36C24219R0002-0002000.docx

Amendment 0002, RFP 36C24219R0002

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 NUMBERE

D 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 reference to the solicitation and this amendmen t, and is received prior to the opening hour and date 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 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) 01-24-2020 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

36C24219R0002

X X X

X This amendment to the above referenced solicitation hereby addresses vendor questions received through January 24, 2020.

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

Allan Preston Contracting Officer This amendment to the above referenced solicitation hereby addresses vendor questions received through January 24, 2020.

Paragraph 2.1 of the Solicitation states “Current standards are 1200 active patients per full time physician and 900 active patients per full time midlevel provider. Actual panel sizes can be determined by the VA in accordance with VHA Directive 1406, Patient Centered Management Module (PCMM) for Primary Care.” We note that our experience has indicated that the VA-assigned panel sizes at individual VA Hospital affiliated clinic locations can be in practice significantly lower than 1200 active patients per full time physician and 900 active patients per full time midlevel provider. Additionally, we note that VHA Directive 1406, Appendix E, provides various factors that affect panel sizes, including teamlet support staff ratio, number of exam rooms per provider, primary care intensity score, and women veteran population. Regarding support staff ratio, the Solicitation requirements of three support staff members per provider would equate to no adjustment to panel sizes, per Table 1 in Appendix E. Regarding exam rooms, the Solicitation requirements of three exam rooms per provider would equate to a +5% adjustment to panel sizes, per Table 2 in Appendix E. Regarding primary care intensity score, we are not sure what, if any, adjustment from Table 3 in Appendix E would apply, as the Solicitation does not indicate the primary care intensity scores for the clinics. Regarding women veteran population, assuming an even distribution of women veterans among the providers at the proposed Schenectady County CBOC location, we are not sure what, if any, adjustment from Table 4 in Appendix E would apply, as the Solicitation does not provide the number of women veterans for this clinic.

In this context of the adjustments indicated by Appendix E (and the assumptions that solicitation requirements for support staff and exam rooms will be followed and that women veterans will be divided evenly among all providers at the proposed Schenectady County CBOC) we ask the following questions:

See 6a and 6b below