36C24919R0003-0002000.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) 01-31-2019 N/A 90C Department of Veterans Affairs Network Contracting Office 9 1639 Medical Center Parkway Suite 400 Murfreesboro TN 37129 90C Department of Veterans Affairs Network Contracting Office - 9 1639 Medical Center Parkway Suite 400 Murfreesboro TN 37129 To all Offerors/Bidders

36C24919R0003 12-19-2018

X X X

FEBRUARY 19, 2019 AT 12 NOON CT

X The purpose of this amendment is to address all questions received in response to this RFP. Additionally, this amendment will provide change pages of those areas in the RFP that were amended. Below is a list of those sections.

Sections B.2 (page 6-9); 3.1 (page 31); 4.6.6. (page 38); and E.12 Subfactor E (pages 134-136) All changes are denoted by a black line in the right margin.

Additionally, the proposal due date is now extended to February 19, 2019 at 12 noon CT.

The past performance due date remains unchanged.

Kimberly S. Carson Contracting Officer Marshall County RFP 36C24919R0003 Questions & Answers:

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

a. Yes, see Section E.12, Sub-factor A, 2nd paragraph. The Memphis VAMC will provide a 3-day notice.

2. Does the current Marshall County CBOC location in Holly Springs, MS meet the new contract size requirements of a minimum of 10,000 NSF as stated in paragraph 4.7.1 of the solicitation?

a. Not in the current state, but there is the space to expand.

3. Does the current Marshall County CBOC location in Holly Springs, MS meet the new contract PACT Space Module Design Guide requirements as stated in paragraph 4.7.1 of the solicitation?

a. No

4. In section 4.7.1 it states that Contractors shall provide space that meets the standards outlined in the PACT Space Module Design Guide. Is the on-stage/off-stage design with the PACT Zone the only design the VA will accept?

a. Yes

5. How many veterans using the Marshall County CBOC are currently on the Primary Care billable roster?

a. Roughly 1,420

6. Will the new contractor inherit the patient’s last Primary Care vesting visit and be allowed to bill for one year from that date upon contract award?

a. Yes

7. How many veterans using the Marshall County CBOC for Mental Health services will start on the Mental Health billable roster upon contract award?

a. Roughly 170 MH

8. Will the new contractor inherit the patients last Mental Health vesting visit and be allowed to bill for one year from that date upon contract award?

a. Yes

9. In paragraph 4.6.9 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 government confirm that the following list of Vaccines are the responsibility of the contractor?

Please see below vaccinations confirmed with our Pharmacy that are carried in the clinic to be provided by the contractor.

a. TDAP – Yes

b. Pneumovax 23 – Yes

c. Prevnar 13 – Yes

d. TD – Yes

e. Flu, High dose flu – Yes

f. Shingrix – Yes

g. Twinrix (Hep A&B) – Yes

h. Hep A – Yes

i. Hep B – Yes

j. HPV – Yes

k. Depo – Yes

10. Are there any additional Vaccines required to be supplied by the contractor other than those listed in question 9 above?

a. Please see question 9. Those confirmed are what are kept on hand at the clinic, but are not limited to as the contractor sees fit.

11. Pursuant to paragraph 4.6.9, please provide a list of Medications the government expects the contractor to dispense from the clinic that would not be a routine medication dispensed through the VA or an urgent/emergent medication dispensed through the VA’s contract with Heritage Health Solutions.

a. Please see a sample inventory from our VA staffed Nonconnah CBOC on Page 10.

12. What is the number of Vaccines, by type as listed in question 9 and any additional Vaccines added by the government pursuant to question 10, that was provided to the Marshall County CBOC Enrolled Veterans in the last 12 months?

a. We do not collect this type of information by the CBOC and unfortunately are unable to provide those numbers for the last 12 months.

13. Is the VA supplying the phones and phone system?

a. No

14. Is the VA or the Contractor responsible for providing the Discipline Specific PACT Team Members listed in Paragraph 2.4?

a. The contractor

15. If the Contractor is responsible for providing the staff listed in Paragraph 2.4 of the Solicitation (as addressed in question 14 above), what mix of positions does the VA prefer?

a. Paragraph 2.4.3 is the only paragraph that refers to a mix. Please see the Uniform Mental Health Services Handbook 1160.01 for PC-MHI requirements, and note the 6 options in paragraph 2.4.3 for proposal.

16. Is the VA or the Contractor responsible for providing the General and Specialty Mental Health Staffing listed in Paragraph 2.5.4?

a. The contractor

17. If the Contractor is responsible for providing the staff listed in Paragraph 2.5.4 of the Solicitation (as addressed in question 16 above), what mix of positions does the VA prefer?

a. Please note the 7 options for proposal.

18. Is the VA or the Contractor responsible for providing the Telehealth Services Support Staff described in paragraph 2.5.4.3?

a. The contractor

19. Is the contractor required to provide a dedicated Telehealth Clinical Technician (TCT)?

a. Yes, please refer to the first section of paragraph 2.5.4.3.

20. In paragraph 4.6.6 it states that the Contractor is to provide on-site x-ray. However, in paragraph 2.5.2 is states that contractor provided radiology services are optional. Does the VA require on-site x-ray, or do they prefer it be outsourced into the community to an approved sub-contractor?

a. The verbiage in 4.6.6 will be corrected remove the mandate for the contractor or sub-contractor to provide on-site X-ray services.

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

a. None

22. Will the VA provided staff require an office at the Marshall County CBOC? If Yes, what type and size.

a. Please see response to question #21.

23. Please provide the address of the VA Core Laboratory where the contractor is required to send twice daily laboratory specimens.

a. Memphis VA Medical Center CW192 Processing Area 1030 Jefferson Avenue Memphis, TN 38104

24. Please provide a list of Mental Health Vesting CPT codes and billing guidance the contractor is to use/follow during the monthly billing process.

a. Please see paragraph 6.1.8 for billing-CPT codes and 6.1.9 for evaluation and management and billable roster in the solicitation.

25. Reference Volume 2, Section 1, Sub-section E - Key Personnel. The instructions are asking for transcripts, evidence of internships/residencies, and copies of diplomas/certificates for the professional staff. In most cases, these documents are submitted at award, not proposal. Can we submit resumes/CVs, licenses and references with the proposal and submit transcripts, residencies/internships and diplomas at award?

a. Section E.12, Subfactor E – Key Personnel was amended to only require the following:

i. Board Certification / Evidence of Board Eligibility or Active, current, unrestricted license, as applicable

ii. Curriculum Vitae / Resume

iii. Three (3) current references

26. Reference Volume 2, Section 1, Sub-section E - Key Personnel requests we submit a spreadsheet listing salary ranges and fringe benefit ranges for professional personnel. The instructions state to submit this worksheet with the pricing information (Volume 1) of the proposal. Does this mean we include the worksheet in BOTH Volume 1 and 2 or just in Volume 1? Where in Volume 1 should it be included?

a. Include the Profession personnel Salary Spreadsheet in Volume I, Section 2.

27. The CLINS start from 950 base year for primary care, but per page 17 of the RFP, the clinic estimated enrollment is 1400. VSSC shows enrollment over 1400 as of September 2108. Please clarify.

a. Please see answer to question #46 and #63.

28. Please list all position titles and number of hours per week that VA will staff in the new contract.

a. There will not be VA staff at the clinic.

29. Please clarify if the contractor is required to provide a Pharmacist and an Anticoagulation Pharmacist on site at the clinic, or if the VA will be providing this service.

a. Please refer to paragraph 4.6.12 for options related to clinical pharmacy services.

30. Is the contractor required to have a Tele-Health Tech on site at all times?

a. Please refer to paragraph 2.5.4.3.

31. Please clarify the VA’s requirement for Podiatrist staffing. The RFP indicates that the VA will want more than 1.0 FTE podiatrist when this clinic’s enrollment is over 1300.

a. Please see the first two sentences of paragraph 2.5.1.

32. For Mental Health staffing, please clarify that 7.72 FTE per 1000 patients is for Mental Health CLINs listed.

a. Yes, please refer to paragraph 2.5.4 for additional information.

33. Is the current contractor providing mental health services at the existing CBOC?

a. Yes

34. Please list the mental health job titles at the existing CBOC.

a. MH Psychiatrist, MH SW, and MH Scheduler

35. Page 46 the RFP states that Contractor will provide Tele- Mental health services. Please clarify which of the Mental health staff are VA and who are to be provided by the contractor for Mental health.

a. The VA will be the provider for tele-mental health services when appropriate and necessary, however, Mental Health services must still be provided as laid out in the RFP.

36. Please clarify business hours when the clinic would need to be open. (page 64 vs page 31).

a. 8:00 a.m. to 4:30 p.m. (Section 3.1 of the PWS was updated)

37. The RFP lists POC testing for pregnancy and Rapid flu. Does the VA require any other POC testing? For example, INR, Glucose, HbA1c and if so, will the VA provide the equipment for the same?

a. No, the VA does require any other POC testing.

38. Please confirm that the VA wishes the new contractor to provide courier service for labs TWICE per day (section 4.6.5).

a. The VA has a contract that covers the contracted clinic courier services once per day.

39. Please list all vaccines that will be the contractor’s responsibility to provide in the clinic.

a. Please see answer to question #9 and #10.

40. Please give historical (or expected) annual dosage of each vaccine the contractor is expected to provide.

a. Please see answer to question #12.

41. Will the VA provide the 10-day bridge medications under the new contract?

a. Per paragraph 4.6.9, “Urgent/Emergent medications needed will be filled via contracted local pharmacy for up to 10 days. Heritage Health Solutions, a contract managed by the Memphis VA Medical Center is responsible for this contract.”

42. Will the homeless outreach specialist and suicide prevention coordinator be provided by the VA?

a. No, please see paragraph 2.5.4.2 regarding smaller facilities.

43. Does the VA require the clinic manager to be a RN?

a. No

44. Is the contractor required to perform X-Rays at the new CBOC, or can they be contracted out?

a. Please see paragraph 1.1.1 and 2.5.2.

45. Please confirm the contractor will be responsible for installing and monitoring a closed-circuit TV system at the clinic. (4.7.10)

a. Yes

46. What is the most current number of billable enrollees at the clinic?

a. Roughly 1,420 PC and 170 MH (Section B.2 of the Price Schedule was updated)

47. What is the current PM/PM rate?

a. We are unable to provide the current PM/PM rates.

48. Will the VA provide the phone system for the new CBOC?

a. No

49. Can the following Key personnel documentation (pages 133-136) be submitted at the time of hire?

1. Current DEA #

1. Three references

1. Transcripts

1. Graduate certificate Requiring these documents be submitted with the proposal is unrealistic and provides an unfair advantage to the incumbent. To collect all of these required documents would demand that we essentially hire all the required staff in less than 30 days. Asking candidates to provide such documentation before there is an available position is not a common practice in recruiting/staffing.

We recommend contractors provide resume’s, CVs, and licenses for candidates as is standard for most VA CBOC RFPs.

a. Please see the answer to question # 25 above

50. In the event, the VA requires the transcripts and graduate certificates for the required positions, would the VA accept a “Degree Verify Certificate” from the National Student Clearinghouse? The National Student Clearinghouse is an agency the VA uses to confirm education. See example attached.

a. Please see the answer to question # 25 above

51. Are existing CBOC staff under a collective bargaining agreement?

a. No

52. Will the government be doing site visits prior to award? If so, how much notice will the offeror be given?

a. See the answer to Question 1 above

53. Does the existing CBOC facility meet the requirements of the RFP?

a. Please see answer to question #2 and #3.

54. RFP states contactor responsible for mammograms please clarify if this is screening, diagnostic, or both.

a. Both. Please see additional information in paragraph 4.6.21.1.

55. Please verify that the government requires a minimum of 4 tele-health exam rooms (two tele-health, one tele retinal room, and one tele-pharmacy).

a. There will be 5 tele-health rooms per paragraph 4.7.1: tele-psychiatry, tele-pharmacy, retinal camera room, and (2) tele-health exam rooms.

56. Please clarify how many tele-psychiatry rooms the government requires.

a. One (1)

57. Please clarify the following statement from the RFP (page 64) “Within this space there will be a corridor between tele-psychiatry, tele-pharmacy, retinal camera room, and (2) tele-health exam rooms.” Does this mean that tele-health exams must be separated from the other rooms? Can these rooms be placed adjacent to each other to better integrate behavioral health with the rest of the clinic?

a. No, they do not have to be separated from the other rooms.

58. Please clarify the size requirements of the two group rooms.

a. Please refer to pages 41 – 43 of PACT Space Module Design Guide at https://www.cfm.va.gov/til/dGuide/dgPACT.pdf and the VA Barrier Free Design Standard at https://www.cfm.va.gov/til/etc/dsBarrFree.pdf to be used as references in designing space that supports accessibility and the PACT model of care.

59. 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?

a. Please see answer to question #8.

60. Please confirm that the offerors should use the most current wage determination #2015-4673 (Rev.-8), dated 12/26/18.

a. Yes, WD 2015-4673 (Rev 8) dated 12/26/18 is still the most current wage determination for this area.

61. Please provide the most recent billing figures/members/enrollees for primary care services and mental health services. (B.2 Schedule of Services)

a. Please see answer to question #46.

62. Estimated Base Year Enrollees = 950 Primary Care and 450 Mental Health. Question – will the Government please provide the most current billable/enrollment figures? (B.2, page 6)

a. Please see answer to question #46.

63. On page 5, the PMPM estimates are 950 PMPM for primary care and 450 mental health; however, on page 17 the estimate total is 1400. Are the MH patients not enrolled as PC patients as well? (B.2, page 6)

a. PC patients may be enrolled for MH as well if services are required by the veteran.

64. Will the VA provide Nutrition/ Dietician services via telehealth for this clinic? (2.1, page 17)

a. Per paragraph 2.4.2, the requirement for a Registered Dietitian / Nutritionist is 1 FTE per 5 PACTs.

65. Please confirm the CPS will be provided by the VA. If so, is it an onsite service or via telehealth? (2.1, page 17)

a. Please refer to paragraph 4.6.12 for options related to clinical pharmacy services.

66. Can a Certified Medical Assistant fill the Telehealth Technician position with the appropriate training or is the minimum qualification an LPN? (2.3.4, page 19)

a. Please refer to paragraph 2.5.4.3.

67. Please provide the number of active Podiatry patients (2.5.1, page 23)

a. There were 1,052 encounters from the five counties surrounding Holly Springs that received Podiatry services here in FY18.

68. Please confirm if the VA will interpret x-ray images or is it contractor’s responsibility? (2.5.2, page 24)

a. Please see answer to question #20.

69. Will the VA provide any mental health providers onsite or via telehealth? (2.5.4, page 24)

a. Please see answer to question #35.

70. Please confirm that all medications and vaccines administered at the CBOC will be provided/procured by the Government. (4.6.11, page 39)

a. Please see answer to question #9, #10, and #11.

71. Does the VA require on-stage/off-stage design elements listed in the PACT Manual? (4.7, page 64)

a. Please see answer to question #4.

72. 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 plan? (4.7, page 64)

a. Please see answer to question #3.

73. Is the current facility adequate to meet the size requirements for the current solicitation? (4.7, page 64)

a. Please see answer to question #2.

74. Can the government please confirm if the “spreadsheet listing salary ranges and fringe benefit ranges for professional personnel…” listed in the Subfactor E Key Personnel section belongs in the Price volume or the Technical volume? (Evaluation Subfactor E, page 133)

a. See the answer to Question 26 above

75. We kindly ask that the government only requires the names and a qualifications summary for all staff or resumes, board certifications and licenses for the Physicians and transcripts, graduation certificates and licenses for the Nurse Practitioners. The requirements above are typical industry CBOC proposal requirements that are achievable and will help increase competition while still providing the VA confidence in the Offeror’s ability to provide high quality staff. (Evaluation Subfactor E, page 133)

a. Please see the answer to question # 25 above

SAMPLE INVENTORY AT VA STAFFED NONCONNAH CBOC (REF. QUESTION 11)

HALOPERIDOL DECANOATE 100MG/1ML

HEPATITIS A 1440 EL.U./ML VACCINE 1ML SYRINGE

HEPATITIS A 720 EL.U/HEPATITIS B 20MCG VACCINE 1ML SYRINGE

HEPATITIS B VACCINE (RECOMBINANT) 20MCG/1ML 1ML SYRINGE

hydrALAZINE 25MG TAB

IBUPROFEN 200MG TAB

RFP

CHANGE PAGES

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2.1.

2.2.

2.3.

2.4.

2.5.

2.6.

2.7.

2.8.

2.9.

2.10.

2.11.

2.12.

2.13.

2.14.

2.15.

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2.17.

B.2 SCHEDULE OF SERVICES

PRICE SCHEDULE AND SERVICES

The following capitated rates are for continuous delivery of Contractor Operation Primary Care Services and Mental Health Care services located in Marshall County, Mississippi within approximately 20 miles of a local hospital in Holly Springs, MS providing emergency room services; and the facility shall have easy access to US-78W. This Marshall County Community Based Outpatient Clinic (CBOC) is for eligible Veterans residing within the coverage area for this CBOC of DeSoto, Benton, La Fayette, Tate, and Marshall County.

BASE YEAR – June 1, 2019 through May 31, 2020

Total for Base Year $________________________

OPTION YEAR 1 – June 1, 2020 through May 31, 2021

Total for Option Year 1 $________________________

OPTION YEAR 2 – June 1, 2021 through May 31, 2022

Total for Option Year 2 $________________________

OPTION YEAR 3 – June 1, 2022 through May 31, 2023

Total for Option Year 3 $________________________

OPTION YEAR 4 – June 1, 2023 through May 31, 2024

Total for Option Year 4 $________________________

TOTAL FOR BASE AND OPTION YEAR$___________________________

** Changes to the contract can only be made by a written modification which is formally executed by the contractor and the Contracting Officer.

Orders shall be issued only the Contracting Officer.

All unit prices shall be a firm-fixed price.

This contract is a fixed price Indefinite Delivery -Indefinite Quantity contract. The guaranteed contract minimum, including the base year and any option years exercised is 950 enrollees and the maximum contract amount, including the base year and any option years exercised shall not exceed 10,500 enrollees.

ORDERS: This is a Fixed Price (FP) Indefinite Delivery/Indefinite Quantity (IDIQ) contract (see FAR 52.216-22).

Task Order Procedures

a. This contract type allows the Veteran Affairs Network Contracting Office (NCO 9) contracting officers to place orders with the contractor on an as needed basis. In accordance with the Federal Acquisition Regulation (FAR) Clauses 52.216-18, Ordering. NCO 9 will obligate the funding and order the services by issuing a task order.

b. VA has the sole authority to assign Veterans treated by the contractor into the Primary Care Management Manual (PCMM) software program used to track primary care clinic veteran rosters. Specific billable processes for issuing task orders under the resultant contract includes: determining veteran eligibility, enrollment eligibility, and required Evaluation and Management Exams is further defined in 6.1.9.

c. The contractor shall initiate work when, so directed by a Task Order issued by the contracting officer. No work under any Task Order shall be performed unless specifically authorized by the contracting officer. Approval of a Task Order shall not constitute approval to exceed any item listed in the contract or general provisions of the contract. The contractor shall not exceed the estimated task order amount, or change the task order without prior written approval of the Contracting Officer.

d. In event the contractor is unable to fulfill the task order requirements for whatever reason; the government reserves the right to fulfill its need outside of this contract. A written confirmation from the contractor indicating the inability to fulfill the task order is immediately required. The quantity of enrollees or PMPM ordered on the unfilled task order will be applied to the minimum quantity. The government’s right to fulfill its need outside this contract does not waive its right to the issuance of a cure notice nor does it waive its right to terminate for default.

Task Order Issuance Procedure. The terms that apply to the issuance of Task Orders under this contract are set forth below:

a. The estimated enrollees or PMPM for performance of each task shall be set forth in each task order. Each task order shall not exceed the enrollees or PMPM specified and total amount obligated for each task order. The total amount of all task orders shall not exceed overall Maximum Order Limitation (MOL) provided in FAR Clause 52.216-19 (b)(2).

Task Order Pricing

a. Task order prices shall be Fixed-Price (FP) as agreed to in the contractor’s schedule and individually funded. The Unit Price is an all-inclusive cost. If the contract Period of Performance (POP) is extended using FAR Clause 52.217-8, the specified rates under this clause will be those rates in effect under the contract each time an option is exercised under this clause.

Task Order Performance Period. Each task order shall have an established period of performance or delivery date. Individual Task order shall not exceed a 12-month period.

36C24919R0003 – Marshall County CBOC – Memphis VAMC 2.18.

2.19. NON-PERSONAL SERVICES: The parties agree that The Contractor, contract staff, agents and sub-Contractors shall not be considered VA employees for any purpose. All individuals that provide services under this resultant contract and are not employees of the Contractor shall be regarded as subcontractors. The Contractor shall be responsible and accountable for the quality of care delivered by all its subcontractors. The Contractor shall be responsible for strict compliance of all contract terms and conditions without regard to who provides the service.

2.20. CONTRACT PERSONNEL: The Contractor shall be responsible for protecting all Contractor personnel furnishing services. To carry out this responsibility, The Contractor shall provide or certify that the following is provided for all contract staff providing services under the resultant contract:

Workers’ compensation Professional liability insurance Health examinations Income tax withholding, and Social security payments

2.21. INHERENTLY GOVERNMENTAL FUNCTIONS PROHIBITED. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees, selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.22. TORT: The Federal Tort Claims Act does not cover Contract staff. When a contract staff member has been identified as a provider in a tort claim, The Contractor’s staff member shall notify the Contractor’s legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor’s provider’s action or non-action is the responsibility of The Contractor and/or insurance carrier.

2.23. RYAN HAIGHT ACT: In support of providing Veterans access to comprehensive Telehealth services, including the provision of controlled substances in compliance with the Ryan Haight Act, Contractor shall apply for DEA registration if this option is available under state law. If DEA registration is not available under state law or the contractor is unable to obtain DEA registration, Contractor shall ensure a DEA registered provider can be present in the room with the patient during discussions of controlled substances prescriptions, at telehealth visits in which controlled substances are prescribed, if the patient has not had at least one prior in-person medical assessment with the prescribing provider.

3. HOURS OF OPERATION: The following outlines the required hours of operation:

3.1. BUSINESS HOURS: Services shall be available from the Contractor for a period of at least eight (8) hours between the hours of 8:00 a.m. and 4:30 p.m. Monday through Friday, excluding federal holidays. Federal holidays are outlined in the next paragraph. If the Federal Holiday falls on a Saturday or Sunday, either the previous Friday or following Monday is the day recognized by the Federal Government as the day the Government is closed. The Contractor may be open for extended hours and on Saturdays at the Contractor’s discretion in order to meet workload requirements.

3.2. FEDERAL HOLIDAYS: The following holidays are observed by the Department of Veterans Affairs:

New Year’s Day Washington’s Birthday Martin Luther King’s Birthday Memorial Day Independence Day Labor Day Columbus Day Veterans Day Thanksgiving systems/instruments and reagents information. When the VA Ancillary Testing Program upgrades waived test systems/instruments, the VA will furnish the Contractor with the new test systems/instruments to maintain the same standard of care. The Ancillary Testing staff will arrange for repair/maintenance in the event of system/instrument failure. If required, the Contractor shall provide a courier to transport instruments and/or reagents to the Contractor or the VA Ancillary Testing staff for linearity/correlation studies and minor repairs. The VA will purchase proficiency testing materials for the Contractor, and the Contractor must comply with the Pathology and Laboratory Medicine, CAP and TJC requirements/regulations for testing proficiency materials and submitting results.

4.6.6. RADIOLOGY SERVICES - The Contractor is responsible for entering requests for Radiology procedures into VISTA utilizing CPRS. All imaging orders shall be clinically appropriate. X-rays may be performed by the Contractor on-site at the outpatient site of care, using Contractor provided equipment or offsite by Contract. Other radiology procedures will be provided by VA Medical Center Memphis via consultative requests. Contractor must provide FDA approved equipment that conforms to the Vista Imaging listing for Digital Image and Communication in Medicine (DICOM) (3.0) DICOM. http://vaww.oed.portal.va.gov/applications/VistAImaging/Lists/VistA%20Imaging%20Approved%20Equipment%20List/AllItems.aspx and http://vaww.oed.portal.va.gov/applications/VistAImaging/Lists/Device%20Validation%20Database%20%20SharePoint%202003%20Archiv/User%20View.aspx and HL7 communications: http://vaww.oed.portal.va.gov/applications/VistAImaging/Lists/Approved%20Devices/Approved%20HL7%20Interfaces.aspx. Images shall be stored and sent in VISTA Imaging which is considered part of the patient’s electronic record. These images shall be a result of direct digital (DR) or computed radiography (CR) acquisition and cannot be from a DICOM film digitizer. These images shall be case edited in the Radiology VistA package by the technologists, and sent to VISTA Imaging and PACS as defined by the VA local policy and VHA Directive RADIOLOGY PICTURE ARCHIVING AND COMMUNICATION SYSTEMS (PACS) 2011-005, within two (2) hours of completion. X-rays performed at VA or at the outpatient site of care can be viewed by the Contractor through VISTA Imaging and the PACS. Contractor is responsible for all daily/weekly quality assurance of imaging equipment as determined by the manufacturer and as required by the VA Healthcare System for repairs and maintenance of that equipment. Repairs and maintenance of equipment is the responsibility of the contractor and equipment down times cannot cause delays in patient care. The Contractor shall submit a contingency plan for equipment down time, network down times, and other systems down times to ensure that timely patient care is not affected. Patient anatomical positioning must provide optimal imaging and shall be of the highest quality control standards based on established practice standards of the ARRT. Contractor shall comply with protocols as outlined by the parent facility’s Radiology Service and provided as an attachment in Section D.

4.6.6.1. INTERPRETATION OF RADIOLOGY RESULTS –X-rays will be interpreted by the Contractor with a board certified/board eligible radiologist. X-ray interpretation reports will be available in VA' s VISTA/CPRS computer system within two (2) working business days of receipt. The VA Radiology Program Service may be contacted at (901)523-8990 ext 7260. The Contractor shall follow VA policy and procedures and TJC standards for any critical results or urgent results.

4.6.7. COMMUNICATING TEST RESULTS TO PROVIDERS AND PATIENTS In accordance with VHA Directive 1088, Communicating Test Results to Providers and Patients, all test results requiring action must be communicated by the ordering provider, or designee, to patients no later than 7 calendar days from the date on which the results are available. For test results that require no action, results must be communicated by the ordering provider, or designee, to patients no later than 14 calendar days from the date on which the results are available. The Contractor shall provide the VA with the name, pager and telephone numbers of a LIP (physician, nurse practitioner, or physician assistant) at the Outpatient Site of Care to accept critical test results discovered on tests done by the VA. For critical results, the LIP must respond back to the VA within forty-five (45) minutes of the initial page or telephone call. The receiving LIP will document the results in the record and conduct a “read back” procedure to ensure accuracy of transmission and translation of all verbal results during regular business hours. VA will not be Pharmacists. The spreadsheet shall have a column listing each professional position, shall have a column showing the salary range for the position; and shall have a column showing the range of costs for fringe benefits. The fringe benefits shall include the cost of insurance benefits, payment for time-off, and any bonuses for which a person in that position might be eligible. This worksheet should be submitted with pricing information in Offeror’s proposal.

The following information is required to be submitted with Offeror’s proposal:

· Provide a list of the names and titles of qualified physicians, psychiatrists, psychologists, physician assistants, nurse practitioners, nurses, and other primary health care and mental health care provider staff intended to be utilized in the performance of this contract, taking into consideration the enrollment numbers for the clinic and the minimum staffing requirements. Also provide the name and title of the Medical Director to oversee the clinic.

· Provide copies of the following information on any Physician to be assigned to this contract. Include physicians providing coverage relief:

Board Certification / Evidence of Board Eligibility as Internist/Family Practitioner Active, current, unrestricted license Curriculum Vitae / Resume Three (3) current references

· Provide copies of the following information on any Psychologists to be assigned to this contract:

Board Certification or Active, current, unrestricted license to practice, as applicable Curriculum Vitae / Resume Three (3) current references

· Provide copies of the following information on any Physician Assistant to be assigned to this contract:

Active current physician assistant certification Board Certification or Active, current, unrestricted license to practice, as applicable Curriculum Vitae / Resume Three (3) current references

· Provide copies of the following information on any Nurse Practitioner to be assigned to this contract:

Board Certification or Active, current, unrestricted license to practice, as applicable Curriculum Vitae / Resume Three (3) current references

· Provide copies of the following information on any Registered Nurse to be assigned to this contract:

Board Certification or Active, current, unrestricted license to practice, as applicable Curriculum Vitae / Resume Three (3) current references

· Provide copies of the following information on any Licensed Advanced Practice Social Worker (LCSW) providing mental health services as assigned to this contract:

Board Certification or Active, current, unrestricted license to practice, as applicable Curriculum Vitae / Resume, to include preferred experience in mental health services Three (3) current references

· Provide copies of the following information on any Licensed Social Worker providing primary care services as assigned to this contract:

Board Certification or Active, current, unrestricted license to practice, as applicable Curriculum Vitae / Resume Three (3) current references

· Provide copies of the following information on any pharmacist to be assigned to this contract:

Board Certification or Active, current, unrestricted license to practice, as applicable Curriculum Vitae / Resume Three (3) current references

· Provide copies of the following information on any dietitian to be assigned to this contract:

Board Certification or Active, current, unrestricted license to practice, as applicable Curriculum Vitae Three (3) current references

· Provide copies of certifications meeting American Registry of Radiologic Technologist standards for Radiology Technicians performing Radiology services. Provide documentation that imaging equipment complies with ACR accredited standards.

· Provide copies of CAP, CLIA, or Joint Commission accreditation and current applicable state licensing and/or Center for Disease Control (CDC) accreditation or proof that such documents are being processed for Laboratory Services.

Sub-factor F: Business Operations: This sub-factor will be used to determine the Offeror’s ability to support the performance of this contract as set forth in the PWS and to evaluate the Government’s exposure if the Offeror is unable to perform putting continuity of care in jeopardy for enrolled Veterans. The Government is concerned with the Offeror’s ability to establish, manage, and operate a facility of the size and scope call for in the PWS. The Government is concerned with the company’s ability to recruit and retain qualified staff to ensure continuity of care to Veterans receiving care at the CBOC. Therefore, the Offeror shall demonstrate that the company is financially responsible, has the assets and financial ability to maintain operations and obtain the facilities and equipment necessary to operation this CBOC. The Offeror shall provide evidence of the company’s overall responsibility, as well as evidence of a reliable accounting system to ensure prompt and correct invoicing, and to ensure prompt payment of the company’s debts and obligations. (PWS Reference: Section 2, Staffing and Qualifications) The following information is required to be submitted with Offeror’s proposal: Provide evidence that salaries and fringe benefits for professional staff are reasonable and in accordance with standard market practices. Demonstrate the company’s responsibility by providing evidence of any malpractice claims and/or tort claims brought against the company, or proposed key personnel, for the past five (5) years. The Offeror shall provide a descriptive statement to explain the facts and circumstances of any claims that were sustained, settled, or that are still pending. The Offeror shall provide evidence of the company’s financial responsibility and its ability to manage and operate the company in a manner to ensure continuous uninterrupted operations. The Offeror shall further provide evidence demonstrating it has the assets and financial ability to acquire the equipment, personnel, and facilities to operate this CBOC. The Offeror shall further demonstrate that assets are not over-leveraged. The Offeror shall describe the company’s accounting systems. The Offeror shall demonstrate that the company is utilizing sound business practices and accounting systems to ensure that invoices will be submitted correctly and in a timely fashion; and to ensure that debts and obligations are paid timely.

EVALUATION FACTOR 2:

Past Performance. Contractor shall submit past performance information with its proposal for at least three (3), but no more than five (5) prior Outpatient Clinic and Healthcare Management contracts that are similar in size and scope to this requirement, include any Federal, State, local government and commercial contracts. Past Performance Questionnaires (Attachment 24 to the RFP) shall be utilized for the past performance information submitted. Questionnaires shall be sent to appropriate points of contact and those points of contact shall send the completed questionnaires directly to the Contracting Officer. The Government will consider Contractor’s record for delivery, quality and past or present malpractice judgments, proposed major subcontractors as it relates to the probability of successfully performing the solicitation requirements. Past performance evaluations will be conducted using information obtained from Contractor Performance Assessment Reporting System (CPARS) or Past Performance Retrieval System (PPIRS) and any other sources deemed appropriate. While the Government may elect to consider data obtained from other sources, the burden of providing current