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Page 1 3/30/2023 608 Lancaster Drive SE Salem, OR 97317 P. 503-877-1995 F. 888-990-1352
GENERAL SERVICES ADMINISTRATION
Federal Acquisition Service Authorized Federal Supply Schedule FSS Price List On-line access to contract ordering information, terms and conditions, up-to-date pricing, and the option to create an electronic delivery order are available through GSA Advantage!®, a menu-driven database system. The INTERNET address GSA Advantage!® is: GSAAdvantage.gov.
Multiple Award Schedule FSC Group: Human Capital Contract number: 47QREA23D0015 Contract period: March 27, 2023 through March 26, 2028 J.D. Health and Wellness Center Inc.
608 Lancaster Dr. SE Salem, OR 97317 503-877-1995 www.jdhealthandwellness.com Areli Fonseca areli@jdhealthandwellness.com Business size: Small Business For more information on ordering go to the following website: https://www.gsa.gov/schedules Prices Shown Herein are Net (discount deducted)
CUSTOMER INFORMATION
1a. Table of awarded special item number(s) with appropriate cross-reference to item descriptions and awarded price(s).
| 624SS |
| Social Services, Professional Counseling and Veterans' Readjustment and Behavioral Health Services |
| OLM |
| Order-Level Materials (OLM’s) |
1b. Identification of the lowest priced model number and lowest unit price for that model for each special item number awarded in the contract. This price is the Government price based on a unit of one, exclusive of any quantity/dollar volume, prompt payment, or any other concession affecting price. Those contracts that have unit prices based on the geographic location of the customer, should show the range of the lowest price, and cite the areas to which the prices apply. See Page 4 1c. If the Contractor is proposing hourly rates, a description of all corresponding commercial job titles, experience, functional responsibility and education for those types of employees or subcontractors who will perform services shall be provided. If hourly rates are not applicable, indicate “Not applicable” for this item. See Page 4
2. Maximum order:
3. Minimum order: $100
4. Geographic coverage (delivery area). Domestic
5. Point(s) of production (city, county, and State or foreign country). 608 Lancaster Dr. SE, Salem, OR 97317
6. Discount from list prices or statement of net price. Government Net Prices (discounts already deducted.)
7. Quantity discounts. None
8. Prompt payment terms. Information for Ordering Offices: Prompt payment terms cannot be negotiated out of the contractual agreement in exchange for other concessions. Net 30 days
9. Foreign items (list items by country of origin). Not Applicable 10a. Time of delivery. (Contractor insert number of days.) Contact Contractor 10b. Expedited Delivery. Items available for expedited delivery are noted in this price list. Contact Contractor 10c. Overnight and 2-day delivery. Contact Contractor 10d. Urgent Requirements. Contact Contractor
11. F.O.B. point(s). Destination 12a. Ordering address(es). 608 Lancaster Dr. SE, Salem, OR 97317 12b. Ordering procedures: For supplies and services, the ordering procedures, information on Blanket Purchase Agreements (BPA’s) are found in Federal Acquisition Regulation (FAR) 8.405-3.
13. Payment address(es). 608 Lancaster Dr. SE, Salem, OR 97317
14. Warranty provision. Standard Commercial Warranty Terms & Conditions
15. Export packing charges, if applicable. Not Applicable
16. Terms and conditions of rental, maintenance, and repair (if applicable). Not Applicable
17. Terms and conditions of installation (if applicable). Not Applicable 18a. Terms and conditions of repair parts indicating date of parts price lists and any discounts from list prices (if applicable). Not Applicable 18b. Terms and conditions for any other services (if applicable). Not Applicable
19. List of service and distribution points (if applicable). Not Applicable
20. List of participating dealers (if applicable). Not Applicable
21. Preventive maintenance (if applicable). Not Applicable 22a. Special attributes such as environmental attributes (e.g., recycled content, energy efficiency, and/or reduced pollutants). Not Applicable 22b. If applicable, indicate that Section 508 compliance information is available on Electronic and Information Technology (EIT) supplies and services and show where full details can be found (e.g. contractor’s website or other location.) The EIT standards can be found at: www.Section508.gov/.
Not Applicable
23. Unique Entity Identifier (UEI) number. MJYULPDCECQ5
24. Notification regarding registration in System for Award Management (SAM) database. Contractor registered and active in SAM
| Labor Category/Service Title |
| Labor Category/Service Description |
| Unit of Issue |
| GSA Price |
| Assessment/ Behavioral Health |
| 90791 Mental Health Assessment to determine behavioral services needed to treat mental health/Substance use disorder |
| Each |
| $371.39 |
| Psychotherapy/Individual |
| 90834 (37-51 min) Individual psychotherapy for outpatient setting |
| 37-51 Min |
| $244.33 |
| Psychotherapy/Individual |
| 90837(52-70 min) Individual psychotherapy for outpatient setting |
| 52-70 Min |
| $332.29 |
| Psychotherapy/Individual |
| 90832(16-30 min) Individual psychotherapy for outpatient setting |
| 16-30 Min |
| $185.69 |
| Psychotherapy/Family |
| 90847(26 min) Family psychotherapy with the patient present |
| 26 Min |
| $244.33 |
| Psychotherapy/Family |
| 90846(26 min) Family psychotherapy without the patient present |
| 26 Min |
| $234.56 |
| Depression Screening |
| G0444 Screening for depression |
| Each |
| $43.98 |
| Screening Brief intervention |
| 99408(15-30 min) Screening brief intervention referral and treatment is a comprehensive, integrated, public health approach for early identification and intervention with patients whose patterns of alcohol and or drug use put their health at risk |
| 15-30 Min |
| $47.89 |
| Screening Brief intervention |
| 99409(30-40 min) Screening brief intervention referral and treatment is a comprehensive, integrated, public health approach for early identification and intervention with patients whose patterns of alcohol and or drug use put their health at risk |
| 30-40 Min |
| $89.91 |
| New Patient/Office Visit |
| 99205(60-74 min Comprehensive history High complexity) Primary Care Office visit for a new patient |
| 60-74 Min |
| $478.89 |
| New Patient/Office Visit |
| 99204(45-59 min or Moderate Complexity) Primary Care Office visit for a new patient |
| 45-59 Min |
| $371.39 |
| New Patient/Office Visit |
| 99203(30-44 min or acute, uncomplicated illness) Primary Care Office visit for a new patient |
| 30-44 Min |
| $273.65 |
| New Patient/Office Visit |
| 99202(new patient, 15-29 min or no data to review) Primary Care Office visit for a new patient |
| 15-29 Min |
| $185.69 |
| New Patient/Office Visit |
| 99201(Nurse visit 5 minutes) Primary Care Office visit for a new patient |
| 5 Minutes |
| $86.01 |
| Office Follow up |
| 99215(60-76 min or Comprehensive history of High complexity) Primary Care Office visit for an established patient |
| 60-76 Min |
| $390.93 |
| Office Follow up |
| 99214(45-59 min or Acute/Chronic illness or 2-3 stable chronic conditions) Primary Care Office visit for an established patient |
| 45-59 Min |
| $293.20 |
| Office Follow up |
| 99213(30-40 min or uncomplicated illness)Primary Care Office visit for an established patient |
| 30-40 Min |
| $205.24 |
| office follow up |
| 99212(15-29 min or no data to review)Primary Care Office visit for an established patient |
| 15-29 Min |
| $146.60 |
| Office Follow up |
| 99211(nurse only)Primary Care Office visit for an established patient |
| Each |
| $92.85 |
| Covid Testing |
| 87811(Covid Testing, reporting) Collecting a Covid sample and reporting it |
| Each |
| $39.09 |
| Annual Screening |
| G0438(Annual Wellness Exam) A patients first annual Wellness Visit designed to detect and prevent illness |
| Each |
| $234.56 |
| Case Management |
| T1016 per 15 minutes(Case management 1 unit per 15 min) Managing and coordinating care of a patient(staff meetings, status reports, communicating with other agencies such as the legal system, parole and probation, DHS, homeless shelters, VA etc. |
| 15 min |
| $43.98 |
| Treatment Planning |
| H0032(Treatment Planning) Designing a patients service Plan |
| Each |
| $146.60 |
| Group Therapy |
| 90853(Group counseling 1 unit every 45 minutes) Group therapy |
| 45 min |
| $146.60 |
| Program Screening |
| T1023(Program Screening for program participation) Screening to Determine if a client is eligible for a recommended program, level of care or treatment modality |
| Each |
| $93.27 |
| Phone Call |
| 98966 (Telephone assessment of patients condition, developing a plan for follow up) |
| Each |
| $136.83 |
| Phone Call |
| 98967 (Telephone assessment of patients condition and developing a follow up plan |
| Each |
| $155.40 |
| Phone Call |
| 98968 (Telephone assessment of patients condition and developing a following up plan |
| Each |
| $165.17 |
| Transition Care |
| 99495 (Medical care provided after released from the hospital |
| Each |
| $342.07 |
Service Contract Labor Standards: The Service Contract Labor Standards (SCLS), formerly known as the Service Contract Act (SCA), is applicable to this contract as it applies to the entire Multiple Award Schedule (MAS) and all services provided. While no specific labor categories have been identified as being subject to SCLS/SCA due to exemptions for professional employees (FAR 22.1101, 22.1102 and 29 CRF 541.300), this contract still maintains the provisions and protections for SCLS/SCA eligible labor categories. If and / or when the contractor adds SCLS/SCA labor categories to the contract through the modification process, the contractor must inform the Contracting Officer and establish a SCLS/SCA matrix identifying the GSA labor category titles, the occupational code, SCLS/SCA labor category titles and the applicable WD number. Failure to do so may result in cancellation of the contract.
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