Amendment 0003 - RFP 36C25625R0058-McComb CBOC.pdf

5. PROJECT NUMBER (if applicable)

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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.

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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.

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(Type or print) (Type or print)

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

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(SEE ITEM 11)

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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.

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AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

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

1 15

0003 09-11-2025

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

9B. DATED (SEE ITEM 11)

10A. MODIFICATION OF CONTRACT/ORDER NUMBER10A MODIFICATION OF CONTRACT/ORDER NUMBER

36C25625R0058

X

X X

____1

** HOUR & DATE for Receipt of Offers is EXTENDED to: 09-19-2025 3:00 PM CT. CDT x ___________ co1(one)

The purpose of this solicitation is to post Question and Answers and extend solicitation due date.

1. See Questions and Answers page 2.

2. Solicitation for McComb Community Based Outpatient Clinic (CBOC) due date is extended to 09-19-2025 at 3:00 PM CST.

3. This amendment 0003 will need to be signed and returned with quote submission to be eligible for award.

Stephanie Keo Contracting Officer

VA-VHA-RPOC-2023-0081

STEPHANIE KEO Digitally signed by STEPHANIE KEO Date: 2025.09.11 15:53:01 -05'00'

36C25625R0058 Amendment 0003

CONTINUATION PAGE

The Network Contracting Office (NCO) 16 received questions in response to Request for Proposal (RFP) 36C25625R0058.

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

Question # Contractor’s Questions Government Responses 1 Section B.2, Page 8

The RFP states, "Fixed price Task Order (TOs) will be issued by the COR (as authorized by Contracting Officer) via email to the contractor, prior to the start of each month, the fixed quantity of members for the upcoming month but billed in arrears based on billable roster. See FAR clause 52.216-19, Order Limitations, for minimum and maximum values of each TO. TOs are contingent upon availability of funds per FAR 52.232- 18."

How many days prior to the start of a month will the applicable TO be issued?

Efforts are made to issue Task Order within 30 days.

2 Section 2.1 Staffing and Qualifications, Page 19

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 for Contractor's Physicians to be Board Certified or Board Eligible?

Yes, it is acceptable for the Physician to be board eligible.

3 Section 2.4 Specialty Care Staffing, Page 23

The RFP states, Physical Therapist: Will be provided by G.V. Sonny Montgomery VAMC either on site and/or remotely via telehealth.

If PT will be onsite, what are the requirements for the PT Space and what equipment will need to be available?

PT will not be provided onsite.

4 Section 2.6 General and Specialty Mental Health Staffing Requirements and Options, Page 24

The RFP states, General MH Staffing will be provided by G.V. Sonny Montgomery VAMC (either on-site or remotely) to provide Mental Health services. Specialty MH Staffing will be provided by G.V. Sonny Montgomery VAMC (either on-site or remotely) to provide Mental Health services.

If Mental Health services are being provided on-site, what are the space requirements and how many offices are required?

Three (3) offices are needed for onsite MH providers, these should meet typical size and privacy standards for mental health offices (e.g., mostly sound proof, large enough to fit a provider, desk, computer, 2 cabinets plus comfortable seating for at least 2 clients (e.g., Veteran & spouse) at a time). Internet connectivity and any networking required to convert offices back/forth to CVT rooms is needed (e.g., in case we can't recruit someone to work onsite, we'd like to be able to use the rooms for remote CVT visits in interim). One

(1) additional office is needed for telemental health services (so 4 total), which should include desk, 2 chairs and CVT equipment and also have reasonable sound proofing. A group room able to accommodate up to 12 Veterans at a time for group therapy sessions will also be needed--does need to be available a few times a week as needed but doesn't need to be dedicated 100% of the time to MH.

5 Section 2.7 Telehealth Services Clinical Staff, Page 26

The RFP states, the following telehealth staffing shall be provided by the contractor. For CBOCs with fewer than 1050 synchronous and/or asynchronous encounters anticipated per year, one Telehealth Clinical Technician (TCT) FTE is required; for CBOCs with 1051-1479 annual synchronous and/or asynchronous encounters anticipated, or those with an expansion plan target in this range, 1.5-2 TCT FTE are required; for CBOCs with over 1480 annual synchronous and/or asynchronous encounters anticipated, or those with an expansion plan target in this range, greater than 2 TCT FTE are required.

Each TCT shall have a trained back-up, e.g., another TCT or a member of the PACT Teamlet such as (PCP, RNCM, or clinical associate) who is able to perform all telehealth duties of the designated telehealth TCT. This staff member will complete all CVT and SF training as the TCT. They will complete all TMS training and skills check off by a Telehealth preceptor. They must complete a minimum of 2 successful teleretinal and teledermatology images per month.

Will the government please provide the total number of telehealth encounters that have occurred over the last 12 months?

It's estimated that there were approximately 550 mental health CVT encounters onsite at the McComb CBOC last year, so one (1) TCT should easily suffice for mental health purposes. Note that this does not count other telehealth encounters that occurred via VVC or phone, it's assumed this doesn't impact TCT staffing. This also doesn't include other telehealth services (e.g., telederm, teleretinal, etc).

6 Section 2.8 License and Accreditation, Page 28

The RFP states, a copy of licenses shall be provided with offer and will be updated annually. However, in the Instructions to Offeror, there is no mention of providing the staff or licenses.

Is the contractor to provide the proposed staff and their licenses with the proposal submission? And if so, in what section should this be provided?

No, the contractor does not need to provide the licenses of proposed staff with the proposal submission.

7 Section 5.4 Ancillary Support Services, Page 48

The RFP states, the contractor is responsible for sending specimens to the VA parent facility Core Laboratory daily and should be scheduled to arrive at the VAMC no later than 1900.

Are specimens sent to the VA parent facility Core Laboratory required once daily?

Yes, once daily.

8 Section 5.5 Mental Health Services, Page 51-52

Mental Health Same Day Access Requirements: The contractor shall provide same day MH access and same day MH evaluation. Any Veteran reporting or identified as being in crisis (including suicidality), will receive an immediate crisis response. Services shall be provided as follows: • Veterans New to MH: In Person: Any Veteran new to MH requesting or referred for care in person will be seen in person the same day by a Licensed Independent Provider (LIP) to screen for and address immediate care needs. By Phone: Any Veteran new to MH calling to initiate care will be scheduled for an initial evaluation. Schedulers answering the phone will ask if the Veteran needs to speak with a provider immediately. If an urgent request is made or suggested, an immediate crisis response will be initiated and follow-up care will be provided, as needed. If an urgent response is not indicated, a LIP will call the Veteran back the same day or no later than the next calendar day.

Per staffing guidelines, VA is providing all Mental Health staff. Will the VA please clarify the contractor's role and responsibility related to general and specialty mental health?

The contractor will provide mental health support staff related to general and specialty mental health services (e.g., reception, scheduling and check in/out services for approximately 4 FTE worth of MH provider time, including the CVT room).

Related to same day access, contractor support services includes responsibility for receiving in person, phone and online requests for MH services, following scripts/guidance related to asking about urgency and helping to schedule or connect Veterans to MH providers in accordance with same day directive mandates.

9 Section 5.5 Mental Health Services, Page 54-55

Primary Care-Mental Health Integration (PCMHI):

Contractor will ensure PACT staff follow processes described in Primary Care – Mental Health Service Agreement. Parent facility shall provide PCMHI services in accordance with VHA Directive 1160.01. Per VHA Directive 1160.01, PCMHI is a required component of the PACT. Where primary care services are offered, PCMHI services shall include co-located collaborative care (CCC) providers who attend PACT huddles and provide consultative advice, brief assessment and problem-focused treatment, and mental health collaborative care managers (CoCM) who use the evidence-based mental health collaborative care management model to provide longitudinal follow-up and decision support for specific mental health conditions. At least 10% of primary care enrolled patients also engage with PC-MHI. New patient referrals will be completed via warm handoff on the same day as the PACT medical visit. 75% of Veterans new to PC- MHI will be seen the same day as the medical visit in which the need was identified. Referral for same-day services will be facilitated via warm-handoff. Less than 25% of Veterans should be referred for non-same services (e.g., via consults). Contractor will ensure that office space for all VA staffed PCMHI positions is co-located within PACT service area. Contractor will also invite PCMHI VA staff to PACT huddles and team meetings.

Will the government please clarify the contractor's role in ensuring VA PCMHI staff completes visits as noted?

As all referrals to PCMHI come from PACT, PCMHI success relies on effective PACT team processes and collaboration. As such, the contractor will be responsible for ensuring PACT and other contracted staff compliance and support for PCMHI initiatives (e.g., ensuring PCMHI office space is co-located with PACT, inviting VA PCMHI providers to participate in PACT huddles, ensuring PACT attends PCMHI-related trainings, ensuring PACT team initiates warm-handoffs to PCMHI in line with VA directives and guidance (including benchmark goals listed for 75% to be same day warm handoff and not consult), ensuring PACT providers follow appropriate levels of care practices (including prescribing mental health medications for Veterans only requiring a PACT level of care), ensuring contracted schedulers comply with business rules related to PCMHI visits, etc).

10 Section 5.5 Mental Health Services, Page 55

The RFP states, Evidence-based Psychotherapy for PTSD: All Veterans with PTSD shall have access to Cognitive Processing Therapy (CPT) or Prolonged Exposure Therapy as designed and shown to be effective. Contractor shall provide evidence-based psychotherapy when it is clinically indicated for patients.

Contractor will refer to onsite PCMHI providers for evaluation if need is anticipated.

If VA is providing the general and specialty mental health staff, what is the contractors role?

The contractor will provide mental health support staff related to general and specialty mental health services (e.g., reception, scheduling and check in/out services for approximately 4 FTE worth of MH provider time, including the CVT room).

Related to this clause, contractors will need to facilitate handoffs to PCMHI from PACT as appropriate (also outlined in previous clause) and will need to ensure schedulers are compliant with scheduling directions related to length and frequency of visits as ordered by providers.

11 Section 5.5 Mental Health Services, Page 56

The RFP states, Family Education and Involvement:

Contractor shall provide family education, family consultation, family psychoeducation, and marriage and family counseling for Veterans who need these services as part of their overall mental health treatment.

Contractor will refer to onsite PCMHI providers for evaluation if need is anticipated. Providers need to discuss family involvement in care with all patients with an ICD 10 mental health diagnosis or as clinically indicated, at the time of mental health treatment initiation or inpatient or residential treatment discharge, at the time of a significant change in the treatment plan, and at a minimum, annually. The treatment plan needs to identify at least one family contact, or the reason for the lack of a contact (e.g., absence of a family, Veteran preference, lack of consent).Family consultation, family education, family psychoeducation, or marriage and family counseling within existing statutory and regulatory counseling authority for Veterans with an ICD 10 mental health diagnosis or as clinically or as clinically indicated shall be provided for those who need them.

This can be provided in the clinic, by telehealth, or by a community provider. Trained staff shall be available to provide these services. Opportunities for family consultation, family education, family psychoeducation or marriage and family counseling within existing statutory and regulatory counseling authority shall be available to all Veterans with an ICD 10 mental health diagnosis or as clinically indicated.

Will the government please provide clarification on what the contractor's responsibility is if the VA is providing general and specialty mental health staff?

The contractor will provide mental health support staff related to general and specialty mental health services (e.g., reception, scheduling and check in/out services for approximately 4 FTE worth of MH provider time, including the CVT room).

Related to this clause, contractor will need to ensure office space conducive to family visits is available when clinically indicated (e.g., standard office space should include at least 2 chairs; space should be found for larger families if needed; use of group room ok for large families).

12 Section 5.6 Specialty Care Services, Page 64

The RFP states, Physical Therapy Support Services: The contractor shall provide the following clerical support services for physical therapy providers (including VA providers if VA provides PT services onsite) at the CBOC. • Schedule and reschedule patients for physical therapists assigned to the clinic. • Check in patients for the above clinics. • Check out patients/encounters for the above clinics. • Utilize the Insurance Capture Buffer to record Veteran insurance information. • Place reminder calls to patients no later than one day prior to their appointment. • Call patients to cancel and reschedule appointments when the provider is unable to see the patient. • Receive and screen phone calls for the above clinics and providers. • Process all consults/referrals for the above clinics. • Provide support for the tele physical

It is acceptable for the PACT clerical staff to provide support.

therapy appointments including scheduling, set-up. • Participate in triaging secure messages.

What is the FTE requirement for the clerical support needed? Is it acceptable for the PACT clerical staff to provide the support for physical therapy?

13 Section 5.7 Telehealth Services Requirements, Page 66

The RFP states, Telephysical Therapy Services: The contractor shall provide clinical physical therapy telehealth services. The contractor shall provide clerical support, including scheduling, and ancillary support for VA telephysical therapy services. Nevertheless, it is important to recognize that there may be limits to the services that can be provided using this technology.

These may include certain complex evaluations or interventions.

What is the FTE requirement for the clerical support needed? Is it acceptable for the PACT clerical staff to provide the support for telephysical therapy services?

It is acceptable for the PACT clerical staff to provide support.

14 Section 5.8 Telephone Access to Clinical Care, Page 66

The RFP states, 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, this is acceptable

15 Section 8. Medical Records/Computerized Record Systems/Disclosure/ Record Retention, Page 75

The RFP 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 dietitian, wouldn't the VA be responsible for ensuring the dietitians electronically complete Event Capture System forms?

Yes, the VA will be responsible for ensuring dietitians electronically complete Event capture system forms.

16 Section Environment of Care, Page 84

The RFP states, Contractor shall meet VHA standards regarding EOC and shall provide EOC management plans addressing safety, security, hazardous materials, hazardous waste, emergency preparedness, life safety, Factor 2: Activation Plan medical equipment, infection control, and utility systems with the submission of their proposal and within 15 calendar days after contract award. However, nowhere in the In the Instructions to Offeror, does it mention providing EOC management plans.

Where in the technical proposal would the VA like to see the EOC management plans?

17 Section 12. Equipment, Office Supplies and Technical Support, Page 85 & 87

The RFP states, VA OIT will provide the primary data and voice circuit on page 85 and the VA parent facility will be responsible for: Providing the primary data (including internet) and voice services on page 87.

Will the VA please confirm if they will be providing the phone circuit, phone system, and the physical phones?

No, the contractor will be responsible

18 Section 13. Equipment, Office Supplies and Technical Support, Page 86

The RFP states, having a contingency plan for computer downtime that defines the processes to ensure continuity of patient care and maintenance of the integrity of the patient’s medical record during periods of loss of computer functions. The contingency plan shall be reviewed and approved by the CO prior to award of the contract. However, nowhere in the instructions to offeror, does it mention providing our contingency plan for computer downtime.

Where in the proposal is the contingency plan for computer downtime to be provided?

Factor 2: Activation Plan

19 Section E.3 Addendum to FAR 52.212-1 Instructions to Offerors - Commercial Items, Page 162

The RFP instructions states, Proposals will consist of two separate proposal volumes. Pricing must be kept separate from Experience, Activation Plan, and Proposal Site. Volume I Price and Volume II – Experience, Activation Plan, Proposed Site, and Completion of items as identified under “Volume II Part 1 Section 1– Completion of SF1449, Signed Amendments, Clauses/Provision fill-in and attachments. And in the Evaluation Factors it states, "Volume II Part 1 Section 1- Completion of SF1449, Signed Amendments, Clauses/Provisions fill-in and attachments.

Is Volume II divided into 2 Parts and 2 separate

Volume II will be one document/file and the sections labeled Parts 1 & 2 within the volume.

Volume II - Part 1 Section 1– Completion of SF1449, Signed Amendments, Clauses/Provision fill-in and attachments D.

Volume II - Part 1 Section 2 - Experience, Activation Plan, and Proposed Site.

documents/files or should it all be in one document/file and the sections labeled Parts 1 & 2 within the volume?

Is Volume II Part 1 - Completion of SF1449, Signed Amendments, Clauses/Provision fill-in and attachments and Volume II Part 2 - Technical includes Experience, Activation Plan, and Proposed Site?

Section 2.3 it says “The following discipline specific staffing shall be provided by the contractor.” However, each position listed says it will be provided by the parent VAMC. Please confirm that the VA will provide all Discipline Specific PACT Team members.

Yes

Regarding Section 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.

McComb Primary Care Uniques were 1,872 in Fiscal Year (FY) 24. PWS specifies this:

- It is estimated that approximately 10% of Veterans assigned to this clinic will require Primary Care Mental Health Integration services . This equals 187 uniques annually.

Note that PCMHI will see these Veterans up to 6 times = 1123 visits annually.

- It is estimated that 30% of Veterans assigned to this clinic will require General or Specialized Mental Health services. This equals 561 uniques annually. Note that BHIP will see these Veterans as often as weekly for 3 months = 6739 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. We anticipate up to 3 FTE located onsite and 1 FTE remote specialty telehealth services. Note that the FTE may be multiple different providers serving McComb Veterans that add up to FTE workload (in case that matters). As such, administrative support will need to be able to provide support staffing for up to 4 MH FTE.

Under Section 2.5 Waived Testing Personnel, is 1 FTE phlebotomist acceptable? The requirement lists 1 FTE Medical Laboratory Technician or Medical Laboratory Scientist, but these positions require higher credentials and pay rates than what is needed for the service in our experience.

No, it must be a Medical Lab Tech or Medical Lab Scientist

Regarding Section 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.

One (1) FTE TCT should suffice

Regarding Section 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.

Regarding Section 5.4, will the VA provide the lab specimen tubes?

No

Are board eligible physicians acceptable?

Can the government extend the submission date by 30 days?

Solicitation due date extended to 09-19-2025 at 3:00 PM CT. See Amendment 0003.

Could the Government clarify how Factor 2 Activation Plan will be evaluated with respect to “clinical staffing”?

Will the inclusion of a clinic staffing model be evaluated favorably?

Yes, inclusion of a clinic staffing model will be evaluated favorably. Is there a plan to staff the clinic, with who/how, do they have experience and do they have similar experience within a clinic in similar size, complexity as current CBOC.

As the proposal instructions focus on activation of clinic and location of proposed site, how will the offeror’s ability to operate the CBOC in line with VA standards be evaluated?

This will be evaluated in Factor 1:

Experience.

The RFP lists McComb, Amite, Lincoln, Pike, and Walthall Counties as acceptable locations for the new CBOC. Does the government have a preference for one county over another? For example, the current McComb CBOC is located in McComb County. If a vendor proposed relocating the clinic to Pike County, how would the government evaluate the trade-offs associated with the new location, particularly considering that some veterans would be required to travel to a different county for services?

The government does not have a preference, the counties identified in the RFP are acceptable.

Confirm whether VA provides lab specimen tubes and IFOBT kits.

The VA will provide IFOBT kits but lab specimen tubes will be the responsibility of the contractor.

Provide a complete list of VA staff requiring offices, with room types/sizes (e.g., consult, shared touchdown).

The names of the VA staff that will work onsite are TBD. Three (3) offices are needed for onsite MH providers, these should meet typical size and privacy standards for mental health offices (e.g., mostly sound proof, large enough to fit a provider, desk, computer, 2 cabinets plus comfortable seating for at least 2 clients (e.g., Veteran & spouse) at a time).

Internet connectivity and any networking required to convert offices back/forth to CVT rooms is needed (e.g., in case we can't recruit someone to work onsite, we'd like to be able to use the rooms for remote CVT visits in interim). 1 additional office is needed for telemental health services (so 4 offices total), which should include desk, 2 chairs and CVT equipment and also have reasonable sound proofing. A group room able to accomodate up to 12 Veterans at a time for group therapy sessions will also be needed--does need to be available a few times a week as needed but doesn't need to be dedicated 100% of the time to MH. This group room can also be used to facilitate larger family sessions if needed.

Note also that the number of unique VA MH staff providing services to McComb remotely will be more than 4 (e.g., may be as many as 10 or more unique individuals of different specialties) --but workload will remain consistent at 4 FTE overall.

Confirm responsibility for phone circuit(s), VOIP service, and handsets (VA vs Contractor).

Contractor

Provide current enrolled veterans assigned to the clinic and five-year enrollment history by month.

Current Enrollment: 1913 Enrollment History Numbers are provided on page 15 below:

Provide the current billable roster count for the last three consecutive months.

August – 1838 July – 1840 June – 1835

Exam and Consultation Rooms:

Please specify the number of consultation rooms required per PACT team.

One Consultation room per PACT team

Telehealth Rooms:

Please clarify the number and types of telehealth rooms required in the facility, and whether exam tables are expected in any of these rooms.

We need one (1) telemental health room; we do not require exam tables for Telemental health rooms--normal desk and patient chair(s) set up is sufficient.

Group Rooms:

Please confirm the VA wants two group rooms at a minimum of 300 square feet (one for telehealth and one for tele-mental health), as referenced on page 78 of the

RFP.

Room Utilization:

Can a procedure room be counted toward the required number of women’s health exam rooms?

Current CBOC Compliance:

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

Design Requirements:

Please confirm whether the new CBOC must be designed using the On/Stage-Off/Stage concept as outlined in the PACT Design Guide.

Billable Enrollees:

Please provide the number of billable enrollees reflected on the most recent invoice.

VA Staff Onsite:

Please list all VA personnel expected to be onsite at the clinic and indicate the approximate number of days per week for each.

3 VA mental health providers are expected to be onsite, each 5 days per week.

Patient Vesting Visits:

Will the new contractor inherit the patients’ last vesting visit and be permitted to bill for one year from the date of contract award?

Site Visits

Will the government conduct site visits prior to award? If so, how much advance notice will be provided?

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.

Mission Act Referrals:

How many Mission Act referrals for Primary Care were made in the past 12 months for enrolled veterans of the McComb CBOC?

Vaccines and Medications:

This is correct. The VA will provide vaccines/medications administered in the clinic

Please confirm that the contractor will not be responsible for providing vaccines or medications administered in the clinic.

Telephones:

Please confirm whether the VA will supply telephones and whether the existing clinic number will be transferred to the new contractor.

The contractor will provide telephones

Price Realism:

Will the government include price realism language in the solicitation to discourage underbidding?

No, the Contracting Officer is responsible for determining the price fair and reasonable.

Maximum Dollar Value:

What is the rationale for the maximum dollar value stated in the solicitation? Would the government consider increasing this value?

Yes. After further evaluation the Contract Maximum is revised to:

From: The ceiling amount for the entire contract effort is $14,000,000.00

To: The ceiling amount for the entire contract effort is $16,000,000.00

ThinPrep Solution:

Will the VA provide the ThinPrep solution, given that contractors may be unable to obtain it?

Female Veterans

Please provide the number of enrolled female veterans.

Contract Term Structure:

Why has the government structured this procurement as a firm 5-year contract rather than using the more common model of a 1-year base period with four 1-year option periods? We respectfully request clarification on the rationale and implications of this approach.

A 5-year ordering period structure is to reduce the administrative burden and help streamline contract management processes and minimize the frequency of administrative tasks such as annual renewals and option exercises.

VA Staff Exam Room Requirements:

Could you please confirm the number of exam rooms required to accommodate VA staff who will be working onsite at the McComb CBOC?

No exam rooms are required for VA mental health staff.

Mental Health Administrative Support:

What is the anticipated Full-Time Equivalent (FTE) requirement for Mental Health administrative support staff? Alternatively, could you provide the projected number of veterans expected to receive general and specialty mental health services at the CBOC?

At least 0.5 to 1 FTE is likely needed for mental health support staff (with back up identified if/when that person is out).

- It is estimated that approximately 10% of Veterans assigned to this clinic will require Primary Care Mental Health Integration services . This equals 187 uniques annually.

Note that PCMHI will see these Veterans up to 6 times = 1123 visits annually.

- It is estimated that 30% of Veterans assigned to this clinic will require General or Specialized Mental Health services. This equals 561 uniques annually. Note that BHIP will see these Veterans as often as weekly for 3 months = 6739 visits annually.

It may be 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. We anticipate up to 3 FTE located onsite and 1 FTE remote specialty telehealth services. Note that the FTE may be multiple different providers serving McComb Veterans that add up to FTE workload (in case that matters), but 4 MH FTE would be total across providers.

Telehealth Visit Volume:

Can you provide the estimated volume of synchronous and asynchronous telehealth visits anticipated at the CBOC? This information will assist in determining the necessary FTE for Telehealth Clinical Technicians (TCTs).

It's estimated that there were approximately 550 mental health CVT encounters onsite at the McComb CBOC last year, so 1 TCT should easily suffice for mental health purposes. Note that this does not count other telehealth encounters that occurred via VVC or phone, it's assumed this doesn't impact TCT staffing but please advise if this data is needed as well. This also doesn't include other telehealth services (e.g., telederm, teleretinal, etc).

See continuation page below

Current enrolled veterans assigned to the clinic and five year enrollment history by month -

OCT-FY25 181

OCT-FY24 179

OCT-FY23 176

OCT-FY22 182

OCT-FY21 186

OCT-FY20 207

NOV-

FY25

NOV-

FY24

NOV-

FY23

NOV-

FY22

NOV-

FY21

NOV-

FY20

DEC-FY25 182

DEC-FY24 180

DEC-FY23 173

DEC-FY22 180

DEC-FY21 189

DEC-FY20 201

JAN-FY25 183

JAN-FY24 180

JAN-FY23 172

JAN-FY22 178

JAN-FY21 190

JAN-FY20 202

FEB-FY25 184

FEB-FY24 179

FEB-FY23 173

FEB-FY22 178

FEB-FY21 191

FEB-FY20 204

MAR-

FY25

MAR-

FY24

MAR-

FY23

MAR-

FY22

MAR-

FY21

MAR-

FY20

APR-FY25 187

APR-FY24 180

APR-FY23 173

APR-FY22 175

APR-FY21 192

APR-FY20 205

MAY-

FY25

MAY-

FY24

MAY-

FY23

MAY-

FY22

MAY-

FY21

MAY-

FY20

JUN-FY25 189

JUN-FY24 179

JUN-FY23 176

JUN-FY22 176

JUN-FY21 182

JUN-FY20 204

JUL-FY25 190

JUL-FY24 179

JUL-FY23 177

JUL-FY22 175

JUL-FY21 181

JUL-FY20 194

AUG-

FY25

AUG-

FY24

AUG-

FY23

AUG-

FY22

AUG-

FY21

AUG-

FY20

SEP-FY24 181

SEP-FY23 178

SEP-FY22 176

SEP-FY21 182

SEP-FY20 193

(End of Amendment 0003)