36C26218Q9475-0001004.docx

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

BY

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) 08-16-2018 00262 Department of Veterans Affairs Network Contracting Office 22 4811 Airport Plaza Drive Suite 600 Long Beach

CA

90815 00262 Department of Veterans Affairs Network Contracting Office 22 4811 Airport Plaza Drive Suite 600 Long Beach

CA

90815 To all Offerors/Bidders

36C26218Q9475 07-30-2018

X X

1. Please acknowledge reciept of this amendment in Section A.2 (cont. of form SF1449), paragraph 5 as A0001.

2. Please review the technical inquiry responses below and the amended schedule of services.

3. The due date for proposals has been amended to 08-30-3018, 4:00 PM (PDT).

Don Weerasinghe Contracting Officer AMENDMENT (A00001) OF RFQ 36C26218Q9475—PRIMARY CARE PHYSICIAN SERVICES; FAMILY PRACTICE AND INTERNAL MEDICINE, FOR THE VA SAN DIEGO HEALTHCARE SYSTEM (VASDHS).

1. Question (Q): Would you be open to agree to credential and alternate multiple docs at locations to ensure that there is no burnout from the physician’s side?

1.1. Answer (A): Yes, that is an important reason why we ask for 2x or double the number of Physicians anticipated (i.e., two (2) physicians needed, four (4) credentialed). We are asking for two (2) FTEE: we need to have at least four (4) credentialed providers to be available for contingencies such as “burnout.”

2. Q: Is there an incumbent in place and if so can you provide the previous RFQ information and award amount.

2.1. A: Yes, Contractor’s: Top Docs, Inc., Vista Staffing Solutions, Inc., and CompHealth. FSS-RFQ VA262-13-0270. BPA’s were awarded: $0.00. Task orders have been issued for option years as needs have been identified over the base, plus (4).

3. Q: Can you please tell me if this is a new requirement? If not, who is the incumbent, and what is the contract number?

3.1. A: Yes, Contractor’s: Top Docs, Inc. (VA262-13-A-0088); Vista Staffing Solutions, Inc., (VA262-13-A-0041) and CompHealth (VA262-13-A-0040).

4. Q: How many shifts does the government anticipate needing to be covered at each of the five (5) locations in the RFQ?

4.1. A: This varies based on VASDHS contingency staffing needs. Contract physicians provide coverage for resignations or unexpected losses.

5. Q: Does the government have an estimated number of hours per year that will need to be provided?

5.1. A: Yes, please refer to the Amended Schedule of Services (see item 39).

6. Q: Will the onsite coverage for the five (5) VASDHS locations be only during normal business hours or are evenings, nights, weekends, and holidays expected to be covered as well.

6.1. A: Normal working hours.

7. Q: In the event a scheduled physician is unable to begin or complete an assigned shift, the Contractor shall provide replacement physician coverage within two (2) hours and notify the Contracting Officer Representative (COR) at VASDHS immediately of the schedule change." This will drive up the costs significantly, can you please confirm with the VALLHS using service this requirement is wanted?

7.1. A: Providing a covering physician is not required.

8. Q: Will the Physicians be assigned to one (1) location during the tenure of their assignment or will they be expected to rotate between facilities?

8.1. A: VASDHS using service attempts to keep physicians in one (1) location, but the using service does ask that contract physicians remain open to providing care at any of the VASDHS locations. Efforts are made by the using service to keep movement to a minimum to provide continuity of care.

9. Q: If Physicians are rotating between facilities, what is the anticipated schedule? (which days will they be providing services at each location?)

9.1. A: The contract physicians will be in one (1) location for one (1) month or more and will only rotate as needed. Physicians do not usually rotate on a daily or weekly basis.

10. Q: Are you only looking for local Physician candidates or will you accept long-term locum tenens candidates in which travel and lodging are included in the rate?

10.1. A: VASDHS seeks physician candidates to provide three (3) months or more of coverage. Travel and lodging should be included in the non-local rate. Offerors are encouraged to provide a local and non-local rate.

11. Q: This section appears to be incorrect as it references Emergency Medicine--can you please confirm it is incorrect? “Standards of Care: The Contractor’s physician(s) care shall cover the range of Emergency services as would be provided in a state-of-the-art healthcare treatment facility, and the standard of care shall be of a quality; meeting or exceeding currently recognized national standards as established by: The American Board of Emergency Medicine; American Board of Osteopathic Emergency Medicine; Relevant professional societies including ACEP. SAEM, AAEM American College of Emergency Physicians: http://www.acep.org.”

11.1. A: RFQ 36C26218Q9475 has been amended to state:

11.1.1. Standards of Care: The Contractor’s physician(s) care shall cover the range of Primary Care Physician services as would be provided in a state-of-the-art healthcare treatment facility, and the standard of care shall be of a quality; meeting or exceeding currently recognized national standards as established by:

11.1.1.1. The American Board of Internal Medicine http://www.abim.org/;

11.1.1.2. VA Standards: VHA Directive 2006-041 “Veterans’ Health Care Service Standards” (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443;

11.1.1.3. The professional standards of the Joint Commission (TJC) http://www.jointcommission.org/emergency_department/;

11.1.1.4. The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=100&type=8 and;

11.1.1.5. The requirements contained in this PWS.

12. Q: If incumbent providers, will those providers have first right of refusal?

12.1. A: Yes, incumbent providers will have the right of first refusal per FAR 52.207-3.

13. Q: 18-20 patients per day requires a lot of CPRS/VistA alert processing. Is there set-aside time for providers to keep up with number of alerts generated?

13.1. A: The maximum number of patients will be 16 patients (eight (8) per half-day); however, schedules are often adjusted and decompressed to account for the fact that patients are largely unfamiliar to the locums. This results in good success in attracting repeat locum physicians to VASDHS.

14. Q: What is lag time from proposal arrival at facility mail room to arrive to you to be timely or is mail room received stamp considered timely?

14.1. A: A mail room “received” stamp is considered timely if received by the due date specified. The CO understands some lag time between delivery and acceptance can happen.

15. Q: Pricing Sheets are designed for "Local" candidates. Can we modify the CLIN to remove "Local" if we have non-local candidates and include GSA Per diem caps on Lodging and add travel costs?

15.1. A: Yes, please provide a local and non-local rate (an amended Schedule of Services is included below with local/non-local rates).

16. Q: The price sheet specifies “local” providers. Will the VA accept providers who are traveling from other states?

16.1. A: Yes, please provide a local and non-local rate (an amended Schedule of Services is included below with local/non-local rates).

17. Q: Will you accept DocuSign signed/dated forms from candidates or only "wet signature”?

17.1. A: Yes, DocuSign is acceptable, as is a wet signature.

18. Q: Hours of Operation, Item 10 on page 37 of 118: currently normal clinic hours are 8:00am to 4:30pm which is 8.5 hours. Does this work day include a 30-minute lunch break? —and if there is, is the clinic closed during the lunch break?

18.1. A: The clinic is not closed during lunch. A normal shift is 8:00am to 4:30pm with a 30-minute lunch break. These are large clinics with many providers and in some cases specialty care.

19. Q: The U.S. National Holidays that are observed are on Friday or Monday. Are these paid days off for the doctors while the clinics are closed in observance of the holidays?

19.1. A: VASDHS does not pay the locum/contract physicians for holidays; only for hours worked. Holiday pay is between the physician and their employer.

20. Q: Typically, the Register of Wage Determinations Under the Service Contract Act discloses the Fringe Benefits to be 4.41 per hour, 176.40 weekly and 764.40 monthly. Is that consistent with the Fringe Benefits for this solicitation as well?

20.1. A: Physicians are not subject to the SCA; not consistent with the solicitation.

21. Q: What is the VALLHS using service’s plan if more than two (2) physicians are needed at the same time? (as this calls for five (5) locations, potentially).

21.1. A: The successful Offeror will provide additional physicians as needed. The two (2) physician requirement is what the VASDHS budget is per year. The VASDHS may have five (5) physicians working for three (3) months and may only need one (1) during a different three (3) month period. Historically, and predominantly over the course of a year, it is equal to two (2) FTEE.

22. Q: Will there be blocks of scheduling or conversely, could this end up being one (1) day coverage (“as-needed”)?

22.1. A: VASDHS using service normally schedules locum/contract physicians for three (3) to six (6)-month periods, but this is based on VASDHS needs. If contract physicians come for a three (3)-month assignment and VASDHS needs change, they may stay for a shorter or longer period.

23. Q: How many hours are projected?

23.1. A: please refer to the amended Schedule of Service included below (item 39).

24. Q: Will providers be required to travel to all the locations listed in the RFQ?

24.1. A: Yes, the VASDHS using service asks the providers to be flexible regarding their willingness to provide services at all VASDHS locations. The using service will try to maintain continuity of care, but these positions are here to meet VASDHS contingency staffing needs at all locations.

25. Q: I would like to inquire as to what (local) means on the price cost schedule?

25.1. A: VASDHS using service asks that you submit a local and a non-local rate. If you provide a local provider to meet staffing needs—the VA will not pay lodging and travel expenses. If the provider is non-local, your rate should include travel and lodging expenses.

26. Q: Are the required documents for each candidate included in the total page count for offerors’ proposal responses? If so, we ask that the Government remove the page limits for these documents, as many of them may entail several pages of content (e.g. resumes) that may reduce the remaining available pages for the actual proposal response.

26.1. A: No, the required documents will not be included in page limits. The CO understands these documents may entail numerous pages and will not be counted towards page limits.

27. Q: The Instructions to Offerors does not specify what section offerors are to place these required documents. Should these documents be provided in a separate binder from the proposal response, or included as a separately tabbed section of their responses? Please clarify.

27.1. A: Please include these documents in the “SPECIALIZED EXPERIENCE” section of the proposal. Please note: D.2 NON-DISCLOSURE AGREEMENT AND STATEMENT OF FINANCIAL INTEREST is NOT needed or evaluated—Offerors: please disregard section D.2.

28. Q: The instructions state that offerors’ completed Price Worksheet must be “included on a CD or thumb drive in excel format.” May we request the Government provide this document in Excel format for offerors to maintain compliance with the instructions?

28.1. A: An excel file is not necessary. RFQ 36C26218Q9475 has been amended to state: This Price Worksheet shall also be included on a CD or thumb drive.

29. Q: Does the term “offeror” include Prime contractors and their subcontractor(s), or is this just the Prime contractor?

29.1. A: The Prime contractor, only.

30. Q: If offerors do not have past performance for prior Primary Care Physician contracts, could they provide contracts of similar scope, such as Physician Assistant or Nurse Practitioner contracts, for evaluation of their capabilities to perform the services?

30.1. A: Offerors without relevant past performance in prior physician contracts or for whom information is not available will not be evaluated favorably or unfavorably, but neutrally. A highly-rated evaluation for factor 1 will be for Offeror’s that demonstrate successful past performance on contracts for board-certified physicians: Federal Government, State or local agencies, or commercial customers.

31. Q: The evaluation criteria for Factor 1 – Past Performance are broad, only specifying relevancy to the PWS requirements as an evaluation factor. Can you please confirm this is the only requirement offerors must meet for past performance references?

31.1. A: The Government reserves the right to obtain past performance information from any available source and may contact customers other than those identified by the Offeror when evaluating past performance. Please review Section 2.: OFFEROR RESPONSE TO EVALUATION FACTORS AND CRITERIA, of the ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS.

32. Q: Section 2.3 reads as follows: “Contract Family Practice physicians shall provide healthcare services for the entire period of performance at the VASDHS or VASDHS CBOC on an as-needed basis. The usual work day will be from 8:00 AM to 4:30 PM (PDT) weekdays. The physician will do outpatient clinic or inpatient clinics during the weekdays per regular clinic schedules usually from 8:00 AM to 4:30 PM (PDT) daily. The physician shall schedule and perform procedures as appropriate.” Could the government please provide additional information regarding inpatient clinics?

32.1. A: The providers will not work at inpatient clinics.

33. Q: Are these outpatient clinics based in the VA hospital or does the contract provider provide clinic services to inpatients?

33.1. A: The VASDHS four (4) outpatient clinics located throughout San Diego County and one (1) Primary Care Clinic at the VASDHS. See Section A.5 Schedule of Services, paragraph 5 in the RFQ for more information.

34. Q: The solicitation did not specify a submission address. Could the government please confirm whether we are to submit to the CO, Mr. Timothy Wanamaker, at the following address or to another destination?

Department of Veterans Affairs Network Contracting Office 22 4811 Airport Plaza Drive, Suite 600 Long Beach, CA 90815

34.1. A: Yes, this is the correct mailing address to submit proposals. Please refer to SF 1449 block 15, and Section A.2 Contract Administration Data of RFQ 36C26218Q9475 for more information.

35. Q: The RFQ requests that we send the following list of assets for our candidates: Three (3) professional references per candidate; Copies of degrees, licenses, and residency training; Board Certification, Board Eligibility documents; Current BLS Certifications. –Candidates do not provide some of these items until the credentialing period of recruiting, which will not happen until after award. Can the VALLHS using service clarify whether these items are required at the time of submission or upon award?

35.1. A: An Offeror should submit what is requested in the RFQ. The source selection team shall evaluate the type of candidates an Offeror will be providing by evaluating the documents furnished by Offerors in their proposals.

36. Q: The solicitation states responses are due August 30th, 2018, however FBO states they are due August 28th, 2018. Can the VA clarify the actual date submissions are due?

36.1. A: The RFQ submission date is correct. Please refer to the SF1449, block 8: 08-30-2018, 12:00 PM PDT, and; E.3 ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS, section 1.b: Period of Acceptance of Offers. The Offeror agrees to hold prices in its offer firm for a period of one-hundred-twenty (120) calendar days from the date specified as AUGUST 30, 2018, 12:00 PM (PDT) for the receipt of offers.

37. Q: Can you explain the purpose of the form “D.5 OTHER THAN CERTIFIED COST AND PRICE INFORMATION”? How can an offeror fill out this form prior to contract award since the physician has yet to be hired?

37.1. A: Physician requirements that are screened through the VHA Medical Sharing Office (MSO) require this form as a mandatory document in RFPs/RFQs. Since this is not a MSO requirement and the CO has confidence that adequate price competition can be obtained among Offerors, this document has been rescinded. Offerors: Please omit D.5 OTHER THAN CERTIFIED COST AND PRICE INFORMATION; and please omit section D.2 NON-DISCLOSURE AGREEMENT AND STATEMENT OF FINANCIAL INTEREST.

38. Q: Can you please review the current NAICS code used (561320) and ensure that NAICS code 621111—Offices of Physicians, is not more appropriate?

38.1. A: The award is anticipated to be a Base, Plus Four BPA. The two (2) primary care physicians requested shall be board-certified/board-eligible, and follow a generally repetitive and recurring schedule. This would align with using NAICS code 621111 which description is “establishments of health practitioners having the degree of M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathy) primarily engaged in the independent practice of general or specialized medicine (except psychiatry or psychoanalysis) or surgery. The NAICS identification is hereby amended to: 621111—Offices of Physicians.

39. AMENDED SCHEDULE OF SERVICES:

BASE YEAR: OCTOBER 1, 2018 THROUGH SEPTEMBER 30, 2019

CLIN NO.

SUB-CLIN

Family Practice and Internal Medicine Physician Services

[NOTE: Physician services include weekday coverages; contingency coverage during call-outs and illnesses]

KEY PERSONNEL

Family Practice Physician Services; Board-Certified/Board-Eligible Physician (Local)

Family Practice Physician Services; Board-Certified/Board-Eligible Physician (Non-Local)

Internal Medicine Physician Services; Board-Certified/Board-Eligible Physician (Local)

Internal Medicine Physician Services; Board-Certified/Board-Eligible Physician (Non-Local)

Family Practice Physician Services; Board-Certified/Board-Eligible Physician (Local)

Internal Medicine Physician Services; Board-Certified/Board-Eligible Physician (Local)

BASE YEAR TOTAL: $

OPTION YEAR ONE (1): OCTOBER 1, 2019 THROUGH SEPTEMBER 30, 2020

CLIN NO.

[NOTE: Physician services include weekday coverages; contingency coverage during call-outs and illnesses]

KEY PERSONNEL

Family Practice Physician Services; Board-Certified/Board-Eligible Physician (Local)

Internal Medicine Physician Services; Board-Certified/Board-Eligible Physician (Local)

Family Practice Physician Services; Board-Certified/Board-Eligible Physician (Local)

Internal Medicine Physician Services; Board-Certified/Board-Eligible Physician (Local)

OPTION YEAR ONE (1) TOTAL: $

OPTION YEAR TWO (2): OCTOBER 1, 2020 THROUGH SEPTEMBER 30, 2021

CLIN NO.

[NOTE: Physician services include weekday coverages; contingency coverage during call-outs and illnesses]

KEY PERSONNEL

Family Practice Physician Services; Board-Certified/Board-Eligible Physician (Local)

Internal Medicine Physician Services; Board-Certified/Board-Eligible Physician (Local)

Family Practice Physician Services; Board-Certified/Board-Eligible Physician (Local)

Internal Medicine Physician Services; Board-Certified/Board-Eligible Physician (Local)

OPTION YEAR TWO (2) TOTAL: $

OPTION YEAR THREE (3): OCTOBER 1, 2021 THROUGH SEPTEMBER 30, 2022

CLIN NO.

[NOTE: Physician services include weekday coverages; contingency coverage during call-outs and illnesses]

KEY PERSONNEL

Family Practice Physician Services; Board-Certified/Board-Eligible Physician (Local)

Internal Medicine Physician Services; Board-Certified/Board-Eligible Physician (Local)

Internal Medicine Physician Services; Board-Certified/Board-Eligible Physician (Local)

OPTION YEAR THREE (3) TOTAL: $

OPTION YEAR FOUR (4): OCTOBER 1, 2022 THROUGH SEPTEMBER 30, 2023

CLIN NO.

[NOTE: Physician services include weekday coverages; contingency coverage during call-outs and illnesses]

KEY PERSONNEL

Family Practice Physician Services; Board-Certified/Board-Eligible Physician (Local)

Internal Medicine Physician Services; Board-Certified/Board-Eligible Physician (Local)

Family Practice Physician Services; Board-Certified/Board-Eligible Physician (Local)

Internal Medicine Physician Services; Board-Certified/Board-Eligible Physician (Local)

OPTION YEAR FOUR (4) TOTAL: $

BASE, PLUS FOUR (4) GRAND TOTAL: $

--END OF AMENDMENT--