36C24423R0132 0003.pdf

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)

1 15

MSO-2023-COM-0030

00244

Department of Veterans Affairs Network Contracting Office 4

100 S. Independence Mall West Philadelphia PA 19106 thomas.cossentino@va.gov

00244

Department of Veterans Affairs Network Contracting Office 4

100 S. Independence Mall West Philadelphia PA 19106

To all Offerors/Bidders

36C24423R0132

11-06-2023

X

X X

01/31/2024 at 2:00PM ET

See CONTINUATION Page

The purpose of this amendment is to provide responses to questions submitted by Offerors, and to extend the solicitation response time, as detailed in the continuation pages.

Kevin M. Balser Contracting Officer

36C24423R0132 P0003

CONTINUATION PAGE

I. Offerors have submitted 72 questions to the Government in response to Solicitation 36C24423R0132. The Government has included all questions submitted by Offerors below, verbatim, and provided responses. Offeror questions (Q#:) appear in regular font; Government responses (A#:) follow in bold font.

Q.1 Section 4.6.3.4.7 Women’s Health Exams: The contractor is not able to procure thin prep from the manufacturer will the VA provide the thin prep to the contractor?

A.1: Yes, VA will provide thin prep to the contractor.

PWS Section 4.6.3.4.7 CHANGE:

Contractor shall provide all equipment necessary to provide comprehensive women’s health services. Examination rooms shall be set up in accordance with current VA standards to afford women with privacy (placement of examination tables in the room, privacy curtains, etc. See Space Requirements section for more details). Equipment such as privacy curtains, exam tables with stirrups and lights, bathrooms adjacent to where pelvic exams are performed, speculums, supplies, and equipment to perform Pap smears and point of care pregnancy testing should be on hand in the clinic area. Each designated women’s health provider shall have an appropriate exam table to conduct the annual women’s health exam. Lebanon VA Medical Center Laboratory will supply Thin Prep bottle and brushes.

Q.2 Section 4.6.4.2.8 Quarterly and annual anticoagulation quality assurance summaries: Since the VA is supplying the CPS & CPS anticoag PharmD, will the VA assume the responsibility of supplying the quarterly and annual anticoagulation quality assurance summaries?

A.2: Yes, The VA will complete the quarterly and annual Anticoagulation summary through the Pharmacy Performance Excellence Counsel.

PWS Section 4.6.4.2.8 CHANGE: The Contractor shall provide Quarterly and annual anticoagulation quality assurance summaries as outlined by the local Pharmacy & Therapeutics Committee. For questions, please contact, POC, VA Anticoagulation Coordinator at: Chelsea.pavone@va.gov. These reports are completed by the Centralized Anticoagulation Service Hub (CASH).

Q.3: Section 4.6.5.2 EKG: EKG will be supplied by the VA at cost to the contractor. What is the total cost of the EKG?

A3: Historical purchases of EKGs in the contracting system (SEPG) were approximately $17,000.00. This estimate is provided for informational purposes based on historical information and is subject to change.

Q.4 Section 4.11.2.8 VA responsibilities: Please confirm if the VA will provide the telephones for clinic operation.

A.4: Yes, VA will provide the telephones for clinic operation.

Q.5: Will the government add price realism language to the current solicitation? To prevent contractors from deliberately underbidding this contract?

mailto:Chelsea.pavone@va.gov

A.5: Yes, the following language is hereby added to Solicitation Section E.1.1.III, “PRICE

VOLUME”:

“If a cost realism analysis is performed, cost realism may be considered by the source selection authority in evaluating performance or schedule risk.”

Q.6: Please explain why the CLINs are declining, and the government does not expect an increase in enrollees at the clinic over the next 10 years, corresponding to Census estimates.

A.6: These estimates were taken from Population dashboard which based is off of current projections for the county.

Q.7: Please provide the number of billable enrollees on the most current invoice.

A.7: For October 2023, the number of billable enrollees was 2123.

Q.8: Is the current number of veterans on the Primary Care billable roster an accurate reflection of what the starting billable roster will be under the new contract?

A.8: Yes, this is an accurate reflection based on current estimates. For October 2023, the number of billable enrollees was 2123. As indicated in the price schedule, all quantities are estimated.

Q.9 Does the current CBOC facility meet the new contract PACT Space Module Design Guide requirements as stated in the Space Requirements document of the solicitation? If not, will the current facility be “grandfathered in” and available for rebid “as-is”?

A.9: Yes, this is designed according to the PACT Space Module Guide. This meets the design layout as proposed by Office of Construction and Facilities Management.

Q.10: Is the incumbent required to move from the current facility?

A.10: VA does not provide this information.

Q.11 Please confirm the new CBOC facilities must be designed with the on/Stage-Off/Stage concept as laid out in the PACT Design Guide.

A.11: Yes, CBOC facility must be designed according to the PACT Space Module Guide with on/stage-Off/Stage concept in the Pact Design Guide.

Q.12: How many VA staffed personnel will be providing services at the each CBOC? Please list by job title and number of days per month.

A.12: VA staffed Mental Health Social Work (Full time), VA Staffed Psychiatrist (3-5 days a week), VA Staffed PCMHI Provider (Full Time), VA Staffed PACT Social Worker (1-3 days a week), HBPC touchdown staff, Homeless SW touchdown, Pharmacy and Nutrition via VVC, Telehealth tech ad hoc for training, Whole Health (1-2 days week). There is a desire for additional space to be available for additional specialties to be provided by VA Staff.

Q.13 How many offices will be needed at the CBOC for the VA provided staff (by position/function)?

Will the new Contractor inherit the patients’ last vesting visit and be allowed to bill for one year from the date upon contract award?

A.13: 1st part. 4 offices for the full time VA staff employees. At least 3 spaces for ad hoc, touchdown or expansion.

2nd Part: The contractor will inherit the patient’s last vesting visit; however, the contractor may not bill VA for patient care services until receiving written notice to commence operations following the startup period per PWS Section 6.1.1.

Q.14 Will the government be making site visits prior to the award? If so, how much advance notice will the contractor be given?

A.14: The government intends to conduct site visits prior to award. However, the government only requires access and any information the contractor wishes to provide regarding the site. The contractor is not required to be present during the site visit. The government intends to provide two weeks’ notice prior to potential site visits.

Q.15: How many Mission Act referrals, for Primary Care, were made in the past 12 months for enrolled veterans of the CBOC?

A.15: 2 Mission Act referrals, for Primary Care, were made in the past 12 months for Schuylkill County CBOC.

Q.16: Please list the vaccines the contractor is responsible for purchasing and provide information on how many of each vaccine were used at the clinic in the past year.

A.16: Lebanon VAMC does not supply vaccines to the contracted CBOC. VA does not have the exact information on vaccines administered at this time.

Q.17: Are contractors responsible for PT/INR Testing?

A.17: No, VA is responsible for PT/INR Testing.

Q.18: Are Contractors responsible for any procedures? If so, please provide a list of expected onsite procedures.

A.18: These procedures are required for providers’ credentialing: Skin procedures such as cryotherapy/superficial excision or destruction, Women’s health Pap smears and pelvic exams, placement of foley catheters, ear flush, laboratory testing, vaccinations, basic wound care, joint injections, incision and drainage (I&D), Burn Care, local anesthetic techniques, management of uncomplicated closed fractures or dislocations, nose packing, peripheral nerve block, management of foreign object non penetration corneal, management of nasal FB, repair simple lacerations, Battle Field acupuncture. This is the minimum required for credentialing; however, this is not a comprehensive list of procedures the contractor may be responsible for.

Q.19: Are there any VA training mandates that require any staff to travel to the VAMC?

A.19: Yes, staff are required to attend new employee orientation and Prevention and Management of Disruptive Behavior (PMDB) training at the Lebanon VA Medical Center.

Q.20: Will the VA continue to provide VA courier services?

A.20: Yes, VA will continue to provide courier services.

Q.21: Does the VA want the Contractor to pay for simple x-rays by subcontractor?

A.21: Emergent x-rays can be sent through a subcontractor; however, for simple x-rays, contractors should place requests through Mission Act/Community Care Consults.

Q.22: Is CITRIX still included in the new contract?

A.22: VA will provide the networking service for the computer systems.

Q.23: Are Contractors responsible for the Generator for emergencies? What is the cost of maintenance?

A.23: Contractor is responsible for the generator. VA is unaware of the cost for maintenance.

Q.24: Will the VA provide a large copier, scanner, and fax machine?

A.24: No, the Contractor is responsible for Copier, Scanner, and Fax machine, which must be compatible with VA’s systems.

Q.25: Who will provide the phones in the clinic?

A.25: Telephones will be provided by the VA.

Q.26: Will the VA provide a temperature tracker for Medication storage?

A.26: No, VA will not provide a temperature tracker. This will be provided by the contractor.

Q.27: Which vaccines are Contractors responsible for providing?

A.27: Contractor is responsible for all vaccines.

Q.28: Are Contractors responsible for paying for any patients individualized treatment/medication/injectables? Please provide a list of medications to be administered by the contractor with anticipated quantity.

A.28: Yes, the contractor is responsible for paying for individualized treatment/medication/injectable that is administered in the clinic. Below is a table of medications based on a CBOC with 5 PACT teams. This is historical information provided for informational purposes and not a comprehensive list of all medications that may be administered. This list also includes vaccines the contractor is responsible for (not a comprehensive list) as VA does not provide vaccines to contracted sites.

Q.29: Are Contractors responsible for mental health medication or injectables? If so, please provide a list.

Are Contractors responsible for administering medication/ paying for medication prescribed by non-contracted providers?

A.29: Yes, the contractor is responsible for supplying Haldol for Behavioral Health Medication. Yes, Contractors are responsible for administering medication/paying for medication prescribed by non-contracted providers.

Q.30: Does the Contractor pay for all Lab supplies? Tubes, Centrifuge, gauze, tape, etc.?

What lab specimen tubes/containers is Contractor responsible for purchasing vs. the VA?

A.30: Laboratory Tubes are provided by the Lebanon VA Logistics. Centrifuge is also provided by equipment purchase through Lebanon VA.

1 Injectables: 53 Oral Medications:

2 Ceftriaxone 1 gram 2 injs 2 injs 54 ASA 81 mg chewable 2 tabs 2 tabs 3 Depo-Provera 2 injs 2 injs 55 ASA 325 mg 2 tabs 2 tabs 4 Diphenhydramine 50 mg/mL 2 injs 2 injs 56 Clonidine 0.1 mg 2 tabs 2 tabs 5 Epinephrine 1 mg/mL 2 injs 2 injs 57 Diphenhydramine 25 mg 4 tabs 4 tabs 6 EpiPen 2 pens 2 pens 58 Famotidine 20 mg 2 tabs 2 tabs 7 Fluphenazine 125 mg/5 mL vial 1 vials 1 vials 59 Gluctose 45 gel 3 tubes 3 tube 8 Glucagon Emergency Kit 1 kit 1 kit 60 Ibuprofen 400 mg 4 tabs 4 tabs 9 Haldol 100 mg/mL 5 vials 5 vials 61 Ibuprofen 600 mg 2 tabs 0 10 Kenalog 40 mg, 5 mL vial 2 vials 2 vials 62 Ibuprofen 800 mg 2 tabs 2 tabs 11 Sodium Chloride 10 mL vial 5 vials 5 vials 63 Maalox XS 30 mL 1 pack 1 pack 12 Solu-Medrol 125 mg/mL 1 injs 1 injs 64 Nitrostat 0.4 mg 1 box 1 box 13 Solu-Medrol 40 mg/mL 1 injs 1 injs 65 Post Exposure Prophy Kit 1 kit 1 kit 14 Sterile Water 10 mL vial 2 vials 2 vials 66 Tylenol 325 mg 20 tabs 20 tab 15 Toradol 30 mg/mL 1 injs 1 injs 67 Vitamin K (Phytonadine) 5 mg 2 tabs 5 tabs 16 Toradol 60 mg/2 mL 1 injs 1 injs 68 Zofran 4 mg 2 tabs 2 tabs 17 Vitamin B-12 1 boxes 1 boxes 69 18 Xylocaine 1% 50 mL vial 1 vials 1 vials 70 19 Xylocaine 1% with Epi 50 mL vial 1 vials 1 vials 71 20 Xylocaine 2% 20 mL vial 1 vials 1 vials 72 Miscellaneous:

21 Xylocaine 2% with Epi 20 mL vial 1 vials 1 vials 73 Ammonia inhalants 2 boxes 1 box 22 74 Albuterol Inhaler 90 mcg 1 inhaler 1 inh 23 Topicals: 75 Drysol 1 bottle 1 bot 24 Bactroban cream 1 box 76 Ethyl Chloride Spray 1 can 1 can 25 Hydrocortisone cream 2.5% 1 box 1 box 77 Hydrogen Peroxide 1 bottles 1 bot 26 Lidocaine cream 4% 30 gram tube 1 tube 1 tube 78 Isopropyl Alcohol 1 bottles 1 bot 27 Lidocaine jelly 2% 30 gram tube 1 tube 3 tubes 79 Lumicain 3 bottles 3 bots 28 80 Narcan Nasal Spray 2 boxes 0 29 81 Silvadene Cream 1% 50 gram 2 tube 1 tube 30 82 Silver Nitrate Applicators 1 box 1 box 31 Vaccines: 83 Surgical Lubricant 1 box 1 box 32 Flu – High Dose 84 Verruca Freeze 1 box 1 box 33 Flu – Regular Dose 85 34 Gardasil 3 doses 3 doses 86 Nebulizer Solutions:

35 Hepatitis A/B Twinrix 3 doses 3 doses 87 Albuterol Sulfate 0.083% 1 box 36 MMR 3 doses 3 doses 88 Duoneb (Albuterol/Ipratropium) 1 box 37 Meningoccal B 3 doses 3 doses 89 Ipratropium 0.02% 1 box 38 Prevnar 5 doses 8 doses 90 39 Shingrix 5 doses 4 doses 91 Special Medications:

40 Td 3 doses 4 doses 92 41 Tdap 5 doses 5 doses 93 42 Covid Vaccine 94 43 RSV Vaccine 95 44 96

Q.31: Regarding paragraph 4.9.1, “consultation rooms for MH/SW 140-160SF each” – how many consultation rooms are required?

A.31: 7 consultation rooms.

Q.32: Regarding paragraph 4.9.1, “2 female exam rooms with connecting restroom 180-200SF each” – are these rooms part of the 2.5 patient care rooms required for each PCP?

A.32: Yes, as long as they are used for primary care visits.

Q.33: Please advise if the women’s health room may count also as a regular exam room?

A.33: Yes, it may be used as a regular exam room.

Q.34: Are the on-stage/off-stage design features of the PACT Space Module Design Guide required? If on-stage/off-stage design is not required, will it be evaluated more favorably than a clinic that does not include on-stage/off-stage design?

A.34: Yes, the CBOC facility must be designed according to the PACT Space Module Guide with on-stage/off stage design.

Q.35: Will the VA provide the lab specimen tubes?

A.35: Yes, VA will provide lab specimen tubes.

Q.36: Regarding Paragraph 4.6.3.4.7, would the VA be willing to provide Well Women’s Health Services Supplies, including Thin Prep Pap Test, Pap Smear Collection Kits, Cytobrushes, as well as the IFOBT kits? In our experience, these supplies are difficult for the contractor to procure.

A.36: Lebanon VA will provide testing kits for Thin Prep tests and IFOBT kits.

Q.37: Does the current site mee the solicitation requirements?

A.37: Yes, this is designed according to the PACT Space Module Guide. This meets the design layout as proposed by Office of Construction and Facilities Management.

Q.38: Are the on-stage/off-stage design features of the PACT Space Module Design Guide required? If on-stage/off-stage design is not required, will it be evaluated more favorably than a clinic that does not include on-stage/off-stage design?

A.38: Yes, the CBOC facility must be designed according to the PACT Space Module Guide with on-stage/off stage design.

Q.39: Can the government increase the transition period to 180 days?

A.39: No, the government intends to maintain the 120-day transition period for this CBOC.

Q.40: Can the government please extend the submission deadline by 30 days? Due to the holidays, there will be delays obtaining RFP requirements.

A.40: Not applicable, the submission deadline has already been extended beyond the request.

Q.41: Please provide the number of billable enrollees on the most current invoice for the last consecutive months.

A.41: For October 2023, the number of billable enrollees was 2123, September 2116, August 2127, July 2115.

Q.42: What is the anticipated award for this procurement?

A.42: Question is not clear.

Q.43: Who is responsible for courier services – VA or contractor?

A.43: VA is responsible for courier services.

Q.44: Will the VA please confirm if VA will provide the phone circuit and physical phones?

A.44: Yes, VA will provide phone circuit and physical phones.

Q.45: Can offers provide copies of graduation certificates for nurse practitioners and Physician assistants at time of award?

A.45: Staff credentials meeting the requirements should be submitted with the proposal.

Q.46: Who is the incumbent contractor and associated contractor number?

A.46: VA will not provide contract information. All public contract information is accessible by searchable database at https://www.fpds.gov/fpdsng_cms/index.php/en/.

Q.47 The price schedule provided is for a 5-year base period and five 1-year option periods, however, there are no estimated quantities listed. Will the VA provide the estimated quantities?

A.47: Estimated quantities were posted to Contract Opportunities as Solicitation Amendment 0001 on 11/08/2023.

Q.48 Section 2: Is a full-time Clinic Manager required?

A.48: Yes, a full time Clinic Manager is required.

Q.49 Section 2.2.1: Considering the national shortage in primary care providers, would the VA consider hiring a new family practice/internal medicine residency graduate if mentorship is provided by the bidder?

A.49: Yes, VA would consider a new provider as long as the contactor provides on-site supervision by an established physician.

Q.50 Section 2.3.2: Contractor will connect Veterans to Anticoagulation CPS by referral to LVAMC staff.

Section 4.6.4.2.7: The Contractor shall meet all requirements for anticoagulation Management outlined in VHA Directive 1108.16 Anticoagulation Therapy Management (or subsequent revisions thereto) as well as local policy related to the management of patients on anticoagulation.

https://www.fpds.gov/fpdsng_cms/index.php/en/

If the contractor refers patients to the VA CPS Anti-Coagulation, wouldn't the VA also provide the anticoagulation management?

A.50: VA provides Anticoagulation therapy for Warfarin therapy through the VA’s CASH (Centralized Anticoagulation Service Hub). Direct Oral anticoagulants (DOAC) Therapy will be prescribed by the contractor with assistance through VA’s Pharmacy Anticoagulation Coordinator. This coordinator will assist with drug interactions, concerns and patient compliance. All PT/INRs are through venous blood draws and not point of care testing. Please see the document entitled “CASH Warfarin Standard Operating Procedure” attached to this amendment.

CHANGE TO PWS: 4.6.5.4.4 (Old Language) Anticoagulation services will be provided by VA clinical pharmacists providers for anticoagulation labwork provided by the PACT teamlet clinical associate.

New Language: Anticoagulation services for Warfarin Therapy will be provided by VA’s CASH (Centralized Anticoagulation Service Hub) and labwork provided by the PACT teamlet clinical associate. All PT/INRs are performed through a venous blood draw and not point of care testing. All other Anticoagulation services for Direct Oral Anticoagulants (DOAC Therapy) will be prescribed by contractor with assistance through VA’s Pharmacy Anticoagulation Coordinator.

Q.51: Section 2.6.2 Phlebotomist/Laboratory Technician services will be provided by PACT Teamlet Clinical Associate and does not require additional FTE.

In our experience operating CBOCs over the past 20+ years, the VA has required a designated Phlebotomist/Laboratory Technician for sites with 1 or more PACT Teams. Given the estimated enrollment in the Schuylkill County CBOC, please verify that VA does not require a designated Phlebotomist/Laboratory Technician, separate from the PACT Team staff?

A.51: Yes, VA does require a designated Phlebotomist.

Q.52: Section 2.8 The FTE ratio for TCT is 1:5,000. At 2,200 enrollment this would equate to

0.44 FTE. Does the VA want 1.0 TCT?

A.52: The VA requires a TCT position, but the position may be a TCT/MSA or TCT/LPN position.

Q.53 Section 4.6.3.4.6: Emergency contraception (e.g., Levonorgestrel (Plan B) etc.) must be available to all women Veteran patients in a timely manner (same day of their appointment) even if a provider has requested to opt out from providing emergency contraception to the patient because of a Rights of Conscience (ROC) Claim. Who is to provide the Levonorgestrel, the VA, or the Contractor?

A.53: The contractor is responsible through the Heritage Prescriptive service.

Q.54: Section 4.6.3.4.7: The RFP states, "Contractor shall provide all equipment necessary to provide comprehensive women’s health services. Examination rooms shall be set up in accordance with current VA standards to afford women with privacy (placement of examination tables in the room, privacy curtains, etc. See Space Requirements section for more details).

Equipment such as privacy curtains, exam tables with stirrups and lights, bathrooms adjacent to where pelvic exams are performed, speculums, supplies, and equipment to perform Pap smears and point of care pregnancy testing should be on hand in the clinic area. Each designated women’s health provider shall have an appropriate exam table to conduct the annual women’s health exam."

The contractor is not able to purchase Thin Prep, will the VA supply Thin Prep?

A.54: Yes, VA will provide Thin Prep kits.

Q.55 Section 4.6.4.1 The Contractor will provide all medications that are to be administered to patients in the clinic (including any necessary vaccines).

-Will the VA provide a list of all medications and vaccines that are to be provided by the Contractor and the amounts that have been administered in the clinic?

-Will the contractor be responsible for providing COVID-19 vaccine?

A.55: Part 1: Below is a table of medications based on a CBOC with 5 PACT teams. This is historical information provided for informational purposes and not a comprehensive list of all medications that may be administered. This list also includes vaccines the contractor is responsible for (not a comprehensive list) as VA does not provide vaccines to contracted sites.

Part 2: Contractor will be responsible for all vaccines including Covid-19 and RSV.

Q.56: Section 4.6.5.3: RFP states the Contractor is responsible for: 1) Entering orders for laboratory tests into the VA EHR. Information concerning the laboratory tests are provided as an attachment in Section D.2) Sending specimens to the VA Core Laboratory twice daily, prior to the Contractor’s mid-day break period and after the close of business of the workday, except for those specified in this PWS.

3) Paying any costs of all lab work, except for lab work sent to the VA or emergency lab work sent to another site which has been authorized by the VA Communications Center and paying any costs associated with transportation of specimens to the VA and for arranging such transportation in a proper secure method.

Based on the size and location of the clinic, would the VA consider once daily lab shipments?

A.56: No. VA Couriers will handle transportation of specimens.

1 Injectables: 53 Oral Medications:

2 Ceftriaxone 1 gram 2 injs 2 injs 54 ASA 81 mg chewable 2 tabs 2 tabs 3 Depo-Provera 2 injs 2 injs 55 ASA 325 mg 2 tabs 2 tabs 4 Diphenhydramine 50 mg/mL 2 injs 2 injs 56 Clonidine 0.1 mg 2 tabs 2 tabs 5 Epinephrine 1 mg/mL 2 injs 2 injs 57 Diphenhydramine 25 mg 4 tabs 4 tabs 6 EpiPen 2 pens 2 pens 58 Famotidine 20 mg 2 tabs 2 tabs 7 Fluphenazine 125 mg/5 mL vial 1 vials 1 vials 59 Gluctose 45 gel 3 tubes 3 tube 8 Glucagon Emergency Kit 1 kit 1 kit 60 Ibuprofen 400 mg 4 tabs 4 tabs 9 Haldol 100 mg/mL 5 vials 5 vials 61 Ibuprofen 600 mg 2 tabs 0 10 Kenalog 40 mg, 5 mL vial 2 vials 2 vials 62 Ibuprofen 800 mg 2 tabs 2 tabs 11 Sodium Chloride 10 mL vial 5 vials 5 vials 63 Maalox XS 30 mL 1 pack 1 pack 12 Solu-Medrol 125 mg/mL 1 injs 1 injs 64 Nitrostat 0.4 mg 1 box 1 box 13 Solu-Medrol 40 mg/mL 1 injs 1 injs 65 Post Exposure Prophy Kit 1 kit 1 kit 14 Sterile Water 10 mL vial 2 vials 2 vials 66 Tylenol 325 mg 20 tabs 20 tab 15 Toradol 30 mg/mL 1 injs 1 injs 67 Vitamin K (Phytonadine) 5 mg 2 tabs 5 tabs 16 Toradol 60 mg/2 mL 1 injs 1 injs 68 Zofran 4 mg 2 tabs 2 tabs 17 Vitamin B-12 1 boxes 1 boxes 69 18 Xylocaine 1% 50 mL vial 1 vials 1 vials 70 19 Xylocaine 1% with Epi 50 mL vial 1 vials 1 vials 71 20 Xylocaine 2% 20 mL vial 1 vials 1 vials 72 Miscellaneous:

21 Xylocaine 2% with Epi 20 mL vial 1 vials 1 vials 73 Ammonia inhalants 2 boxes 1 box 22 74 Albuterol Inhaler 90 mcg 1 inhaler 1 inh 23 Topicals: 75 Drysol 1 bottle 1 bot 24 Bactroban cream 1 box 76 Ethyl Chloride Spray 1 can 1 can 25 Hydrocortisone cream 2.5% 1 box 1 box 77 Hydrogen Peroxide 1 bottles 1 bot 26 Lidocaine cream 4% 30 gram tube 1 tube 1 tube 78 Isopropyl Alcohol 1 bottles 1 bot 27 Lidocaine jelly 2% 30 gram tube 1 tube 3 tubes 79 Lumicain 3 bottles 3 bots 28 80 Narcan Nasal Spray 2 boxes 0 29 81 Silvadene Cream 1% 50 gram 2 tube 1 tube 30 82 Silver Nitrate Applicators 1 box 1 box 31 Vaccines: 83 Surgical Lubricant 1 box 1 box 32 Flu – High Dose 84 Verruca Freeze 1 box 1 box 33 Flu – Regular Dose 85 34 Gardasil 3 doses 3 doses 86 Nebulizer Solutions:

35 Hepatitis A/B Twinrix 3 doses 3 doses 87 Albuterol Sulfate 0.083% 1 box 36 MMR 3 doses 3 doses 88 Duoneb (Albuterol/Ipratropium) 1 box 37 Meningoccal B 3 doses 3 doses 89 Ipratropium 0.02% 1 box 38 Prevnar 5 doses 8 doses 90 39 Shingrix 5 doses 4 doses 91 Special Medications:

40 Td 3 doses 4 doses 92 41 Tdap 5 doses 5 doses 93 42 Covid Vaccine 94 43 RSV Vaccine 95 44 96

Q.57: Section 4.6.6.3: Mental Health Support Services: The Contractor shall provide the following clerical support services for VA mental health providers (including VA providers if VA provides MH services onsite) at the CBOC.

How many contracted clerical support staff are required for the VA staff on-site?

A.57: 1 FTE for VA Staff

Q.58: Section 4.6.8: The RFP states, the contractor shall support and provide telehealth services.

Does the VA require 1.0 FTE TCT to provide support and provide telehealth services?

A.58: The VA requires a TCT position, but the position may be a TCT/MSA or TCT/LPN position.

Q.59: Section 4.6.8.1: TELEPHARMACY SUPPORT SERVICES: The Contractor shall provide clerical support, including scheduling, and ancillary support for VA telepharmacy services as appropriate. The support services should be consistent for each scheduled clinic to include but not limited to intake vitals by LVN/LPN, Unlicensed Assistive Personnel (health tech or nursing assistant), or similar, downloading of blood sugar from meters, POC INR testing and downloading, teaching patients how to use BP monitors at home, calling patients for lab reminders, scheduling patient visits and contacting patients who no-show for rescheduling.

How many contracted clerical and clinical support staff are required for all VA supported services?

A.59: The workload for this service is small enough that this can be shared with clinical and clerical staff. The workload is less than 0.2 FTE.

Q.60: Section 4.9: PACT space standards are found in the PACT Space Module Design.

Will the Government please confirm if VA will provide the phone circuit and physical phones?

A.60: Yes, VA will provide phone circuits and physical phones.

Q.61: Section 4.9.1: The RFP states, Contractors shall provide space that meets the standards outlined in the PACT Space Module Design Guide (see link above) and for the purposes of this solicitation the following minimum space requirements are: an open area reception, and waiting room 900SF; 2.5 patient care rooms for each PCP provider and consultation rooms for MH/SW 140-160SF each...

Is the VA requesting 2.5 MH/SW rooms for each PACT Team? If not, how many MH/SW rooms does the VA need?

A.61: No, VA is not requesting 2.5 MH/SW rooms for each PACT team. The VA is requesting 2.5 exam rooms for PCP providers. The VA is also requesting 7 Consultation Rooms.

Q.62: Section 4.9.1: The RFP states, Contractors shall provide space that meets the standards outlined in the PACT Space Module Design Guide (see link above) and for the purposes of this solicitation the following minimum space requirements are: an open area reception, and waiting room 900SF; 2.5 patient care rooms for each PCP provider and consultation rooms for MH/SW 140-160SF each; 2 female exam rooms with connecting restrooms 180-200SF each; etc...

The VA is requesting 2 female exam rooms with connecting restrooms. Are these exam rooms included in the 2.5 patient care rooms for each PCP provider?

A.62: Yes, they are included.

Q.63: Section 4.11.1.2: The installation and maintenance of the network cabling infrastructure within the facility including all cabling located inside the walls and plenum space of the structure, cabling racks, network equipment racks, patch panels, wall ports, extension cabling from the demarc to the communications closet, and a secure communications closet space to house the networking equipment.

Will the Government please confirm if CAT 6 or CAT 6A is preferred?

A.63: CAT 6A is preferred.

Q.64: 4.11.2.5.1-2: Power requirements:

Four (4) L6-20 receptacles, one (1) L6-30 receptacles in the closet.

Will the Government please confirm the power requirements and if two 20-amp dedicated receptacles are acceptable?

A.64: No, they need the 5 outlets as listed in the power requirements.

Q.65: Section 4.11.2.6.7: Infrastructure installer should install Leviton CAT6 patch panels and connectors in the rack.

Will the Government please confirm if a comparable brand to Leviton is suffice?

A.65: An equivalent brand that meets all specifications for EHRM is acceptable.

PWS SECTION 4.11.2.6.7 CHANGE: Infrastructure installer should install Leviton [or equivalent brand meeting EHRM specifications] CAT6 patch panels and connectors in the rack.

Q.66: Section 6.1: The Contractor shall have 120 days from contract award to commencement of the provision of medical care to local Veterans.

Would the VA consider 180 days from contract award to commencement of the provision of medical care to local Veterans due to the national shortage of building supplies?

A.66: No, the VA intends to maintain the 120-day startup period.

Q.67: Section 6.2.1.1.4: The billable roster for the PC LIN will include all patients assigned to the Contractor’s site of care in the Patient Centered Management Module (PCMM) with at least one qualifying encounter by the Contractor’s Primary Care Provider(s) (PCP) within the previous 12 months.

Will the Contractor inherit the patient's last vesting visit and be allowed to bill for one year from that date upon contract award?

A.67: The contractor will inherit the patient’s last vesting visit; however, the contractor may not bill VA for patient care services until receiving written notice to commence operations following the startup period per PWS Section 6.1.1.

Q.68: Proposal Instructions to Offeror Submission: All proposals must be sent via e-mail.

Are there any email size restrictions when submitting the proposal electronically via email?

A.68: The combined file size per message is 20 MB.

Q.69: Section D.1: Proposed contractor's facility must be in the city limits of Pottsville, Pennsylvania.

Due to the fact that there is no available space in the city limits of Pottsville, Pennsylvania that meet the RFP requirements, will the VA allow for the facility to be located in the adjacent North Manheim Township with a Pottsville, Pennsylvania mailing address and zip code?

A.69: The VA will relax the requirement to allow sites that are located within Schuylkill County, within the 9th Congressional District, and within 5 miles’ driving distance of the city limits of Pottsville, Pennsylvania.

Solicitation Section E.1.I.D. “Subfactor (d): Geographic Location” is changed as follows:

D. Subfactor (d): Geographic Location (site visit may be conducted at VA discretion prior to award)

1. Proposed contractor’s facility must be located within Schuylkill County, within the 9th Congressional District, and within 5 miles’ driving distance of the city limits of Pottsville, Pennsylvania. Parent facility is the Lebanon VA Medical Center in Lebanon, Pennsylvania. Describe location of proposed facility to be utilized under this contract. Include mailing address, street address, city, village, town, and county as applicable, and provide evidence of driving distance from the contractor’s proposed facility to the city limits of Pottsville, Pennsylvania. This element of the subfactor will be evaluated to confirm the site’s location within Schuylkill County, within the 9th Congressional District, and within 5 miles’ driving distance of the city limits of Pottsville, Pennsylvania.

Q.70 Proposal Instructions to Offerors Submission: C. The Offeror shall also provide a list of all contracts for services same or similar to those called for in this solicitation, that were provided to the Department of Veterans Affairs or other Federal agencies.

What information would the VA like to the Contractor to provide in this list of all contracts for services same or similar to those called for in the solicitation?

A.70: Prime Contractor Name | Contract Number | Brief Identification (ie. “Schuylkill County CBOC”) | Performance Period Dates | Total Dollar Value of Award | Government Point of Contact

Q.71: Will the VA please provide the historical enrollment for the past five years?

A.71: Historical enrollment data for patients assigned to Schuylkill VA Clinics follows:

2019-2245 Veterans 2020-2354 Veterans 2021-2283 Veterans 2022-2232 Veterans 2023-2236 Veterans

Q.72: Does the current Schuylkill County Pennsylvania CBOC facility meet the PACT Space Module Design guide and space requirements for this RFP? If not, will the location be "grandfathered in" and available for rebid "as-is"?

A.72: Yes, this is designed according to the PACT Space Module Guide. This meets the design layout as proposed by Office of Construction and Facilities Management.

The Government has provided responses to all questions submitted in response to Solicitation 36C24423R0132.

II. The solicitation response time is hereby extended to 01/31/2024 at 2:00PM ET.

End of Document