CLASS Draft RFP and Industry Day Question Set.pdf

CLASS Draft RFP and Industry Day Question Set

ID Date Question Response

PRE-INDUSTRY DAY QUESTIONS

1 23 Nov 10 I see this is a follow-on effort. I was wondering if you could provide the incumbent name, as well as the contract number for the current/previous CSS effort.

The following contracts and Contractors were/are part of the Clinical Support Services (CSS) effort:

FA7014-06-D-0001- American Hospital Service Group

FA7014-06-D-0003 - The Healing Staff

FA7014-06-D-0004 - RLM Services

FA7014-06-D-0005 - TerraHealth Services, Inc.

FA7014-06-D-0015 - Luke And Associates

FA7014-06-D-0016 - Magnum Medical, JV

2 24 Nov 10 Is FA7014-06-D-0001 still expected to expire on 11/14/2015?

Is FA7014-06-D-0002 still expected to expire on 11/14/2015?

Is FA7014-06-D-0003 still expected to expire on 11/14/2015?

Is FA7014-06-D-0004 still expected to expire on 11/14/2015?

Is FA7014-06-D-0005 still expected to expire on 11/14/2015?

Is FA7014-06-D-0015 still expected to expire on 11/14/2015?

Is FA7014-06-D-0016 still expected to expire on 11/14/2015?

Where may I locate the solicitation for the follow-on discussed under

FA8053-11-R-0002?

The following contracts ended on 14 Nov 09:

FA7014-06-D-0003

FA7014-06-D-0016

The following contracts will end in May 2012:

FA7014-06-D-0001

FA7014-06-D-0004

FA7014-06-D-0005

FA7014-06-D-0015

The DRAFT solicitation for the follow-on contracts is located on the www.fbo.gov website at:

https://www.fbo.gov/notices/464f5c42eb33c36cd54130d

73fe3a5fa.

3 24 Nov 10

Where may I locate the solicitation for the follow-on discussed under

FA8053-11-R-0002?

See response to question 2

4 29 Nov 10 Will there be match making sessions for businesses who attend the event?

There will not be formal networking sessions at the

Industry Day event. However, there will be several lengthy breaks and a long lunch period allotted for all attendees, which should provide networking opportunities.

5 29 Nov 10 Will vendors who do not attend industry day be eligible to submit proposals in response to this solicitation?

Attendance at Industry Day is not a requirement to submit a proposal in response to the solicitation.

http://www.fbo.gov/ https://www.fbo.gov/notices/464f5c42eb33c36cd54130d73fe3a5fa https://www.fbo.gov/notices/464f5c42eb33c36cd54130d73fe3a5fa

6 29 Nov 10 What is the agenda for the Dec. 14 event?

The agenda can be found on FedBizOpps in the CLASS

Industry Day Notice

(https://www.fbo.gov/download/cff/cff913b3e1a5de40ec

32dca57f4f6ac3/CLASS_Industry_Day_Notice.pdf)

7 29 Nov 10 What are the Air Force diversity recruitment goals for permanent clinical staffing positions at Air Force MTF's?

The draft RFP does not discuss the Air Force goals for the permanent staff, but rather is designed for contractor clinical personnel to supplement permanent Military

Treatment Facility (MTF) staff.

8 29 Nov 10 Is there an incumbent for these services? If so, who? See response to question 1

9 30 Nov 10 Will you release the names of the companies who responded to the

CLASS Market research RFI?

The Government will not release the names of the businesses who replied to the CLASS market research request for information. However, the Government will post the names of the businesses that attended the

CLASS Industry Day on www.fbo.gov.

10 3 Dec 10 In review of the draft posted on FBO we noticed that in Attachment

8, Table B-1 under “Base” there is listed a number as opposed to a name. Would we be able to get something that tells us which MTF corresponds to which base number? This would be immensely helpful in market research.

This is a Draft RFP and Attachment 8, Table B-1 is a representation of what the Representative Task Order will look like in the final RFP.

The Government will not publish the names of the bases for the draft RFP. The Final RFP will have the respective bases listed.

11 8 Dec 10 Will all Contracting Offices be held to the same standardized task order process?

All ordering Contracting Offices will use the task order process in Section H.2 for Representative Task Orders, and the task order process in Section H.3 for Subsequent

Task Orders.

12 8 Dec 10 Will Contracting Offices be allowed to request TOPR responses in a period less than the 10 calendar day response time identified in the contract?

The Government did not intend for the response time to be shorter; however, the Government will consider this area (see response to question 13). Keep in mind, a contractor can always submit qualifying documentation before the 10 calendar days.

13 8 Dec 10

If TOPR responses are required in less than 10 calendar days, can a

Contractor opt not to accept the TOPR request which is technically

The Government will consider this adjustment, should shorter response times be allowed.

https://www.fbo.gov/download/cff/cff913b3e1a5de40ec32dca57f4f6ac3/CLASS_Industry_Day_Notice.pdf https://www.fbo.gov/download/cff/cff913b3e1a5de40ec32dca57f4f6ac3/CLASS_Industry_Day_Notice.pdf http://www.fbo.gov/ not in the scope of the 10 day response time and if they decline to respond, will this count toward the 85% Task Order response rate?

14 8 Dec 10 On page 34 of the Draft solicitation if the CO does not receive qualifying documentation after sending the Letter of Intent to Award to a third contractor after validating a requirement the CO may consider cancelling the TOPR. If the TOPR is cancelled will the

Government still count the failure of the contractors who were unable to provide the qualifying documentation against them per the

Services Summary, or will this not be counted since the TOPR was cancelled?

Yes, the LOIA will be counted against the Contractor.

15 8 Dec 10 Will the professional positions (most specifically doctors) fall under different criteria since the recruiting pools for these positions are much smaller?

The Government will follow the recruiting requirements outlined in Section H.3 for subsequent task orders.

16 8 Dec 10 Is this watch list internal to the Government or public to all contract holders?

This watch list is internal to the Government. However, contract statistics will be available to all contractors using the blind benchmark approach, which will show the performance statistics without identifying individual contractor names.

17 8 Dec 10 Any small business joint venture must be formed with all small business entities that meet the size standard of the procurement. Is this interpretation correct?

All joint ventures must comply with 13 CFR 121.103(h).

18 8 Dec 10 Only a joint venture formed under the 8(a) Mentor Protégé program can include a large business. Is this interpretation correct?

All joint ventures must comply with 13 CFR 121.103 and the requirements of the Mentor-Protégé program identified in 13 CFR 124.520, as well as any other applicable regulation or requirement.

19 8 Dec 10 In reviewing the explanation of the Sample Allocation Table, we see that a company may be the low bidder but not receive a Task Order

Award if the contractor has maxed out their allocation. If this allocation table is the controlling factor for determination of award, does this supersede the requirement that all awardees must bid on at least 85% of the TOPRs in order to receive a positive performance rating once they have reached their allocation limit and they cannot receive additional awards?

The allocation table for the representative task order is not a controlling factor for task order awards, but rather the method the Government intends to use to allocate the representative task order requirements to each of the contractors. The base contracting offices may award all, some, or none of the requirements. The 85% participation rate applies only to task order proposal requests for subsequent task orders.

20 8 Dec 10 If awards are determined by the allocation table format in Table

H-1, how does that correlate to the LOIA process wherein if a contractor cannot fill a position within 10 calendar days, the

LOIA will be issued to the next closest offer? Does the process prevail or the allocation table prevail?

The Program Management Office (PMO) will use the representative task order (RTO) allocation method to allocate requirements on the RTO to base contracting offices. The base ordering Contracting Officers will issue an LOIA to the Contractor allocated to their base requirements. Ordering Contracting Officers may award all, some or none of their RTO requirements. If the

Contractor is not able to fill a position after receiving a

LOIA, the base ordering Contracting Officer will follow the process in Section H.2 and H.3.

21 8 Dec 10 If the contractor has 60 days after an award for a credentialed

HCW to start employment, why is the contractor being given only 30 days for a replacement credentialed HCW to start in the case of a backfill?

The Government expects the Contractor to manage their existing staff and minimize the gaps between fills as necessary to ensure a vacancy does not exceed 30 calendar days. The only exception to the 30-day vacancy requirement is for the permanent replacement of credentialed health care workers due to sudden loss, such as serious injury or death, which allows the Contractor 60 days to recruit a replacement.

22 8 Dec 10 Due to the nature of this process, does this mean that resumes will not be required in the TOPR response?

Qualifying documentation for the individual HCW is required by the Government to demonstrate the potential candidate meets the preliminary Government minimum qualifications for education, experience, certification and licensure. This documentation is only required after the

Contractor receives an LOIA. What documentation the

Contractor uses to demonstrate the candidate meets the preliminary Government minimum requirements, such as resumes, is based on the Contractor's process.

23 8 Dec 10 Will only one contractor receive the Letter of Intent to Award? If the best value Contractor provides acceptable qualifying documentation, and the MTF approves the candidate, then only one Contractor will receive an LOIA. If either of those two criteria is not met, the ordering Contracting

Officer will follow the process in Section H.2 and H.3.

24 8 Dec 10 2.2.1.2.1 states: Credentialed HCWs will be subject to the credentialing and privileging requirements of AFI 44-119, Clinical Performance Improvement, to include adverse actions.

Could the Government please provide clarification on what is meant by "to include adverse actions"?

Adverse action relates to the clinical adverse action “due process” for health care workers outlined in Chapter 9, AFI 44-119.

25 8 Dec 10 2.2.1.2.5 states: The Contractor shall make all proposed credentialed HCWs available for interview (via telephone) by the MTF during the recruiting and credentialing process. Due to the critical nature of the positions included in this contract, we would like to recommend that the Government consider using face-to-face interviews instead of telephone.

The Government anticipates the recruiting effort to be conducted locally, regionally and nationally, and, will not pay travel expenses for candidates recruited outside of the local area. Should any candidate request an on-site visit, the Government will not reimburse those expenses as outlined in H.3.

26 8 Dec 10 Could the Government please provide a more concise explanation of what is expected for this approach to monitoring and maintaining expenditure rates?

Please see Section M4.3.3.2 Contract Compliance

Measure of Merit: This requirement is met when the offeror demonstrates through flowcharts, checklists, critical decision points, fill rates, timelines, milestones, and tracking and monitoring of billable hours as established in the work schedule for credentialed and non-credentialed HCWs a methodology that ensures expenditure rates meet the AQL based on the average hourly rates in Table H-4.

27 8 Dec 10 2.4.3.1.5 Medical Tests. No medical tests or procedures required by the contract will be performed by the Government

(with the exception of Tuberculosis testing after start of work and/or exposure). Expenses for all required tests and/or procedures (e.g., N95 particulate respirator duckbill mask fitting) shall be borne by the Contractor or HCW at no expense to the Government.

This paragraph seems to conflict with paragraph 2.4.3.1.1.

Please clarify?

Paragraph 2.4.3.1.1 discusses immunizations prior to start work and post blood borne exposure protocols for exposure in the work environment. Paragraph 2.4.3.1.5 discusses medical tests or procedures required to perform services. For example, should exposure or occupational health hazards exist during work, the Government will follow established protocols at no cost to the Contractor;

however, should a particular type of work require an N95 mask, the cost associated with the fitting will be borne by the Contractor.

28 8 Dec 10 2.4.3.1.6 Health Notifications: The Contractor should inform the Government quality assurance personnel (QAP)/Supervisor whenever a HCW will be away from work for an extended period of time for medical reasons (e.g., pregnancy). The

Government will notify the Contractor of any work hazards. If work hazards exist, it will be the Government’s decision whether the HCW continues work in the environment. Could the Government clarify the meaning of "extended period of time"?

Table C-1 Services Summary states that vacancies do not exceed 30 days.

29 8 Dec 10 2.4.10.2.1.1 The MTF Unit Security Manager is expecting the

HCW’s arrival and is available to receive and process the security package (i.e., SF-85P, Questionnaire for Public Trust

Positions) either through a secure website called Electronic

Questionnaires for Investigations Processing (e-QIP) Direct or from a downloadable form on the Office of Personnel Manage-ment (OPM) Website. Will the desired submission method be specified in the TOPR?

The TOPR will not include security information. The

Government provides the Unit Security Manager information when awarding a task order as outlined in

Section H.2 and H.3.

INDUSTRY DAY QUESTIONS

30 14 Dec 10 Will the Government provide incumbent contact information with the

LOIA (there will obviously be some incumbents who will wish to retain their positions).

The Government may provide incumbent information for non-

Service Contract Act (SCA) positions with the Task Order

Proposal Request (TOPR) for subsequent task orders when the information is available. The Government will comply with

FAR Part 52.222-41(n) for SCA covered positions.

31 14 Dec 10 Who (position) is responsible for conducting the phone interviews with our candidates – will it be different at each MTF?

The Quality Assurance Personnel (QAP) will conduct the interview at the MTF when desired; however, the Service

Contract Manager (SCM) will coordinate the interview with the health care worker (HCW) and the QAP. The name of the

SCM will be provided to the contractor with the LOIA.

32 14 Dec 10 Since this is a personal services contract, are specialty providers’ salaries limited to a max rate of $400k/ year? Is this going to be a problem for

AFMS?

The total amount of compensation paid to a HCW cannot exceed the amount specified in 10 U.S.C. 1091 IAW Section H.21.

33 14 Dec 10 Was there a benchmark for selecting only 10 companies for this

IDIQ?

The Government targeted the number of companies to ensure adequate competition for future requirements and effective management of companies.

34 14 Dec 10 Once a company is given an LOI, are you still in competition with other companies?

No. Once an LOIA is issued, that Contractor is responsible for providing qualifying documentation IAW Section H.2 and H.3

35 14 Dec 10 If a candidate has not submitted [qualifying documentation] within 10 days, does the LOI company lose that award?

As discussed in Section H.3, should the Contractor either fail to meet the 10-day requirement or provide valid contact telephone numbers, the ordering Contracting Officer may withdraw the

LOIA.

36 14 Dec 10 Are the awards going to be broken down by SB, 8A, SDVOSB, WOSB, etc., or will they all just be SB?

Awards will not be broken down by small business designation such as 8A, SDVOSB, and WOSB

37 14 Dec 10 This personal services contract does not create an employer-employee relationship between the government and any corporation, partnership business association or other party or legal entity with which the HCW may be associated, to include the prime contractor; therefore, prime contractors are responsible for their own insurance and liability coverage. Should this clause be interpreted as any 1099 or independent contractor is not covered by the government for medical malpractice insurance?

Under a personal services contract, the Government indemnifies the individual HCW, regardless of IRS designation, while that HCW is performing in scope on the contract.

38 14 Dec 10 If a 1099 or independent HCW is not covered for medical malpractice, is there still an employer-employee relationship created between HCW and government?

See response to question 37.

39 14 Dec 10 Can we get a listing of the orders for the various jobs from the current contract (used to plan for 50% limitation on subcontracting) The Government is unclear what is meant by this question. The requirement to expend at least 50% of the work on employees of the company is provided in FAR Part 52.219-14.

40 14 Dec 10 Do I understand correctly that requests can come from any MTF centrally? How many requests come through on a monthly basis?

Central task orders will be issued and administered in San

Antonio as outlined in Section H.15. The number of task orders awarded by month can vary; however, during calendar year 2009, the following number of task orders awards were issued:

Jan – 15

Feb – 16

Mar – 17

Apr – 16

May – 20

Jun – 29

Jul – 21

Aug – 43

Sep – 79

Oct – 32

Nov – 6

Dec – 12

41 14 Dec 10 The biggest constraint on 85% participation is knowledge of the upcoming procurements. How does the commodity council plan to provide notice of impending TOPRS?

The Air Force Medical Service Commodity Council

(AFMSCC) does not intend to provide any information about future requirements. The CLASS program uses decentralized ordering at the base level IAW Section H.15.

42 14 Dec 10 Is there going to be any improvement on variability for security this time around?

The CLASS contract requires the contractors to establish an appointment with the Unit Security Manager on the first duty day as outlined in Section C2.4.10.

43 14 Dec 10 Is the first duty day billable? Yes.

44 14 Dec 10 You may get your 85% participation rate, but you will get some highly priced TOPRs. The sooner you give us notification, the better. How do you measure 85%? In dollars? In numbers of TOPRS? You may want to rethink the 85% participation rate.

The AFMSCC does not intend to provide any information about future requirements. The CLASS program uses decentralized ordering at the base level IAW Section H.15.

The task order participation rate is based on the number of

TOPRs issued as defined in Section H.24f.

45 14 Dec 10 How will the 85% participation rate be calculated--in dollars, people?

The task order participation rate is based on the number of

TOPRs issued as defined in Section H.24f.

46 14 Dec 10 How long will the Government take to evaluate and issue the LOI?

How long will the Government take to approve a candidate and award the task order?

The time it takes to evaluate proposals varies across the Air

Force. Candidate approval timelines are addressed in Sections

H.2, H.3, H.16, and H.17.

47 14 Dec 10 Will QAPs provide contractors with the appropriate unit security manager POC contact info?

The Government will provide the unit security manager information during the award of a task order (TO) as outlined in section H.3.

48 14 Dec 10 If you could put the timelines on the process charts, it could make it easier for us to determine reasonableness. Maybe two notional timelines on flow charts, credentialed or non-credentialed.

The timelines associated with the task order process are incorporated in the written text of Sections H.2 and H.3.

49 14 Dec 10 Do you have the evaluation criteria for TO requirements? Evaluation criteria for subsequent TOs are outlined in section

H.3.

50 14 Dec 10 How will performance on TOs be used to award future TOs? Flow charts do not go into feedback for past performance.

In accordance with Section H.3 past performance is one of the criteria used for award of subsequent TOs.

51 14 Dec 10 Are ordering officials required to contact you before using this contract? If so, can you issue a preliminary notice to contractors as you are working with them to publish the actual TOPR?

Ordering officials are not required to contact the AFMSCC before using the contract. They are authorized to use this contract vehicle IAW Section H.15.

52 14 Dec 10 Is there a requirement for response time by contracting personnel for approval on candidates? Will there be more mandates for decentralized contracts to have reasonable timetables for TOPR responses?

Sections H.2 and H.3 establish the times for candidate approval. The terms and conditions of the contract are the same for decentralized and centralized TOs.

53 14 Dec 10 Will our folks be able to participate in local certification classes and

CME classes?

Paragraph 2.4.13 of Section C outlines certification and CME requirements. CME classes may be available at the MTF on a space-available basis only. The Government does not represent that potential CME classes will be sufficient to meet CME requirements.

54 14 Dec 10 Please provide more detail on TO evaluation and award criteria. Who will perform evaluation? What is required for TO proposals?

Section H.3 outlines the TO evaluation and award process.

55 14 Dec 10 Please provide anticipated volume of TOs. During Industry Day, you estimated nearly 1500 TOs over 5 years. For an approximate annual volume of 300 TOPRs per year. Also what is the time phasing of these?

At 85% that is 255 Task Order proposal per year to be compliant.

See response to question 40.

56 14 Dec 10 Do attachments and exhibits count in page requirement, especially management processes?

Section L3.4.7 outlines page limitations. Management processes are included in the 40 page limit.

57 14 Dec 10 Can the Government revise the highly relevant requirement to maybe

8-10 states or even certain numbers of MTFs?

The Government will consider this request.

58 14 Dec 10 Will the Government tell contractors which positions in TOs are currently encumbered?

See response to question 30.

59 14 Dec 10 If a firm has a BPA with multiple call orders is the BPA considered 1 reference?

The qualifying criteria for a past performance reference to be considered unique on the proposal is the contract number.

Therefore, if the call order results in a contract number, the

Government will allow that call order to stand as an individual reference. The Government will not accept multiple call orders that reference the same contract number.

60 14 Dec 10 A number of slides say we want to hear from you. How do we give feedback to you?

The Government’s preferred method of communication is via e-mail to Anita Bailey, the Contracting Officer, listed in the

Draft RFP.

61 14 Dec 10 For RTOs, do positions have incumbents? Will that be in the RFP? The Government may list the incumbent Contractors on the

RTO.

62 14 Dec 10 If the firm is on the GSA schedule, is that considered one reference?

Propose that each call order be a different reference as it goes to different MTFs.

See response to question 59.

63 14 Dec 10 On the burn rates, are you going to consider CME requirements? Burn rates are calculated IAW Section H.24g and are based on billable hours only. CME is not billable to the Government.

64 14 Dec 10 1920 hours is hard to meet with family days, down days, etc. Will you take this into consideration?

The Government will review the standard hours for a Full Time

Equivalent (FTE).

65 14 Dec 10 Regarding the blind benchmark report, if all contractors are below standards, will Government reconsider requirements?

The Government intends to set the AQL at an achievable level based on past experience and market research.

66 14 Dec 10 Have you gotten buy in from credentialing departments to try to streamline the process?

The Government is unsure of the comment regarding “buy-in”.

The Air Force credentialing offices follow the credentialing process outlined in AFI 44-119, which is referenced in paragraph 2.2.1.2 of Section C

67 14 Dec 10 What is the current % of physicians that are 1099 vs. W2? The IRS designation on current contract physicians is not available to the AFMSCC.

68 14 Dec 10 Can we get current blind benchmark report for incumbents? This is unique to the CLASS program and therefore not available on previous contracts.

69 14 Dec 10 With the requirement for 50% of contract workers to be employees, can you tease out 1099 employees?

The Contractor must comply with the Limitation of

Subcontracting clause (FAR Part 52.219-14).

70 14 Dec 10 Does the 50% rule apply to TO level? Annual? Ongoing 50%? The Government will consider the reporting period in compliance with FAR Part 52.219-14.

71 14 Dec 10 Past performance requirement for the offeror to have 3 current contracts as the Prime, limits those small businesses that have been successful subcontractors with the incumbents from bidding on the solicitation as prime. Will the Government reconsider allowing the offeror to use past performance references where the offeror is the subcontractor if the performance is relevant?

The offeror must have a minimum of 3 past performance references as either a prime contractor or subcontractor IAW

Section M4.5.4.2

72 14 Dec 10 Do we understand correctly that requests for services can come from any MTF or centrally?

Task orders on this contract can be awarded and administered from any office authorized to use this contract vehicle IAW

Section H.15.

73 14 Dec 10 Would an award escrow to allow for managing the planning process be out of the question?

The Government will not be using an award escrow.

74 In order to be considered highly relevant you are stipulating contracts of $2M or greater. Considering the size standard of $10M would seem this would be more geared to evaluating larger teaming partners and not the prime (small). Would consideration be given to the meeting of 2 of 3 bullet points under a given rating?

The relevancy table takes into consideration the scope, magnitude, and complexity of the CLASS requirement (Section

M4.5.4). The relevancy for this CLASS acquisition considers all three areas.

75 14 Dec 10 Are ordering offices required to contact central CO? No. Ordering offices are authorized users without approval

IAW Section H.15.

76 14 Dec 10 Let’s say there is a TOPR for 10 physicians and you have 9 within 10 days. Does the contractor lose out after the LOIA?

The ordering Contracting Officer will determine to withdraw all or any part of an LOIA IAW Section H.3.

77 14 Dec 10 If a company gets an LOI, will the runner up company get a notification?

The Government does not intend to notify the next best offeror.

78 14 Dec 10 How will performance be used on evaluation on future TOs? Performance on the CLASS Acquisition will follow the criteria in Section H.3.

79 14 Dec 10 It is difficult for SB to provide 3 references; can the number be decreased within the required period?

The Government does not intend to decrease the number of past performance references required.

80 14 Dec 10 Can the Government revise the highly relevant requirement to 10 states?

The Government will consider this information.

81 14 Dec 10 If due to unforeseen reasons, a team member must drop out, can the prime replace the team member?

The draft RFP did not have any restriction on replacing team members after contract award; however, the Government may review this area.

82 14 Dec 10 How long will it take for TO approval to get CO to award TO? TO approval varies across the AF.

83 14 Dec 10 Will the Government provide incumbent contact information? See response to questions 30 and 61.

84 14 Dec 10 It is difficult for SB to get a $2 mil line of credit. What we are asking for is really contingent upon award for some small companies.

Generally, contingent upon award is satisfactory. You should reconsider this.

The Government will consider this information.

85 14 Dec 10 How many companies can a large business be a subcontractor for during a proposal?

The limitation on cross-teaming, defined in Section L3, states that during contract competition a company may only be part of one proposal.

86 14 Dec 10 Does subcontracting experience qualify for past performance if subcontracts are DoD?

IAW Table M-3 Relevancy Table, DoD experience is one of the criteria for a reference to be highly relevant and relevant.

87 14 Dec 10 Can subcontracting teaming partners attend post award conference contract meetings when meeting with the contracting offices?

IAW Section H.1a, the Government will pay $5000 for the post award conference for up to 3 Contractor management (prime or subcontractors) staff to attend the post award conference.

88 14 Dec 10 Are MTFs required to conduct preceptor training/orientation? The MTF’s will provide orientation training at the place of performance.

89 14 Dec 10 Is pricing for RTO considered NTE rate for contract? How can we consider high costs versus low?

Pricing on the RTO will be firm fixed prices for only those requirements listed in Table B-1 when awarded. Subsequent task orders are priced at time of task order award and will not be related to the firm fixed prices on RTO requirements.

90 14 Dec 10 Security process is confusing; each base has its own rules, any chance this will improve?

The CLASS contract requires the contractors to establish an appointment with the Unit Security Manager on the first duty day as outlined in Section C, paragraph 2.4.10.

91 14 Dec 10 Will incumbent providers contact info be available to the contractors for the TOPR response (not after the LOIA)?

See response to question 30.

92 14 Dec 10 How will the Government account for irregular MTF interview, acceptance, credentialing delays?

Candidate approval timelines will follow the process in

Sections H.2, H.3, H.16, and H.17. The Government will consider delays due to the credentialing process.

93 14 Dec 10 Please note that disallowing the small prime from including 1099 expenses in effect forces the prime to work mostly in less profitable, lower paid employees passing high profit physicians to the subs.

Noted.

94 14 Dec 10 If a provider goes to the appointment with the Unit Security manager, can we assume that the provider will have billable work at the MTF each day after that appointment?

The HCW’s first duty day is the day the HCW has a scheduled appointment with the Unit Security Manager. The HCW will be allowed to bill the Government beginning on the first duty day as long as the HCW does not delay the completion of the security paperwork as discussed in Section C, paragraph

2.4.10.2.1.3.

95 14 Dec 10 NAICS 622110 Size standard $34.5M Navy uses on MATO

Solicitations

The Government will review the NAICS based on the scope, magnitude, and complexity of the CLASS acquisition. If after review a change is deemed appropriate, the final RFP will reflect the applicable NAICS.

96 Will the slides from today be posted on FedBizOpps? Yes.

97 14 Dec 10 You said any number of personnel can attend post award conference but H1.a.1 says up to 3 people please clarify?

See response to question 87.

98 14 Dec 10 [The Government] should accept letter of credit from factoring firms based on today’s banking standards.

The Government uses the Letter of Credit as acceptable evidence that the prospective contractor has the resources to meet the start up costs associated with this acquisition IAW

FAR Part 9.104-3(a).

99 14 Dec 10 The offeror should obtain assurance that with an award they should be able to support 90 days of the new award outside their current credit needs. $2M may be too high or too low.

Noted.

100 14 Dec 10 Request DCAA to perform assessment of financial capability. See response to question 98.

101 14 Dec 10 How does the Government intend on making this a fair Total Small

Business contract when it is favoring the SBA Mentor Protégé

Program? The SBA Mentor Protégé JV is only for 8a’s, certified

SDVOSB’s and other deserve a fair JV opportunity s either under

SBA Mentor Protégé or DoD, AF programs.

The Government does not intend to favor SBA Mentor Protégé proposals during the evaluations. The SBA Mentor Protégé

Program is one of many opportunities available to potential offerors.

102 14 Dec 10 Could line of credit be lower to $1M? The Government does not intend to lower the letter of credit amount.

103 14 Dec 10 Will cover pages count against the total page count? Section L3.4.7 outlines page limitations.

104 14 Dec 10 The HCW average rate concept is confusing. Can you provide an example as to how this works? Would you consider 1880 hours to take into consideration down days, training days, CME, etc?

For an example of the average rate concept: A credentialed

HCW contracted to work 1880 hours actually works 1840 hours due to delays in initial fill. The unproductive 40 hours are multiplied by the credentialed HCW average hourly rate of

$93.12 in table H-4. This credentialed HCW has an unobligated amount of $3,724.80.

The Government will review the standard hours for a Full Time

Equivalent (FTE).

105 14 Dec 10 The RTO allocation process is confusing. Will a single contractor win one or two locations? The result being only 1 contractor will be at a location? How will the Government factor in the degree of difficulty between locations to performance metrics?

A single Contractor may be awarded RTO requirements up to the estimated allocation amount. This may include one or many locations. The RTO allocation process assumes that

Contractors will price each requirement independent from other requirements and will not shift risk by pricing a requirement lower than market rates.

106 14 Dec 10 With regards to the 10 calendar day requirement for the LOIA, would a tiered time frame based on labor category and location be considered?

The Government does not intend to make this a tiered process.

107 14 Dec 10 Can subcontractor teaming partners attend contract meetings with the prime when meeting with the Government?

See response to question 87.

108 14 Dec 10 Does subcontracting experience relevant to scope, magnitude, and complexity qualify for past performance if subcontracts are DoD.

See response to questions 71 and 86.

109 14 Dec 10 Will multiple prime proposals be allowed from offerors who share a common parent?

The limitation on cross-teaming during contract competition only allows for a company to be part of one proposal.

110 14 Dec 10 How will you handle a JV when they effectively have no Past

Performance?

If an offeror is a JV with no past performance information, the past performance record of all companies forming the JV will be considered IAW Section M4.5.4.3.

111 14 Dec 10 How is a JV formed? For a large business to be part of a JV does the small business have to be an 8a?

The AF cannot comment on how a JV is formed. Please refer to the Small Business Administration for further guidance. For a large business to be part of a Mentor-Protégé JV, the small business must be an 8a.

112 14 Dec 10 If they use personal SSN as a 1099 [can they] count them as employees? If they use a different TIN [can they] count [them] as subcontract[ors]?

See response to question 69.

113 14 Dec 10 Does the sample allocation table apply to just initial work or all

TOPRs over the 4 year contract?

The allocation table applies to work on the RTO requirements only.

114 14 Dec 10 How many positions will be new requirements? How many will be incumbents?

This is an ID/IQ acquisition, which by definition is not known at the time of contract award.

POST INDUSTRY DAY QUESTIONS

115 15 Dec 10 […] is a part of a larger Health Care company […]. […] has its own

Duns number and is listed on the Federal Supply as […]. We specialize in Physicians and […] specializes in nursing. Due to different market segmentations, can […] team on one proposal and

A business entity, including affiliates, as described in the question, is prohibited from participating in more than one proposal in accordance with Section L3.1. The Government interprets this to mean affiliated companies may not each submit

[…] on another? a proposal.

116 16 Dec 10 A major one will be the 10 day recruitment period before a TO award is made (btw, I DO like the LOIA idea and am anxious to see how well it works and what, if any, are the unintended impacts). At any rate, 10 days has consistently proven to be simply too short.

Probably ok for a non-credentialed provider, but not a credentialed one…not unless there is already an incumbent in place. A contractor is simply too dependent on the responsiveness of a provider to have 10 days as any meaningful standard. We suggest that 20 business days may be more realistic. Let me also say at the risk of being brutally honest…this contract will (and should) encourage teaming arrangements and many, in an attempt to satisfy the short recruitment timeline, will be tempted to go with large companies with databases of locum tenens providers who are ready with CVs on a moment’s notice. The problem there however is that those recruitment pools are geared to providers who are not normally interested in the long term commitments that the DoD customer seeks. As a healthcare agency that was built serving DoD for over 20 years, we speak from experience and are concerned that an unintended consequence of a 10 day turnaround is that we have addressed one issue (having providers start on time) only to be replaced with another major issue(retention problems). With experience and forethought this can be managed; but only to a certain extent should a 10 day recruitment requirement stay in place.

Another aspect that doesn’t seem to be addressed in this equation is that a flat 10 days (or whatever number is decided upon) simply doesn’t account for the complexity of locations and specialties which we all recognize as a “hard to fill”.

A potential unintended consequence of a flat 10 days (or perhaps even 20 business days as suggested above) is that you end up penalizing that contractor who is willing to take on the “hard to fills”. Perhaps the Air Force can rack and stack locations and specialties to allow a second tier or standard beyond whatever is ultimately decided upon as the recruitment period between LOIA and TO award so as NOT to penalize that contractor who has those

“hard to fills” and yet still provide a realistic metric upon which performance can be measured when such challenges are assumed.

The Government may consider increasing the amount of time for submitting qualifying documentation following a LOIA, but does not intend to have a tiered process.

117 16 Dec 10 The only other problematic issue we see is the proposed 1920 hour standard for the burn rate metric. Again, having 20 years worth of experience, we’ve found that as much as we’d all like to think there are 1920 billable hours per year, RARELY is that even remotely possible. 1880 hours is a more realistic data point simply due to days lost to weather and “local holidays” (AKA “training down” days); days bled off of those 1920 hours; days for which the contractor simply has no control. And that’s just assuming we’re talking about a burn rate for a full time equivalent…I don’t believe we’ve taken into account fractions of FTEs or TOs awarded two days before a start date (or even after the start date, which has certainly been known to happen as even when those dates are noted, they tend to get “lost” in the aggregate.) Again, we think using 1880 hours might be a more fair representation of a burn rate than using

1920 hours.

See response to question 64.

118 16 Dec 10 Escalation Rates - We understand that under the current RFP, escalation rates would be national, and according to the Industry

Day Conference, the Government is looking to have escalation rates based on the Consumer Price Index (CPI) for All Items (i.e. "...

prices paid by urban consumers for a market basket of consumer goods and services," which we will hereinafter refer to as "All

Items" in accordance with the name of the BLS table for data of this category, as opposed to CPI for strictly Medical Care Services.

Concern - The historical average increase for the CPI for All Items is approxi-mately 3.37% annually (according to our calculations using BLS data dating from 1913 through 2010). However, the CPI increase for All Items over the past 10 years (2000 to 2010) is even lower: 2.40%. On the other hand, according to our calculations of the BLS's Medical Services CPI Table (see attached*), the average

CPI increase over the same ten years (2000 to 2010) is 4.46% annually. Even with the current economic downturn. In fact, if we remove from consideration, data for the past 2 years as anomalous for both CPIs, we find that the difference between the All Items CPI and Medical Services CPI is relatively consistent at about 2%.

Exceptions, however, need to be made for certain medical and dental services with rates which are closer to those of the CPI for All Items, namely those services by labor categories that require far less

The Government has not recognized any index for the national escalation rate.

education and training than most other medical and dental labor categories. These are services provided by health care workers that require only high school education and technical school training (as opposed to those higher level categories that require college and/or medical school or other graduate education). These labor categories are more directly affected by general labor market rates, than by medical services or medical labor market rates.

Lastly, escalation rates may be affected by unexpected events such as changes in national health insurance rates, which would have a direct impact on price escalation.

*Suggestion:

1. Perhaps, the Government may accept escalation rates based on

BLS Medical Services CPI increases for all labor categories with the exception of those deemed to have escalation rates which more closely follow the All Items CPI (rather than the Medical Services

CPI). Of the 160 labor codes provided in Attachment 4 of the subject draft RFP, we suggest that the following be excluded from the Medical escalation rates (and that all other labor categories be escalated according to Medical Services CPI):

*Certified Medical Technician (Inpatient

*Certified Medical Technician (Outpatient)

*Dental Assistants, *Emergency Medical Technicians (Basic)

*License Practical Nurses

*Licensed Vocational Nurses

*Pharmacy Technicians

*Phlebotomists.

2. Make allowance for events, such as changes in healthcare insurance rates nationwide.

All other services would then be escalated according to the BLS's

Medical Services CPI. This would allow each contractor to reduce its turnover rates, by being able to compensate providers according to information more in line with actual market forces. Recruiting would also be facilitated for the same reasons.

119 16 Dec 10 Deadlines for replacement of credentialed and non-credentialed personnel - According to the subject draft RFP, Par 2.4.5.4 "The

Contractor shall replace permanent HCWs such that vacancies will not exceed 30 consecutive calendar days for both credentialed and non-credentialed HCWs except in the case of the sudden loss of a credentialed HCW due to serious injury or death." However, the draft RFP allows 60 calendar days after task order award for credentialed (Para H.3.g.). The recruiting and credentialing challenges are the same for replace-ment of personnel as they are for initial Task Order implementation. Therefore, not having the same

60 calendar days for replacement of credentialed healthcare workers could present serious challenges, especially as they relate to, not only meeting such deadlines, but also, with keeping new applicants and candidates interested in continuing to participate in the recruiting and credentialing process. Furthermore, Task Order implementation is premised on already having candidates because they were provided during pre-award/post LOIA; therefore, recruiting has already been performed successfully; whereas these

10 days are not included in the 30 days for replacement personnel to begin working. Suggestion: Provide, at a minimum the same requirement for recruitment and credentialing of replacement of credentialed HCWs as are required for initial implementation of

TOPRs.

Recruiting challenges for replacements and substitutions of an existing workforce should be more easily managed than initial fills. As a result the Government allows more time for initial fills of credentialed HCWs than replacement fills.

120 12 Dec 10 L5.1.2.4 Limitations on Subcontracting - According to the subject

RFP and the FAR, "the offeror shall submit a business plan that ensures at least 50 percent of the cost of contract performance incurred for personnel shall be expended for employees of the prime contractor (FAR 52.219-14, Limitations on Subcontracting)."

However, as was brought up during the Industry Day Conference, this requirement does not make allowance for HCWs who wish to work as subcontracted (i.e. they are issued IRS form 1099 for tax purposes, as opposed to the W2 issued by employers to their employees). If most Physicians prefer to be subcontracted, and if the majority of TOPRs issued for any given contractor happen to be for Physician Services, this requirement could present a problem.

Suggestion: Make exception for 1099 HCWs if at all possible.

See response to question 69.

121 16 Dec 10 Deadlines for placement of credentialed and non-credentialed personnel - According to Paragraph H.3.i (page 40), "The

Contractors do not conduct primary source verification, which is an inherently Government responsibility.

credentialed HCW(s) shall physically start work 60 calendar days from the period of performance date in the task order or the date specified in the task order, which shall not be less than 60 calendar days from the period of performance date without a bilateral modification." However, it then states, "A complete and accurate credentialing package shall be submitted to the MTF no later than 30 calendar days before the start work date." This means that contractors only have 30 days to gather all documents from

Credentialed HCW (60 days minus 30 days), and prime source verify everything. For replacement personnel, it is even less, because only 30 days are provided. Which means that contractors would have to recruit and credential in only 30 days, (whereas with

Task order implementation, they would have had at least 10 days during the LOIA period to recruit). Suggestion: Allow for an additional 30 days for credentialed HCWs for both TOPR post award implementation and for replacement of Credentialed HCWs.

Recruiting challenges for replacements and substitutions of an existing workforce should be more easily managed than initial fills. As a result the Government allows more time for initial fills of credentialed HCWs than replacement fills.

122 16 Dec 10 Providing a qualified candidate within 10 days of receiving the LOI:

The process of finding and screening viable professional and nonprofessional HCWs is a time-consuming job even with support agencies and refined internal processes. Since professional HCWs generally have competing offers, a vendor must have ample time for discussion and negotiations. Ensuring proper documentation is obtained from candidates in a timely manner can also be problematic as a company only has so much control over prospective candidates response time. From our experience, it takes at least 10 business days to interview and compile documentation of interested non-credentialed candidates and 20 business days for credentialed, professional candidates to commit and forward required documentation.

See response to question 116.

123 16 Dec 10 Burn Rate Percentage: My experience as a vendor trying to ensure burn rate metrics are met has demonstrated that adequate consideration is rarely given to training holidays, family days, CME, etc. I appreciated the comment from the speaker acknowledging that this issue was understood and that the metric was focusing on the larger gaps of 30 or 60 days of non-compliance. However there is significant administrative hardship associated with tracking this type of metric and capturing the reasons for gaps – large and small.

Ultimately, the pure metric is evaluated by the government typically

See response to question 64.

with no consideration of the exceptions/reasons or adjustments for small gaps of time. This many times leaves a vendor falling short in the compliance rate percentage through no fault of their own.

Considering the use of 1880 hours for an FTE might serve as a truer representative of hours to be worked each year.

124 16 Dec 10 What is industry’s opinion of a national escalation rate? The

National escalation rate is an acceptable rate to use in pricing out-years.

Noted.

125 16 Dec 10 Are the instructions for the allocation of RTO requirements clear?

In general, the instructions do not offer an adequate level of explanation to understand and complete the spreadsheet. For instance, it appears each MTF is given a corresponding number for reference, but nowhere in the instructions is this explained nor is the correlation between the number and the MTF provided. Also, why are both 1880 and 1920 used to note full time equivalents?

An explanation would be helpful.

The Government intentionally left the base name off of the Draft

RFP. The actual RFP will include the Base names.

The Government will review the standard hours for a Full Time

Equivalent (FTE).

126 16 Dec 10 Is it clear how the Total Evaluated Price (TEP) is calculated and evaluated? Again, further explanation would be helpful to understand the Total Evaluated Price verses the Fully Burdened

Price.

The total evaluated price is the sum of the product of all fully burdened hourly rates times the number of hours for all requirements.

127 17 Dec 10

Please clarify: If JV companies are bidding on this solicitation, the size standard would need to be within the $10M size…