S06 - 36C26019R0032 0002.pdf

5. PROJECT NUMBER (if applicable)

CODE7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO. 1. CONTRACT ID CODE

FACILITY CODECODE

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

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER 16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30 PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243

(Type or print) (Type or print)

(Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code)

(If other than Item 6)

(Specify type of modification and authority)

(such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer)

1 6

0002 04-27-2021 None

Department of Veterans Affairs Network Contracting Office 20 8524 N Wall St Spokane WA 99208 scott.reed2@va.gov

Department of Veterans Affairs Network Contracting Office 20 8524 N Wall St Spokane WA 99208

To all Offerors/Bidders

36C26019R0032

04-01-2021

X

X X

5:00 PM PST, 20 May 2021

THE PURPOSE OF THIS AMENDMENT IS TO ADDRESS PROSPECTIVE OFFEROR QUESTIONS AND EXTEND THE PROPOSAL DUE DATE.

A) Prospective offerors' questions have been addressed. Please see continuation pages.

B) Proposal due date has been extended by three days from 17 May 2021 to 30 May 2021. Time remains 5:00 PM PST.

C) Contracting POC for this action is Scott Reed at (509) 321-1909 or scott.reed2@va.gov.

ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED

36C26019R0032 00002 Bonner County CBOC

Questions and Answers

Q: Is this a follow-on requirement or a new requirement? If it is a follow-on requirement, could you please provide the previous contract or task order number?

A: This is a follow-on requirement. The current contract number is 36C26021D0018 and the current task order number is 36C26021N0392.

Q: “Total Estimated Patients enrolled/assigned to site: 1500.” Please provide the most recent 3-month billing figures/members/enrollees for primary care services.

A: Jan 1449; Feb 1430; March 1445. The number of enrollees would have been much higher if clinic consistently contacted Veterans to schedule their required annual appointment.

Q: Can the VA please provide the list of medications and vaccines the contractor will be responsible for providing? Additionally, can the VA also provide estimated utilization numbers/quantity for each medication/vaccine required (or historical information)?

A: TD, Tdap, Shingles, PCV13, MMR, Hep A, Hep B, Covid-19 and any other required vaccines not provided by the VA that are to be administered to patients in the clinic. The contractor is only required to provide medications to patients that are to be administered to patients in clinic.

VA provided vaccines within last 5 years (10/1/2015-9/30/2020)

==> OUTPATI ENT - SANDPOI NT

DI PHTHERI A/ TET TOX/ PERTUSSI S VACCI NE I NJ 372 7952. 62

HEPATI TI S B VACCI NE, 20MCG, 1 ML 8 251. 87

I NFLUENZA VAC, QUAD ( AGE 65+) SYR 0. 7ML 50 1679. 85

I NFLUENZA VACCI NE, QUAD, ( AGE<65) SYR 332 4119. 46

MEASLES, MUMPS & RUBELLA I I 5 220. 81

NALOXONE HCL 4MG/ SPRAY SOLN NASAL SPRAY 1 0. 01

PNEUMOCOCCAL 13- VALENT CONJ VACCI NE 646 73053. 56

PNEUMOCOCCAL 23- VALENT POLYSAC VACCI NE 238 12787. 26

TETANUS & DI PTH TOXOI D 0. 5ML I NJ 30 427. 08

VACCI NE, HEPATI TI S A 1440U/ ML, 1 ML 2 65. 35

ZOSTER VACCI NE, RECOMBI NANT I NJ 510 45292. 08

z I NFLUENZA VAC, TRI HI GH- DOSE SYR 2017- 18 20 535. 00 z I NFLUENZA VI RUS VACCI NE 2015- 16 SYRI NGE 380 1976. 00 z I NFLUENZA VI RUS VACCI NE 2016- 17 SYRI NGE 310 1949. 90 zz I NFLUENZA VACC TRI , ADJUV ( AGE 65+) SYR 150 3790. 50 zz I NFLUENZA VI RUS VACC PFS 0. 5ML 2010- 11 60 568. 56

TOTAL 3114 154669. 90

Q: Please confirm that the new contractor will inherit the patient’s last vesting visit and is eligible to bill for one year from that date upon contract award?

A: Yes, if award is made to a contractor other than the incumbent, the new contractor will inherit the enrolled veterans on the billable roster upon award.

Q: Will the Government please provide the RFP in a Microsoft Word Document?

A: No.

Q: In which volume should the contractor include the small business subcontracting plan?

A: Please provide the small business subcontracting plan in Part V: Veterans Involvement/Socioeconomic Indicators.

Q: Will the Government allow bidders to use a font smaller than size 12-point for tables?

A: Offerors may use 10-point font for text within tables.

Q: PACT design guidelines state that telehealth exam rooms to be 12’x12’ with an exam table, but this guidance on 4.9.1.1.5 states that 2 tele-health exam rooms are to be provided at 125 sf. Could we get clarification?

A:125 square feet is what is indicated on PACT Space Module Design Guide. Procedure Rooms are 180 sq ft.

However, the PWS does state, “Teleheath multi-purpose conference/group room minimum 250 sq. ft.”

Q: The solicitation states that 2 telehealth exam rooms are needed, will these 2 rooms be used for the Clinical Pharmacy Specialist, Licensed Clinical Social Worker, Dietitian/Nutritionist, and Primary Care Mental Health Integrations, as well as medical exams? Or will each discipline require their own telehealth rooms?

A: The two telehealth exam rooms will be shared for all telehealth needs to include the above disciplines. These rooms should be separate from the PACT exam rooms. One of these rooms is a TH multi-purpose conference/group room minimum 250 sq feet.

Q: Clarification – will the procedure room also double as the Women’s Health Exam Room or does it need to be separate?

A: Yes. The procedure room and WH exam room can be used interchangeably

Q: Does each PACT team require its own Women’s Health Exam Rooms:

A: The WH PACT teams do require their own WH exam room

Q: Do all Women’s Health Exam Rooms need to be a procedure room? PACT design guidelines state that a Women’s Health Exam Room only needs to be an exam room with an ensuite restroom.

A: No

Q: Is Board Eligible allowed for both CMD and Team Physician?

A: If CMD is Clinical Medical Director, yes Board Eligible for both

Q: Will there be PCMHI staffed on site to handle urgent MH needs and warm handoffs?

A: No it will be via TH. PCMHI can still assist with urgent but not emergent

Q: In a clinic of only 2 providers, will both providers need to be WH certified?

A: Yes

Q: Will all EKGs performed at CBOC be overread by VA cardiologist?

A: Yes.

Q: Please clarify “Smaller CBOCs must provide access to MH services for those who require them by on-site or part-time mental health staff.” Is contractor responsible for hiring those staff to work on-site, in addition to the staffing provided by the VA?

A: It states in 4.6.5.4.4. “Smaller CBOCs must provide access to mental health services for those who require them by: On-site full, or part-time, mental health staff; Telemental health; Referrals to nearby VA medical centers;

Referrals to nearby Vet Centers, when the services in these Centers meet the patient’s needs and clinical standards of care; Either sharing arrangements, contracts or Community Care to the extent that the Veteran”. This means that telemental health is acceptable to provide services

Q: Please confirm the total number of women’s health exam rooms that are required and the number of procedure rooms that are required. Can these be the same rooms or shall they be separate? Do these rooms count toward the required number of exam rooms per PACT?

A: WH exam room and procedure room can be interchangeable. The WH exam room does count toward the number of exam rooms per PACT. Each WH PACT needs at least one WH exam room to be included in their total number of exam rooms per PACT.

Q: Telehealth rooms are typically 12’ x 12’. Please confirm the VA only requires these telehealth rooms to be 125 square feet each.

A: 125 square feet is what is indicated on PACT Space Module Design Guide. Procedure Rooms are 180 sq ft.

However, the PWS does state, “Teleheath multi-purpose conference/group room minimum 250 sq. ft.”

Q: Does the VA require swinging or sliding doors on primary care exam rooms. If sliding doors are required, are they required on both sides of the room?

A: Swinging doors with exam door lock, door push/pull handles that comply with accessibility

Q: Is the contractor responsible for the telephones and phone lines at the clinic?

A: Yes

Q: Will the VA inherit the enrollees last vesting visit upon award?

A: Contractor will inherit the enrolled veterans on the billable roster upon award.

Q: Please confirm existing enrollees under the current contract are vested for a period of 12 months.

A: Yes. The vesting date for each enrollee is a rolling date. For example, veteran Z was seen on 2/1/2021 so active enrollee through 2/28/2022.

Q: What is the most recent number of billable enrollees at the clinic?

A: 1445

Q: Will the VA consider extending the clinic start up period to 120 days from the expiration of the protest period after award?

A: Yes, start up period is now 120 calendar days instead of 90 days.

Q: How many VA personnel will be providing services at the clinic. Please list by job title, number of hours per week, and space requirements for them.

A: Social Worker up to 24 hours a week. 125 sq ft room

Q: Will the current VA clinic be “grandfathered in” and not required to meet the space requirements in the

RFP?

A: No

Q: Paragraph 2.6.1 requires one Diagnostic Radiologic Technologist per x-ray machine. Please confirm that this staffing may be provided by x-ray subcontractor, as paragraph 4.6.4.1 states “X-rays shall be performed by the Contractor on-site at the outpatient site of care, using Contractor provided equipment or by subcontractor (emphasis added).”

A: Yes, staffing can be subcontracted out or Contractor can choose to send patients to another location for required x-rays.

Q: Paragraph 2.7 states that the VA will provide mental health services but also requires the Contractor to provide a Suicide Prevention Coordinator and a Homeless Outreach Specialist. As this site serves less than 10,000 patients, these would be collateral assignments with mental health providers.

Please clarify who is providing a Suicide Prevention Coordinator and a Homeless Outreach Specialist.

If the contractor is to provide a Suicide Prevention Coordinator and a Homeless Outreach Specialist, please indicate required qualifications and FTE levels for these positions.

A: This position would be a collateral duty. The contract staff would need to understand the program and how to access these services through MGVAMC collaborating with the VA Suicide Prevention Coordinator and Homeless Outreach Specialist.

Q: Regarding paragraph 4.9.1.1.1; 4.9.1.1.2; 4.9.1.1.3:

Does the Procedure room required by paragraph 4.9.1.1.2 count as one of the exam rooms required by 4.9.1.1.1?

Paragraph 4.9.1.1.3 requires “One of the exam rooms with attached toilet room per WH Directive and to be used as a procedure room.” Is this the same procedure room required of paragraph 4.9.1.1.2? Does this room count as one of the exam rooms required by 4.9.1.1.1?

A: Yes, the procedure room required by paragraph 4.9.1.1.2 will count as one of the exam rooms required by

4.9.1.1.1. Each WH PCP is required to have an exam room with attached toilet. The procedure room can double as one of the WH exam rooms.

Q: The Schedule of Service in the Solicitation estimates 43% patient growth over the 10 year contract period.

However, we note that it is projected for Veteran populations to decrease generally on a nationwide basis over the upcoming contract term. For example, “Current and Future Demographics of the Veteran Population, 2014-2024” published in Population Review Volume 57, Number 1 (2018), states “We project that the population of U.S. veterans will decrease by 19 percent over the next 10 years: from 21.6 million in 2014 to 17.5 million in 2024.” Given this information, could the Government indicate the factors that lead to the predicted long-term growth for the coming 10 year period under the current Solicitation, such as anticipated enlargement of the services area, anticipated influx of veterans to the area, etc.?

A: The current contract clinic has almost 1500 enrolled Veterans. A 43% growth would be 645 veterans. Based on current eligible veterans in two of the main counties for this clinic the clinic enrollment could grow even higher. In Bonner County, ID, there are 2,896 eligible Veterans and in Boundary County, ID there are 911. In 10 years, it is estimated there will be a 14% decrease in eligible veterans in Bonner County, Idaho and a 11% in Boundary County, Idaho.

Q: Would the VA consider allowing a 150 or 180 build out time frame instead of the 90 days indicated in paragraph 6.1.2? The basis of this request is that longer times frames are needed during the COVID-19 pandemic due to supply chain disruptions that are beyond the Contractor’s control. Reflective of this issue, we note that recent VA CBOC solicitations by other VA hospital systems have called for 180-day build out time frame, such as 36C24920R0114 (Tupelo, MS) and 36C24920R0007 (Hopkinsville, KY).

A: The 90 day start-up period has been increased to 120 calendar days.

(End of Q&A)