresses forty-one questions received from potential offerors to clarify requirements. Key details include: the incumbent contractor will inherit enrolled patients and be able to bill for services immediately; medications, vaccines and certain medical equipment will be the responsibility of the contractor to provide; at least one onsite physician is required along with other clinical staff and exam rooms; one full-time equivalent VA employee will provide social work services onsite; offerors must meet all VA standards and guidelines for safety, security and clinical operations; and subcontracting goals will align with the annual VA targets for the total value of projected subcontracts. The amendment extends the offer acceptance period to 200 days and responds to vendor questions on various administrative, clinical, facility and contractual requirements for the community-based outpatient clinic opportunity in Plattsburgh, New York.
36C24218R0611 0002 36C24218R0611 0002.docx
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| 36C24218R0611-0003000.docx | DOCX document | |
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| 36C24218R0611-017.pdf | ||
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| 36C24218R0611-026.pdf | ||
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Solicitation 36C24218R0611 Amendment 0002 Questions received through 9:00 AM on 04/12/2019
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 ITEM 10A.
15C. DATE SIGNED
B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADM
INISTRATIVE 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 reference to the solicitation and this amendment, and is received prior to the opening hour and d ate specified.
C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:
D. OTHER
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 3
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) 04-12-2019 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
36C24218R0611 04-12-2019
X X X
X This amendment to the above referenced solicitation hereby addresses vendor questions (beginning on page 2) received through April 12, 2019 at 9 AM. Questions pertaining to safety and security will be answered in a separate amendment.
This amendment also further modifies Addendum to FAR 52.212-1, to extend the period of acceptance offers from 180 days to 200 days.
All other terms and conditions remain unchanged and in full force and effect.
Allan Preston Contracting Officer
| ITEM |
| QUESTION |
| ANSWER |
| 1 |
| 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? |
| Refer to 4.5.22.2. 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. |
| 2 |
| Please provide the most recent billing figures/ members/enrollees for primary care services and mental health services |
| Refer to B.2 PRICE SCHEDULE OF SERVICES; mental health services are provided by the VA |
| 3 |
| Please confirm that all medications and vaccines administered at the CBOC will be provided/procured by the Government. |
| Medications and vaccines administered at the CBOC are the responsibility of the Contractor. |
| 4 |
| “The contractor will provide all medications, including any necessary vaccines that are to be administered to patients in the clinic.” Question – Please confirm that the medications and vaccines will be procured by the VA. |
| Medications and vaccines administered at the CBOC will be procured/are the responsibility of the Contractor. |
| 5 |
| On page 47 paragraph 4.5.9. of the RFP it states, “the Contractor will provide all medications, including any vaccines that are to be administered to patients in the clinic.” In addition, it states, “urgent/emergent medications needed will be filled via contracted local pharmacy for up to 10 days. VA is responsible for this contract. All other prescribed medications will be via the VA EHR, faxed or mailed to the VA pharmacy for filling.” It states that the contractor will provide all medications, however, it then states the VA is responsible for urgent/emergent medications and all other prescribed medications will be sent to the VA pharmacy for filling. Please clarify who is providing urgent/emergent medications and all other prescribed medications and vaccines? |
| Refer to 4.5.9.; when urgent/emergent medications are not available at the CBOC, those medications will be provided through the Albany VAMC’s local pharmacy (“first fill”) contract. |
| 6 |
| 4.5.9. states that the contractor will provide all medication, including any necessary vaccines. Please list specific medication and vaccines that the contractor is to supply, plus expected 12-month usage |
| For a list of anticipated vaccines and estimated quantities, refer to attachment D.9 of the solicitation. |
| MEDICATION |
| QTY |
| ALBUTEROL SO4 0.083% INHL 3ML |
| 6 |
| LIDOCAINE HCL 2% INJ 10ML |
| 5 |
| LIDOCAINE HCL 2% (PF) INJ 10ML |
| 4 |
| LIDOCAINE 1% (PF) INJ 30ML |
| 2 |
| LIDOCAINE 2% INJ 20ML |
| 1 |
| ASPIRIN 325MG TAB |
| 1 |
VA has provided historical utilization data. However, patient care needs may dictate a requirement for other medications (such as ammonia inhalants, epinephrine auto-injectors, or dextrose squeeze tubes, etc.) or immunizations other than those listed on D.9 which will be the Contractor’s responsibility.
| 7 |
| 4.5.14.11. Substance Abuse Disorders (SUD): Subsection 4.5.14.5.17. and 18: Is the Contractor required to pay for and distribute Buprenorphine or methadone as a means of treatment? |
| There will be no distribution of buprenorphine or methadone at a clinic. VA Pharmacy provides the buprenorphine pursuant to a prescription entered by a provider with the DEA certification allowing buprenorphine prescription authority. The VA does not have a methadone maintenance clinic. |
| 8 |
| On page 60 paragraph 4.5.14.11.5.19. 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.” Currently the Plattsburgh CBOC providers are not waivered providers and refer Opiate abuse patients to pain management and/or mental health for treatment. Will the VA accept this practice for the new contract? |
| Yes |
| 9 |
| 4.5.9. Pharmacy Services: Will Albany VAMC put a Pyxis medication dispenser in the CBOC? |
| No |
| 10 |
| 2.4. Ryan Haight Act: Is it a requirement that the Contractor obtain a Clinic DEA registration for telehealth visits? |
| Yes |
| 11 |
| 2.4.2. requires 1 FTE Clinical Pharmacy Specialist per PACT team, but it does not specify who shall provide. Is the VA providing the CPS to meet this requirement or is the contractor responsible? (Note 2.4.2 states that the VA will provide the CPS for anticoagulation) |
| Refer to 2.4.1. CLINICAL PHARMACY SPECIALIST (CPS) – the Contractor shall provide. |
Refer to 2.4.2. CLINICAL PHARMACY SPECIALIST ANTI-COAGULATION – the VA shall provide
| 12 |
| 4.5.10.15. Anticoagulation Management: In reference to section 2.4. Discipline Specific 2, subsection 2.4.2. states that VA will supply the CPS for Anticoagulation. Can the VA confirm that subsection 4.510.15., VA CPS would provide quarterly and annual anticoagulation quality assurance summaries to Albany VAMC? |
| In the event that the Contractor provided CPS provides support to the VA CLINICAL PHARMACY SPECIALIST ANTI-COAGULATION, the Contractor CPS would be required to provide summaries and data. |
| 13 |
| 4.5.11.1. states that the CPS will be provided by the contractor. Is this the CPS referred to in 2.4.2.? |
| No, it is the CPS referred to in 2.4.1. |
| 14 |
| 4.5.11.2. Support Services: Is the contractor required to have dedicated support services to the CPS? If so, what is the required FTE? Is an LPN required? |
| The Contractor can determine who/how support for the CPS will be provided. Other team members can be cross utilized to support this position. |
The support for the CPS should be similar to the support provided for all primary care clinics. The CPS is to function as a mid-level provider so an MSA should assist with scheduling patients, the LPN should room the patient, and the CPS may enlist the support of the RN care manager in the same way a physician, NP or PA would.
| 15 |
| 4.2.1. requires a Registration and Enrollment specialist. Does the government want an additional administrative person hired to do this job or is this an added duty to the PACT administrative staff? |
| 4.2.1. does not require a Registration and Enrollment Specialist. All PACT Administrative Staff should be trained in this responsibility. |
| 16 |
| Explain why the VA projects the enrollment at the clinic will increase when 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. |
| As the veteran population in Clinton, Franklin and Essex counties continues to age, the anticipated number of enrollees seeking care (Priority Groups 1-6) is expected to increase slightly as reflected in B.2 PRICE SCHEDULE OF SERVICES. |
| 17 |
| On page 61 paragraph 4.5.14.12.1 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? |
| Yes |
| 18 |
| Can a Nurse Practitioner see patients in the CBOC if the Nurse Practitioner is supervised remotely by a CBOC Physician based at another location? |
| Refer to 2.2. and 2.3.1. At least one PCP must be a physician on site. |
| 19 |
| Does the VA require on-stage/off-stage design elements listed in the PACT Manual? |
| Yes |
| 20 |
| Is the current facility designed to meet the VA’s standards to accommodate the PACT Model; is the current facility using the on-stage/off-stage plan? |
| No; No |
The space requirements in the current solicitation are different than the previous requirement.
| 21 |
| Is the current facility adequate to meet the size requirements for the current solicitation? |
| No, not in its current configuration. |
| 22 |
| The RFP states a “Minimum of (3) three exam rooms and (1) one exam/consultation room per PACT teamlet,” which seems more rooms than necessary. The PACT design guide on page 24 states, “the modules utilizes a ratio of approximately 3 exam rooms per Teamlet.” Does 3 exam/consult room per team meet the requirements? |
| Three exam rooms are required per PACT (one room for the LPN, one for the RN, and one for the provider). One of the three exam rooms can also be used as a consultation/exam room. |
| 23 |
| The RFP requires three exam rooms and one consult room per PACT team in addition to one women’s health room. Would the VA consider revising to two exam rooms per PACT and including the women’s health room in that number? |
| No, refer to 4.6.1.1., 4.6.1.2. and 4.6.1.3. |
| 24 |
| On page 72 paragraph 4.5.20.8.3.13. of the RFP it states, “Women veterans must have women-only or unisex toilet rooms and bathing/shower facilities.” Is it the VA’s intent to have bathing/shower facilities in the outpatient Plattsburgh Clinic? |
| Bathing/shower facilities are not required. |
| 25 |
| Does the VA require a small group room at the CBOC? |
| Refer to 4.6.1.7. |
| 26 |
| On page 82 paragraph 4.6.1.9. of the RFP 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 Plattsburgh CBOC utilizes a water cooler. Is it acceptable to the VA to use a water cooler in the Plattsburgh CBOC instead of a wall mounted drinking fountain? |
| Yes |
| 27 |
| On page 46 paragraph 4.5.6. of the RFP, it states, “Routine radiology procedures will be provided by the Albany Stratton VA Medical Center.” Who will be responsible for urgent x-rays, the Albany VA Medical Center or the Contractor? |
| The Albany VAMC will provide either onsite at the VAMC or through referral in the community |
| 28 |
| Can the government please confirm that the conducting x-ray services? |
| The Albany VAMC will provide either onsite at the VAMC or through referral in the community |
| 29 |
| On page 82 paragraph 4.6.1.14. of the RFP states, “Situated between blood draw rooms with pass through windows on each side.” And paragraph 4.6.1.15. states, “Approximately 120 square feet with pass through window from adjacent patient restroom.” In 2016-2018, the OIG inspected CBOCs and specifically looked to ensure lab pass throughs were closed off/locked as this was identified as a patient privacy issue per OIG. Based on OIG findings/inspections, many VA's directed CRA to close off/remove/lock the pass throughs. Please clarify this is now to be reversed and pass throughs used again and are no longer considered a HIPAA concern. |
| In accordance with the PACT design guide, pass through windows are optional. However, they are preferred and if included, must have locks for patient privacy and security. |
| 30 |
| In section 4.5.16.3. 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 4.6.13.2.1. states the VA will be responsible for, “providing PC workstations, software, primary telecommunications lines and networking equipment required to access the EHR.” |
Is the VA providing the phones throughout the clinic or is that a contractor responsibility?
The Contractor is responsible for providing telephones and phone lines; the VA will provide telecommunications (i.e. T1 lines)
| 31 |
| Will the VA provide phones and the phone system? |
| No |
| 32 |
| 4.5.5.3. states that the contractor shall provide POC equipment, validation and supplies, but section 4.5.5.3.5. states that the VA will provide test systems/instruments and reagents for contractor-waived testing, except for FOBT cards and developer. Please specifically list what will be provided by the VA and what is the contractor’s responsibility to provide. |
| VA will provide the Glucometers and strips and control (staff will be trained at the CBOCs on use and maintenance), FOCBT cards, PAP kits, specific viral transport kits, and centrifuges |
The contractor is required to provide urine pregnancy kits and controls, collection tubes, urine transport cups/tubes, etc.
| 33 |
| 4.5.5.3.4. Ancillary Testing Systems POC: Please confirm that VAMC, Albany will maintain all POC test equipment? |
| VA will maintain the VA supplied Glucometers |
| 34 |
| If the VA requires the staff to attend training at the VA in Albany for scheduling training, tele-health training, or any other training, is the contractor responsible for the associated cost of the training? |
| Yes |
| 35 |
| 2.10. Training ACLS/BLS: Is it a requirement that providers have ACLS and BLS training? |
| Yes |
| 36 |
| Will the Government be conducting a site visit prior to award? If so, how much notice will the contractor be given? |
| Refer to page 171: Part II, Section 3 - Site Visits: Site visits may be conducted of proposed locations. Provide a point of contact for coordination of site visits. If a site visit will be conducted, the contractor will be given approximately 48 hours advanced notice. |
| 37 |
| What is the total number of VA personnel that will be providing services at the Plattsburgh CBOC? Please list by title and number of hours per week. |
| One FTE VA employee will be providing services at the CBOC; PACT Social Worker, 5 days per week |
| 38 |
| Because this is a 10-year contract, if the VA changes the panic alarm requirements, would the contractor be responsible for bringing the system into compliance with the new regulations? |
| Changes may be required. However, not until a bi-lateral contract modification was completed. |
| 39 |
| On page 85 paragraph 4.6.12 of the RFP states, “Contractor must meet VHA standards regarding EOC and shall provide the following Safety and Health EOC documents, as required by Joint Commission, with the submission of their proposal/within 15 calendar days after contract award.” Is the Contractor required to submit Safety and Health EOC documents with the submission of the proposal OR within 15 calendar days after contract award? |
| 15 calendar days after contract award |
| 40 |
| On page 92 paragraph 4.8 of the RFP states, “The Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming services per FAR 52.212-1.” FAR 52.212-1 deals with instructions to offerors. Did the VA mean to reference FAR 52.212-4(a) here? |
| 52.212-1 shall be replaced with 52.212-4 |
| 41 |
| On page 131 paragraph (c ) of C.12 of the RFP states that the minimum goals for award of subcontracts to SDVO businesses and VO businesses shall be commensurate with the Department’s annual SDVO business and VO business prime contracting goals for the total value of projected subcontracts to support the sales for the commercial plan. Will you please clarify the 2019 percentages for the subcontracting goals? |
| The 2019 subcontract goals can be found at: http://vaww.va.gov/osdbu/library/accomplishments.asp |
| 42 |
| In the Quality Assurance Surveillance Plan (Attachment D.1 of the RFP) number 6. Measures, it lists the Standard and the Acceptable Quality Level for each measure. Why are some of the Contractor’s Acceptable Level higher than the Standard Level? |
| Contract CBOCs are expected to perform at least as well as VA run CBOCs. For that reason, some acceptable quality levels are higher than the standard since the VA run CBOCs are performing at or above the level indicated. |
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