Ada CBOC QA - 12132023.pdf

1. QUESTION: 4.6.3.1 Pharmacy Services - If a new vaccine becomes available after the start of a contract will the contractor be responsible to supply the new vaccine at their cost?

Government Response: Yes. 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.

2. QUESTION: 4.6.3.2.8 Medication Management - Since the VA is providing CPS and Anticoagulation PharmD service, will the VA be responsible to provide the quarterly and annual quality assurance summaries to the Pharmacy?

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.

3. QUESTION: 4.6.2.2 Electrocardiogram Services - The VA is supplying the EKG to the contractor at cost, please provide that cost?

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

4. QUESTION: 4.6.4.4.5 Laboratory Centrifuge - The VA will supply the laboratory centrifuge at a cost to the contractor, what is that cost?

Government Response:

PWS paragraph 4.6.4.4.5. The Contractor laboratory centrifuge will be supplied by VA at cost to the contractor. Updated to The Contractor laboratory centrifuge must meet specifications provided by VA.

Specifications are included in Section D (attachments).

5. QUESTION: 4.11.3.1 Telephones - Will the VA be supplying the telephones, fax, scanners, and printers for the CBOC?

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.

6. QUESTION: 2.8.3 Solicitation says TCT must go to all training, remote and in person question re: how many in-person trainings will be required, length of training as we will have to pay for travel and housing etc.?

Government Response: The TCT is a VA staff member and contractor is not responsible for cost related to trainings.

2.8. TELEHEALTH SERVICES CLINICAL STAFF: Telehealth Clinical Technician (TCT) will be staffed by Oklahoma City VAHCS. 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. Contractor’s telepresenters, RNs, LPNs, LIPs and support staff providing telehealth services shall be required to complete all Telehealth required training, both virtual and in-person.

7. QUESTION: 4.6.1.1.1.2 - PACT training and Whole Health training, must be done within 90 days… solicitation says both live and TMS for PACT, but looks like the whole health is live – Can this be attended remotely, and will it be offered within 90 days? Will the contractor close the clinic, or will two sessions be offered?

Government Response: PACT Training may be completed within TMS. Whole Health will be offered within 90 days remotely or with trainer going to location. Two sessions will be offered.

8. QUESTION: Will the VA approve a location without a sprinkler system, if it is compliant with the city/county code?

Government Response: No.

4.9.7. Automatic Fire Sprinkler System

4.9.7.1. In VA occupied buildings, fire sprinkler protection shall be required to protect patients, visitors, and staff; also for maintaining the continuity of important clinical and administrative activities; and protecting VA property. This is for compliance with the Federal Fire Safety Act PL-102-

522. This applies to all categories of VA construction and renovation projects, station level projects, and acquisition of all VA property (including contracted outpatient clinics).

4.9.7.2. The entire Building shall be protected throughout by an automatic fire sprinkler system.

Automatic fire sprinkler system(s) shall be installed in accordance with the requirements of NFPA 13, Standard for the Installation of Sprinkler Systems that was in effect on the actual date of installation.

9. QUESTION: Will the VA provide the “thin-prep” solution for the female pap exams?

Government Response: No, please refer 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.

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

Government Response: 1776

11. 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: Please refer 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.

12. QUESTION: 12: 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.

13. 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.

14. 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.

15. QUESTION: Will the government be conducting 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 refer 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).

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

Government Response: 0

17. QUESTION: Are the current providers designated Women’s Health Providers?

4.6.2.4.3.1. To be initially designated as a Women’s Health PCP (WH-PCP), a provider must have at least one of the following:

4.6.2.4.3.2. Documentation of attendance at a Women’s Health Mini-Residency within the previous 3 years;

4.6.2.4.3.3. Documentation of at least 20 hours of women’s health continuing medical education (CME) or continuing education unit (CEU) within the previous 3 years;

4.6.2.4.3.4. Documentation of at least 3 years in a practice with at least 50% women patients within the previous 5 years;

4.6.2.4.3.5. Evidence of completion of an internal medicine or family practice residency; women’s health fellowship; or women’s health, adult or family practice NP or PA training within the previous 3 years;

4.6.2.4.3.6. Documentation of a current preceptorship arrangement with an experienced WH-PCP such as weekly meetings (for at least 6 months); or

4.6.2.4.3.7. Evidence of being recognized as a known women’s health leader and subject matter expert with experience practicing, teaching, and/or precepting women’s health.

4.6.2.4.3.8. Renewal of status for Women’s Health PCPs requires ten (10) hours of CME or CEU in women’s health every 2 years.

4.6.2.4.3.9. The Contractor must provide ongoing education and training to the Women’s Health Primary Care Providers to assure competency, proficiency and expertise in providing care to women Veterans.

18. QUESTION: 4.9.1 - Does the women’s health/procedure room count as one of the three exam rooms per team?

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 http://www.cfm.va.gov/til/dGuide/dgPACT.pdf http://www.cfm.va.gov/til/etc/dsBarrFree.pdf 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.

19. QUESTION: Please clarify the general instructions for proposal submissions. Please confirm that the government is requesting (2) complete proposals, (1) redacted proposal (1) technical with no reference to cost/price, for a total of four, all sent electronically?

Government Response: The offeror shall submit two (2) complete proposals; a complete proposal consists of three (3) Volumes: Technical, Past Performance and Price. The technical proposal must not contain any reference to cost/price. Offerors shall ensure their proposal clearly identifies the appliable sections relating to each factor. One proposal will be a redacted proposal.

20. QUESTION: 2, page 15 - Is a full-time Clinic Manager required and if so, would the VA prefer they be a registered nurse?

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

21. QUESTION: 2.3.1, page 17 - Considering the national shortage in primary care providers, would the

VA consider hiring a new family practice/internal medicine residency graduate if mentorship is provided by the bidder?

Government Response: Yes

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.

OPTION 1: Physician (MD/DO): Qualifications: Physicians shall demonstrate evidence of education, training, and experience in Internal Medicine or Family Practice. Physicians performing under this contract shall be board certified or board eligible by the ABMS in Internal Medicine and/or Family Practice or the BOS in Internal Medicine and/or Family Practice. Authorization for prescriptive authority is required. If proposed staff do not meet VA credentialing requirements, the Contractor shall propose substitute acceptable personnel within five (5) calendar days. Physicians shall be licensed in the state in which the Outpatient Site of Care (i.e. CBOC) is located; otherwise qualifications as per VA Handbook 5005, Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care, providing health care commensurate to the PCP’s licensure and clinical privileges or scope of practice, ensuring the patient’s care plan contains medical recommendations for clinically indicated care, offering clinically indicated health care services to patients assigned to the PACT, and providing or arranging for care to which patients consent, providing leadership to the team including shared delegation of appropriate care and care processes to appropriate team members, reviewing available clinical and performance data with the team, and focusing on continuous improvement of critical team processes, ensuring the patient has same-day access for face-to-face and virtual care visits during regular clinic hours, and collaborating with PACT staff to develop personal health plans that incorporate care management and care coordination appropriate to the patient’s needs.

22. Reference: 2.4.2, page 21 - The contractor will provide referrals to CPS Anti-Coagulation through consult to VA through EHR.

Reference: 4.6.3.2.7, page 45 - The Contractor shall meet all requirements for anticoagulation Management outlined in VHA Directive 1108.16(1) Anticoagulation Therapy Management (or subsequent revisions thereto) as well as local policy related to the management of patients on anticoagulation.

QUESTION: If the contractor refers patients to the VA CPS Anti-Coagulation, wouldn't the VA also provide the anticoagulation management?

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.

23. Reference: 2.8.3, page 22 - Contractor’s telepresenters, RNs, LPNs, LIPs and support staff providing telehealth services shall be required to complete all Telehealth required training, both virtual and in-person.

QUESTION: Where and when will the training be held and what is the duration of the training?

Mandatory trainings for these positions mainly consist of TMS courses online which are available at any time. The number and duration of the online train courses largely depend on the employee’s role. The total time it takes to complete these courses can range from approximately 1 -4 hours, depending on the requirements. Many of the roles require a hands-on skills assessment competency checkoff with a National Preceptor, however this can be accomplished virtually and can be scheduled at a time that works for both the employee and preceptor.

24. Reference: 4.6.2.4.7, page 40 - The RFP states, "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."

QUESTION: The contractor is not able to purchase Thin Prep, will the VA supply Thin Prep?

Government Response: No, please refer 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.

25. Reference: 4.6.3.1, page 40 - The Contractor will provide all medications (including any necessary vaccines) that are to be administered to patients in the clinic.

QUESTION: 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: Flu about 1 per unique; shingrex about 2 per unique 60 and older (most are finished with second dose); TDAP around 300; Hep A; Hep B; Hap AB around 20 each for the year; Pneumovax 23 around 30; pneumovax 20 around 300; tuberculin, PPD T.U. test averaged 1 ten test vial per month (expired out 28 days after opening).

D.38 Voucher Formulary added to Section D

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

Government Response: Yes. 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.

26. Reference: 4.6.4.3, page 46 - 2) Sending specimens to the VA Core Laboratory daily, except for those specified in this PWS.

QUESTION: Will the VA please verify that courier services will be provided once per 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.

27. Reference: 4.6.6.3, page 55 - Mental Health Support Services: The Contractor shall provide the following clerical support services for VA mental health providers at the CBOC.

QUESTION: 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.

28. Reference: 4.6.8.3, page 59 - 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.

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

Government Response: 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.

29. Reference: 4.9, page 71 - PACT space standards are found in the PACT Space Module Design

QUESTION: Will the Government 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.

30. Reference: 4.9.1. page 71 - 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...

QUESTION: Is it acceptable to the VA if the contractor includes the PACT Consultation Room as one of the 3 exam rooms per PACT team?

Is it acceptable to the VA if the contractor includes the Women's Health/Procedure Room as one of the 3 exam rooms per PACT team?

Will the VA please clarify what, "4 rooms for telehealth - 1 exam room" means? Is it 3 telehealth rooms and 1 telehealth exam room for a total of 4 rooms for telehealth, or is it 4 telehealth rooms and 1 exam room to accommodate VA?

Government Response: No, PACT consultation rooms and Women’s Health/Procedure Rooms cannot be included as one of the 3 exam rooms per PACT, 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 http://www.cfm.va.gov/til/dGuide/dgPACT.pdf http://www.cfm.va.gov/til/etc/dsBarrFree.pdf 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.

In response to “4 rooms for telehealth”: There will need to be 4 rooms dedicated to services that utilize the telehealth modality. These rooms will be scheduled and utilized at the discretion of the OKC VA HCS employed TCT and OKC VA HCS Telehealth program leadership. Listing below:

• 1 exam room

• 1 exam/group room

• 1 Tele-eye exam room

• 1 teleconsultation room

31. Reference: 4.11.1.2. page 79 - 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.

QUESTION: Will the Government please confirm if CAT 6 or CAT 6A is preferred?

Government Response: 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.

32. Reference: 4.11.2.5.1-.2, page 81 - Power requirements:

Four (4) L6-20 receptacles, one (1) L6-30 receptacles in the closet

QUESTION: Will the Government 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 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.

33. Reference: 4.11.2.6.7 - Infrastructure installer should install Leviton CAT6 patch panels and connectors in the rack.

QUESTION: Will the Government please confirm if a comparable brand to Leviton is suffice?

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

34. Reference: Instructions for Proposal Submission, page 159 - The Offeror shall submit two (2) electronic copy of the complete proposal, one proposal will be redacted proposal.

QUESTION: 10 Pitch is equivalent to a 12 point font. Does the VA want the proposal to be 12 point font size or larger or can it be 10 point font size or larger? Is it acceptable to have graphics and tables with a 10 point font size?

Government Response: The font size shall not be less than 10 point.

35. Reference: Instructions for Proposal Submission, page 159 - The Offeror shall submit two (2) electronic copy of the complete proposal, one proposal will be redacted proposal.

QUESTION: Does the VA want the Technical Proposal, Past Performance and Price Proposal submitted in two electronic copies, one that is not redacted and one that is redacted?

Government Response: Yes, the offeror shall submit two (2) complete electronic proposals;

Technical Proposal, Past Performance and Price Proposal. One that is redacted and one that is not redacted.

36. Reference: Instructions for Proposal Submission, page 159 - Please indicate the name of the business on the first page only in the redacted proposal. DO NOT place business name on every page of the proposal, use "our company" in place of business name after the first page.

QUESTION: Is it acceptable to the VA, if the bidder redacts the company name after the first page instead of using "our company" in the redacted proposal? And 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: 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.

37. Reference: Evaluation Factors and Criteria - Requiring transcripts and graduation certificates gives the incumbent an unfair advantage.

QUESTION: Will the VA accept transcripts and graduation certificates at the time of credentialing rather than at the time of proposal submission?

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

38. QUESTION: Will the VA please provide the historical enrollment for the past five years?

EOFY 2019 EOFY 2020 EOFY 2021 EOFY 2022 EOFY 2023

Primary Care Services

1810 1822 1855 1907 1803

39. QUESTION: The Offeror Instructions Checklist has a column with "Yes" and a column with "No", but each item in the checklist is not marked whether it is "Yes" or No". Will all items in this list be required to be submitted with the proposal?

Government Response: The Instruction Checklist is an aide to the offerors. Offerors should thoroughly review and be familiar with the requirements of the solicitation, clauses, provision and attachments prior to submitting proposals to be fully aware of the scope of services required.

40. QUESTION: Does the current Ada Oklahoma CBOC facility meet the PACT Space Module Design guide and space requirements for this RFP?

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