36C26219R0026-0003000.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

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) 09-18-2019 None 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

36C26219R0026 08-02-2019

X x x x Amendment 0003 is hereby issued to:

1. Publish the final Questions and Answers received in response to the RFP.

2. Amend the RFP as specified.

CHELSEA BLACK

CONTRACTING OFFICER

CONTINUATION PAGE

Amendment 0003 contains:

A. Questions and Answers B. Amendments to the RFP

A. Questions and Answers #2

1. RFP states there will be mobile carts in the exam rooms, what are the dimensions of these carts? The dimensions for the mobile carts are one foot wide by 8 inches deep with a height that is adjustable between 4 foot 2 inches and 5 feet 5 inches.

2. Is sterile preparation for Pharmacy required? If so, where is this to be located? The VA does not require the contractor to perform sterile preparation or compounding. RFP has been amended to remove this requirement.

3. RFP 29.17.1.1, what is required for window tinting in regard to blast protection and front door entry? Window tinting and façade protection requirements do not apply and therefore will be removed from the PWS. An amendment will be issued to remove this section from the PWS.

4. RFP 29.17.13, which sites will require mailrooms and loading docks? The references to the mailroom and loading docks and other areas requiring separate return air can be removed from the PWS. An amendment will be issued to remove this section from the PWS.

5. RFP 30.8, IT room security, will CCTV be required if the doors have two independent locks? There are no mandated requirements for CCTV in the CBOCs per VHA Handbook 0730 unless the CBOCs has a pharmacy, agent cashier, and canteen storage.

6. RFP 30.8.7 is Leviton the only manufacturer or can others like CommScope, Panduit etc… be used? Yes, other manufactures can be used provided they are of similar quality and meet VHA IT standards.

7. Page 54, #27 – Work Related Incident Treatment: When treating the Veteran for injuries sustained because of a work-related incident or accident, the Contractor must complete the appropriate forms to allow the VA to assert a Federal Medical Care Recover Act (FMCRA) or a Workers Compensation Claim.

a. Please clarify as to not include providing services that are not required by a designated worker’s comp facility or provider that has the Division of Worker’s Comp Level II Accreditation?

No, VA providers are not required to complete these forms and is not considered as part of patient care.

8. Page 36, 22.19.3 Telepharmacy Support Services: Contractor shall provide clerical support including scheduling, and ancillary support for VA tele-pharmacy services as appropriate.

a. Can the telepharmacy support staff be shared with Primary Care or does the VA prefer designated telepharmacy support staff Yes, telepharmacy support staff can be shared with Primary Care. The VA has no specific requirements that would prohibit the contractor from using their discretion in deploying support staff for this service.

9. Page 43 Section 22.25: Non-emergent specialty consultations, care, and diagnostic tests not provided at VA or Contractors site: The charges incurred from non-emergent specialty evaluations, diagnostic testing, and care provided at sites other than the VA will be the responsibility of the Contractor, unless prior authorization is obtained from the non-VA care section at (909) 894-7084 x5245. A request for authorization for Non-VA care services is requested by the ordering provider by completing the VA HER Non-VA Care Consult with full vendor information including name, address, fax, phone and date of appointment, if the date of the appointment is known. Subsequent approval may be granted upon review by the Non-VA Care Approving Physician or Nurse. These authorizations, however, will be granted only in rare instances, as non-emergent referrals should be made to the VA.

a. Please clarify that the Contractor will not be held for charges incurred for non-authorized non-emergent specialty care obtained by a veteran.

The Contractor will not be held liable by VA for charges incurred if a veteran independently obtains non-emergent specialty care that has not been pre-approved by VA.

10. Is it the Contractor’s responsibility to provide emergency contraception (Levonorgestrel [Plan B])? No, Emergency contraceptives are on the National Formulary and is being filled as an outpatient prescription through our retail pharmacy PBM contract. However, if provided in the clinic then the contractor will be responsible for the cost.

11. How many VA telehealth rooms does the VA require and for what specific services?

Currently only (1) one telehealth room is required at each CBOC.

12. Who pays for training if our staff travels to the VA? If VA requires CBOC staff to attend training at the VA, the VA will not reimburse to the cost of travel.

13. Regarding the 80% maximum panel size – when a panel gets to 80% an additional PACT team is required. There are two issues: 1) If we are still required to see 95% of the billable roster, this will negatively affect reimbursement; 2) If the current panel size is above 80%, should another PACT team be added in the initial contract bid? If so, how will that impact the 95% return rate in regard to the billable roster.

There are no requirements in the PCMM Directive that states an additional PACT is required when the 80% maximum panel size is reached. Also, there is no 95% return rate requirement in this RFP.

14. Pg. 19, B.3, 2.5.1: Clarify the degree needed. It says it can be a regular pharmacist with clinic experience or do they need a pharmacist with a doctorate degree? Is one for every three PACT teams realistic? For example, the Palm Desert clinic currently has seven providers, which according to this clause, would require three clinical pharmacy specialists. As outlined in the requirements, the PACT staffing ratio is (1) CPS FTE for every (3) PACT teams as stipulated.

CPS who is a licensed pharmacist who is a graduate of an Accreditation Council for Pharmacy Education (ACPE) accredited College or School of Pharmacy with a baccalaureate degree in pharmacy (BS Pharmacy) or a Doctor of Pharmacy (Phar.D.) degree and has at least 1 year of pharmacy equivalent experience.

15. Pg. 20, B.3, 2.7.1 indicates they have to have completed a course of approximately one year in a medical or clinical laboratory school. Currently we use Mas. Later in the paragraph is says CMAs can fill that slot. Please clarify.

The CBOCs are only required to perform blood/urine draws and do not perform any testing. Any of the listed levels of Phlebotomist [MA, CMA or Medical Laboratory Technicians] are trained and qualified to perform those duties.

16. What is the expected ratio of support staff to mental health providers.

The expected MH support staff ratio is not based on ratio to MH providers but rather size of clinic – Corona -1 clerk, Murrieta – 2 clerks, Palm Desert- 2 clerks, Rancho -2 clerks and Victorville- 2 clerks.

Is the VA communications center solely answering appointment calls? What types of calls will they be transferring? The expectation is a live person in the clinic will answer within 30 seconds with a call abandonment rate of less than 5%. For staffing purposes, what is the expected percentage of calls that will be transferred from the call center?

VA will answer all inbound calls for all five CBOC locations and will transfer only those calls that are PACT team specific. Inbound calls for all CBOC locations will be processed by the VA Communications Call Center and the cited abandonment rate only applies to the VA Communications Call Center and not the contractor.

17. When leasing multi-tenant building space, we do not have the right to observe other people non-VA patients. What is the recommendation? CCTV’s are not required at any CBOC location.

18. Will VVC encounter be a qualifying encounter for an annual visit? Is it 3-2-3 stop code? Yes, VVC is considered a qualifying encounter and the 323-stop code is the correct stop code for each encounter/visit.

19. If there are ergonomic issues requiring furniture/equipment alterations for mental health personnel, how will that be reimbursed?

Any ergonomic related issues will be handled by the VA for mental health employees.

20. Is the VA supplying the phones and phone system for the CBOCs or is the contractor to provide? Yes, the VA will be supplying the phones for all CBOC locations. The contractor is responsible for the infrastructure.

21. The RFP states a “minimum of three exam rooms and one exam/consultation room per PACT teamlet”, which seems to be more rooms than necessary. The PACT design guide on page 24 states “the modules utilize a ratio of approximately three exam rooms per teamlet”. Does two exam rooms and one exam/consult room per team meet the requirements Yes, a 2+1 ratio (two exam rooms and one exam/consult room) per PACT team will meet this requirement. The RFP will be amended to reflect this change.

22. Please confirm the VA will provide all necessary equipment and supplies for tele-retinal services. If this equipment is the responsibility of the contractor, please provide a list of the equipment and supplies required, as well as its associated cost. VA will provide equipment and supplies for all tele-retinal services.

23. What is the current PM/PM rate at the existing CBOCs? VA declines to provide detailed pricing information regarding the current contract.

24. Will bids over $110,000,000.00 be considered? The resulting contract for CBOC services is an IDIQ contract. $110,000,000 is the maximum dollar value of orders that can be placed under the services portion of the resultant contact over the life of that contract. When the contract ceiling will be reached will be determined by the actual number of patients serviced under the contract and the agreed-upon per-member per-month (PMPM) price for CBOC services. An offered PMPM price for CBOC services whose aggregate amount exceeds $110,000,000 when multiplied by the estimated number of patients to be served over the life of the contract (base plus option periods) will not automatically result in rejection of the proposal. However, all offered prices are subject to a requirement that they be reasonable. The Government intends to make contract award without discussions, so offerors are advised that their initial offer should contain the offeror's best price terms. Section E.15 of the solicitation explains how Price will be considered when evaluating proposals.

25. Please clarify pg. 97, C.4 (b)(1)(2). This is an order limitation associated with task orders issued under the resultant contract.

26. With regard to the SF1449, SF30 (if any), Contractor Data Sheet, and all other standard submission forms, where should these pages be included in our submission? The Instructions to Offerors will be amended to include the requirement to submit one copy of all standard forms into Proposal Submission (2) Past Performance, Veteran Involvement and Price/Cost Proposal.

B.RFP Amendments:

1. Section 2.5.1 is deleted in its entirety and is replaced with the following:

2.5.1 DISCIPLINE SPECIFIC 1: CLINICAL PHARMACY SPECIALIST (CPS) – FTE Ratio Performance Standard: 1.0 FTE per 3 PACTs:

Qualifications: Required education and experience demonstrating skills and abilities to perform duties ensuring smooth site operations. CPS who is a licensed pharmacist who is a graduate of an Accreditation Council for Pharmacy Education (ACPE) accredited College or School of Pharmacy with a baccalaureate degree in pharmacy (BS Pharmacy) or a Doctor of Pharmacy (Phar.D.) degree and has at least 1 year of pharmacy equivalent experience. In addition to the requirements listed above, the CPS must meet licensed qualification standards to include a graduate of a degree program in pharmacy from an approved college or university and have post-graduate experience performing chronic disease state and medication management services (e.g., post-graduate residency, direct patient care under collaborative practice agreement or similar equivalent experience). The CPS has duties and responsibilities as defined in VHA Handbook 5005, Part 2, Appendix G15, Licensed Pharmacist Qualification Standards. Current, full, active, and unrestricted license in the state of the Outpatient Site of Care (i.e. CBOC) http://www.va.gov/vapubs/viewPublication.asp?Pub_ID=512&FType=2. Authorization for a VA scope of practice is required, in accordance with VHA Directives 2008-043 and 2009-014 or subsequent policy release, and must adhere to pharmacy practice acts within that state. If proposed staff do not meet VA credentialing requirements, the Contractor shall propose substitute acceptable personnel within five (5) calendar days. Position Responsibilities: Responsible for the provision of covered services to enrolled and unassigned patients presenting for care. Clinical Pharmacy Specialists shall be scheduled to sufficiently provide the needs of enrolled patients functioning in the capacity of a mid-level provider (under SOP or collaborative practice agreement) as their primary duty is to assist providers with comprehensive medication management.

2. Section 4.3 is deleted in its entirety and is replaced with the following:

4.3 Contractor shall ensure that all Nurse Practitioners, Clinical Pharmacy Specialists, and Physician Assistants to be employed under this contract also participate in the Credentialing process through VA’s “VetPro,” in accordance with VHA Handbook 1100.19. Clinical Pharmacy Specialists, and Physician Assistants are not recognized by the VA as independent practitioners, they function under a VA Scope of Practice (not Clinical Privileges). The VA Scope of Practice must adhere to applicable practice acts within that state. The credentials and scope of practice for Nurse Practitioners, Clinical Pharmacy Specialists, and Physician Assistants are reviewed at the time of the initial appointment and at least every two years thereafter by an appropriate VA discipline-specific Professional Standards Board.

3. Section 5 is deleted in its entirety and is replaced with the following:

5. TRAINING (BLS/VA MANDATORY): Contractor staff shall complete VA mandatory training as requested and complete BLS training and keep BLS certifications current throughout the life of the contract. Copies of current certifications shall be provided to the COR. The contractor shall coordinate, and cover contract staff travel expenses in accordance with General Services Administration (GSA) rates. https://www.gsa.gov/portal/category/100000

4. Section 29.2.1 is deleted in its entirety and is replaced with the following:

29.2.1 PATIENT CARE ROOMS (EXAM/CONSULTATION ROOMS): Each exam room contains a consultation zone and an examination zone and should be a minimum of 125 square feet. Door openings should be 3’ 6” to allow for scooters, bariatric access and mobile equipment. Exam rooms contain standardized/modular casework consisting of a counter with a sink, upper cabinets and open space below for built-in drawers or roll away mobile carts for storage. All exam rooms shall have (2) two voice/data jacks.

5. Section 29.2.2 is deleted in its entirety and is replaced with the following:

29.2.2 PRIMARY CARE: Minimum of (2) two exam rooms and (1) one exam/consultation room per PACT teamlet. Exam rooms shall be a minimum of 125 square feet.

6. Section 29.2.6 is deleted in its entirety and is replaced with the following:

29.2.6 PATIENT CORRIDOR: Must be a minimum of (6) six feet wide.

7. Section 29.4.9 is deleted in its entirety:

29.4.9 USP General Chapter 797 Pharmaceutical Compounding – Sterile Preparations

8. Section 29.17.1.1 is deleted in its entirety:

29.17.1.1 Window glazing and façade protection level, with a performance condition as prescribed by WINGARD 4.1 or later or WINLAC 4.3 software.

9. Section 29.17.1.3 is deleted in its entirety:

29.17.1.3. Lobbies, mailrooms, and loading docks shall not share a return-air system with the remaining areas of the Building. The Contractor shall provide lobby, mailroom, and loading dock ventilation systems' outside air intakes and exhausts with low leakage, fast acting, isolation dampers that can be closed to isolate their systems. Dedicated HVAC shall be required for mailrooms only when the Government specifically requires a centrally operated mailroom. On Buildings of more than four stories, air intakes shall be located on the fourth floor or higher. On Buildings of three stories or less, air intakes shall be located on the roof or as high as practical. Locating intakes high on a wall is preferred over a roof location.

10. Section 29.20 is deleted in its entirety:

20.20 Closed Circuit Television (CCTV): Shall be provided by the Contractor to monitor building entrances, restricted areas, mission critical asset areas, and alarm conditions. CCTV system shall be used for surveillance and observations of defined exterior areas, such as site and roadway access points, parking lots, and building perimeter, and interior areas such as hallways, common areas and waiting areas, CCTV system will be viewed from a VA location determined by the VA Physical Security Officer. The design, installation, and use of CCTV cameras shall support the visual identification and surveillance of persons, vehicles, assets, incidents, and defined locations. The Contractor shall contact the VA Physical Security Officer at (804) 825-7084 x2135 prior to installation of CCTV system in order to ensure proper placement.

11. Section 36.2 is deleted in its entirety and is replaced with the following:

36.2 The Contractor shall have one- hundred and eighty (180) days from contract award to commencement of the provision of medical care to local veterans. However, the Contractor must have all start-up requirements in place and ready to commence operation NLT a hundred and seventy-three (173) calendar days from contract award. The final seven (7) days will be used for training and resolution of any last minute or unexpected technical or personnel related challenges. The Contractor shall comply with the following contract requirements prior to commencement of clinical operations:

12. Addendum to FAR 52.212-1 Instructions to Offerors -Commercial Items. 1. b. (2) is deleted in its entirety and is replaced with the following:

(2) Past Performance, Veteran Involvement and Price Proposal and Responsibility- Offerors shall submit a separate binder with the information the solicitation requires offerors to provide regarding the following items:

a. Past Performance evaluation

b. Veteran Involvement evaluation

c. Price evaluation

d. Responsibility Determination.

e. Signed 1449, SF30 Amendment(s), and Contractor Data Sheet Only one paper copy is required, but all shall be placed in one binder clearly marked with the Offeror’s name, Point of Contact, Phone Number and email address, and the RFP number. Additionally, one CD with an electronic version of all documents contained in this binder shall also be included in the binder.

13. Section F is deleted in its entirety and is replaced with the following:

SECTION F VA SPACE REQUIREMENT -REAL PROPERTY LEASE

36C26219R0026 -A0003

Page 1 of

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SECTION 1

Contractor/Lessor shall provide space within the Premises for VA exclusive use to provide services to eligible veterans as defined by VA eligibility criteria. The space shall be contiguous or co-located and be integrated with the proposed Capitated Community Outpatient Clinic (CBOC) with turnkey improvement, fully serviced, and fully furnished consistent with the customary standards of the CBOC. The VA shall have a leasehold interest in the space together with rights to the unrestricted use of common area parking and other areas as set forth in the Contract.

NOTE: IN ADDITION TO THE GOVERNMENT’S CAPITATED CBOCS REQUIREMENTS SPECIFIED IN THE SOLICITATION; THE GOVERNMENT INTENDS TO AWARD FIVE (5) SEPARATE LEASES – ONE FOR EACH CLINIC/LOCATION – FOR SPACE TO BE OCCUPIED BY VA STAFF. OFFERORS ARE REQUIRED TO COMPLETE A SEPARATE LEASE PROPOSAL FOR EACH CLINIC UTILIZING THE REQUEST FOR LEASE PROPOSAL (RLP) DOCUMENTS PROVIDED IN SECTION D21-D25 OF THE RFP.

1.01 SPACE REQUIREMENTS:

Clinic hours are Monday-Friday 8:00 am to 4:30 pm and extended hours twice a week. The contractor will provide keys and/or electronic entry cards for access to the suite, including external building access for all VA employees.

CORONA CBOC MENTAL HEALTH SPACE:

1.01.1 Two (2) large group rooms, 300 square feet, large enough for 15-20 attendees, which also include Tele mental health equipment and Patient education.

1.01.2 Seven (7) Individual Therapy Rooms, 10 X 12 (120 Square Feet), one of which will also include the tele mental health equipment, and large enough to meet Americans with Disability Act requirements, office space for therapist, wheel chair bound patient and a family member. These offices shall accommodate the providers in the Behavioral Health Interdisciplinary Program (BHIP) including, but not limited to psychiatrists, psychologists, clinical social workers, and psychology and social work practicum students and the future growth of an addiction therapist, a peer support specialist, mental health LVN/RN, and additional psychotherapists for the BHIP program.

1.01.3 Four (4) Individual Therapy Rooms, 10x12 (120 square feet), embedded in the primary care clinic, and large enough to meet Americans with Disability Act requirements. These rooms will support two (2) PCMHI Therapists, one (1) PACT Social Worker and one (1) DCM for face-to-face patients for psychosocial assessment. All Mental Health space must include offices for PCMHI/PACT/DCM programs as outlined in the UNIFORM MENTAL HEALTH SERVICES IN VA MEDICALCENTERS AND CLINICS handbook. PCMHI/PACT/DCM offices must be co-located in the primary care area.

1.01.4 Two (2) Individual Therapy Rooms for the UCR Psychiatry Residency Program, 10x12 (120 square feet), and large enough to meet Americans with Disability Act requirements, office space for therapist, wheel chair bound patient and a family member.

1.01.5 The VA shall supply the CBOC Mental Health office with supplies and equipment.

MURRIETA CBOC MENTAL HEALTH SPACE:

1.01.6 1.01.5 Two (2) large group rooms, 300 square feet, large enough for 15-20 attendees, which also includes Telemental equipment and Patient education.

1.01.7 Ten (10) Individual Therapy Rooms, 10 X 12 (120 Square Feet), one of which will also include the Telemental health equipment, and large enough to meet Americans with Disability Act requirements, office space for therapist, wheel chair bound patient and a family member. These offices shall accommodate the providers in the Behavioral Health Interdisciplinary Program (BHIP) including, but not limited to psychiatrists, psychologists, clinical social workers, and psychology and social work practicum students and the future growth of an addiction’s therapist, a peer support specialist, mental health LVN/RN, and additional psychotherapists for the BHIP program.

1.01.8 Four (4) Individual Therapy Rooms, 10x12 (120 square feet), embedded in the primary care clinic, and large enough to meet Americans with Disability Act requirements. These rooms will support two (2) PCMHI Therapists, one (1) PACT Social Worker and one (1) DCM for face-to-face patients for psychosocial assessment. All Mental Health space must include offices for PCMHI/PACT/DCM programs as outlined in the UNIFORM MENTAL HEALTH SERVICES IN VA MEDICALCENTERS AND CLINICS handbook. PCMHI/PACT/DCM offices must be co-located in the primary care area.

1.01.9 Three (3) Individual Therapy Rooms for the UCR Psychiatry Residency Program, 10x12 (120 square feet), and large enough to meet Americans with Disability Act requirements, office space for therapist, wheel chair bound patient and a family member.

1.01.10 The VA shall supply the CBOC Mental Health office with supplies and equipment.

PALM DESERT CBOC MENTAL HEALTH SPACE:

1.01.11 Two (2) large group rooms, 300 square feet, large enough for 15-20 attendees, which also includes Telemental health equipment and Patient education.

1.01.12 Eleven (11) Individual Therapy Rooms, 10 X 12 (120 Square Feet), one of which will also include the Telemental health equipment, and large enough to meet Americans with Disability Act requirements, office space for therapist, wheel chair bound patient and a family member. These offices shall accommodate the providers in the Behavioral Health Interdisciplinary Program (BHIP) including, but not limited to psychiatrists, psychologists, clinical social workers, and psychology and social work practicum students and a mental health supervisor that also sees patients and the future growth of an addictions therapist, a peer support specialist, mental health LVN/RN, and additional psychotherapists for the BHIP program.

1.01.13 Four (4) Individual Therapy Rooms, 10x12 (120 square feet), embedded in the primary care clinic, and large enough to meet Americans with Disability Act requirements. These rooms will support two (2) PCMHI Therapists, one (1) PACT Social Worker and one (1) DCM for face-to-face patients for psychosocial assessment. All Mental Health space must include offices for PCMHI/PACT/DCM programs as outlined in the UNIFORM MENTAL HEALTH SERVICES IN VA MEDICALCENTERS AND CLINICS handbook. PCMHI/PACT/DCM offices must be co-located in the primary care area.

1.01.14 Three (3) Individual Therapy Rooms for the UCR Psychiatry Residency Program, 10x12 (120 square feet), and large enough to meet Americans with Disability Act requirements, office space for therapist, wheel chair bound patient and a family member.

1.01.15 The VA shall supply the CBOC Mental Health office with supplies and office equipment.

RANCHO CUCAMONGA CBOC MENTAL HEALTH SPACE:

1.01.16 Two (2) large group rooms, 300 square feet, large enough for 15-20 attendees, which also includes Telemental equipment and Patient education.

1.01.17 Ten (10) Individual Therapy Rooms, 10 X 12 (120 Square Feet), one of which will also include the Telemental health equipment, and large enough to meet Americans with Disability Act requirements, office space for therapist, wheel chair bound patient and a family member. These offices shall accommodate providers in the Behavioral Health Interdisciplinary Program (BHIP) including, but not limited to psychiatrists, psychologists, clinical social workers, and psychology and social work practicum students and a mental health supervisor that also sees patients and the future growth of an addiction’s therapist, a peer support specialist, mental health LVN/RN, and additional psychotherapists for the BHIP program.

1.01.18 Four (4) Individual Therapy Rooms, 10x12 (120 square feet), embedded in the primary care clinic, and large enough to meet Americans with Disability Act requirements. These rooms will support two (2) PCMHI Therapists, one (1) PACT Social Worker and one (1) DCM for face-to-face patients for psychosocial assessment. All Mental Health space must include offices for PCMHI/PACT/DCM programs as outlined in the UNIFORM MENTAL HEALTH SERVICES IN VA MEDICALCENTERS AND CLINICS handbook. PCMHI/PACT/DCM offices must be co-located in the primary care area.

1.01.19 Three (3) Individual Therapy Rooms for the UCR Psychiatry Residency Program, 10x12 (120 square feet), and large enough to meet Americans with Disability Act requirements, office space for therapist, wheel chair bound patient and a family member.

1.01.20 The VA shall supply the CBOC Mental Health office with supplies and office equipment.

VICTORVILLE CBOC MENTAL HEALTH SPACE:

1.01.21 Two (2) large group rooms, 300 square feet, large enough for 15-20 attendees, which also includes Telemental health equipment and Patient education.

1.01.22 Seven (7) Individual Therapy Rooms, 10 X 12 (120 Square Feet), one of which will also include the Telemental health equipment, and large enough to meet Americans with Disability Act requirements, office space for therapist, wheel chair bound patient and a family member. These offices shall accommodate the providers in the Behavioral Health Interdisciplinary Program (BHIP) including, but not limited to psychiatrists, psychologists, clinical social workers, and psychology and social work practicum students and a mental health supervisor that also sees patients and the future growth of an addiction’s therapist, a peer support specialist, mental health LVN/RN and additional psychotherapists for the BHIP program.

1.01.23 Two (2) Individual Therapy Rooms for the UCR Psychiatry Residency Program, 10x12 (120 square feet), and large enough to meet Americans with Disability Act requirements, office space for therapist, wheel chair bound patient and a family member.

1.01.24 Four (4) Individual Therapy Rooms, 10x12 (120 square feet), embedded in the primary care clinic, and large enough to meet Americans with Disability Act requirements. These rooms will support two (2) PCMHI Therapists, one (1) PACT Social Worker and one (1) DCM for face-to-face patients for psychosocial assessment. All Mental Health space must include offices for PCMHI/PACT/DCM programs as outlined in the UNIFORM MENTAL HEALTH SERVICES IN VA MEDICALCENTERS AND CLINICS handbook. PCMHI/PACT/DCM offices must be co-located in the primary care area.

1.01.25 The VA shall supply the CBOC Mental Health office with supplies and equipment.

1.02 AUDIOLOGY CLINIC SPACE:

1.1

1.02.1 Current services being provided at the Community Based Outpatient Clinics (CBOCs) within the VA Loma Linda Health Care System (VALLHCS) are as follows:

· Palm Desert CBOC: Full Audiology Site

· Murrieta CBOC: Full Audiology Site.

· Victorville CBOC: Tele Audiology and Repair Clinic

1.02.2 The clinic hours at all CBOCs will be Monday – Friday 8:00 am to 4:30 pm. The CBOCs will be staffed by VA Audiology staff and/or telehealth technicians and operated up to five days a week with various staffing levels, according to need. The VA will supply and be responsible for audiology equipment and supplies except for the Audiometric Examination Suites/Sound Rooms. These suites will be purchased and installed by the contractor. The contractor should adhere to the VA Audiology and Speech Pathology Design Guide, PG-18-19 Space Planning Criteria (published on TIL March 2018).

1.02.3 Palm Desert Audiology

The Contractor shall provide within the CBOC the following spaces to accommodate VA Audiology Services. All spaces must have connectivity capabilities to the VA Network and VA phone system, unless noted. All measures provide below are estimated.

1.02.3.1 Reception Area:

1) General Waiting Area (260 NSF)

2) Reception Area (260 NSF)

3) Universal Toilet (60 NSF)

4) Patient Check-In Kiosk (40 NSF)

5) Patient Education Cubicle (30 NSF)

6) Wheelchair Alcove (30 NSF)

7) Audiology Clinic Patient Area:

8) Three: Audiology Rehabilitation/Counseling Room (140 NSF)

9) One: Hearing Aid Repair Room (160 NSF)

10) Two: Audiometric Examination Suite’s (prefab 2-sided suite, 300 NSF x 2) with 36-inch clear opening doors, full vision 20x60 glass windows in each door, 80-inch door height, 86 inches of ceiling height, design build: with a recessed floor installed within a Pit (floor of booth is flush with building floor) or low-profile option where a Pit is not feasible (2-inch). Construction of the Audiometric Examination Suite shall meet VALLHCS specifications.

11) Two: Programming/Fitting Rooms (150 NSF x 2)

12) One: Cerumen Management Room (160 NSF)

13) One: Vestibulography Room (240 NSF) with attached Patient Toilet – Vestibulography (60 NSF).

14) One: Small Audiology Group Room (240 NSF) with room for up to 12 veterans and VA staff.

15) One: Patient Toilet (60 NSF)

1.02.3.2 Support Area:

1) One: Clean Audiology Supply Room (80 NSF) for storage of clean supplies/instruments utilized for medical procedures. Does not require VA network or phone connectivity.

2) One: Audiology Soiled Holding Room (80 NSF) for the temporary holding of bagged waste or used/soiled instruments utilized for medical procedures. Does not require VA network or phone connectivity.

3) One: Equipment Storage room (120 NSF). Does not require VA network or phone connectivity.

4) One: Hearing Aid Lab (140 NSF)

5) One: Hearing Aid Processing Area (180 NSF)

6) One: Housekeeping Aides Closet (60 NSF). Does not require VA network or phone connectivity.

7) Staff and Administrative Area:

8) One: Supervisor Office (100 NSF)

9) One: Administrative Assistant Workstation (56 NSF)

10) One: Copy/Mail Distribution Room (120 NSF)

11) One: Staff Lounge (140 NSF)

12) One: Staff Toilet (60 NSF)

1.02.4 Murrieta Audiology

The Contractor shall provide within the CBOC the following spaces to accommodate VA Audiology Services. All spaces must have connectivity capabilities to the VA Network and VA phone system, unless noted.

1.02.4.1 Reception Area:

1) General Waiting Area (260 NSF)

2) Reception Area (260 NSF)

3) Universal Toilet (60 NSF)

4) Patient Check-In Kiosk (40 NSF)

5) Patient Education Cubicle (30 NSF)

6) Wheelchair Alcove (30 NSF)

7) Audiology Clinic Patient Area:

8) Three: Audiology Rehabilitation/Counseling Room (140 NSF)

9) One: Hearing Aid Repair Room (160 NSF)

10) Two: Audiometric Examination Suite’s (prefab 2-sided suite, 300 NSF x 2) with 36-inch clear opening doors, full vision 20x60 glass windows in each door, 80-inch door height, 86 inches of ceiling height, design build: with a recessed floor installed within a Pit (floor of booth is flush with building floor) or low-profile option where a Pit is not feasible (2-inch). Construction of the Audiometric Examination Suite shall meet VALLHCS specifications.

11) Two: Programming/Fitting Rooms (150 NSF x 2)

12) One: Cerumen Management Room (160 NSF)

13) One: Vestibulography Room (240 NSF) with attached Patient Toilet – Vestibulography (60 NSF).

14) One: Small Audiology Group Room (240 NSF) with room for up to 12 veterans and VA staff.

15) One: Patient Toilet (60 NSF)

1.02.4.2 Support Area:

1) One: Clean Audiology Supply Room (80 NSF) for storage of clean supplies/instruments utilized for medical procedures. Does not require VA network or phone connectivity.

2) One: Audiology Soiled Holding Room (80 NSF) for the temporary holding of bagged waste or used/soiled instruments utilized for medical procedures. Does not require VA network or phone connectivity.

3) One: Equipment Storage room (120 NSF). Does not require VA network or phone connectivity.

4) One: Hearing Aid Lab (140 NSF)

5) One: Hearing Aid Processing Area (180 NSF)

6) One: Housekeeping Aides Closet (60 NSF). Does not require VA network or phone connectivity.

7) Staff and Administrative Area:

8) One: Supervisor Office (100 NSF)

9) One: Administrative Assistant Workstation (56 NSF)

10) One: Copy/Mail Distribution Room (120 NSF)

11) One: Staff Lounge (140 NSF)

12) One: Staff Toilet (60 NSF)

1.02.5 Victorville Audiology

The Contractor shall provide within the CBOC the following spaces to accommodate VA Audiology Services. The location of the telehealth exam rooms should be in the quietest area possible within the space, as this is necessary for appropriate examination of patients who are utilizing telemedicine. All spaces must have connectivity capabilities to the VA Network and VA phone system, unless noted.

1.02.5.1 Reception Area:

1) Reception area will likely be shared with other services and their usage will be coordinated with those shared services.

2) Audiology Clinic Patient Area:

3) One Telehealth Exam Room (125 NSF)

4) One Hearing Aid Repair Room (160 NSF)

5) One Patient Toilet (60 NSF)

1.02.5.2 Support Area:

1) One Clean Audiology Supply Room (80 NSF) for storage of clean supplies/instruments utilized for medical procedures. Does not require VA network or phone connectivity.

2) One Equipment Storage room (120 NSF). Does not require VA network or phone connectivity.

1.02.5.3 Staff and Administrative Area:

1) Area will be shared with other services and their usage will be coordinated with those shared services.

1.03 1.04 VA has final approval over the suitability of space offered by the contractor.

1.03 EXPRESS APPURTENANT RIGHTS

The Government shall have the non-exclusive right to the use of Appurtenant Areas and shall have the right to post Rules and Regulations Governing Conduct on Federal Property, Title 41, CFR, Part 102-74, Subpart C, within such areas. The Government will coordinate with Lessor to ensure signage is consistent with Lessor’s standards. Appurtenant to the Premises and included in the Lease are rights to use all parking space as required by applicable code. In addition, the Lessor shall provide such additional parking spaces as required by the applicable code of the local government entity having jurisdiction over the Property.

1.04 RENTAL CONSIDERATION FOR SIMPLIFIED LEASES

In consideration for the Lease, the grant of all associated rights, express or implied, and the performance or satisfaction of all of the Lessor's other obligations set forth herein, the Government shall pay the Lessor annual rent for the space upon delivered for occupancy and use by the Government. Payment shall be made monthly in arrears. Rent for a lesser period shall be prorated based on a 30-day calendar month. Rent shall be paid by Electronic Funds Transfer to an account to be designated by Lessor. The Rent is calculated on a Full-Service Gross (FSG) basis, which includes but not limited to utilities, janitorial services, all operating expenses, taxes, maintenance, and parking. The Rent Schedule reflects an all-inclusive rental rate and there shall be no other adjustment throughout the Term, except as provided elsewhere in the Contract.

1.05 TERMINATION RIGHTS

The Government may terminate this Lease, in whole or in parts, by providing not less than 180 days’ prior written notice to the Lessor. The effective date of the termination shall be the day following the expiration of the required notice period or the termination date set forth in the notice, whichever is later. No rental shall accrue after the effective date of termination.

1.06 RENEWAL RIGHTS

a. This Lease may be renewed at the option of the Government at the rental rate(s) set forth in the Lease; all other terms and conditions of this Lease, as same may have been amended, shall remain in full force and effect during any renewal term.

b. Termination rights outlined “Termination Rights (Simplified)” paragraph apply to all renewal terms

1.07 SUMMARY PRICING SCHEDULE:

The Contractor shall provide space outlined below for VA staff at each of the Clinics:

RENTAL RATE: BASE YEAR

RENTAL RATE: YEAR 1

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RENTAL RATE: YEAR 2

RENTAL RATE: YEAR 3

RENTAL RATE: YEAR 4