36C25021Q0183 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) 01-04-2021 None 36C250 Department of Veterans Affairs Network Contracting Office (NCO) 10 Chalmers P. Wylie Ambulatory Care Center 420 North James Road Columbus OH 43219-1834 36C250 Department of Veterans Affairs Contracting Office (NCO) 10 Chalmers P. Wylie Outpatient Clinic 420 North James Road Columbus OH 43219-1834 To all Offerors/Bidders

36C25021Q0183 12-23-2020

X X X January 14, 2021 at 2:00 EST

Solicitation 36C25021Q0183 is hereby amended to:

1) Change the Size Standard in Block 10 of the SF-1449 from $30 Million to $12 Million.

2) Address questions received from interested parties. See pages 2 through 6.

3) Extend the date specified for receipt of quotations from 1/11/2021 to 1/14/2021 at 2:00 pm EST.

No other changes have been made.

Karen Williams Contracting Officer

CONTINUATION PAGE

Solicitation 36C25021Q0183 – Amendment 0001 Questions (Q) and Answers (A)

Q1 - Can you please let me know if the above mentioned job requires the staffing agency to supply medmal?

A1 - If medmal refers to medical malpractice, in accordance with 3.2 of the performance work statement all contractor personnel must have general liability and malpractice insurance.

Q2 - I am hoping to find out if there is an incumbent contractor currently performing these services, if similar services have been performed in the past, or if this is a new requirement. If this is a follow-on requirement, could you please provide the previous contract or task order number?

A2 - The incumbent is NES Government Services under contract V797P-7291A, VA251-15-F-2581 Q3 - On page 14, Section 9.4: The Contractor shall bear the expense of obtaining background investigations. If the Office of Personnel Management (OPM) conducts the investigation, the Contractor shall reimburse VA within 30 days. Please share with vendors what the cost incurred would be for each provider?

A3 – On page 15, section 9.10 it states the estimated cost for a Low Risk Level (NACI) Background Investigation is $200. With the new fiscal year, the prices may have changed.

Q4 - Instructions to Offerors indicates a listing of Key Personnel to be included in the proposal. Do you only want the names of the proposed candidates or do you want candidate packet to include CV, Medical License, DEA, BLS, ACLS and references to be included in the Technical section of Proposal?

A4 – The requirement is to provide a list of all proposed physicians, their specialty, and if they are VETPRO registered. CV’s, medical license, DEA, BLS, ACLS and references for each proposed physician is not required at this stage.

Q5 - Please clarify and advise if the QASP and/or Conflict of Interest Statement should be completed by each candidate also or only the vendor?

A5 – The QASP and conflict of interest shall be completed by the contractor, not each individual physician.

Q6 - Candidates will be asking if there will be a COVID-19 pay rate due to increased exposure in the hospital setting. Please advise if you can include a separate CLIN to address this scenario or confirm the patients being seen by MOD's will have been pre-screened and shown to be negative or have antibodies for COVID-19?

A6 – No, there will be not be a separate CLIN to address COVID patients or additional pay. There will be a prescreening performed for each patient to determine if they meet COVID criteria. PPE is provided for providers should this be required to see possible COVID patients. The UC operates similar to and Emergency Department.

Q7 - Will this contract be awarded to 1 contractor or multiple?

A7 – One contractor Q8 - What is the average number of patients typically seen in urgent care by MOD between 4:30pm - 8am?

A8 – 6-10 patients Q9 - Do VANIHCS in Marion accept acute in-patients? If so, what is the average number of in-patient census? and what is the total number of in-patient beds in this facility?

A9 – Marion does not have an acute inpatient medical bed center, patients requiring inpatient admission will be coordinated and transferred to Fort Wayne VA or the closest non-VA medical facility should they not meet VA standards for admission acceptance.

Q10 - What is the average number of pager calls typically received by MOD between 4:30pm - 8am?

A10 – 2-3, generally most are due to patient falls within the continued living Q11 - What is the average census in Community Living Center (CLC), Mental Health (MH), SARRTP services, Long Term Care, Acute and Chronic Psychiatry? Please list the numbers for each of these facilities?

A11 – CLC 0- 131 beds, SARRTP – 30 beds, MH – 25 beds, Acute MH – 18 beds. Census is usually, pre COVID 90%. Post COVID it varies. SARRTP is currently closed/changed to a backup COVID unit right now. When it's open during COVID they only had 15 max.

Q12 - Is there a psychiatrist on call at night available for specialist assistance as needed?

A12 – Yes Q13- Where are the patients typically transferred if they need an inpatient admission? (If Marion doesn't have inpatient capabilities).

A13 – If they meet criteria, Fort Wayne VA hospitalist/ ICU intensivists will accept the patient transfers. A NOD/ or transfer coordinator will be available to assist with acceptance criteria. Those that do not meet will be transferred to a non-VA facility.

Q14 - On average, how many patients does the MOD see during the weeknights? Weekends?

A14 – 6-10 during weeknights, often much less. Individual weekend days vary between 10-18 per day.

Q15 - On average, how many calls does the MOD receive from the CLC, MH and SARRTP departments during the weeknights? Weekends?

A15 – 3-4 calls each day Q16 - What support staff is available? (Other Physicians, mid-levels, RN’s, LVN’s) A16 – There are RNs, LPNs, 24/7. The only mid-level that will be available are those that are supporting the CLC and inpatient mental health units.

Q17 - What back-up call is available?

A17 – On-call inpatient psychiatry, social work. Subspecialist are available from Fort Wayne (Cardiology, Neurology, GI, General Surgeons, etc.).

Q18 - On average, how many admissions occur during the weeknights? Weekends?

A18 – 1-2 admissions to the inpatient MH unit may occur each night. Weekends vary about 2-3.

Q19 - On average, how many transports occur during the weeknights? Weekends?

A19 – UC does not accept ambulances. We do have availability to transfer patients out. On average 1-2 per day will be transferred out.

Q20 - Are there any procedures required?

A20 – minor, depending on privileges, joint injections, I&D, sutures.

Q21 - What are some examples of the calls they may receive?

A21 – Patient fall, Code Pink (psych detention/ restraints).

Q22 - Who will be calling the MOD? Other Physicians? Nurses?

A22 – Nurses, some calls from transferring facilities for EDO detentions or transfers from another VA to CLC, inpatient MH.

Q23 - What kind of census should a physician expect to carry, or said another way, how many patients should a provider anticipate seeing in a day / year?

A23 – See Q8 and Q14 Q24 - Can the contracting team please comment on how many admissions we should expect to see on average?

A24 –See Q18 Q25 - Is the contracting team able to share how admissions during the day spread amongst the hospitalists? Round robin? Another way?

A25 -Admissions are only handled by the MOD afterhours. The MOD acts as the solo physician on site for the campus. Most admissions will require formal medical clearance through the Urgent Care and will be accepted by the inpatient NP.

Q26 - What is the average total encounters per day including rounding and admissions?

0. Ex: 15 plus 2 maybe 3 admits is busy but doable.

0. Ex: More than 2-3 admits is busy with a full census to round on.

A26 – See Q8, Q14, and Q18.

Q26 - Is the ICU open? If ICU is open, do we commonage with the intensivist if there is one A26 – No onsite ICU, no onsite inpatient medical center. Patients requiring higher level of care are transferred to the appropriate medical facility or to Fort Wayne inpatient medical unit/ ICU.

Q27 - Is there an admit team?

A27 – Yes, generally consists of NOD, MOD, LPN/RNs. Bed coordinator duty is completed by the Nurse on Duty (NOD) afterhours. This is coordinator through each facility Q28 - What hours are the shifts?

A28 – M-F 4:30pm-08:00am. Weekends and all Federal Holidays 24 hours.

Q29 - Are there mid-levels? If so, what are the mid-level responsibilities?

A29 – Mid level works in collaboration for CLC/inpatient MH admissions. The Mid-level cannot operate within the Urgent Care.

Q30 - Would it be expected that the Hospitalist supervise the mid-levels?

A30 – They will act as a collaborative as needed afterhours, they do not supervisor but may need to co-sign orders if applicable.

Q31 - Does the hospital require an MOD to see a patient already seen by a midlevel?

A31 – not for the inpatient unit, unless specifically requested for collaboration.

Q32 - Can the contracting team please comment on how many other rounding hospitalists day time hospitalists are working? How many Nocturnists?

A32 – 2 day time Urgent Care providers, various NPs within the CLC and inpatient MH units during regular business hours. There are no hospitalist onsite since this is not a medical inpatient unit but a MH unit. There will be a NP covering afterhours to assist in the CLS and inpatient MH units.

Q33 - Are there morning or afternoon rounds with the Nurses/case managers? If so, what time and is it mandatory?

A33 – huddles take place during shift changes at 4:30pm and 08:00am. It is requested that the MOD provide a warm handoff to the oncoming provider.

Q34 - How many admissions on average at night?

A34 – See Q18 Q35 - Are MODs alone at night or is there a mid-level provider or another physician? We're asking as many of the places we're aware of that have just a physician plus mid-level at night can get really busy at night. We'd like to better understand this so that we can plan accordingly.

A35 – MOD is the only physician at night. There is a mid-level but they are only responsible for inpatient Mental health and CLC units; they do not assist in the Urgent Care with the physician.

Q36 - Will procedures be required? If so, is the team able to speak to which ones?

A36 – See Q20 Q37 - Can the contracting team please let us know who responds to codes?

A37 – the MOD will respond to all codes along with the designated code team members.

Q38 - Is it possible to include subcontractor past performance in addition to past performance from the prime?

A38 – Only the prime’s past performance will be evaluated in accordance with the instructions to offerors (52.212-1) and (evaluations) 52.212-2 of the solicitation.