36C26325R0004 0005.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. NUMBER3. 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 9

0005 N/A

36C263

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

316 Robert Street N. STE. 506

St. Paul MN 55101

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

316 Robert Street N. STE. 506

St. Paul MN 55101

To all Offerors/Bidders 36C26325R0004

X

X X

X 1

The purpose of this amendment is to post Questions and Answers.

Daniel Vagts

Contract Officer

VA-VHA-SAOC-2019-161D3612

Questions and Answers

#1

1.4.9 VHA Directive 1220(1): Facility Procedure Complexity Designation Requirements to Perform

Invasive Procedures in Any Clinical Setting

1.4.12 VHA Handbook 1100.17: National Practitioner Data Bank (NPDB) Reports

1.5.1 ABIM: American Board of Internal Medicine http://www.abim.org/

1.5.2 ACGME: Accreditation Council for Graduate Medical Education

1.5.3 ACLS: Advanced Cardiac Life Support

1.5.7 Clinical Privileging: Clinical Privileging is the process by which a practitioner, licensed for independent practice; e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration, etc.; is permitted by law and the facility to practice independently, to provide specific medical or other patient care services within the scope of the individual’s license, based upon the individual’s clinical competence as determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility-specific and provider-specific, and within available resources.

1.5.16 DEA: Drug Enforcement Agency

1.5.17 FSMB: Federation of State Medical Boards

1.5.25 Medical Emergency: A sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably result in:

Permanently placing a patient's health in jeopardy, causing other serious medical consequences, Causing impairments to body functions, or Causing serious or permanent dysfunction of any body-organ or part.

• We respectfully ask the government to remove these, as it is not applicable to Audiology Technicians.

Answer: These are boiler plate definitions that are contained on all current PWS formats.

#2

2.1.3 Credentialing and Privileging: Credentialing and privileging are to be done in accordance with the provisions of VHA Directive 1100.20 and VHA Directive 1100.21 referenced above. The Contractor is responsible to ensure that proposed physician(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any Key Personnel prior to obtaining approval by the Facility Medical Executive Board and Medical Center Director.

http://www.abim.org/

Answer: 2.1.3 Credentialing and Privileging: N/A

#3

2.1.4 Technical Proficiency: Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all Key Personnel and contractor’s physician (s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

Answer: No. That is critical verbiage holding the contractor and key personnel accountable.

#4

2.1.5 Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the facility. Key Personnel registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. Contractor shall report CME hours to the credential’s office for tracking.

These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for contract physician(s).

• We respectfully ask the government to remove these, as privileging is not applicable to Audiology Technicians.

Answer: 2.1.5 Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements: N/A

#5

2.1.7.5 INFLUENZA: Contractors shall provide proof that all Contractor physicians have received the annual Influenza vaccine unless it is contraindicated. If the Contractor physician has a medical contraindication to the vaccine they shall be required to wear a mask during the Influenza season. {This is applicable to all health care workers}.

• Current VHA guideline VHA Directive 1192.01 Seasonal Influenza Prevention Program (attached regulation) allows for both Medical and Religious Declination of the Influenza Vaccine as long as the VHA Directive 1192.01Appendix B form is completed and provided.

o Please note that the solicitation references this VHA Directive as applicable in section

1.4.8 of the RFP.

• In this PWS section, we ask you remove the requirement of Influenza vaccine “unless medically contraindicated” and replace with medical or religious reasons for declination compliant with VHA Directive 1192.01 Seasonal Influenza Prevention Program, to be compliant with the VHA Directive.

• We also ask you to please remove the phrase “physician”

Answer: These are boiler plate directives that are contained on all current PWS formats. The term “Key Personnel” can be inserted to replace “Contractor Physicians.”

#6

2.1.7.5 INFLUENZA: Contractors shall provide proof that all Key Personnel have received the annual

Influenza vaccine unless it is contraindicated. If the Key Personnel has a medical contraindication to the vaccine they shall be required to wear a mask during the Influenza season. {This is applicable to all health care workers}.

#7

2.1.10 Conflict of Interest: The Contractor and all Key Personnel are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance. At the time of proposal, the Contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest

(financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided. The Contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services. The

Contractor must also provide relevant facts that show how it’s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70 Organizational

Conflicts of Interest and fully outlined in response to the subject attachment in Section D of the solicitation document.

• We do not believe this is relevant to the Audiology Technician requirement; will the government please review this and remove it if it is not applicable.

Answer: The Conflict of Interest definition is essential verbiage that provides clarity to the issue.

#8

2.3 Non Personal Healthcare Services: The parties agree that the Contractor and all contractor’s physician(s) shall not be considered VA employees for any purpose.

• We respectfully ask the government to amend this as applicable to Audiology Technicians not physicians.

Answer: 2.3 Non Personal Healthcare Services: The parties agree that the Contractor and all key personnel shall not be considered VA employees for any purpose.

#9

4.2 Standards of Care: The Key Personnel’ care shall cover the range of Hospital Medicine Physician services as would be provided in a state-of-the-art health care treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by:

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

4.2.4 The professional standards of The Joint Commission (TJC) http://www.jointcommission.org/

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

4.2.6 The requirements contained in this PWS.

4.2.1 The Society of Hospital Medicine (http://www.hospitalmedicine.org ) would be the most reasonable replacements.

Answer: No. These are still key references and fall backs for all standards of care.

#10

4.7.4 Performance Standards: 4.7.4.2 Measure: Qualifications of Key Personnel

Performance Requirement: All Key Personnel shall be certified in accordance with HIS Standards.

Standard: All (100%) contract physicians are certified.

Acceptable Quality Level: 100%

Surveillance Method: Periodic Inspection or Random Sampling of qualification documents.

Frequency: Upon Certification

• We respectfully ask the government to remove these, as it is not applicable to Audiology Technicians.

4.7.4 Performance Standards: 4.7.4.2 Measure: Qualifications of Key Personnel

Performance Requirement: All Key Personnel shall be certified in accordance with contract PWS requirements.

Standard: All (100%) contract physicians are certified.

Acceptable Quality Level: 100%

Surveillance Method: Periodic Inspection or Random Sampling of qualification documents.

Frequency: Upon Certification http://www.abim.org/ http://www.jointcommission.org/ http://www.hpoe.org/resources?show=100&type=8 http://www.hospitalmedicine.org/

#11

4.7.4 Performance Standards: 4.7.4.3 Measure: Scope of Practice

Performance Requirement: Key Personnel perform within their individual scopes of practice/privileging.

Standard: All (100%) Key Personnel perform within their scope of practice/privileges 100% of the time.

Acceptable Quality Level: 100%.Key Personnel perform within their scope of practice/privileges 100% of the time.

Surveillance Method: Random Sampling of records.

Frequency: Quarterly

Technicians as they are not privileged.

Answer: Scope of practice is the set of activities that a health care professional is permitted to perform based on their education, training, and experience. Please use this version that doesn’t have privileging.

4.7.4 Performance Standards: 4.7.4.3 Measure: Scope of Practice

Performance Requirement: Key Personnel perform within their individual scopes of practice.

Standard: All (100%) Key Personnel perform within their scope of practice 100% of the time.

Acceptable Quality Level: 100%.Key Personnel perform within their scope of practice 100% of the time.

Surveillance Method: Random Sampling of records.

Frequency: Quarterly

#12

4.7.4.4 Measure: Time and Attendance

Performance Requirement: The Contractor shall provide contractor’s physician(s) in accordance with the operating hours and VA clinical schedule outlined in this PWS.

Standard: All (100%) contractor’s physician(s) are on time and available to perform services.

Acceptable Quality Level: Contractor’s physician(s) is on-time and available to perform services 95% of the time.

Surveillance Method: Periodic Inspection of Time and Attendance Sheets

Frequency: Monthly

• We respectfully ask the government to update this as applicable, and please remove the reference physicians

Answer: Please use this corrected version with key personnel.

4.7.4.4 Measure: Time and Attendance

Performance Requirement: The Contractor shall provide key personnel in accordance with the operating hours and VA clinical schedule outlined in this PWS.

Standard: All (100%) key personnel are on time and available to perform services.

Acceptable Quality Level: Key personnel are on-time and available to perform services 95% of the time.

Surveillance Method: Periodic Inspection of Time and Attendance Sheets

Frequency: Monthly

#13

PWS 6.1.1 QASP: ACLS/BLS Certification

• We respectfully ask the government to remove ACLS as it is not applicable to Audiology

Technicians

Answer: Just strike ACLS. Here is the updated version.

BLS Certification Upon award and every year after award.

COR

#14

Section C – Page 69 – FAR Part 52.222-42: [X] (2) 52.222-42, Statement of Equivalent Rates for Federal

Hires (MAY 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67) - the Employee Class and the Monetary Wage-

Fringe Benefits are blank

• Compliant with the Service Contract Labor Standards statute we ask the government to please provide this information

Answer: Service Contract Act doesn’t apply to this solicitation.

The following are unchecked/N/A:

52.222-54 52.222-41 52.222-42 52.222-43 52.222-55 52.222-62

#15

E.3 PROPOSAL SUBMITTAL INSTRUCTIONS - ADDENDA TO 52.212-1 PROPOSAL PREPARATION

INSTRUCTIONS

Part 1 TECHNICAL PROPOSAL (d) offeror shall submit a listing of personnel in the following format within the Schedule of Services:

• Please confirm that this information is correct and in the appropriate section; Schedule of Services is required as part of the Pricing Volume Part 3

Answer: Confirmed.

#16

PART 2 – PAST PERFORMANCE: The government is especially interested in recent and relevant past performance that relates very closely to the requirement set forth in the performance-based work statement.

• We request the government provide its definition of “recent” as outlined above; it is our assumption the government’s definition of recent are contractual efforts worked in the last 36-month period from the time of submission due date, however, would like confirmation of the “recent” criteria evaluation factor.

Answer: Past three years.

#17

• We request the government provide its definition of “relevant” more importantly its definition of “relates very closely” as a quantifiable evaluation criterion. In our research of active/inactive within 36-month Audiology Technician contracts at the VA, there is only one – the incumbent for this RFP. We would like to know what the government defines as “relates very closely to”.

o Additionally, #2 specifically asks vendors to provide “relevant” Past Performance examples of contracts performed.

1. Identify the type and scope of practice for the past three (3) years addressing professional background, experience, and level of professional competence.

• We believe that this is an error and relevant to physician practice, and respectfully ask the government to remove this.

Answer: Error removed.

#18

Technical Sub Factor B Clinical Experience:

• The offeror must provide information regarding optician’s ability to meet clinical requirements by providing information on experience to include: Number of years of experience and Information regarding any special training

• We believe that this is an error and is meant to refer to Audiology technicians, will the government please advise/amend.

Answer: Issued new amendment 36C26325R0004 0006 – Technical Evaluations Factors

#19

Technical Sub Factor C Clinical Skills: The offer must provide information that demonstrates the

Audiology Technician skills and expertise. This includes information regarding:

• Furnish a list of three (3) references (within the last three years) including phone numbers of persons with direct knowledge of Audiology Health Technician skills and can provide information on the Audiology Health Technicians clinical abilities and expertise.

o The resultant award is a non-personal services contract, and the provision of references for outreach directly by the government prior to a contract award creates the illusion of an employer-employee relationship. The VA receives and reviews references of all candidates through the VetPro/Credentialing process. We respectfully request the government remove this requirement.

Answer: Removed issued amendment 36C26325R0004 0006 – Technical Evaluation Factors

#20

NAICS Code: There is not a NAICS code on the 1449, however the SAM posting shows the NAICS at

621340 - Offices of Physical, Occupational and Speech Therapists, and Audiologists.

• This NAICS code is defined as “This industry comprises establishments of independent health practitioners primarily engaged in one of the following: (3) diagnosing and treating speech, language, or hearing problems. These practitioners operate private or group practices in their own offices (e.g., centers, clinics) or in the facilities of others, such as hospitals or HMO medical centers. Illustrative Examples: Audiologists' offices” o Can the government confirm that this is the correct NAICS code since Audiology Technicians are not the same labor category or qualified as “Audiologists” as referenced in this NAICS explanation.

Answer: Switched to 541990 – All Other Professional, Scientific and Technical Services.