36C26319R0092-0002001.pdf

Questions and Responses

RFP 36C26319R0092

St. Cloud, MN Mental Health Services

1. When do you foresee the start date for the clinicians?

As soon as an acceptable candidate is Credentialed/Privileged and background check (security assessment) completed.

2. Are there incumbent psychiatrists or nurses?

Yes, permanent VA hired staff. If so, can you provide the current contract value or contract company? Mental Health does not currently have contracted staff.

3. Can you please confirm the on-call rotation to hold the pager? And will providers be on-call for the In-patient ward only?

MHOD coverage (Mental Health Officer of Day) during the week, for a month a person typically covers these duties 2-5 times a month. These duties include evening call which means that if the MOD (Medical Officer) needs to consult after business hours in regards to a patient they will call via phone for collaboration, it is very infrequent when the MOD contacts the MHOD after hours.

The duties of the MHOD during the day (0800-1630 CST) is to work with our MH Triage for urgent and emergent needs of patients (admitting to the acute unit, 72 hour holds, medication needs).

Weekend and Holiday Coverage on Acute Psychiatric Unit: We count a weekend as Saturday and Sunday the hours vary depending on practice preferences, typically a Psychiatrist spends about 4-6 hours each day (Saturday and Sunday) providing coverage. Holiday coverage is 8 hours. Currently our Psychiatrists are covering weekends about every 5-6 weeks and holiday coverage 2 times per year. The holiday and weekend coverage is completed by sign up and typically not assign, so most of the time there is choice of what weekends and holidays to cover.

4. What is the number of beds in the unit, and what support staff is available?

The Acute Mental Health unit has 15 beds, and 148 Residential Rehab Treatment Program (SUD/PTSD) Beds

5. What is the historical volume of patients in the in-patient unit?

Historically, the MH inpatient unit consistently maintains a >90% bed occupancy rate.

6. To be technically acceptable, do we need to provide 2 psychiatrists and 2 RN’s for the base year bid even though there are no hours for the second positions allocated?

To be technically acceptable for the base year the vendor needs to provide one Psychiatrist and one MH (Psych) APRN

7. Confirm the need for 2 psychiatrists and 2 APRN’s begins in Option Year 1.

Yes.

8. Would the facility consider a psychiatrist that would do either I/P or O/P, but not both?

Or do the providers HAVE TO BE WILLING to do both I/P and O/P

The candidates will need to cover both areas. It is anticipated that most of the work will be on an outpatient basis.

9. Is there holiday call or not? Says weekend and weekdays only but what if holiday lands on a weekend/weekday then that would be holiday correct call correct? Yes, there is holiday call. Holidays do not fall on the weekend, they are always observed Friday or Monday. When we indicate a holiday, it is the day that the Federal Government workforce observes it as a holiday.

10. Hours are 8:00-4:30 but what will they be doing? In patient or outpatient? The SOW does not say. What services are they providing? Inpatient & Outpatient

11. What is the call rotating? How many psychiatrists do you have on staff? How many staff psychiatrists share rotating call? We have 6 psychiatrist (current state, this will change), three are part-time. They all are currently covering or will be in the future.

12. For year one you need one MD and one NP. For years 2 and on you need 2 MD’s and 2 NP’s. Correct

13. For the first year, you also need back up credential providers, correct? If provider not able to fulfill contract duties, Yes, it is up to the contracted vendor to find replacement

14. When the Doc is MOHD, they are admitting inpatients. Therefore, is this an outpt job EXCEPT for when they are on-call?

The MHOD is on call for all of MH (inpatient and outpatient) when covering. During regular business hours, this would require assisting with triage and assessing patients, some of which may meet criteria for a 72 hour hold. The MHOD would make that assessment and direct an admission to the inpatient unit. When the MHOD is covering off hours and during the weekend, they will provide consultation (almost always over the phone) to the MOD and other staff. If the MHOD is on-call and covering a weekend, they will also come to the medical center and round the inpatient psych unit. Usually this takes 4-6 hours each day. It is anticipate that the vast majority of work would be in the outpatient setting. However, we will need candidates that are flexible in the event that we need more inpatient coverage

15. How much inpatient is there actually? 15 Acute MH beds; 147 Residential Rehab Treatment Program (PTSD and SUD) beds 148 MHRRTP Beds.

16. How many beds in the inpt unit? 15 Acute MH beds; 147 Residential Rehab Treatment Program (PTSD and SUD) beds 148 MHRRTP Beds.

17. What is the avg census in the inpt. Unit? >90% occupancy rate for both programs

18. What is the avg census in the outpt unit? There is no outpatient unit, not sure what this is referencing.

19. Will you consider making multiple awards? Not at this time

20. Are immunization requirements required at submission of bid or during credentialing. submission of bid

21. Us citizen. Can they have a green card? Please see the attached document. If you need further details, please let us know. (Attachment 4)

22. Do they have to be on site during weekend and weekday call? No do not have to be on site – but do need to respond timely – if needing to come in must come in within an hour

23. What is your orientation requirement and what TMS modules are to be required before beginning? Listed in contract

24. Will you accept BE? Possibly, if a good candidate

25. Will you consider a line item for Holiday call since they will be working call on a Holiday. Part of call compensation – up to Contracting Officer - Not at this time.

26. Could you please tell me if the Combined Synopsis/Solicitation posted as solicitation number 36C26319R0092 on FBO contains requirements similar to any work performed currently or in the past, or will this be a new requirement? If possible, can you please provide the most recent contract or task order number?

This is a new requirement.

27. Since you only need one MD and one NP for year one, does that mean we don’t have to submit two MD’s and two NP’s since you don’t need them in year one but in year two? Does that make sense?

That is correct. You only need to submit 1 Psychiatrist and 1 MHAPRN of the base period. The need for 2 Psychiatrists and 2 MHAPRN’s begins in Option Year One.

28. Does the APRN participate in call?

Yes, but only during their normal working tour as they cover as the MHOD. No after hours coverage however.

29. Coverage is for the outpatient clinic and acute psy unit only?

Coverage is for Outpatient and Inpatient (Acute Mental Health and Mental Health

RRTP)

30. Does the physician and/or the APRN have any responsibilities related to the psychiatric

RRTP?

Yes, all areas for both

31. Do they round on each unit? What are the duties for each unit? Meaning where does the doc go when they report for duty?

They will report to duty where they assigned. Most commonly this will be to out the outpatient clinic. However, it could be acute psych or MHRRTP as well. There will be a schedule in place so the provider will clearly understand where to report.

32. Orientation? Is it a day, 3 days, a week, what? I can’t find it in the 98 pages of the SOW.

About 2 weeks, depending on VA experience and/or comfort level of contract employee

33. Do they rotate Holiday call or is the contractor always put on holiday call?

APRN participates in call but only during their normal working tour as they cover as the MHOD. No after hours coverage however. The Psychiatrist rotates call with the other seven Psychiatrists – one Psychiatrist on call at a time

34. During Holiday call do they come in for an 8 hour day and then take call till 8a the next morning?

Yes, there is holiday call – call coverage. Holidays do not fall on the weekend, they are always overserved Friday or Monday. When we indicate a holiday, it is the day that the Federal Government workforce observes it as a holiday.

35. All we really need to know is HOW MANY PATIENTS PER DAY does each PSYCH see (or are responsible for) ? On average. Inpatient/outpatient.

I can speak to the MH outpatient patient numbers: The provider will see an average of 10 patients a day.

• A full time provider would have twelve 30 minute slots in an 8 hour day on average.

• RTC are 30 minutes and intakes are 60 minutes.

• The number of slots per day varies based on BHIP meetings etc.

36. Is Medicare part of your payor mix?

No.

37. Regarding Medicare….can an “opt out” provider work in your VA setting?

Yes

38. Regarding the APRN – do they need to be PMHNP?

The Mental Health APRN must be ANCC Certified Psychiatric-Mental Health Advanced Practice Nurses (PMH-APRNs).

39. Would like to confirm that Base Period staffing needs are 1 FTE Psychiatrist and 1 FTE MH/ARNP. Option years will require 2 FTE Psychiatrists and 2 FTE MH ARNP’s. ( Page 6, middle of the page, states that 1 psychiatrist and 1 MH ARNP is required for the Base Period. Page 21 2.9.1 states that there will be two of each beginning year 1. Want to clarify which one is correct)

Correct

40. Will you accept Board Eligible candidates who are willing to sit for Board Certification within 1 year of starting at the VA?

If an otherwise good qualified candidate.

41. How many years of experience must the Psychiatrist and MH/ARNP have in order to be considered for the positions? Will you accept providers who just completed their training?

Possibly, if an otherwise good qualified candidate.

42. How many other Psychiatrists will be in the group to handle rounds over the weekends and on holidays?

Only one Psychiatrist is needed to be on call at one time.

43. How many other Psychiatrists will in the group to handle the weekly call schedule?

There are seven (7) other Psychiatrist that will rotate call.

44. Is there a room for them to sleep when they are rounding and taking call on the weekend? Not needed for the Mental Health Providers that are on call. The facility has contracted providers (hospitalists), Medical Officers of Day (MODs), that cover weekends and holidays. The MODs have a room for them to sleep. The Psychiatrist is on call to answer questions for the MODs. Rarely are the Psychiatrists required to come in on weekends and holidays (other than the time they come in on Saturday and Sunday mornings to round on the inpatients, and see a few scheduled outpatients)

45. On average, how many patients will these providers see in a day? Approximately 10 outpatients seen per provider per day.

46. How long do you allow for the 1st visit? On average 60 min How much time allotted for follow-up visits? On average 30 min

47. How many patients will they have assigned to their panel? This is highly variable depending on access and complexity of patients. Rough estimate is 300-500.

48. Is there an incumbent contractor providing these services now? If so, who is the current contractor? No