36C25721R0043 0005.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 6

09/23/2021

N/A

36C257

Department of Veterans Affairs VHA Regional Procurement Office West El Paso Contracting Office 11495 Turner Road El Paso, TX 79936

Same as Block 6.

To all Offerors/Bidders

36C25721R0043

04-02-2021

X

X

X 1

The purpose of this amendment is to post answers to vendor questions received by 9/15/2021 due date.

All other terms and conditions remain unchanged.

Frank Gamboa III Contracting Officer

VA-VHA-2020-58ED4EC5

CONTINUATION PAGE

DOCUMENT: Solicitation, Amendment 0004

PAGE: 3-5

SECTION: Paragraph B.2 Schedule of Services

Per CLINS, it is projected for the New Braunfels CBOC to exceed 10,000 enrolled veterans by Year 5. Per criteria, this puts the CBOC in the category of a “Super CBOC”, which changes several aspects of clinic services. We have been told historically that CBOCs exceeding 10,000 enrollees are considered differently than CBOCs with less than 10,000 enrollees.

QUESTION 1: Is there anything that the Contractor needs to be aware of regarding the New Braunfels clinic when it exceeds the 10,000 threshold? Are there details that the contractor needs to know regarding these services, to effectively prepare for this potential change in status during the 10-year contract period.

STVAHCS

ANSWER 1:

No

PAGE: 3-5

SECTION: Based on the Estimated Enrollment in the Revised Schedule in Amendment 0004, it appears the Government is anticipating the Seguin, TX CBOC enrollees will now be transferred to the New Braunfels, TX CBOC clinic beginning on 3/1/2022.

QUESTION 2: Will the new Contractor inherit the patients’ last vesting visit and be allowed to bill for one year from the date upon contract award?

Will the Government please confirm that the Seguin, TX CBOC enrollees are transferring to New Braunfels, TX CBOC beginning on 3/1/2022? If transferring, please confirm these transferred enrollees will not require a new qualified annual visit and will be billable on day one of the New Braunfels, TX CBOC contract start date?

ANSWER 2:

Seguin CBOC does not deactivate until 4-30-23. VA does not plan to move Seguin patients before then. VA has process in place to notify patients/congressional reps; etc. about move and able to be seen in Seguin up until deactivation date.

DOCUMENT:

Solicitation, Amendment 0004

PAGE: 10

SECTION: Paragraph 2.2. Physician Director

States the Contractor’s Physicians performing under this contract shall be board certified (or board eligible) by the ABMS in Internal Medicine and/or Family Practice or the BOS in Internal Medicine and/or Family Practice.

Section 2.3.1. option I states 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.

QUESTION 3: Will the Government allow the Primary Care Providers under Section 2.3.1 Option 1 to be board eligible?

ANSWER 3:

Yes

PAGE: 15

SECTION: Paragraph 2.4 Discipline Specific PACT Team Members (Required for All Sites)

States that CPS services will be provided by VA. On page 42 paragraph

4.6.4.4.1 states only mandated POC testing is Pregnancy test and non-mandated testing is HbA1C (paragraph 4.6.4.4.2). On page 43, paragraph

4.6.4.4.3 states anticoagulation services will be provided by Contractor using the following process: for conditions requiring chronic anticoagulation with warfarin, Contractor shall perform POCINR testing to allow for real time adjustment of warfarin dosing.

QUESTION 4: Will the Government please clarify if contractor is expected to perform anti-coagulation services in clinic without POCINR being allowed, or if this service will be provided by VA CPS remotely?

ANSWER 4:

It should be venipuncture for PT/INR, not POC

PAGE: 46

SECTION: Paragraph 4.6.5.2.1.9

States To ensure the availability of outreach and referral services to homeless Veterans, all contractor sites must designate at least one outreach specialist, usually a clinical social worker, to provide services to homeless Veterans. Contractor sites with 10,000 or more patients shall have a dedicated specialist. In smaller sites serving less than 10,000, this may be a collateral assignment.

QUESTION 5: Will the government be providing a homeless veteran specialist or is the contractor required to provide this specialist once the billable primary care enrollment is over 10,000?

ANSWER 5:

SW dedicated for New Braunfels is able to deal with homeless.

PAGE: 46

SECTION: Paragraph 4.6.5.2.1.10

States Sites with 10,000 patients or more shall have a Suicide Prevention Coordinator (SPC) with a full-time commitment to suicide prevention activities. In smaller sites serving less than 10,000, this may be a collateral assignment.

QUESTION 6: Will the government be providing a SPC or is the contractor required to provide this specialist once the billable primary care enrollment is over 10,000?

ANSWER 6:

PCMHI will cover this

PAGE: 52

SECTION: Paragraph 4.6.5.5.8 Peer Support Counseling:

States Contractor sites treating 10,000 patients or more must provide individual or group counseling from peer support technicians for Veterans treated for SMI when this service is clinically indicated and included in the Veteran’s treatment plan. Other contractor sites must make peer counseling available for Veterans with SMI when it is clinically indicated and included in the Veteran’s treatment plan. Peer counseling may be made available by telemental health, referral to VA facilities that are geographically accessible, or by referral to community-based providers.

QUESTION 7: Will the government be providing peer support counselors or is the contractor required to provide this service once the billable primary care enrollment is over 10,000?

ANSWER 7:

PCMHI will cover this

PAGE: 101

SECTION: Paragraph 6.1.2

States the Contractor shall have 120 days from contract award to commencement of the provision of medical care to local veterans.

QUESTION 8: Would the VA consider increasing the build out schedule to 180 days? We have seen other CBOC locations with buildouts based upon a 180 day schedule that were for much smaller and less complex clinics than the New Braunfels clinic. Additionally, will the VA be able to install the telecom lines and data circuit within the 90-120 day timeframe and by clinic Open for Business date? If not, then we request the VA consider increasing the current buildout period to 180 days to reduce the risk that any delays for whatever reason will not impact the contractually required Open for Business date.

ANSWER 8:

Yes, 180 Days

PAGE: FAQs, Amendment 0002 & Amendment 0003

SECTION: The Government provided a FAQs sheet and questions and answers.

QUESTION 9: Do all questions and answers provided in the FAQ’s document and Amendments 0001-0003 apply to the Schedule of Services on pages 3-5 and the revised Performance Work Statement on pages 6-119 in Amendment 00004 of this solicitation?

ANSWER 9:

Yes, reiterating space requirements/need for space and equipment for the following below:

Amendment 0002 Q13. How many VA staffed personnel will be providing services at the New Braunfels CBOC? Please list by job title and number of days per month.

- Answer: 8, Social Worker, Pharm. D., Mental Health (5 days a week) and Prosthetic Technician, 5 days a week; 2 Radiology Technicians , 5 days a week, 2 Physical Therapist, 5 days a week.

Amendment 0002 Q14. How many offices will be needed at the New Braunfels CBOC for the VA provided staff (by position/function) identified in question 13?

- Answer: 4, Social Worker, Pharm. D., Mental Health and Prosthetic Technician

Amendment 0002 Q15. How many VA staffed personnel will be providing services at the Seguin CBOC? Please list by job title and number of days per month.

- Answer: 3, Social Worker, Pharm.D., Mental Health

End of Document