Kay County CBOC Questions and Response.docx

1. QUESTION: As a set aside, can the incumbent bid on this RFP?

Government Response: All offerors must be certified in VetCert on Veteran Small Business Certification (sba.gov) as an SDVOSB to be qualified to submit an offer in response to the solicitation.

2. QUESTION: Please explain why the VA believes this clinic will experience growth over the lifetime of the contract when the current trend is flat.

Government Response: The Government has based its estimated growth upon internal data. For estimation purposes, in good faith, the data suggests the number of patients will increase. As confirmed by FAR 52.216-22, the estimates provided are “estimates only.”

3. QUESTION: Please advise if the womens health room may count also as a regular exam room.

Government Response: No, please refer to the following paragraph(s) in the solicitation:

4.9 SPACE REQUIREMENTS: PACT space standards are found in the PACT Space Module Design Guide at http://www.cfm.va.gov/til/dGuide/dgPACT.pdf. Accessibility design standards are defined in the VA Barrier Free Design Standard at: http://www.cfm.va.gov/til/etc/dsBarrFree.pdf These documents are used by VA as a reference in defining space requirements for this solicitation. Contractor’s design of space will be evaluated on how it best supports accessibility and the PACT model of care.

4.9.1. Contractors shall provide space that meets the standards outlined in PACT Space Module design guide (see link above) and for the purposes of this solicitation the following minimum space requirements are: waiting room for VA patients only, patient restrooms, 3 exam rooms per team, 1 women’s health exam room per two teams, 1 consult room, 1 group room, 1 mental health office for VA employee, clean utility room, dirty utility room, medication room, storage room for oxygen and liquid nitrogen, equipment storage room, staff breakroom, four (4) dedicated rooms for Telehealth Services to include all needed furniture and supplies (ex. telephone, desk, locking cabinet for supplies and medication storage, dedicated patient corridor. Space should provide privacy for patients to meet confidentially in an individual or group setting with providers at Contractor clinic or at the VA via telehealth submissions.

4. QUESTION: Can the consultation rooms also count as an exam room?

Government Response: No, please refer to the following paragraph(s) in the solicitation:

4.9 SPACE REQUIREMENTS: PACT space standards are found in the PACT Space Module Design Guide at http://www.cfm.va.gov/til/dGuide/dgPACT.pdf. Accessibility design standards are defined in the VA Barrier Free Design Standard at: http://www.cfm.va.gov/til/etc/dsBarrFree.pdf These documents are used by VA as a reference in defining space requirements for this solicitation. Contractor’s design of space will be evaluated on how it best supports accessibility and the PACT model of care.

4.9.1. Contractors shall provide space that meets the standards outlined in PACT Space Module design guide (see link above) and for the purposes of this solicitation the following minimum space requirements are: waiting room for VA patients only, patient restrooms, 3 exam rooms per team, 1 women’s health exam room per two teams, 1 consult room, 1 group room, 1 mental health office for VA employee, clean utility room, dirty utility room, medication room, storage room for oxygen and liquid nitrogen, equipment storage room, staff breakroom, four (4) dedicated rooms for Telehealth Services to include all needed furniture and supplies (ex. telephone, desk, locking cabinet for supplies and medication storage, dedicated patient corridor. Space should provide privacy for patients to meet confidentially in an individual or group setting with providers at Contractor clinic or at the VA via telehealth submissions.

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

Government Response: One group room is required capable of housing 6 patients. Please see the following paragraph(s) in the solicitation:

Per paragraph - 4.9.1. Please reference PACT Space Module design guide 4.0 PLANNING AND DESIGN, 4.3.5. Group Care Rooms: Each PACT Space Module is allocated one Group Care Room. Please refer to 4.9 SPACE REQUIREMENTS: PACT space standards are found in the PACT Space Module Design Guide at http://www.cfm.va.gov/til/dGuide/dgPACT.pdf. Accessibility design standards are defined in the VA Barrier Free Design Standard at: http://www.cfm.va.gov/til/etc/dsBarrFree.pdf These documents are used by VA as a reference in defining space requirements for this solicitation. Contractor’s design of space will be evaluated on how it best supports accessibility and the PACT model of care.

4.9.1. Contractors shall provide space that meets the standards outlined in PACT Space Module design guide (see link above) and for the purposes of this solicitation the following minimum space requirements are: waiting room for VA patients only, patient restrooms, 3 exam rooms per team, 1 women’s health exam room per two teams, 1 consult room, 1 group room, 1 mental health office for VA employee, clean utility room, dirty utility room, medication room, storage room for oxygen and liquid nitrogen, equipment storage room, staff breakroom, four (4) dedicated rooms for Telehealth Services to include all needed furniture and supplies (ex. telephone, desk, locking cabinet for supplies and medication storage, dedicated patient corridor. Space should provide privacy for patients to meet confidentially in an individual or group setting with providers at Contractor clinic or at the VA via telehealth submissions.

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

Government Response: 558 billable enrollees were on the most recent invoice.

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

Government Response: The following VA Staff will be onsite as follows: Mental Health Provider – 1 day every 2 weeks; Telehealth Clinical Technician (TCT) – 1.5 days per week.

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

Government Response: Yes, please refer to 6.2.1.1.4. The billable roster for the Primary Care line item will include all patients assigned to the Contractor’s site of care in the Patient Centered Management Module (PCMM) with at least one qualifying encounter by the Contractor’s Primary Care Provider(s) (PCP) within the previous 12 months.

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

Government Response: In accordance he Government may be doing site visits prior to award. The government will give two (2) weeks advanced notice. Please refer to the solicitation, Section E, Addendum to 52.212-1, paragraph 2. Requirements for Technical Proposals, Factor 1, Sub-factor (e) – Geographic Location/Accessibility (site visit may be conducted prior to award).

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

Government Response: Since the Greenville CBOC is not within the Oklahoma City VA Health Care System, we are unable to provide this information.

11. QUESTION: Can transcripts for mid-level provider candidates be submitted after award?

Government Response: Unofficial transcripts can be submitted with the proposal; however, after award, the official transcript will be required.

12. QUESTION: 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.

Government Response: The contractor is responsible for purchasing the vaccines listed below. The following quantities of each were used in the clinic within the past year:

Tdap Immunization – approximately 30 Pneumococcal PPS23 – approximately 34 Pneumococcal 20 – approximately 120 Shingrix vaccine – approximately 57 Hepatitis vaccine – approximately 0 Influenza high – approximately 215 Influenza low – approximately 140

13. QUESTION: 4.6.3.4 Redistribution of Covid 19 Vaccine – Will the Covid 19 vaccine sent to the clinic be able to be stored in pharmacy grade refrigerator or will it require -90°C and -60°C (-130°F and -76°F) freezer?

Government Response: The Covid 19 Vaccine may be stored in a pharmacy grade refrigerator. Please refer to the PWS within the solicitation, paragraph 4.6.3.4. Redistribution of COVID-19 Vaccine to Contracted Outpatient Sites of Care – Contractor is responsible for: Storage, Security, Administration and Monitoring Requirements of COVID-19 Vaccine.

STORAGE

Ensuring all COVID-19 vaccine is properly stored and handles in accordance with the U.S. Department of Health and Human Services Centers for Disease Control (CDC) Vaccine Storage and Handling Toolkit that may be accessed at: https://www.cdc.gov/vaccines/hcp/admin/storage/index.html

14. QUESTION: 4.6.4.2 EKG – Please clarify who supplies and pays for the EKG machine?

Government Response: The VA will supply the EKG machine, but the contractor will pay for the EKG machine. Please reference 4.6.4.2 Electrocardiogram Services: MUSE – compatible EKGs shall be used which are interfaced with the VA EHR Imaging. This will be supplied by VA at cost to the contractor.

15. QUESTION: 4.6.4.4.5 Centrifuge – Please clarify who supplies and pays for the Centrifuge?

Government Response: The VA will supply the centrifuge, but the contractor will pay for the centrifuge. Please reference 4.6.4.4.5. The Contractor laboratory centrifuge will be supplied by VA at cost to the contractor.

16. QUESTION: Will the VA supply telephones for the CBOC?

Government Response: No, please reference the PWS within the solicitation, paragraph 4.11.3. The VA will be responsible for: 4.11.3.1. providing PC workstations, software, primary telecommunications lines and networking equipment required to access the VA EHR.

17. QUESTION: Please confirm it is acceptable for a Physician director to oversee mid-level providers if he/she is not on site.

Government Response: Please refer to the PWS within the solicitation, paragraph 2.2 PHYSICIAN DIRECTOR (MANDATORY FOR ALL SITES): Position Responsibilities: Serves as medical director to oversee and be responsible for the provision of covered services to enrolled and unassigned patients presenting for care at the site. The Medical Director does not have to be on site.

18. QUESTION: Page 165 states, “the Government may give higher preference for facilities that provide services in space exclusively dedicated to veterans.” Could the VA provide additional information regarding whether or not facilities that are dedicated to veteran will be given preference? What features would need to be in place for the VA to provide a more favorable rating for a facility that is exclusively devoted to veterans? We believe the words “may give” as ambiguous and does explicitly describe what the government wants/ requires for this CBOC. This can also lead to protest in our experience. Can you please clarify what the government requires?

Government Response: Per para 4.9.7 . Parking should be adequate to accommodate Veteran patients and shall include at least two (2) handicapped parking spaces. In context with “Offerors shall describe the availability of adequate parking at the facility to include the number of handicap parking spaces and accessibility to the facility, the Government may give a higher rating for facilities that provide services in space exclusively dedicated to veterans.” The statement refers to handicap parking spaces and accessibility to the facility. Contractors that propose a facility with parking space exclusively dedicated for veteran patients may receive a higher rating over a proposal that meets the minimum requirements as stated in para 4.9.7.

19. QUESTION:: Page 166 states, “The Government may give higher preference for a standalone facility versus a co-located facility.” Could the VA provide additional information regarding whether or not a standalone facility will be given preference? What features would need to be in place for the VA to provide a more favorable rating for a standalone facility? We believe the words “may give” as ambiguous and does explicitly describe what the government wants/ requires for this CBOC. This can also lead to protest in our experience. Can please clarify what the government requires?

Government Response: Paragraph 4.9 Space Requirement provides the requirement the contractor shall meet for the CBOC facility. For a standalone CBOC Facility the contractor must meet the requirements as stated in PWS section 4.9, with the exception of Para 4.9.17 VETERANS ONLY CLINIC REQUIREMENT FOR CO-LOCATED FACILITIES which provides requirements in the PWS for a Veteran only co-located facility as follows. “Offeror shall provide a floor plan of their proposed space as part of their proposal and indicate how it meets the design standards in the PACT Space Module Design Guide, Offerors shall describe building/floor layout, design, energy efficiency, ADA compliance and aesthetics that meets the PACT Space Design Guide specifications. 8 ½ x 11 Layout/drawing of proposed space is preferred and should include square footage and other specifications noted in the Guide.” The Government may give a higher rating for a standalone facility versus a co-located facility. Contractors that submit a proposal a stand-alone facility IAW the PWS versus a Veterans Only Clinic for co-located facility may receive preference over a proposal submitted for a Veterans Only Clinic IAW 4.9.17.

20. QUESTION: Are the on-stage/off-stage design features of the PACT Space Module Design Guide required? If on-stage/off-stage design is not required, will it be evaluated more favorably than a clinic that does not include on-stage/off-stage design?

Government Response: On-stage/off-stage design features are required. The Contractor’s design of space will be evaluated on how it best supports accessibility and the PACT model of care. On-stage/off-stage design is referenced in the PACT Space Module design guide in section 4.0 PLANNING AND DESIGN: 4.1 Clinic Organization, 4.2 PACT Space Module Core Design Strategies, 4.3 PACT Space Module Core Components, and 5.0 SPECIAL CONSIDERATIONS: 5.1 Interiors and Finishes. Please also reference 4.9 SPACE REQUIREMENTS: PACT space standards are found in the PACT Space Module Design Guide at http://www.cfm.va.gov/til/dGuide/dgPACT.pdf. Accessibility design standards are defined in the VA Barrier Free Design Standard at: http://www.cfm.va.gov/til/etc/dsBarrFree.pdf These documents were used by VA as a reference in defining space requirements for this solicitation. The Contractor’s design of space will be evaluated on how it best supports accessibility and the PACT model of care.

4.9.1. Contractors shall provide space that meets the standards outlined in PACT Space Module design guide (see link above) and for the purposes of this solicitation the following minimum space requirements are: waiting room for VA patients only, patient restrooms, 3 exam rooms per team, 1 women’s health exam room per two teams, 1 consult room, 1 group room, 1 mental health office for VA employee, clean utility room, dirty utility room, medication room, storage room for oxygen and liquid nitrogen, equipment storage room, staff breakroom, four (4) dedicated rooms for Telehealth Services to include all needed furniture and supplies (ex. telephone, desk, locking cabinet for supplies and medication storage, dedicated patient corridor. Space should provide privacy for patients to meet confidentially in an individual or group setting with providers at Contractor clinic or at the VA via telehealth submissions.

21. QUESTION: Who is responsible for courier services – VA or contractor?

Government Response: The Contractor is responsible for courier services. Please reference the following paragraph with the PWS of the solicitation: 4.6.4.3. Laboratory Services: Contractor is responsible for: 2) Sending specimens to the VA Core Laboratory daily except for those specific in this PWS.

4.6.4.4.8. If required, the Contractor shall provide a courier to transport instruments and/or reagents to the Contractor or the VA Ancillary Testing staff for linearity/correlation studies and minor repairs.

22. QUESTION: Will the VA provide the lab specimen tubes?

Government Response: No, the VA will not provide the lab specimen tubes. Please reference the following paragraph with the PWS of the solicitation: 4.6.4.3. Laboratory Services: Contractor is responsible for: 5) Ensuring the proper collection, collection supplies, and other preservation of specimens and providing appropriate specimen collection containers that are compatible with the instrumentation and methodology used by the VA laboratory.

23. QUESTION: What is the current size of the vested primary care patient roster for the clinic? How many are women veterans?

Government Response: The current size of the vested primary care patient roster is 558 enrollees, of which 40 enrollees are women Veterans.

24. QUESTION: Does the women’s health exam room count as one of the 3 exam rooms required per team?

Government Response: No, the women’s health exam room does not count as one of the three (3) exam rooms. Please refer to the following paragraph with the PWS of the solicitation: 4.9 SPACE REQUIREMENTS: PACT space standards are found in the PACT Space Module Design Guide at http://www.cfm.va.gov/til/dGuide/dgPACT.pdf. Accessibility design standards are defined in the VA Barrier Free Design Standard at: http://www.cfm.va.gov/til/etc/dsBarrFree.pdf These documents are used by VA as a reference in defining space requirements for this solicitation. Contractor’s design of space will be evaluated on how it best supports accessibility and the PACT model of care.

4.9.1. Contractors shall provide space that meets the standards outlined in PACT Space Module design guide (see link above) and for the purposes of this solicitation the following minimum space requirements are: waiting room for VA patients only, patient restrooms, 3 exam rooms per team, 1 women’s health exam room per two teams, 1 consult room, 1 group room, 1 mental health office for VA employee, clean utility room, dirty utility room, medication room, storage room for oxygen and liquid nitrogen, equipment storage room, staff breakroom, four (4) dedicated rooms for Telehealth Services to include all needed furniture and supplies (ex. telephone, desk, locking cabinet for supplies and medication storage, dedicated patient corridor. Space should provide privacy for patients to meet confidentially in an individual or group setting with providers at Contractor clinic or at the VA via telehealth submissions.

25. QUESTION: Regarding Paragraph 4.6.2.4.7, 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.

Government Response: No, VA will not provide Well Women’s Health Services Supplies, including Thin Prep Pap Test, Pap Smear Collection Kits, Cytobrushes, as well as the IFOBT kits. Please refer to the following paragraph(s) within the PWS of the solicitation: 4.6.2.4.7. Contractor shall provide all equipment necessary to provide women’s health services. Examination rooms shall be set up in accordance with current VA standards to afford women with privacy (placement of examination tables in the room, privacy curtains, etc. See Space Requirements section for more details). Equipment such as privacy curtains, exam tables, with stirrups and lights, bathrooms adjacent to where pelvic exams are performed, speculums, supplies, and equipment to perform Pap smears and point of care pregnancy testing should be on hand in the clinic area.

4.6.4.4.7. The VA will provide the test systems/instruments and reagents for contractor waiver testing except for fecal occult blood testing cards and developer. The Contractor must contact the VA Ancillary Testing staff prior to purchasing fecal occult blood test kits to ensure consistency of methodology/manufacturer. If VA changes fecal occult blood testing methodology/ manufacturer, the Contractor must comply with the change to maintain the same standard of care.

26. QUESTION: Page 149 states, “Volume 1 Technical Capability page limit shall not exceed 30 pages, any information that exceed this page limit will not be reviewed.” The Technical Capability Factor covers five (5) sub-factors with 29 bulleted items for offers to address. We do not believe 30 pages will be sufficient to adequately address each of these items. Would the VA consider allowing up to 60 pages for the Technical Capability submission? In addition, can the government clarify what types of pages/ documents that will not be counted? For example, do cover pages, table of contents, floor plans, and attachments count throws the page count?

Government Response: The page limit for Volume 1, Technical Capability shall not exceed 45 pages. The Cover sheet, Table of Content, Floor Plans and Drawings, Certification(s), Transcript(s), Certificate (s), License(s), and Curriculum Vitae (s) will not be counted towards the Technical Capability page limit.

27. QUESTION:: On Page 164, it states that transcripts are required for Nurse Practitioners. Is it acceptable to submit transcripts after award as transcripts can take weeks to obtain and this timeline is beyond the control of the Contractor?

Government Response: Unofficial Transcripts can be submitted with the proposal; however, after award, the official transcript will be required.

28. QUESTION: Please confirm that any copies of documents for providers or staff that are required to be submitted do not count against the proposal page limits.

Government Response: The following will not be counted in the Capability: Certification(s), Transcript(s), Certificate (s), License(s), and Curriculum Vitae(s).

29. QUESTION: Please confirm that floor plans and/or facility drawings do not count against the proposal page limits.

Government Response: Floor Plans and Drawings will not be counted in the Technical Capability page limit.

30. QUESTION: Please confirm that cover sheets and tables of contents do not count against the proposal page limits.

Government Response: Cover Sheets and Tables of Content will not be counted in the Technical Capability page limit.

32. Question: What is the estimated time of award for this opportunity?

QUESTION:

Government Response: The Government anticipates award prior to September 30, 2023.

33. QUESTION: Can the government confirm who will provide phones, printers, and AEDs for the clinic (contractor or government).

Government Response:

The Contractor is responsible for phones, printers except one small desktop color printer. The VA will provide AEDs. Please reference 4.11.3. The VA will be responsible for: 4.11.3.1. providing PC workstations, software, primary telecommunications lines and networking equipment required to access the VA EHR. 4.11.3.7. providing one small desktop color printer for printing patient education information. 4.11.3.8. ensuring hardware/software compatibility with VA approved list: a listing in Attachment D of the printers have passed compatibility testing with the VA EHR Encounter Form.

4.6.10.7 The VA will provide the Contractor with an AED and train Contractor’s staff in its use and checks of the device.

34. QUESTION: Who is the current incumbent contractor for this opportunity and the contract number associated?

Government Response: The current incumbent is Blackwell Family Medicine. The contract number is 36C25923C0003.

35. QUESTION: Can the government please extend the submission date by 30 day to give vendors time to make adjustments to their proposal while awaiting a response for questions?

Government Response: The solicitation is extended to April 21, 2023, 2PM, MST.

Government Response: The VA determined its estimated based on internal data analysis which assisted in to determining growth in Kay County, Kay County Community Based Outpatient Clinic, and surrounding areas.

37. QUESTION: Given that the Kay County CBOC is in a rural area, the socioeconomic conditions, the local talent pool, and the labor market, in the event of an emergency or short-term absence of the CBOC primary care provider, would the VA allow these services to be provided via telemedicine?

Government Response: No, telemedicine is not an option for this requirement. Please reference the following paragraph within the PWS of the solicitation: 2.3.1. TEAMLET MEMBER 1: Primary Care Provider (PCP): FTE Ratio Performance Standard: Current standards are 1200 active patients per full time physician and 900 active patients per full time midlevel provider. Contractor shall propose quantity of FTE to meet Standard FTE ratio to panel size. Contractor to propose mix of PCP from the options below. There must be one full time physician on-site carrying a panel of patients.

Page 164 states: Offerors shall provide copies of the following for any physician(s) to be assigned to perform services under the contract, including any physicians to provide coverage relief: • Board Certification in Internal Medicine and/or Family Practice

38. QUESTION: Will the VA accept either Board Certified or Board Eligible at the time of proposal submission?

Government Response: Yes, the VA will accept either Board certified or Board eligible physician providers.

2.4.2. The contractor will provide referrals to CPS Anti-Coagulation through consults to VA through the EHR.

4.6.3.2.7 The Contractor shall meet all requirements of anticoagulation management.

4.6.3.2.8. The Contractor shall provide Quarterly and annual anticoagulation quality assurance summaries.

4.6.3.2.9. The contractor is required to enter all prescription orders using the VA EHR outpatient medication order entry option.

39. QUESTION: If the VA is providing the CPS staff, will the VA be responsible for anticoagulation management, quarterly and annual anticoagulation quality assurance summaries, and entering all prescription orders using the VA EHR outpatient medication order entry options?

Government Response: In accordance with the solicitation, the contractor will be responsible for the following: anticoagulation management; quarterly and annual anticoagulation quality assurance summaries; and entering all prescription orders using the VA EHR outpatient medication order entry options. Please reference the following paragraph(s) within the PWS of the solicitation: 4.6.3.2 MEDICATION MANAGEMENT

4.6.3.2.7 The Contractor shall meet all requirements of anticoagulation management outlined in VHA Directive 1108.6 Anticoagulation Therapy Management (or subsequent revisions thereto) as well as local policy related to the management of patients on anticoagulation. Local policy is included in the attachments section.

4.6.3.2.8. The Contractor shall provide Quarterly and annual anticoagulation quality assurance summaries as outlined by the local Pharmacy & Therapeutics Committee.

4.6.3.2.9. The contractor is required to enter all prescription orders using the VA EHR outpatient medication order entry option. The Contractor must include complete directions for the prescription (“PRN” alone is not acceptable), and must include the indication for medication use, the appropriate quantity, and subsequent refills for the medication.

40. QUESTION: Who is to provide the Levonorgestrel, the VA, or the Contractor?

Government Response: The contractor is responsible, please reference the following paragraph(s) within the PWS of the solicitation: 4.6.3.1. Prescription Fulfillment: Urgent/Emergent medications needed will be filled via contracted local pharmacy for up to 10 days. The contract clinic is responsible for the contract with the local Pharmacy.

41. QUESTION: As the Contractor is unable to purchase Thin Prep, will VA supply it?

Government Response: The contractor is responsible for providing Thin Prep, please reference the following paragraph(s) within the PWS of the solicitation: 4.6.2.4.7 Contractor shall provide all equipment necessary to provide comprehensive women’s health services. Examination rooms shall be set up in accordance with current VA standards to afford women with privacy (placement of examination tables in the room, privacy curtains, etc. See Space Requirements section for more details). Equipment such as privacy curtains, exam tables with stirrups and lights, bathrooms adjacent to where pelvic exams are performed, speculums, supplies, and equipment to perform Pap smears and point of care pregnancy testing should be on hand in the clinic area. Each designated women’s health provider shall have an appropriate exam table to conduct the annual women’s health exam.

Urgent/Emergent medications needed will be filled via contract local pharmacy for up to 10 days. The contract clinic is responsible for the contract with the local Pharmacy.

42. QUESTION: Does the VA or the Contractor pay for the urgent/emergent medications filled at the local pharmacy?

Government Response: The contractor pays for urgent/emergent medications filled at the local pharmacy, please reference the following paragraph(s) within the PWS of the solicitation: 4.6.3.1. Prescription Fulfillment: Urgent/Emergent medications needed will be filled via contracted local pharmacy for up to 10 days. The contract clinic is responsible for the contract with the local Pharmacy.

The Contractor will provide all medications (including any necessary vaccines, with the exception of vaccines for COVID-19 as indicated in section 4.6.3.4) that are to be administered to patients in the clinic.

43. QUESTION: Will the VA provide a list of all medications and vaccines that are to be provided by the Contractor and the amounts to be administered in the clinic?

Government Response: The following required vaccines and quantities administered within the past year are listed below:

Tdap Immunization – approximately 30 per year Pneumococcal PPS23 – approximately 34 per year Pneumococcal 20 – approximately 120 per year Shingrix vaccine – approximately 57 per year Hepatitis vaccine – approximately 0 per year Influenza high – approximately 215 per year Influenza low – approximately 140 per year

The medication listing for emergent medications is attached and will be added to the solicitation in Section D, as D.36 EMERGENT MEDICATION LIST

44. QUESTION: Will the VA confirm lab courier will transport one time per day?

Government Response: Yes, the lab courier will transport one time per day.

MENTAL HEALTH SUPPORT SERVICES: The Contractor shall provide the following clerical support services for mental health providers at the CBOC.

45. QUESTION: How many contracted clerical support staff are required for the VA staff on-site?

Government Response: Please reference the following paragraph(s) within the PWS of the solicitation: 4.6.5.3. MENTAL HEALTH SUPPORT SERVICES: The contractor shall provide the following clerical support services for mental health providers at the CBOC.

4.6.7.3. TELEPHARMACY SUPPORT SERVICES: The Contractor shall provide clerical support, including scheduling, and ancillary support for VA telepharmacy services as appropriate.

contacting patients who no-show for rescheduling.

46. QUESTION: How many contracted clerical and clinical support staff are required for all VA support services?

Government Response: Please reference the following paragraph(s) within the PWS of the solicitation:, 2.8. TELEHEALTH SERVICES CLINICAL STAFF: The contractor will provide a trained Telepresenter (e.g., a member of the PACT teamlet (LIP, RNCM, or LPN)) to assist TCT on an as needed basis.

4.6.5.3. MENTAL HEALTH SUPPORT SERVICES: The contractor shall provide the following clerical support services for mental health providers at the CBOC.

· Schedule and reschedule patients for Mental Health Providers assigned to the clinic and the Quit Smart program.

· 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 patient.

· Receive and screen phone calls for the above clinics and providers.

· Process all consults for the above clinics.

· Provide support for the telemental health appointments including scheduling, set-up.

· Participate in triaging secure messages.

4.6.7.2. TELEMENTAL HEALTH SERVICES: The VA shall provide a qualified professional for telemental health service. The Contractor will provide support for VA provided telemental health services, providing staff to arrange appropriate time and space for the veteran, and technical support as needed.

4.6.7.3. TELEPHARMACY SUPPORT SERVICES: The Contractor shall provide clerical support, including scheduling, and ancillary support for VA telepharmacy services as appropriate. The support services should be consistent for each scheduled clinic to include but not limited to intake vitals by LVN/LPN, Unlicensed Assistive Personnel (health tech or nursing assistant), or similar, downloading of blood sugar from meters, POC INR testing and downloading, teaching patients how to use BP monitors at home, calling patients for lab reminders, scheduling patient visits and contacting patients who no-show for rescheduling.

47. QUESTION: Will the new Contractor inherit the patient’s last vesting visit and be allowed to bill for one year from that date upon contract award? – Contracting please confirm

Government Response: Yes, please refer to the following paragraph(s) within the PWS of the solicitation: 6.2.1.1.4. The billable roster for the PC CLIN will include all patients assigned to the Contractor’s site of care in the Patient Centered Management Module (PCMM) with at least one qualifying encounter by the Contractor’s Primary Care Provider(s) (PCP) within the previous 12 months.

48. QUESTION: Will the VA require onstage and offstage in the facility?

Government Response: Yes, on-stage/off-stage design features are required. On-stage/off-stage design is referenced in PACT Space Module design guide in 4.0 PLANNING AND DESIGN: 4.1 Clinic Organization, 4.2 PACT Space Module Core Design Strategies, 4.3 PACT Space Module Core Components, and 5.0 SPECIAL CONSIDERATIONS: 5.1 Interiors and Finishes. Please also reference 4.9 SPACE REQUIREMENTS: PACT space standards are found in the PACT Space Module Design Guide at http://www.cfm.va.gov/til/dGuide/dgPACT.pdf. Accessibility design standards are defined in the VA Barrier Free Design Standard at: http://www.cfm.va.gov/til/etc/dsBarrFree.pdf These documents are used by VA as a reference in defining space requirements for this solicitation. Contractor’s design of space will be evaluated on how it best supports accessibility and the PACT model of care.

4.9.1. Contractors shall provide space that meets the standards outlined in PACT Space Module design guide (see link above) and for the purposes of this solicitation the following minimum space requirements are: waiting room for VA patients only, patient restrooms, 3 exam rooms per team, 1 women’s health exam room per two teams, 1 consult room, 1 group room, 1 mental health office for VA employee, clean utility room, dirty utility room, medication room, storage room for oxygen and liquid nitrogen, equipment storage room, staff breakroom, four (4) dedicated rooms for Telehealth Services to include all needed furniture and supplies (ex. telephone, desk, locking cabinet for supplies and medication storage, dedicated patient corridor. Space should provide privacy for patients to meet confidentially in an individual or group setting with providers at Contractor clinic or at the VA via telehealth submissions.

49. QUESTION: Will the VA please confirm if VA will provide the phone circuit and physical phones?

Government Response: No contractor will provide phone circuit and physical phones, reference the following paragraph(s) within the PWS of the solicitation: 4.11.3. The VA will be responsible for: 4.11.3.1. providing PC workstations, software, primary telecommunications lines and networking equipment required to access the VA EHR.

51. 4.9.18. Physical Security: The contract clinic site for the VA clinic shall comply with VA

50. QUESTION: Is the current location “co-located”? If so, does the current location meet all requirements of the RFP?

Government Response: The requirements outlined within this solicitation are required for performance of services in the resultant contract. All interested parties are encouraged to submit a proposal that conforms to the requirements, terms, and conditions of this solicitation.

51. QUESTION: Will the VA please confirm if CAT 6 wiring is preferred and not CAT 6A?

Government Response: Please reference the following paragraph(s) within the PWS of the solicitation: 4.11.1.2. the installation and maintenance of the network cabling infrastructure within the facility including all cabling located inside the walls and plenum space of the structure, cabling racks, network equipment racks, patch panels, wall ports, extension cabling from the demarc to the communications closet, and a secure communications closet space to house the networking equipment. Cabling infrastructure and closet design shall adhere to ANSI/ITA-568, ISO/IEC 11801, and VA EHRM standards.

52. QUESTION: This section says that Contractor is responsible for other peripheral office equipment, VA typically will not connect Contractor equipment to the VA network. Will the VA provide the type of office equipment the VA will supply for the daily operation?

Government Response: Please refer to the following paragraph(s) within the PWS of the solicitation: 4.11.3. The VA will be responsible for:

4.11.3.1 providing PC workstations, software, primary telecommunications lines and networking equipment required to access the VA EHR.

4.11.3.7. providing one small desktop color printer for printing patient education information.

4.11.3.8. ensuring hardware/software compatibility with VA approved list: a listing in Attachment D of the printers have passed compatibility testing with the VA EHR Encounter Form. The following scanners listed in Attachment D has passed compatibility testing with the VA EHR Imaging System and any other model used will require approval and certification for the VA EHR Imaging.

53. QUESTION: Will the VA please confirm the power requirements and if two 20-amp dedicated receptacles are acceptable?

Government Response: No, two 20-amp dedicated receptacles are not acceptable. Please refer to the following paragraph(s) within the PWS of the solicitation: 4.11.2.5 POWER REQUIREMENTS: 4.11.2.5.1. four (4) L6-20 receptables 4.11.2.5.2. one (1) L6-20 receptacle in the closet

54. QUESTION: Will the VA please confirm if shelves are required?

Government Response: Yes, shelves are required. Please refer to the following paragraph(s) within the PWS of the solicitation: 4.11.2.6. Racks: 4.11.2.6.6. both racks will have 2 shelves on the bottom installed to hold IT computers

DOCUMENT:

Solicitation

55. QUESTION: Could the government please confirm if a comparable brand to Leviton is sufficient?

Government Response: No, it is not sufficient. Please reference the following paragraph(s) within the PWS of the solicitation: 4.11.2.6.7. Infrastructure installer should install Leviton CAT6 patch panels and connectors in the rack

56. QUESTION: Considering the VA will need at least 180 days to get primary data lines installed and given the global supply chain issues with the delivery of some construction materials, will the VA consider amending the start-up time frame to 180 days?

Government Response: No, the VA does not anticipate needing 180 days to get primary data lines installed. Please reference the following paragraph(s) within the PWS of the solicitation: 6.1.2 The Contractor shall have one hundred-twenty (120) days from contract award to commencement of the provision of medical care to local Veterans.

Volume 1 Technical Capability page limit shall not exceed 30 pages, any information that exceed this page limit will not be reviewed.

57. QUESTION: Given the documentation required to be submitted with the proposal, i.e., licenses, CVs, board certification, transcripts, graduation certificates, medical and administrative equipment, steps and key milestones, etc., is it acceptable to provide attachments to the proposal that do not count towards the 30-page limitation?

Government Response: The page limit for Volume 1, Technical Capability shall not exceed 45 pages. The Cover sheet, Table of Content, Floor Plans and Drawings, Certification(s), Transcript(s), Certificate (s), License(s), and Curriculum Vitae (s) will not be counted towards the Technical Capability page limit.

Evaluation Factors and Criteria, (3) Factor 2 – Past Performance states the following:

Questionnaire/Survey (ATTACHMENT D.31) in Section D of the RFP, and have it returned to the CO/CS by the response date listed in Block 8 of SF1449. Questionnaires can be scanned and emailed from the references only to patricia.toliver@va.gov. It is the Offeror’s responsibility to ensure their references complete and submit these questionnaires.

Limited to no more than 2 pages per contract identified. Offerors are demonstrates satisfactory performance under the referenced contracts.

Quality and Satisfaction Rating for Contracts Completed in the Past Three Years: Provide any information currently available (letters, metrics, customer surveys, independent surveys, etc.) which demonstrates customer satisfaction with overall job performance and quality for same or similar type contracts.

58. QUESTION: With the page limitation, is it acceptable to the VA if we attach all the letters, metrics, customer surveys, independent surveys, etc., and not have it count towards the 7-page limitation?

Government Response: Volume 2, Past Performance page limit shall not exceed 7 pages. The Letters, metrics, customer surveys will not be counted towards the 7 page limit.

Please indicate the name of the business on the first page only of every volume in the proposal. DO NOT place business name on every page of the proposal.

59. QUESTION: Does the VA want the bidder to fully redact the entire proposal of the business name except for the first page on all Volumes (Technical Capability, Past Performance, and Price)?

Government Response: The offerors are to indicate the name of the business on the first page only for all volumes.

60. QUESTION: Will the VA accept…