36C26119R0001-0003000.docx

36C26119R0001 Amendment 0003 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 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) 04-29-2019 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 ** HOUR & DATE for Receipt of Offers is EXTENDED to: May 15, 2019 at 11:00 AM

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

b. Extend the offer due date to May 15, 2019 at 11:00 AM.

c. All other terms and conditions remain.

Gary Basile Contracting Officer

1. Does the current clinical space meet the new contract requirements?

a. Yes

2. Can the government share the current vested roster as of 04/2019?

a. This information was previously released; 984 were on the roster for last invoice (March 2019)

3. Can the government share the utilization/ workload/ projections rate for the clinic?

Workload encounters

1,926

4. Can vendor expand their site selections/ place of performance to Fort Jones, which is 15 mins from Yreka? There are limited sites that offer the best value to the government in Yreka.

a. No, Yreka is the location that was approved by the Deputy Under Secretary for Health for Operations and Management (DUSHOM) for a clinic based on an assessment conducted by the Office of Rural Health.

5. Will the clinic have VA staff on site, if so, what specialty or discipline specific PACT team members will be on site?

a. Yes, Telehealth Tech, Behavioral Health LCSW, HBPC RN

6. To ensure vendors can properly plan and develop a proposal that meets all of the solicitation’s requirements can the proposal submission date be extended by 30 days from Q&A released? This will give us adequate time to obtain required documentation, develop clinical designs, and recruit the staffing / teamlete requirements.

a. No, in order to meet the award date, this can only be extended to 5/15/2019. Additionally the QAs have not led to any changes in the requirement.

7. Paragraph 2 states, “Actual panel sizes can be determined by the VA in accordance with PCMM Handbook 1101.02.” It is our understanding that PCMM Handbook 1101.02 has been superseded by VHA Directive 1406. Please clarify if panel sizes should be in accord with PCMM Handbook 1101.02 or with VHA Directive 1406.

a. VHA Directive 1406

8. Does the government require separate/ additional support for CPS?

a. No support is needed for the Clinical Pharmacist Specialist.

9. Is the contractor responsible for lab courier services, or is this service provided under a different contract?

a. The contractor will utilize the VA’s UPS account for courier services.

10. Does the government require a PACT model design for this requirement?

a. No

11. Does the government want two (2) consult rooms: one (1) clinical consult room and one (1) BH consult room; or can one (1) consult room meet both requirements?

a. No, there should be two separate consult rooms.

12. In section 4.7.28.2 the government request a specialty exam room. Can the government clarify is they are referring to a procedure room?

a. No procedure rooms are needed, just an exam room for specialty providers to utilize.

13. Can the procedure room be utilized as both a women’s exam room and procedure room given this room meets all requirements, or would the government require both room types?

a. No procedure rooms, just Women’s Health

14. Will the VA provide the VOIP phones for the CBOC?

a. Yes

15. Is the 50-page limitation for the technical factors 1-5 or all factors 1-8?

a. The 50-page limitation only applies to factors 1-5; additionally, the limitation does not apply to key personnel resumes or CVs.

16. For Factor 5, can vendors provide latest state or local inspection of facility after contract award? Some potential sites have not been built and will not have this level of documentation available.

a. Only for current building projects.

17. What is the expected award date for the solicitation?

a. July 1, 2019

18. Question 1 on Amendment 0002 asked if the new contractor will inherit the patient’s last Primary care vesting visit and be allowed to bill for one year from that date upon contract award. The VA responded No. New contractors will need to established a service date baseline to established a service date baseline.

Please clarify the VA intent is that under the new “Contract” ALL contractors will need to establish a new baseline. If the VA’s intent is that only NEW Contractors (to exclude the incumbent) have to establish a new baseline, then VA’s response puts the incumbent contractor at a significant advantage over other bidding contractors. Under this approach only the incumbent will be able to price with all current vested enrollees on their roster and as such will be able to bill the VA at the 984 level as stated in the answer to question 19 starting month one of the new contract. Conversely, under this scenario, New contractors will be required to start from zero on day one and build up to the enrollment levels currently on the billable roster which will take up to a year thus significantly increasing our cost to the VA. This approach, in our opinion, is protestable based on the aforementioned explanation.

a. After discussion, and research about how transfers of CBOC rosters are handled in other NCOs, it has been decided that all patients seen in the 12 months prior to the beginning of the period of performance will be transferred to new awardee. For example, if incumbent sees a patient on 6/30/2019, the new awardee will assume the same patient to their billable invoice. New awardee must perform vesting visit by 6/30/2020 or patient is removed from billable invoice.

19. Question 2 from Amendment 0002 askes: Does the provider (Physician or AP) have to be in the clinic providing services each day the clinic is open for business. The VA responded: A provider should be available for contact during business hours.

Please clarify that 1. The VA’s response means that we do not have to have a provider in the clinic each day as long as a provider is available to contact either by phone or e-mail. And 2. How many days of the week will the VA allow the contractor not to have a physician or AP in the clinic seeing patients.

a. The provider needs to be clinic Monday-Friday, there can and will be instances where the provider is on leave/ill etc. and a clinician needs to be available for contact.

20. Question 12 from amendment 00002 asks: Is the VA supplying the phones and phone system for the CBOC or is the contractor to provide? The VA responded Yes.

Please clarify: Is the VA is responding “Yes” meaning that the VA will provide the phones and phone system?

a. Yes, VA will provide VOIP phones

21. Where does telehealth play a role?

a. Telehealth is for Specialty care

22. Can primary care services can be provided via telehealth or do they need to be in-person?

a. in person

23. Will the specialists provide virtual care as well?

a. Specialty care will be provided through telehealth

24. General Instructions: Total of Three (3) separate PDF attachments 1. Technical Proposal (TP) 2. Past Perf 3. Price General Instruction state proposal documents shall not exceed 50 total pages.

Does this mean each “volume” will not exceed 50 pages or ALL three (3) volumes will total 50 pages or less? Which proposal documents?

a. The 50 page limitation applies to factors 1-5 of the technical volume and excludes/does not apply to key personnel resumes or CVs.

25. Proposal Format: Limitation to 5 MB. Because Email transmission with large attachment may be rejected. The information being sought by the Government in some of the Factors (ie: Factor 1 – Quality of Care Standards, as well as Factor 5 – Sustainability and Accessibility of Facility) is likely to exceed 5MB due to the nature of content that will be necessary to satisfy this requirement. Please advise if there are any other means by which large files (eg: Map imaging) information can be transmitted?

a. No, proposals must be submitted via email. Please separate attachments as needed so that they are less than or equal to 5 MB attachments and label as appropriate to indicate that there are more emails to follow; e.g., Vendor Name – Factor 1 (1 of 3)–36C26119R0001 – Yreka CBOC.

26. Proposal Format A. ii b) Each document shall contain appropriate headers to clearly identify sections to address the information requested in each sub-factor.

This instruction appears to provision for sub-factors only? Is it safe to assume that these instructions will also apply to Factors as well?

a. Yes, headers shall identify sections to address the information requested, be it factor, bulleted item, etc.

27. iii. In addition to addressing the evaluation factors stated in 52.212-1, please use these Specific Factor Instructions:

There are only Factors. No clearly designated sub-factors. Bullets and paragraph indentations are not sub-factors. Please clarify?

a. Bullets are not subfactors, they provide a list of all of the information that is needed to evaluate each factor.

28. Factor 2 – The Experienced project data sheet Attachment D.7 shall be submitted in excel format. Submission instructions stated technical volumes are to be submitted in PDF only.

The submission instructions state that the technical volumes are to be submitted via PDF but the instructions also state that Attachment D.7 shall be submitted in excel format. Please clarify?

a. Sorry for the confusion, the management and staffing shall be submitted in excel format.

29. Factor 3 - The Experienced project data sheet Attachment D.7 shall be submitted in excel format. Submission instructions stated technical volumes are to be submitted in PDF only.

The submission instructions state that the technical volumes are to be submitted via PDF but the instructions also state that Attachment D.7 shall be submitted in excel format. Please clarify?

a. Sorry for the confusion, the management and staffing shall be submitted in excel format.

30. Factor 6 - Past Performance states that the definition of relevant is in accordance with the definition in Factor 2.

There is no definition of relevant in Factor 2. Can you please provide a definition for relevant?

a. Relevant is defined as projects that are similar in size, scope, and complexity to this RFP.

31. Does the Government have a preference with respect to a past performance questionnaire? (ie: Is there a standard past performance questionnaire (PPQ) that should be used?)

a. No Past Performance Questionnaire is requested, please refer to specific factor instructions, iii. f)

32. Can an extension be granted for this requirement to allow Vendors the opportunity to review the answer to these RFI’s and incorporate into the proposal?

a. No, in order to meet the award date, this can only be extended to 5/15/2019 at 11:00 AM. Additionally, the RFIs have not led to any changes in the requirement.