36C24924R0034 0001.docx

36C24924R0034 0001

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) Department of Veterans Affairs Network Contracting Office 9 (90C)

NCO 9

1639 Medical Center Parkway, Suite 204 Murfreesboro TN 37129 90C Network Contracting Office 9 Department of Veterans Affairs Network Contracting Office (90C) 1639 Medical Center Parkway Suite 204 Murfreesboro TN 37129 To all Offerors/Bidders

36C24924R0034

X X X

1. The purpose of this Amendment is to respond to questions received and make corrections to Solicitation 36C24924R0034.

2. The RF P due date remains the same at WED N ESDAY, JULY 31, 2024 AT 10:00 AM Central Time.

Carol Franklin Contracting Officer The purpose of this amendment is to address received questions and update the solicitation where required:

1. We would like to know how many Emergency Room doctors will be requested on the solicitation?

a. Answer: The requirement is for 6 FTE with a minimum of 12 key personnel being proposed.

2. Are the ER Physician positions for full time or to augment with coverage hours?

a. Answer: The requirement is for 6 FTE with a minimum of 12 key personnel being proposed.

3. Does the VA already know the numbers of physicians needed?

a. Answer: The requirement is for 6 FTE with a minimum of 12 key personnel being proposed.

4. Do you anticipate Board Certified Emergency physicians, or do you accept Board Certifications w/ER experience from other physicians?

a. Answer: The requirement is for Board Certified / Board Eligible Emergency Medicine Physician Services. Will accept Board Certified EM/FM with ED experience case by case review

5. Is there an incumbent contractor? If so please provide the contract number.

a. Answer: Yes, there is a one-year purchase order in place. Please reference PO #36C24923P0885

6. Question: If there is a current incumbent, can you please cite the contract number.

a. Answer: Yes, there is a one-year purchase order in place. Please reference PO #36C24923P0885

7. Question: Is there any incumbent for this opportunity who is currently performing these services? If yes, please provide us the Contract number, incumbent vendor’s name and the performance duration.

a. Answer: Yes, there is a one-year purchase order in place. Please reference PO #36C24923P0885

8. Question: Is this contract a follow on to incumbent contracts? If so, would the Government kindly share the contract numbers with us?

a. Answer: Yes, there is a one-year purchase order in place. Please reference PO #36C24923P0885

9. Question: Is there a current incumbent? If so, please identify the company?

a. Answer: Please reference PO #36C24923P0885

10. Question: Does the Government already have any incumbents that are certified/qualified?

a. Answer: There is a one-year purchase order in place. Please reference PO #36C24923P0885. This PO is set to expire and be replaced by this RFP.

11. Question: Are there incumbent physicians already in place? If so, are positions currently filled?

a. Answer: There is a one-year purchase order in place providing coverage. Please reference PO #36C24923P0885. This PO is set to expire and be replaced by this RFP.

12. Question: If there is an incumbent and current employees, does the government wish to retain the current staff? If so, please add FAR Clause 52.207-3 to the contract.

a. Answer: Noted, thank you.

13. Question: I would like to confirm whether this is a new requirement or if there is already a current provider.

a. Answer: There is a one-year purchase order in place. Please reference PO #36C24923P0885

14. Question: Would the Government confirm if this Task Order new or being added onto a previous one? Will it be added to in the future?

a. Answer: There is a one-year purchase order in place. Please reference PO #36C24923P0885 for additional information. This RFP is for a new requirement to provide a base plus four years coverage.

15. Is solicitation 36C24924R0034 for Emergency Room Physician Services unrestricted or is this RFQ SDVOSB set-aside 100%?

a. Answer: This RFP is a 100% SDVOSB set-aside.

16. Question: If no qualifying SDVOSBs are found, would proposals from other set-aside categories be considered?

a. Answer: This RFP is a 100% SDVOSB set-aside.

17. Question: Can you please confirm that this solicitation is unrestricted so that we may bid on it as a large company?

a. Answer: This RFP is a 100% SDVOSB set-aside.

18. Question: Can the government please confirm the set aside on this solicitation?

a. Answer: This RFP is a 100% SDVOSB set-aside.

19. Will you accept ABIM or ABFM board certified physicians with ER experience?

a. Answer: Yes, case by case review

20. What are the current shifts? Are they all 12 hours?

a. Answer: 10-hour shifts, Main ED 7a-5p, 8a-6p, 10a-8p (PIT), 11a-9p, 3p-1a, 4p-2a, 10p-8a, and Fast Track 7a-4p, 8a-5p, 12p-10p.

21. Question: Can the government please provide on average how many hours are worked on a monthly/yearly basis out of the 12,480 allocated hours, based on the "as needed basis"

a. Answer:10 hour shifts-weekdays 7a-5p, 8a-6p, (PIT) 10a-8p, 11a-9p, 12p-10p (covers fast track 5p), 7a-5p Fast track, 9a-7p Fast track. Weekends no PIT or 11a shift.

22. Would the Government please clarify if this is an on-call Emergency Physician?

a. Answer: No.

23. If not, what are the shifts for the Physicians? Are they expected to take on 8-, 10-, or 12-hour shifts?

a. Answer: Answered above.

24. How many staff doctors are on the ED schedule? What hours/shifts do they work?

a. Answer: 10 staff per weekday, 8 staff per weekend/holiday

25. Question: Who drafts the schedule?

a. Answer: Deputy Chief of ED.

26. Question: Can a schedule of contractor shifts be forwarded for reference?

a. Answer: Current shifts have been provided in other answers.

27. Question: What type of support staff are on site to assist with direct patient care?

a. Answer: Nurse/techs

28. Question: What is the facility patient volume?

a. Answer: 23K per year

29. Question: What are the providers expected daily patient volume?

a. Answer: 1-1.5 patients per hour acute side, 2 patients per hour fast track

30. Question: How far in advance is the schedule set for providers?

a. Answer: 30 days

31. Question: Is there a shift schedule already in place for the expected 6 FTE need? If so, what shifts are these 6 FTEs expected to cover?

a. Answer: 11a-9p, 12p-10p, 3p-1a. Fill in 9a-7p (Tract) for a total of 6 FTE.

32. How many advanced practitioners are on the ED schedule? What hours/shifts do they work?

a. Answer: 3 APP’s only on the track as above. We do not need locum APP’s.

33. What shifts/hours do the contractors typically cover?

a. Answer: Shifts with other providers

34. What are the shift hours for weekdays, weekends and holidays?

a. Answer: As above

35. How many man hours of physician and APPs are currently staffed in the ED? Can you provide the details of the shift coverage (ex: MD 7a-7p, MD 12p-12a, MD 7p-7a, APP 7a-7p etc)

a. Answer: As above

36. Question: Can you specify how the contractors are scheduled?

Answer: Please reference above.

37. Question: What are the associated shift hours? For example (i.e. 07-7p, 7p-07a), or are they 8 hour shifts (i.e. 08a-430p, 4p-12 midnight, mid-08a)?

Answer: Please reference above.

38. Is there a trauma designation for the ER facility?

a. Answer: No trauma unless dropped, trauma center across street

39. What are the current medical and surgical specialties available in the hospital?

a. Answer: Medicine: Psychiatry, Cardiology, Gastroenterology, ID, Endocrinology, Neurology, and Dermatology. Surgery: Limited Neurosurgery, Orthopedics, General Surgery, Vascular Surgery, Colorectal Surgery and ENT.

40. How many current federal employed physicians work in emergency department?

a. Answer: 12 plus ED Chief and Deputy

41. What is the current annual ER volume?

a. Answer: 23K

42. What’s the annual ED volume?

a. Answer: 23K

43. On an average how many patients per hour is seen by the ER physician?

a. Answer: 10

44. What is the average number of patients per day? Annual ED patient census?

a. Answer: 50-90 (Sometimes 100 on Mondays)

45. Is there a fast track? If so, can you provide the distribution of patient volume the main ED and fast track?

a. Answer: Yes, Fast Track-40% patients (level 4+5 ESI)

46. How many beds in the acute care facility?

a. Answer:

47. Who does the admissions from the ED? Who writes the admit orders?

a. Answer: ED providers-write basic admit orders to get bed-then medicine completes orders

48. What percentage of hospital admissions come through the ED?

a. Answer: 20%

49. Do ED providers respond to Codes outside the department in other areas of the facility (i.e. rehab unit or domiciliary units)?

a. Answer: No

50. Is there a respiratory team / code team? Who manages/runs the codes?

a. Answer: RT responds to codes-ED runs its own codes

51. What level acuity is the ED?

a. Answer: All levels

52. What specialties / support staff are on call to back up the ED (i.e. cardiologist, psychiatrist, surgery)?

a. Answer: All services have on call.

53. Will this VA accept Green Card holders / permanent residents as contractors?

a. Answer: No

54. Question: Is there historical data available that will demonstrate evidence of hours for full time, part time, locum tenens and per diem positions?

a. Answer: 40 hours a week is full time. Asking for 6 FTE which would equal 6 providers at 40 hrs a week. No part time. We do have fee basis prn.

55. Question: Will the Government kindly share the type of support the ED and other services might provide for the contract ED Physician personnel?

a. Answer: We have inpatient medicine-including cardiology, GI, endocrinology etc, surgery-including orthopedics, neurosx-spine, vascular, colorectal etc.

56. Question: Will you accept Board Certified/Eligible Family Practice or Internal Medicine Physicians with ER experience?

a. Answer: Yes, as purview of chief of department.

57. Question: Can you please confirm if the solicitation is to fill Family/Internal medicine providers or if it is to fill Emergency Department providers?

a. Answer: Emergency Medicine Providers.

58. Question: Will the Government accept an Internal Medicine certification for the ER Physicians?

a. Answer: Yes, with experience and at purview of chief of department.

59. Question: Will the Government please clarify intention for all listed items to confirm if they are mandatory with the proposal, including those that say “Required at the time of award and/or required 30 days after award” – or other dates apart from the proposal due date?

a. Answer: Items referenced on page 94, (from (a) to (g)) are correct in being required “at the time of award”, or, required “after 30 days of award”. Section 6.1.1 has hereby been modified to reflect “Within 30 days of receiving award” rather than “upon proposal” for licenses, board certifications, NPI, to include primary source verification of all licensed and certified staff.

60. Question: RFP Page 94 under heading “Instructions to Offeror” – bullet point 10 lists down Qualification documents for all key personnel. But, each of these (from (a) to (g) are either required “at the time of award”, or, required “after 30 days of award”. Contradicting with this, same RFP document Page 39, Para 6.1.1 has a table, which says “Copies of any and all licenses, board certifications, NPI, to include primary source verification of all licensed and certified staff” are to be submitted “upon Proposal”. These both instructions are in conflicting with each other. Please re-confirm when and how should we be submitting the copies of Licenses/Certifications etc.

a. Answer: Items referenced on page 94, (from (a) to (g)) are correct in being required “at the time of award”, or, required “after 30 days of award”. Section 6.1.1 has hereby been modified to reflect “Within 30 days of receiving award” rather than “upon proposal” for licenses, board certifications, NPI, to include primary source verification of all licensed and certified staff.

61. Question: RFP Page 94 Para E.1.1 (4) says, “Offeror must submit one (1) electronic copy via email. Each file shall be a “stand alone” document and be complete in itself.” Please clarify whether we can submit all the content other than price as one standalone document and price as a separate standalone document? In other words, how many volumes (files), shall we be submitting in response to this RFP.

a. Answer: The completed price schedule should be included in the standalone proposal.

62. Question: Will the Government also confirm the request for no more than 20 pages will include all Administrative, Past Performance (Factor 1), Technical Capability Sub-factors 2A-2C, and Factor 3: Price?

a. Answer: The referenced 20-page limit is dedicated to your technical narrative and response to the technical qualifications. The completed price schedule does not count towards the page limit.

63. Question: RFP Page 95 Para 13 (a) specified page limits as 20 pages excluding any Attachments. Can the Government please list down what are the Attachments, those are required and are exempted from the page count?

a. Answer: The referenced 20-page limit is dedicated to your technical narrative and response to the technical qualifications.

64. Question: RFP Page 95 Para 13 (a) specified page limits as 20 pages excluding any Attachments. Request to exclude Cover Page, Cover Letter, Table of Contents from the page count.

a. Answer: A single page cover page, cover letters, table of contents, and completed price schedule do not count towards the page limit.

65. Question: Do cover letters and cover pages count toward our total page count?

a. Answer: A single page cover page, cover letters, table of contents, and completed price schedule do not count towards the page limit.

66. Question: Should the signed attachments be included in the proposal? Or attached separately?

a. Answer: Signed attachments should be included with the proposal.

67. Question: Can the Government please add on Call and Call back CLINs?

a. Answer: The Government will not be adjusting the Line Item structure.

68. Question: The Solicitation Package contains a Past Performance Questionnaire Form (Attachment D.4). But, the Instructions to Offeror, or the Evaluation Factors DO NOT talk anything about submission of this PPQ Form. Shall we submit this Attachment D.4 PPQ Form for each of the Past Performance Reference we use, to the Reference Government POC for filling the ratings and onward submission to VA Contracting Officer?

a. Answer: The Past Performance Questionnaire shall be forwarded to laura.edelman@va.gov by the Reference Government POC who completed the form.

69. Question: Are we required to use the PPQ attachment provided? Or are previously completed PPQs acceptable to the Government?

a. Answer: The relevant Attachment D.4 referencing 36C24924R0034 should be utilized for consideration.

70. Question: Additionally, how many PPQs will the Government require?

a. Answer: Up to three Past Performance Questionnaires will be reviewed.

71. Question: RFP Page 90 indicates the solicitation’s NAICS to be as 541519; on the other hand, same document SF1449 column 10 shows the NAICS code to be as 621111. Please clarify.

a. Answer: The appropriate NAICS, 621111, can be found on the SF 1449 cover page. The other referenced NAICS, 541519, is standard language provided in provision 52.212-1.

72. Question: Does the Government anticipate issuing one task order a time for one year or is there a potential to issue multiple task orders for varied lengths of time but no longer than one year duration?

a. Answer: The government intends to issue one task order at a time for one year.

73. Question: RFP Page 101, Para E.7 states “The Government contemplates award of a Fixed Price, Indefinite Delivery/Indefinite Quantity (FP-IDIQ) contract resulting from this solicitation” Shall we understand that, this is a Single Award IDIQ?

a. Answer: Yes, the Government anticipate awarding to a single source.

74. Question: Can we request the government for tentative award date?

a. Answer: Tentative award date is October 01, 2024.

The following updates are incorporated via this amendment:

1. Correct the verbiage in Section B.3 Performance Work Statement, Section 2.1.2. Changes are in red, bold italics.

FROM:

a. Board Certification: All contractor’s physicians shall be Board Certified / Board Eligible in Emergency Medicine through ABEM, ACEP, or AOBEM and be currently certified in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) through the American Heart Association or equivalency.

TO:

b. Board Certification: All contractor’s physicians shall be Board Certified / Board Eligible in Emergency Medicine through ABEM, ACEP, or AOBEM and be currently certified in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) through the American Heart Association or equivalency. Board Certified/Eligible Family Practice or Internal Medicine Physicians with at least three years-preferable high performance ER experience will be considered at the discretion of the Chief of Department. ABIM and ABFM board certified physicians with ER experience will be reviewed on a limited, case-by-case basis.

2. Correct the verbiage in Section B.3 Performance Work Statement, Section 6.1.1. table row two, middle column. Changes are in red, bold italics.

FROM:

a. Upon proposal and as frequently as indicated in the performance standards.

TO:

b. Within 30 days of receiving award, upon renewal of licenses, upon renewal of option periods, or change of key personnel.

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