36C25618R0078-00002000.docx

Amendment 2 – 36C25618R0078 Houma CBOC – questions and responses (PART 2 of 2)

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

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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 ITE M 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 r eference 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

BY

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) 00002 04-18-2018 Department of Veterans Affairs for SL Veterans Health Care System Network Contracting Office 16 400 Veterans Avenue Biloxi MS 39531 Department of Veterans Affairs Gulf Coast Veterans Health Care System Network Contracting Office 16 400 Veterans Avenue Biloxi MS 39531 To all Offerors/Bidders

36C25618R0078 04-18-2018

X X X 5/17/2018 1630 Central X This amendment of 36C25618R0078 for Houma CBOC is hereby extended as stated above to 5/17/2018.

Responses to questions are included on the following pages and are in two parts.

Also, attached are a corrected Table of Contents an d Price Schedule to be inserted and replaced original versions.

D42 and D43 are attached as part of response to questions.

Reminder- Submittal instructions Section E - Addendum to 52.212-1

Melanie Hawley Contract Specialist

NCO1616L3-0035

4:30 pm Central per FAR 52.212-1 (f)(1)

Am 1 corrected this error by providing the corrected RFP. The correct numbering is pages 7-9 for the price schedule. The TOC is corrected and included in this amendment.

Yes, each patient will receive a PCP and a MH Team Leader as needed per diagnosis or referral from APC.

The CPS works in the manner of a mid-level provider within allied health services. They work within a multidisciplinary team to support both the veterans and to support the providers and nurses.

The last three invoices (2018) rendered an average of 3271 for APC and 1266 for MH monthly. We cannot account for patient’s fluctuation and usage of VA Services; however, SLVHCS recently opened the new state of the art VA Hospital in New Orleans, LA. Current Price Schedule is estimated 3200 Primary and 1250 MH and will be updated to reflect the more current average and is included with this amendment to replace the original version.

Yes

Confirmed via MH

This attachment was provided due to the link in 1.4.41; however, it should be removed as it is not applicable

These calculations are from the PACT model that is included in the link in the solicitation. It is based on provider panels and workload. The numbers are based on 1000 veterans per each FTE. The 7.72 is correct for Mental Health. Actual panel sizes can be determined by the VA in accordance with PCMM Handbook 1101.02.

Yes, unless the number increases or decreases during contract. Quantities are estimates only and the reason for an Indefinite Delivery, Indefinite Quantity type contract.

2.5.4.6;

2.5.4.7;

2.5.4.9;

2.5.4.10 What are the FTE Ratio Performance Standards for each of these positions?

The Specialty Mental Health Options 1-5 (2.5.4.3 to 2.4.5.7) is contingent on the makeup of staffing that is offered and satisfies the requirement in the solicitation. Clinical performance standards are addressed in the QASP and other aspects of the PWS/RFP.

2.5.4.9 and 2.5.4.10 can be collateral duties therefore performance standards cannot be determined. The VA staffing has a primary SPC for all CBOC as well as an Outreach Coordinator.

Yes, the Utilization Management department sends out a daily report to all CBOCs. PACTs are still ultimately responsible in assisting with coordination of all care as needed.

SLVHCS (Southeast Louisiana Veterans Health Care System) has one primary contract with Acadian Ambulance Services.

The Contractor covers the costs of the ‘bridge’ medications for patients that can’t wait until they receive them in the mail. The Capitated Rate is to be all inclusive (including medications).

Providers get credit for telephone visits as well as face to face. Yes.

CARF (Commission on Accreditation of Rehabilitation Facilities) can review any standard pertaining to Aging Services, Behavioral Health, Community, Vision, Medical Rehabilitation, Opioid treatment, and Homelessness Program.

Tele-Mental Health is in addition (component) to having someone on-site for MH services. Offerings include MST, SUDT, PTSD, and a myriad of possible services as needed.

Group therapy can be directed at different era’s (Vietnam, OIF/OED/OND), whatever is applicable to population mandates. The Family Program is out of New Orleans and can be arranged via telehealth, coordinating a VA worker to be on-site for specific entities, or coordinated at local Vet Center.

The Houma CBOC does not have to offer or make referrals to CWT at this time. However, the Houma CBOC will make available, the information about the CWT Program and criteria for participation.

https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking VA MH SUDT/SATP goes by same guidelines regarding alcohol abuse.

MH RRTP (Mental Health Residential Rehabilitation Treatment Program) provides residential rehabilitative and clinical care to eligible Veterans who have a wide range of problems, illnesses, or rehabilitative care needs which can be mental health, SUD, co-morbid medical, homelessness, vocational, educational, or social.

4.6.22.1 “4.6.20.1 NOTE: Contactor sites with 5,000 or more patients must provide care for MST-related mental health conditions on-site.” Is this based on PC patients only, or PC plus MH patients?

This is based on PC and MH patients.

The CVT, usually a LPN, physically conducts the entire visit with instruction from Dermatology via tele-dermatology.

AQL Minimum of 95% with a goal of being at 100% (standard). The PWS should be corrected to read the same as the QASP (Attachment D5).

VHA Handbook 1907.01 is now ATTACHMENT D42 and VHA Directive 1605.01 is now ATTACHMENT D43

This link is to VA CPGs, but we are unable to locate the current performance measures. Please provide a copy of the current performance measures, or an accessible link to them.

Strategic Analytics for Improvement and Learning (SAIL). https://www.va.gov/QUALITYOFCARE/measure-up/Strategic_Analytics_for_Improvement_and_Learning_SAIL.asp Additional measures can be found through EPRP - https://www.va.gov/HEALTHPOLICYPLANNING/VISION/5CHAP4.pdf and SHEP. The CPG’s are currently being updated. Access will be available to awardee. Refer to PWS 4.8.9. Contractor will be held to the standards as outlined in PWS 4.9 and to the QASP Attachment D5.

Please see answer to #26 above

(NOTE: Links for surveillance are provided at the bottom of this section)” The links provided are to VA intranet sites and are inaccessible. Please provide accessible links, or documents as attachments.

All available documents have been attached to solicitation. Link Access will be available to awardee.

4.9.3 4.9.4 Is this the same data that is used to report public wait times?

Information is obtained from a combination of resources such as VSSC and Access to PWT (https://www.accesstopwt.va.gov/). The public site, VSSC (rolling day average is 2 days let us know direction we are headed, and pending appointments over 30 days of create date are reviewed daily. The VSSC is an internal monitor due to patient sensitivity. It will be accessible after bidding process.

VHA Directive 1731 can answer most of these questions. DSS uses identifiers known as “Stop Codes” that determines the level of care vs the level of finance paid for per visit. The more quantitative the more just the cost.

http://vaww.va.gov/vhapublications/searchresults.cfm

According to MH approximately less than 10% of PC patients are enrolled in MH simultaneously.

Please refer to SBA now instead of OSDBU:

SBA webpage: https://www.sba.gov/allsmallmpp All Small Mentor Protégé Program Tutorial :

https://www.sba.gov/tools/sba-learning-center/training/sbas-all-small-mentor-protege-program For more information on the ASMPP: allsmallmpp@sba.gov

Yes, it should read but not limited to.

Not required for fixed-price (FAR 52.216-1 Type of Contract). The evaluation will be completed as stated in FAR 52.212-2; however, the following statement under the Paragraph 3 BASIS FOR CONTRACT AWARD should be removed: “Unrealistically proposed prices may be grounds for eliminating an offer from competition either on the basis that the offeror does not understand the requirement or the offeror has made an unreasonable/unrealistic proposal.”

VA256-16-R-0015 was cancelled in its entirety and has no further bearing on the new solicitation.

Amendment 2- 36C25618R0078 Houma CBOC- questions and responses (PART 1 of 2)

1. Paragraph 2.1, p. 17, states “Actual panel sizes can be determined by the VA in accordance with PCMM Handbook 1101.02.” It is our understanding that PCMM Handbook 1101.02 has been superseded by VHA Directive 1406. Please clarify if panel sizes should be in accord with PCMM Handbook 1101.02 or with VHA Directive 1406. Yes, PCMM Handbook1101.02 has been rescinded. VHA Directive 1406 is already attached as D19 as referenced at 1.4.35; in addition, please note the link to VHA Handbook 1101.10 at 1.4.36.

2. Paragraph 2.1, p. 17, “The Clinical Pharmacy Specialist (CPS) shall be provided the same support staffing given to other providers on the team when they are working in the capacity of a mid-level provider.” Could the VA please confirm what support staff is required for the CPS. Is there to be an RN Care Manager, Clinical Associate, and Clerical Associate provided for each CPS? If so, is this to be provided by the contractor? No additional support staff is needed for the CPS. They work parallel to the teamlets.

3. Paragraph 2.3.1, p. 18, states “There will be at least one Physician MD/DO in addition to the Physician Director.” Based on the requirement for 0.05 FTE Medical Director per PACT (paragraph 2.2), Medical Director services are only needed on a part-time basis. If a single full-time physician is used to provide the required Medical Director services and to also provide Primary Care Provider services with the remaining available time, does this satisfy this requirement? Or is another physician (who is not the Medical Director) required in addition to the provision of (part-time) Medical Director services? One primary care physician will perform the medical director duties in addition to seeing primary care patients. The other PCPs will be full-time patient care providers.

4. Paragraph 6.1.2, p. 87, states “The Contractor shall have at least ninety (90) days but no more than one hundred twenty days (120) from contract award to commencement of the provision of medical care to local veterans.” Would the VA be able to clarify if the requirement will be for 90 days or120 days as this could affect pricing and vendor availability? 90 days is still preferred; however, some flexibility was provided as some offerors may require more build-outs than others. As stated, the VA target start date is October 1, 2018.

5. Page 159, under Evaluation Factors and Criteria for Sub-factor (a), requires: “Offerors shall submit documentation of current workload ratio for patients per physician per day.” Could the Government clarify how non-incumbent offerors are able to comply with this request as such offerors would not have current workload ratios? If physician is currently providing patient care, some detail about their care and the number of patients seen per day should be provided.

6. Page 160, under Evaluation Factors and Criteria for Sub-factor (b), requires the submission of transcripts for Nurse Practitioners. Would it be acceptable to submit transcripts with credentialing packets after Contract Award due to the fact that many qualified personnel do not keep transcripts, and the timelines for obtaining official transcripts can take several weeks, depending on the university? Yes

7. What is the current number of patients on the billable roster for primary care? For February 2018, 70 new billables for PC (Includes both New Enrollees and Patients who re-qualify for enrollment after previous disenrollment; Original 27, Return 43) – MH 40 (Original 14, Return 26). FY 17 new billables were 1462 APC and 519 for MH.

8. Will the primary care billable roster be rolled over to the awardee for billing purposes under the new contract? The existing billing roster will roll over for the first period of performance.

9. Are mental health services currently provided? If so: Yes.

a. What is the current number of patients on the billable roster for mental health? (Please see above #7) (If mental health does not have a separate billable roster, what is the current mental health enrollment?) For March 2018, 1272 MH Enrollees. Please see #7.

b. Will the mental health billable roster be rolled over to the awardee for billing purposes under the new contract? The existing billing roster will roll over for the first period of performance.

10. Regarding wiring and jack specifications:

a. Does the VA IT require wire baskets or are J-hooks OK? Wire Baskets

b. Does the VA IT have any specific color combination for wiring and jacks? Blue Cat6 Wires\Jacks Computer\printer White Cat6 wires\jacks are telephone\VOIP.

c. Does VA IT want regular two post Rack or a locking cabinet rack in IT room? Two Post rack provided all IT Closet security standards are in place.

d. Does the VA IT have any specific requirement for Brand for jacks and rack? Cat6 Standards must be met.

e. What are the jack requirements per drop location? 2 data/ 2 voice or 2 data and 1 voice? 2 Data/2Voice

f. What size CAT wiring is required? CAT6

g. Is there a specific color of wire needed for data and voice wiring? Same as question b

11. In light of the Solicitation requirement under section 4.4.22, p. 61, that “Benchmarks include an average speed of answer by a live person within 30 seconds and a call abandonment rate of less than 5%.” Does the VA recommend a call center that is located and staffed separately from the reception/check-in area? The VA monitors call via the ACD lines using a system called Openscape. The VA Telephony monitors the program. The PACT #’s is given to the patient and rolls over to another team member if not answered. If no answer is rendered, the call is routed to NOLA. No call center is needed.

12. Paragraph 4.7.1, p. 74, states, “Include space for other staff and services (such as x-ray, telehealth, and VA staff).” Could the VA specify the space requirements for VA staff? There will be no VA Staff physically located at the Houma CBOC.

13. Paragraph 2.5.4, p. 25, states in regard to Mental Health staffing, “A mix of the following provider types may be selected to meet FTE staffing level required.” Please confirm that Registered Nurses staffing listed in paragraph 2.5.4.2 on p. 25 counts toward the requirement for 7.72 FTE Mental Health Staffing per 1000 mental health patients. Yes (A mix of the following provider types may be selected to meet FTE staffing level required. Staffing ratio outlined is “minimum” and may be adjusted locally by the VA to provide appropriate Mental Health Care). See the Uniform Mental Health Services Handbook 1160.01 for General and Specialty Mental Health requirements. (Paragraph 1.4.44)

14. Is the current CBOC Facility utilized by the incumbent suitable and appropriate for use based on the specifications in the current RFP. Each solicitation and contract stands alone, so unable to provide answer to this question. This will not be determined until evaluation phase has been completed.

15. Are there currently any positions that are unfilled? If so, please list the open positions. Each solicitation and contract stands alone, so unable to provide answer to this question. This will not be determined until evaluation phase has been completed.

16. What is the actual number of primary care patient visits per month. What was the total number of primary care patient visits for the entire calendar year of 2017. In March 2018, PC 3266 visits. MH 1272. Stats were provided with Attachment D1.

17. What is the actual number of Mental Health patient visits per month. What was the total number of Mental Health patient visits for the entire calendar year of 2017. In March 2018, MH 1272. Please see above. Stats were provided with Attachment D1.

18. Is the incumbent eligible to rebid this opportunity. As stated, in the SF 1449 block 10, this is unrestricted.

19. On page 158, under section 2.4, you ask for a CD to be included in the proposal. Will you accept a Mighty USB Thumb drive instead. Can it be either or, or does it have to be burned to a CD? No, must be Compact DISC as requested.

20. Please provide the most current billable enrollees/patients for both primary care and mental health services. Answered in other questions previously.

21. Paragraph 4.6.6 Laboratory Services pg 49 of 180, Please confirm the courier service transporting laboratory specimens from the CBOC to the VAMC will be provided by the VAMC. Yes

22. Paragraph 4.6.9 Pharmacy Services (Prescription Fulfillment) pg 53 of 180, Please confirm the cost of the vaccines administered to patients in the CBOC will be borne by the Government Yes, VA supplies vaccines.

23. 2.0 General Instructions for Proposal Submission pg 157 of 180, Please confirm the number of hard copies for each transmittal (number of hard copies for Technical/Past Performance for Dr. Buth and number of hard copies Price/Business for Melanie Hawley). As stated, one hard copy. This is to reduce paper and cost to all parties.

24. 2.5.3.5 Technical and Past Performance Instructions pg 159 of 180, Section 2.5.3.5 states “Please indicate the name of the business on the first page only of every volume in the proposal. DO NOT place business name on every page of the proposal.” Is the government requesting a sanitized/redacted version of our proposal where all company names, addresses, logos, references and other identifiable information is removed after the first page? Yes.

25. Can an NP see patients in the CBOC if they are supervised by CBOC Physician from another location? A supervising physician must be on site.

26. Will the government be doing site visits prior to award? If so, how much advance notice will the contractor be given? As stated under Factor 2 of FAR 52.212-2 a Site Visit may be conducted to determine acceptability. It depends; however, a minimum of at least one-week advance notice will be provided by the VA.

27. Will the VA or the Contractor be financially responsible for the cost of 10-day bridge medications? Contractor – this is a change from previous solicitations/contracts

28. Will the contractor or the VA be responsible for paying for POC equipment, validation and supplies?

The POC supplies, consisting of Roche ACCUCHEK Inform II whole blood glucose meters, WBG reagent strips and QC, Urine Pregnancy kits and QC, are provided by SLVHCS (VA).

This is to ensure consistency of testing throughout all clinics under SLVHCS (VA) oversight.

29. Does the VA require the Tele-health tech to be a Medical Assistant or LPN? MA or LPN- either is acceptable as long as the MA can provide the competencies are met. (Refer to TCT section 2.5.1 page 28)

30. Will the new contractor inherit the patient’s last vesting visit and be allowed to bill for one year from that date upon contract award? The billable rosters will be rolled over for the first period of performance.

31. Please explain why the VA believes the enrollment at the clinic will increase while VetPop shows a declining Veteran population in the catchment area. Please indicate which zip codes or counties the VA expects to grow during the life of the contract.

Veteran with various zip codes are listed in the attachment below.

32. Is the contractor responsible for providing services to traveling Vets? If so, how many are anticipated per year? Yes, number is small and no actual stats are available

33. Would the VA consider beginning the startup period on the day that the protest period has expired as opposed to the date of the contract award? The VA will follow Section 6.1 for start-up, a notice to proceed will be issued at the appropriate time.

34. How many VA staffed personnel will be providing services at the CBOC? Please list by job title and number of days per month. No VA Staff will be stationed at the CBOC

35. Please confirm that the courier service costs will be borne by the contractor. Confirmed.

36. What is the veteran population in the catchment area by zip code?

37. How will PCMHI be provided? In person or via telehealth? Both

38. How many VA telehealth rooms does the VA required and for what specific services? At a minimum, one telehealth is required. Services is for PCMHI, MH, Compensation and Pension as needed, basically any services that is needed and can be rendered such as dermatology and possibly cardio.

39. Is the contractor responsible for providing a primary care LMSW? Yes

40. What is the current PM/PM rate at the existing CBOC? Rule #4 is FOIA Exemption #4. Release of “unit prices”/capitated rates would have our incumbent suffer “substantial competitive harm” so therefore is not releasable. Each solicitation stands on its own merit.

41. Are existing employees under a collective bargaining agreement? No

42. Does the current PC floorplan meet the requirements of the RFP or does the VA require the PACT design of Onstage/Offstage? Each solicitation and contract stands alone, so unable to provide answer to this question. This will not be determined until evaluation phase has been completed.

43. Will the government confirm who is responsible for supplying ALL of the following vaccines? Are there any additional vaccines required to be supplied by the contractor? VA provides the vaccines:

TDAP

Pneumovax 23 Prevnar 13

TD

Flu High dose flu Shingrix Twinrix (hep a &b) Hep A Hep B

HPV

Tubersol (PPD) (not a vaccine)

44. Does the VA wish to continue the use of a security guard? Armed or Unarmed? Yes, armed. Refer to PWS 4.7.5 and 4.7.9.

45. Does the VA require the contractor to purchase a refrigerated centrifuge? No; preferred but not required.

46. Is the VA supplying the phones and phone system? Yes

47. Is the Women’s Health room required to have a bathroom? Yes

48. How many IT closets are required? One

49. Does the clinic need a DEA number? The VA requires each medical provider to have their own number for prescription tracking purposes.

50. How many exam rooms per provider? Two rooms per provider is a minimum requirement

51. Is a consultation room need for each provider? Yes, as stated in the solicitation.

52. How many procedures rooms does the contract require? At a minimum, one.

53. Is group care room the same as BH group room? If BH is Behavioral Health, then yes.

54. In total, how many group rooms are required for this facility and what are the size requirements? Refer to PWS Section 4.7, offerors to make that determination based on the solicitation.

55. Please clarify if this contract is a 1-year base plus 4 option years or is this a set 5-year contract. This is a five-year term and FAR 52.212-2 should be corrected (page 163):

(5) Factor 5 – Price.

(a) Offerors shall submit their Price using the Schedule of Services continuation section (Price Schedule). The price proposal shall be specific, complete in every detail, and separate from the technical proposal. Line items for base period and each option year each Period of Performance for the five-year(s) shall be sufficiently completed.

56. What staffing models do the most successful CBOC’s follow? The PACT model.

c. Are there any other CBOC’s that utilize this staffing model and is it successful? Yes

d. Are the Clerical Associates that are part of the PACT also expected to function in the capacity of front office staff checking patients in and out? Yes. Each clerk is ¼ of the PACT.

57. What diagnosis codes (PC vs.MH) are the most prevalent. Varies

58. How many patients are typically seen a day in the clinic PC vs. MH? Varies, usually 10-12 for PC

59. Pharmacy P.21 – Last paragraph under position responsibilities….provide the needs of enrolled patients functioning in the capacity of a mid-level provider…CPS functions supporting PACT teamlets.

60. 2.4.2 Please clarify – item is noted to be N/A but the note is indicating VA provided. The CPS Anti-coagulation is provided by VA

SUPPORTING OUR VETERANS DURING THEIR TRANSITION FROM UNIFORMED SERVICE TO CIVILIAN LIFE

61. How many veterans are discharged a year from this area? Varies

62. Is there a projection on how that will impact clinic volumes? No.

63. According to the solicitation requirements, I'm aware of the PACT Team expectations based on what's outline in the Solicitation. Are you able to provide the current staffing breakdown of the current incumbent? No, each solicitation stands on its own merit and this is will be evaluated with offers.

64. Are you able to provide a break down on the total number of specialty visits that occur during a calendar year? For instance, Total # of Psychiatrists, Podiatrists, OB/GYN MDs encounters, etc. within a calendar year? No, Refer to Attachment D1 for stats that are available. Podiatrists are not applicable.

65. Is the contractor required to provide a Letter of Intent with the landlord of any proposed locations? Yes, under Addendum to 52.212-2, Factor 2, 1st bullet, add the following: Offerors shall provide a Letter of Intent from Landlord for proposed facility.

66. Does the VA need to know estimated time for build-outs, permit process?

Yes, under Addendum to 52.212-2, Factor 2, 7th and last bullet, add the following: Offerors shall also provide an estimated timeline of any proposed build-outs to include permits.

See attached document: ATT D42 -VHA HDBK 1907.01 4.6.31.1.17.

See attached document: ATT D43- VHA DIR 1605.01 4.6.31.1.17.

See attached document: insert and replace TOC for 36C25618R0078.

See attached document: Insert and replace PRICE SCHEDULE-REV.

End of Document image1.emf

Clinic Stops and Persons (Houma).xls Clinic Stops and Persons

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Data Current Through: Apr 10 2018

Product Last Updated Apr 10 2018

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ENCOUNTERS(UNDUPLICATED) UNIQUES NEW UNIQUES

Clinic Identifier Fiscal Month Cumulative Monthly Clinic Stops per Uniques Cumulative Monthly New Uniqs Cumulative New Uniqs Monthly New to VHA New to VISN New to Facility New to Division New to Clinic

(323) PRIMARY CARE/MEDICINE

(V16) (629GA) Houma

SEP-FY17 5,680 572 1.83 3,109 503 21 21 8 2 1 4 6

(502) MH CLINIC IND

(V16) (629GA) Houma

SEP-FY17 3,253 347 2.88 1,128 305 20 20 2 18

(527) TELEPHONE/PSYCH

(V16) (629GA) Houma

SEP-FY17 137 16 1.63 84 14 7 7 7

(550) MH CLINIC GROUP

(V16) (629GA) Houma

SEP-FY17 490 23 4.85 101 13 0 0

(562) PTSD-INDIV

(V16) (629GA) Houma

SEP-FY17 64 3 6.40 10 1 0 0

If no results are returned validate the selections you have made in the parameters. Please see data definitions for complete explanation.

• If Summary Level = National, then VISN, Facility and Division Parameters must say 'Default'

• If Summary Level = VISN, then Facility and Division Parameters must say 'Default'

• If Summary Level = Facility, then Division Parameter must say 'Default'

&L&"Arial"&8&F Page &P of &N &C&"Arial"&8 4/11/2018 10:09:19 AM &R

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Clinic Stops and Persons (Houma).xls Clinic Stops and Persons

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Clinic Stops and Persons

Data Definitions

Data Current Through: Apr 10 2018

Product Last Updated Apr 10 2018

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How does the Summary Level work?

Rate Report

Click here to see Year to Year Comparison

Click here to see New Unique SSNs

ENCOUNTERS(UNDUPLICATED) UNIQUES NEW UNIQUES

Clinic Identifier Fiscal Month Cumulative Monthly Clinic Stops per Uniques Cumulative Monthly New Uniqs Cumulative New Uniqs Monthly New to VHA New to VISN New to Facility New to Division New to Clinic

(323) PRIMARY CARE/MEDICINE

(V16) (629GA) Houma

SEP-FY17 5,680 572 1.83 3,109 503 21 21 8 2 1 4 6

(502) MH CLINIC IND

(V16) (629GA) Houma

SEP-FY17 3,253 347 2.88 1,128 305 20 20 2 18

(527) TELEPHONE/PSYCH

(V16) (629GA) Houma

SEP-FY17 137 16 1.63 84 14 7 7 7

(550) MH CLINIC GROUP

(V16) (629GA) Houma

SEP-FY17 490 23 4.85 101 13 0 0

(562) PTSD-INDIV

(V16) (629GA) Houma

SEP-FY17 64 3 6.40 10 1 0 0

If no results are returned validate the selections you have made in the parameters. Please see data definitions for complete explanation.

• If Summary Level = National, then VISN, Facility and Division Parameters must say 'Default'

• If Summary Level = VISN, then Facility and Division Parameters must say 'Default'

• If Summary Level = Facility, then Division Parameter must say 'Default'

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Users and Enrollees by State (Drill down on state to Zipcodes)).xml

Pyramid Analytics Wednesday, April 11, 2018

Users and Enrollees by State (Drill down on state to Zipcodes)).xml

Pyramid Analytics