36C25621R0091 0005.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

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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 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

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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)

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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-0018

Department of Veterans Affairs Network Contracting Office 16 Michael E. DeBakey VA Medical Center 2002 Holcombe BLVD Houston TX 77030 4298 Department of Veterans Affairs Network Contracting Office 16 Michael E. DeBakey VA Medical Center 2002 Holcombe BLVD Houston TX 77030 4298 To all Offerors/Bidders

36C25621R0091 09-19-2021

X X X

X This solicitation amendment includes answers to all questions asked during the solicitation phase.

Response date has been extended until November 05, 2021 @ 3:00 PM CST.

Contractor shall submitt signed copies of all amendments with their proposal submission.

Corey Labbe Contract Specialist Amendment:

Solicitation: 36C25621R0091 Questions and Answers #1

The Network Contracting Office (NCO) 16 received questions in response to Request for Proposal (RFP) 36C25621R0091

Please see below for the Contractor’s questions and NCO 16’s respective answers accordingly.

2. Please clarify if this is the correct ratio. Please verify estimated PACT team numbers.

3. Please verify that discipline specific team members that contractor will be responsible to provide

2.1. MINIMUM PATIENT ALIGNED CARE TEAM (PACT) STAFFING REQUIREMENTS:

PACTs comprise the patients, the patients’ personal support persons, teamlets (Primary Care Providers (PCPs), Registered Nurse Care Managers (RNCMs), Clinical Associates, Administrative Associates), and discipline specific team members (Clinical Pharmacy Specialists (CPSs), Licensed Clinical Social Workers (LCSWs), Registered Dietician/Nutritionists, and Primary Care-Mental Health Integration (PCMHI) staff. The Contractor shall provide PACT staffing in numbers and qualifications capable of fulfilling the standards outlined in the resultant contract.

Primary Care Providers of at least three full time equivalent (FTE) support staff (1 FTE RNCM, 1 FTE Clinical Associate, 1 FTE Administrative Associate) for each FTE Primary Care Provider

8. The contractor is unable to network contractor owned equipment to VA network if it is not owned and operated by VA, yet 4.11.1.5 states the contractor shall provide installation and maintenance of all printers, copiers, scanners, fax machines*, shredders, or other peripheral office equipment and all related and ongoing supplies (paper, toner, ink cartridges) required to operate the equipment in support of the facility under the specifications of this contract.

Will the government please provide a list of the equipment the VA will supply the contractor, such as copiers, fax, printers, scanners, or other peripheral office equipment or lab label printers that can be connected to the network?

SECTION 4.11.1 The Contractor shall be responsible for:

4.11.1.5 the procurement, installation and maintenance of all printers, copiers, scanners, fax machines*, shredders, or other peripheral office equipment and all related and ongoing supplies (paper, toner, ink cartridges) required to operate the equipment in support of the facility under the specifications of this contract.* OIT will provide certain printers, scanners or other peripheral that is approved to meet OIT standards for this location on the OIT network only.

four (4) L6-20 receptacles one (1) L6-30 receptacle in the closet Yes, this should be adequate, but is dependent and the size and scope of the Clinic.

Offerors shall provide copies of the following on any nurse practitioner(s) to be assigned to perform services under the contract, including any nurse practitioner(s) to provide coverage relief:

16. Does the Government require both a phlebotomist and medical laboratory technician (MLT) for this facility? Will the VA accept an MLT whose duties include phlebotomy?

PWS Section 2.5 Ancillary Support Services A Medical Laboratory Technician is required but can also perform Phlebotomy if workload allow and great customer service is maintained.

17. The solicitation mentions a separate space for telepsychiatry, are any additional telehealth rooms required? If so, how many?

PWS Section 4.9.1 Space Requirements Three rooms total are needed for tele health and they can be multipurpose rooms. 1 Room for TeleRetinal clinic. this room must be wheelchair assessible. 1 room for CVT and Telederm clinic. this room must have an exam table in it and sink. 1 room for Mental Health/Telepharmacy. 3 rooms will be enough.

18. How many Women’s Health exam rooms are required? Would each PACT team need their own Women’s Health exam room?

One room for each PACT Team

19. Does each PACT Team require a consultation room?

Each PACT Team does not require a consultation room as long as there are enough rooms that can be shared and are available for this purpose.

20. How many discipline specific offices will be required for VA staff?

PWS Section 4.9.1 Space Requirements 6 offices for MH staff.

30. On page 21 paragraph 2.4.4 of the Solicitation states, Registered Dietitian/Nutritionist: Services will be provided by the parent VAMC via telehealth (by referral), individual instructions and group classes, and/or telephone clinic.” And on page 78 paragraph 4.7.6.6 of the Solicitation states, “Contractor shall ensure that Dietitians electronically complete an Event Capture System form for all direct patient care, whether individual visits, group visits or team meetings that discuss individual patients.” If the parent VAMC is providing the Registered Dietitian/Nutritionist, wouldn’t the VAMC ensure that the Dietitians electronically complete the Event Capture System form and not the Contractor?

Yes, VA personnel will need to track reports to ensure no gaps in request are pending at the CBOC. Registered dietitians are required to document workload for all patient care visit using the ECS system and are monitored to ensure compliance.

1 Room for TeleRetinal clinic. this room must be wheelchair accessible. 1 room for CVT and Telederm clinic. this room must have an exam table in it and sink. 1 room for Mental Health/Telepharmacy. 3 rooms will be enough.

37. Please clarify how imaging films will be integrated between EMR. Will the VA accept disks sent to the VA for review

4.6.4.1 RADIOLOGY SERVICES – The Contractor is responsible for entering requests for radiology procedures into the VA EHR. All imaging orders shall be clinically appropriate. X-rays and other radiological services shall be performed by the parent facility’s radiology department or by a community facility via consult entered by the ordering contract provider. The contractor provider will assist the Veteran in making the radiological service choice based on community care eligibility consult tool in the CPRS HER.

X-rays performed at VA or through community care can be viewed by the Contractor through the VA EHR Imaging and the PACS. All studies must be transferred to the VA EHR Imaging and must be available in the VA EHR Imaging for the ordering clinician and others to review so that patient care delays are avoided X-rays performed at VA or through community care can be viewed by the Contractor through the VA EHR Imaging and the PACS. All studies must be transferred to the VA EHR Imaging and must be available in the VA EHR Imaging for the ordering clinician and others to review so that patient care delays are avoided.

The Government will be responsible for all cost related to VA provided Radiology Services.

38. Please clarify if the contractor is to provide HUD VASH LCSW

4.6.5.5.12 HOMELESS PROGRAMS: To ensure the availability of outreach and referral services to homeless Veterans, all contractor sites must designate at least one outreach specialist, usually a clinical social worker, to provide services to homeless Veterans. Contractor sites with 10,000 or more patients shall have a dedicated specialist. In smaller sites serving less than 10,000, this may be a collateral assignment.

Homeless Services are provided by the Medical Center. Our Outreach Specialists for the Homeless Programs are located here not at the contract site. Our contract Social Workers refer Homeless services to the Homeless Program.

Enrollment 2021: 5279, 2020: 5306, 2019: 5464, 2018: 5155, 2017: 5123 (Source VSSC)

40. How many VA staffed personnel will be providing services at the CBOC? Will the Government please list job title and number of days per month.

It is anticipated that a LCSW will be required at CBOC 40 hours per week to handle anticipated mental health workload effectively. 6 Mental Health Staff 5 days a week.

41. Will the VA provided staff require an office at the CBOC? If yes, what type and size?

Yes. 6 offices at 8x8.

42. Will the VA require a clinic manager?

Yes

43. On page 186, the RFP states, "Offerors shall submit documentation of current workload ratio for patients per physician per day." Since we are not the incumbent and do not have access to the workload ratio, can the Government please clarify this requirement?

Offerors shall submit their current incumbent workload ratio of existing patients visits per provider per day via face to face, telephone, or VVC visits to meet this requirement.

44. On page 16 paragraph 2.1 of the Solicitation states, “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.” Is it acceptable to utilize a PACT team member for CPS support?

Yes, the support for the CPS can be shared support for the clinic unless the volume of patients would necessitate a full-time staff member support for the CPS.

45. On page 16 and page 17 sections 2.2 and 2.3, can the government please clarify if Board Eligible physicians/CMDs are acceptable?

Yes, Either Board Certified or Board Eligible is acceptable.

46. On page 21 paragraph 2.4.4 of the Solicitation states, Registered Dietitian/Nutritionist: Services will be provided by the parent VAMC via telehealth (by referral), individual instructions and group classes, and/or telephone clinic.” And on page 78 paragraph 4.7.6.5 of the Solicitation states, “Contractor shall ensure that Dietitians electronically complete an Event Capture System form for all direct patient care, whether individual visits, group visits or team meetings that discuss individual patients.” If the parent VAMC is providing the Registered Dietitian/Nutritionist, wouldn’t the VAMC ensure that the Dietitians electronically complete the Event Capture System form and not the Contractor?

Yes, VA personnel will need to track reports to ensure no gaps in request are pending at the CBOC. Registered dietitians are required to document workload for all patient care visit using the ECS system and are monitored to ensure compliance.

47. On page 23 paragraph 2.8 of the Solicitation states, “Telehealth Clinical Technician (TCT) FTE Ratio performance standard 1.0 FTE Telehealth Clinical Technician (TCT) per estimated 5,000 patients at clinic, with a trained back-up (e.g., another TCT or a member of the PACT Teamlet (LIP, RNCM, or LPN), depending on size of clinic/clinic workload/clinic telehealth services).” Is it acceptable to utilize an LPN or an MA for the TCT position?

Yes, as long as they are trained.

48. On page 32, Federal Holidays – Juneteenth Holiday is missing. For clarity, should this be added to the list of VA Holidays?

Yes

50. On page 64 paragraph 4.6.5.4 of the Solicitation states, “The Contractor shall provide the following clerical support services for mental health providers (including VA providers if VA provides MH services onsite) at the CBOC.” And on page 95 under the Space Requirements for Mental Health of the Solicitation states, “Contractor shall provide space and administrative support for 5 VA mental health practitioners who will provide services to enrolled CBOC patients in person or via teleconferencing.” Is it acceptable to utilize PACT team members for clerical/administrative support of the VA mental health providers or will dedicated clerical/administrative support be required? If dedicated support is required, how many FTEs does the VA prefer the Contractor provide?

Yes, duties can be share depending our size of patient volume and case mix.

51. On page 79 paragraph 4.6.8.4 states, “The Contractor shall provide space for clinical pharmacy telehealth services at the Contractor’s location as appropriate.” On page 79 paragraph 4.6.8.4.1 states, “Space should provide privacy for patients to meet confidentially in an individual or group setting with providers at the VA via electronic transmissions.” On page 95 it indicates the Contractor is to provide a private group room at least 300 sq. ft. in size for mental health. Also, on page 96 it indicates the contractor is to provide individual or group setting with providers at the VA via electronic transmission for telepsychiatry. Is the Contractor required to provide a clinical pharmacy telehealth services group room, a telehealth group room and a telepsychiatry services group room for a total of 3 group rooms? If not, how many and what type of group rooms would the VA like the Contractor to provide?

Yes 3 rooms are required. One of the three required rooms need to be a group room. 1 Room for TeleRetinal clinic. this room must be wheelchair accessible. 1 room for CVT and Telederm clinic. this room must have an exam table in it and sink. 1 room for Mental Health/Telepharmacy. 3 rooms will be enough. One of these rooms may be a group room.

52. On page 77 paragraph 4.6.7 of the Solicitation states, “Contractor shall implement VHA Telehealth Services…” and states, “It is the responsibility of the contractor to ensure that all telehealth services provided by contractor’s staff meet all such requirements. Staff, Space and Equipment requirements shall be as required by this document.” On page 77-78 paragraph 4.6.8 states, “The veterans may visit with primary care VA providers, specialty care providers and rehabilitative service providers over a proprietary VA Telehealth Network that initially includes Tele-Retinal, Tele-Dermatology, Tele-Pharmacy and Mental Health Services. Primary care providers may refer for other telehealth consultative services from specialty providers and rehabilitative service providers.” On page 78 paragraph 4.6.8.1 of the Solicitation states, “The Contractor shall provide teleretinal imaging services...” On page 78 paragraph 4.6.8.3 states, “The Contractor will support for VA provided tele-mental health services.” And on page 79 paragraph 4.6.8.4 states, “The Contractor shall provide space for clinical pharmacy telehealth services at the Contractor’s location as appropriate.” In addition to the group rooms asked about in question 10 above, how many individual telehealth rooms are required by the VA?

Three rooms are required. 1 Room for TeleRetinal clinic. this room must be wheelchair accessible. 1 room for CVT and Telederm clinic. this room must have an exam table in it and sink. 1 room for Mental Health/Telepharmacy. 3 rooms will be enough. One of these rooms may be a group room.

53. On page 95 paragraph 4.9.1 of the Solicitation states, “Contractor shall provide space and administrative support for 6 VA mental health practitioners who will provide services to enrolled CBOC patients in person or via teleconferencing.” In addition to the group rooms and telehealth rooms in questions 10 and 11 above, is the Contractor to provide space for 6 VA mental health practitioners? What is the total number of dedicated offices, exam rooms, telehealth rooms, group rooms and exam rooms that will be needed for VA staff at the Hattiesburg CBOC and how many are shared rooms with Contractor staff?

No, the 6 exam rooms do not include the mental health exam room. A mental health exam room is required but can be a shared room.

54. On page 94 paragraph 4.9.1 of the Solicitation includes a table with minimum space requirements which includes the number of required exam rooms per PACT Teamlet. And on page 95 it states, “Contractor shall provide space and administrative support for 6 VA mental health practitioners who will provide services to enrolled CBOC patients in person or via teleconferencing. Exam room(s) should be available for mental health services.” Do the exam rooms listed on page 94 for the PACT Teamlets included in the exam room(s) for mental health services, or are separate exam rooms required for mental health staff? If separate mental health exam rooms are required, how many exam rooms required by the VA?

No, the 6 exam rooms do not include the mental health exam room. A mental health exam room is required but can be a shared room.

55. On page 96 under Telepsychiatry, last sentence states, “The Contractor’s non-medical MH LCSW will”. It is an incomplete sentence. What was the VA trying to state in this sentence?

The Contractor’s non-medical MH LCSW will facilitate use of the equipment for the veterans.

56. On page 103 paragraph 4.8.21 of the Solicitation states, “Closed Circuit Television (CCTV): Shall be provided by the Contractor to monitor building entrances, restricted areas, mission critical asset areas, and alarm conditions. CCTV system shall be used for surveillance and observations of defined exterior areas, such as site and roadway access points, parking lots, and building perimeter, and interior areas such as hallways, common areas and waiting areas, CCTV system will be viewed from a VA location determined by the VA Physical Security Officer.” When the VA states the “CCTV system will be viewed from a VA location determined by the VA Physical Security Officer”, does that mean the VA will decide where within the CBOC the CCTV system can be viewed? Does the VA need to monitor the CCTV activities remotely or is the Contractor’s CCTV system required to record activity at the CBOC facility and be available to the VA for playback if needed? Will the VA please clarify? Could the government please confirm if there is any preference in using Dome and Bullet cameras versus Fisheye or 360 cameras?

There is no current requirement of VA monitoring by the VA Security Officer.

57. Per RFP Section 4.11, all equipment attached to the VA network will be owned by the VA. Question: The contractor is unable to network contractor owned equipment to VA network if it is not owned and operated by VA, yet 4.11.1.5 states the contractor shall provide installation and maintenance of all printers, copiers, scanners, fax machines*, shredders, or other peripheral office equipment and all related and ongoing supplies (paper, toner, ink cartridges) required to operate the equipment in support of the facility under the specifications of this contract.* Please provide a list of the equipment the VA will supply the contractor, such as copiers, fax, printers, scanners, or other peripheral office equipment or lab label printers?

OIT will provide certain printers, scanners or other peripheral that is approved to meet OIT standards for this location on the OIT network only.

58. Per RFP Section 4.11.1.8, one small desktop color printer for printing patient education information. Question: Please confirm that VA will supply small desktop color printer for patient education documents since contractor owned equipment is not permitted on VA network?

VA will provide network printers as appropriate.

59. Per RFP Section 4.6.2.4.7 Thin prep: The RFP states contractor will provide supplies for PAP testing. If the contractor is not able to purchase Thin Prep, will the VA supply?

If it is confirmed that the contractor cannot purchase required supplies the Medical Center will facilitate providing the needed supplies when appropriate.

60. Per RFP Section 4.9 SPACE REQUIREMENTS: Question: Does the current clinic meet the space requirements as outlined in section 4.9 of the RFP?

YES

61. On page 93, Section 4.9, Contractors shall provide space that meets the standards outlined in the PACT Space Module Design Guide. Will the Government please confirm if VA will provide the phone circuit and physical phones?

VA will not provide telephones or telephone service to the CBOCs.

62. On page 104, Section 4.11.1.1 CAT 6 wiring. Will the Government please confirm if CAT 6 wiring is preferred and not CAT 6A?

CAT 6A is required

63. On page 107, Section 4.10.2.5 Power Requirements four (4) L6-20 receptacles one (1) L6-30 receptacle in the closet. Could the government please confirm the Power Requirements and if two 20-amp dedicated receptacles are acceptable?

Yes, this should be adequate, but is dependent and the size and scope of the Clinic.

64. On page 107, Section 4.10.2.6.6 Racks - both racks will have 2 shelves on the bottom installed to hold IT computers. Could the government please confirm if shelves are required?

The configuration of the shelves can be variable if they are setup to all the proper functioning of the equipment and ability to clean the area when appropriate.

65. Will individual offices/consult rooms be required for all five (5) discipline specific PACT team members provided by the VA?

Section 4.9.1 Each PACT Team does not require a consultation room as long as there are enough rooms that can be shared and are available for this purpose.

66. Will patient consult rooms be required for each PACT team?

Each PACT Team does not require a consultation room as long as there are enough rooms that can be shared and are available for this purpose.

67. Does each PACT team require a WH Exam room? If not, how many are required?

One room for each PACT Team

68. Can WH Exam rooms be included in the PACT exam room count?

Yes, but the WH exam rooms should be attached to a bathroom.

69. Will individual telehealth exam/consult rooms be required for Tele-Retinal, Tele-Dermatology, Tele-Mental Health, and Telepharmacy Support Services in addition to Tele-Psychiatry?

Section 4.6.8 Yes, an individual room exam room will be needed.

70. Will the VA require radiology services be provided on-site?

Section 4.6.4.1 The Government will be responsible for all cost related to VA provided Radiology Services.

71. Total Estimated Patients enrolled/assigned to site: 5700.” Please provide the most recent 3-month billing figures/members/enrollees.

SectionB.2 Primary Care 5029 Mental Health 341 Monthly average volume (last Billable of Enrollees)

72. Would the government be willing to reconsider the staffing requirements for nurse practitioners and only required CVs and licenses, waiving the requirement for transcripts and graduation certifications? Aside from the current requirements favoring the incumbents, the VA will be duplicating efforts upon contract award and credentialing. Upon contract award, the majority of these items will be recollected by the VA credentialing team utilizing Primary Source Verification.

Section: Evaluation Factors No

73. Will the VA please provide the actual number of enrollees based on the last invoice?

Section B.2 Primary Care 5029 MH 341 (last billable of enrollees)

74. How many veterans are currently on the Hattiesburg, MS CBOC Primary Care invoice (most recently billed by the current vendor)?

Primary Care 5029 Mental Health 341 Monthly average volume (last billable)

75. Can the government provide a breakdown showing the number of enrollees by the enrollee’s home zip code?

Grand total of 5290 zip codes

76. In paragraph 2.3.3 Teamlet Member 3: Clinical Associate: It lists Option 1 as a Licensed Practical Nurse (LPN), and Option 2 as Licensed Vocational Nurse (LVN). Will a Medical Assistant (MA) also work to fulfill the Clinical Associate requirement for the PACT team?

LPN/LVN required

77. Please list all positions the VA will staff on site at the CBOC by title and number of hours per week/month those employees will be on site.

PCMHI and MH LCSW 40 hours a week.

6 Offices.

78. Will the Contractors proposed space be required to meet the on-stage/off-stage design with the PACT Zone?

Yes

79. Is the current facility and existing layout of the clinic acceptable to the VA?

Yes

80. In section 4.10.2.6 of the solicitation item (f/Gf), it states:

Racks:

· Two standard 19” wide data/relay racks; one to support network equipment, one to support PC/Servers, similar to the one displayed below

· height from 40-48 RU and a depth no less than 21”

· secured and grounded to the floor

· placed such that at there is at least 3 feet in the front of and behind the rack

· either aluminum or steel construction and the holes should be standard 10-32 tapped

· both racks will have 2 shelves on the bottom installed to hold IT computers

· infrastructure installer should install Leviton CAT6 patch panels and connectors in the rack

Cable Management:

· cables should be installed to the patch panel at the hinged end so that the articulation of the panel doesn’t stress the terminations

· vertical cable trough on both sides of rack

· horizontal cable troughs between patch panels

Based on our calculations it will not be possible to place 2 data/relay racks in a 10x10 room and maintain the required building code clearances around the racks. Will the VA allow the contractor to install a single relay/rack to meet all the above requirements?

The configuration of the shelves can be variable if they are setup to all the proper functioning of the equipment and ability to clean the area when appropriate.

81. Sub-Factor B – Quality Staffing – For the NPs: Can resumes and licenses be submitted with the proposal and transcripts from the accredited NP Program be submitted post award?

No

82. In Section B.2 Schedule of Services on page 6 of the Solicitation states, “* All unit prices shall be a Fixed-Price (FP) and all inclusive. Any build out cost incurred shall be the responsibility of the contractor. The government will only pay for services identified in PMPM rate. PMPM includes cost of unassigned patient visits, contractor shall not bill separately or propose an additional Line Item or bill separately for these costs." Does this mean that the contractor cannot include the costs of its buildout as line items in the calculation of the PMPM rate? And, if this is the case, and no VA funds can be used to offset the costs of buildout, then why is the contractor required to pay Davis-Bacon wage rates for construction, as specified in Section 4.9, on page 94 of the Solicitation?

We are required in solicitations where build-out may result, to identify the applicable Davis-Bacon wages. However, build-out costs and associated functions in this solicitation/requirement will be the responsibility of the contractor. It is at the discretion of the contractor on what they would like to submit for their PMPM rate as one line item in accordance with the solicitation requirements.

83. On page 125 paragraph 6.2.1.1.4 states, “the billable roster for the PC CLIN will include all patients assigned to the Contractor’s site of care in PCMM with at least one qualifying encounter by the Contractor’s Primary Care provider within the previous 12 months.” Will the current PCMM assigned patient’s previous 12 month qualifying encounter rollover to the new Contractor for PC patients, and be billable on day one?

Yes

84. On page 109 paragraph 6.1.2 of the Solicitation states, “The Contractor shall have 90 days from contract award to commencement of the provision of medical care to local Veterans.” Based on the size, scope and logistics of drawings, permits, and realistic construction timeframes, would the VA consider a 180-day start-up period for the cost effectiveness and efficiency for all systems start-up components?

Yes

85. On page 177 it states, Offeror shall complete and submit the following in two separate proposal volumes: Volume I – Price and Volume II – Completion of SF1449, Signed Amendments, Clauses/Provision fill-in and attachments. Volume III - Technical Capability, Geographic Location/Accessibility, Past Performance, Veterans Participation, and Subcontracting. Can the Government please confirm that three (3) Volumes are required for a compliant proposal submission? Volume 1 – Price; Volume 2 - Volume II – Completion of SF1449, Signed Amendments, Clauses/Provision fill-in and attachments; and Volume III – Technical Capability, Geographic Location/Accessibility, Past Performance, Veterans Participation and Subcontracting).

Yes 3 volumes are required.

In regard to Addendum to FAR 52.212-1 Instructions to offerors the following clarification to the submission Volumes is outlined below.

Volume 1

· Price Volume II

· Completion of SF1449, Signed Amendments, Clauses/Provision fill-in and attachments Volume III

· Volume III - Technical Capability, Geographic Location/Accessibility, Past Performance, Veteran Participation and Subcontracting

86. On page 177 it states for Volume II – Completion of SF1449, Signed Amendments, Clauses/ Provision fill-in and attachments, under number 6 states, “the Offeror must return a signed copy of the following documents from section D Attachments:” and lists D.3 Small Business Subcontracting Plan/Certification and D.4 Subcontracting Plan. However, in Volume III – Technical Capability, Geographic Location/Accessibility, Past Performance, Veteran Participation and Subcontracting, it also lists Section 4. Veteran Participation and Section 5. Subcontracting. The Subcontracting Plan is listed in Volume II and Volume III. Which Volume should the Contractor submit their Subcontracting Plan?

In regard to Addendum to FAR 52.212-1 Instructions to offerors the following clarification to the submission Volumes is outlined below.

Volume 1

· Price Volume II

· Completion of SF1449, Signed Amendments, Clauses/Provision fill-in and attachments

· Volume III - Technical Capability, Geographic Location/Accessibility, Past Performance, Veteran Participation and Subcontracting

87. In the Instructions to Offeror section of the Solicitation on pages 177-178 indicates the completion and submission of the following items will constitute Volume III and includes Sections: 1 Technical Capability, 2 Geographic Location/Accessibility, 3 Past Performance, 4 Veteran Participation and 5 Subcontracting. On pages 178-179 it states the following will be included and legible in each of the respective sections of Volume III and includes: Section 1 Technical – Offeror Capability which include Offeror’s Capability/Experience; Quality Staffing; Coordination and Continuity of Care, Key Personnel, including salary range worksheet and other supporting documents; and Implementation Plan. It also includes Section 2 Geographic Location/Accessibility, Section 3 Past Performance, Section 4 Veteran Participation, and Section 5 Subcontracting. And on page 185 in the Evaluation Factors, the Technical Capabilities lists: a) Offeror’s Capability/Experience, b) Quality Staffing and c) Implementation Plan, but does not mention anything about Coordination and Continuity of Care and Key Personnel. Is Key Personnel and Coordination and Continuity of Care part of the evaluation? If so, what does the VA want the Contractor to address in Key Personnel and Coordination and Continuity of Care?

In regard to Addendum to FAR 52.212-1 Instructions to offerors. Section 1 is as follows.

Section 1 Technical – Offeror Capability

Offeror’s Capability/Experience

Quality Staffing

Key Personnel, including salary range worksheet and all other supporting documents

Implementation Plan

Remove “Coordination and Continuity of Care”

Quality staffing will include all staff CVE’s, licenses and certifications if applicable.

In response to the inclusion of “Salary Worksheets” this will assist the Contracting Officer in determining the PMPM rates are fair and reasonable as well as assist the Contracting Officer in determining fair and reasonable pricing to any future Contract Modification requesting additional staff.

88. Will the new contractor inherit the patients’ last vesting visit and be allowed to bill for one year from that date upon contact award?

Yes

89. Per RFP Section 6.1.2, performance shall begin no later than 90 days after effective date of contract award. Question: The RFP states the VA will provide the primary telecommunications lines, installation of such lines is taking 180 days and beyond, does the VA have a contingency plan to provide data lines within the required 83 days after award? If not will the VA consider extending the clinic start date?

Yes VA will extend start date.

91. Will the VA be updating the Wage Determination (2015-5151) to be utilized for this solicitation? The WD included with the solicitation is dated 5/22/2020 (Revision No: 13). The latest WD is dated 7/21/2021 (Revision No: 16).

Yes

92. Past Performance is requested both in Volume 2 #6/D.6 and in Volume 3, Section 3. Please confirm that you would like a response in both areas and if not, which one?

Both areas.

93. On Page 177 of 208, in the Instructions to Offerors – it states that proposal will consist of two separate proposal volumes, but then it lists three volumes total. Should Volume 1 and 2 be combined and then Volume 3 be separate?

In regard to Addendum to FAR 52.212-1 Instructions to offerors the following clarification to the submission Volumes is outlined below.

Volume 1

· Price Volume II

· Completion of SF1449, Signed Amendments, Clauses/Provision fill-in and attachments

· Volume III - Technical Capability, Geographic Location/Accessibility, Past Performance, Veteran Participation and Subcontracting