HT0015-23-R-0030 0001.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

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 (Type or print)

30-105-04EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

STANDARD FORM 30 (Rev. 10-83) Prescribed by GSA

FAR (48 CFR) 53.243

The purpose of this amendment is to:

1. Provide solicitation questions and Government answ ers as they apply to RFP HT0015-23-R-0030 (added as Attachment F).

2. Make changes to the RFP as outlined in the Summary of Changes to include:

-Adding Exhibit T, Exhibit U, Exhibit V and Exhibit W.

-Updating Attachment A and Attachment C.

-Updating PWS w as updated at 1.3., 1.7.1., 5.13.2.5.6., 5.14., 5.14.1.3., 6.3., 6.5.5.1., and Part 7.

-Updating CLINs 1001, 2001, 3001 and 4001 (changed from 45,000 to 51,000 Enrolled Beneficiaries).

-Updating Addendum to 52.212-1 and Addendum to 52.212-2 (highlighted areas).

3. All other terms and conditions remain the same.

1. CONTRACT ID CODE PAGE OF PAGES

S 1 28

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

16C. DATE SIGNED

BY 18-Dec-2023

16B. UNITED STATES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR

(Signature of Contracting Officer)(Signature of person authorized to sign)

8. NAME AND ADDRESS OF CONTRACTOR (No., Street, County, State and Zip Code) X HT001523R0030

X 9B. DATED (SEE ITEM 11)

29-Nov-2023

10B. DATED (SEE ITEM 13)

9A. AMENDMENT OF SOLICITATION NO.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offer is extended, X is not extended.

Offer 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:

(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 telegram 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 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 telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

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.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(B).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

10A. MOD. OF CONTRACT/ORDER NO.

2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

18-Dec-2023

CODE

DHA CONTRACTING OFFICE-(EMS-CD) HT0015

DHA EMS-CD HT0015

4130 STANLEY ROAD SUITE 208

FORT SAM HOUSTON TX 78234

HT0015 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

HT001523R0030

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

SUPPLIES OR SERVICES AND PRICES

CLIN 1001

The CLIN extended description has changed from:

The Contractor shall provide performance of all facility-related (except MRI equipment) requirements (PWS 5.16) (including any amortized facilities costs incurred during the phase-in transition period (PWS 1.7.1)), administrative requirements (PWS 5.13.2.1) and the Performance Work Statement (PWS) requirements associated with the following services:1. Primary Care (PWS 5.13.2.2) (for ACC enrolled/assigned beneficiaries only)2. Urgent Care (PWS 5.13.2.3) (for ACC enrolled/assigned beneficiaries only)3. Radiology and Laboratory (PWS 5.13.2.5 and 5.13.2.4) (all for ACC enrolled/assigned beneficiaries only)The quantity for this CLIN represents Enrolled Beneficiaries represented by the unit of issue "Each". The Contractor may invoice each month for up to 45,000 Enrolled Beneficiaries IAW the PMPM clause and the PWS.

To:

The Contractor shall provide performance of all facility-related (except MRI equipment) requirements (PWS 5.16) (including any amortized facilities costs incurred during the phase-in transition period (PWS 1.7.1)), administrative requirements (PWS 5.13.2.1) and the Performance Work Statement (PWS) requirements associated with the following services:1. Primary Care (PWS 5.13.2.2) (for ACC enrolled/assigned beneficiaries only)2. Urgent Care (PWS 5.13.2.3) (for ACC enrolled/assigned beneficiaries only)3. Radiology and Laboratory (PWS 5.13.2.5 and 5.13.2.4) (all for ACC enrolled/assigned beneficiaries only)The quantity for this CLIN represents Enrolled Beneficiaries represented by the unit of issue "Each". The Contractor may invoice each month for up to 51,000

CLIN 2001

The Contractor shall provide performance of all facility-related (except MRI equipment) requirements (PWS 5.16) (including any amortized facilities costs incurred during the phase-in transition period (PWS 1.7.1)), administrative requirements (PWS 5.13.2.1) and the Performance Work Statement (PWS) requirements associated with the following services:1. Primary Care (PWS 5.13.2.2) (for ACC enrolled/assigned beneficiaries only)2. Urgent Care (PWS 5.13.2.3) (for ACC enrolled/assigned beneficiaries only)3. Radiology and Laboratory (PWS 5.13.2.5 and 5.13.2.4) (all for ACC enrolled/assigned beneficiaries only)The quantity for this CLIN represents Enrolled Beneficiaries represented by the unit of issue "Each". The Contractor may invoice each month for up to 45,000

The Contractor shall provide performance of all facility-related (except MRI equipment) requirements (PWS 5.16) (including any amortized facilities costs incurred during the phase-in transition period (PWS 1.7.1)), administrative requirements (PWS 5.13.2.1) and the Performance Work Statement (PWS) requirements associated with the following services:1. Primary Care (PWS 5.13.2.2) (for ACC enrolled/assigned beneficiaries only)2. Urgent Care (PWS 5.13.2.3) (for ACC enrolled/assigned beneficiaries only)3. Radiology and Laboratory (PWS 5.13.2.5 and 5.13.2.4) (all for ACC enrolled/assigned beneficiaries only)The quantity for this CLIN represents Enrolled Beneficiaries represented by the unit of issue "Each". The Contractor may invoice each month for up to 51,000

CLIN 3001

The Contractor shall provide performance of all facility-related (except MRI equipment) requirements (PWS 5.16) (including any amortized facilities costs incurred during the phase-in transition period (PWS 1.7.1)), administrative requirements (PWS 5.13.2.1) and the Performance Work Statement (PWS) requirements associated with the following services:1. Primary Care (PWS 5.13.2.2) (for ACC enrolled/assigned beneficiaries only)2. Urgent Care (PWS 5.13.2.3) (for ACC enrolled/assigned beneficiaries only)3. Radiology and Laboratory (PWS 5.13.2.5 and 5.13.2.4) (all for ACC enrolled/assigned beneficiaries only)The quantity for this CLIN represents Enrolled Beneficiaries represented by the unit of issue "Each". The Contractor may invoice each month for up to 45,000

The Contractor shall provide performance of all facility-related (except MRI equipment) requirements (PWS 5.16) (including any amortized facilities costs incurred during the phase-in transition period (PWS 1.7.1)), administrative requirements (PWS 5.13.2.1) and the Performance Work Statement (PWS) requirements associated with the following services:1. Primary Care (PWS 5.13.2.2) (for ACC enrolled/assigned beneficiaries only)2. Urgent Care (PWS 5.13.2.3) (for ACC enrolled/assigned beneficiaries only)3. Radiology and Laboratory (PWS 5.13.2.5 and 5.13.2.4) (all for ACC enrolled/assigned beneficiaries only)The quantity for this CLIN represents Enrolled Beneficiaries represented by the unit of issue "Each". The Contractor may invoice each month for up to 51,000

CLIN 4001

The Contractor shall provide performance of all facility-related (except MRI equipment) requirements (PWS 5.16) (including any amortized facilities costs incurred during the phase-in transition period (PWS 1.7.1)), administrative requirements (PWS 5.13.2.1) and the Performance Work Statement (PWS) requirements associated with the following services:1. Primary Care (PWS 5.13.2.2) (for ACC enrolled/assigned beneficiaries only)2. Urgent Care (PWS 5.13.2.3) (for ACC enrolled/assigned beneficiaries only)3. Radiology and Laboratory (PWS 5.13.2.5 and 5.13.2.4) (all for ACC enrolled/assigned beneficiaries only)The quantity for this CLIN represents Enrolled Beneficiaries represented by the unit of issue "Each". The Contractor may invoice each month for up to 45,000

The Contractor shall provide performance of all facility-related (except MRI equipment) requirements (PWS 5.16) (including any amortized facilities costs incurred during the phase-in transition period (PWS 1.7.1)), administrative requirements (PWS 5.13.2.1) and the Performance Work Statement (PWS) requirements associated with the following services:1. Primary Care (PWS 5.13.2.2) (for ACC enrolled/assigned beneficiaries only)2. Urgent Care (PWS 5.13.2.3) (for ACC enrolled/assigned beneficiaries only)3. Radiology and Laboratory (PWS 5.13.2.5 and 5.13.2.4) (all for ACC enrolled/assigned beneficiaries only)The quantity for this CLIN represents Enrolled Beneficiaries represented by the unit of issue "Each". The Contractor may invoice each month for up to 51,000

The following have been modified:

FAR ADDENDUM 52.212-1

Instruction to Offerors:

Pursuant to FAR 12.302(a), FAR Provision 52.212-1, Instructions to Offerors (ITO) – Commercial Items, is tailored. The basic provision paragraphs (a), (d), and (f) through (k) of the Addendum to FAR 52.212-1 are not replaced. The following paragraphs of specific instructions to offerors for this solicitation replace the basic provision paragraphs (b), (c), and (l). The basic provision paragraph (e) is deleted for this solicitation:

FAR Provision 52.212-1, Instructions to Offerors - Commercial Items is tailored by addendum as follows:

(b) Submission of Offers

1. General Instructions and Information This section provides general guidance for preparing proposals, as well as specific instructions on format and content of proposals.

Offerors are cautioned to follow the instructions provided in this section carefully to ensure the Government receives consistent information in a form that will facilitate proposal evaluation.

Proposals that take exception to inclusion of specific requirements in the resultant contract shall not be considered. Proposal must include all data and information requested herein and must be submitted in accordance with these instructions. The offeror is solely responsible for reading the solicitation and submitting a proposal in compliance with all instructions, requirements, terms, and conditions. The Government will review proposals for completeness and compliance with the solicitation and preparation instructions. Non-conformance with the instructions provided herein may result in an unfavorable proposal evaluation or rejection of the proposal. If an Offeror

(1) fails or refuses to assent to any of the terms and conditions of the solicitation, (2) proposes additional terms and conditions of this solicitation, or (3) fails to submit any of the information required by this solicitation, then the Government may consider the offer to be materially non-compliant, which could make the offer ineligible for contract award.

The Government is providing PWS references for the Offeror's convenience only. The Offeror is responsible for reading and complying with the solicitation requirements.

2. Proposal Organization Offerors shall submit proposals as stated in Addendum to FAR 52.212-1.

Organize your proposal as set forth in Table 1, Proposal Organization, into five (5) separate volumes. Failure to provide all information requested and in the appropriate format may cause the offer to be rejected and no longer considered for award.

Volume I – Cover Letter, Table of Contents, Business Information, Filled and Signed SF1449 as Amended, Contractor Team Organization Team Document and Representations & Certifications.

Volume II – Compensation Plan, Small Business Participation Commitment Document (SBPCD), Key Personnel List Volume III – Facility Approach, Administrative Approach and Clinical Operations Approach Volume IV – Past Performance Volume V – Price Title the volumes of your proposal with your company name, volume number, and tab number as shown in the filename example of Table 1. For example, ABC Incorporated filename for Volume I, Administration is ABC_VolumeI_Tab1.pdf.

Table 1 – Proposal Organization

Volume Required Volume File Name Required Document Title Page Limit1 Format

I - Administrative ABC_VolumeI_Tab1thruTab5

Cover Letter

Tab 1 – Table of Contents

Tab 2 – Business Information

Tab 3 – Signed SF 1449 with all Amendments

(SF 30)

Tab 4 – Representations and Certifications

5 pages and will not be evaluated

Tab 1: 5 pages and will not be evaluated.

Tab 2: 10 Pages

Tab 3: No page limit unless identified in another section of Addendum to 52.212-1

Tab 4: No page limit unless identified in another section of Addendum to 52.212-1

PDF for all in Volume 1

II - Compensation Plan/SBPCD/Key Personnel: Factor 1, 2 & 32

ABC_VolumeII_Tab1thruTab3 Tab 1 – Compensation Plan

Tab 2 – SBPCD

Tab 3 – Key Personnel Information

Tab 1: Fill out compensation plan for each position listed

(ATTACHMENT

B)

Tab 2: Fill out Small Business Participation Commitment Document

(SBPCD) –

ATTACHMENT

C

Tab 3: Key Personnel Qualifications with supporting documentation List

- 20 pages

Microsoft Excel

PDF

PDF

III –

Technical/Risk:

Factor 42

ABC_VolumeIII_Tab1thruTab3 Tab 1 – Facilities Approach

Tab 2 – Administrative Operations Approach (Access to Care Plan)

Tab 3 – Clinical Operations Approach

Tab 1: 10 pages

Tab 2: 25 pages

Tab 3: 25 pages

PDF for all in Volume III

IV – Past Performance: Factor

ABC_VolumeIV_Tab1thruTab2 Tab 1A thru 1E References

Tab 2 – Organizational Change History

Tab 1A thru 1E:

5 pages per Tab

Tab 2:

Organizational Change History: 5 pages.

PDF for all in Volume in

V – Price: Factor 6 ABC_VolumeV_Tab1 Tab 1 – Price matrix

Limited to Government-provided spreadsheet

Microsoft Excel. Use Price matrix (Attachment

A)

1. Page limitations will be counted as maximums. If exceeded, the excess pages may not be read or considered in the evaluation of the proposal. Each side of a page will be counted as 1 page except for the following: Volume Cover Pages, Summary of Section, Glossaries, and Blank Pages.

2. The offeror is required to provide 2 copies of its proposal; (1) sanitized copy and (2) un-sanitized copy.

FORMAT AND CONTENT

Submit a second sanitized/redacted version of your technical proposal having all company names, addresses, logos, references, and other identifiable information removed.

Separate paragraphs by at least one blank line. Clearly identify the sanitized and un-sanitized copy of your proposal.

Font must be Arial or New Times Roman and no less than a 12-point size. Tables and illustrations may use a font size no less than 8-point.

Cross-referencing: Each volume shall be written on a standalone basis so that its contents may be evaluated with no requirement to cross-reference to other volumes of the proposal. Information required for proposal evaluation which is not found in its designated volume will be assumed to have been omitted from the proposal. Offerors are responsible for the accuracy of their proposals and the Government need not search for information that is not provided in the required volume.

Proprietary information shall be clearly marked. Proprietary information submitted in response to this solicitation will be protected from unauthorized disclosure as required by Subsection 27 of the Office of Procurement Policy Act as amended (41 U.S.C. 423), herein after referred to as “the Act,” as implemented in the FAR.

Digital and/or picture image signatures are acceptable.

3. Submission of Questions and Proposals

QUESTIONS

Comments, and questions shall be provided on attached feedback form (Attachment E) titled RFP_Att_E_ATAMMC_ACC_Q&A form. Participants are required to follow the instructions provided in Tab1 of the ATAMMC ACC Feedback form.

PROPOSAL

Submit proposals, a completed and signed solicitation as instructed in Addendum to FAR 52.212-1, and signed amendments, no later than the date/time specified in Block 8 of the solicitation (Standard Form [SF] 1449).

Email all questions, correspondence, and proposals to dha.ncr.acq‐sustainment.mbx.atammc‐ acc@health.mil

The offeror is responsible for verifying that the government has received its questions and proposals. Offerors may request verification by email to dha.ncr.acq‐sustainment.mbx.atammc‐ acc@health.mil to confirm that the government is in receipt of questions and proposals by the time specified in the solicitation.

4. Volume I – Administrative

Offerors shall submit Volume I with the following documents and information:

Tab 1: Table of Contents The Table of Contents serves as an overall guide to the files that are included, the volume and tabs they are located in, and a brief description of the documents. This document must be in Microsoft Word or Adobe PDF compatible format.

Tab 2: Business Information At a minimum, this document must include contact information such as e-mail addresses and telephone numbers for the principal point of contacts, company cage code, DUNS number, Tax ID number, and legal business name and other information about the business and major subcontractors as applicable. Offerors shall submit an organizational structure for all teaming partners and subcontractors used to demonstrate technical capability and past performance. If there are major subcontractors (performing 25% or more of the work), the offeror must state what percentage of the effort the subcontractor(s) will be performing. This document Adobe PDF compatible format.

Tab 3: SF1449 with Amendments Acknowledged Fully completed and signed SF 1449, page 1, Blocks 17a & b, 30a, b & c. Page 1 of the SF 1449 must be submitted in PDF compatible format. The offeror is not required to submit the entire SF 1449. The offeror MUST submit the SF 1449 pages that have been filled out by the offeror. Signed amendments (if any). Only Page 1 of the amendment shall be submitted and must be done so in PDF compatible format. The offeror should combine the SF 1449 and Amendments into a single file.

Tab 4: Representations and Certifications If the Offeror has not completed the annual representations and certifications electronically at the System for Award Management (SAM) website (https://www.sam.gov) or if the Offeror’s SAM registration does not include the following representations, the Offeror shall submit one (1) completed copy of each of the following:

FAR Provision 52.203-2, Certificate of Independent Price Determination FAR Provision 52.204-17, Ownership or Control of Offeror FAR Provision 52.204-24, Representation Regarding Certain Telecommunications and Video Surveillance or Equipment FAR Provision 52.204-26, Covered Telecommunications Equipment or Services- Representation

FAR Provision 52.209-2, Prohibition on Contracting with Inverted Domestic Corporations— Representation FAR Provision 52.209-5, Certification Regarding Responsibility Matters FAR Provision 52.209-7, Information Regarding Responsibility Matters FAR Provision 52.209-11, Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law FAR Provision 52.212-3 (Alternate I), Representations and Certifications – Commercial Items FAR Provision 52.219-1 (Alternate 1), Small Business Program Representations FAR Provision 52.222-22, Previous Contracts and Compliance Reports FAR Provision 52.222-25, Affirmative Action Compliance

ADDITIONAL INSTRUCTIONS AND INFORMATION

Proposals shall be clear and concise and include sufficient detail for effective evaluation and for substantiating the validity of any stated claims. Proposals shall not simply rephrase or restate the Government's requirements, but rather shall provide convincing rationale to address how the offeror intends to perform the requirement. The proposal shall not reflect a marketing or sales presentation. Unnecessarily elaborate proposals beyond those sufficient to present a complete and effective response to this solicitation are not desired. The proposal shall illustrate the Offeror’s capability and clearly demonstrate the organization and methodology that will satisfy the solicitation requirements. Offerors shall assume that the Government has no prior knowledge of their experience and will base its evaluation solely on the information presented in the Offeror's proposal.

Proposal Preparation Costs. The Government will not pay any costs incurred in the submission of an offer, in making any necessary studies for the preparation thereof, or for any visit(s) the Contracting Officer may request for the purpose of clarification of the offer.

The Government will not accept alternate proposals.

5. Volume II – Compensation Plan, SBPCD and Key Personnel Information

Offerors shall submit Volume II with the following documents and information:

Tab 1: Compensation Plan (Factor 1)

The Offeror shall use the Compensation Plan matrix (Attachment B) to identify the minimum compensation rates (salary and fringe benefits) proposed, for all contract periods of performance, for the professional employees Identified on the Attachment B.

Offeror compensation plans shall include/reflect a minimum 2.4% annual salary increase for all professional personnel.

Re-competition of service contracts may in some cases result in lowering the compensation (salaries and fringe benefits) paid or furnished professional employees.

This lowering can be detrimental in obtaining the quality of professional services needed for adequate contract performance. It is therefore in the Government’s best interest that professional employees, as defined in 29 CFR 541, be properly and fairly compensated.

The compensation levels proposed should reflect a clear understanding of work to be performed and should indicate the capability of the proposed compensation structure to obtain and keep suitably qualified personnel to meet mission objectives. The salary rates or ranges must take into account differences in skills, the complexity of various disciplines, and professional job difficulty. Additionally, proposals envisioning compensation levels lower than those of predecessor contractors for the same work will be evaluated on the basis of maintaining program continuity, uninterrupted high-quality work, and availability of required competent professional service employees. Offerors are cautioned that lowered compensation for essentially the same professional work may indicate lack of sound management judgment and lack of understanding of the requirement.

Tab 2: Small Business Participation Commitment Document (SBPCD) (Factor 2) All Offerors (both other than small businesses and small businesses) shall submit a completed SBPCD (Attachment C) to demonstrate how the Offeror will meet the solicitation small business objectives.

1. Pursuant to FAR Part 19, the Government’s objective is that Small Business Concerns (SBC) are used to the maximum extent practicable in your proposed approach to satisfy the requirements of this solicitation for the entire performance period. The Offeror shall identify small businesses that are to be used in their proposed approach to satisfy the requirements.

2. Alaska Native Corporation (ANC) and Native American, and Tribally owned subcontractors may be counted as part of the SBPCD percentage in accordance with FAR 19.703(c).

3. Small business prime contractors may include the cost of work self-performed toward meeting the Small Business requirement. Small business subcontractors may be included in every category for which they qualify.

Tab 3: Key Personnel Qualifications (Factor 3) The Offeror shall submit a listing of Key Personnel and demonstrate how each meets the minimum qualifications (either by submission of resumes or by other means) for their positions, as described in the PWS. Key personnel for each clinic are the Clinic Administrator, Alternate Clinic Administrator, and Nursing Supervisor. Key personnel at the contract level are the Contract Program Manager, Alternate Contract Program Manager, and Lead Physician (PWS paras 1.18, 5.13.2.1.1, 5.13.2.1.2, 5.13.2.1.3, 5.13.2.1.4).

6. Volume III – Technical (Factor 4)

The Offeror shall submit a technical proposal which effectively demonstrates the Offeror’s understanding of the requirement and provides a successful technical solution for the prospective contract.

The Offeror’s technical proposal shall address the following topics:

Facilities/Leasing Administrative Operations Clinical Operations

Tab 1 (Subfactor TRS1): Facilities/Leasing Approach - Provide a comprehensive facilities strategy/plan describing the Offeror’s approach for acquiring and preparing the facilities necessary to deliver the full range of community-based health services (for up to 51,000 beneficiaries) described in the PWS. Specifically, the Offeror’s proposal shall describe:

1. How the Offeror proposes to carry out the following activities:

(a) Facility acquisition – The Offeror’s proposal shall identify the facilities/sites it intends to use for meeting the ACC requirement and describe its approach and rationale for selecting those facilities/sites, selecting the particular number of facilities, and for distributing/allocating employees and services among its proposed sites. The Offeror’s proposal shall discuss its facility leasing strategy, if any, to include discussing the terms of any existing facility lease(s) and/or any future leases it intends to enter in support of the ACC requirement. The Offeror’s proposal shall discuss its overall approach to providing/maintaining necessary parking, facility entrances, and facility security features at each site. (PWS para 1.3.1.5, 5.16)

(b) Facility preparation – The Offeror’s proposal shall describe its plan/approach for preparing each facility to deliver the health care services described in the PWS (para 5.13). The Offeror’s facility preparation plan/approach shall integrate pertinent elements of its administrative and clinical operations plans and include a proposed layout of the facilities that shows the proposed number and types of rooms and proposed patient flows. (PWS para 1.7, 5.13.2.19.4, 5.16)

2. How the Offeror will carry out transition-in activities and schedule for opening the facility for healthcare delivery not later than 9-months from award to include evidence from the facility owner of availability. The Offeror’s proposal shall include a detailed transition plan/schedule explaining its approach (and identifying major milestones) for preparing its proposed facilities for full operational capability at the date specified for the start of healthcare delivery. (PWS 1.3.1, 1.7, 5.13, 5.16)

Tab 2 (Subfactor TRS2): Administrative Operations Approach - Provide a comprehensive Administrative Operations plan (Access to Care plan) describing the human resources functions and approaches the Offeror proposes to use to ensure the ACCs are appropriately staffed to ensure continuous successful contract performance:

1. The Offeror shall describe the process and approach it will use to timely identify, recruit, retain, and prepare provider staff to meet (and maintain) all qualification and credentialing requirements, including (but not limited to) requirements relating to the initial verification of licensure, certification, education, life support training, and completion of applicable health and vaccination requirements. (Exhibit K, PWS para 1.25)

2. The Offeror shall describe how it will structure/organize its provider training and support functions (PWS para 5.2.11) and how those functions will be integrated to support the delivery of seamless, quality care. The Offeror shall also describe its approach for providing required support functions such as reception, eligibility checks, appointing, nurse triage services, housekeeping, and coding in a manner that will support timely beneficiary access to care.

(PWS para 5.13.2.1)

Tab 3 (Subfactor TRS3): Clinical Operations Approach - Provide a comprehensive Clinical Operations Plan that describes how the Offeror will continuously deliver timely and high-quality health care services to beneficiaries.

1. The Offeror’s Clinical Operations plan shall describe its proposed approach to (and demonstrate its knowledge of) managing comprehensive clinical operations, using template scheduling, and ensuring continuity of care for enrolled beneficiaries. (PWS paras 1.15, 5.13.2.1.5.6, 5.13)

2. The Offeror’s proposal shall describe its approach to using appointments/templates, programs, processes, and/or procedures to address high beneficiary demand periods and how it will incorporate “improved access” appointing processes for primary care, efficiently allocate acute and routine appointments, meet TRICARE access standards for specialty and ancillary care, and support NCR Business rules. (PWS paras 1.3.1.3, 5.13.2.1.5.6, 5.13.2.5.5, 5.13.2.6, 5.14, Exhibit N)

3. The Offeror’s proposal shall describe the staffing model/approach it will use to deliver all health care services described in the PWS.

(a) The Offeror’s staffing model shall detail the numbers of FTEs (inclusive of clinical, ancillary, and support positions) the Offeror will use to staff each Department/Specialty area of each ACC facility (PWS paras 1.3.1, 5.13) and describe how its proposed staffing level will support meeting access to care standards and delivering high quality care (PWS para 1.3.1, 5.14). If the Offeror proposes to use separate shifts to meet the PWS requirements, then the Offeror shall describe how it will organize its shift change process to ensure continuous patient care/avoid disruption of care.

(b) Ratios: The Offeror shall describe, as part of its staffing model, the provider-to-patient ratios and provider-to-support staff ratios it will use and explain how its approach (with the staffing ratios) will support delivering a patient-focused, team-based health care model --- giving special attention to Primary Care Managers and the delivery of primary care services. (PWS para 5.7, 5.13.2.2)

(c) Productivity: The Offeror shall describe its productivity goals, and the basis for such goals, for primary care, urgent care, specialty care, and ancillary service areas. (PWS para 1.13, 5.9, 5.13, Exhibit AA-4)

4. The Offeror’s proposal shall describe the programs and procedures it will use for monitoring performance against contract metrics and terms and conditions. (PWS Part 9)

5. The Offeror’s proposal shall describe any tools/methods/programs it will use to appropriately manage beneficiary utilization and reduce the DHA’s overall cost of health care for the enrolled population and how the services it proposes to offer will maximize resources and minimize referrals to the regional TRICARE managed care support contractor. (PWS paras 1.3.1.2, 5.9, 5.13.2.1.5.7)

7. Volume IV – Past Performance (Factor 5)

Tab 1A-1D: References:

The Offeror shall submit past and present performance information regarding the Offeror and any subcontractors that will perform major (more than 25% of the work) or critical aspects of the work. Offerors shall submit no more than five (5) separate past performance contract references in response to this solicitation. Each reference shall include a completed and signed PPQ. Offerors shall name each reference in the past performance volume in accordance with the Required Document Formant identified in Table 1. Each Tab will be limited to 5 pages, i.e.

Tab 1A = 5 pages, Tab 1B = 5 pages, etc.

1. As a reference, the offeror shall submit no more than five (5) contracts reflecting work relevant to the solicitation. The contracts may be for the Offeror’s own work or for the work of a subcontractor performing major (as defined above) or critical aspects of the work and may reflect work performed for federal, state, or local governments or commercial businesses. At least one

(1) of the contract references submitted must be for the Offeror’s own performance of work relevant to this solicitation—whether as a prime contractor or a subcontractor. If an Offeror provides past performance information rendered by a predecessor company (or a predecessor to a major subcontractor), then the Offeror must also submit a Organizational Change History (Tab 2) describing changes in its organization in order to facilitate the Government’s relevancy determination.

a. The Offeror shall provide the following information with each contract reference:

Name of contracting activity.

Contract number.

Contract title Contract type Brief description of contract or subcontract and relevance to this requirement Total contract value Period of performance Contracting Officer, telephone number, and e-mail address

(if available) Program manager/project officer, telephone number, and e-mail address (if available) Administrative Contracting Officer, if different from above, telephone number, and e-mail address (if available) List of subcontracts (if applicable).

b. The Offeror should not provide general information on their performance on the identified contracts and subcontracts. General performance information will be obtained from the references.

c. The Offeror may provide information on problems encountered and corrective actions taken on the identified contracts and subcontracts. References that may be contacted by the Government include the Contracting Officer, program manager/project officer, or the Administrative Contracting Officer.

d. If the Government cannot reach a contract reference POC, the Government will attempt to: contact another reference identified by the Offeror, contact a reference not identified by the Offeror, or complete the evaluation with those references who responded. The Government shall consider the information obtained from other sources when evaluating an offeror’s past performance (such as PPIRS, FAPIIS, etc.). The Government is not responsible for the failure of any source to respond to a request for a past performance assessment on a timely basis.

2. Past Performance Questionnaires (PPQs) See Attachment D: For each contract reference submitted (pursuant to paragraph 1 above). The Offeror shall send a PPQ to each reference to be filled out independently. Offeror’s will submit the signed Past Performance references with their proposal IAW the terms of this solicitation. It is the Offeror’s responsibility to ensure the references complete the questionnaires. The questionnaires shall be completed by the cognizant representative of the contract or program (the customer); or, if the reference is for a Government contract, by the Contracting Officer (CO) or Contracting Officer’s Representative (COR) for the contract or program.

Questionnaires shall not be completed by employees representing the interests of the Offeror or its major subcontractor(s) whose performance is being reviewed on the PPQ, including its own employees and those of parents, affiliates, subsidiaries, subcontractors, and other team members.

Note: The Offeror may submit a supplemental narrative for each PPQ if the PPQ does not fully contain the following information: Demonstrates relevancy as evidenced by size, scope, magnitude, complexity, use of key personnel, dollar value, and contract type associated with this ACC requirement. The narrative should also explain, if necessary, what work any major subcontractor(s) were performing. For each identified effort for a commercial customer, the Offeror shall also submit a client authorization letter, authorizing release to the Government of requested information on the Offeror's performance.

8. Volume V – Price (Factor 6)

Offerors shall submit price proposals as stated below.

1. Using the Price matrix (Attachment A), propose Firm-Fixed unit prices for each Contract Line Item (CLIN) listed.

2. Although the Price matrix (Attachment A) includes automated formulas to calculate subtotal and total prices, Offerors are responsible for ensuring that their price proposal is free from mathematical errors. Offerors are further cautioned that failing to propose unit prices on Firm-Fixed-Price CLINs may result in the Government finding their offers non-responsive and eliminate them from consideration for award.

3. Do not propose cost for any cost CLINs listed in the Price matrix. The Government has provided costs on each cost CLIN as an estimate for Offerors. The Government will not include the cost CLINs as part of the total evaluated price.

4. The Offeror shall ensure that its offered prices do not include costs associated with medical malpractice or liability insurance for any personal services Health Care Providers (HCPs). Pursuant to 10 USC 1089(a), DoD shall process any personal injury claim alleging negligence by personal services

HCPs within the scope of their performance as claims alleging negligence by DoD military or civil service HCPs. For personal services, neither the contractor nor the HCPs are required to maintain medical malpractice liability insurance, and the Government will not reimburse or otherwise pay for such insurance should any be purchased.

5. Firm-Fixed unit prices proposed by the successful offeror on the Price matrix will be incorporated into the contract. If the Government issues modifications, the Government will use the unit prices proposed by the successful offeror.

6. The Offeror is advised that by submitting a proposal, it agrees to hold the prices in its offer firm for 360 calendar days.

9. Subcontracting Plan Prior to the award of a contract in response to this solicitation, the Government will request the Offeror’s Subcontracting Plan (if applicable) to ensure compliance with FAR 19.704; FAR 52.219-8, Utilization of Small Business Concerns; FAR 52.219-9, Small Business Subcontracting Plan; DFARS 252.219-7003, Small Business Subcontracting Plan (DoD Contracts); and DFARS 215.304.

If the Offeror is a large business, then the Offeror shall submit upon request from the Government a Subcontracting Plan as required under FAR 19.702 and FAR 19.7044.

Subcontracting Plans shall reflect and be consistent with the commitments offered in the Small Business Participation Plan. Subcontracting plan, upon approval by the contracting officer, will be incorporated into the award.

(End of Addendum to 52.212-1)

FAR ADDENDUM 52212-2

ADDENDUM TO FAR 52.212-2 EVALUATION – COMMERCIAL ITEMS

1. GENERAL EVALUATION INFORMATION

The Government intends to make a single contract award resulting from this solicitation.

However, the Government reserves the right to make no awards. Award will be made to the responsible Offeror whose proposal represents the best value (see FAR 2.101) in accordance with the evaluation criteria herein.

To be eligible for award, the Offeror must be deemed responsible in accordance with FAR 9.1 and its proposal must meet all the requirements of the solicitation, including Limitations on Subcontracting (if applicable) and conform to all required terms and conditions. Offerors must propose to provide all contract line items to be eligible for award.

Alternate proposals are not allowed. Proposals with contingent terms and conditions may be deemed non-responsive and could result in the rejection of an Offeror’s proposal.

1. Competitive, Best-Value Source Selection: This is a best value source selection conducted in accordance with FAR Parts 12 and 15. Award will be made to the offeror whose proposal is determined to best meet the needs of the Government after consideration of all factors. “Best value” is defined here as the selection process that results in the most advantageous acquisition decision for the Government and is performed though an integrated assessment and trade-off analysis among the price, technical/risk, and past performance factors. Application of this best value analysis, tradeoff methodology may result in an award to a higher-rated, higher-priced Offeror where such a decision is consistent with the evaluation factors and the Source Selection Authority reasonably determines that the overall benefit associated with the traded-off non-price factors outweighs the price difference.

2. Discussions: The Government intends to award the contract without discussions with Offerors; however, the Government reserves the right to hold discussions if the Contracting Officer determines them to be necessary. Therefore, the Offeror’s initial proposal should contain the Offeror’s best terms.

3. Competitive Range: If the Government determines that discussions are necessary, then it will establish a competitive range. If the Contracting Officer determines that the number of proposals that would otherwise be in the competitive range exceeds the number at which an efficient competition can be conducted, the Contracting Officer may limit the number of proposals in the competitive range to the greatest number that will permit an efficient competition among the most highly rated offerors.

4. Clarifications: In accordance with FAR 15.306(a), Offerors may be given the opportunity to clarify certain aspects of their proposals or to resolve minor clerical issues.

2.0. EVALUATION METHODOLOGY

Proposals must be prepared and submitted in accordance with FAR Provision 52.212-1 and its addendum. The Source Selection Authority will select the Offeror whose proposal is considered the best value to the Government based solely on the evaluation of the following factors and subfactors.

2.1. Factors

Factor 1 (F1): Compensation Plan (non-price) (Acceptable/Unacceptable)

Factor 2 (F2): Small Business Participation Commitment Document (non-price) (Acceptable/Unacceptable)

Factor 3 (F3): Key Personnel Qualifications (non-price) (Acceptable/Unacceptable)

Factor 4 (F4): Technical/Risk (non-price)

Subfactor TRS1 – Facilities/Leasing Approach Subfactor TRS2 – Administrative Operations Approach Subfactor TRS3 – Clinical Operations Approach

Factor 5 (F5) Past Performance (non-price)

Factor 6 (F6): Price

2.2. Factor and Subfactor Weighting

F1, F2 and F3 will not be associated with the tradeoff process as only those non-price factors not rated on an “acceptable vs. unacceptable” basis can be used in the tradeoff with price.

For purposes of the tradeoff analysis, F4 is the most important factor with F4 subfactors TRS1, TRS2, and TRS3 weighted equally. F5 is less important than F4.

F4 and F5 when combined are significantly more important than F6.

Even though price is a substantial factor in source selection, this competition may result in an award to a higher-rated, higher-priced Offeror. However, the significance of Price as an evaluation factor will increase with the degree of equality in overall merit of competing proposals in meeting solicitation requirements.

2.3. Proposal Evaluation

The Government intends to conduct a concurrent evaluation of all factors followed by the selection process (trade-off analysis). The evaluation includes the Acceptability of Factors F1, F2, and F3, a Technical/Risk Rating for F4, a Confidence Assessment for F5, and a Determination of Fair and Reasonable Pricing for F6.

2.4 Non-Price Evaluation Criteria

Factor 1 (F1): Compensation Plan (non-price) will be evaluated using the descriptions and acceptable or unacceptable ratings in Table 1 and consistent with the requirements of FAR 52.222-46. Only proposals receiving an acceptable rating for this Factor will be considered for award.

Table 1. Total Employee Compensation Acceptable/Unacceptable Rating Method Rating Description Acceptable

The Professional Employee Compensation is sufficient to recruit and retain qualified candidates to support this requirement.

Unacceptable

The Professional Employee Compensation is insufficient to recruit and retain qualified candidates to support this requirement.

Factor 2 (F2): Small Business Participation Commitment Document (non-price) will be evaluated using the descriptions and acceptable or unacceptable ratings in Table 2. Only proposals receiving an acceptable rating for this Factor will be considered for award.

The Government will consider how the Offeror’s proposed Small Business Participation Commitment Document compares with the small business goals listed below. The Government will consider the extent to which the Offeror identifies intended small business partners in its commitment document and the extent to which the document explains the good faith efforts the Offeror will make to meet the specified goals by using small business, SDVOSB, HUBZone small business, SDB, and WOSB subcontractors to the maximum extent practicable.

The Subcontracting goals are as follows:

Total (combined) Small Business Participation: 30%

Women Owned Small Business (WOSB) 5% Small Disadvantaged Business (SDB) Concerns 5% Service-Disabled Veteran Owned Small Business (SDVOSB) 3% Historically Underutilized Business Zone (HUBZone) 3%

Table 2: Small Business Participation Acceptable/Unacceptable Rating Method

Rating Description Acceptable Small Business Participation Commitment meets or exceeds the solicitation small business participation goals.

Unacceptable Small Business Participation Commitment does not meet or exceeds the solicitation small business participation goals.

Factor 3 (F3): Key Personnel Qualifications (non-price) will be evaluated using the descriptions and acceptable or unacceptable ratings in Table 3. Only proposals receiving an Acceptable rating for this Factor will be considered for award.

The Government will evaluate the Offeror’s proposed Key Personnel to ensure they possess the minimum necessary qualifications as described in the PWS. The Government will evaluate the key personnel qualifications on an Acceptable/Unacceptable basis. If any key person proposed by an Offeror does not possess the requisite minimum qualifications, then the Government will assign an Unacceptable rating—which will result in an Unacceptable rating for the entire Factor.

Key personnel for each clinic are the Clinic Administrator, Alternate Clinic Administrator, and Nursing Supervisor. Key personnel at the contract level are the Contract Program Manager, Alternate Contract Program Manager, and Lead Physician (PWS paras 1.18, 5.15.2.1).

Table 3. Key Personnel List Acceptable/Unacceptable Rating Method

Acceptable Key personnel meet the minimum requirements of the PWS paragraphs 1.18 & 5.13.2.1.1, 5.13.2.1.2, 5.13.2.1.3, 5.13.2.1.4.

Unacceptable Key personnel do not meet the minimum requirements of the PWS paragraphs 1.18 & 5.13.2.1.1, 5.13.2.1.2, 5.13.2.1.3, 5.13.2.1.4.

Factor 4 (F4): Technical/Risk (non-price)

F4 Subfactor’s TRS1, TRS2 and TRS3 will be evaluated for the quality of the offered technical approaches in meeting the Government’s requirement. The combined Technical/Risk Rating includes consideration of risk in conjunction with the significant strengths, strengths, weaknesses, significant weaknesses, uncertainties, and deficiencies in determining the technical rating. The evaluation of F4 and Subfactor’s TRS1, TRS2 and TRS3 will use a combined technical/risk rating listed in Table 4 and the risk description in Table 5.

Combined Technical/Risk Rating Table 4

Outstanding Proposal demonstrates an exceptional approach and understanding of the requirements and contains multiple strengths and/or at least one significant strength, and risk of unsuccessful performance is low.

Good Proposal indicates a thorough approach and understanding of the requirements and contains at least one strength or significant strength, and risk of unsuccessful performance is low to moderate.

Acceptable Proposal meets requirements and indicates an adequate approach and understanding of the requirements, and risk of unsuccessful performance is no worse than moderate.

Marginal Proposal has not demonstrated an adequate approach and understanding of the requirements, and/or risk of unsuccessful performance is high.

Unacceptable Proposal does not meet requirements of the solicitation and, thus, contains one or more deficiencies and is un-awardable, and/or risk of performance is unacceptably high.

Risk Rating Table 5

Low Proposal may contain weakness/weaknesses which have low potential to cause disruption of schedule, increased cost, or degradation of performance. Normal contractor emphasis and normal Government monitoring will likely be able to overcome any difficulties.

Moderate Proposal contains a significant weakness or combination of weaknesses which may have high potential to cause disruption of schedule, increased cost, or degradation of performance. Special contractor emphasis and close Government monitoring will likely be able to overcome any difficulties.

High Proposal contains a significant weakness or combination of weaknesses which may have a moderate potential to cause disruption of schedule, increased cost, or degradation of performance. Special contractor emphasis and close Government monitoring will likely be able to overcome any difficulties.

Unacceptable Proposal contains a deficiency or combination of significant weaknesses that causes an unacceptable level of risk of unsuccessful performance.

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