36C24920R0088 0001.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 NUMBERE

D 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 amendmen t, 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) 10-22-2020 None Department of Veterans Affairs Network Contracting Office 9 (90C)

NCO 9

1639 Medical Center Parkway, Suite 400 Murfreesboro TN 37129 90C Network Contracting Office 9 Department of Veterans Affairs Network Contracting Office (90C) Medical Center Parkway Suite 400 Murfreesboro TN 37129 To all Offerors/Bidders

36C24920R0088 10-05-2020

X X X

The purpose of this amendment is to provide questions and answers. The proposal due date of 11/9/2020 remains the same.

Jackie L. Merriman Contracting Officer

CONTINUATION PAGE

RFP Language: “Submit with Offeror’s proposal a spreadsheet listing salary ranges and fringe benefit ranges for professional personnel including the following: Dietician, Licensed Social Workers, Licensed Clinical Social Workers, Nurse Practitioners, Physician Assistants, Physicians, Psychiatrists, Psychologists, and Pharmacists.”

1. Question: In order to maintain separation between the technical volume and pricing information, will the government accept the submittal of the salary range spreadsheet as part of Volume I?

YES – PLEASE SUBMIT THIS SPREADSHEET WITH VOLUME I

2. Please clarify the number of Women’s Health exam rooms requested, in addition to the preferred dimensions and square footage for the exam room and en suite bathroom.

There must be a minimum of (1) WH exam room per PACT. The (1) WH exam room per PACT can be included as part of the requirement to have (3) exam rooms per PACT. All building requirements, standards, codes, etc. are in the solicitation.

3. Please provide the most recent 3-month billing figures/members/enrollees for primary care and mental health services.

Primary Care: 2288 for September 2020, 2297 for August 2020, and 2325 for July 2020 Mental Health: 521 for September 2020, 526 for August 2020, and 528 for July 2020 Additionally, there are currently 54 veterans who are waiting to turn from pending to active on the VSSC Active Panel List.

4. The solicitation shows that the contract maximum is $16M. Did the Government conduct an Independent Government Cost Estimate (IGCE) for this requirement? If so, what is the value associated with this estimate?

THE GOVERNMENT DOES HAVE AN INDEPENDENT GOVERNMENT ESTIMATE HOWEVER THIS ESTIMATE IS NOT ALLOWED TO BE SHARED WITH CONTRACTORS.

5. 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)?

Please see Section 4.6.3.1.2.1 – The Jonesboro CBOC is responsible for procuring and providing their own medications and vaccines; However, the Memphis VA Pharmacy will provide ophthalmology medications for the VA staffed on-site ophthalmology clinic as stated in Section 4.6.3.1.2.2. In response to the question of estimated utilization numbers/quantities, this data cannot be pulled by the Memphis VA because it is the responsibility of the contractor and not ordered through the Memphis VAMC Pharmacy, Laboratory, etc. The administration is entered as a note in the veteran’s EHR, but not as an order. We can however provide the FY20 data for ward stock currently supplied by the Memphis VA to the Jonesboro CBOC. The new contract will shift the responsibility to the contractor to provide ward stock. In addition to the data below, there were also (3) RABIES VACCINE 2.5 UNT/ML 0.25 UNIT/DOSE given.

6. Section 2.14 states, “ACLS certification is required for health care personnel that order, administer, monitor, or supervise moderate sedation, monitored anesthesia care, or general anesthesia, according to current VHA policy.” Since the CBOC providers do not administer, monitor or supervise moderate sedation, is ACLS required for the CBOC providers?

No, it is not required

7. 2. The PACT Space Module Design Guide identifies the possible use of sliding doors but does not require them. Does the VA have a preference for the use of sliding door in the Jonesboro CBOC? If so, please clarify if sliding doors are preferred on the patient side of each exam room or on both sides of each exam room.

The Memphis VA does not have a preference on if sliding doors are used

8. Will the VA allow board eligible primary care physicians?

Yes

9. Will the VA allow board eligible psychiatrists?

Yes

10. Section 2.4.5 allows Registered Nurses as a staffing option for PCMHI services, but Registered Nurses are not listed under Section 2.6 as a staffing option for Mental Health services. Would the VA consider adding Registered Nurses as one of the allowable staffing options for Mental Health services? In consideration of the functions provided by a Psychiatric RN, such as triage, consults, and injections, we believe that this discipline would be a helpful addition to the Mental Health roster of staffing options.

Please understand that the RN option is for the primary care and mental health integration (PCMHI) team only, which works together with the primary care staff and mental health providers, respectively. If the contractor chooses to utilize a RN as part of their PCMHI FTE staffing, the contractor can also choose to utilize the same RN to support the separate MH providers i.e. psychiatrist, nurse practitioner, social worker, etc. for the functions you stated in this question. For example, the contractor chooses to utilize a RN as 0.2 FTE of their PCMHI staffing, but also elects to utilize the same RN as a 0.8 FTE to support the mental health team providers. This is allowable; However, contractor shall ensure that the RN supports and fulfills their PCMHI FTE role first, and then the remaining FTE can be utilized to support the MH providers. Remember that a MH RN is not a billable provider under the MH roster and is only support staff, and that section 2.6 is only detailing what type of MH providers are allowable and billable.

11. Paragraph 2.3.4 states that the Administrative Associate will support the “VA-staffed audiology and ophthalmology clinics.” Paragraph 4.9.1 requires space for an ophthalmology clinic but not an audiology clinic.

Please see the response for question 13 and 14

12. Is an audiology clinic a requirement for the Jonesboro CBOC? If so, please provide required specifications for this space.

The Memphis VA currently does not have a need for a full-time or consistent part-time audiology clinic at the Jonesboro CBOC. If this changes in the future, the Memphis VA will request a quote from the contractor. Occasionally, VA audiologists will travel to the Jonesboro CBOC to assist with hearing aid repairs or other audiology needs. Currently, audiologists are addressing needs curbside due to the pandemic. Prior to the pandemic, it has been requested by the VA audiologists if they can utilize an open room for specific hours on a certain day to see patients inside the clinic. This is always requested and coordinated ahead of time at the discretion and approval of the contractor and office manager.

13. Could the VA provide an estimated quantity of annual ophthalmology appointments (and audiology appointments, if such services are to be provided at the Jonesboro CBOC) so that the Contractor can ensure appropriate administrative support?

Per VA Ophthalmology leadership: 25 – 30 patient appointments per week

Per VA Audiology leadership: The Jonesboro Audio Telerepair clinic grid (patient side of the hearing aid repair via telehealth with a VA audiologist located at Memphis) would require roughly 3-6 scheduled appointments per week. Additionally, VA Audiology leadership is in the process of procuring diagnostic audiology and fitting equipment to be placed on a telehealth cart that is expected to deploy prior to the end of 2020. This separate clinic grid would require roughly 5-10 scheduled appointments per week

14. Paragraph 6.1.2 states “The Contractor shall have (120) days from contract award to commencement of the provision of medical care to local Veterans. However, the Contractor must have all start-up requirements in place and ready to commence operation NLT (83) calendar days from contract award. The final seven (7) days will be used for training and resolution of any last minute or unexpected technical or personnel related challenges.” Based on the provisions that provide 120 days from contract award to commencement of services and the need for the final seven (7) days to be reserved for training and resolution of issues, is it the VA’s intention that “the Contractor must have all start-up requirements in place and ready to commence operation NLT (113) calendar days from contract award?”

Yes, we apologize for the typographical error

15. Would the VA consider allowing a 150 or 180 build out time frame instead of the 120 days indicated in paragraph 6.1.2? The basis of this request is that longer times frames are needed during the COVID-19 pandemic due to supply chain disruptions that are beyond the Contractor’s control. We further note that recent CBOC solicitation have included a 180-day build out time frame, such as 36C24920R0114 (Tupelo, MS) and 36C24920R0007 (Hopkinsville, KY).

No, given the need for the start date to be 1 July 2021 with no room for extension on that, buildout must remain at 120 days.

16. We note the following question was asked in a recent Memphis VAMC Solicitation (36C24920R0114, Tupelo, MS CBOC): “What is the required setback distance of the site to the bollards required for physical security? Will a 25-foot setback be required if the clinic is in a shopping center? If so, can bollards or planters be used to keep the minimum distance 8 feet away?” The answer provided was “Physical security measures and location(s) must be submitted and approved by the Memphis VAMC Police Services prior to installation.” Can the VA confirm this same answer applies to the current Solicitation for Jonesboro, AR?

Yes, the same answer applies

17. Section 4.6.2.4.3 presents the requirement for the clinic to have two (2) Women’s Health PCPs. Based on this requirement, does the VA agree that two (2) Women’s Health exam rooms are acceptable?

Please see the response for question 3 image1.png