36C25622R0004-0002.pdf

5. PROJECT NUMBER (if applicable)

CODE 7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER 3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO. 1. CONTRACT ID CODE

FACILITY CODE CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office. is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER 16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30 PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243

(Type or print) (Type or print)

(Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code)

(If other than Item 6)

(Specify type of modification and authority)

(such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer)

1 4

04-20-2022

36C256

Department of Veterans Affairs Network Contracting Office 16 5075 Westheimer Road, Suite 750

Houston TX 77056-5643

36C256

Department of Veterans Affairs Network Contracting Office 16 5075 Westheimer Road, Suite 750

Houston TX 77056-5643

To all Offerors/Bidders

36C25622R0004

03-14-2022

X x x 1

The Purpose of this amendment is to publish Questions and Answers.

Christopher D. Vu

VA-VHA-SAOC-2018-E8E15CC2

36C25622R0004-0002

CONTINUATION PAGE

Q.

No.

Question Answer

1 What are the delivery instructions for the proposal? Is email submission acceptable?

Refer to instructions to Offerors on the solicitation addendum to FAR 52.212-1 page 153 of 180 paragraph 1.

2 On page 165, it states that transcripts are required for Nurse Practitioners. Is it acceptable to submit transcripts after award, as transcripts can take weeks to obtain?

Yes

3 Paragraph 4.9 references the PACT Space Module Design Guide. Are the on-stage/off-stage design features of this guide required for the Natchez, MS CBOC?

Yes

4 If on-stage/off-stage design is not required – is there a preference for on-stage/off-stage design?

Not Applicable, see answer above

5 If on-stage/off-stage design is required – is there a preference for sliding doors on the patient side of exam rooms?

No Preference

6 P. 79 states, “The Contractor shall provide a private office, no smaller than 120 square feet, and appropriate office furniture for each VA mental health provider who will work out of the CBOC.” Please confirm the number of VA mental health provides who will work out of the CBOC.

One MH provider

7 What is the minimum required width of hallways in the clinic?

8 Feet

8 What is the minimum required width for doorways?

48 Inches

9 How many telehealth rooms are required for the telehealth services that will be provided at the clinic?

Three (3) Rooms

10 The Solicitation references telesurgery services. Please confirm if the Natchez MS CBOC will provide telesurgery services. If so, is a tele-procedure room required?

A tele-procedure room is NOT required as there will be no tele-procedures performed in the Natchez CBOC. The telesurgery services are for consults and follow-up only.

11 Would the VA provide an extension of 30 days to allow vendors sufficient time to coordinate with third parties and prepare an appropriate response to the Solicitation requirements?

The proposal due date has been extended through 5/4/2022 3:00 PM Central Standard Time

12 Please clarify the phlebotomy staffing requires under paragraph 2.6.2. The table states, “Contractor shall provide Medical Laboratory Technician (MLT) and a Medical Laboratory Technologist (MT),” and Phlebotomist qualifications are also listed in the table. In our experience, a full-time phlebotomist is able to accommodate the workload for a clinic of this size. Is it sufficient for the Contractor to provide one qualified phlebotomist for the Natchez

CBOC?

Either an (MLT or MT) and a Phlebotomist are required.

13 Please confirm that the VA will furnish the mental health services under section 4.6.5.

Yes, VA will furnish MH services

14 Are board-eligible physician acceptable?

Yes, but board certified are preferred

15 Which proposal volume should include the SF1449 and other solicitation fill-in sections?

Volume 1 Technical

16 80 states, “The Contractor’s non-medical MH LCSW will facilitate use of the equipment for the veterans.” We do not see a requirement for the Contractor to furnish a non-medical MH LCSW. Please clarify if the Contractor is to provide any social worker staffing. If so, please provide the qualifications and role for the Contractor provided social worker(s).

The contractor does not have to provide SW staffing.

17 Please confirm the estimated quantities for ordering periods 3

Confirmed, estimated quantities are correct.

and 4 in the Schedule of Service. We note that the estimated quantity goes from 1550 in ordering period 2 to 1660 in ordering period 3 and then back down to 1650 in ordering period 4.

18 Who is responsible for courier services – VA or contractor?

Contractor

19 Will the VA provide the lab specimen tubes?

Yes

20 Will the clinic provide COVID vaccinations?

No, the contractor shall be responsible for administering COVID vaccines that are supplied by the VA

21 What is the current size of the vested patient roster?

22 Does the current clinic location meet the space requirements of this solicitation?

No, upgrades per the solicitation PWS are required.

Current facility or any other facility proposed by the Contractor shall meet the requirements of the solicitation.

23 Will the VA conduct a site visit of proposed sites?

The VA may conduct a site visit.

24 Who is responsible for telephones and the telephone system – VA or Contractor?

Telephones and the telephone systems at the CBOCs shall be provided by the contractor.

25 Paragraph 4.6.4.2.2 states, “This [EKG machine] will be supplied by VA at cost to the contractor.” Can the VA indicate the cost of the EKG machine so that this can be accounted for in vendors’ price proposals?

Paragraph 4.6.4.2.2 is revised to state “This [EKG machine] shall be supplied by the contractor.”

26 Is the network/data room referenced in paragraph 4.12.2 the same room as the communications/technology closet referenced on page 78?

Or are these two separate requirements?

Is the same requirement, Offerors shall comply with the requirements of Paragraph 4.12.2

27 Please confirm the VA will provide all vaccinations in accord with Section 4.6.3.1.

Also, please provide a list of the vaccines to be administered at the clinic.

Yes, VA will provide all vaccinations. The following vaccines will be available through the VA: Prevnar 13, Pneumovax 23, Hepatitis A, Hepatitis A/B, Shingrix, Flu vaccine, Moderna vaccine, DPT Boostrix, High Dose Flu vaccine

28 B.2 Schedule of Services

Ordering Period 1 through option year 5-Estimated

Estimates have decreased during the last two years as a result of the Coronavirus disease Pandemic. Current enrollment is expected to increase for calendar year 2023 and beyond as the Pandemic impact is decreased. Also, the VA will engage in an advertising campaign for the

Quantity

QUESTION: As the incumbent contractor, the current enrollment at the Natchez CBOC is 1,274 enrollees as of February 1, 2022, which is 15% lower than the RFP’s ordering period 1 estimate of 1,500 enrollees.

The last 5 years has seen an overall decrease of approximately 5% in enrollment, however, the RFP is calculating a 13% increase over the next 5 years.

Will the VA please explain the rationale for the higher starting estimated quantity and the large 13% 5-year growth rate given the history of enrollment trends?

Would the VA consider adjusting the starting Estimated Quantity and growth rate more in line with current trends for a more accurate estimated cost?

Natchez MS and surrounding areas to increase VA Primary Care services availability awareness.

29 Solicitation PAGE: 18 of 180 and 45 of 180 SECTION: B.3 Performance Work Statement

2.4.2 Discipline Specific 2:

Clinical Pharmacy Specialist (CPS) Anti- Coagulation:

Services will be provided by the parent VAMC via telehealth.

4.6.3.5.7 The Contractor shall

meet all requirements for anticoagulation management outlined in VHA Directive

1108.16 Anticoagulation

Therapy Management (or subsequent revisions thereto) as well as local policy F- 119-66 related to the management of patients on anticoagulation.

QUESTION: Will the government please confirm the VA will provide all anti-coagulation services?

Yes, the VA will provide all anti-coagulation services via a consult to the Anticoagulation Clinic, entered by the PCP, into VA EHR.

30 Solicitation

PAGE: 19 of 180

SECTION: 2.5 Specialty Services

QUESTION: Who will be responsible for providing the Podiatrist, the government or the contractor?

The VA Government will provide Podiatrist services via Contractor referrals. Contractor shall enter consults for Podiatry services entered through a consul by the Contractor through the VA EHR.

31 Solicitation

PAGE: 19 of 180

SECTION: 2.6.2

Phlebotomist/Laboratory Technician

QUESTION: This proposal section lists the requirement for an MLT and an MT for the lab. Is it the intention of the government to have both lab professionals in the CBOC or one or the other with a phlebotomist?

See answer 12

32 Solicitation

PAGE: 20 of 180

SECTION: 2.8 Telehealth Services

QUESTION: The proposal states 1 FTE for Telehealth with an enrollment of 5000. Is it the expectation of the government to have 1 FT TCT (with a backup) in the clinic with the enrollment of 1500-1700 enrollees?

Yes. There will be several Telehealth services offered in the CBOC and a dedicated staff member is recommended.

Other staff may be trained as TCT back-ups.

33 Solicitation

PAGE: 49 of 180

SECTION: B.3

Performance Work Statement

4.6.4.1. RADIOLOGY

All Radiology services will be provided by the VA except STAT radiology services. Contractor shall be responsible for providing STAT radiology services

If it is a STAT they need to go somewhere locally.

SERVICES- The Contractor is responsible for submitting requests for radiology procedures. All imaging orders shall be clinically appropriate.

X-rays will be performed by the VA or VA approved community facility including other radiology procedures. Contractor shall submit a consult to Radiology Service for desired studies. If specific radiological studies not available or provided by facility, consult will be referred through community care to an approved facility.

QUESTION: Does the language in 4.6.4.1 mean that the Contractor will not be required to enter into a contract with a local radiology facility to provide radiological services to CBOC patients?

34 Solicitation

PAGE: 49 of 180

SECTION: 4.6.4.2.2

Electrocardiogram

QUESTION: Will the government be providing the required GE 5500 with modem EKG machine at the expense of the contractor?

The Contractor shall be responsible for providing the GE 5500 with Modem EKG Machine. See answer to Q. 25 for additional details.

35 DOCUMENT: Solicitation

PAGE: 78 of 180

SECTION: 4.9 PACT space standards are found in the PACT Space Module Design

QUESTION: Will the Government please confirm if VA will provide the phone circuit and physical phones?

See answer to Q. 24.

36 Solicitation

PAGE: 78-80 of 180

SECTION: 4.9 Space

Teamlets are historically provided three (3) exam rooms each. The Program for Design for this clinic provides a total of Four (4) general patient care rooms, 1 Multi-use/Bariatric patient care room, and one (1) Women Veteran patient care

Requirements

QUESTION: How many exam rooms are required per Pact Team?

room.

37 Solicitation

PAGE: 78-80 of 180

SECTION: 4.9 Space Requirements

QUESTION: How many consultant rooms are required per Pact Team?

1 each

38 Solicitation

PAGE: 78-80 of 180

SECTION: 4.9 Space Requirements

QUESTION: Are any women health rooms required, if so, do they require a connecting rest room?

Yes, and women health rooms require a private bathroom (not shared). The program for design provides only one (1) women patient care room, but it is preferred that each teamlet have a women patient care room.

39 Solicitation

PAGE: 78-80 of 180

SECTION: 4.9 Space Requirements

QUESTION: Is On Stage / Off Stage design required?

See answer to Q. 3.

40 PAGE: 78-80 of 180

4.9 Space Requirements

QUESTION: Is a procedure room required?

No

41 Solicitation

PAGE: 80 of 180

SECTION: 4.9 Space

See Q. 9 Answer

Requirements

QUESTION: The solicitation calls for the Contractor to provide space for Telehealth services equipment including:

telepsychiatry, teleretinal, mental health, and telesurgery be placed within the facility by the VA. How many telehealth rooms are required?

42 Solicitation

PAGE: 87 of 180

SECTION: 4.10.1.1.6

Closed Circuit Television

(CCTV):

QUESTION: Will the government please confirm if there is any preference in using Dome and Bullet cameras versus Fisheye or 360 cameras?

Any brand that meets the minimum requirements of the paragraph 4.10.1.1.6 (CCTV) is acceptable.

43 Solicitation

PAGE: 88 of 180

SECTION: 4.12.1.1 CAT 6

wiring

QUESTION: Will the Government please confirm if CAT 6 wiring is preferred and not CAT 6A?

CAT 6 is the minimum unless CAT 6A is more appropriate for the surrounding network infrastructure.

44 Solicitation

PAGE: 89 of 180

SECTION: 4.12.2.5 Power Requirements four (4) L6-20 receptacles one (1) L6-30 receptacle in the closet

QUESTION: Will the government please confirm the power requirements and if two 20-amp dedicated receptacles are acceptable?

Yes, power requirements are confirmed, At least two 20-amp dedicated receptacles are acceptable unless amperage load calculation of equipment proposed required additional receptacles.

45 Solicitation Yes, the shelves are required in the rack. This will be required for further growth when EHRM comes along.

PAGE: 90 of 180

SECTION: 4.12.2.6.6 Racks -both racks will have 2 shelves on the bottom installed to hold IT computers

QUESTION: Will the government please confirm if shelves are required?

46 Solicitation

PAGE: 90 of 180

SECTION: 4.12.2.6.7

Infrastructure installer should install Leviton CAT6 patch panels and connectors in the rack.

QUESTION: Will the government please confirm if the Contractor can install a comparable brand to Leviton, such as CommScope, Panduit, etc.?

Installer shall install Leviton CAT6 patch panels and connectors rack.

47 DOCUMENT: Solicitation

PAGE: 121 of 180

SECTION: B.3

Statement of Work

5.5 - EHRM Infrastructure Upgrades - CBOCs

QUESTION: Throughout this section, the language refers to a Lessor, not Contractor.

This solicitation is for an IDIQ service contract, not a lease. Is this language applicable to this solicitation, or has it been included in error? If the language is applicable, should all appearances of the word “Lessor” be interpreted to mean “Contractor”? In the event of a conflict between the requirements of Section 5.5 and Section 4.9 (Space Requirements) or Section 4.12

All references to “lessor” are revised to read “contractor” In the event of conflict between this and other sections. PWS Section 5.5 takes precedence. Offeror will treat “lessor” references to mean “contractor”.

(Equipment, Office Supplies and Technical Support), which section controls?

48 Solicitation

PAGE: 122 of 180

SECTION: 5.4.1.3.1

Communication infrastructure including new data outlets, patch panels, upgrades to Cat 6A cable, fiber infrastructure backbone within building.

QUESTION: Will the government please confirm if Cat 6A is required?

CAT6A cable is required.

Yes

49 Solicitation

PAGE: 126 of 180

SECTION: 5.4.6.10.1 UPS

Functional Requirements: This Scope of Work includes UPS requirements for OIT equipment only. All OIT equipment in the Telecommunications Room shall be connected to the UPS.

QUESTION: Will the government please confirm if an APC SMX1500RM2UCNC Smart- UPS X 1500VA Rack/Tower LCD 120V with Network Card and

SmartConnect Port will meet the UPS requirements?

Any UPS proposed equipment is acceptable as long as it meets the minimum UPS requirements.

50 Solicitation

PAGE: 154 of 180

SECTION: E.1 52.212-1

Instructions to Offerors- Commercial Items (Nov 2021)

d. Offeror shall submit pages that require fill-ins to include.

D.1: Acknowledged and Sign the Quality Assurance Surveillance Plan Section

D.2: Signed Organization Conflict of Interest Section

Contractor signature of the SF1449 will indicate contractor acknowledgment of the VA conflict of interest directive. VA signatures will only be required if the contractor is proposing VA employees that will resign from the VA to participate in the CBOC performance to provide Primary Care.

PP Questionnaires requested by the Contractor may be sent to the Contractor and the Contract Specialist, PP references may also be sent directly from the Contractor to the Contract Specialist. They may be subject to verification when the Contractor sends PP references to the Contract Specialist.

D.14 If applicable fill Subcontracting Plan Model Section

D.26: Past Performance Questionnaire fill as necessary Section D.27: Past Performance References fill as necessary

Section E. 52.212-3 Offeror Representations and Certifications— Commercial Items (Oct 2018) Fill as required.

Section E. 52.209-7 Information Regarding Responsibility Matters

QUESTION: Where on the Organization Conflict of Interest document does the VA want the Contractor to sign? Who would the VA like to sign the Organization Conflict of Interest?

How is the Contractor to include the D.26 Past Performance Questionnaire in our proposal, when the completed questionnaire is to be submitted by the reference and sent directly to Frank Mendoza and not the Contractor?

51 Solicitation Factor 3 Past Performance

PAGE: 166

SECTION: (3) Factor 3

– Past Performance. Limited to no more than 2 pages per contract listed.

(3) a. Rated Contracts Completed in the Past Three Years prior to the solicitation release date: Provide any information currently available (letters, metrics, customer surveys, independent surveys, etc.)

which demonstrates customer satisfaction with overall job performance and quality for same or similar type

Yes, attachments to PP References will not count as part of the two page limit.

Yes, proposal Due date has been extended, see amendment 0001.

contracts. In addition, explain corrective actions taken in the past, if any, for substandard performance and any current performance problems.

(3)b. Provide a list of three (3) to five (5) most recent relevant contracts performed for Federal agencies and commercial customers within the last three

(3) years.

QUESTION: Will the VA allow the contractor to provide letters, customer surveys, independent surveys, etc. as an attachment and not count towards the 2 page limit to Past Performance? Does the VA want contracts completed in the past 3 years prior to the solicitation release date or does the VA want the most recent relevant contracts?

Not knowing what past performance references to use until we receive clarification to the above question, would the VA consider extending the due date for receipt of the Past Performance Questionnaires?

(End of Amendment)