36C24824R0092 0003.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) 516-24-1-213-0070 None 36C248 Department of Veterans Affairs Network Contracting Office 8 (NCO 8) 10,000 Bay Pines Blvd Bay Pines

FL

33744 36C248 Department of Veterans Affairs Network Contracting Office 8 (NCO 8) C.W. Bill Young VA Medical Center 10000 Bay Pines Blvd.

Bay Pines

FL

33744 To all Offerors/Bidders

36C24824R0092 06-20-2024

X X X ** HOUR & DATE for Receipt of Offers is EXTENDED to:

516-3640160-213-820100 Medical Service-3131 Medical, Dental and Scien-010040175 X one A. The purpose of this amendment is to provide a response to questions received.

B. See pages 2 - 11 for Questions and Answers.

C. There are no other changes to the solicitation.

D. All other terms and conditions remain.

Moneque Rodriguez Contracting Officer C.W. Bill Young VA Medical Center Physiological Monitoring Questions and Answers

Ambulatory Surgery (ASU) What is the number of staff members per shift

· 15 per shift Please confirm if you are using Masimo or Nellcor Technology or just the SpO2 sensors from these vendors. Are you using an adapter with the sensors?

· Masimo, currently no adapters are not needed.

Bronchoscopy What is the number of staff members per shift

· 2 per shift Who is the vendor for anesthesia carts

· Draeger Please confirm if you are using Masimo or Nellcor Technology or just the SpO2 sensors from these vendors. Are you using an adapter with the sensors?

· Masimo, currently no adapters are not needed.

Catheterization (Cath) Labs What is the number of staff members per shift

· 4 per shift Who is the vendor for anesthesia carts

· Draeger How many Edwards Hemospheres per care area

· VA Bay Pines has 4 total Edwards Hemospheres for the whole hospital. Anesthesia has the capability to move them around.

Please confirm if you are using Masimo or Nellcor Technology or just the SpO2 sensors from these vendors. Are you using an adapter with the sensors?

· Masimo, currently no adapters are not needed.

Computerized Tomography (CT) Holding Area What is the number of staff members per shift

· 8 per shift Please confirm if you are using Masimo or Nellcor Technology or just the SpO2 sensors from these vendors. Are you using an adapter with the sensors?

· Masimo, currently no adapters are not needed.

Emergency Department (ED) What is the number of staff members per shift

· 15 per shift Please confirm if you are using Masimo or Nellcor Technology or just the SpO2 sensors from these vendors. Are you using an adapter with the sensors?

· Masimo, currently no adapters are not needed.

Gastroenterology (GI) What is the number of staff members per shift

· 12 per shift Who is the vendor for anesthesia carts

· Draeger Please confirm if you are using Masimo or Nellcor Technology or just the SpO2 sensors from these vendors. Are you using an adapter with the sensors?

· Masimo, currently no adapters are not needed.

Hybrid Operating Room (OR) What is the number of staff members per shift

· Included with OR (30 per shift) How many Edwards Hemospheres per care area

· VA Bay Pines has 4 total Edwards Hemospheres for the whole hospital. Anesthesia has the capability to move them around.

Please confirm if you are using Masimo or Nellcor Technology or just the SpO2 sensors from these vendors. Are you using an adapter with the sensors?

· Masimo, currently no adapters are not needed.

Main Operating Room (OR) What is the number of staff members per shift

· 30 per shift How many Edwards Hemospheres per care area

· VA Bay Pines has 4 total Edwards Hemospheres for the whole hospital. Anesthesia has the capability to move them around.

Please confirm if you are using Masimo or Nellcor Technology or just the SpO2 sensors from these vendors. Are you using an adapter with the sensors?

· Masimo, currently no adapters are not needed.

Main Operating Room Pre Op (2) Bays Please define the monitoring needs for this care area

· Include Telemetry, same needs as PACU What is the number of staff members per shift

· Included with ASU (15 per shift) Please confirm if you are using Masimo or Nellcor Technology or just the SpO2 sensors from these vendors. Are you using an adapter with the sensors?

· Masimo, currently no adapters are not needed.

Main Post Anesthesia Care Unit (PACU) What is the number of staff members per shift

· 5 per shift How many Edwards Hemospheres per care area

· VA Bay Pines has 4 total. Anesthesia has the capability to move them around.

Please confirm if you are using Masimo or Nellcor Technology or just the SpO2 sensors from these vendors. Are you using an adapter with the sensors?

· Masimo, currently no adapters are not needed.

Inpatient Wards (4A, 4C, 5A, 5B) What is the number of staff members per shift

· 5b – 14 per shift

· 5d – 14 per shift

· 3d – 14 per shift

· 4a – 16 per shift Please confirm if you are using Masimo or Nellcor Technology or just the SpO2 sensors from these vendors. Are you using an adapter with the sensors?

· Masimo, currently no adapters are not needed.

Medical Intensive Care Unit (MICU) What is the number of staff members per shift

· 6 per shift How many Edwards Hemospheres per care area

· VA Bay Pines has 4 total Edwards Hemospheres for the whole hospital. Anesthesia has the capability to move them around.

Please confirm if you are using Masimo or Nellcor Technology or just the SpO2 sensors from these vendors. Are you using an adapter with the sensors?

· Masimo, currently no adapters are not needed.

Surgical Intensive Care Unit (SICU) What is the number of staff members per shift

· 6 per shift How many Edwards Hemospheres per care area

· VA Bay Pines has 4 total Edwards Hemospheres for the whole hospital. Anesthesia is the clinical end user for these devices and moves them around as needed.

Please confirm if you are using Masimo or Nellcor Technology or just the SpO2 sensors from these vendors. Are you using an adapter with the sensors?

· Masimo, currently no adapters are not needed.

Outpatient Surgery Center (OSC) Operating Room (OR) Please confirm if you are using Masimo or Nellcor Technology or just the SpO2 sensors from these vendors. Are you using an adapter with the sensors?

· Masimo, currently no adapters are not needed.

Outpatient Surgery Cetner (OSC) Pre and Post Anesthesia Care Unit (PACU) What is the number of staff members per shift

· Included with ASU (15 per shift) Please confirm if you are using Masimo or Nellcor Technology or just the SpO2 sensors from these vendors. Are you using an adapter with the sensors?

· Masimo, currently no adapters are not needed.

Central Command Unit (CMU) What is the number of staff members per shift

· 4 per shift

Infrastructure (IT and BioMed) What version of Vocera are you using and what type of badge/phone are you using

· Patient monitoring isn’t connected yet to the current Vocera system, version 6.x. New Vocera system software may be upgraded in 2025.

Please confirm where the shared database and servers will be located for C.W Bill Young VA Medical Center and Lee County Healthcare Center

· Bay Pines- located on the 3rd floor of building 2, but will be relocated to the 2nd floor of building 2.

· Lee County- Servers and databases are located on the second floor Are all com closets on provided floorplans available to use with rack space and emergency power

· All Bay Pines racks are on emergency power, and have room. Bay Pines Preference would be to use the virtual server farm.

· Lee County racks are on emergency power and have room. Lee County must be physical.

Lee County Healthcare Center (LCHC) Physiological Monitoring Questions and Answers

Ambulatory Care Center (ACC)

· Are all com closets on provided floorplans available to use with rack space and emergency power?

· Yes

· We did not see Vocera being used for clinical alarms at the LCHC location during our walk through. Do you already use a middleware solution for alarms at LCHC or is a plan for the future?

· Yes, the plan is to use Vocera or equal. Preference would be to have capability to monitor but not a priority.

· Do you need a middleware solution, or a data feed, for alarms to Vocera?

· No middleware solution is currently needed as Spacelabs connects to Vocera. A middleware software would be required if designated by vendor.

· Philips supports Nellcor, Masimo and Philips spO2 technology. Is there a preference for which spO2 technology is supplied?

· Masimo

Operating Room/GI

· We did not see Vocera being used for clinical alarms at the LCHC location during our walk through. Do you already use a middleware solution for alarms at LCHC or is a plan for the future? Do you need a middleware solution, or a data feed, for alarms to Vocera for the GI beds?

· Yes, the plan is to use Vocera or equal. Preference would be to have capability to monitor but not a priority.

· Philips supports Nellcor, Masimo and Philips spO2 technology. Do you have a preference for which spO2 technology is supplied?

· Masimo

Pre and Post Anesthesia Unit

· Do you need a strip recorder on the monitor if you can print strips at the central station?

· Post/ Pre Op do not need strip printers, in the OR they do as they do not connect back to the central station.

· We did not see Vocera being used for clinical alarms at the LCHC location during our walk through. Do you already use a middleware solution for alarms at LCHC or is a plan for the future?

· Yes, the plan is to use Vocera or equal. At this time, we do not use Patient Monitoring for clinical alarms and there is no middleware being used. Preference would be to have capability to monitor but not a priority.

· Do you need a middleware solution, or a data feed, for alarms to Vocera?

· No middleware solution is needed as spacelabs connects to Vocera.

· Are you using the Edwards Hemosphere for CO in the Pre and Post Anesthesia Unit?

· No.

· Philips supports Nellcor, Masimo and Philips spO2 technology. Do you have a preference for which spO2 technology is supplied?

· Masimo

Post Anesthesia Care Unit (PACU)

· Do you need a strip recorder on the monitor if you can print strips at the central station?

· Post/ Pre Op do not need strip printers, in the OR they do as they do not connect back to the central station.

· We did not see Vocera being used for clinical alarms at the LCHC location during our walk through. Do you already use a middleware solution for alarms at LCHC or is a plan for the future? Do you need a middleware solution, or a data feed, for alarms to Vocera?

· Yes, the plan is to use Vocera or equal, would like capability but not a priority.

· Are you using the Edwards Hemosphere for CO in the PACU?

· No.

· Philips supports Nellcor, Masimo and Philips spO2 technology. Do you have a preference for which spO2 technology is supplied?

· Masimo

Infrastructure

· The current server at LCHC is physical. Would you like virtual or physical servers for this location?

· LCHC servers need to be physical, with 72hrs sent to Bay Pines. Currently connected as 1 data-base, sent through network (wide area network).

· If virtual, will the datacenter be located at Lee County Healthcare Center at 2489 Diplomat Parkway East, Cape Coral, FL 33909, or a different location?

· Not applicable.

· Can the LCHC facility share the data center with Bay Pines where the Bay Pines patient Monitoring servers will be located?

· Yes

· Is low voltage (CAT-5e/6 and coax) cable required to be inside of conduit in all locations, or just as required in NFPA 70?

· CAT-6A is required to be within conduit or tray/troughs.

· Please advise the location, size, and type of new conduit installation, if any is required.

· Minimum 3/4in conduit, where required by NEC. Use existing trays in the interstitial space and conduit through penetration, with the preference being that all cable run in interstitial space.

· Are containment pods required for use during ceiling work and will VABP provide?

· Containment is only needed for install of new wall-plates. Contractor will provide HEPA carts. Contractor will work with VA local Infection Control. All dust/ debris generated in patient care/ hallways will need the Infection Control Risk Assessment (ICRA).

· If Vendor does not support Microstream technology, is vendor equivalent an acceptable substitute?

· If the vendor does not support Microstream the VA must review the equivalent is acceptable and ensures it meets nursing’s needs.

· Please advise requirements for waste removal (size, location, duration).

· Waste removal will be coordinated with VA.

· Please advise any new cabling/network requirement.

· CAT-6A minimum, with adherence to NEC.

· ER Director wanted the (26) monitoring watched in the Telemetry CMU – also confirming number of watched devices in the ER for Central Station,

· 26 confirmed

· Customer asked for (3) patient monitoring for the (3) Pre-op Bays (Qube monitor would only fit in that area.)

· Not needed

· Please provide a comprehensive set of technical requirements for determining version compatibility with Picis clinical information system, Phillips eICU system, Cerner Careware BMDI, and Vocera.

· PICIS- the vendor will work with VA and PICIS to build and modify drivers for the Patient Monitoring System to work with PICIS.

· Vocera is not currently integrated with patient monitoring, if this desired by nursing then the vendor will work and provide requirements to work with the Vocera Adapters.

· Cerner Careware- The BP VA does not currently have Cerner but this is a contracting requirement for the system to be compatible with Cerner.

· Vendor will need to work with the VA to create interface between the current teleICU system and Patient Monitoring. The national team has rolled this out across the nation and all Patient Monitoring manufacturers have the ability to interface.

· Please clarify the technical requirements needed to comply with the following statement from RFP Section 15.2.1: “The physiological monitoring system must have the ability for a patient to be continuously monitored without modifying the Admit Discharge Transfer (ADT).”

· Monitoring needs to be without interruption/or transfer message when monitoring the patient ambulatory.

· The OSC Operating Room lists Cerebral Oximetry as a required parameter. Is this Masimo O3 Regional Oximetry or Edwards?

· Edwards

· Please provide the most up to date maps with defined coverage areas.

· See Attachment included in the RFP

· The VA Security Language in requirement number 7 states the Contractor shall use Government IT equipment shall be used in accordance with Bay Pines VA Healthcare System policy. Please provide the relevant policies that must be adhered to (if not already included in the RFP).

· All relevant policies are listed in the RFP

· Sections 16.1.2, 16.5.5, 16.8.2, 16.8.4, 16.8.6, 16.8.8, 16.8.10, 16.8.12, 16.10.5, 16.12.3, 16.13.3, 16.14.5, 16.15.4, 17.1.2, 17.4.2 and 17.5.2 specify a Networked Printer. Please clarify if this is provided by the Contractor or Government. If provided by the Contractor, please specify the requirements.

· Only one unit uses government printer, and the rest use vendor provided printers.

· No requirements, but must be compatible with patient monitoring

· Please provide the requirements for the VA physical access policy (RFP Section 14.1).

· Vendor must register with OR Traxs. To access servers they must coordinate with one of 3 people with access, and VA staff needs to be present with vendor for the duration of the visit(s).

· Please provide the technical system requirements required to comply with Section 3.1.1 (equipment and middleware compatible with Picis clinical information system, Philips eICU system, Cerner Careware BMDI and Vocera).

· Currently VA Med center doesn’t connect Vocera with patient monitoring, though it would be preferred. System is currently set up to directly feed to picis and then to the patient record. Vendor will provide recommendations to the VA and Picis to create compatible driver.

· PICIS - the vendor will work with VA and PICIS to build and modify drivers for the Patient Monitoring System to work with PICIS.

· Vocera is not currently integrated with patient monitoring, if this desired by nursing then the vendor will work and provide requirements to work with the Vocera Adapters.

· Cerner Careware- The BP VA does not currently have Cerner, but this is a contracting requirement for the system to be compatible with Cerner.

· Vendor will need to work with the VA to create interface between the current teleICU system and Patient Monitoring.

· Manufacturer will be responsible for compatibility and work with VA to get Draegar compatible parts.

· Please clarify the technical specifications needed to meet the requirements of RFP section 15.2.2.

· Coordinate with Picis to connect.

· Please clarify the technical specifications needed to meet the requirements for Vocera integration.

· Currently both LCO and Bay Pines VA Med center don’t connect Vocera with patient monitoring. This would be preferred, and must be compatible with the most up-to-date adaptor, as seen on Vocera’s website.

· Please clarify what system components must be FIPS 140-3 compliant.

· FIPS 140-2 is currently mandatory for anything that is wireless or capable of being wireless. All wireless components MUST have FIPS 140-2 or they will not be able to be added to the VA Network.

· Are there any VISN, VA, or Bay Pines VAMC initiatives to reduce false alarms or detecting critical alarms?

· Yes

· Please confirm the exact square footage for Telemetry that needs to be quoted. Page 31 of RFP states approximately “260,000” sq feet. The plans (marked in red) provided by C.W. Bill Young / Bay Pines VA Medical Center indicate more than 280,000 sq feet.

· 1st floor – 81,132 2nd floor – 84,976 3rd floor - 81,759 4th floor - 83,658 5th floor - 77,980

· RFP states “The telemetry staff must be able to view all telemetry receivers (transmitters) and all bedside monitors to include the portable devices” If there will be 160 telemetry transmitters, and 25 Bedside Portables on the Inpatient Wards, please confirm the total number of devices (patients) is 185.

· 160 patients in total being monitored at one time, with 185 devices total.

Section 15.1.3 regarding Servers, states, “Virtual servers capable of residing on our current hosts or additional hosts we be provided."

· Please clarify which party will provide the Virtual servers residing on your host. Specifically, will VA Bay Pines provide the virtual servers and hosts, or will the vendor provide the Virtual servers residing on your hosts or additional hosts needed?

· The host and the virtual servers will be provided by the VA, and software will be provided by vendor.

· Does VA Bay Pines need vendor to provide the hardware?

· VA Bay Pines would not need it provided, but LCO would need it to be provided.

· Will VA Bay Pines provide VM host environment and licenses?

· Yes

The purpose of this amendment is to address Questions and Answers.

As a reminder from the previous amendment, this Request for Proposals (RFP) Close date and time is currently June 28, 2024 at 15:00PM EST.

Page 1 of