36C26119R0001-0002000.docx

36C26119R0001 Amendment 0002 Answers to Questions and Requests for Information

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. 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 CODE

CODE

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 ADM

INISTRATIVE 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 d ate 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 3

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) 04-19-2019 None Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Sierra Nevada Health Care System 975 Kirman Avenue Reno NV 89502-2597 Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Sierra Nevada Health Care System 975 Kirman Avenue Reno NV 89502-2597 To all Offerors/Bidders

36C26119R0001 04-09-2019

X X X

a. The purpose of this amendment is to provide answers to questions requests for information.

b. All other terms and conditions remain.

1. Will the new contractor inherit the patient’s last Primary Care vesting visit and be allowed to bill for one year from that date upon contract award?

a. No, new contractors will need to establish a service date baseline.

2. In paragraph 3.1 Business Hours, it states that Services shall be available from the Contractor for a period of at least eight hours between the hours of 7:30 am and 5:30pm Monday through Friday. Does the provider (Physician or AP) have to be in the clinic when the clinic providing services each day the clinic is open for business?

a. A Provider should be available for contact during business hours.

3. How many Choice/Mission Act referrals occurred in the past 12 months for enrolled veterans of the Yreka CBOC?

a. 695

4. In paragraph 4.7.10 it states that the Contractor will provide all medication, including any necessary vaccines that are to be administered to patients in the clinic. Please confirm that the following list of Vaccines are the responsibility of the contractor?

a. TDAP

b. Pneumovax 23

c. Prevnar 13

d. TD

e. Flu, High dose flu

f. Shingrix

g. Twinrix (Hep A&B)

h. Hep A

i. Hep B

j. HPV

k. Depo Answer for 4-7: This is an error, ALL medications and vaccines are provided by the VA

5. Are there any additional Vaccines required to be supplied by the contractor other than those listed in question 4 above? See above.

6. Pursuant to paragraph 4.7.10, please provide a list of Medications the government expects the contractor to dispense from the clinic that would not be a routine medication dispensed through the VA or an urgent/emergent medication dispensed through the VA’s contract with a local pharmacist. See above

7. What is the number of Vaccines, by type as listed in question 4 and any additional Vaccines added by the government pursuant to question 5, that was provided to the Yreka CBOC Enrolled Veterans in the last 12 months? N/A

8. In paragraph 2.5.5 it states that the VA will provide Telehealth Services Clinical Staff. In paragraph 4.7.19.4 the solicitation indicates that the Contractor is to provide Telehealth Staff. Does the VA require the contractor to provide a Telehealth Tech to operate VA Telehealth equipment?

a. No, the VA will provide Telehealth Staff.

9. How many Telehealth visits were originated (patient at the Yreka CBOC) from the Yreka CBOC in the last 12 months?

2018-2019

|YRK TH BEHAV HLTH MM PAT| 183 |

|YRK TH DIET IND PAT | 11 |

|YRK TH DM ED GRP PAT | 0 |

|YRK TH MOVE IND PAT | 16 |

|YRK TH NEURO PAT | 27 |

|YRK TH RSVP-X | 4 |

|YRK TH SPEECH THERAPY PA| 2 |

|YRK TH SW TCM PAT | 0 |

YRK TH TBI CM PAT | 1 |

|YRK TH TBI PAT | 6 |

|YRK THSF DERM PAT | 19 |

|YRK THSF RETINAL PAT | 7 |

Total 276

10. Does the current Yreka CBOC meet the new contract PACT Space Module Design Guide requirements as stated in paragraph 4.7.28.1 of the solicitation?

a. Yes

11. In section 4.7.28.1 it states that Contractors shall provide space that meets the standards outlined in the PACT Space Module Design Guide. Is the on-stage/off-stage design with the PACT Zone the only design the VA will accept?

a. No. The VA will also accept standard clinical settings complaint with previously stated regulatory standards.

12. Is the VA supplying the phones and phone system for the CBOC or is the contractor to provide?

a. Yes

13. How many VA staffed personnel will be providing services at the CBOC? Please list by job title and number of days per month.

a. Telehealth Tech- daily LCSW Behavioral Health- daily Audiology Tech- daily HBPC RN- daily

14. How many offices will be needed at the Yreka CBOC for the VA provided staff (by position/function) identified in question 13?

a. One each for the above except Telehealth requires 4 exam rooms.

15. What is the address of the core laboratory noted in paragraph 4.7.6?

a. Redding VA OPC, 351 Hartnell Ave Redding CA 96002

16. How many times per day does the VA want specimens sent to the VA core laboratory from the Yreka CBOC?

a. Once daily

17. In paragraph 6.1.2 it states that the Contractor shall have ninety (90) days from contract award to commencement of medical care to local veterans. Will the government change this to 120 days?

a. Yes

18. The CLINS show enrollment at 1,300 enrollees over the life of the contract. Historically (since AUG-FY17) the enrollment levels as shown in the Yreka PACT COMPASS report, has been flat to declining starting at 1,048 in August of 2017 (no earlier data is shown) and is at 1,000 enrollees in February 2019. Our concern is that going from 1,000 enrollees, as indicated on the PACT COMPASS report, to 1,300 enrollees in the CLINS in an environment where the government (VetPop2016) indicates a declining population is problematic and can place the contractor in a loss position if the growth is not achieved due to the lack of eligible veteran enrollees. Please explain how the government came up with the CLIN Enrollment numbers shown in the CLINS considering the above presented information based on actual results shown in the PACT COMPASS and government population estimates.

a. The previous contract was capped at 1000 due to the CHOICE Act. We have removed those limitations with the new Missions Act and 1300 allows for clinic growth. PACT Compass reports starts at August 2017 for the Yreka CBOC as this the date that Yreka was assigned a unique station identifier.

19. How many veterans using the Yreka CBOC are currently on the Primary Care billable roster?

a. The March 2019 invoice was 984.

20. Who is providing the services?

a. The Contractor provides Primary Care Services

21. How many patients /veterans how do they serve? Numbers?

a. Currently 1000. New contract allows for growth

22. Are caregivers important?

a. yes

23. Is mobile APP and applicable?

a. No

24. What percentage or time is required in person?

a. As much as needed to care for the patient

25. What percentage of time is

26. What is the need for behavioral health providers? What is the need for psychiatrist, psychologist?

a. Mental health providers are provided by the VA

27. Are advance practice nurses able to deliver the services?

a. Please refer to PACT model

28. What are the percentage of primary care services to behavioral health services?

a. Usually 10% of enrolled Primary Care patients

29. Are they expecting us to bring providers or are we bringing in providers?

a. The Contractor provides providers

30. What specialty are we servicing if they do need providers?

a. Specialty care is provided by the VA

31. How many hours are needed?

a. 8 hrs/day, 5d/week

32. How many days per week of coverage?

33. What states would need coverage?

a. Yreka California

34. Who will provide the specialties? Where will they be located?

a. Specialty care will be provided by VA or the Community

35. Are they looking for both provider services and education (DPP)?

a. Yes

36. How important is health education?

a. Very