Vendor Questions

1 Will you provide the list of participants and contact information for individuals attending the preproposal conference?

ANSWER: No, a participant list nor the contact information will be made available.

2 What are the surgical capabilities on post? GeneralQuestion

ANSWER: All elective procedures. See list on Performance Work Statement (PWS) page 7, Section 1.6.4.

3 How many Operating Rooms are on post? GeneralQuestion

ANSWER: Three.

4 Can the RFP be split into two separate RFP’s one for a base/post component and the second for an off base/post? General Question

ANSWER: No.

5 Can you clarify the hours related to availability of services (outpatient, hospital, emergency and clinic) (PWS Page 1 1.2.2)

ANSWER: It is in the PWS regarding the availability of the specialty.

6 Can you confirm that the On call 24 hr telephone standby is for 7 days a week? (PWS Page 1 1.2.2)

ANSWER: Yes.

7 If we hire an American state licensed, and credentialed doctor for work on-base/post, are they required to have approval by the Turkish Health Department? General Question

ANSWER: No. However be advised that Per Article VI of Supplementary Agreement 3 [Installations] to the Agreement for Cooperation on Defense and Economy (DECA) says that "For the purposes of this Agreement, material, equipment, provisions, supplies, services, and civilian labor required by the Government of the United States shall be procured in Turkey to the extent feasible." In addition to this, access to the installation is solely under the control of the Turkish installation commander. The commander can prevent access to the base for any contractor, and may use that authority to enforce Article VI accordingly.

8 How many procedures are done off-base/post annually? General Question

ANSWER: Varies due to emergent nature of the patients needs.

9 Are the procedures done off-base/post reimbursable? General Question.

ANSWER: Yes, an example is provided in the contract in order to be reimbursed for any off base procedures and overtime that is stipulated in the PWS.

10 Is it possible for a Turkish business concern to provide more than one individual in support of this contract (i.e. a full-time individual, 40 hours per week on-base/post in support of the clinic and call back hours, while a second part-time individual 20 hours per week works with the major local hospital consultations.)? General Question

ANSWER: If you provide a bid as a company all individuals that will provide service must meet all the same criteria.

11 Will you provide a list of the list of major local hospitals, to include address, phone and point of contact information in which the 39 MDG maintains preferred provider network agreements? PWS Page 3 1.2.2

ANSWER: This information must be obtained from Tri –Care.

12 If the company is allowed to have 2 individuals supporting the requirements of the Performance Work Statement (PWS), can the individual provider (Anesthesiologist) working the clinic portion of the hours on base be an American citizen? General Question

ANSWER: Yes, if the company is Turkish. However be advised that Per Article VI of Supplementary Agreement 3 [Installations] to the Agreement for Cooperation on Defense and Economy (DECA) says that "For the purposes of this Agreement, material, equipment, provisions, supplies, services, and civilian labor required by the Government of the United States shall be procured in Turkey to the extent feasible." In addition to this, access to the installation is solely under the control of the Turkish installation commander. The commander can prevent access to the base for any contractor, and may use that authority to enforce Article VI accordingly.

13 Can the Turkish business concern who hires an American citizen who meets the educational, performance and credentialing requirements of the PWS receive a waiver for approval by the Turkish Health Department for work performed in the MTF? PWS N/A General Question

ANSWER: The bidding contractor will have to resolve this issue with the Ministry of Health.

14 How many anesthesiologists may the company credential in support of this contract award? (PWS Page 6 1.4)

ANSWER: The preference is no more than three-four: a main reason is continuity.

15 How long is the credentialing process if a completed packet is submitted in accordance with AFI 44-119 and by whom? (PWS Page 6 1.3.1)

ANSWER: If all documentation is provided and in order, it could be less than three weeks. Credentialing is accomplished by 39 Medical Group personnel.

16 Do credentialing packets which are submitted upon award date and then final authority by the MTF is not granted at no cause of the Turkish business concern, will the start date of within 5 days after contract award be extended? (PWS Page 6 1.3.2)

ANSWER: PWS, page 6, 1.3.1 “…The anesthesiologist is responsible to ensure that proposed credentials are sufficient to enable the granting of privileges by the MTF sufficient to allow for performance of all tasks identified in Section C-5 of this SOW…”

17 If the physician has graduated from an approved US school of medicine and is residency trained in Anesthesia outside of the country, will the credentials be deemed acceptable by the Turkish Doctor’s Chambers? (PWS Page 7 1.6.1)

ANSWER: The bidding contractor will have to resolve this issue with the Ministry of Health.

18 If we have more than one individual supporting this requirement for non-personal services, can those individuals we have supporting the 39 MDG clinic be a Non-Turkish National working for a Turkish business concern? PWS N/A General Question

ANSWER: The individuals that are providing service must be able to communicate not only with American(s) patients but be able to dialog with the Host Nation facilities physicians.

19 Will the Turkish Ministry of Health certify Non-Turkish Nationals as Anesthesia Specialists if the doctors have equivalent credentials from their country of origin? (PWS Page 7 1.6.3)

ANSWER: The bidding contractor will have to resolve this issue with the Ministry of Health.

20 Will the contractor’s doctors be required to exhibit competency regarding training and experience of rapid sequence intubation & proper protocols for the use of Dantrolene thru documentation or hands-on demonstration. (PWS Page 7 1.6.4)

ANSWER: Verification of competency is completed by the credentialing office and during the interview process you may be asked to describe the steps in both procedures above.

21 Throughout Section 1.6 and the PWS, there is reference to both the Anesthesiologist and the Contractor turning in all supporting documents prior to contract performance. Can you provide a point of contact for the documents to submit to upon contract award? (PWS Page 7 and the document 1.6)

ANSWER: Documents shall be provided prior to contract performance not upon contract award. It is preferred that documents be provided to the 39th Contracting Squadron with the proposal.

22 In regard to performing certain types of anesthesia procedures, does this detailed list take precedence over the experience criteria noted in the PWS Page 7, Section 1.6.4? RFP Page 13 of 34 1 (a) (ix)

ANSWER: There is no precedence. The list of proceedures stated on page 13 under C. Specific Instructions 1. PART I – Technical Proposal, a (ix) must have proof of experience provided as part of the technical proposal in support of the evaluation factors as stated in provision 52.212-2 and found to be technically acceptable. Additionally, 52.212-2 (c) (e) states that the offeror’s attempt at both the conditions of the solicitation and the PWS will be evaluated on a pass/fail basis.

23 In regard to work history, does this detailed requirement take precedence over experience criteria noted in the PWS, Page 7, Section 1.6.4 RFP Page 13 of 34 1 (a) (viii)?

ANSWER: There is no precedence. The list of proceedures stated on page 13 under C. Specific Instructions 1. PART I – Technical Proposal, a (viii) states what documentation must be provided as part of the technical proposal in support of the evaluation factors as stated in provision 52.212-2 and found to be technically acceptable. Additionally, 52.212-2 (c) (e) states that the offeror’s attempt at both the conditions of the solicitation and the PWS will be evaluated on a pass/fail basis.

24 Can you supply a list of the govt. provided equipment to include medications, anesthesia equipment, oxygen, disposable anesthesia supplies and anesthesia machine, etc for the base year and option years? RFP Page 3 of 34 0001

ANSWER: We have a fully functional anesthesia department the orientation of a new employee(s) will be accomplished regarding any and all materials, equipment utilized by the contractor after the bid has been awarded.

25 Can you provide the volume and type of patients and procedures which will require the tools, incidental materials, etc for the base and option years? RFP Page 3 of 34 0001

ANSWER: We have a relatively healthy population and the capability of the facility is to do mostly ASA I & II’s with the occasional III. Any and all equipment needed to run a clinic, surgery and provide anesthesia will be provided by the MTF.

26 Can we provide a breakout cost of labor separate from tools and materials? RFP Page 3 of 34 0001

ANSWER: No, any and all equipment needed to run a clinic, surgery and provide anesthesia will be provided by the MTF.

27 Can you provide the estimated number of consultations handled off-base for the base and option years? RFP Page 3 of 34 0002

ANSWER: Varies due to emergent nature of the patients needs.

28 Will you provide a copy of the TMA fee schedule in English? RFP Page 3 of 34 0002

ANSWER: The TMA schedule is not in English and will have to be translated by the contractor as has been accomplished by this MTF.

29 Can you explain the negotiated profit rate for Anesthesia services for the base and option years of this solicitation? RFP Page 3 of 34 0002

ANSWER: See Q&A #37

30 Can you clarify why compensation for services rendered in support of L&D start after the second hour and not at initiation of care for both the base and option years? RFP Page 4 of 34 0003

ANSWER: No.

31 In support of L&D services, do we need to provide tools, incidentals and materials for both the base and option years? RFP Page 4 of 34 0003

ANSWER: L&D services are commonly accomplished in hospitals contracted with Tri-Care. Any and all incidentals and materials are provided by these hospitals.

32 Can you clarify the number and type of cases for L&D services which are rendered on an annual basis currently? RFP Page 4 of 34 0003

ANSWER: The number is fluid due to the turnover rate of beneficiaries.

33 Can you clarify if L&D Services are rendered after 40 hrs per week or call back hours, we may charge an additional fee as well as profit for our lump sum price? Will this price vary between the base and option years? RFP Page 4 of 34 0003

ANSWER: The price quoted shall include all profit and fees associated with the service. Variance will be up to the offeror.

34 Can you clarify who will schedule the contractor anesthesiologist and who determines the contractor hours as the is deemed a “Non-Personal Services Contract” (PWS Page 3 1.2.2)

ANSWER: The schedule is set weekly by the Surgical Services Flight Commander and this is based on the needs of the MTF.

35 Can you clarify the language “as required and directed by the MTF” with regard to on-call coverage where this could be perceived as relatively continuous supervision, while this is regarded as a “Non-Personal Services Contract”? (PWS Page 3 1.2.2.1)

ANSWER: Continuous supervision is accomplished by the Quality Assurance Personnel (peer reviews) and by Staff Assistance which are USAF credentialed Anesthesiologist.

36 What are the malpractice rules for Turkey? (PWS Page 9 1.14)

ANSWER: The minimum liability amounts are on the proposal. The offeror will need to research any other rules, laws or direction that is required for Turkey.

36 Due to the posting of questions and Answers following the pre-proposal conference, would you consider extending the proposal submission date in order to provide a proper response? General Question

ANSWER: The proposal due date has been extended accordingly.

37 Item # 0002 , 1002, 2002, 3002, 4002 are not clear. Without knowing the number of external patients per month it is not possible to fill this section. There may be many when the Base OR is closed.

Answer: The required entry for CLINs 0002, 1002, 2002, 3002, 4002 is the profit rate that the contractor expects above the proceedure fee as listed in the Turkish Medical Association Minimum Fee Tariff. The profit rate is to be presented as a percentage. The formula presented in the solicitation is based on the fees as taken from the Turkish minimum fee schedule and increases the procedure by the contractor’s profit rate. This profit rate should be an overall average and should include all expenses outside of the proceedure fee. The same profit rate will be applied to each proceedure.

38 The sample prices mentioned at 14 of 1449 page doesn’t have Hospital Conversion Factor which is x1 for avarage hospitals like Universale or private clinics or private offices. Acibadem and BSK Metropark Hospitals have already declared their conversion factors as x2 to SOS. For being able to give anesthesia at those hospitals I am supposed to have a contract with (either) of them which forces me to give 50 or 60% of the amount I earn to them and 40% as tax to Turkish government. What profit rate are we talking about ?

Answer: The profit rate asked for in CLINs 0002, 1002, 2002, 3002, 4002 and discussed in the Addendum to 52.212-1,PART II - Price Proposal, (e); consists of any expenses the contractor would incur or monies required that are over and above the proceedure fees called out in the Turkish Medical Association Minimum Fee Tariff.