MEDEVAC QUESTIONS AND ANSWERS -001 AMENDED PWS FORTHCOMING 060822.docx

MILITARY SEALIFT COMMAND

N3220522Q0077

QUESTIONS AND ANSWERS - 0001

The following are answers to questions received from potential offerors. The answers provide clarification only and DO NOT constitute an amendment to the draft solicitation.

1. We are hoping to find out if there is (was) an incumbent contractor performing these services, or if this is a brand new contract. If there is an incumbent, could you please provide the current / previous contract number?

ANSWER: Amended PWS is Forthcoming.

2. Part 5. As the current document specifies that the Contractor’s responsibility shall terminate once a medical treatment facility has accepted custody of a patient I was wondering who will monitor the patient’s admission and potential future care?

3. Part 5. And if they are later deemed to be fit to return back to the ship, will they handle that travel arrangement on their own?

4. Section 52.212-1, Page 25. Can the USG confirm that the Pricing Spreadsheet does not count toward the 15-page page count?

5. Section 52.212-1, Page 25. Can the USG confirm that resumes are out of page count?

6. Section 52.212-1, Page 25. Can the USG confirm if tables and graphics can 10-point font Times New Roman?

7. Section 52.212-1, Page 25. Can the USG confirm if additional past performance narrative will be accepted from the Offeror to demonstrate our most relevant projects?

8. Part 5. Is the contractor expected to refer or manage urgent but not emergent portside evaluations for acute and chronic illness?

9. Part 5. Does the facility list need to include sites for urgent but not emergent evaluations for patients who are expected to return to the ship?

10. Part 5. Is there a requirement to evacuate a mariner from a ship that is not in port?

11. Part 5. Will the U.S. Government/Department of State assist with entry into countries that have defined waiting periods for entry to assist the contractor to meet the 24-hour transport (med-evac) requirement?

12. Part 5. Often local port agents arrange port to facility transportation. Is the intent of the Government to utilize the contractor for all these services or only in cases when the port agent cannot meet the need?

13. Part 5. Is the Government asking the contractor to provide all guarantees of payment for local medical transport, medical services, and MEDEVAC?

14. Part 5. Are we to issue Guarantee of Payment as well for treatment being sought on shore?

15. Part 5. What is the maximum coverage for cost of care and travel arrangements (including Medical Evacuations)?

16. Part 5. Are repatriations other than those conducted via air ambulance included in this effort?

17. Technical Exhibit 1, Page 12. Regarding PRS 1, it appears that the performance objective pertains to medical advisory services, but the standard pertains to medical evacuation services. Is this an error?

18. Technical Exhibit 1, Page 13. Regarding PRS 8, when does the 24-hour transport requirement start and end?

19. Paragraph 5.1.2.f of the draft PWS states: “Physician's Recommendation/Referrals. The Contractor shall provide recommendations and assistance to the ship and to MSC activities ashore in selecting the sources and location of appropriate, competent treatment 24/ 7- 365/366 days a year. This service is required when obtaining professional treatment that requires transport of the patient.”

Question: Does MSC require bidders to coordinate acceptance of the patient at the receiving facility? Does MSC require bidders to guarantee payment at the receiving facility?

20. Moreover, 5.1.2.d requires bidders to provide medical records for on-going current cases.

Question: Does this mean simply the records associated with advice provided by the bidder to MSC? Or does MSC intend this to include records of diagnosis and treatment provided by local healthcare providers to which the MSC civil mariner has been referred?

21. Finally, does MSC want a “return to duty” recommendation as part of overall case management?

22. PRS #2. This section refers to a Medical Protocol Manual. Question: What does MSC require for this manual? ANSWER: Amended PWS is Forthcoming.

23. PRS #2. XXXX’s standard practice is to develop, collaboratively with our clients, unique Operations Procedures that lay out the steps to be followed to provide assistance and/or evacuation to that particular client’s employees.

Question: Is that what MSC has in mind for this requirement?

24. If MSC requires guarantees of payment, then the pricing spreadsheet will require an additional CLIN for the cost-reimbursable payments to medical providers. Furthermore, if MSC requires medical records for current cases to include translated medical records from local healthcare providers, or if MSC will require interpreters for real-time telephonic support to patients in local hospitals, this should be specified in the PWS. The cost for these services can be estimated and included in the case fee (see recommended Contract Strategy below), or can be priced separately in a cost reimbursable CLIN.

25. 1.6.912. “[Personnel utilized to perform medical advisory services under this Contract shall meet the requirements specified below:] Licensed to practice medicine in the United States. Our operational model of 27 Assistance Centers distributed worldwide allows us to leverage the local knowledge and expertise of medical professionals licensed in countries other than the United States to ensure an in-depth understanding of the capabilities and limitations of healthcare in a given geographic region.

Recommendation: We recommend that MSC allow for Non-U.S. licensed but Qualified Physicians / Specialists to provide medical advice to MSC ships. This enables MSC to benefit from individuals that are specialized not only in safe medical practices but knowledgeable of available medical infrastructure, standards of care, and nuances of social and professional norms in the locations in which treatment is being sought.

26. Paragraph 52.212-1.e.(2) Technical Approach (page 24) states that bidders must provide complete resumes of “the personnel who will provide service under any contract awarded pursuant to this RFQ.” XXXX believes this is overly broad. To coordinate an aeromedical evacuation from Diego Garcia, for example, XXXX may activate both its Philadelphia and Singapore Assistance Centers, involving medical, operations and aviation personnel in both locations. If the movement isn’t completed within a single shift, then the next shift’s counterparts would pick up the case and continue working it to completion. Literally dozens of our employees may be involved in a single case, not including the administrative, aviation, and medical staff of any third-party air ambulance provider we retain to complete the movement.

Recommendation: MSC should identify specific and key roles (for example, a program manager, medical director, or aviation manager) for the offeror to provide proposed resumes.

27. PRS #4. This requires daily email updates in addition to 365/366 day portal access.

Recommendation: XXXX recommends that MSC consider an “as appropriate or required, but no less than weekly” email update requirement to alleviate the burden of daily updates if no new information is available.

Furthermore, this requirement includes a provision that the portal provide a summary in Excel format.

Recommendation: We recommend that MSC not specify the format of the portal’s report.

For example, XXXX provides clients with our “Manager View” portal that offers 7x24x365 access to all case information, in parallel with an email “Notification of Case” that is sent to clients with case updates. While these are not in Excel format, they provide our clients with all relevant data to ensure they are aware of the status of cases involving their employees.

28. PRS #7. This requires bidders to provide information for known health risks, emerging threats, etc. with a 100% completion rate within 12 hours. Although much of this information is maintained on XXXX’s portal (available to MSC 7x24x365) any non-standard requests for information may require research on the part of XXXX staff and experts. We are usually able to provide a verbal answer within 12 hours, but if MSC requires a written report, that may require longer than a 12 hour window for completion.

Recommendation: We recommend MSC consider a verbal update within 12 hours, and a written report within 48 hours. Note that this requirement is repeated in the Table of Deliverables on page 14 and would need to be edited there as well.

29. PRS #8. This requires bidders to be able to transport patients within 24 hours. Medical Evacuation Services are dependent upon various factors some of which can be controlled and managed by the Contractor others that are outside of our purview. For example, patient condition, treatment facility, aircraft availability, and air strip availability are some of the various factors that go into determining an evacuation timeline. All of this is significantly more challenging and time consuming during the COVID-19 pandemic, when landing rights may be difficult to secure based on local COVID mitigation measures, even for non-COVID-positive patients.

Recommendation: XXXX recommends that MSC remove this requirement.

ANSWER: Amended PWS is Forthcoming.

30. Section 52.212-2 of the draft solicitation states “The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government. The Government will award to the lowest priced technically acceptable (LPTA) offeror.”

Recommendation: XXXX recommends that MSC instead elect to evaluate offers on the basis of “Best Value” to enable MSC to select a solution based on a qualitative evaluation of the proposed solutions, balanced against the government’s own estimates of cost and the added value a superior solution provides. Best value evaluation also permits MSC to receive diverse and innovative solutions that address the performance-based requirements and consider solutions that enable medically and fiscally sound decisions on a case-by-case basis.

31. Past Performance. Coordinating aeromedical evacuation from remote locations such as the ones identified in MSC’s proposed Notional Scenarios (Diego Garcia, Ascension Island) is challenging under normal circumstances, and even more so during the COVID-19 pandemic.

Recommendation: XXXX recommends that MSC require bidders to demonstrate:

1) Successful past performance of aeromedical evacuation of patients from very challenging, remote locations.

2) Successful past performance of aeromedical evacuations of COVID-19 positive patients from diverse geographic locations.

30. CLIN 0001 – Medical and Travel Advisory Services For the medical and travel advisory services portion of the contract, XXXX recommends a fixed price CLIN which will be at monthly amount based on the pre-determined size of the population. This will provide unlimited health and travel risk assistance for all MSC covered population. The covered population will be supported no matter where in the world by our regionally dedicated ACs.

31. CLIN 0002 – Medical Evacuation Case Management Fee

For medical evacuation support to MSC Ships, XXXX recommends fixed fee and cost reimbursable CLINs which would provide a fixed case fee for managing the evacuation and separately a third-party cost for the evacuation. This is similar to the structure under the TRICARE Overseas Program contract where DHA pays a fixed fee amount for the arrangement of medical evacuation services and reimburse the actual cost of the evacuation through a claim against the TRICARE benefit.

Thus, XXXX recommends an FFP case fee for this CLIN, and the cost reimbursable CLIN 0003 shown below.

32. CLIN 0003 – Medical Evacuation Costs

XXXX suggests having a plug number based on MSC’s historical cost for evacuations which would be a bundled amount to include the cost of the aircraft, medical personnel, and flight personnel. MSC would be provided a quote in each instance a medical evacuation is needed and a detailed invoice after the evacuation is performed.

33. “Attachment 1 – Pricing Spreadsheet.xlsx” requests hourly rates for medical professionals in various geographic locations. XXXX recommends not taking this approach to pricing the services required under the draft Performance Work Statement.

The approach presented by MSC to medical evacuation and assistance support pricing is not typical in the overseas marketplace. Without specific known locations of patient origin, known destinations (e.g. receiving medical facility), the various priority factors for the patient (e.g. criticality of patient’s situation), and the various potential patient conditions (which may change the mix of medical professionals on board the evacuation aircraft), this pricing structure will lead bidders to price to accommodate the highest potential evacuation scenario that can be conceived.

A more financially prudent approach for determining price reasonableness would be to have the bidders price the Notional Scenarios presented by MSC in section 52.212-1 (page 24) of the draft PWS. Upon contract award, MSC can issue requirements for creating a more fiscally responsible approach. For example, because each bidder is likely to rely on a global network of vetted independent air ambulance providers, MSC could require the successful bidder to present multiple firm-fixed price evacuation quotes for each required evacuation on a case-by-case basis. The quotations will then consider the aspects mentioned above and MSC can then choose the most medically and fiscally appropriate solution.

34. Therefore, will MSC consider asking the bidders to price scenarios and make a determination of reasonableness on that premise with the ultimate contract requiring multiple quotes for any actual evacuations? Given the small number of evacuations that MSC conducts per year this seems like a valid approach with the risk of pricing concern mitigated by comparing competitive offerings.

35. We note also that the page limitations (noted on page 25 of the draft solicitation) do not address the length of the past performance volume.

Question: Does MSC intend for past performance to be included in the overall 15-page limit for the Price Quote and Technical Approach?

36. XXXX offers the following for MSC’s consideration in developing a procurement strategy:

MSC’s approach to this procurement will lay the foundation for effective, responsive and timely contractor-provided overseas access to care for years to come. To acquire the high-level talent, expertise, and proven processes and systems necessary to meet the needs of MSC’s globally-deployed personnel, XXXX recommends an acquisition strategy with the following elements:

· Award to a Single Contractor will prove to be beneficial and in the best interest to the MSC’s covered population. A fully integrated global medical and security assistance program provides information, advice and assistance from a combined medical, security and travel perspective.

· A full and open procurement that allows industry to propose best-in-class solutions that are already scaled to support MSC’s demanding needs.

· Evaluation of the financial strength and scale of offerors. Access to information, evacuation capabilities, and financial stability and resources are crucial for the success of a program like the one detailed in the RFI. For example, in various locations and/or with various providers the only avenue for successful medical care is a guarantee of payment. Therefore, financial resources to make these international payments are critical.

· Confirm the Program is Quality Certified to ensure there is a consistent and monitored approach to the services being provided.

· Ability to deliver range of services related to Duty of Care. Competent organizations look to prevent / mitigate issues, raise employee awareness, take care of the employee based on what is available at the location (not just immediately execute an evacuation), and deliver comprehensive, integrated solutions. MSC’s requirements may change over time and it is critical that the partner chosen for the Duty of Care responsibilities has the ability to grow and change with MSC.

37. Section 52.212-1, Page 24. Is a completed Pricing Spreadsheet all that is required for a complete Price Quote? Can additional narrative be provided in a separate Price Volume is the Offeror deems it beneficial?

38. I received an update that the subject Pre-solicitation has been updated today. However, the only change I can find is an updated response date of 4 March. But there is no amplifying information concerning response – documents are still draft, and there is no narrative concerning the response.

Appreciate any guidance and amplification you can provide.

39. We are actively assessing the updated RFQ from you guys in SAM.Gov. and are interested in bidding. I cannot find anything that resembles a Capabilities Statement or Form to Demonstrate Abilities in the documents listed. Am I missing something?

Please let me know your thoughts.

ANSWER: Amended PWS is Forthcoming.

40. What do you require from us by April 22nd to notify you we are interested in Bidding on this new contract?

** NO FURTHER QUESTIONS WILL BE RECEIVED AS OF 09 JUNE 2022. THANK YOU **