36C24220R0146 0001.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 ITEM 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 reference 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

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) 03-09-2021 Department of Veterans Affairs Network Contracting Office 02 1304 Buckley Road Suite C104 Syracuse NY 13212 Department of Veterans Affairs Network Contracting Office 02 1304 Buckley Road Suite C104 Syracuse NY 13212 To all Offerors/Bidders

36C24220R0146 02-18-2021

X X X ** HOUR & DATE for Receipt of Offers is EXTENDED to: RESPONSE DATE IS NOT EXTENDED.

This amendment addresses questions received through 3/9/2021.

DATE AND TIME FOR RECEIPT OF PROPOSALS IS NOT CHANGED.

Allan Preston Contracting Officer A00001

1. The PACT Space Module Design Guide identifies the possible use of sliding doors but does not require them. Does the VA have a preference for the use of sliding doors in the Watertown CBOC? If so, please confirm if sliding doors are preferred on the patient side of each exam room or on both sides of each exam room.

ANSWER: We do not have a preference for sliding doors.

2. What is the required setback distance of the site to the bollards required for physical security? Will a 25-foot setback be required if the clinic is in a shopping center? If so, can bollards or planters be used to keep the minimum distance 8 feet away?

ANSWER: Bollards or planters can be used to keep the minimum distance 8 feet away. We don’t see a distance requirement from site to bollard.

3. The Solicitation references several telehealth services that will be provided at the clinic, including teleretinal, teledermatology, telemental and telepharmacy (paragraphs 4.6.7.1-4.6.7.5). Please confirm that the one (1) telemental health room (as required by paragraph 4.9.1.3) and one (1) telehealth rooms (as required by 4.9.1.4) is the total number of required rooms for all telehealth and telemental health services.

ANSWER: Correct.

4. Paragraph 4.9.1.8 requires “Lab/Blood Draw: Shall be a separate dedicated room located near the patient exam rooms,” and paragraph 4.9.1.17 requires “Patient Restroom: Situated between blood draw rooms with pass through windows on each side.” Is the requirement for one blood draw room? If more than one is required, is it acceptable to have multiple blood draw stations separated by privacy curtains rather than separate blood draw rooms?

ANSWER: One blood draw room is acceptable. It is acceptable to have multiple blood draw stations/chairs separated by privacy curtains.

5. Is there required to be any space for VA staff, services, or equipment beyond those spaces listed in section 4.9.1:

Five (5) Mental Health offices (paragraph 4.9.1.2), One (1) telemental health exam rooms (paragraph 4.9.1.3), one (1) pharmacist office (paragraph 4.9.1.9), one LCSW office (4.9.1.10) Mental Health MSA workspace (paragraph 4.9.1.15), Mental Health TCT workspace (paragraph 4.9.1.16)?

ANSWER: Contractor must review space requirements listed in Section 4.9.1. Specifically, 4.9.1.1.3 requires 2 exam rooms needed for VA Staff to see patients. This is in addition to Patient Care rooms in 4.9.1.1 and Women’s Health room in 4.9.1.1.2.

6. Paragraph 2.1 states “The Clinical Pharmacy Specialist (CPS) shall be provided the same support staffing given to other providers on the team when they are working in the capacity of a mid-level provider. Clinical pharmacist will be provided by VA via telehealth or on-site.” Is the Contractor required to provide dedicated support staff for the VA-provided CPS? If so, please indicate the numbers of support staff needed.

ANSWER: The Clinical Pharmacist will be provided mostly via telehealth but in the event they do come to the CBOC to provide services they do not require dedicated support staff.

7. Would the VA consider allowing a 150 or 180 build out time frame instead of the 120 days indicated in paragraph 6.1.2? The basis of this request is that longer times frames are needed during the COVID-19 pandemic due to supply chain disruptions that are beyond the Contractor’s control. Additionally, we note that constructions costs are significantly higher for a 120-day build out as compared to a 150- or 180-day build out. These factors are particularly applicable to the geographically remote location of St Lawrence County, NY. Reflective of this issue, we note that recent VA CBOC solicitations by other VA hospital systems have called for 180-day build out time frame, such as 36C24920R0114 (Tupelo, MS) and 36C24920R0007 (Hopkinsville, KY).

ANSWER: The start-up is 120 days.

8. Paragraph 4.6.3.3 on page 49 states “X-ray radiology procedures will be interpreted by the contractor or radiology facility.” Please provide the qualifications for a Diagnostic Radiologist.

ANSWER – See attachment D.32 Qualifications

9. Please confirm the VA will provide all telephones and telephone lines as this is our understanding of paragraph 4.11.3.1.

ANSWER: - The VA will provide the telephones. See paragraph 4.11.1.1 – 4.11.1.4 for contractor responsibilities.

10. Is a phone room required in addition to the Network/Data room required by paragraph 4.11.2, or can the Network/Data room also house the VA phone system? If a separate phone room is required, please provide square footage requirements, security requirements, and any other requirements.

ANSWER: Network/Data room and Phone Room are the same.

11. Paragraph 3.2 says “The clinic shall be accessible to VA Behavioral Health staff from 7:00 AM to 7:00 PM Monday through Friday. Does the Contractor need to provide administration and/or building support during these extended hours?

ANSWER: Contract staff do not need to be in the building during the extended hours (4:30PM – 7:00 PM). It is required for the VA Staff to have access as their tour of duty may be an extended one.

12. Would the Contractor be allowed to offer evening or weekend hours for primary care services?

ANSWER: Yes the contractor can provide evening or weekend hours with the permission of the COR.

13. Paragraph 4.9.1.15 requires space for VA Mental Health MSA, and paragraph 4.6.5.3 requires the contractor to provide backup clerical support for mental health services at the clinic. a. Can the Government confirm the quantity and FTE level of any VA-provided Mental Health MSAs? b. Could the Government clarify what is meant by “backup” mental health clerical support? Would these services be provided on a daily basis based on patient volume or is backup support only needed in special circumstances? c. Is it acceptable for backup support to be provided by the PACT Administrative Associates already on staff, or will the Contractor need to provide dedicated clerical support for Mental Health services?

ANSWER:

a. VA will have 1 MSA.

b. Back-up is only needed in the absence of the VA MSA

c. Dedicated clerical support is not needed.

14. Would a Medication room and/or Medical Equipment storage room be the equivalent of a “Core Supply Area” as required by paragraph 4.9.1.13?

ANSWER: No, the contractor would store their meds there and limited and secured access to Nursing staff only. Core supply would be accessible to most staff.

15. Regarding group room/conference room:

a. Please confirm one (1) group room/conference room of 360 square feet (as required by paragraph 4.9.1.5) is the total number of group/conference rooms required for the St. Lawrence County CBOC.

b. Is it anticipated that this room will be used by both Contractor and VA staff?

ANSWER:

a. One group room/conference room is the total number required.

b. The group/conference room can be used by both Contractor and VA staff. The room shall also be available for Mental Health Veteran groups as well.

16. Paragraph 4.9.1.1.2 requires one Women’s Health exam room with a minimum of 125 square feet. a. Does the Women’s Health exam room count as one of the exam rooms required by paragraph 4.9.1.1.1? b. If more than one Women’s Health exam room is provided, does each Women’s Health exam room count as one of the exam rooms required by paragraph 4.9.1.1.1? c. Please confirm the space requirement for Women’s Health exam rooms under this contract effort is 125 square feet as identified in paragraph 4.9.1.1.2.

ANSWER:

a. No it does not count as one of the exam rooms required by 4.9.1.1.

b. See response “a” above.

c. Square footage is correct as stated.

17. If there is the availability of maintaining existing VA-approved clinic space for the St. Lawrence County CBOC effort, would the VA allow for hallways with widths less than six feet and for doorways less than 42 inches in already established clinic space and/or other medical facility space within St. Lawrence County?

ANSWER: Door openings shall be 3’-6” and corridors/hallways must be 6”.

18. Question: The solicitation shows that the contract maximum is $100M. Did the Government conduct an Independent Government Cost Estimate (IGCE) for this requirement? If so, what is the value associated with this estimate?

ANSWER: Yes, an IGCE was done. Government estimates are not released.

19. Please provide the most recent 3-month billing figures/members/enrollees for primary care services

ANSWER: Nov. 1909, Dec 1910, Jan 1903

20. Please confirm that the new contractor will inherit the patient’s last vesting visit and be allowed to bill for one year from that date upon contract award?

ANSWER: Not correct. Patient must be seen within 12 months of last vesting visit.

21. One exam room with a bathroom in the exam to be utilized for woman Veterans. Room shall be a minimum of 125 square feet with an adjacent full restroom. This room does not count as an exam room required by paragraph 4.9.1.1.1.” Please confirm that the facility only requires one women’s health exam room.

ANSWER: one Women’s health exam room is required.

22. Do the additional exam room for VA Staff (4.7.1.1.3) need to be connected to the teamwork zone?

ANSWER: No but they do need to be set up like the other exam rooms to include alarm systems.

23. Please confirm the VA wants only one Telemental Health room (4.7.1.3).

ANSWER: At least one exam room should be available for telemental health services.

24. Please confirm the VA wants only one Telehealth room (4.7.1.4).

ANSWER: Locations with 4000 or less assigned Veterans – one (1) Telehealth room is required. Locations with 4000 or more assigned Veterans – two (2) Telehealth rooms are required.

25. Will the existing clinic be “grandfathered in” and not required to meet the PACT Team design standards?

ANSWER: No it will not be “grandfathered in”.

26. Does the Government require one or both of the patient exam room doors to have sliding doors?

ANSWER: The Government does not “Require” any of the exam room doors to be sliding. The VA has no preference to the types of doors used as long as the PACT design guide is followed.

27. Since the RFP is unclear as to whether three PACT teams will eventually be required at this clinic, will the Government score proposals equally if two or three PACT teams are proposed, or will the Government give preference to clinics designed for three PACT teams?

ANSWER: Offerors are required to staff the clinic in accordance with the guidelines in the PWS and clinic enrollement.

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

ANSWER: It is not possible to provide a complete list of the staff that will be working at the clinic or the number of days per month as it has not been finalized and days could vary from month to month. Below is a list of the staff for mental health that are known at this time. This does not include the pharmacist or the VA staff that will be using the additional 2 exams rooms required for specialty clinics. The number of rooms required is fixed as identified in 4.9.1 however the staff occupying these rooms and the day’s they are working is not fixed.

· 1 MSA

· 3 Therapists

· 2 prescribers

29. What is the veteran population in the catchment area by zip code?

ANSWER: See attachments D.29 and D.33

30. What is the most recent three (3) months of invoiced enrollment at the CBOC?

ANSWER: See response to question 19.

31. Since its implementation, how many Mission Act referrals have occurred for enrolled veterans at the CBOC?

ANSWER: See Attachment D.35

32. Please specify how many of the referrals were for primary care patients? Please specify the types of specialty services by number of patients.

ANSWER: See Attachment D.35

33. (4.3.1) How many traveling vets are anticipated per year?

ANSWER: it is not possible to provide an accurate number. The contractor shall be prepared to provide 40 nurse only and 10 provider visits per month.

34. Will the Government confirm who is responsible for supplying ALL of the following vaccines? Are there any additional vaccines required to be supplied by the contractor? TDAP Pneumovax 23 Prevnar 13 TD Flu High dose flu Shingrix Twinrix (hep a &b) Hep A Hep B HPV Tubersol (PPD) (not a vaccine).

ANSWER: Contractor is responsible for supplying all routine vaccines.

35. Will the VA provide Naxolone for veterans who require it as a precaution?

ANSWER: Yes, Naloxone is available via prescription for Veterans; order through CPRS to be mailed to the patient.

36. Does the VA require the contractor to purchase a refrigerated centrifuge?

ANSWER: No.

37. How far in advance will the Government conduct its site visit?

ANSWER: I assume your asking how much advance notice the Government will give prior to a site visit. The VA will try to provide at least 48 hours’ notice of the need for a site visit.

38. Who is responsible for setting up a contract with a local ambulance company, the VA or the Contractor (4.6.10.1)?

ANSWER: Contractor.

D.35 – Mission Act Referrals Massena: *2021 totals are through February 8, 2021

COMMUNITY CARE-CIH MSG THP SY-528A7

COMMUNITY CARE-DS OPTO SY-528A7

COMMUNITY CARE-CIH ACUPUN SY-528A7

COMMUNITY CARE-COLONOSCOPY SCREENING SY-528A7

COMMUNITY CARE-ADMIN PC SY-528A7

COMMUNITY CARE-COVID 19 TESTING SY-528A7

COMMUNITY CARE-IR SY-528A7

NON VA CARE HCPS PERITONEAL DIALYSIS SY-528A7

COMMUNITY CARE-HEMODIALYSIS SY-528A7

COMMUNITY CARE-CARD REHAB SY-528A7

COMMUNITY CARE-COLONOSCOPY SURVEILLANCE SY-528A7

COMMUNITY CARE-DENTAL GEN SY-528A7

COMMUNITY CARE-PLASTICS SY-528A7

COMMUNITY CARE-BARIATRIC SY-528A7