S02 - 36C26324R0005 SF30 Amd 0004 06132025.pdf

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)

1 1

0004 6/13/2025

MSO-2024-COM-0002

36C263

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

316 Robert Street N. STE. 506 St. Paul MN 55101

Same as Issued By

To All Prospective Offerors

36C26324R0005

06/13/2025

X

UNCHANGED: June 30, 2025 17:00 CDT

X -one-

The purpose of this amendment is to address the following:

1.) Responses to Vendor questions which were unintentionally omitted have been posted below, as attached.

2.) B.3 PWS has been updated in response to vendor questions.

3.) E.2 Proposal Preparation Instruction has been updated in response to vendor questions.

All other terms and conditions remain unchanged.

John Becker Contracting Officer

Pierre, South Dakota CBOC

36C26324R0005 AMD 0004

Response to Questions To all potential offerors: These are responses to additional questions that were submitted timely.

1. RFP 36C26324R0005-0002 & Amd 1 Q&A’s: (Reference B.2 Schedule of Services; 2.1 minimum PACT staffing requirements, Amd 1, Question 17; Pages 13-14)

The enrollment in the base year is 900. However, in the minimum PACT staffing requirements it states the estimated patients assigned to site is 883 (as of 2/6/2025). In addition, in Amendment 1, Question 17, enrollment beginning fiscal year 2023 was 908, year 2022 was 954, year 2021 was 912, year 2020 was 964, and year 2019 was 1,022.

Will the VA consider lowering the enrollment to more accurately reflect the enrollment?

And, why is the Schedule of Services showing an enrollment increase over the life of the contract, when enrollment has been steadily decreasing over the last 6 years?

a. Response: Please note, in the Sources Sought announcement posted 5/30/25, as well as in Solicitation 36C26324R0005, AMD 0003, Schedule B.2; the estimated population has been updated to reflect the current population with an estimated annual 2% growth. This is also addressed in Question 6, AMD 0003. Lastly, There are currently 2,182Veterans eligible for VA care with a market penetration rate of 40%. We project with a solid marketing plan we could pull these Veterans into VA care.

2. RFP: 36C26324R0005-0002: (Reference 2.6 General and Specialty Mental Health Staffing Requirements and Options; 5.5 Mental Health Services; Pages 18 & 38-47)

The RFP states, the Contractor is not required to provide general and specialty Mental Health Staffing. These services will be provided to Veterans by VA staff members via telehealth or face-to-face visits at the main facility. In several places in the RFP it states the contractor will provide mental health services or doesnt' clearly say who provides the services, i.e.

evidence-based psychotherapy for PTSD, evidence-based psychotherapy for depression and anxiety disorders, evidence-based somatic therapies, ECT, psychotherapy groups, family education and involvement, social skill training, CWT, transitional work, supported employment, SUD, suicide prevention, scheduling support, etc.

Will the VA please confirm that all mental health services will be provided by the VA and the contractor only provides clerical support services for VA mental health providers?

a. Response: PWS Section 2.6 General and Specialty Mental Health Staffing Requirements and Options; Pages 18-19: Each of the specialties listed contains the following paragraph. “The Contractor is not required to provide general and specialty Mental Health staffing. These services will be provided to Veterans by VA staff members via telehealth or face-to-face visits at the main facility. The Contractor will be required to place referrals for these services by placing a consult in CPRS.” The Main facility is Fort Meade, however a Veteran could request Hot Springs. 5.5 Mental Health Services, Pages 38-47 If a Veteran screens positive, it is the responsibility of the primary care provider to complete the next level screen.

3. 36C26324R0005-0002: (Reference 2.6 License and Accreditation; 5.5 Mental Health Services; Page 21) The RFP states, a copy of licenses shall be provided with offer and will be updated annually. However, in the Instructions to Offeror, there is no mention of providing the staff or licenses. Is the contractor to provide the proposed staff and their licenses with the proposal submission? And if so, in what section should this be provided?

Response: This sentence has been removed from the PWS.

4. 36C26324R0005-0002: (Reference 3.1 Business Hours; Page 25, 5.7 Telehealth Services

Requirements; Page 48 and 11 Space Requirements; Page 59)

The RFP states the business hours are 8:00 AM - 4:00 PM Monday - Friday for regularly scheduled appointments. The RFP also states, it is anticipated the VA will utilize telehealth services at this site for up to 40 hours per week during Monday through Friday from 07:30 a.m. to 4:00 p.m. Telehealth staff will be available Monday through Friday from 07:30 to 16:00. And in the Space Requirements section it states the normal business hours are 8:00 AM - 4:30 PM, Monday through Friday.

What are the normal business hours for all services in the clinic?

Response: All hours have been adjusted in the PWS to read 8:00 am – 4:00pm.

5. 36C26324R0005-0002: (Reference 5.3 Pharmacy Services; Page 33) The RFP states, the

Contractor will provide all medications that are to be administered to patients in the clinic (including any necessary vaccines). Will the VA please provide a complete list of medications and vaccines to include all injectable medications that the contractor is expected to provide? And, will the VA provide their historical monthly and annual usage at this CBOC for the past 3 years so we can include in our pricing?

a. Response: Please refer to AMD 0003 Quest 1 response for the approximate monthly spend for medications. Routine vaccines should be provided and the list as defined by the CDC can be found here: https://www.cdc.gov/vaccines/hcp/imz-schedules/adult-schedule-vaccines.html

TECS medications (Tropicamide, proparacaine and latanoprost); aspirin 81mg, naloxone, steroid injection, epinephrine auto-injectors, ceftriaxone.

There is no historical usage report the VA can provide as the medications aren’t provided by the VA.

6. 36C26324R0005-0002: (Reference 5.3 Pharmacy Services; Page 33) The RFP states, urgent/emergent medications needed will be filled via contracted local pharmacy for up to a 10-day supply. Who pays for the cost of these contracted local pharmacy medications?

a. Response: Medications filled utilizing this contract are at the cost of the VA.

https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Fvaccines%2Fhcp%2Fimz-schedules%2Fadult-schedule-vaccines.html&data=05%7C02%7C%7Cce97f7552ad7496f126408dda2ba9bd1%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C638845644540256963%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=QxsxHYhZYxQQUt%2BgjTuVd1IMyEvOe8M14WJzaID7I9w%3D&reserved=0 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Fvaccines%2Fhcp%2Fimz-schedules%2Fadult-schedule-vaccines.html&data=05%7C02%7C%7Cce97f7552ad7496f126408dda2ba9bd1%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C638845644540256963%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=QxsxHYhZYxQQUt%2BgjTuVd1IMyEvOe8M14WJzaID7I9w%3D&reserved=0

7. 36C26324R0005-0002: (Reference 5.5 Mental Health Services; Page 35) The RFP states, the Contractor shall meet all requirements for anticoagulation management outlined in VHA Directive 1108.16(1), "Anticoagulation Therapy Management" (or subsequent revisions thereto) as well as local policy related to the management of patients on anticoagulation. Local policy is included in Section D (attachments). The Contractor shall provide quarterly, and annual anticoagulation quality assurance summaries as outlined by the local Pharmacy & Therapeutics Committee.

If the VA is providing the Clinical Pharmacy Services, wouldn't the VA be responsible for the anticoagulation management?

a. Response: This has been removed from the PWS, for clarity.

8. 36C26324R0005-0002: (Reference 5.6 Specialty Care Services; Page 47) The RFP states that the contractor will provide clerical support to the VA's physical therapy providers. It also states that the contract will not be required to provide "podiatry" services on site (likely meant to say "physical therapy"). Will the VA clarify the contractor's role for physical therapy support?

a. Response: The PWS has been corrected to reflect physical therapy services.

9. 36C26324R0005-0002: (Reference 5.2 Telephone Access to Clinical Care; Page 49) The RFP states, The contractor shall make provisions for toll free telephone care, twenty-four

(24) hours a day, seven (7) days a week, including evenings, weekends, and holidays, for all Veterans. Is it acceptable to the VA if the Contractor uses the VA's after hours call center to provide after-hours telephone access?

a. Response: Yes.

10. 36C26324R0005-0002: (Reference 5.7 Telehealth Service Requirements; Pages 47-48) The RFP states, the Contractor shall provide the following telehealth services, which may be added or removed as needed throughut the contract: Teleeye Care, Teledermatology, Telespirometry, Telemental Health, Telepharmacy, and Telephysical Therapy.

Does the VA require that each Service have is it's own dedicated room? If not how many rooms are being requested?

a. Response: The offeror is required to provide 1 exam room in support of all telehealth services.

11. 36C26324R0005-0002: (Reference 11 Space Requirements; Pages 57-58) The RFP states, contractors shall provide space that meets the standards outlined in the PACT Space Module Design Guide (see link above) and for the purposes of this contract the following minimum space requirements are: Can the VA provide quantities for the rooms listed on pages 57-58?

a. Response:

Requirement Minimum Square Feet

(1) Telehealth Group Space 288

(1) Individual Telehealth Space 125

Exam Room (Minimum of 2 Rooms per Provider)

(1) Women’s Health Exam Room with Bathroom Attached

185 (125 exam room, 60 bathrooms

(1) Lab 600

(1) Consultation 120

(1) Teamwork Support Zone 112

12. 36C26324R0005-0002: (Reference 11 Space Requirements; Pages 57-58) The RFP states, Furnished Teamwork Support Zone (300 sq.ft.) with Desks and Chairs for VA staff. Is the VA requesting a separate Team Work Zone for VA staff than the PACT Team Work Zone?

a. Response: It doesn’t have to be separate space.

13. 36C26324R0005-0002: (Reference 11 Space Requirements; Pages 57-58) Does the current facility meet the PACT Module Design?

a. Response: Yes.

14. 36C26324R0005-0002: (Reference 12 Environment of Care; Page 62) The RFP states, Contractor shall meet VHA standards regarding EOC and shall provide EOC management plans addressing safety, security, hazardous materials, hazardous waste, emergency preparedness, life safety, medical equipment, infection control, and utility systems with the submission of their proposal and within 15 calendar days after contract award. However, nowhere in the In the Instructions to Offeror, does it mention providing EOC management plans. Where in the technical proposal would the VA like to see the EOC management plans? Given that our EOC management plans are close to 100 pages long, is it acceptable to provide this as an attachment and have it not count towards the 100 page limit, or can this information be provided after contract award?

a. Response: It is acceptable to provide the plan as an attachment in the appendix of the Technical proposal. It is encouraged to present the EOC Plan in a concise manner. It is preferred, the EOC Plan be 50 pages or less (avoiding double-sided print). E.2 Proposal Preparation Instructions has been updated to reflect the change.

15. 36C26324R0005-0002: (Reference 13 Equipment, Office Supplies and Technical Support; Page 63) The RFP states, the contingency plan for computer downtime must be reviewed and approved by the Contracting Officer prior to award. However, nowhere in the instructions to offeror, does it mention providing our contingency plan for computer downtime. Where in the proposal is the contingency plan for computer downtime to be provided?

a. Response: It is acceptable to provide the plan as an attachment in the appendix of the Technical proposal. E.2 Proposal Preparation Instructions has been updated to reflect the change.

16. 36C26324R0005-0002: (Reference 13 Equipment, Office Supplies and Technical Support; Page 65) Providing PC workstations, software, primary telecommunications lines and networking equipment required to access the VA EHR. Will the VA provide Laptops or Desktops? Will the VA provide the telecommunication lines for the phone system and physical phones?

a. Response: VA will provide laptops and/or desktops as needed. Yes, VA will provide the telecommunication lines for the phone system and physical phones.

17. 36C26324R0005-0002: (Reference: Instructions to Offerors (Page 135, 138 and 140) The RFP states, (10) Past performance information, when included as an evaluation factor, to include recent and relevant contracts for the same or similar items and other references (including contract numbers, points of contact with telephone numbers and other relevant information). However, in Addendum to FAR 52.212-1 Instructions to Offeror, there is no mention of Past Performance. Is the Past Performance the same thing as Factor 1:

Experience?

a. Response: No.

18. 36C26324R0005-0002: (Reference: Instructions to Offerors (Page 135, 138 and 140) Under Factor 5: Price, it refers to the SF 1449, all fill-ins in the B.1 Contract Administration Data section of the solicitation and to complete the necessary fill-ins and certifications in in the Contract Clauses section. Representations and Instructions section shall be returned on the original Government Form. It also says in the Price section, the Technical proposal shall not exceed a 100-page count, (excluded from page count: Cover Letter, Cover Pages, TOC, Clause and Provision fill-ins, the required Section D attachments, and Exhibits). Clause and Provision fill-ins and required Section D attachments shall be at the end of the Technical proposal.

(i) Are these Representations and Instructions different than those in SAM, if not, could you please clarify what Representations and Instructions the government would like returned?

(ii) Is the SF 1449, all fill-ins in the B.1 Contract Administration Data section of the solicitation, all necessary fill-ins and certifications in the Contract Clauses section to be provided in the Price proposal or the Technical proposal?

a. Response: Offerors may provide a SAM print out of their Reps & Certs for inclusion at the end of the Technical Proposal IAW the instructions. B.1 Contract Administration Data information belongs within the Technical Proposal. B.2 Schedule of Services belongs within the Price proposal

19. 36C26324R0005-0002: (Reference: E.3 Evaluation; Page 141) Factor 4 states, Non- Veteran offerors proposing to use certified SDVOSBs or VOSBs as subcontractors will receive some consideration under this evaluation factor. Offerors must state in their proposals the names of the certified SDVOSBs and VOSBs with whom they intend to subcontract and provide a brief description of the proposed subcontracts and the approximate dollar values of the proposed subcontracts. In addition, the proposed subcontractors must be listed at the time of submission of offers and at time of award, as a certified SDVOSB/VOSB in the SBA certification database. Does the VA want non- Veteran owned bidders to submit a Small Business Subcontracting Plan? If so, given that our VA approved Commercial Company-wide Plan is 9 pages long, is it acceptable to the VA to provide this plan as an appendix at the end of our Technical Proposal and not count towards the 100-page limit requirement?

a. Response: Non-Veteran owned bidders: provide a Small Business Subcontracting Plan. It is acceptable to provide the plan as an attachment in the appendix of the Technical proposal.

20. 36C26324R0005-0002: (Reference: E.3 Evaluation; Page 141) Proposals will be subject to an initial screening for compliance with proposal preparation instructions. Failure to comply, will result in a proposal being excluded from competition without further evaluation of the proposal beyond the initial screening. Is the Contractor allowed to provide additional information in the proposal as long as it is within the 100 page limit or is the Experience, Activation Plan, Proposed Site and Veterans Involvement the only sections allowed in the Technical Proposal?

a. Response: Supplemental information which may present additional value to the Government may be contained within the 100-page limit.