36C25718R0379 0002.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

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 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

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) none

GRE2018

36C257 Department of Veterans Affairs

NCO 17

11495 Turner Rd.

El Paso TX 79936 36C257 El Paso Contracting Office Department of Veterans Affairs 11495 Turner Road El Paso TX 79936-1372 To all Offerors/Bidders

36C25718R0379

X X X

This amendment answers questions submitted to CO by the due date. The Q&A session is now closed. No other changes

Carlos Leon Contracting Officer

CONTINUATION PAGE

1. How many veterans are currently on the billable roster?

2. Please provide the historical enrollment for the past five years?

2016 – 2081 2017 – 2279 2018 – 2645 2019 – 2924 2020 – 2940 *Source: Billable Rosters

3. B.2. Schedule of Services, Pages 6-8, PMPM/CLINS over 5 year-contract: The projected growth of 300 patients per year for the first four years and 200 for the last represents an average 8% annual increase over the five-year contract. Please explain the basis/rationale for this robust enrollment projection. Please confirm that this enrollment projection is accurate to ensure the appropriate staffing of the clinic over the contract term.

The growth numbers are consistent with historical growth and are estimated.

4. Please indicate which zip codes or counties the VA expects to grow during the life of the contract.

Data is not available

5. Will the new Contractor inherit the patients’ last vesting visit and be allowed to bill for one year from the date upon contract award?

Yes.

6. Since its implementation, how many Mission Act referrals have occurred for enrolled veterans at the CBOC?

Data not available

7. Please specify how many of the referrals were for primary care patients? Please specify the types of specialty services by number of patients.

In the past 12 months, there were 40 Mission Act referrals for community primary care. Most of these remain vested at the CBOC as the VA PCP must enter the medication orders to be filled through the VA as well as any specialty consults requested by the community PCP.

8. Will the VA require a clinic manager?

Yes

9. 2.1, Page 14, Physician Director: Please confirm that either a board certified or board eligible provider is considered satisfactory for qualifications and credentialing for all physicians. Although only “board certified” is noted under the Physician Director Qualifications on page 14, both “board certified” and “board eligible” are allowed on page 15 2.2.1 for Physician MD Qualifications.

The physician that serves as the medical director must be board certified. Any other physicians may be board certified or board eligible.

10. 2.2.1 Page 15, – Does the stipulation of “At least one Primary Care provider must be a physician” mean in addition to, or including, the CMD? In other words, would the CMD alone be sufficient to comply with this agreement?

The Clinic Medical Director may serve as the one physician primary care provider for the clinic. However, in a clinic of this size, two physicians are preferred.

11. 14. 4.6.5.6.12 calls for a Homeless coordinator. Who will provide this specialist, the VA or the Contractor?

The VA will provide the Homeless Coordinator.

12. How may VA staffed personnel will be providing services at the CBOC? Please list job title and number of days per month.

Telehealth Technician – 1 FT

Mental Health Provider – 2 therapists and 1 MD. Hours depend on enrollee needs.

PACT Social Worker – 1 PT but with plans to increase to FT as number of enrollees increase.

Clinical Pharmacist – will support the clinic virtually and in person as needed based on enrollee needs.

Dietitian - will support the clinic virtually and in person as needed based on enrollee needs..

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

In addition to the VA swing offices as noted in the PWS, the following offices are needed for VA staff.

Telehelath Technician – 1 office

Mental Health Providers – 2 dedicated TeleHealth rooms. May use VA swing office at times.

SW – 1 office

Clinical Pharmacist – will use VA swing office when needs to be onsite

Dietitian – will use VA swing office when needs to be onsite.

14. VA requests two exam rooms and a consult room for each PACT teams. Can the required Women’s Health rooms be included in this count or are they separate?

The Women’s Health rooms are in addition to the clinic exam room/consult room count.

15. 4.6.4.3, Electrocardiogram Services, Page 51 – Will MUSE EKG results be reviewed and confirmed by VA cardiology?

Yes.

16. 4.6.2.4.6 requires Depo-Provera administration, please provide estimated quarterly quantity to be administered.

Due to the low number of female veterans this is not a large demand. 1 to 2 per quarter is the estimated volume.

17. Page 52, 4.6.4.5.1 – Please clarify how FOBT/FIT is POC at the clinic. Is it performed in the exam room by the provider and developed on site? Or, is the FOBT/FIT card dispensed by the lab tech to be completed by the patient at home and mailed back?

Also, is POC INR testing allowed?

FOBT/FIT may be collected onsite or may be completed by the patient at home and mailed back – cards are sent to the VA lab for processing.

POC INR testing is not recommended.

18. Will the government confirm who is responsible for supplying ALL of the following vaccines? Are there any additional vaccines required to be supplied by the contractor? TDAP Pneumovax 23 Prevnar 13 TD Flu High dose flu Shingrix Twinrix (hep a &b) Hep A Hep B HPV Tubersol (PPD) (not a vaccine)

The contractor is responsible for supplying all medications, including but not limited to the vaccines and medications in the list above.

19. Will on-site x-ray services be required?

Yes

20. What additional COVID-19 related services will be required?

The contractor will be responsible for PPE and staff to operate the point of entry screening process. Although the VA will supply COVID 19 vaccine to the clinic, based on availability, this may change to an item the contractor is responsible for as vaccine becomes available to private clinics.

21. The RFP requires courier services two times daily. Is this needed? Will the VA consider once daily service?

The VA requires two (2) lab courier deliveries to the VA core lab as specified in the PWS.

22. Does the Current PC floorplan meet the requirements of the RFP or does the VA require the PACT design of Onstage/Offstage?

The current clinic space does not support the PACT onstage/offstage design, but they do not currently operate under the PACT model of care.

The contractor’s proposed space should be in accordance with the references specified in the PWS including the PACT Space Module Design Guide as well as the other guides, manuals and references outlined in section 4.9.5. of the PWS. The contractor’s design of space will be evaluated on how it supports accessibility and the PACT model of care.

23. Please confirm the government does not require a mail room or a loading dock for this CBOC.

The government does not require a mail room of loading dock for this CBOC.

24. 6.1.2 requires 90-day buildout. Since data lines are currently taking 180 days for installation will the VA consider extending the buildout time.

No

25. Will the government be doing site visits prior to award? If so, how much advance notice will the contractor be given?

Site visits will be done by the government. The site visits will be coordinated with the contractors with at least 5 business day notice.

Who is the current incumbent at the CBOC?

CRAssociates

26. How many Mission Act referrals, for Primary Care, were made the past 12 months for enrolled veterans of the Greenville CBOC?

40 each - Most of these remain vested at the CBOC as the VA PCP must enter the medication orders to be filled through the VA as well as any specialty consults requested by the community PCP.

27. In paragraph 4.6.3.1. it states that the Contractor will provide all medication, including any necessary vaccines that are to be administered to patients in the clinic. Will the Vaccines be provided to the clinic at the cost of the Contractor or the VA?

The contractor is responsible for purchasing the vaccines and all other medications for administration at the CBOC.

28. If the cost of vaccines discussed in question 3 above are the responsibility of the contractor, please confirm that the following list of Vaccines are the responsibility of the contractor?

a. TDAP

b. Pneumovax 23

c. Prevnar 13

d. TD

e. Flu, High dose flu

f. Shingrix

g. Twinrix (Hep A&B)

h. Hep A

i. Hep B

j. HPV

k. Depo

Yes, the list above and all other vaccines and medications to be administered at the CBOC are the responsibility of the contractor.

29. If the cost of vaccines is the responsibility of the contractor…. Please list any additional Vaccines required to be supplied by the contractor other than those listed in question 4 above?

The vaccines list in question above is the current vaccine list. This may change over time based on the needs of the Veterans enrolled in the clinic and changing community/global needs such as the current pandemic. Although the VA is currently supplying COVID 19 vaccine to outpatient contract clinics, this is likely to change as the vaccine supplies/availability improves.

30. If the cost of vaccines is the responsibility of the contractor…. What is the number of Vaccines, by type as listed in question 4 and any additional Vaccines added by the government pursuant to question 5, that was provided to the Greenville CBOC Enrolled Veterans in the last 12 months?

The VA does not supply the vaccines to the Greenville CBOC and is unable to provide the requested information.

31. Pursuant to paragraph 4.6.3.1. please provide a list of Medications the government expects the contractor to dispense (at the cost of the Contractor) from the clinic that would not be a routine medication dispensed through the VA or an urgent/emergent medication dispensed through the VA contracted local pharmacy.

Data not available

32. How many Telehealth visits were originated (patient at the Greenville CBOC) from the Greenville CBOC in the last 12 months?

The number of Telehealth visits has been impacted by the current COVID 19 pandemic and the numbers from the past 12 months are not indicative of normal volume. The VA will supply one full time Telehealth Technician. The contractor staff will be trained to serve as backup and assist with Telehealth care as outlined in the PWS.

33. Is the VA supplying the phones and phone system for the CBOC or is the contractor to provide?

The contactor is responsible for supplying the phone and phone system.

34. What factors did the government consider that resulted in the CLINs growing from 3,000 enrollees in the Base year to 4,100 in OP4.

Vet population growth in the area, all numbers are estimated

35. What is the address of the VA Core Laboratory used to support the Greenville CBOC?

Dallas VA Medical Center, 4500 S. Lancaster Rd., Dallas, TX 75216 Building 2J, Room 1C.311

36. Can the Women’s health room be counted as one of the patient care rooms?

No

37. Can the Procedure room serve a dual purpose and also be used as the Women’s health room?

Yes

38. Is the maximum cap of $21,600,000 the firm/fixed maximum the VA will accept for the total value of the proposals?

Suggest you propose according to your assessment. We will determine if offer is acceptable.

39. In reference to Section E.7 52.212-2 Evaluation – Commercial Items Sub-factor (a) Quality on page 185 of the Solicitation, if a contactor is Joint Commission accredited and provides valid documentation for item 1) under this section, does the VA still require information from the Joint Commission accredited Contractor for item 2) …to provide evidence of a working knowledge…?

If item #1 is provided item #2 is not required.

End of Document