36C25022R0041 0003.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)

MSO-2021-COM-0031

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 Network Contracting Office (NCO) 10 Chalmers P. Wylie Outpatient Clinic 420 North James Road Columbus OH 43219-1834 To all Offerors/Bidders

36C25022R0041 04-14-2022

X X X June 21, 2022

The purpose of this solicitation amendment is revise PWS Sections 2.5.1 and 4.6.6.1 for Podiatry services; 2.6.2 for Phlebotomist/Laboratory Technician; and 4.9.1.1 remove the requirement for a mobile, modular supply cart. See pages 2-4.

This amendment also addresses questions received. See pages 5-11.

Closing date has been extended to 6/21/2022 at 12:00pm Local Time

There are no other changes.

Alexander Daniel Contracting Officer

CONTINUATION PAGE

SOLICITATION 36C25022R0041, AMENDMENT 0003

The following are revisions to the PWS:

1) Revise the requirements for Podiatrist Services as stated below:

Remove:

2.5.1 PODIATRIST: FTE Ratio Performance Standard: 1.0 FTE per an estimated 950 patients requiring podiatry services with only a single room available for services or 1 FTE per an estimated 1300 patients requiring podiatry services with two rooms and Clinical support (such as a nail technician). Staffing ratio may be adjusted upward locally to provide VA standard patient care average of 14 – 16 patients/8-hour period being seen. Qualifications: Degree of doctor of podiatric medicine, or its equivalent, from a school of podiatric medicine approved by the Secretary of Veterans Affairs. Approved schools are United States schools of podiatric medicine approved by the Council on Podiatric Medical Education of the American Podiatric Medical Association in the year in which the degree was granted. Current, full, active, and unrestricted registration as a podiatrist in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA Handbook 5005 Part II Appendix G4 located at: https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1325&FType=2. Podiatrist Qualification Standards Intermediate Grade with experience necessary to run a Clinical practice in a remote area. (1) Four years of podiatric practice or its equivalent. One year of the required experience must have been in a multidisciplinary Clinical setting. Two years of approved residency training or its creditable equivalent acceptable to the Council on Podiatric Medical Education of the American Podiatric Medical Association and, as applicable, the appropriate specialty board is acceptable in lieu of 4 years of practice, including the above 1-year requirement. (2) The podiatrist at this level possesses stature that would warrant appointment at the Clinical instructor or higher level at a school or college of podiatry or other appropriate affiliated school or college. (3) Has achieved a high level of professional attainment as illustrated by one or more of the following typical examples (more examples found in qualifications handbook link). (a) Is a recognized expert in dealing with a variety of unusually difficult cases which are referred by other facilities for resolution and recommended courses of action to provide for maximum rehabilitation. Typically, in this capacity serves as a consultant to podiatrists or other professionals in other health care facilities. (b) Has assumed responsibility for a comprehensive podiatry program at a facility for the care of diabetic, peripheral vascular disease and other systemic conditions involving the foot, and a program for the care of the geriatric patient. Typically, a high degree of competence and skill in responding to the needs of this patient category is demonstrated in the program development and innovative methods and techniques employed. Training in podiatry and medical or other appropriate professional areas and/or research activities of considerable scope commonly from a part of the program. Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care

And Replace With:

2.5.1 PODIATRIST: The contractor will provide referrals to Podiatrist through consult to VA through the EHR.

Remove:

4.6.6.1 PODIATRY SERVICES

4.6.6.1.1 Podiatry services shall be provided on site and shall focus on wellness of the foot and ankle, prevention of podiatric disease, screening for disease precursors and timely interventions and the management of existing conditions. Management includes: The diagnosis, medical, and mechanical treatment of ailments and deformities of the human foot and ankle. Surgical and more specialized podiatric cases shall be referred to the VA.

4.6.6.1.2 All Clinical podiatry instruments, to include RME (e.g., nippers, rasps, files, knives, spatulas, scissors, mosqs, anvils, elevators, etc.), will be provided by the VA. The Contractor shall provide a sterile processing cabinet to securely store sterilized RME at the Contractor’s Outpatient Site of Care. The cabinet must have drawers/shelves and lockable doors to store and protect the sterile RME. Contaminated instruments must never be placed in or near this cabinet. The Contractor shall take reasonable precautions to maintain the RME provided by the VA and will replace any RME that is damaged or lost due to Contractor negligence.

4.6.6.2 The Contractor shall transport RME to and from the VA. All transportation and handling of the RME shall be at the Contractor’s expense. Reusable burs may be included in this exchange program, if they are properly marked with identifying information to ensure return to the Contractor. Reusable burs must be of the type that can be steam sterilized. It is highly recommended that the Contractor uses disposable burs. Contractor personnel handling or supervising the exchange of RME must complete an Initial and Annual Competency Assessment Checklist to document understanding of the process for set-up, use, reprocessing, maintenance, and transportation of RME. The contractor must adhere to the specific 12-hour requirements and enzymatic spray policies included in the attachments section.

4.6.6.3 Equipment/services that shall be supplied by Contractor: Volume of instruments shall ensure contingency for SPS reprocessing delays. A ratio of an extra day supply at a minimum shall be available. For example, if 20 patients are seen daily and the reprocessing of instruments takes two days and Clinic runs daily, 60 instruments (20 for day one, 20 for day two and 20 in reserve in case day one’s instruments are not returned in a timely manner). The following are examples: Sterile Processing Cabinet, lockable and located away from sinks, Personal Protective Equipment (PPE) for personnel handling and using RME, Burs (either disposable or properly marked with identifying information to ensure return to the owning site), Initial cleaning of contaminate RME to remove any visible soil, the enzymatic spray cleaner, small biohazard bags (sealable baggie style) for storage of contaminated RME, Rotation of RME on a first-in, first-out basis to ensure consistent use/rotation of equipment, Inventory of RME to be exchanged daily with the VA SPD, Transportation of RME to and from the VA SPD.

4.6.6.4 The Contractor’s Outpatient Site of Care does not possess the required sterilization equipment and facilities necessary to comply with RME policy. Therefore, the VA SPD will sterilize all Clinical podiatry RME used by the Contractor. The Contractor and VA will coordinate the daily exchange of contaminated RME with sterilized RME. The VA Sterile Processing POC is Chief, SPD at 313-576-1000, ext. 64263 or 64262 The VA will provide:

4.6.6.5 Sufficient RME to conduct daily exchange with VA Sterile Processing. A ratio of an extra day supply at a minimum will be provided. For example, if 20 patients are seen daily and the reprocessing of instruments takes two days and Clinic runs daily, 60 instruments (20 for day one, 20 for day two and 20 in reserve in case day one’s instruments are not returned in a timely manner);

4.6.6.6 Bins for transporting both contaminated and sterilized RME; Cleaning and sterilization of instruments and burs;

4.6.6.7 Repair/replacement of any unserviceable equipment, damaged or worn due to normal wear and tear.

And Replace With:

4.6.6.1 PODIATRY SERVICES: Will be coordinated by the contractor through referral to Podiatry Specialty Services at the JDD VAMC.

2) Revise the requirements for Phlebotomist/Laboratory Technician as stated below:

Remove:

2.6.2 PHLEBOTOMIST/LABORATORY TECHNICIAN: The JDD VAMC will be responsible for drawing blood And Replace With:

2.6.2 PHLEBOTOMIST/LABORATORY TECHNICIAN: The contractor will be responsible for drawing blood. Qualifications: required education and experience demonstrating skills and abilities to perform duties ensuring smooth site operations. Position may be covered by Phlebotomist, Laboratory Technician, or PACT teamlet staff. Position Responsibilities: Responsible for drawing blood from patients presenting to the CBOC.

3) Under 4.9.1.1, in the second paragraph, Exam Room: Design Objectives, last sentence Remove: the following sentence from Exam Room: Design Objectives

· Provide one mobile, modular supply cart in each Patient Care Room that can be stored under the counter.

SOLICITATION 36C25022R0041, AMENDMENT 0003

QUESTIONS AND ANSWERS

0. Why was this solicitation not set aside for veteran owned small businesses under the VA rule of two?

Answer: In accordance with the Government’s market research only one VIP verified SDVOSB/VOSB was identified that appeared capable of performing the requirement.

0. On what dates was the market research performed and what were the findings?

Answer: Market research was conducted on three different occasions, January 2019, July 2020, and September 2021. The findings were that only one VIP verified SDVOSB/VOSB was identified that appears capable of performing the requirement.

0. We do not recall seeing a sources sought notice or a Request For Information with regard to this procurement. Please inform us if either was done, and when.

Answer: Two sources sought was issued, January 8, 2019, and July 7, 2020. A third sources sought was not issued.

0. Please explain why the CLINs are flat and the government does not expect a decline in enrollees at the clinic over the next 10 years, corresponding to Census estimates.

Answer: Due to the pandemic of COVID-19 for the past two years, we do not expect a decline in enrollees, we anticipate more veterans will be enrolling.

0. Please advise how many exam rooms and how many consultation rooms the VA requires per PACT team.

Answer: Two exam rooms for providers and one office area

0. Please advise how many telehealth rooms (by type) the VA requires in this facility and if the VA would like exam tables in the rooms.

Answer: 4 Telehealth rooms and 2 offices. 1 exam room has an exam table

0. Please confirm the size and number of small group rooms and large group rooms required in this facility.

Answer: Exam Room: 125sq ft. Consultation Room: 125sq ft. Procedure Room: 180sq ft.

0. Please confirm the number of procedure rooms and womens health exam rooms required in this clinic.

7. Can a procedure room count toward the number of required womens health exam rooms?

Answer: : 1 procedure room and 1 women’s health room

0. Does the current CBOC meet the government’s space requirements, and if not, will the location be “grandfathered in” and available for rebid “as-is”?

Answer: New contract awardee will be required to meet space requirements.

0. Please confirm the new CBOC must be designed with the On/Stage-Off/Stage concept as laid out in the PACT Design Guide.

Answer: Yes

0. Will podiatry services be conducted in procedure rooms?

Answer: Included in this amendment, sections 2.5 and 4.6.6.1 of the PWS has been revised to remove the requirement for the contractor to provide podiatry services.

0. Please provide the number of billable enrollees on the most current invoice.

Answer: 4005

0. Please list all VA staff that will be onsite at the clinic and the approximate number of days per week they will be there.

Answer: We currently have 2 VA employed staff (TCT Tech, Medical Social Worker), 1 employee is here 4 days a week and 1 is here 2-3 days a week in office

0. Will the new Contractor inherit the patients’ last vesting visit and be allowed to bill for one year from the date upon contract award?

Answer: No

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

Answer: Yes, 1 week notice.

0. How many Mission Act referrals, for Primary Care, were made the past 12 months for enrolled veterans of the Greenville CBOC?

Answer: Do not know, but the Yale CBOC Mission Act is 8342.

0. Will the government consider extending the start up time to 120 days instead of 90?

Answer: No change

0. Transcripts are required to be submitted for NP candidates with the proposal. Can these transcripts be submitted after award?

Answer: No

0. Proof of ACLS and BLS are required to be submitted for Physicians with the proposal. Can these be submitted after award?

Answer: No

0. Please list the vaccines the contractor is responsible for purchasing and provide information on how many of each vaccine were used at the clinic in the past year.

Answer:

- pneumococcal vaccine - 600

- Hep A vaccine - 300

- Hep B vaccine - 300

- Influenza vaccine -1,200

- TDAP vaccine- 300

- COVID-19 vaccine – 1,500

- Shingles vaccine – 300

0. Please advise how mental health will be handled in the clinic (is contractor or VA providing, or will it be referred to VAMC) Answer: VA will provide mental health service via telehealth services

0. Section 2.6.d2 of the RFP suggests the VA will provide the lab tech and draw blood. Please confirm this is the VA’s intention and the contractor does not need to provide a lab tech.

Answer: Included in this amendment, sections 2.6.2 of the PWS has been revised to require the contractor to draw blood.

0. 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)? (PWS 4.6.3.1 page 42 of 171) Answer:

- pneumococcal vaccine - 600

- Hep A vaccine - 300

- Hep B vaccine - 300

- Influenza vaccine -1,200

- TDAP vaccine- 300

- COVID-19 vaccine – 1,500

- Shingles vaccine – 300

0. Please confirm that the new contractor will inherit the patient’s last vesting visit and be allowed to bill for one year from that date upon contract award? (PWS 6.2.1 page 100 of 171) Answer: No, all billing activity will take place once contract is awarded.

0. “Provide certification that staff list have been compared to OIG list (see PWS 2.20).” Please confirm the “certification” can be a statement from the offeror confirming that no staff listed are on the OIG list. (Part IV Miscellaneous page 146 of 171) Answer: Correct, the certification may be a statement from the offeror confirming that no staff listed are on the OIG list.

0. Please confirm that the government will accept alternative terms for pricing; specifically carving out elements from the unit price for non-primary care services will remain in compliance with the solicitation requirements. (E.1 (3) Multiple Offers page 142 of 171) Answer: Alternate pricing that changes the LIN structure in the solicitation or any alternate form of pricing is not permitted. Submission of a proposal that includes an altered LIN structure or any other alternate form of pricing will not be considered further for award.

0. Will an offer be in compliance if offerors segregate constructions costs from the capitated rates (per member per month) in Section B. Schedule of services? (E.1 Part III page 146 of 171) Answer: Alternate pricing that changes the LIN structure in the solicitation or any alternate form of pricing is not permitted. Submission of a proposal that includes an altered LIN structure or any other alternate form of pricing will not be considered further for award.

0. Please clarify how the government evaluates the PMPM unit prices for the performance period. Does the government look for consistent pricing for the base year and each option year? (page 6 of 171) Answer: Price will be considered in the overall evaluation to ensure pricing is fair and reasonable. We will review pricing over the life of the contract, including a possible 6-month extension period in accordance with FAR clause 52.217-8 Option to Extend Services.

0. Can offerors apply all the transition and start-up costs in the base year unit price and then propose lower unit prices starting in option year one? (page 6 of 171) Answer: Yes.

0. Please clarify how the government determines pricing to be “significantly unbalanced”. What criteria are used to determine balance or unbalanced pricing? For example, the total evaluated price, for the base year and all option years, remains the same regardless of when costs are proposed and captured in the unit prices. (E.7 Factor 4 page 154 of 171) Answer: In accordance with FAR Clause 15.404-1(g) unbalanced pricing exists when, despite an acceptable total evaluated price, the price of one or more line items is significantly over or understated as indicated by the application of cost or price analysis techniques.

0. There has been a significant increase in construction costs and significant challenges in supply chains for construction materials. Will the government consider sharing the risk of the construction component of the project by accepting offers with separate CLINs for construction in either a T&M, Fixed Price, or Cost-Plus format? (E.1 (3) Multiple Offers page 142 of 171) Answer: Alternate pricing that changes the LIN structure in the solicitation or any alternate form of pricing is not permitted. Submission of a proposal that includes an altered LIN structure or any other alternate form of pricing will not be considered further for award.

0. Incorporating attachment D.23 Davis-Bacon Act WD MI20220098 (4-1/2022) establishes the governments recognition of the increased relevance of the construction component of the project creating greater barriers for offerors to identify qualified general contractors capable of managing the increased costs and reporting requirements. Ultimately these increased costs are passed on to the government. Will the government allow contracts to recover these costs in a cost reimbursable CLIN? (Section D page 140 of 171) Answer: Alternate pricing that changes the LIN structure in the solicitation or any alternate form of pricing is not permitted. Submission of a proposal that includes an altered LIN structure or any other alternate form of pricing will not be considered further for award.

0. “For any buildout/construction that might be required to prepare space for performance of this contract,” Please confirm whether the current CBOC conforms to the PACT space standards. (4.9.1 Space Requirements page 76 of 171) Answer: Yes

0. Is there a requirement for designated WH exam rooms, if so, how many? Can they be included in the exam room count? (4.9.1 Space Requirements page 76 of 171) Answer: 1 WH exam room

0. The PACT Module Design Guide recommends a ratio of approximately 3 Exam Rooms per teamlet, is this the required ratio for this clinic? If not, what is the desired ratio for patient care exam/consult rooms? (4.9.1 Space Requirements page 76 of 171) Answer: Yes

0. How many telehealth rooms are required? (4.9.1 Space Requirements page 76 of 171) Answer: 4 telehealth rooms based on patient population

0. Since the contract awardee will be providing space for the exclusive use of the government does the government intend to enter into a subleasing arrangement in compliance with General Services Administration lease arrangements using GSA Form L201A? (4.9.1.3 page 77 o 171) Answer: No

0. Will the government consider relaxing requirements key personnel documentation including BLS, ACLS, and transcripts? The solicitation's requirements for staff will be limiting competition due to the documentation and references required at proposal submission. Potential candidates are typically unwilling or unable to provide copies of BLS, ACLS certificates, and transcripts in such a short period of time, especially when there is no guaranteed position. The typical VA industry standard for key personnel requirements at proposal submission either requires identification of all staff members proposed and a summary of their qualifications (years of experience, education, licenses, certifications), or resumes and attainable documentation from the primary care provider staff (physicians, physician assistants, and nurse practitioners). Attainable documentation for the clinical personnel includes board certifications and licenses. (E.7 Factor 2 page 153 of 171) Answer: No

0. Is the current facility staffed in alignment with PACT staffing requirements? (1.12.1 page 12 of 171) Answer: Yes, they are in alignment.

0. Is the current CBOC clinic manager an RN as well as a manager?

Answer: Yes

0. If the government does not guarantee the estimated quantity in the Scheduled of Services what options do vendors have to request unit price adjustments if the quantity declines to the point of not covering the project costs? Can the vendor request unit price adjustments to account for lower enrollment numbers while continuing to incur the same costs?

Answer: The only guarantee in the contract is the guaranteed minimum amount. The contract type is fixed-price, IDIQ. Since it is fixed-price, there will be no price adjustments on the basis of the contractor’s cost experience in performing the contract.

0. Can the Government clarify if the estimated enrollment is within 5% of the average amount of Veterans invoiced for in the months of Jan-Mar 2022? If not, will the Government provide the average for that three-month period for each CLIN? (B.2 page 6 of 171) Answer: Yes

0. Will the Government verify that facilities/proposals that do not meet the PACT Space Module Design Guide’s principals that take patient privacy and security, streamlined processes and enhanced teamwork through design features such as the on-stage/off-stage concept, teamwork zones and separate patient/staff corridors will be considered non-compliant? (PWS 4.9 Space Requirements page 75) Answer: See solicitation section E.7 52.212-4 Evaluation - Commercial Products and Commercial Services, which states how the government intends to evaluate proposals.

0. Will the Government consider proposals with separate CLIN(s) to recapture costs of clinic construction? If so, what contract types (CPFF, FFP, etc.) will the Government find acceptable? (PWS 2.5 Specialty Care Staffing page 21) Answer: No

0. Will VA be converting to use the Prevnar 20 vaccine?

Answer: Yes

0. Please confirm if VA is responsible for providing staff for the phlebotomy position?

Answer: Included in this amendment, sections 2.6.2 of the PWS has been revised to require the contractor to provide staff to draw blood.

0. Can the tele-health tech be a medical assistant?

Answer: Yes

0. Section 4.11.1.5, 4.11.1.7, 4.11.1.9, Please list all of the printers, scanners, and fax machines that VA will provide, since the VA will not connect non-VA equipment to their network.

Answer: VA will not provide equipment

0. Is the LCSW listed on page 19 section 2.4.9 considered part of the 0.67 FTE for PCMHI? Does this LCSW conduct behavioral health counseling?

Answer: Yes

0. On page 76 procedure room, is an overhead lift system required in a CBOC?

Answer: No

0. Will the VA be using Kiosk in the waiting room?

Answer: Yes

0. Will the current VA employed Medical Social Worker remain at the new Yale CBOC or is the contractor required to hire a Medical Social Worker? Will all specialty mental health be provided via telehealth at the parent facility or by a VA employed mental health provider at the CBOC?

Answer: All specialty mental health services will be provided via telehealth.

0. Under 2.5.1, is the contractor required to hire a Podiatrist or are the Podiatry services completed by a VA employed Podiatrist at the CBOC?

Answer: Included in this amendment, sections 2.5 and 4.6.6.1 of the PWS has been revised to remove the requirement for the contractor to provide podiatry services.

0. Under 2.6.2, "the JDD VAMC will be responsible for drawing blood", is the VA providing a VA employed laboratory technician/phlebotomist to draw blood at the CBOC?

Answer: Included in this amendment, sections 2.6.2 of the PWS has been revised to require the contractor to provide staff to draw blood.

0. Under 4.3.1, is the CBOC able to bill the VA for unassigned patients that are seen in the CBOC for the month that they are seen?

Answer: No, all CBOC patients are required to be assigned to a provider, prior to payment.

0. Under 4.6.3.1, "the contractor will provide all medications, (including all necessary vaccines that are given at the CBOC)", will the VA be able to change the template in the EHR to reflect the outside contractors flu vaccine and other vaccines, lot numbers and expiration dates?

Answer: No

0. Under 4.6.4.2, "the EKG machine being supplied at cost to the contractor". What is the cost to the contractor for the EKG machine being supplied to the CBOC?

Answer: Cost per each $2495.00 Data Scope Passport II

0. Under 4.6.4.3.3, is it acceptable to send the currier 1 time daily with labs?

Answer: No.

0. Under 4.6.4.5.3, will the VA continue to provide the machines for Hemoglobin A1Cs and INRs with necessary supplies or will the CBOC be responsible for purchasing machines and providing supplies?

Answer: Yes the VA will provide.

0. Under 4.6.4.5.7, "the VA will provide the test systems/instruments and reagents for contractor waived testing except for fecal occult blood testing cards and developer." Will the VA still provide the current FOBT kits that are given to patients and sent into the VA for results?

Answer: Yes

0. Under 4.9.1.1, what is the mobile, modular supply cart that needs to be in each exam room? Will those be supplied by VA, or will that be the responsibility of the contractor to purchase?

Answer: The sentence “Provide one mobile, modular supply cart in each Patient Care Room that can be stored under the counter” was removed from the solicitation.

0. Under 4.9.2.2, is the telehealth coordinator the current employed TCT at the Yale CBOC?

Answer: No, it is a Telehealth Clinical Technician that is in place at this time.

0. Under 4.9.9, if the building is designated as a business occupancy and no fire sprinkler system is required, is this acceptable Answer: No

0. If the physicians carry $1,000,000 and $3,000,000 for malpractice and the mid-levels carry $200,000 and $600,000 is this ok for malpractice insurance Answer: Yes

Amendment 0003 – Q&A and PWS revisions

Page 1 of

Page 1 of