36C24919R0003-0004000.docx

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION

OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR

ACKNOWLEDGMENT TO BE RECEIVED AT

THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO:

Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADM

INISTRATIVE CHANGES

SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and d ate specified.

C. THIS SUPPLEMENTAL AGREEMENT IS

ENTERED INTO

PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 3

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO

MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer) 02-05-2019 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

X The purpose of this amendment is to clarify responses previously provided to questions #31; #41; and #67 due to the additional questions received. These Questions/Answers were previously addressed in Amendment 0002 and 0003 that was posted January 31, 2019 and February 4, 2019, respectively

The proposal and past performance due dates remain unchanged.

Kimberly S. Carson Contracting Officer Marshall County RFP 36C24919R0003 Questions & Answers (3):

1. CPS staffing. Question 14 in Amendment 2 asked “Is the VA or the Contractor responsible for providing the Discipline Specific PACT Team Members listed in Paragraph 2.4?” and the answer provided is “The contractor”. We note that the position of Clinical Pharmacy Specialist Anti-Coagulation is listed under Paragraph 2.4, and so the answer to this question indicates that the contractor is required to staff the Clinical Pharmacy Specialist Anti-Coagulation.

However, the answer to Question 29 in Amendment 2 states “Please refer to paragraph 4.6.12 for options related to clinical pharmacy services.,” and paragraph 4.6.12 states “Clinical Pharmacy Services shall be provided by the Memphis VAMC.” This indicates that the contractor is not required to provide the position of Clinical Pharmacy Specialist Anti-Coagulation.

Accordingly, we request the following:

Please clarify if there is any requirement for the Contractor to provide Clinical Pharmacy Specialists (inclusive of Clinical Pharmacy Specialists and/or Clinical Pharmacy Specialists-Anti-Coagulation) at the Marshall County CBOC?

a. The VAMC Memphis will provide Clinical Pharmacy Services as we do now for all the CBOC’s.

2. Podiatrist staffing. There were two questions asking for clarification on podiatry staff, but the answers appear to now leave stand two ambiguities: 1) as to whether podiatry staffing is based on total number of active patients (i.e. active PMPM Schedule B patients under the Contract) or on number of active podiatry patients seen at the CBOC and 2) as to an estimated number of active podiatry patients for the CBOC.

Question 31 in Amendment 2 requested clarification on Podiatrist staffing, and the answer is “Please see the first two sentences of paragraph 2.5.1.” Paragraph 2.5.1 indicates the following staffing requirement for podiatrists: “1.0 FTE per 950 active patients and only a single room available for services or 1 FTE per 1300 active patients with two rooms and clinical support.”

In turn, Question 67 in Amendment 2 asks “Please provide the number of active Podiatry patients (2.5.1, page 23),” and answer provided is “There were 1,052 encounters from the five counties surrounding Holly Springs that received Podiatry services here in FY18.” This answer provided by the VA does strongly indicate that the podiatrist staffing level requirement called for under 2.5.1, page 23 is to be determined by podiatry specific, rather than general primary care specific patient data. However, the VA provided podiatry patient encounter numbers from FY 18 remain somewhat “apples to oranges” with the terms of paragraph 2.5.1 and/or Question 67 which call for the requested patient data in terms of number of active patients rather than in terms of number of Podiatry encounters.

Accordingly, we request the following:

Please clarify if the “active patients” referred to in paragraph 2.5.1 indicates “active podiatry patients” or any active PMPM Schedule B CBOC patient.

Please also indicate how many unique patients contributed to the 1,052 Podiatry encounters in FY 18 referenced in the answer to Question 67.

a. The expectation is fort 1.0 FTE per 950 active patients and 1 room or 1 FTE per 1,300 active patients with 2 rooms and clinical support. Our CBOC at this location currently has 1,373 active patients with 87 awaiting to be assigned. So, the new vendor will be required to provide 1 FTE Podiatrist and a clinical support FTE and two rooms.

b. The number of unique patients for the 1,052 encounters was 600.