36C25724R0010 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 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) 11-07-2024 36C257 Department of Veterans Affairs VHA RPO West - NCO 17 El Paso Contracting Office 11495 Turner Road El Paso TX 79936

SEE BLOCK 6

To all Offerors/Bidders

36C25724R0010

X X X R eceipt of Offers is EXTENDED to: 12-02-2024 12:00 PM CST See CONTINUATION Page X The purpose of this amendment is to post the questions received and answers and to extend the proposal due date to 2 December 2024 at 1200 Mountain Time.

Any further questions are due to noel.ramirez2@va.gov NO LATER THAN 15 NOVEMBER 2024 at 1200 PM Mountain Time.

NOEL E. RAMIREZ

Contracting Officer

VA-VHA-RPOW-2024-0115

CONTINUATION PAGE

GRANBURY, TX, CBOC

QUESTIONS AND ANSWERS: RFP 36C25724R0010

Q1: If a contractor has a clinic in the DFW area (Plano, TX) and will set up a satellite clinic in Granbury, could the site visit be at the current in Plano or must the clinic in Granbury be ready before the site visit?

On Page 9 of 36C25724R0010, the place of performance is within the city limit of Granbury, Texas but on Page 134, it is "within the limits of Hood County". Can you please clarify the location?

2.1 Place of Performance: Services shall be performed by contractor within the city limits of Granbury, Texas, on behalf of VA North Texas Health Care System, 4500 South Lancaster Road, Dallas, Texas, 75216.

Sub-factor (d) – Geographic Location (may include a site visit prior to award)

2.2 Proposed contractor’s facility must be located within the limits of Hood County, Texas. The parent facility is the North Texas Veterans Health Care System (NTVHCS) located in Dallas, Texas. A site visit may be conducted as part of the evaluation process.

A: The anticipated clinic (CBOC) shall be within the city limits of Granbury, Texas. The site visit location must be at the proposed clinic location within the limits of Granbury, Texas.

Q2: Since this procurement is set-aside for a SDVOSB, would the Government consider an initial fixed price contract, with a cost reimbursement line item, for a six-month construction/transition period? RFP would require the contractor to provide all necessary facilities, maintenance, staffing, supplies, and equipment for the CBOC. RFP would list contract required services and supplies in the form of contract line items (CLINs). The first CLIN would correspond to facility development/construction, equipment, furnishings, and other start-up during a six-month transition period (reimbursable). During the six-month startup period, monthly progress payments would be reimbursed. Upon completion of start-up and commencement of services, contractor would be paid PMPM for enrolled Veteran population (Fixed Price IDIQ).

A: Offerors are reminded that they are required to submit proposals that conform to the solicitation terms and conditions. This solicitation is for a fixed-price indefinite-delivery indefinite quantity (IDIQ) contract. The first payment will be the PMPM payment for the first month the contractor provides care to VANTHCS Veterans.

Q3: The solicitation states, "The contractor will provide all medications that are to be administered to patients in the clinic (including vaccines in accordance with current and future Advisory Committee on Immunization Practices (ACIP)/CDC recommendations and guidance)." What medications are considered routine for Mental Health patients that will be required to be administered in the clinic?

A: Medications administered in outpatient clinics vary based on the needs of the population served. The VA does not supply or track the medications at the contract clinics. A list of common medications stocked in PACT clinics at VANTHCS is listed below. NOTE: This is not to be considered an all-inclusive listing. In addition to these medications, the contractor will be expected to supply needles for battlefield acupuncture and the supplies needed for Korean Hand Therapy.

Acetaminophen 325mg

ALBUTEROL 3/IPRATROP 0.5MG/3ML INHL 3ML

amLODIPine BESYLATE 10MG TAB

ARIPiprazole 1064MG/3.9ML SA INJ SUSP

ARIPiprazole 300MG/KIT SA INJ SUSP

ARIPiprazole 400MG/KIT INJ SUSP SA

ARIPiprazole 441MG/1.6ML SA INJ SUSP

ARIPiprazole 662MG/2.4ML SA INJ SUSP

ARIPiprazole 675MG/2.4ML SA INJ STARTER

ARIPiprazole 882MG/3.2ML SA INJ SUSP

Aspirin Tab 81mg Chewable

ASPIRIN 325MG EC TAB

CEFTRIAXONE INJ 250MG VIAL

cefTRIAXone NA VIAL 1GM INJ

Clonidine HCL Tab 0.1mg (BP) cloNIDine HCL 0.2MG TAB

CYANOCOBALAMIN INJ 1000MCG/ML, 1ML

dexameTHASONE INJ 4MG/1ML 1ML INJ

DEXTROSE 15GM/37.5GM SQUEEZE TUBE

DEXTROSE SQUEEZE 24GM/32.2ML 32.2ML GEL

diphenhydrAMINE 50MG/1ML 1ML INJ

Diphenhydramine Cap 25mg

DIPHTH, PERTUSS (ACELL), TET 2-2.5 0.5

Epinephrine (EQV-EPI-PEN) 0.3mg/0.3ml fluPHENAZine DECANOATE 125MG/5ML 5ML INJ

Glucagon Emergency Kit

GLUCOSE 4GM CHEW TAB

GLUCOSE ORAL GEL DEXTROSE 15GM/37.5GM SQUEEZE TUBE

HAEMOPHILUS B TETANUS TOX CONJ V

Haloperidol DECANOATE 50MG/ML INJ

HALOPERIDOL DECANOATE 100MG/ML 1ML INJ

Hepatitis A Vaccine 1440 EL. U/ml INJ

Hepatitis A/Hepatitis B Vaccine 1ml SYR

Hepatitis B Vaccine 200mcg/ml INJ 1ml hydrALAZINE HCL 25MG TAB hydroCHLOROthiazide 25MG TAB

HYDROCORTISONE 1% UD CREAM

HydrOXYzine HCL 10MG TAB

Ibuprofen Tab 400mg/Change to 200mg

Influenza Vaccine (PF) SYR 0.5ml

INFLUENZA VAC, HIGH-DOSE SYR 0.7M

INSULIN HUMAN 70/30 (NPH/REG) INJ

INSULIN NPH HUMAN 100 UNIT/ML

INSULIN REG HUMAN 100UNIT/ML INJ

IPRATROPIUM BROMIDE 0.02% 2.5ML INH SOL

Ketoralac INJ 30mg

Ketoralac INJ 60mg

LEVONORGESTREL (EQV-PLAN B) 1.5MG PKG 1

Lidocaine HCL 1% INJ 20ml vl

Lidocaine HCL 2% Top Jelly

LISINOPRIL 20MG TAB

measLES,MUMPS,RUBELLA VACCINE LIVE

MEDROXYPROGESTERONE 150MG/ML INJ SYR 1ML

MedroxyPROGESTERONE ACETATE 150MG/1ML 1ML INJ SUS

MENINGOCOCCAL B (BEXSERO) INJ SYR 0.5ML

MENINGOCOCCAL (MENVEO 1-VIAL) INJ, SOL

Methylpred Na Suc Inj 40mg, 1ml VL

Methylprednisol Ace Par Susp 80mg/ml 1ml

Methylpred NA Suc Inj 125mg 2ml VL

MENINGOCOCCAL OLIG CONJ (MENVEO) INJ

MENINGOCOCCAL B (BEXSERO) INJ SYR 0.5ML

metoPROlol TARTRATE 50MG TAB

NALOXONE HCL 4MG SPRAY/NASAL SPRAY

NALTREXONE HCL 380MG/1VI 1VI INJ, SUS

NEOMY, POLY, BACI OINT UNIT DOSE PK

Nitroglycerin 0.4mg SL Tab

OLANZapine RAPID DISINTEGRATING 10MG TAB

ONDANSETRON HCL INJ 2MG/1ML 2ML INJ

PALIPERIDONE KIT (3 MONTH) 273MG SA INJ

PALIPERIDONE PALMITATE ER 117MG/KIT INJ

PALIPERIDONE PALMITATE ER 156MG IN

PALIPERIDONE PALMITATE ER 234MG/KIT INJ

PALIPERIDONE PALMITATE ER 39MG/KIT INJ

PALIPERIDONE PALMITATE ER 410MG IN

PALIPERIDONE PALMITATE ER 546MG/KIT INJ

PALIPERIDONE PALMITATE ER 78MG/KIT INJ

PALIPERIDONE PALMITATE SA 819MG INJ

Papillomavirus 9-Valent Vacc 0.5ml Syr (HPV everybody?)

PEN G BENZAT/PROCA SUS,600,000UNT/ML,2ML

Pneumococcal 23-Valent Polysacc Vaccine

POTASSIUM CHLORIDE SA 10MEQ TAB

POTASSIUM CHLORIDE SA 20MEQ TAB

risperiDONE MICROSPHERE 25MG/2ML 2ML SYRINGE risperiDONE SA 12.5MG/2ML 2ML SYRINGE risperiDONE SA 37.5MG/2ML 2ML SYRINGE risperiDONE SA 50MG/2ML 2ML SYRINGE

RSV VACCINE LYPHL INJ SYR KIT

SOD POLYSTYRENE SULFON 15GM/60ML 60ML SUSP

SPACE-INHALER

TETANUS/DIPHTH TOXOID, ADULT 0.5ML SYRINGE

Triamcinolone 40mg/ml 1ml

Tuberculin PAR I.D INJ 5TU/0.1ml

TYPHIM VI VACCINE INJ SYR 0.5ML SYRINGE

WATER FOR INJECTION WO/PRES 10ML VI

ZOSTER VACCINE, RECOMBINANT INJ

Q4: The solicitation states, “The contractor will provide all medications that are to be administered to patients in the clinic (including vaccines in accordance with current and future Advisory Committee on Immunization Practices (ACIP)/CDC recommendations and guidance)." Would the Government consider modification of the PMPM on a case-by-case basis to fund unknown, or as of yet undeveloped, vaccines and requirements?

A: The contractor is expected to factor into their cost projections variables to be able to continue to provide care and services as required by the contract without modifications. However, if a new vaccine is developed and to be offered to the Veterans at the CBOC at an exorbitant cost to the contractor, the government would consider a contract modification on a case-by-case basis.

Q5: The solicitation states, “The contractor will provide all medications that are to be administered to patients in the clinic (including vaccines in accordance with current and future Advisory Committee on Immunization Practices (ACIP)/CDC recommendations and guidance)." Will the Government please provide a list of required medications and vaccines that the CBOC will be responsible for administering to patients in the clinic?

A: SEE Q3

Q6: Solicitation states under Medication Management "Contractor shall ensure that all vaccines and medications requiring refrigeration or freezing are stored in pharmaceutical grade purpose-built refrigerators and freezers." Will the Government be providing a Pixis System or is the Contractor responsible to purchase the appropriate pharmaceutical grade refrigerator and freezer?

A: The contractor is responsible to purchase the pharmaceutical grade purpose-built refrigerator and freezer as stated in section 5.3 Pharmacy Services under the paragraph titled Medication Management on page 33.

Medication Management: All medications and supplies used in the treatment of outpatients on premises are required to be stored and secured to meet compliance with VHA policies. Efforts should be made to limit the number of ward stock medications and supplies stored at the outpatient site of care. The contractor is responsible to ensure all medications are subject to routine inspection, as required by VA Pharmacy, proper storage (in a secure and locked location) and meet all VA policies for medication management. Contractor shall ensure all vaccines and medications requiring refrigeration or freezing are stored in pharmaceutical grade purpose-built refrigerators and freezers. Contractor will also ensure monitoring of the temperatures for medication refrigerators and freezers, United States Pharmacopoeia (USP), and VA standards. In addition, contractor shall ensure that vaccines and medications exposed to temperature excursions are not used for patient care.

Q7: The solicitation states, "the contractor shall meet all requirements for anticoagulation management." The solicitation also states, "Clinical Pharmacy Services: Services will be provided by the VA via onsite visits, telehealth and other virtual modalities including VVC and telephone." If the VA is providing the Clinical Pharmacy Services, isn't the VA also providing anticoagulation management?

A: The contractor is responsible for participating in anticoagulation management as outlined in Attachment D.8 VANTHCS Memorandum 118-18 under the Section 4, Responsibilities, i. Outpatient Anticoagulation Therapy, (1). Primary Care Provider.

Q8: Solicitation states that " The contractor shall provide all Specimen collection materials and containers". We are not able to provide the Thin Prep required for specimen collection for women’s health as the manufacturer will only sell to the VA. Will the Government provide the Thin Prep solution needed for Pap testing to the CBOC?

A: The VA will provide Thin Prep as outlined in section 5.2 Women Veterans Health Care Services; paragraph titled Cervical Cancer Screening on page 29.

Cervical Cancer Screening: The VA will supply the Thin Prep Pap test. The contractor shall provide cervical cancer screening in accordance with VHA Directive 1330.01(7) Health Care Services for Women Veterans (or subsequent policy). The cervical pathology report of normal results shall be communicated to the patient in terms easily understood by a layperson within 14-calendar days from the date of the pathology report and the Human Papilloma Virus (HPV) report becoming available to the ordering provider. Documentation of a letter and/or verbal communication with the patient shall be entered into VA EHR. If using the United States Postal Service, confirmation of the receipt of these results is not required. For any abnormal cervical pathology report, the results shall be communicated within 7-calendar days of the report (including both cytology and HPV) becoming available to the ordering provider.

Q9: The solicitation 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?

A: Yes, it is acceptable for the contractor to use the VANTHCS after hours call center to provider after-hours telephone access.

Q10: The solicitation 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." How can the contractor be held responsible for ensuring that the VA staffed dietitian completes Event Capture System forms?

A: The VA will supply dietitian support to the clinic. This would only be applicable to the contractor if the contractor were providing the dietitians.

Q11: The solicitation 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, medical equipment, infection control, and utility system with the submission of their proposal and within 15 calendar days after contract award." Is it acceptable for the Contractor to provide the EOC within 15 calendar days after contract award?

A: Yes, it is acceptable for the contractor to provide the required EOC management plans within 15 days after contract award.

Q12: The solicitation states, "the Contractor shall have 120 calendar days from contract award to commencement of medical care to VA parent facility patients." Would the VA consider 180 calendar days from contract award to commencement of the provision of medical care to VA parent facility patients?

A: No.

Q13: It states, "each offeror must submit a Technical Proposal, Past Performance Questionnaire(s), and a Price Proposal via separate PDF documents." Per the instructions in the PPQ, shouldn't the PPQ be sent directly to the Contracting Officer and not included in our Past Performance volume? Or do you want the bidder to include a copy of the PPQ that was submitted to the reference in the Past Performance Volume?

A: A Past Performance Volume should consist of the items identified in 52.212-2 Factor 2. PPQs are a separate requirement for Past Performance and all PPQs will come from a party other than the offeror and not included in the Past Performance Volume.

Q14: Will the Government please clarify what is meant by “subcontractor plans"? In addition to providing the bidder's experience, is the Government asking for the bidder to provide the experience of any subcontractors we are using? And if so, do you also want the clinical and administrative contact point for each experience episode provided for any subcontractors?

A: If the offeror is planning on utilizing subcontractors to perform any work under this contract, the offeror must adhere to the requirements of VAAR 852.219-75, VA Notice of Limitations on Subcontracting – Certificate of Compliance for Services and Construction. An individual subcontracting plan is NOT REQUIRED, however a contractor completed certification from VAAR 852.219-75 is required to be returned with proposals.

Q15: In Sub-factor (b) - Management, Experience, Staffing, under number 2) ii it states, "describe capability and/or mechanisms to be used to begin contract performance within required time frames after contract award including staffing for the first 90 days of clinic operation." In Sub-factor (c) - Transition Plan it states, "describe capability and/or mechanisms to be used to begin contract performance within required time frames after contract award including staffing for the first 90 days of clinic operation." Does the Government want this information in Sub-factor (b) and Sub-factor (c)?

A: This is a duplicate error. Please include the “capability and/or mechanisms to be used to begin contract performance within required time frames after contract award including staffing plan for first 90 days of clinic operation.” ONLY under Subfactor C.

Q16: The solicitation states, "1 consultation room per PACT teamlet for use by clinical pharmacist, social worker, dietician, and other VA staff". Would the VA allow one of the 3 exams per teamlet be used for consultations?

A: No.

Q17: In looking at the instructions for submission of the Granbury CBOC proposal, number 2 on page 125 of the RFP states “proposals shall be double spaced, times new roman font, 11 minimum font size.” Does this refer only to Part 1 Technical Proposal, or does it include Part 2 Past Performance Proposal and Part 3 Pricing Proposal?

A: The double spaced, times new roman font, 11 minimum font size only applies to PART 1 TECHNICAL PROPOSAL. However, the double-spaced requirement is not required. Single spaced documents will be acceptable.

Q18: Can the government please explain how the expected patient population to double over a 10-year period. We have not seen this level of growth for CBOCs of this size in the market.

A: Growth rates are calculated based on historical volumes and VA growth projection and planning models. VANTHCS has seen unprecedented growth related to the PACT Act of 2022 which expanded who is eligible for VA services.

Q19: Paragraph 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.

A: The contractor should plan for 1.5 TCT upon opening of the clinic.

Q20: Do the women’s health exam rooms and procedure exam room required on page 54 count towards the required 3 exam rooms per PACT?

A: Yes, the women’s health exam rooms and the procedure exam room can count towards the required 3 exam rooms per PACT.

Q: Will the VA provide the lab specimen tubes?

A: Yes.

Q21: 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.

A: Yes.

Q22: Page 125 paragraph 2 says “PROPOSALS SHALL BE DOUBLE SPACED, TIMES NEW ROMAN FONT, 11 (MINIMUM) FONT SIZE”. Would the Government consider removing the requirement for proposals to be “double spaced”?

A: Yes. Proposals may be single spaced.

Q23: Will the Government accept Nurse Practitioner transcripts after award. The majority of qualified candidates are not willing to provide this type of document for a position that does not exist yet.

A: Transcripts for nurse practitioners are not required.

Q24: Please confirm the email address(es) that the proposal should be submitted to.

A: noel.ramirez2@va.gov

Q25: Who is responsible for VOIP phones for the clinic?

A: The contractor is responsible for the telecommunication lines, telephone system and phones.

Q26: Can the government consider giving contractors up to 180 days to start up the contract.

A: No.

Q27: Can the government please extend the submission deadline by 30 days?

A: No.

Q28: What is the anticipated award for this procurement?

A: Approximately 75-90 days after receipt of proposals due to required levels of reviews.

Q29: Who will provide the centrifuge machine?

A: The contractor will supply the centrifuge machine.

Q30: What is the most current billable roster? Can you provide the history over the last 3 months?

A: Current billable roster for the Granbury CBOC as of September 2024 is 2,851.

Q31: Can the VA please provide the historical enrollment for the past five years?

A: 2020 – 1,732 PMPM / 21,015 annual PMPM 2021 – 1,968 PMPM / 22,514 annual PMPM 2022 – 2,372 PMPM / 25,537 annual PMPM 2023 – 2,571 PMPM / 28,677 annual PMPM 2024 – 2,851 PMPM / 32,739 annual PMPM

Q32: 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?

A: Medications administered in outpatient clinics vary based on the needs of the population served. The VA does not supply or track the medications at the contract clinics. A list of common medications stocked in PACT clinics at VANTHCS has been provided in Q3.

Q33: We are a Service-Disabled Veteran-Owned Small Business (SDVOSB) currently working on a proposal for Notice 36C25724R0010, Granbury, Texas CBOC (April 1, 2025 – March 31, 2035). The pre-solicitation posted on October 11 and the solicitation posted on October 15 both indicated that this opportunity was a Service-Disabled Veteran-Owned Small Business set-aside.

However, with the amendment posted on October 21, we noticed the opportunity is now listed as unrestricted. Could you please clarify the current set-aside status and provide any insights into the reason for this change?

A: This RFP has been and will remain a SDVOSB set-aside.

Q34: Please advise how many exam rooms and how many consultation rooms the VA requires per PACT team.

A: The VA requires 3 exam rooms per PACT provider/teamlet. One consult room and one mental health counseling room is required per PACT provider/teamlet.

Q35: Please advise how many telehealth rooms (by type) the VA requires in this facility and if the VA would like exam tables in the rooms.

A: One tele-retinal room, one tele-spirometry room, telemental health room, and one general telehealth room. An exam table is needed for the general telehealth room.

Q36: Please confirm the size and number of small group rooms and large group rooms required in this facility.

A: One shared medical appointment room at 400 square feet with an additional 100 square feet for storage and one mental health group room at 300 square feet.

Q37: Please confirm the number of procedure rooms and women’s health exam rooms required in this clinic.

A: One procedure room and two women’s health exam rooms are required.

Q38: Can a procedure room count toward the number of required women’s health exam rooms?

A: If appropriately equipped, the procedure room may count toward the required women’s health exam rooms.

Q39: 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”?

A: No, the current CBOC does not meet the projected space requirements and will not be “grandfathered in” or available for rebid “as-is”.

Q40: Please confirm the new CBOC must be designed with the on/Stage-Off/Stage concept as laid out in the PACT Design Guide.

A: Yes, the on stage/off stage design is required.

Q41: Please provide the number of billable enrollees on the most current invoice.

A: Please see response to Q30.

Q42: Please list all VA staff that will be onsite at the clinic and the approximate number of days per week they will be there.

A: Following the space requirements of one consult room and one mental health counseling room per PACT provider/teamlet will ensure adequate space is available for VA staff.

Q43: Will the new Contractor inherit the patients’ last vesting visit and be allowed to bill for one year from the date upon contract award?

A: Yes, the contractor will inherit the patient’s last vesting visit and be allowed to bill the PMPM rate starting the month the clinic starts providing care to Veterans at their outpatient site of care.

Q44: Will the government be making site visits prior to the award? If so, how much advance notice will the contractor be given?

A: Yes, the government will be making site visits as part of the proposal evaluation process prior to contract award with at least 10 calendar days of notice.

Q45: How many Mission Act referrals, for Primary Care, were made in the past 12 months for enrolled veterans of the Granbury CBOC?

A: This information is not relevant to the solicitation.

Q46: Will the government consider extending the start-up time due to supply chain issues availability of construction materials to 180 days instead 120?

A: No.

Q47: Transcripts are required to be submitted for NP candidates with the proposal. Can these transcripts be submitted after the award?

A: Please see response to Q23.

Q48: Proof of ACLS and BLS are required to be submitted for Physicians with the proposal. Can these be submitted after the award?

A: Proof of BLS is required as part of the credentialing process and may be submitted after award.

Q49: 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.

A: Please see response to Q32.

Q50: Please confirm if the VA will supply the telephones and will the existing number be rolled over to the new contractor?

A: Please see response to Q25. It is anticipated that the existing clinic phone number will be rolled over to the new contractor.

Q51: Will the government add price realism language to the current solicitation? To prevent contractors from deliberately underbidding this contract?

A: No, prices will be evaluated as stated in E.12 FAR Clause 52.212-2 Evaluation- "FACTOR 3 Price" page 135 which states "A fair and reasonable price determination assessment will be conducted by the Government on the offeror's proposed price. Prices shall be evaluated for fairness and reasonableness and will be compared against competing proposals, similar/current market prices and IGCE.”

Q52: In reference to: Space requirements pg. 54: Nurse triage room for walk-ins located near check-in.

Would this need to be accessible from the lobby? I am assuming this would be like a height/weight alcove with scale and stadiometer?

A: This room should be located near the check in area but does not have to be directly accessible from the lobby. It should be separate from the height/weight alcove.

Q53: Will the nurse triage room have a minimum square footage requirement? What are the furniture requirements? Will it need to be accessible from the lobby?

A: The minimum square footage requirement is 100 square feet, with at least a desk or workstation and desk chair, guest chair, vital sign equipment, and handwashing sink.

Q54: What is the government’s rationale for substantial enrollment growth throughout the duration of this contract?

A: Please see response to Q18.

Q55: 2.7 Telehealth Services Clinical Staff: Please provide the number of synchronous and asynchronous encounters in 2024.

A: Based on projections, please plan for 1.5 TCT at the start of the contract.

Q56: Is the government aware of the moratorium on construction in Granbury, TX? Considering the extension of the moratorium, will the government permit the use of a temporary existing location during the construction period?

A: Yes, the Government is aware of the moratorium, and we have been advised that this is not necessarily a showstopper. The proposed facility will still have to get approval from the City of Granbury prior to work starting. Please contact comdev@granbury.org or call 815-573-1114 for further information and guidance.

Q57: In reference to: 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. Describe capability and/or mechanisms to be used to begin contract performance within required time frames after contract award including staffing plan for first 90 days of clinic operation.

Please confirm if the government is requesting information on past performance. If not, could you clarify the specific details or type of information the government is seeking with this requirement?

A: Yes, please put this information in your Past Performance Volume of the proposal. NOTE: the past performance questionnaires will come from someone other than the offeror.

Q56: 2.5 Ancillary Support Services Staffing, Waive Testing Personnel Please confirm that VA will provide the proficiency testing materials from CAP?

A: No, the VA will not provide proficiency testing materials from CAP.

Q57: Will the government extend the due date for this solicitation by 30 days?

A: No.

Q58: Telephones. Will VA be supplying the telephones and telephone system for the clinic? Including fax?

A: The contractor is responsible for the telecommunications line, telephone system and the telephones. The government will provide fax capability on the VA multifunction devices (printer, copier, fax).

Q59: When can we expect the answers to be posted and when is the deadline to submit our questions?

A: The answers to all questions will be posted as soon as possible. The deadline to submit questions, in accordance with the RFP: Questions need to be submitted within 14 calendar days of solicitation issuance. The solicitation was issued on 15 October 2024. Questions will not be accepted after 29 October 2024. Answers will be posted as soon as possible. The updated RFP due date and time is updated to 2 December 2024 at 1200 Mountain Time.

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