Altus CBOC QA - Combined 02282024.docx

1. QUESTION: 2 Is a full-time Clinic Manager required and if so, would the VA prefer they be a registered nurse?

Government Response: No, reference to 2. STAFFING AND QUALIFICATIONS

2. QUESTION: 4.6.2.4.3 The Contractor must develop a plan to assign women preferentially to the designated Women’s Health PCPs at the contracted site. All outpatient sites of care must have at least two WH-PCPs. (Because of small populations of women at most CBOCs, CBOC WH-PCPs will usually have mixed gender panels). It is necessary to have two WH-PCPs to provide full coverage for women during sick leave and vacation. All newly enrolling women should be assigned to a Women’s Health PCP. Women in panels of non-women’s health PCPs should be offered the opportunity to request transfer to a Women’s Health PCP at the same site of care. It is recommended that women Veterans be clustered in teams where the provider and all team members have experience, knowledge and established systems of care to provide equitable, high-quality care to women Veterans. It is recommended that Women’s Health PACT teamlets are assigned a panel size of at least 100 women Veterans, thus allowing all teamlet members to care for a volume of patients to support maintenance of expertise in the care of women.

Are two WH PCP required for this staffing?

Government Response: Yes, reference to 4.6.2.4.3 The Contractor must develop a plan to assign women preferentially to the designated Women’s Health PCPs at the contracted site. All outpatient sites of care must have at least two WH-PCPs. (Because of small populations of women at most CBOCs, CBOC WH-PCPs will usually have mixed gender panels). It is necessary to have two WH-PCPs to provide full coverage for women during sick leave and vacation. All newly enrolling women should be assigned to a Women’s Health PCP. Women in panels of non-women’s health PCPs should be offered the opportunity to request transfer to a Women’s Health PCP at the same site of care. It is recommended that women Veterans be clustered in teams where the provider and all team members have experience, knowledge and established systems of care to provide equitable, high-quality care to women Veterans. It is recommended that Women’s Health PACT teamlets are assigned a panel size of at least 100 women Veterans, thus allowing all teamlet members to care for a volume of patients to support maintenance of expertise in the care of women.

3. QUESTION: 4.6.2.4.6 Emergency contraception (e.g., Levonorgestrel (Plan B) etc.) must be available to all women Veteran patients in a timely manner (same day of their appointment) even if a provider has requested to opt out from providing emergency contraception to the patient because of a Rights of Conscience (ROC) Claim.

Who is to provide the Levonorgestrel, the VA, or the Contractor?

Government Response: The contractor is responsible, please reference 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.

4. QUESTION: 4.6.3.1 The Contractor will provide all medications (including any necessary vaccines) that are to be administered to patients in the clinic.

Will the VA provide a list of all medications and vaccines that are to be provided by the Contractor and the amounts that have been administered in the clinic?

Government Response: Past usage:

Past usage approximate values are listed below. If a vaccine is not listed that vaccine usage was approximately 0.

D.39 Vaccine List is added to RFP.

QUESTION: Will the contractor be responsible for providing COVID-19 vaccine?

Government Response: Yes, please reference 4.6.3. PHARMACY SERVICES: 4.6.3.1. PRESCRIPTION FULFILLMENT: The Contractor will provide all medications (including any necessary vaccines) that are to be administered to patients in the clinic.

5. QUESTION: 4.6.4.3 2) Sending specimens to the VA Core Laboratory daily, except for those specified in this PWS.

Will the VA please verify that contractor will provide courier services once per day to the VA Core Laboratory and not twice a day?

Government Response: VA will not provide the courier, the contractor is responsible for courier services, please reference 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. Confirming one time per day.

6. QUESTION: 4.6.4.4.3 The laboratory tests designated as waived under the Clinical Laboratory Improvement Amendments of 1988 and all amendments (CLIA), 42 CFR 493.15(b) and 493.15(c). In the CLIA regulations, waived tests were defined as simple laboratory examinations and procedures that are cleared by the FDA for home use; employ methodologies that are so simple and accurate as to render the likelihood of erroneous results negligible; or pose no reasonable risk of harm to the patient if the test is performed incorrectly. To perform these tests, The Contractor must apply for and maintain a current VA CLIA Certificate. The application for the VA CLIA Certificate, obtained from the Chief Medical Technologist, is sent to the National Enforcement Office who issues the CLIA Certificate.

4.6.4.4.4 In addition, the Contractor must apply for and maintain an Oklahoma Department of Health Level II Clinical Laboratory Permit. In the performance of these tests, the Contractor must comply with the terms and requirements of the Ancillary Testing Policy, CM 113-14. The Ancillary Testing Policy is included in Section D (attachments).

RFP asks to get the CLIA Certificate through VA, is the intent for more VA lab oversight?

Are there lab draws outside of the CLIA waiver that would require the Oklahoma Department of Health Level II permit?

Government Response: Please review 4.6.4.4.3. The Contractor must apply for and maintain a current VA CLIA Certificate. 4.6.4.4.4 In addition, the Contractor must apply for and maintain an Oklahoma Department of Health Level II Clinical Laboratory Permit.

7. QUESTION: 4.6.6.3 Mental Health Support Services: The Contractor shall provide the following clerical support services for VA mental health providers at the CBOC.

How many contracted clerical support staff are required for the VA staff on-site?

Government Response: Please reference 4.6.6.3. MENTAL HEALTH SUPPORT SERVICES: The contractor shall provide the following clerical support services for mental health providers at the CBOC.

8. QUESTION: 4.6.8.3 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.

How many contracted clerical and clinical support staff are required for all VA supported services?

Government Response: Please reference 4.6.8.3. TELEPHARMACY SUPPORT SERVICES: The Contractor shall provide clerical support, including scheduling, and ancillary support for VA telepharmacy services as appropriate.

9. QUESTION: 4.9.1 Will the government please confirm if 8 data ports are required per room?

Government Response: Reference 4.9.1. Contractors shall provide space that meets the standards outlined in the PACT Space Module Design Guide (see link above) and for the purposes of this solicitation the following minimum space requirements are: 1 waiting room, 1 public restroom in waiting area, check in area, 2 patient restrooms within the clinical area, 1 staff restroom within the clinical area, 3 exam rooms per team, 1 women’s health/procedure room per two teams, teamwork zone, 1 consult room per two teams, 1 large group room, 1 mental health office with office supplies and office furniture to accommodate VA employee, patient and visitor (at least 125 sq feet, room must include at least 4 data ports and 4 electrical outlet on 2 two walls (8 data ports and 8 electrical outlets total), file cabinet, and desk that is at least 4 feet long to accommodate two monitors/computer and phone), clean utility room, dirty utility room, medication room, storage room for oxygen and liquid nitrogen, equipment storage room, staff breakroom, dedicated patient corridor, and lab draw area, 4 rooms for Telehealth – 1 exam room to accommodate VA employee, patient, and visitor (at least 125 sq feet with sink, no carpet, at least 4 electrical outlets on all 4 walls (16 total), at least 4 data ports on 2 walls (8 total), exam table, storage of clinical supplies), 1 exam/group room to accommodate VA employee, patients, and visitors (at least 180 sq feet with sink, no carpet, at least 4 electrical outlets on all 4 walls (16 total), at least 4 data ports on 2 walls (8 total), storage of clinical supplies, file cabinet, desk that is at least 4 feet long to accommodate two monitors/computer and phone, office chair), 1 Tele-eye exam room to accommodate VA employee, patient, and visitor (at least 180 sq feet with sink, no carpet, room needs to be configured in a way that can it support a 2'x3' piece of equipment be accessible to patient while being at least 10 feet away from an adjacent, blank wall where a screen could be mounted, room also needs to have no windows or windows blacked out, room lights need to be dimmable or have the ability to shut off lights (no motion sensor) with desk lamp present for minimal lighting when needed, at least 4 electrical outlets on all 4 walls (16 total), at least 4 data ports on 2 walls (8 total), file cabinet, desk that is at least 4 feet long to accommodate two monitors/computer and phone, office chair), 1 teleconsultation room to accommodate VA employee, patient, and visitor (at least 80 sq feet, room must include at least 4 data ports and 4 electrical outlet on 2 two walls (8 data ports and 8 electrical outlets total), file cabinet, and desk that is at least 4 feet long to accommodate two monitors/computer and phone). Please review attached link. 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 transmissions. The codes, standards, and references listed below indicate minimum performance requirements. Compliance is required with applicable codes and standards throughout the process of design, construction, acceptance, and on-going maintenance of the outpatient site of care facility. Design and documentation of the outpatient site of care shall be in compliance with the requirements of the codes, standards, and references listed below. This also covers construction materials and standards not fully addressed by the codes, standards, and references below.

10. QUESTION: 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.

Will the government please confirm if CAT 6 wiring is preferred and not CAT 6A?

Government Response: CAT 6A is preferred.

Please reference 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.

11. QUESTION: 4.11.2.5 Power requirements

Will the government please confirm the Power Requirements and if two 20-amp dedicated on each of the two racks is acceptable?

Government Response: No, two 20-amp dedicated receptacles are not acceptable. Please see 4.11.2.5.1 Four (4) L6-20 receptacles and 4.11.2.5.2. one (1) L6-30 receptacle in the closet.

12. QUESTION: 4.11.2.6.6: Racks: both racks will have 2 shelves on the bottom installed to hold IT computers.

Will the government please confirm if shelves are required?

Government Response: Yes, please reference to 4.11.2.6. Racks: 4.11.2.6.6. both racks will have 2 shelves on the bottom installed to hold IT computers.

13. QUESTION: 4.11.2.6.7 Racks: infrastructure installer should install Leviton CAT6 patch panels and connectors in the rack.

Will the government please confirm if a comparable brand to Leviton would suffice?

Government Response: No, please reference 4.11.2.6.7. Infrastructure installer should install Leviton CAT6 patch panels and connectors in the rack.

14. QUESTION: Does the current site meet the solicitation requirements?

Government Response: Unable to answer, question alludes to proposal ratings.

15. 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. On-stage/off-stage design is referenced in PACT Space Module design guide in 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.

See Sub-Factor (5) – Geographic Location/Accessibility – 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.

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

Government Response: No, please reference 4.6.4.3. Laboratory Services: Contractor is responsible for: 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.

17. QUESTION: 4.8.11.16 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, please reference to 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.

18. QUESTION: Please provide the number of billable enrollees on the most current invoice for the last 3 consecutive months?

Government Response: 1245

19. QUESTION: Can the government please extend the submission deadline by 30 calendar days?

Government Response: Review amendment blocks 11 and 14 for offer Due Date and Time

20. QUESTION: What is the anticipated award for this procurement?

Government Response: The Government will post an award notice once the evaluation process is complete and an award decision is made.

21. QUESTION: Will the government provide a centrifuge for the lab?

Government Response: The PWS is updated to reflect “4.6.4.4.5. The Contractor laboratory centrifuge must meet specifications provided by VA. Specifications are included in Section D (attachments)”

22. QUESTION: Please advise if the women’s health room may count also as a regular exam room?

Government Response: No, 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. For any buildout/construction that might be required to prepare space for performance of this contract, Davis-Bacon Wages (https://www.dol.gov/agencies/whd/government-contracts/construction) must be paid to any personnel working on the buildout/construction of the space and certified payrolls for all buildout/construction workers are due to the COR and Contracting Officer, no later than 10 business days prior to the clinic opening.

4.9.1. Contractors shall provide space that meets the standards outlined in the PACT Space Module Design Guide (see link above) and for the purposes of this solicitation the following minimum space requirements are: 1 waiting room, 1 public restroom in waiting area, check in area, 2 patient restrooms within the clinical area, 1 staff restroom within the clinical area, 3 exam rooms per team, 1 women’s health/procedure room per two teams, teamwork zone, 1 consult room per two teams, 1 large group room, 1 mental health office with office supplies and office furniture to accommodate VA employee, patient and visitor (at least 125 sq feet, room must include at least 4 data ports and 4 electrical outlet on 2 two walls (8 data ports and 8 electrical outlets total), file cabinet, and desk that is at least 4 feet long to accommodate two monitors/computer and phone), clean utility room, dirty utility room, medication room, storage room for oxygen and liquid nitrogen, equipment storage room, staff breakroom, dedicated patient corridor, and lab draw area, 4 rooms for Telehealth – 1 exam room to accommodate VA employee, patient, and visitor (at least 125 sq feet with sink, no carpet, at least 4 electrical outlets on all 4 walls (16 total), at least 4 data ports on 2 walls (8 total), exam table, storage of clinical supplies), 1 exam/group room to accommodate VA employee, patients, and visitors (at least 180 sq feet with sink, no carpet, at least 4 electrical outlets on all 4 walls (16 total), at least 4 data ports on 2 walls (8 total), storage of clinical supplies, file cabinet, desk that is at least 4 feet long to accommodate two monitors/computer and phone, office chair), 1 Tele-eye exam room to accommodate VA employee, patient, and visitor (at least 180 sq feet with sink, no carpet, room needs to be configured in a way that can it support a 2'x3' piece of equipment be accessible to patient while being at least 10 feet away from an adjacent, blank wall where a screen could be mounted, room also needs to have no windows or windows blacked out, room lights need to be dimmable or have the ability to shut off lights (no motion sensor) with desk lamp present for minimal lighting when needed, at least 4 electrical outlets on all 4 walls (16 total), at least 4 data ports on 2 walls (8 total), file cabinet, desk that is at least 4 feet long to accommodate two monitors/computer and phone, office chair), 1 teleconsultation room to accommodate VA employee, patient, and visitor (at least 80 sq feet, room must include at least 4 data ports and 4 electrical outlet on 2 two walls (8 data ports and 8 electrical outlets total), file cabinet, and desk that is at least 4 feet long to accommodate two monitors/computer and phone). Please review attached link. 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 transmissions. The codes, standards, and references listed below indicate minimum performance requirements. Compliance is required with applicable codes and standards throughout the process of design, construction, acceptance, and on-going maintenance of the outpatient site of care facility. Design and documentation of the outpatient site of care shall be in compliance with the requirements of the codes, standards, and references listed below. This also covers construction materials and standards not fully addressed by the codes, standards, and references below.

23. QUESTION: Will the VA provide a list of all VA staff that require an office at the CBOC, including what type and size of office (if any).

Government Response: Please reference 4.9.1. Contractors shall provide space that meets the standards outlined in the PACT Space Module Design Guide (see link above) and for the purposes of this solicitation the following minimum space requirements are: 1 waiting room, 1 public restroom in waiting area, check in area, 2 patient restrooms within the clinical area, 1 staff restroom within the clinical area, 3 exam rooms per team, 1 women’s health/procedure room per two teams, teamwork zone, 1 consult room per two teams, 1 large group room, 1 mental health office with office supplies and office furniture to accommodate VA employee, patient and visitor (at least 125 sq feet, room must include at least 4 data ports and 4 electrical outlet on 2 two walls (8 data ports and 8 electrical outlets total), file cabinet, and desk that is at least 4 feet long to accommodate two monitors/computer and phone), clean utility room, dirty utility room, medication room, storage room for oxygen and liquid nitrogen, equipment storage room, staff breakroom, dedicated patient corridor, and lab draw area, 4 rooms for Telehealth – 1 exam room to accommodate VA employee, patient, and visitor (at least 125 sq feet with sink, no carpet, at least 4 electrical outlets on all 4 walls (16 total), at least 4 data ports on 2 walls (8 total), exam table, storage of clinical supplies), 1 exam/group room to accommodate VA employee, patients, and visitors (at least 180 sq feet with sink, no carpet, at least 4 electrical outlets on all 4 walls (16 total), at least 4 data ports on 2 walls (8 total), storage of clinical supplies, file cabinet, desk that is at least 4 feet long to accommodate two monitors/computer and phone, office chair), 1 Tele-eye exam room to accommodate VA employee, patient, and visitor (at least 180 sq feet with sink, no carpet, room needs to be configured in a way that can it support a 2'x3' piece of equipment be accessible to patient while being at least 10 feet away from an adjacent, blank wall where a screen could be mounted, room also needs to have no windows or windows blacked out, room lights need to be dimmable or have the ability to shut off lights (no motion sensor) with desk lamp present for minimal lighting when needed, at least 4 electrical outlets on all 4 walls (16 total), at least 4 data ports on 2 walls (8 total), file cabinet, desk that is at least 4 feet long to accommodate two monitors/computer and phone, office chair), 1 teleconsultation room to accommodate VA employee, patient, and visitor (at least 80 sq feet, room must include at least 4 data ports and 4 electrical outlet on 2 two walls (8 data ports and 8 electrical outlets total), file cabinet, and desk that is at least 4 feet long to accommodate two monitors/computer and phone). Please review attached link. 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 transmissions. The codes, standards, and references listed below indicate minimum performance requirements. Compliance is required with applicable codes and standards throughout the process of design, construction, acceptance, and on-going maintenance of the outpatient site of care facility. Design and documentation of the outpatient site of care shall be in compliance with the requirements of the codes, standards, and references listed below. This also covers construction materials and standards not fully addressed by the codes, standards, and references below.

24. 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: Past usage approximate values are listed below. If a vaccine is not listed that vaccine usage was approximately 0.

D.39 Vaccine List is added to RFP.

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

Government Response: VA will not provide the courier, the contractor is responsible for courier services, please reference 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.

26. 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 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.

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

Government Response: Regarding phone circuit – yes, VA will provide. Regarding physical phones – no, physical phones are not included. See 4.11.3. The VA will be responsible for: 4.11.3.1 providing PC workstations, software, primary telecommunication lines and networking equipment required to access the VA EHR.

28. QUESTION: How long does it typically take the government to install T-1 access for information technology?

Government Response: 180 days minimum

29. QUESTION: May candidate transcriptions be provided post-award? Transcripts can take weeks to obtain, and this timeline is beyond the control of the Contractor?

Government Response: Unofficial Transcripts and graduation certificates can be submitted at the time of proposal.

30. QUESTION: 4.6.3.2.8 If the VA is managing anticoagulation, would the VA Pharmacist be responsible for providing quarterly and annual quality assurance summaries?

Government Response: The contractor will 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. Please reference 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. For questions, please contact, POC, VA Anticoagulation Coordinator, Jennifer Bird at Jennifer.bird@va.gov.

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.

31. QUESTION: 4.6.4.2 Electrocardiogram services: VA will supply the MUSE compatible EKG to contractor at a cost. What is the cost of the EKG?

Government Response: Cost at this time will be approximately $25,000.

32. QUESTION: 4.6.4.4.6 Centrifuge What is the cost to the contractor for the VA supplying the centrifuge for the lab?

Government Response: The PWS is updated to reflect “4.6.4.4.5. The Contractor laboratory centrifuge must meet specifications provided by VA. Specifications are included in Section D (attachments)”

33. QUESTION: 4.11.3.1 Telephones. Will VA be supplying the telephones and telephone system for the clinic? Including fax?

Government Response: Telephones, fax, and scanners are not supplied by the VA. Please see 4.11.3. The VA will be responsible for 4.11.3.7. providing one small desktop color printer for printing patient education information.

34. QUESTION: Does the government require CAT6 or CAT6A cabling?

Government Response: CAT 6A is preferred.

Please reference 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.

35. QUESTION: There are 1239 enrolled now, how does the government estimate the clinic getting to 1600?

Government Response: Conclusions of data analysis led government to determine growth in Altus Community Based Outpatient Clinic.

36. QUESTION: In sub-factor (2) - Quality Staffing,

a. can we submit physicians' Board Certifications, and NP/PA transcripts and Graduate certificates post award?

b. are resumes and licenses included in the page count?

Government Response: Technical Capability page limit 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. Any information that exceeds this page limit will not be reviewed.

37. QUESTION: In which Factor should we include our TJC and SDVOSB verifications.

Government Response: IAW PWS para 12.2 If the Contractor is TJC accredited, he/she will be required to furnish a copy of the accreditation letter(s) upon request by the Contracting Officer prior to award.

Per 52.212-1 addendum Offeror shall be registered and verified in the Small Business Administration Veteran Small Business Certification (VetCert) database as a SDVOSB, https://veterans.certify.sba.gov/ effective before the closing date of this solicitation.

Per VAAR 852.219-73 (c) Representation. Pursuant to 38 U.S.C. 8127(e), only certified SDVOSBs listed in the SBA certification database are considered eligible to receive award of a resulting contract. By submitting an offer, the prospective contractor represents that it is an eligible and certified SDVOSB as defined in this clause, 13 CFR 121, 125, and 128, and VAAR subpart 819.70.

Per this clause (2) Any award resulting from this solicitation shall be made to a certified SDVOSB listed in the SBA certification database who is eligible at the time of submission of offer(s) and at the time of award.

The contracting office will verify offerors certification upon submission of offer and at award.

38. QUESTION: Please clarify the depth of redaction you require. Is it simply stripping the company name and any identified company personnel or do you want all branding colors removed as well (aka, turn it into a black and white version only).

Government Response: In the redacted proposal, the offeror shall use “our company” in place of the business name after the first page in the Technical Proposal, in the Past Performance, and in the Price Proposal.

39. QUESTION: On what dates was the market research performed and what were the findings?

Government Response: The market research report is an internal document to the Government and is used to determine the acquisition strategy used for these services. The market research findings are exhibited in the Government’s determination to publish this solicitation as an SDVOSB set-side.

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

Government Response: Please reference 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. For any buildout/construction that might be required to prepare space for performance of this contract, Davis-Bacon Wages (https://www.dol.gov/agencies/whd/government-contracts/construction) must be paid to any personnel working on the buildout/construction of the space and certified payrolls for all buildout/construction workers are due to the COR and Contracting Officer, no later than 10 business days prior to the clinic opening.

4.9.1. Contractors shall provide space that meets the standards outlined in the PACT Space Module Design Guide (see link above) and for the purposes of this solicitation the following minimum space requirements are: 1 waiting room, 1 public restroom in waiting area, check in area, 2 patient restrooms within the clinical area, 1 staff restroom within the clinical area, 3 exam rooms per team, 1 women’s health/procedure room per two teams, teamwork zone, 1 consult room per two teams, 1 large group room, 1 mental health office with office supplies and office furniture to accommodate VA employee, patient and visitor (at least 125 sq feet, room must include at least 4 data ports and 4 electrical outlet on 2 two walls (8 data ports and 8 electrical outlets total), file cabinet, and desk that is at least 4 feet long to accommodate two monitors/computer and phone), clean utility room, dirty utility room, medication room, storage room for oxygen and liquid nitrogen, equipment storage room, staff breakroom, dedicated patient corridor, and lab draw area, 4 rooms for Telehealth – 1 exam room to accommodate VA employee, patient, and visitor (at least 125 sq feet with sink, no carpet, at least 4 electrical outlets on all 4 walls (16 total), at least 4 data ports on 2 walls (8 total), exam table, storage of clinical supplies), 1 exam/group room to accommodate VA employee, patients, and visitors (at least 180 sq feet with sink, no carpet, at least 4 electrical outlets on all 4 walls (16 total), at least 4 data ports on 2 walls (8 total), storage of clinical supplies, file cabinet, desk that is at least 4 feet long to accommodate two monitors/computer and phone, office chair), 1 Tele-eye exam room to accommodate VA employee, patient, and visitor (at least 180 sq feet with sink, no carpet, room needs to be configured in a way that can it support a 2'x3' piece of equipment be accessible to patient while being at least 10 feet away from an adjacent, blank wall where a screen could be mounted, room also needs to have no windows or windows blacked out, room lights need to be dimmable or have the ability to shut off lights (no motion sensor) with desk lamp present for minimal lighting when needed, at least 4 electrical outlets on all 4 walls (16 total), at least 4 data ports on 2 walls (8 total), file cabinet, desk that is at least 4 feet long to accommodate two monitors/computer and phone, office chair), 1 teleconsultation room to accommodate VA employee, patient, and visitor (at least 80 sq feet, room must include at least 4 data ports and 4 electrical outlet on 2 two walls (8 data ports and 8 electrical outlets total), file cabinet, and desk that is at least 4 feet long to accommodate two monitors/computer and phone). Please review attached link. 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 transmissions. The codes, standards, and references listed below indicate minimum performance requirements. Compliance is required with applicable codes and standards throughout the process of design, construction, acceptance, and on-going maintenance of the outpatient site of care facility. Design and documentation of the outpatient site of care shall be in compliance with the requirements of the codes, standards, and references listed below. This also covers construction materials and standards not fully addressed by the codes, standards, and references below.

41. QUESTION: Please confirm the number of procedure rooms and women’s health exam rooms required in this clinic. Can a procedure room count toward the number of required women’s health exam rooms?

Government Response: Yes, a procedure room can count toward the number of required women’s health exam rooms. 1 women’s health/procedure room per two teams.

4.9.1. Contractors shall provide space that meets the standards outlined in the PACT Space Module Design Guide (see link above) and for the purposes of this solicitation the following minimum space requirements are: 1 waiting room, 1 public restroom in waiting area, check in area, 2 patient restrooms within the clinical area, 1 staff restroom within the clinical area, 3 exam rooms per team, 1 women’s health/procedure room per two teams, teamwork zone, 1 consult room per two teams, 1 large group room, 1 mental health office with office supplies and office furniture to accommodate VA employee, patient and visitor (at least 125 sq feet, room must include at least 4 data ports and 4 electrical outlet on 2 two walls (8 data ports and 8 electrical outlets total), file cabinet, and desk that is at least 4 feet long to accommodate two monitors/computer and phone), clean utility room, dirty utility room, medication room, storage room for oxygen and liquid nitrogen, equipment storage room, staff breakroom, dedicated patient corridor, and lab draw area, 4 rooms for Telehealth – 1 exam room to accommodate VA employee, patient, and visitor (at least 125 sq feet with sink, no carpet, at least 4 electrical outlets on all 4 walls (16 total), at least 4 data ports on 2 walls (8 total), exam table, storage of clinical supplies), 1 exam/group room to accommodate VA employee, patients, and visitors (at least 180 sq feet with sink, no carpet, at least 4 electrical outlets on all 4 walls (16 total), at least 4 data ports on 2 walls (8 total), storage of clinical supplies, file cabinet, desk that is at least 4 feet long to accommodate two monitors/computer and phone, office chair), 1 Tele-eye exam room to accommodate VA employee, patient, and visitor (at least 180 sq feet with sink, no carpet, room needs to be configured in a way that can it support a 2'x3' piece of equipment be accessible to patient while being at least 10 feet away from an adjacent, blank wall where a screen could be mounted, room also needs to have no windows or windows blacked out, room lights need to be dimmable or have the ability to shut off lights (no motion sensor) with desk lamp present for minimal lighting when needed, at least 4 electrical outlets on all 4 walls (16 total), at least 4 data ports on 2 walls (8 total), file cabinet, desk that is at least 4 feet long to accommodate two monitors/computer and phone, office chair), 1 teleconsultation room to accommodate VA employee, patient, and visitor (at least 80 sq feet, room must include at least 4 data ports and 4 electrical outlet on 2 two walls (8 data ports and 8 electrical outlets total), file cabinet, and desk that is at least 4 feet long to accommodate two monitors/computer and phone). Please review attached link. 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 transmissions. The codes, standards, and references listed below indicate minimum performance requirements. Compliance is required with applicable codes and standards throughout the process of design, construction, acceptance, and on-going maintenance of the outpatient site of care facility. Design and documentation of the outpatient site of care shall be in compliance with the requirements of the codes, standards, and references listed below. This also covers construction materials and standards not fully addressed by the codes, standards, and references below.

42. QUESTION: 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”?

Government Response: All offers must meet the Government’s space requirements per the Performance Work Statement in the RFP.

43. QUESTION: Please confirm the new CBOC must be designed with the on/stage-off/stage concept as laid out in the PACT Design Guide.

Government Response: On-stage/off-stage design features are required. On-stage/off-stage design is referenced in PACT Space Module design guide in 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.

See Sub-Factor (5) – Geographic Location/Accessibility – 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.

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

Government Response: 1245

45. 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: Mental Health Provider – 5 full days, Monday-Friday, Telehealth Clinical Technician (TCT) – 5 full days, Monday-Friday

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

Government Response: Yes, please reference to 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.

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

Government Response: The government will give 2 weeks advanced notice if the government does a site visit. Please reference to EVALUATION FACTORS AND CRITERIA. (1) FACTOR A – Technical Capability, Sub-factor (5) – Geographic Location/Accessibility (please note a site visit may be conducted to determine acceptability).

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

Government Response: 0

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

Government Response: Unofficial Transcripts and graduation certificates can be submitted at the time of proposal.

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

Government Response: Yes, ACLS and BLS are not required to be submitted for physicians with the proposal.

51. 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 Past usage approximate values are listed below. If a vaccine is not listed that vaccine usage was approximately 0.

D.39 Vaccine List is added to RFP.

52. QUESTION: Please advise how mental health will be handled in the clinic (is contractor or VA providing, or will it be referred to VAMC)

Government Response: VA providing Mental Health provider on site; however, contractor will be responsible for the following:

Please reference 4.6.6.2.1 MENTAL HEALTH AND SUBSTANCE USE SCREENING AND CARE: As part of standard primary care services, the Contractor’s staff shall provide screening and care for common mental health and substance use conditions, consistent with team members clinical privileges, skills, scope of practice, position description, or functional statement.

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

Government Response: The RFP indicates the offeror’s initial offer should contain the offeror’s best terms from a price and technical standpoint.

54. QUESTION: Would another vendors CAT6 panel be acceptable?

Government Response: No, please reference 4.11.2.6.7. Infrastructure installer should install Leviton CAT6 patch panels and connectors in the rack.

55. QUESTION: In reference to Pg.11 SUM TOTAL ESTIMATE FOR BASE AND OPTION YEARS $_________________________ This solicitation includes FAR 52.217-8 and will be evaluated. The evaluation will assume that the prices for any option exercised under FAR 52.217-8 will be at the same rates as those in effect under the contract at the time the option is exercised. The evaluation will therefore assume that the addition of the price or prices of any possible extension or extensions under FAR 52.217-8 to the total price for the basic requirement and the total price for the priced options has the same effect on the total price of all proposals relative to each other, and will not affect the ranking of proposals based on price, unless, after reviewing the proposals, the Government determines that there is a basis for finding otherwise. The evaluation will consider the possibility that the option can be exercised at any time and can be exercised in increments of one to six months, but not for more than a total of six months during the life of the contract. This evaluation will not obligate the Government to exercise any option under FAR 52.217-8.

Please clarify if the government will score pricing based on the total roll-up of the base year or base year along with all option years.

Government Response: The Government evaluate the total price for the basic requirement and the total price for the priced options.