36C25924R0145 0002.pdf

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Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

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AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

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1 1

0002 10-24-2024

N/A

36C259

Department of Veterans Affairs

Network Contracting Office

NCO 19

6162 South Willow Drive, Suite 300

Greenwood Village CO 80111

36C259

Department of Veterans Affairs

Network Contracting Office

NCO 19

6162 South Willow Drive, Suite 300

Greenwood Village CO 80111

To all Offerors/Bidders

36C25924R0145

10-24-2024

X

X X

X ONE(1)

THE PUROPOSE OF THIS AMENDMENT IS TO:

A.) ANSWER VENDORS QUESTIONS

B.) NO ADDTIONAL QUESTIONS WIL BE ACCEPTED.

C.) ALL OTHER TERMS AND CONDITONS OF SOLCITATION 36C25924R0145 REMAIN UNCHANGED.

PATRICIA TOLIVER

Questions for RFP 36C25924R0145 0002

1. The 2021 RFQ for these perfusion services was #36C25921R0008, which had a final performance period ending February 28, 2027. Why are these services going back out to solicitation early based on previous solicitation? Did something change in scope of services or incumbent capability? That contract was ended early because RMR had no need for services since two perfusionist were hired.

2. Who is the incumbent vendor? What is the contract number? The Incumbent is EGA

Associates LLC. Contract number, 36C25924C0059.

3. What is the expected award date? What is the expected performance start date? Will the

VA agree to have the performance start date no sooner than 60 days from award?

Onboarding and credentialing at the VA requires many weeks of cooperative effort.

Award date is November 1, 2024, and it would be acceptable to have performance start no later than January 01, 2025.

4. What is the historical volume of perfusion cases (not hours) for 2022, 2023, and 2024

YTD? How many average hours per case? Since January 01, 2022, we have averaged about 2 cases a month. We would plan for about 8 hours per case.

5. What specific types of cases will the perfusionists support? Can you please break out the case types by volume? We expect 50-70 cases per year for the first year and anticipate that volume will continue to increase with a goal of 100 -120 cases per year, plus approximately 35 TAVR. Most the procedure we are currently performing are following:

• Coronary artery bypass grafting (CABG)

• Open surgical aortic valve replacement (AVR)

• AVR CABG

• Concomitant maze procedure.

• Mitral valve repair or replacement and mini mitral.

• We plan to start hemiarch ascending aortic replacement with circulatory arrest (in the past were used to frequently perform this procedure).

• Backup for thoracic endovascular aortic repair.

It is impossible to provide a breakdown of cases to be performed in advance. However, 40% of our procedures are CABG, 20% are AVR and 30% are remaining combined procedures as listed above.

6. What are your ECMO expectations? How many ECMO setups annually? How long on average are ECMO patients kept on ECMO at this facility before they’re removed from the machines or transported to another facility? Will perfusionists monitor ECMO or will in-house staff like RNs or RTs do the ongoing monitoring?

We do not perform ECMO procedure routinely at the VA. However, the anticipated volume will be 1-2 ECMO per year at the most. These will be likely some unexpected post cardiotomy cardiogenic shock patients requiring

ECMO. We have placed 4 patients on ECMO and last 9 years. Patient will be cannulated at the VA and then immediately transferred for the advanced level care at the nearest ECMO center. Perfusionist will monitor the patient's on

ECMO while they are at the RMR VA Medical Center and for a brief period between the cannulation and transport. Perfusionist will accompany the patient during the ECMO transport.

7. Similarly, what are your TAVR expectations? Setups? Monitoring?

We have not even started the TAVR program yet. So, this is only an estimate.

TAVR procedure will be performed without cardiopulmonary bypass support and pump available on standby in the operating room. For the first 2 years we expect to perform

25-30 TAVR and case volume might continue to increase after starting the program.

Patient will be monitored by the cardiac anesthesia and set up includes open surgical instruments available in case of any emergency as a backup, possible ECMO cannula selected in advance and have them available in the room. The perfusionists are available, a physically present in the room during the procedures. These procedures will be performed by cardiology and cardiac anesthesia combined.

8. What about your HIPEC usage for cancer treatment? Is this a service your surgeons currently desire or anticipate for the future? Yes, but not very often, 2-3 procedures per year at the max

9. How many concurrent cases do you need perfusionists to cover? Currently we do not plan on running concurrent cases.

10. Who provides the perfusion-related supplies and capital equipment: vendor or hospital?

Currently the VA will supply all capital equipment and supplies.

11. Who provides the ECMO-related supplies and capital equipment: vendor or hospital?

Currently the VA will supply all capital equipment and supplies

12. 12. How often are perfusionists called to cover cases outside of normal hours? This is not a frequent occurrence however we anticipate 3 to 4/year.

13. How many non-cardiac autotransfusion procedures will vendor be required to cover?

Please provide historical volumes for 2022, 2023, and 2024 YTD.

2-3 times per month

14. Please confirm that perfusionists are only required to be at the hospital for case coverage, not report for a standard shift regardless of whether cases are scheduled

(sections 2.9.2 and 2.9.3). Common practice nationally is for clinicians to only report for procedures.

15. The contracted perfusionist are only required to be on site during cases and available for call.

16. Section B.2 indicates that services will be billable by the hour. Far more common practices nationwide are for monthly retainers or per case fees. This can save hospitals significant money overall since they only have to pay for when perfusion services are actually needed. Would the VA please accept an alternative pricing structure?

17. Since we are currently rebuilding the program, Per hour is the best way for our facility to acquire these services.

18. We reviewed the solicitation and noticed the NAICS changed from 561320 to 621399 for the new procurement. Are you able to provide any insights on the change?

Due to legal ramifications and previous protest on NAICS Codes, we had to change the

NAICS.