36C24621R0068 Amendment 00001.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 5

00001

Department of Veterans Affairs

Network Contracting Office 6

100 Emancipation Drive

Hampton, VA 23667

To all Offerors/Bidders

36C24621R0068

08-25-2021

00001

X

X X

09/02/2021 16:30 EDST

X 1

This amendment A00001 is issued to answer vendors’ questions and to extend the solicitation closing date from 08/30/2021 at

16:30 EDST to 09/02/2021 at 16:30 EDST.

See CONTINUATION page for vendors’ Questions and Contracting Officer's Answers.

Mario L. Santiago

Contracting Officer

CONTINUATION PAGE

Solicitation Questions

1. How many veterans are currently on the Tazewell, VA CBOC Primary Care invoice (most recently billed by the current vendor)?

Answer: 830

2. How many veterans are currently on the Tazewell, VA CBOC Mental Health invoice (most recently billed by the current vendor)?

Answer: 0; Salem is providing this service via CVT but desires that the Tazewell CBOC location be able to provide equal services as 4 other CBOCs currently provide this service.

3. Can the government provide a breakdown showing the number of enrollees by the enrollee’s home zip code?

Answer:

(Note: Chart encompasses enrollees for Primary Care and Mental Health while current billing numbers are for Primary Care patients only)

4. Can the government provide the average enrollment of the clinic for the past five years?

Answer: The average enrollment over the past 5 years is 900 veterans per year for Primary Care treatment only.

5. Why does the government believe the clinic will continue to grow when the area population is projected to decline?

Answer: The Department of Veterans Affairs VSSC (VHA Support Service Center) projects the

Veteran enrollment to increase based on the following factors: as the current population ages, more veterans may become eligible for VA health care, veterans being cared for in surrounding areas may choose to receive care from the Tazewell Clinic.

6. Please list all positions the VA will staff on site at the CBOC by title and number of hours per week/month those employees will be on site.

Answer: The VA will not be providing staffing at this site.

7. Will the Contractors proposed space be required to meet the on-stage/off-stage design with the PACT

Zone?

Answer: Space must be inclusive of the areas listed in the PWS.

8. Is the current facility and existing layout of the clinic acceptable to the VA?

Answer: Yes.

9. Will the government give preference to a stand-alone clinic in the scoring of proposals? A stand-alone clinic would be not shared with another practice. The building could be in a strip mall or simply a free-standing building, but not shared with another healthcare facility. This would offer Veterans a dedicated entrance, US and POW/MIA flags, and clear signage.

Answer: All offers meeting the requirements of PWS will be considered.

10. In paragraph 4.6.3.1. it states that the Contractor will provide all medication, including any necessary vaccines that are to be administered to patients in the clinic. Will the Vaccines be provided to the clinic at the cost of the Contractor or the VA?

Answer: The PWS states contractor will provide all medications including vaccines.

11. If the cost of vaccines discussed in question 7 above are the responsibility of the contractor, please confirm that the following list of Vaccines are the responsibility of the contractor?

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

Answer:

VACCINE LIST:

Haemophilus B Conjugate Vaccine (HIB)

Hepatitis A Vaccine

Hepatitis B Vaccine

Hepatitis A & Hepatitis B Recombinant Vaccine (TWINRIX)

Human Papillomavirus 9-valent Recombinant Vaccine (Gardasil) Types 6, 11, 16, 18

Influenza Vaccine Quadrivalent (HIGH DOSE)

Influenza Vaccine Quadrivalent (LOW DOSE)

Meningococcal Vaccine (Menveo)

M-M-R II Vaccine SDV A&B 10

Pneumococcal 23-Valent Polysacc Vaccine (Pneumovax)

Pneumococcal -13 (Prevnar)

PPD

Shingrix 50MCG/.5ml

Td

Tdap

12. If the cost of vaccines is the responsibility of the contractor…. Please list any additional Vaccines required to be supplied by the contractor other than those listed in question 11 above.

Answer: See List in the Answer to #11.

13. If the cost of vaccines is the responsibility of the contractor…. What is the number of Vaccines, by type as listed in question 11 and any additional Vaccines added by the government pursuant to question 12, that was provided to the Tazwell CBOC Enrolled Veterans in the last 12 months?

Answer: Vaccines should be provided based upon patient's clinical need. It is anticipated that the majority of Veterans served in the Tazewell area would be eligible for Pneumonia Vaccines, Shingles, etc. All Veterans are eligible to receive flu vaccines when available seasonally.

14. Pursuant to paragraph 4.6.3.1 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 VA contracted local pharmacy.

Answer: The CBOC would not be dispensing medications. Vouchers are provided for Veterans to fill prescriptions at local pharmacies as needed and/or until medications are shipped from

Salem Pharmacy or CMOP. Medications for Veteran to “take home” should be ordered in CPRS and provided by VHA. If urgent need medication is needed before normal VA medication process, Salem VAMC has an emergency contract in place to facilitate the provision of urgent need medications limited to 10-day supply via a local pharmacy. List will be provided for

“urgent need medications” covered by the Salem pharmacy contract.

15. The last sentence of paragraph 2.3.1 states “A minimum of one physician and up to one mid-level provider (NP or PA) are required.” The Governments estimate for Option 5 Year 10 of the contact is

968 enrollees. Based on VA’s Primary Care staffing standard this would require one Physician (up to

1,200 enrollees). Does the VA require a full time mid-level AND a Full time Physician? Or does the

VA desire the contractor to base staffing on VA’s staffing standards?

Answer: There is a need for a primary practitioner to be on site. There needs to be a back-up employed, credentialed and available in the event of primary provider sickness, planned leave, etc.

16. Can a mid-level provider work in the clinic with remote supervision from a Virginia licensed

Physician (similar to the current arrangement in the clinic), or must the supervising physician be on site at all times?

Answer: There is a need for a primary practitioner to be on site. There needs to be a back-up employed, credentialed and available in the event of primary provider sickness, planned leave, etc.

17. In reference to the evaluation section, Factor 1, Subfactor C: Management, Expertise, and Staffing;

Would the government be willing to reconsider the staffing requirements and only require names and qualifications summary for all staff and/or resumes, board certifications and licenses for Primary Care

Providers (MDs, PAs, and NPs)? Aside from the current requirements favoring the incumbents, the

VA will be duplicating efforts upon contract award and credentialing. Upon contract award, the majority of these items will be recollected by the VA credentialing team utilizing Primary Source

Verification.

Answer: No. Proposals must include all requirements outlined in the solicitation.

18. In reference to section B.2 Staffing and Qualifications; “Total Estimated Patients enrolled/assigned to site: 805.” Please provide the most recent 3-month billing figures/members/enrollees for both primary care and mental health services.

Answer: Current billing information will not be disclosed.

19. In reference to section B.2 Staffing and Qualifications; Will the government allow for a Nurse

Practitioner to run the clinic with Physician Medical Director providing oversight remotely at the .05

FTE per PACT ratio?

Answer: There is a need for a primary practitioner to be on site. There needs to be a back-up employed, credentialed and available in the event of primary provider sickness, planned leave, etc.

20. In reference to section 4.6.3.1 Prescription Fulfillment; “The Contractor will provide all medications

(including any necessary vaccines, with the exception of vaccines for COVID-19 as indicated in section 4.6.3.4) that are to be administered to patients in the clinic.” Can the VA please provide the list of medications and vaccines the contractor will be responsible for providing? Additionally, can the VA also provide estimated utilization numbers/quantity for each medication/vaccine required (or historical information)?

Answer: This is answered above #11, #12, #13

21. In reference to section 4.9.1; Will any discipline specific offices be required for VA staff? If so, how many?

Answer: VA staff will not be present at this clinic.

22. In reference to section 4.9.1; Are patient consult rooms required for each PACT team?

Answer: The requirements for space are listed in the PWS.

23. In reference to section 4.9.1; Does each PACT team require a women’s health Exam room?

Answer: The requirements for space are listed in the PWS. One WH appropriate exam room is sufficient.