36C24419R0074-0001000.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 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) 09-17-2019 00244 Department of Veterans Affairs Network Contracting Office 4

00244 Department of Veterans Affairs Network Contracting Office 4

To all Offerors/Bidders

36C24419R0074

X X X ** HOUR & DATE for Receipt of Offers is EXTENDED to: 10/29/19 @ 4:00 PM EDT

1. Issuance of Amendment A0 01 See Continuation Page for complete details on Questions and Answers.

2. Solicitation is hereby extended, proposal due date is October 29, 2019 at 3:00 PM EDT.

3. All Other terms and conditions remain unchanged.

Mark Knorr Contracting Officer

CONTINUATION PAGE

Set 1 Questions and Answers:

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 section 6.2.1 Billable Roster in the PWS.

2. B.2; Please provide the most recent billing figures/members/enrollees for primary care services. For the month of July 2019 there were 1,048 members.

3. How many Choice/Mission Act referrals occurred in the past 12 months for enrolled veterans of the McKean County CBOC? 447 referrals.

4. B.3; 4.6.10 PG 32, Please confirm that the Contractors are not responsible for costs associated with medications and vaccines. If the contractor is responsible for these costs, can the VA provide the list of medications, including vaccines the contractor is responsible for providing (such as the ones listed below)? Additionally, can the VA also provide estimated utilization numbers for each medication/vaccine required (or historical information)? Contractor is not responsible for the costs associated with medications and vaccines.

a. TDAP

b. Pneumovax 23

c. Prevnar 13

d. TD

e. Flu, High dose flu

f. Shingrix

g. Twinrix (Hep A&B)

h. Hep A

i. Hep B

j. HPV

k. Depo

5. If the cost of vaccines is the responsibility of the contractor…. Are there any additional Vaccines required to be supplied by the contractor other than those listed in question 4 above? N/A

6. Pursuant to paragraph 4.6.9, please provide a list of Medications the government expects the contractor to dispense (at the cost of the Contractor) from the clinic that would not be a routine medication dispensed through the VA or an urgent/emergent medication dispensed through the contracted local pharmacy. N/A

7. In paragraph 4.6.9. it states the Urgent/Emergent medication needed will be filled via contracted local pharmacy for up to 10 days. Is this a VA contracted pharmacy or will the Contractor be expected to set up a local contracted pharmacy at the cost of the contractor? This is a VA contracted pharmacy; the Contractor is not responsible to set up.

8. How many Telehealth visits were originated (patient at the McKean County CBOC) from the McKean County CBOC in the last 12 months? 635 visits.

9. Per paragraphs 2.4.1-2.4.5; 2.5.1; 2.5.2; and 2.5.4.1 all expanded teamlet services, PCMHI services, Mental Health services, podiatry services, and radiology services are to be provided by the Erie VAMC. Is the contractor required to provide any tele-health support for these services on site at the Bradford CBOC? Is the contractor required to provide any clinic space for these services (e.g. offices and/or exam rooms) on site the Bradford CBOC? Minimum Space requirements are identified in 4.7 of the PWS. Specialty and consult rooms can be utilized for expanded services as needed. VA will staff the teleheath support.

10. 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 Patient Aligned Care Team (PACT) concept in accordance with the PACT Space Module Design Guide? No, the current facility does not meet the VA standards to accommodate the PACT Model, and no it is not using the on-stage, off stage concept.

11. B.3; 4.7.1, E.1.4.; Is the current facility adequate to meet the size requirements for the current solicitation? No.

12. Will the Contractors proposed space be required to meet the on-stage/off-stage design with the PACT Zone? Proposed space will be required to meet the on/off stage design. Please reference section E.1.4 VI. Evaluation factors for award.

13. Regarding Section 4.6.17 Telephone Access to Clinical Care – currently the Erie VAMC provides the telephones and telephone lines. Will the Erie VAMC still provide this service under the upcoming contract? Yes.

14. On page 126, the instructions indicate: “Offeror shall identify and provide a list of the names for the Physician Director, Clinical Nurse Administrator, qualified physicians, nurse practitioners, and other primary care staff intended to be utilized in the performance of the resultant contract.” Is there are requirement for an RN Administrator for this CBOC? Could the Government clarify any specific qualification requirements for this position? No, RN Administrator needed, this role is a RN Case Manager.

15. 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.” Is the Contractor required to provide an RN, Clinical Associate, and Administrative Associate in support of the CPS in addition to PACT support already required to be provided for any Primary Care Provider? No.

16. Section 4.6.11.8 states “The Contractor shall provide Quarterly and annual anticoagulation quality assurance summaries as outlined by the local Pharmacy & Therapeutics Committee. For questions, please contact, Chief of Pharmacy.” Since the Erie VA is providing the Anti-Coag CPS, we are not sure how the CBOC would provide quarterly reports for a VA service. Could the Government please clarify? All VA patient anticoagulation needs are provided by the VA’s anticoagulation clinic. The anticoagulation clinic would also be responsible for providing any such reporting.

17. We note that, per paragraph 2.1 and 2.2, a Physician Director will need to be provided on a 0.05 FTE basis and that this would allow the Physician Director to provide services as Primary Care Provider on a 0.95 FTE basis, for a total of 1140 patients (based on 1200 patients per 1.0 FTE Primary Care Provider). The estimated patient enrollment provided in the price schedule is just above this number for the base year – 1145 patients, which is more than the current clinic enrollment. These numbers create ambiguities with regard to the staffing of primary care providers and staff. Our questions in this regard are:

a. Is it the Government’s intention that a second PACT teamlet be provided on day one of contract performance to account for up to 1145 patients, or is one full time PACT Teamlet with a Physician Director acceptable? One full-time PACT Teamlet is acceptable.

b. With the anticipated patient growth, it is likely that, even if a second PACT teamlet is not required on day one, it will be necessary at some point. Are Nurse Practitioners and Physician Assistants acceptable in the role of Primary Care Provider for this second teamlet? If so, what are the required qualifications for mid-level providers? Nurse Practitioners are acceptable, Physician Assistants are not.

c. What are the scheduling requirements for a part-time second PACT teamlet? For example, especially considering the geographic remoteness of the clinic, would regular periodic biweekly scheduling be acceptable? Part-time providers not acceptable in this location

21. B.3; 4.7.1, E.1.4; Can the VA please confirm if the quantity for the exam rooms is per PACT teamlet or the total number? Per PACT

22. B.3; 4.7.1, E.1.4; Can the VA please confirm if the minimum size (square feet) requirements listed for the Women’s Exam Room includes the square footage for the attached restroom? Square footage includes the restroom. *Note Refer to 4.0 Planning and Design of Pact Space Design Module.

23. B.3;4.7.1, E.1.4; Can the VA please confirm if the minimum size (square feet) requirements listed for the Lab Processing Area includes the square footage for the attached restroom(s)? Square footage includes the restroom.

24. B.3; 4.7.1, E.1.4; Can the VA please confirm that the Lab Processing Area includes blood draw? Square footage includes area for blood draw.

25. B.3; 4.7.1; E.1.4; Can the VA please clarify the purpose and equipment for the Mechanical Room? This room will house any mechanical systems that are required per code to operate the building. Example: HVAC.

26. B.3; 4.7.1; E.1.4; Can the VA please confirm if the Supervisor Office is dedicated for VA personnel? Correct, it is for VA personnel.

27. B.3: Can the VA please confirm the total minimum quantity and size of Exam Rooms? There is a discrepancy between the tables in Section 4.7.1 (p. 58) and Section E.1.4 (p. 124). PER VHA Directive 1406 PCMM - Levels of 2.5 examination rooms per 1.0 FTE provider have been recommended as a minimum for VHA.

28. In section 4.7.15.1.5 the procurement, installation and maintenance of all printers, copiers, scanners, fax machines*, shredders, or other peripheral office equipment….. However section 4.7.15 EQUIPMENT, OFFICE SUPPLIES AND TECHNICAL SUPPORT: In accordance with VA and VHA directives, policies, and handbooks, all equipment attaching to a VA network will be owned by the VA and controlled by the VA. No other equipment will be connected to this network. Question: will the VA provide all printers and scanners that are connected to the VA network? Yes, the VA will provide a single, floor model Multi-Function Device (MFD)

End of Document