Attachment 1 AM 3 Answers to Questions Kosciusko CBOC 2-11-2025.xlsx
XLSX spreadsheet 32 KB Posted
- Solicitation number
- 36C25625R0028
About this file
This is a Q&A document containing 52 questions and answers regarding solicitation 36C25625R0028 for the Kosciusko Community Based Outpatient Clinic (CBOC) in Mississippi. Key clarifications include: providers can be board eligible in Internal Medicine or Family Practice; a full-time RN clinic manager is preferred; PCMHI services will serve approximately 10% of veterans (205 patients annually) while 30% will require general/specialized mental health services (615 patients annually); the VA will provide laboratory tubes and supplies while the contractor must provide the centrifuge; and the current facility has approximately 1,900-2,000 enrolled veterans with 142 female veterans.
The document clarifies operational requirements including: contractors must provide daily lab courier service to the VAMC by 1900; after-hours phone coverage can utilize the VA's call center; mental health rooms do not require exam tables; contractors must meet VA space requirements and cannot use the current "grandfathered" facility; the contractor must provide telephones and fax capabilities; and the contract term will be extended to September 30, 2025 under FAR 52.217-8. The Q&A also addresses proposal submission requirements regarding staffing information, salary ranges, transcripts/certificates, and past performance documentation.
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Questions
| 36C25625R0028 Kosciusko CBOC- Mississippi | |||||
| Question # | Section | Page # | Question for Government | Answer from VA- Government | |
| 1 | 2.1 | 17-18 | The RFP states, "Contractor's Physicians performing under this contract shall be board certified by the ABMS in Internal Medicine and/or Family Practice or the BOS in Internal Medicine and/or Family Practice. | ||
| Is it acceptable to the VA if the Physician is board eligible by the ABMS in Internal Medicine and/or Family Practice or the BOS in Internal Medicine and/or Family Practice? | Yes It is acceptable for the provider to be board eligible in IM or FP | ||||
| 2 | 2 | 17 | Is a full-time Clinic Manager required and if so, would the VA prefer they be a nurse? | Yes The VA prefer it to be a RN | |
| 3 | 2 | 19 | It states three years of clinical nursing experience is required for the Advanced Practice Registered Nurse (APRN). Then it says a minimum of one (1) year clinical experience as a CNP is required (three (3) years preferred). Will the VA please clarify what experience is required? | One year of experience is the absolute minimum amount acceptable and it is required | |
| 4 | 2 | 22 | The RFP states in 2.3 Discipline Specific 5, Primary Care Mental Health Integration (PCMHI): The support services shall be consistant for LCSW as with other providers for each LCSW scheduled clinic to include but not limited to calling patients, triaging, secure messages, scheduling patient vists to include Face to Face, Telephone and VVC (or other modalities) and contracting patients who no show and reschedule. | ||
| Is the VA requesting an administrative person or Licensed Practical Nurse for mental health support? And can this person be part of the PACT Team or does it need to be a separate person? | Yes, we will need support staffing assist the PCMHI provider. These duties are typically performed for VA staff by Health Administration Staff (HAS) and/or Program Support Assistants in VA, so staffing disciplines equivalent to these roles would be appropriate. It is acceptable for this support person to be a PACT team member since the PCMHI staff member is considered to be a member of the PACT team. Will note that it is important that the support person be trained in MH business rules, as these sometimes differ from PC business rules (e.g., minimum scheduling effort differs between PC and MH) |
| 5 | 2.2 | For primary care teamlet staffing, is a physician required? | No Its acceptable for NP or a PA to be the lead in the PACT Teamlet | |
| 6 | 2.6 | Please confirm that the VA is providing all clinical mental health staff and that the only mental health staff provided by the contractor is administrative support. | Correct, that is the plan at this time. | |
| 7 | 2.6 | Please provide the number of veterans receiving General and Specialty MH services so that the contractor can determined the FTE level of administrative support needed. | Kosciusko Primary Care Uniques were 2050 in FY24. PWS specifies this: | |
| o | It is estimated that approximately 10% of Veterans assigned to this clinic will require Primary Care Mental Health Integration services . This equals 205 uniques annually. Note that PCMHI will see these Veterans up to 6 times = 1230 visits annually. | |||
| o | It is estimated that 30% of Veterans assigned to this clinic will require General or Specialized Mental Health services. This equals 615 uniques annually. Note that BHIP will see these Veterans as often as weekly = 8610 visits annually. |
NOTE: It’s probably easier to estimate level of administrative support required based on FTE. In MH, 1 FTE is expected to have 30 bookable hours, including scheduling in 30-minute increments between 0800 and 1630 and associated check ins, check outs, calls, letters, etc.
| o | We anticipate up to 3 FTE located onsite and up to 2 FTE remote specialty telehealth services. Note that the 2 remote FTE are anticipated to be multiple different providers serving Kosciusko Veterans, not 2 persons per se (in case that matters). As such, administrative support will need to be able to provide support staffing for up to 5 MH FTE. | ||||
| 8 | 2.6 | If fewer than 1000 veterans are receiving General and Specialty MH services, may administrative support be provided at less than 1.0 FTE? | We are fine with whatever administrative FTE allocations the contractor deems sufficient to meet MH support needs. It’s more important that appointments be scheduled in accordance with MH business rules than any specific FTE number. It’s also fine to have multiple admin FTE assisting with MH scheduling and check ins/outs if preferred. | ||
| 9 | 2.7 | Please provide the number of synchronous and/or asynchronous encounters are anticipated for the clinic so that the contractor can determine the right staffing levels for the TCT positions. | 500 | ||
| 10 | 5.2 | 46 | The RFP states, "Contractor shall provide all equipment necessary to provide comprehensive women’s health services. Examination rooms shall be set up in accordance with current VA standards to afford women with privacy (placement of examination tables in the room, privacy curtains, etc. See Space Requirements section for more details). Equipment such as privacy curtains, exam tables with stirrups and lights, bathrooms adjacent to where pelvic exams are performed, speculums, supplies, and equipment to perform Pap smears and point of care pregnancy testing should be on hand in the clinic area. Each designated women’s health provider shall have an appropriate exam table to conduct the annual women’s health exam." | ||
| Since the contractor is not able to purchase Thin Prep, will the VA supply Thin Prep? | Contractor will provide | ||||
| 11 | 5.2 | Would the VA be willing to provide Well Women’s Health Services Supplies, including Thin Prep Pap Test, Pap Smear Collection Kits, Cytobrushes, as well as the IFOBT kits? In our experience, these supplies are difficult for the contractor to procure. | Yes | ||
| 12 | 5.3 |
5.3
5.3 49
50 The RFP states the following:
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 or standard operating procedures related to the management of patients on anticoagulation.
The contractor shall provide quarterly, and annual anticoagulation quality assurance summaries as outlined by the local Pharmacy & Therapeutics Committee.
Clinical Pharmacy Services - These services shall be provided by the parent facility via virtual coverage and site visits."
| If the VA Laboratory is providing clinical pharmacy services, wouldn't the VA Laboratory also provide anticoagulation management? | Labortory will only perform the test managed by provider. | ||||
| 13 | 5.4 | 52 | The RFP states, "the contractor is responsible for packaging and transporting in a manner that ensures integrity of the specimen and proper safeguarding of protected health information. The daily specimen pick up should be scheduled to arrive at the VAMC no later than 1900." | ||
| Will the VA please verify that the contractor is to courier labs to the VA once per day? | Yes, contractor will send labs daily. | ||||
| 14 | 5.4 | Will the VA provide the lab specimen tubes? | Currently the facility is providing collection tubes and supplies. | ||
| 15 | 5.4 | Who will be responsible for providing the centrifuge? The contractor or the government? | Provided by the contractor. | ||
| 16 | 5.8 | 73 | The RFP states, "Telephone Access to Clinical Care: The contractor shall make provisions for toll free telephone care, twenty-four (24) hours a day, seven (7) days a week, including evenings, weekends, and holidays, for all Veterans." | ||
| Is it acceptable to the VA if the Contractor uses the VA's after hours call center to provide after-hours telephone access? | Yes, phones need the capability to roll over to VA after hour call center. | ||||
| 17 | 12 | 86 | In the space requirements it references the TeleRetinal, TeleHealth, VA Mental Health provider, and TeleMental Health rooms as exam rooms but does not reference it requiring an exam table. In the VA specialty provider room it does specifically reference needing an exam table. | ||
| Does the VA want exam tables in the TeleRetinal, TeleHealth, VA Mental Health provider, and TeleMental Health exam rooms? | We do not require exam tables for mental health or Telemental health rooms. Normal desk and provider/patient chairs set up sufficient. | ||||
| 18 | 13 | 94 | The RFP states, "ENVIRONMENT OF CARE (EOC): Contractor shall meet VHA standards regarding EOC and shall provide the following safety and health EOC documents, with the submission of their proposal/within 15 calendar days after contract award." | ||
| Is it acceptable for the Contractor to provide the EOC within 15 calendar days after contract award? | Yes | ||||
| 19 | Instructions to Offeror | 181 | The RFP states the proposals will consist of two separate proposal volumes: Volume I - Price and Volume II - Technical Capability, Geographic location, and Past Performance. It also states there is a Volume II Part 1 Section 1 and a Volume II Part 2. | ||
| Should the proposal be split into 3 completely separate documents (Volume I Price, Volume II Part 1 Administrative, and Volume II Part 2 Technical Capability, Geographic location, and Past Performance), or do we combine Volume II Part 1 and Part 2 into one document? | Combining or keeping separate is fine, as long as Price proposal is kept separate from Technical and Past Performance. | ||||
| 20 | 182 | The instructions for Section 2 of the proposal require the provision of “Key Personnel, including salary range worksheet and all other supporting documents (Provide ATT D4-complete staff listing and if position needs recruited, please state).” This requirement heavily favors the incumbent contractor as this is the only offeror who will have incumbent employees at the CBOC. All other offerors will necessarily need to recruit for all CBOC positions during the proposal period, as such offerors will not have access to the roster of incumbent employees until after award. Would the VA consider removing this requirement for salary ranges and recruitment status? | Contractors are required to possess the ability to propose staffing salary ranges consistent with ERI data for the area and have the ability to recruit qualified staff. | ||
| 21 | 182 and 194 | Please clarify what information is required to be provided on Attachment D4-Key Personnel. Page 182 references salary ranges, but there is no space for this information on Attachment D4. Should this attachment include personnel who have been recruited for the upcoming contract but who are not yet employees of the Offeror? | Contractors are required to possess the ability to propose staffing salary ranges consistent with ERI data for the area and have the ability to recruit qualified staff. | ||
| 22 | Section D | ATT D4 | May this attachment be provided post award once the Contractor has had chance to review incumbent employees and hire outside employees for open positions? This attachment favors the incumbent Contractor as they are the only offeror in a position to affirm Key Personnel have no conflict of interest. Other Offerors will not have access to this information prior to award. | Offerors are required to have the ability to recruit qualified staff. | |
| 23 | E.16 52.212-2 Evaluation | 193 | In Subfactor A Capabilities/Experience it says to describe familiarity with VA's electronic medical record. Then in Subfactor D Implementation Plan it says the offerors shall indicate if the Offeror has experience with VA health record information database systems. | ||
| Should the familiarity/experience with VA's electronic medical record be in both Sufactor A and Subfactor D? | Yes, as subfactor a relates to overall experience and then under subfactor d relates to how it will impact implementation, as if the offeror's staff are not familiar then it will require more training. | ||||
| 24 | E.16 52.212-2 Evaluation | 193 | In Subfactor A Capabilities/Experience it says to describe contingency plan for equipment downtime and in Subfactor C it says to describe your contingency plan for equipment downtime. | ||
| Would the VA like to see the contingency plan for equipment downtime in Subfactor A or Subfactor C? | Yes, the first, under subfactor a, is in general whereas under subfactor c should be in more detailed as how if it impacts patient care. | ||||
| 25 | 194 | May graduation certificates and transcripts be submitted after award? In our experience, the majority of qualified candidates are not willing to provide this documentation during a proposal period for a position that does not exist yet. | Yes | ||
| 26 | 194 | Page 194 states “Offerors shall emphasize if proposed qualified staff members possess experience providing services containing the same level of size, magnitude, and complexity of the requirements of the PWS. Greater evaluation rating will be given to Offerors proposing staff with experience providing services containing the same level of size, magnitude, and complexity of the requirements of the PWS.” This requirement heavily favors the incumbent contractor as this is the only offeror who will be able to provide a roster of incumbent employees during the proposal period. However, after the award is made, the awarded Contractor will be able to work with the incumbent employees who have “experience providing services containing the same level of size, magnitude, and complexity of the requirements of the PWS.” Would the VA consider removing this requirement? | Offerors will be required to provide qualified staff for the job requirements as outlined. This does not mean VA specific experience. | ||
| 27 | E.16 52.212-2 Evaluation | 195 | In Subfactor C Coordination and Continuity of Care in the transition it states, to provide a transition plan that addresses the steps and key milestones necessary to assume full responsiblity for the management and operating activities required to become fully operational under the resulting contract. In Subfactor D Implementation Plan it states, offerors shall provide a detailed operational plan to include staffing that shows the CBOC will be ready to provide services within 90 days of contract award in accordance with the Performance Work Statement. | ||
| What is the difference between the Transition Plan in Subfactor C Coordination and Continuity of Care and the Operational Plan in Subfactor D Implementation Plan? | Transition plan is regarding the offeror's plan to transition the CBOC from the current contractor to the new offeror (phase-in) and more about the change itself. The Operation plan is about the ongoing execution after the change is implemented. | ||||
| 28 | E.16 52.212-2 Evaluation | 196 | Factor 3 - Past Performance. Limited to no more than 2 pages per contract listed. Only references (ATT D29) for same or similar type contract desired. Past Performance evaluation will include information provided by the Offeror and information close at hand from other sources. |
Quality and Satisfaction Rating for 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 contracts. In addition, explain corrective actions taken in the past, if any, for substandard performance and any current performance problems.
| Will the VA allow the bidder to provide letters, metrics, customer surveys, independent surveys, etc. as an attachment and not count towards the 2 page limit to Past Performance? | Yes, that is acceptable. This is only needed if no CPARS is available. | ||
| 29 | Can the government please extend the submission deadline by 30 days? | Please note the extension provided on Amendment 3 SF30 | |
| 30 | What is the most current billable roster? Can you provide the history over the last 3 months? | Dec 1907, Nov, 1919, Oct 1928 | |
| 31 | Can the VA please provide the historical enrollment for the past five years? | Yes | |
| 32 | Will the VA provide the lab specimen tubes? | Yes, the facility will provide | |
| 33 | Who will provide centrifuge machine, the contractor or government? | The contrator will provide. | |
| 34 | Will the government allow contactors to price the cost of the clinical buildout as a separate CLIN in the base year of the contract? | Alternate proposals are allowed, but it is the VA decisions of whether or not to accept. | |
| 35 | Who is responsible for the VOIP phones. The contractor or the government? | Currently the contractor |
| 36 | SF1449 | 1 | The RFP states that the contractor shall provide CBOC services within city limits of Kosciusko, Mississippi per the terms and conditions stated herein. | |
| Would the VA consieer extending the geographic location for the new CBOC outside of the Kosciusko city limits, as there are limited suitable facilities within the city itself? | Limited to the city limits | |||
| 37 | 9 | We have not seen six months CLINS based on the Fiscal Year for a CBOC contract before. (reference RFP page 9—first and last CLINs)? |
a) Is this part of a new VA template?
b) How will this affect award timing?
| c) What happens to the timing if the government makes an award it is protested? | No, this is not part of the VA template. The task orders are being set up not to cross fiscal year (end 30 Sep) due to budgetting. This doesn't impact award timing. If protested, then the current contract will be extended and this requirement will be ad | ||||
| 38 | 12 | 86 | The VA says two general exam rooms and one dedicated Women’s Health exam room per PACT teamlet. Please confirm this means the VA wants one Women’s Health exam room for EACH PACT teamlet. (We believe two women’s health exam rooms would be more than necessary for this clinic.) (reference RFP section 12 (space requirements), page 86). | Based on the current PACT teams and enrollment only one womens health exam room would meet specifications | |
| 39 | 86 | Does the VA require a separate specific “procedure room” for this clinic other than any exam or women’s health rooms that are specifically mentioned? (Space requirements, page 86. | No | ||
| 40 | How many female veterans are enrolled at the Kosciusko CBOC? | 142 | |||
| 41 | 180 | Pg. 180: Please clarify the specific requirements and format for the salary range worksheet and any other supporting documents needed. | Providing "salary range worksheet" is optional and not mandatory. If provided should be in excel format. | ||
| 42 | 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”? | No, current space does not meet government’s space requirements and will not be grandfathered in. | |||
| 43 | Please provide the number of billable enrollees on the most current invoice. | 1919 | |||
| 44 | Please list all VA staff that will be onsite at the clinic and the approximate number of days per week they will be there. | N/A | |||
| 45 | Will the new Contractor inherit the patients’ last vesting visit and be allowed to bill for one year from the date upon contract award? | The contractor will be provided a list of all patients on the billable roster at the time when the contractor begins performing clinical services and will be able to bill for those patients on the billable roster in the following month’s invoice (p.8#B.2). | |||
| 46 | Will the government be making site visits prior to the award? If so, how much advance notice will the contractor be given? | It is possible that a site visit may be needed as part of the evaluation process and the date and time will be determined that is best for all parties involved. | |||
| 47 | How many Mission Act referrals, for Primary Care, were made in the past 12 months for enrolled veterans of the Kosciusko CBOC? | 27 | |||
| 48 | 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. | VA currently stocks Pixis for vaccines | |||
| 49 | Please confirm if the VA will supply the telephones and will the existing number be rolled over to the new contractor? | Currently contractor supplys telephones | |||
| 50 | Telephones. Will VA be supplying the telephones and telephone system for the clinic? Including fax? | Currently contractor supplys telephones | |||
| 51 | Will the government add price realism language to the current solicitation? To prevent contractors from deliberately underbidding this contract? | No, the Contracting Officer is responsible for determining the price fair and reasonable. | |||
| 52 | 194 | Pg. 194: Transcripts graduation certificates are required to be submitted for NP candidates with the proposal. Can these be submitted after the award, during the credentialing process? | Once award received will provide credentialing |
| NOTE: Current contract 36C25620D0009 is due to expire 3-31-2025; however, this is being extended 6 months to 9-30-2025 under FAR 52.217-8. |
| Please refer to ATT 2 for the revised price schedule for this requirement. |
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