36C25721R0019 0004.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) 04-19-2021 36C257 Department of Veterans Affairs VHA Regional Procurement Office West El Paso Contracting Office 11495 Turner Road El Paso TX 79936

To all Offerors/Bidders

36C25721R0019 04-19-2021

X X X

3 MAY 2021 AT 12:00 MST

See CONTINUATION Page X The purpose of this amendment is to post the questions received and answers for the second and final Q & A period.

There are no further changes to the terms and conditions.

MARISELA GALARZA

Contracting Officer

VA-VHA-2020-534D2907

CONTINUATION PAGE

RFP 36C257-21-R-0019

SE San Antonio CBOC

QUESTIONS & ANSWERS #2

1. Amendment 0002, question 16 asks if CVs and licenses can be excluded from the 30-page limit and if transcripts for the NPs can be submitted post award.

The Government answered “Yes” to questions 1 and 2 – CVs/transcripts may be submitted after award; however, the proposed staffing plan/coverage relief plan must be submitted with proposals, which are limited to 30 pages.

Note: the answer indicates both CVs and transcripts should be submitted post award but does not address when licenses should be submitted. When should licenses be submitted?

A: Licenses and CV should be submitted with initial proposal. Transcripts can be submitted post-award. Yes, they can be submitted in an Appendix outside of the 30-page limit with the initial proposal.

2. Amendment 0002, question 30 asks if licenses are required for all staffing. The Government answered, “for all staffing.”

Then Amendment 0002 question 31 asks if CVs can be submitted in place of transcripts for the NPs. The Government answered, “VA will accept a current CV in place of transcripts.”

Clarification 1: What exactly should be included in the proposal regarding CVs, License and Transcripts and what should be submitted post-award?

A: Licenses and CV should be submitted with initial proposal. Transcripts can be submitted post-award. Yes, they can be submitted in an Appendix outside of the 30-page limit with the initial proposal.

Clarification 2: If required to be submitted with the proposal, what, if any, of these documents can be excluded from the 30-page limit?

A: Licenses and CV should be submitted with initial proposal. Transcripts can be submitted in an Appendix outside of the 30-page limit with the initial proposal.

3. Question number 14 is answered 2,452, however question 19 states, most “recent billed” enrollment is 2,079, please clarify which number is correct?

A: 2,079

4. Current enrollment seems to be approximately 15% lower than CLIN will the VA consider adjusting the CLIN?

A: No, these are estimated quantities based on monthly projections.

5. What percentage of the most recent billable roster contains veterans with a qualifying vesting visit past 12 months?

A: 81% of Veterans from 1 October 2020 until end of February 2021.

6. Will the VA allow the contractor to open the clinic with three PACT teams and complete construction of space for additional PACT teams as enrollment warrant?

A: Yes.

7. Thank you for your previous response regarding vaccinations. Unfortunately, your response provided no actionable information with which to properly estimate the number of vaccinations required in the new contract. Would the VA consider providing an estimate as to the number of enrollees on a percentage basis that would require vaccinations? If all potential offerors use the same basis of estimate it would offset the historical knowledge advantage of the incumbent contractor and level the playing field.

A: Historical data could not be obtained.

8. Please clarify the boundaries of the geographic location in which the CBOC is to be located.

A: The boundaries are explained in Amendment 0001, paragraph 52.212-2, Factor 2, Geographic Location.

9. Can you please confirm the VA only requires three offices for its employees at the CBOC? This is the same number required for the Southwest San Antonio CBOC and the enrollments are significantly different.

A: Yes, three offices are required for VA staff.

10. On page 15 paragraph 2.2 Physician Director of the Solicitation states, “Contractor’s Physicians performing under this contract shall be board certified (or board eligible)….” On page 15 paragraph 2.3.1 Option 1: Physician (MD): Qualifications under the Primary Care Teamlet Staffing states, “Physicians performing under this contract shall be board certified…” Is it acceptable to the VA if the physicians are board certified or board eligible regardless of whether they are the Physician Director or a physician as part of the Primary Care Teamlet staffing?

A: Yes, board-certified or board-eligible is suitable.

11. In Section 4.6.3.4 page 43 of the Solicitation states, “VA will provide COVID-19 vaccines in accordance with the January 12, 2021 memorandum from the Assistant Undersecretary of Health for Patient Care Services ….” However, in Amendment 002 answer to question 24 states, “The contractor must provide ALL in-clinic medications. Whatever the clinic needs, they need to provide. We do not list specific meds, because then it becomes too exhaustive/restricted. Contractor will be required to provide the COVID-19 vaccine.” As a contractor, we do not have access to order the COVID-19 vaccine. Is the VA providing the COVID-19 vaccine to the contractor at the VA’s expense?

A: Yes, VA will provide COVID-19 vaccines as required.

12. On page 83 paragraph 4.9.21 of the Solicitation states, “Closed Circuit Television (CCTV): Shall be provided by the Contractor to monitor building entrances, restricted areas, mission critical asset areas, and alarm conditions. CCTV system shall be used for surveillance and observations of defined exterior areas, such as site and roadway access points, parking lots, and building perimeter, and interior areas such as hallways, common areas and waiting areas, CCTV system will be viewed from a VA location determined by the VA Physical Security Officer. The design, installation, and use of CCTV cameras shall support the visual identification and surveillance of persons, vehicles, assets, incidents, and defined locations. The Contractor shall contact the VA Physical Security Officer at STVHCS prior to installation of CCTV system to ensure proper placement.” The requirement for the VA to be able to monitor the CCTV activities remotely appears to be intended for a VA leased and operated facility as opposed to a contractor operated and leased facility. Our current contracted CBOC facilities across the U.S. utilize high resolution CCTV security cameras for both interior and exterior monitoring and routinely have recording capability of up to 30 days. This is the only specification that requests the government to monitor these cameras which require cellular based services and special equipment to accomplish. Was it the VA’s intent to utilize this level of monitoring by the government, as opposed to the contractor responsibility, to monitor the camera activities at the privately leased contracted facility? Was this requirement placed in the specification in error as it is not normally utilized. Will you please clarify?

A: Yes, VA’s intent to utilize this level of monitoring by the government.

13. In the Instructions to Offeror paragraph 1.c on page 138 of the Solicitation states, “Each offeror must submit a Technical Proposal, Geographic Location, Past Performance Information, Veteran Participation Information, Price Proposal and Subcontracting Plan (large businesses only) See Section D, Subcontracting Plan – Attachment D.25.” Is it acceptable with the VA, if we replace the template included as Attachment D.25 Small Business Subcontracting Plan Revised 01/26/2017 with the VA FSS Subcontracting template revised 10/20/2020? This is the template we are required to use to submit our Small Business Plan for approval by the U.S. Department of Veterans Affairs, VA Federal Supply Schedule Services, Office of Acquisition, Logistics and Construction, Hines, Illinois.

A: It is acceptable to use the VA FSS subcontracting plan template – revised 20 October 2020.

14. On page 139 Part 1- Requirements for Technical Capability, there is a limit of 30 pages and any pages beyond 30 will not be reviewed by the Evaluators. On page 23 paragraph 2.9.6 of the RFP states, “A copy of licenses must be provided with offer and will be updated annually.” On page 147 of the RFP states, “Also submit copy of licenses for all staffing.” And on page 148 it states, “if the contractor is not accredited by the Joint Commission, Contractor shall provide Infection Control Plan, Blood borne Pathogen Plan and Tuberculosis Control Plan.” In Amendment 0002 question 16, the VA said ‘yes’ the CVs/transcripts can be provided as an appendix and not count towards the 30-page limit. Is it also acceptable to the VA for the Contractor to provide the licenses and Infection Control Plan, Blood borne Pathogen Plan and Tuberculosis Control Plan as appendices and not counted towards the 30-page limit?

A: Yes, it is acceptable. However, information in response to these questions beyond the 30-page limitation must be added via Appendix and clearly names/identified.

15: On page 139 Part 1 – Requirements for Technical Capability, it states, “Submit one e-mailed electronic copy along with one e-mailed redacted electronic copy for evaluation.” Is the VA only requiring a redacted electronic copy for Factor #1 Technical Capability? Does the VA require redacted version for Factor 2 Geographic Location? Are there any email size requirements in the submission of the electronic copies emailed to the VA?

A: Interested offerors shall provide redacted copies of their technical proposal and for the proposed geographic location, Factor 2. Proposals may have to be submitted in several e-mails due to e-mail size restrictions. Please limit e-mails to no more than 40mb.

16. In Section E.11 52.212-2 Evaluation-Commercial Items under Sub-factor (A) – Experience/Management Plan on page 146 it says, “identified all relevant company experience in providing the same/similar types of services identified in this solicitation, including VA experience, and other government and/or private sector experience. Provide a clinical and administrative contact point for each experience episode provided.” Is the VA looking for a list of all contractor’s relevant contract experience and the point of contact information? With the number of contracts we have along with the page limitations outlined in the RFP, it is physically impossible to include all this information in the 30 page limitation. Would the VA consider removing the page limitation or reducing the amount of relevant company experience requested in this section? Is this point of contact information requested in Part 1 Technical Proposal (Factor 1) different than the 3 references and point of contact information provided in Part 3 Past Performance (Factor 3)? Please clarify what the difference is between what is being asked for in Factor 1 and Factor 3.

A: No, on removing the page limitation or reducing the amount of relevant company experience. Factor 1 is Technical Proposal with three subfactors and Factor 3 is for Past Performance information.

17. Amendment 0002, Question 14 and 32 states, “How many Veterans using the SE San Antonio (Pecan Valley) CBOC are currently on the Primary Care Billable roster?” The VA answered 2,242. As the incumbent contractor, the latest verified billable roster was 2,079 Veterans, is the 2,242 listed the actual PCMM count, not the true billable roster?

A: 2,242 is the PCMM count.

18. In reference to Amendment 0002 question 27, for further clarification on the use and application of the Davis Bacon Act, we ask and provide the following information. The use of the Davis- Bacon specification and clause is normally utilized in GSA/VA facilities based contracts, and not in service contracts that are paid by PMPM rate with the facility and all other services and components inclusive in the PMPM rate for each billable enrollee. In short, there is no construction contract vehicle, as part of the specification, in this personal services contract vehicle being solicited and procured by the government. Davis Bacon unintentionally, is being utilized out of context for this type of service contract procurement. CBOC procurements across the U.S. have not utilized the Davis Bacon requirement as it was determined that it was not related or relevant to this type of service contract procurement and raises construction costs by over 50% unnecessarily. Based on this information and cost affect for all bidders, would the government consider removing its Davis Bacon Act requirement from this CBOC solicitation as it appears to not be applicable and saves substantial costs in startup?

A: CBOCs are not considered personal service contracts and the Government will not consider removing its Davis-Bacon Act requirement from this CBOC solicitation. Below is the reason as to why.

Historically, community-based outpatient clinic (CBOC) procurements have been considered services contracts and logically included clauses for wages required under the Service Contract Act (SCA). This practice was questioned in a June 2020 GAO protest in which a potential vendor, alleged the CBOC solicitation should also include wages required under the Davis-Bacon Act (DBA). The Protester's argument was that, although it was primarily a services contract, the solicitation also included construction work that the VA would pay for indirectly; further, that the buildout of the proposed facility must be constructed pursuant to VA's very specialized requirements. As a result of the protest, OGC District Contract Law National Practice Group (DCNPG) contacted the Department of Labor (DOL) to request its opinion on inclusion of the DBA.

DOL policy and legal staff advised that the protested CBOC solicitation should have included the DBA. In addition to adding DBA language and clauses to solicitations still in the planning stages, DOL advised that any applicable CBOC procurement in which construction was ongoing should include the DBA.

END OF DOCUMENT