36C26220R0021 0002_1.docx

Contract Opportunity Amendment to a Previous Combined Solicitation

PRODUCT SERVICE CODE

SUBJECT

CONTRACTING OFFICE'S

ZIP-CODE

SOLICITATION NUMBER

BASE NOTICE TYPE

RESPONSE DATE/TIME/ZONE

ARCHIVE

DAYS AFTER THE RESPONSE DATE

RECOVERY ACT FUNDS

SET-ASIDE

NAICS CODE

CONTRACTING OFFICE

ADDRESS

POINT OF CONTACT

(POC Information Automatically Filled from User Profile Unless Entered)

DESCRIPTION

See Attachment

AGENCY'S URL

URL DESCRIPTION

AGENCY CONTACT'S EMAIL

ADDRESS

EMAIL DESCRIPTION

ADDRESS

POSTAL CODE

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ADDITIONAL INFORMATION

GENERAL INFORMATION

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* = Required Field Contract Opportunity Amendment to a Previous Combined Solicitation Q201

EMERGENCY DEPARTMENT STAFFING - VA LONG BEACH

90815 36C26220R0021 09-25-2020

3:00 PM

PACIFIC TIME, LOS ANGELES, USA

N 621111 Department of Veterans Affairs Network Contracting Office 22 4811 Airport Plaza Drive Suite 600 Long Beach CA 90815 Presidential Management Fellow Tashodra Rogers Tashodra.Rogers@va.gov 562-766-2246 VA Long Beach Healthcare System

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) 09-14-2020

MSO-2020-CMP-0031

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

36C26220R0021 09-14-2020

X

X

This amendment is issued to update the following:

1). Update block 8 on the SF1449.

2). Update E.3 (1)(b) - Format 3). Update E.3 (1)(h)(1)(a) – Special Standard of Responsibility 4). Update E.4 (1)(A)(1)(a) – Special Standards of Responsibility 5). Answer questions that were submitted.

Please see page two (2) for details. As a result of this amendment, all other terms and conditions remain unchanged.

Alice McGruder Contracting Officer Amendment

1. Proposals are due on September 25, 2020 by 3:00PM PST.

2. Format. Offerors will present their written offers on 8.5” by 11” paper, using legible eleven (11) point font, single spaced, with 1” margins all around. The offeror will not be more than 150 pages including all supporting documentation; bound with black paper clip or placed in a three-ring binder to allow for ease of disassembling sections of the offer. Offerors proposals will contain one (1) hard copy, clearly marked with RFP 36C26220R0021. Offerors proposals shall be mailed to:

Tashodra Rogers Contract Specialist, Healthcare Resources Branch Department of Veterans Affairs Network Contracting Office 22 4811 Airport Plaza Drive, Suite 600 Long Beach, CA 90815

3. Contractor Board Eligible/Board Certified Emergency Medicine Physician:

a. Provide a narrative describing the Offeror’s experience providing Board Eligible/Board Certified Physician staff for Emergency Medicine to a hospital or medical center. If the Offeror’s experience is as the owner/operator of one or more Emergency Department, provide details about the Offeror’s experience, providing Board Eligible/Board Certified Physician staff for those facilities. If the Offeror’s experience is as a contractor providing contracted Board Eligible/Board Certified Physician staff for Emergency Medicine to a hospital or medical center operated by someone else, provide contract number, contract point of contact (POC), place of performance, and the period of performance for each contract used to demonstrate the Offeror has the required experience.

For the Board Eligible/Board Certified Emergency Medicine Physician the Offeror proposes, provide documents that show:

a. Board certification in Emergency Medicine.

b. Active/unrestricted license in a State, Territory, or Commonwealth of the U.S. or in the District of Columbia

c. American Heart Association issued Basic Life Support and Advanced Cardiac Life Support certification cards

4. Contractor Board Eligible/Board Certified Emergency Medicine Physician:

b. Provide a narrative describing the Offeror’s experience providing Board Eligible/Board Certified Physician staff for Emergency Medicine to a hospital or medical center. If the Offeror’s experience is as the owner/operator of one or more Emergency Department, provide details about the Offeror’s experience, providing Board Eligible/Board Certified Physician staff for those facilities. If the Offeror’s experience is as a contractor providing contracted Board Eligible/Board Certified Physician staff for Emergency Medicine to a hospital or medical center operated by someone else, provide contract number, contract point of contact (POC), place of performance, and the period of performance for each contract used to demonstrate the Offeror has the required experience.

For the Board Eligible/Board Certified Emergency Medicine Physician the Offeror proposes, provide documents that show:

a. Board certification in Emergency Medicine.

b. Active/unrestricted license in a State, Territory, or Commonwealth of the U.S. or in the District of Columbia

c. American Heart Association issued Basic Life Support and Advanced Cardiac Life Support certification cards

RESPONSE TO QUESTIONS

1. Due to this being a LOCUM contract is it possible to change the NAICS code to 561320 which is applicable for Locums?

No. This is not a LOCUM requirement.

2. Are the hours correct? The base year of the contract calls for 3270 hours for Physicians which is just over 1.5 FTE, however the solicitation states a minimum of 8 Physicians be presented and credentialed.

Yes. The hours are correct. The Physicians would need to be readily available at any given time due to the various hours/days and unknowns.

3. What is the trauma level of the Hospital?

Do not have a trauma designation but function similar to a level three (3).

4. Where are high acuity patients transported to?

Higher levels of care are sent to either Long Beach Memorial, University of California Irvine or Saint Mary’s.

5. How many patients per day on average during the day shift? Night shift?

90-120 patients a day during the week and 70-90 patients on the weekend. The bulk is during the week.

6. How many other ER Physicians/mid-levels are on staff during the day shift? Night shift?

During the day its either double coverage and triple coverage during the peak hours. Single coverage is restricted to early morning and overnight shift.

7. What specialty support is available at the Hospital?

Broad subspecialty support coverage.

8. How far in advance is the schedule made?

A month in advance.

9. What are the ER shifts? (ex. 9a – 5p, 7a – 5p, 12p – 10p)?

7am – 3pm; 10am – 6pm; 3pm-11pm; 6pm-2am; 11pm-7am

10. The solicitation lists below, however the Providers on this contract do not fall under the SCA and will be 1099 contractors. Will this be removed from the solicitation?

No Employee Status: The Contractor shall be responsible for protecting Contractor’s physician(s) furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

0. Workers’ compensation

0. Professional liability insurance

0. Health examinations

0. Income tax withholding, and

0. Social security payments

This section shall remain in the solicitation.

11. What is the annual volume of the facility?

Approximately 30,000.

12. What specialty backups are available?

Refer to the response in question 8.

13. Do you have a preference for residency trained emergency medicine physician’s vs Internal Medicine or Family Practice?

Emergency medicine training and Boarded or board Eligible.

14. On page 92-93 in section b. Format you are requesting 4 hard copies to be mailed to you. This is quite a lot of paper which is contraindicated with the Paper Reduction Act. Will you consider receiving proposals via e-mail with separate sections for Administrative Documents to include the signed SF1449, SF30's, 52.212-3, Appendix A form, Appendix D forms and Vendor Past Performance and Contingency Plan (1 e-mail) and a separate e-mail containing reps and certs, responsibility matters (1 e-mail) and another e-mail containing candidate documents (which may be multiple e-mails within size restriction limits and lastly a final e-mail containing the Pricing Section (1 e-mail)?

Amended to one (1) hard copy.

15. CLINS on pricing sheet do not include line items for on-call rates. On page 22, in section 3. Hours of Operation indicates in section 3.1.3. that Patients must be seen within 4 hours of the page which indicates on-call is required but does not offer the call rotation. Will that be 1 in 2 or 1 in 3 or other? Will you consider adding CLINs for on-call rates?

Please refer to section B.3 Schedule of Services for the CLINs.

16. What is the patient volume per shift in ER for Physicians?

About 90-110 per day approximately and 70-90 on weekends.

17. What is the patient volume per shift for NP/PA's in the EM Outpatient unit?

35% of daily ED volume. Please also refer to the response in question 21.

18. Will NP/PA's be seeing any patients in the Inpatient Unit?

They don’t see the patients.

19. Please clarify if night shifts will be available? SOW indicates clinic hours but also states that ED coverage is 24/7 and schedules may be adjusted if necessary.

Please refer to the response in question 10.

20. On page 94 in item 1. Contractor Board Eligible/Board Certified Emergency Medicine Physician the following is requested:

a. If the Offeror’s experience is as a contractor providing contracted Board Eligible/Board Certified Physician staff for Emergency Medicine to a hospital or medical center operated by someone else, provide contract number, contract point of contact (POC), place of performance, and the period of performance for each contract used to demonstrate the Offeror has the required experience.

The contract # and contract point of contact is information is not normally made available to the Locum EM Physician when they work on multiple contracts. They simply rotate assignments once privileges are issued and their Locum company does not share the contract # or facility CO contact details with them and in many cases, there is no contract # for commercial placements, just agreements. Candidates will likely not have this information or be given these details if they worked for other vendors in the past. These providers just list the clinical locations in which they worked on their CV. Will that clinical location be acceptable to satisfy this requirement?

This requirement is for Emergency Department Physicians, not Locums. Please refer back to section E.3 (1)(h) Special Standards of Responsibility.

21. How many daily hours for both MD and mid-level coverage?

Minimum hours are unknown. Please refer to response in question 10 for shifts.

22. Minimum number of shifts per month?

Do not know the need.

23. EMR system in place?

Yes.

24. Support staff/services in house?

Yes

25. Type of EHR, acuity (admission rate) About 20% approximately.

26. Typical duration of stay in the ER average day?

For most patients it’s about 180 minutes approximately.

27. What is the number of minimum shifts per month per provider that you will accept?

The minimum is unknown.

28. Is there an incumbent? If so, what was their last all-inclusive hourly rate for the ER Physicians and Mid-Levels?

This is a new requirement.

29. Do you give preference to providers that are ABEM?

Please refer to B.4 section 2 Qualifications.

30. Do we have to present candidates with our bid? If price is the determining factor for award then why would candidates need to be presented? See below.

a. Offers will be evaluated in the following manner. The lowest-priced offer will be identified. The lowest-priced offer will be evaluated to determine if the offered price exceeds the amount of funding available for the procurement. If the offered price does not exceed the amount of funding available for the procurement, the offered price will be evaluated to determine if it is reasonable. If the offered price is found to be reasonable, the offeror who submitted this offer will be identified as the “successful offeror.”

Please refer to E.3 Section (1)(h) Special Standards of Responsibility.

31. Do we need to present candidates on the bid or just pricing?

Please refer to E.3 Instructions to Offerors.

32. Can you advise on the Mid Levels schedules? Are they also on 8- or 10-hour shifts?

Schedules are unknown. They’re on 10-hour shifts.

33. Is there a Fast Track? What is the volume of Fast Track?

Yes. 35% of the daily volume.

34. Will 24-hour shifts be approved?

No

35. Will PPE be available?

Yes

36. Is this a re-compete bid?

No.

37. Is there any present incumbent for this project?

Yes.

38. What is the estimated budget this year?

Pending availability of funds.

39. What will be the estimated budget for this project?

Pending availability of funds.

40. What will the actual contract Start date for this Date?

Start date shall be on or about January 1, 2021.

41. What support staff will be on-site with the contract providers?

Please refer to the response in question 8.

42. Clins 0001 - 3270: 0002 - 2860:

Clins 1001 - 2080: 1002 - 1040:

Clins 2001 - 1040: 2002 - 520:

Clins 3001 - 1040: 3002 - 1040:

Clins 4001 - 1040: 4002 - 520:

Why is there a variance in the Clins lines?

The CLINs are accurate.

43. How many shifts will the contractor cover per month per each labor category?

Unknown

44. Do we have to provide Copies of any and all licenses, board certifications, NPI, to include primary source verification of all licensed and certified staff for the Emergency Physicians? Or is that only for the mid-level providers.

Amended to include Physicians.

45. What is the anticipated start date it usually takes 6-8 weeks to credential December 1st?

The start date shall be on or about January 1, 2021.

46. Would the Government consider changing acquisition strategy from Lowest Price Technically Acceptable to Best Value Trade-off?

The acquisition strategy is Price Only with Special Standards of Responsibility.

47. Do Emergency Medicine residents rotate through the Emergency Department? If so, wouldn’t the supervising physicians need to be Board-Eligible/Board-Certified Emergency Medicine physicians rather than Family Medicine/Internal Medicine as are allowed in PWS 2.4?

Yes and will have some supervisory role.

48. There was no time marked in block 8 of the SF1449. Can the Government confirm what time proposals are due on 25 September?

Amended to 3:00PM PST.

49. E.3; 52.212-1 (1)(h)(1)(a) does not ask offerors to submit documents for proposed physicians but does for Mid-Levels. Historically, for similar solicitations we have seen requirements for offerors to submit qualifying documents for physicians. Can the Government confirm that qualifying documents are not required for the physicians?

Amended to include Physicians.

50. E.3; 52.212-1 (1)(h)(2) provides a number of qualifying documents that must be submitted with the proposal, however there is no mention of a CV/resume. Does the Government want offerors to submit CVs as part of the documents for proposed Mid-Level candidates?

Refer to E.3 Instructions to Offerors.

51. E.3; 52.212-1 (1)(h)(2) does the Government want offerors to submit Letters of Commitment as part of the documents for proposed Mid-Level Candidates?

Refer to E.3 Instructions to Offerors.