N62645-17-R-0020_Amendment_0001_Combined_Synopsis_&_Solicitation.docx

N6264517R0020

COMBINED SYNOPSIS/SOLICITATION

CAPABILITY-BASED MEDICAL TREATMENT FACILITIES

FOR

NAVY EXPEDITIONARY HEALTH SERVICES SUPPPORT

AMENDMENT 0001

The purpose of this amendment is to answer questions from potential offerors and to extend the closing date.

This is a combined synopsis/solicitation for commercial items prepared in accordance with FAR 12.6, Streamlined Procedures for Evaluation and Solicitation of Commercial Items. This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued. It is the contractor’s responsibility to be familiar with the applicable FAR and DFARS clauses and provisions. The FAR and DFARS clauses may be accessed in full text at http://farsite.hill.af.mil/ current to FAC 2005-95.

The NAICS Code is 332312, with a business size standard of 500 employees.

This Request for Proposal (RFP) is a full and open competition for a Role 2 Enhanced (R2E) facility of Capabilities-Based Medical Treatment Facility that uses rigid-wall containers to provide a theatre medical facility which is clinically effective, as well as, being a rapidly deployable, independently operable, scalable, and modular expeditionary medical capability.

The solicitation number is N62645-17-R-0020.

This solicitation will result in one Firm Fixed Price contract.

Proposal Submission.

Proposals shall be submitted in accordance with the RFP (Addendum to 52.212-1 Instructions to Offerors – Commercial Items) to justin.d.robertson12.civ@mail.mil and heather.m.skimson.civ@mail.mil.

QUESTIONS AND ANSWERS

1. Offerors are required to provide a list of all essential durable medical equipment that is included to provide the operational functionality of the R2E as well as the total price for delivering that equipment. The 100% completed Solution will include this equipment but will undoubtedly be interpreted differently by each Offeror. Will the Government provide a list (with Part Numbers and Cage codes) of this durable medical equipment so that its evaluation of each Offeror’s proposal is consistent with the Streamlined Procedure under FAR 12.6?

Response: The Government will provide a list (Attachment 2 Appendix A and Attachment 3 Appendix B) of equipment currently in use in a similar Role 2 Enhanced tent-based capability, however the list is not intended to be directive in nature but used as a guideline.

2. If the Government cannot provide this equipment list, how will offers that contain different and wide ranging equipment lists get streamlined by the Government for its evaluation?

Response: See response to question #1.

3. To more accurately estimate Life Cycle Costs how many patients and non-patients are expected to occupy the R2E facility on any given day? The formula for Total Water Cost, for example, contains daily water usage for patients and non-patients but does not specify the daily number of patients and non-patients who will use this water. A low estimate by an Offeror will result in a lower Life Cycle Cost.

Response: This question will be addressed in the next amendment.

4. Section 2.2 states that the R2E will have the capability to hold at least 10 post-surgical patients. What is the maximum number of post-surgical patients that would need to be accommodated at one time?

Response: This question will be addressed in the next amendment.

5. Section 4.1.16 states “The rigid-wall containerized capability shall have a singular standalone space to support morgue operations with storage capacity for up to 6 remains.” Is this standalone space to be included in the 9 TEU’s or can it be an additional, separate storage container?

Response: This question will be addressed in the next amendment.

6. Section 4.1.23 states the requirement for bathroom and shower service for a minimum of 10 patients. Do separate bathrooms and showers facilities need to be provided for male and female patients?

Response: This question will be addressed in the next amendment.

7. What is the maximum number of patients that would be using these bathroom/shower facilities?

Response: This question will be addressed in the next amendment.

8. Can drawings be submitted on 11 x 17 pages in the proposal?

Response: Yes. ADDENDUM TO 52.212-1 INSTRUCTIONS TO OFFERORS: paragraph B. Proposal Format and Preparation Instructions, paragraph 5.a of the RFP has been revised.

9. Section 3.1.8. Please explain the rationale for establishing the objective of nine TEU’s. What was the basis for this objective?

Response: This objective is based upon observations and lessons learned.

10. Addendum C (Vol III)(2). LCC=I+Repl-Res+E+W+L(OM&R)+O; What is the assumed interest rate to be used to convert FV to PV?

Response: Please refer to the following website. https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/memoranda/2017/m-17-10.pdf

11. Addendum C (Vol III)(2). LCC=I+Repl-Res+E+W+L(OM&R)+O; What is the depreciation method to be used?

Response: Depreciation shall be calculated using the straight-line method.

12. Addendum C (Vol III)(2). LCC=I+Repl-Res+E+W+L(OM&R)+O; What is the cost rate ($/gallon) of water consumption over time?

Response: This question will be addressed in the next amendment.

13. Addendum C (Vol III)(2). LCC=I+Repl-Res+E+W+L(OM&R)+O; What is the cost rate of electricity ($/W) consumption over time?

Response: This question will be addressed in the next amendment.

14. Addendum C (Vol III)(2). LCC=I+Repl-Res+E+W+L(OM&R)+O; Is there an average amount of power usage per day to use in the calculations?

Response: Offerors shall estimate the average amount of power usage per day based on number of days/number of patients contained in solicitation and their knowledge of how their equipment functions or amount of power their equipment utilizes.

15. Addendum C (Vol III)(2). LCC=I+Repl-Res+E+W+L(OM&R)+O; Is the lifetime expectancy of the equipment representative of how long the equipment is expected to last or the useful life of the equipment?

Response: As stated in the solicitation in ADDENDUM TO 52.212-1 INSTRUCTIONS TO OFFERORS, paragraph C. Evaluation Criteria – Instructions, Volume III, paragraph 2, “The estimated lifetime expectancy for the containers is 20 years and the lifetime expectancy of the medical equipment is seven years.”

16. Section 3.1.4. Please clarify the equipment/capabilities provided by the external communications connection provided by the ship and host unit? We want to ensure compatibility for power, weight, space, etc.

Response: This question will be addressed in the next amendment.

17. Section 4.1.15. Please clarify capacity needed for food and perishable refrigeration, since the previous RFP requirements for Mess facilities are no longer requirements for the system.

Response: There is no requirement in this RFP to provide food service capability, so no need for food refrigeration.

18. Is there an estimated start date to use for CLIN0001? We need a start date to determine our costs.

Response: The estimated award date for the contract is 1 October 2017 and the delivery date for CLIN 0001 is 29 December 2017.

19. Will the government award CLIN0001 and CLIN0002 at the same time?

Response: The contract will be awarded with both CLINs. The CLINs have separate delivery dates and payments will not be made until delivery is made.

20. If CLINs not awarded at the same time, will long lead items be authorized prior to award of CLIN0002?

Response: See response to question #19.

21. Addendum C (Vol III)(1)(c). Volume I Tab 3 milestones are requested. However, in same section Volume III requirements it states “Note: Milestone payments will not be provided” Please clarify.

Response: Yes, milestones are required as a part on an offeror’s Time Phased Project Plan. Additionally, Volume III requires offers to propose estimated prices that crosswalk to the completion of specific tasks identified in the Time Phased Project Plan submitted with Volume II. This is to help the government understand how offerors calculated their total price. Milestone payments will not be made. Only two payments will be made; one each upon delivery of CLIN 0001 and CLIN 0002.

22. Section 3.1.1. The requirement is for six casualties to arrive at once. Can the ICU/acute care beds be utilized for patient/casualty receiving or is it assumed that the patient receiving area needs its own beds?

Response: The casualty receiving area is separate from the intensive care unit and acute care ward.

23. Addendum C (Vol III)(1)(c). Solicitation N62645-16-R-0039 Offeror’s were requested to propose milestone payments. It appears the government changed the requirement? Please clarify.

Response: Each solicitation stands alone. Under this solicitation and resultant contract milestone payments will not be authorized.

24. Payment type. The Solicitation is Firm Fixed Price with WAWF. However, the acceptance criteria associated with the deliverables do not appear to be clearly defined. In order to alleviate uncertainty, would the government accept a proposed milestone payment schedule?

Response: Milestone payments will not be made under the resultant contract.

25. Addendum C (Vol III)(1)(c). Paragraph C under Volume III requirements it states “Note: Milestone payments will not be provided”. Will the government entertain a potential milestone payment schedule prior to contract award?

Response: Milestone payments will not be made under the resultant contract.

26. Section 3.1.1. Previous RFP provided a list of equipage. No list was provided with the new request for proposal. Will the customer provide the same equipage list from the previous request for proposal?

Response: See response to question #1.

27. Addendum C (Vol III)(1)(c). Paragraph C under Volume III requirements it states “Note: Milestone payments will not be provided”. If Milestone payments are not acceptable, then would the government entertain other forms of payment during contract performance prior to final acceptance of deliverables?

Response: Contract financing payments will not be made under the resultant contract.

28. Are soft-sided access or connecting walkways acceptable?

Response: Access and/or connecting walkways must meet all applicable American Bureau of Shipping and U.S. Coast Guard requirements per RFP paragraph 4.1.4.

29. What is the Temperature Range Operation required? It appears that two different ranges are listed between Section 4.1.8 and 4.1.12.

Response: This question will be addressed in the next amendment.

30. Section 4.1.15 notes “separate monitored refrigeration for food and other perishables”. What are the associated food and perishable requirements, if any?

Response: See response to question #17.

31. Is the morgue space considered part of the medical capability?

Response: This question will be addressed in the next amendment.

32. Per 3.1.6, will the network need to be able to perform dynamic routing through protocols such as OSPF or EIGRP?

Response: This question will be addressed in the next amendment.

33. Per 3.1.5, will the networks only have 1 point of egress through the router that will be connected, and if so, what types of egress circuits will be used?

Response: This question will be addressed in the next amendment.

34. Per 3.1.4, what are the hardware requirements for the computers and networking equipment to connect to the TMIP-M and JOMIS systems?

Response: This question will be addressed in the next amendment.

35. Per 3.1.6, which modules must have the necessary equipment to connect to the SIPRnet? Which modules must have the necessary equipment to connect to the NIPRnet?

Response: This question will be addressed in the next amendment.

36. Per 4.1.19, what kinds of radios are required?

Response: This question will be addressed in the next amendment.

37. What is the required bandwidth for the containers uplinks to the nets via external communication connections?

Response: This question will be addressed in the next amendment.

38. What rooms will require SIPR connections?

Response: This question will be addressed in the next amendment.

39. Although the TEU’s can be repurposed for different functions, is there a defined preference for how they should best be arranged to transfer patients between staging elements?

Response: No, the Government expects and desires industry innovation to achieve a solution to meet the specified performance objectives.

40. What medical equipment does the Government or its SME’s recommend for its interpretation of a 100% Solution?

Response: This question will be addressed in the next amendment.

41. Can the successful Offeror’s proposed medical or communications equipment be modified after an award?

Response: Upon mutual agreement of the parties an equal to or greater than substitution/replacement may be considered if determined to be within scope of the contract.

42. Since there are a significant number of questions pending response and these responses may greatly affect the design of the system, can the government please provide at least a 2 week extension on the due date to allow for time to incorporate the answers provided into the proposal?

Response: The closing date of the solicitation has been extended. Please see ADDENDUM TO 52.212-1 INSTRUCTIONS TO OFFERORS: paragraph A.6.

43. Since the answers to questions may result in additional questions, can the deadline to submit questions be extended?

Response: The closing date of the solicitation has been extended. Please see ADDENDUM TO 52.212-1 INSTRUCTIONS TO OFFERORS: paragraph A.6.

44. 3.1.2 The rigid-wall containerized medical capability shall contain the necessary medical equipment and supplies to be able to stabilize post-surgical cases for evacuation to definitive medical care.

Does the government intend on providing a bill of materials of what medical equipment and supplies it desires as a minimum requirement?

Response: This question will be addressed in the next amendment.

45. 3.1.8 - The medical capability shall be packed, loaded and transportable in the fewest number, with an objective of no more than nine, 20 foot equivalent units (TEU’s), not including TEU’s necessary for storage of 15 days of supply.

45.a. Does the government plan on including the spaces for administration, medical logistics, biomedical repair, and Command and Control sections in the nine, 20 foot equivalent units (TEU’s) medical capability?

Response: Yes.

45.b. If the nine TEU is the objective does the government have a threshold?

Response: This question will be addressed in the next amendment.

46. 4.1.22 - The rigid-wall containerized capability shall have universal component interlocking capability to connect or disconnect allowing for multiple complexing configurations within the design, consistent with envisioned operations within the hold of a cargo ship. Patients and staff shall be able to transition from one location to another without exiting the rigid-wall container capability.

Is the government acceptable to soft sided boots that seal the connections between containers?

Response: See response to question #28.

47. 3.1.17 - The rigid-wall containerized system shall be equipped with 208V, 30 amp 3 phase capability and water recovery technology to support sterilization procedures.

Does the government mean that the water recovery only pertains to the sterilization system that is used to sterilize the medical instruments and not water recovery for any other requirement like grey waste water?

Response: Yes, water recovery only pertains to sterilization.

48. 3.1.11/4.1.10 - The rigid-wall containerized capability tie downs, secure tracks or other technology to secure equipment, furniture, etc. design shall have the flexibility to support various configurations to support scalability and complexing (i.e., snapping together) of multiple MSFPs. For example, a container initially outfitted with equipment to support a specific function (e.g., radiology, laboratory, etc.) may be repurposed to support a different function simply by relocating the equipment from one container to another.

48.a. Is the specified requirement that the design shall have the flexibility to support multiple configurations tied to complexing capabilities of specific MTF functional modules or the ability to shift the functional use of individual modules, i.e., OR can be shift to support ICU or ACU or vice versa or both?

Response: This question will be addressed in the next amendment.

48.b. Please specify which containers are medical capability that need to be interchangeable and which containers are considered non-medical that will need to be interchangeable? ie: medical capability containers are the OR, ICU, ACU & Casualty Receiving Point. Non-medical are Admin, C2, Lab etc?

Response: This question will be addressed in the next amendment.

49. 4.1.17 - The rigid-wall containerized capability shall meet all ABS standards for fire alarm notification system that can be integrated with existing ship alarm systems and vice versa; each container shall meet all ABS standards for operable mounted 10B NFPA fire extinguishers and carbon monoxide detectors.

What is the existing shipboard alarm notification system with specific connection types to support MTF solution alarm system integration?

Response: This question will be addressed in the next amendment.

50. 4.1.19 - The rigid-wall containerized capability shall have organic internal communication (phones, radios, intercom) that must integrate with host unit/ship general and emergency communications systems and shall be designed with multiple ports for server and network connections; a minimum of 2 stations per container.

What is the existing shipboard general and emergency communications systems with specific connection types to support MTF solution voice/data communications system integration?

Response: This question will be addressed in the next amendment.

51. 4.1.11 The rigid-wall containerized capability shall have the capacity to store all medical equipment, as well as 15 days of supply of medical, surgical, and pharmaceutical consumables to include a combination safe to secure controlled narcotics and administrative supplies. The safe should be at least large enough to hold controlled narcotics sufficient for the operation of the R2E capability for 15 days.

Does the government intend to issue a list of what they require for a 15 day of supply of medical, surgical, and pharmaceutical consumables to include controlled narcotics and administrative supplies?

Response: The Government will provide a list of consumables currently in use in a similar Role 2 Enhanced tent-based capability, however the list is not intended to be directive in nature but used as a guideline.

52. 4.1.23 The rigid-wall containerized capability shall provide central laundry service (capable of washing soiled medical linen, scrubs, gowns and the like (Center for Disease Control min 160 degrees Fahrenheit-25 mins), bathroom and shower service for a minimum of 10 patients. Approximately100 pounds per day.

What are the design parameters - number or personnel/patients per latrine, shower, and laundry that would meet the government’s needs? Do the showers and latrines need to be handicap accessible / accommodate a wheel chair? Are two latrines, two showers, two sinks and 1 each washer/dryer a sufficient quantity for this requirement?

Response: This question will be addressed in the next amendment.

53. 3.1.5 The rigid-wall containerized capability shall maintain voice communications with supported units’ evacuation and command nets via external communications connections provided by the host unit/ship.

Is there a standard connection type that is provided by the host unit/ship?

Response: This question will be addressed in the next amendment.

54. 3.1.6 The rigid-wall containerized capability shall provide connectivity to shore via Secret Internet Protocol Router Network (SIPRnet) and Non-classified Internet Protocol Router Network (NIPRnet) sufficient for patient movement and patient regulation activities. The rigid-wall containerized capability must connect to the Theater Medical information Program Maritime (TMIP-M) network and TRANSCOM Regulating and Command & Control Evacuation System (TRAC2ES).

Will the host unit/ship provide the operational SIPR/NIPR communication network for connectivity or is a standalone satellite communication system required to provide this capability?

Response: The host unit/ship will provide network connectivity.

55. 3.1.12 The rigid-wall containerized medical capability shall provide no less than (93% +/-3%) portable oxygen. The rigid-wall containerized capability shall have portable medical oxygen generation capability sufficient to support 7 surgeries per day, 10 post-surgical patients (up to 4 ICU patients), and filling oxygen bottles for evacuation of up to 2 patients per day.

What Is the desired minimum number of liters of oxygen required to support 7 surgeries per day, 10 post-surgical patients (up to 4 ICU patients), and filling oxygen bottles for evacuation of up to 2 patients per day? Is there a requirement for additional gases?

Response: This question will be addressed in the next amendment.

56. 3.1.13 The rigid-wall containerized communication capability shall provide network display capability (monitors) to review medical information throughout the R2E medical facility.

Is there a minimum or desired size of the display to provide sufficient/best ability to review medical information? Is this a workstation that requires a keyboard, mouse and computer as well?

Response: This question will be addressed in the next amendment.

57. 4.1.11 The rigid-wall containerized capability shall have the capacity to store all medical equipment, as well as 15 days of supply of medical, surgical, and pharmaceutical consumables to include a combination safe to secure controlled narcotics and administrative supplies. The safe should be at least large enough to hold controlled narcotics sufficient for the operation of the R2E capability for 15 days.

Is there a recommended loadout list for the 15 days of supply of medical, surgical, and pharmaceutical consumables, to include the controlled narcotics, required for continued operations that would allow a better determination of containerized and secure safe storage configuration and capacity?

Response: See response to question #51.

58. 4.1.20 The rigid-wall containerized capability shall be capable of receiving and distributing power from the host ship or unit to the entire complex to include electrical cabling, plugs, adapters, power panels, central digital monitoring and the necessary redundant equipment for independent operations or scaled to increase capacity.

Is the contractor required to provide the connecting cable(s) for receiving power from the host ship or unit? If yes, what type of connectors are used to plug into host ship/unit power?

Response: This question will be addressed in the next amendment.

59. 4.1.24 The rigid-wall containerized capability shall have the means to receive and distribute potable water from host ship/unit as well as to transfer hazardous/medical waste (estimated at 45 ppd) and grey/black water to the host ship or unit for collection and/or disposal.

Is the contractor required to provide the connecting hoses to transfer grey/black water to the host ship or unit? If yes, what type of hose connectors are used to integrate into host ship/unit system?

Response: This question will be addressed in the next amendment.

60. 4.1.16 The rigid-wall containerized capability shall have a singular standalone space to support morgue operations with storage capacity for up to 6 remains. Container should be able to refrigerate at standard morgue temperatures of 34 to 40 degrees Fahrenheit or 1.1 to 4.4 degrees Celsius.

Please confirm that the government does not require the standalone morgue unit to be physically connected to the medical complex?

Response: The morgue does not need to be physically connected to the medical complex.

61. 4.1.25 The rigid-wall containerized capability shall include spaces for administration, medical logistics, biomedical repair, and Command and Control sections. A minimum of a 3 network drops, monitors, furniture and workstations for each section are required.

Please confirm that 3 network drops, monitors, furniture and workstations are required for each of the 4 sections: administration, medical logistics, biomedical repair and C2, for a total of 12 sets?

Response: This question will be addressed in the next amendment.

62. 4.1.15 The rigid-wall containerized capability shall provide monitored refrigeration capability to store up to 60 Packed Red Blood Cells or liquid plasma units, pharmaceuticals and other medical supplies at 1 to 6°C, and separate monitored refrigeration for food and other perishables.

4.1.15 calls out a separate monitored refrigerator for food. What size refrigerator for food and other perishables will be required?

Response: See response to question #17.

63. 4.1.12 The rigid-wall containerized capability shall be capable of being cooled or heated independently or as part of the integrated grouping capable of operating in temperatures ranging from 25°F to 140 °F.

Please confirm that each container is required to have it’s own self-contained heating and cooling system as part of the container system and can also be connected to central heating/cooling systems typically found in FOBs?

Response: Yes, each container is required to have its own self-contained heating and cooling system as part of the container system and can also be connected to central heating/cooling systems provided by host unit/ship.

64. We request a 30-day extension to the current deadline to allow our team to prepare a comprehensive solution for the proposed solicitation.

Response: The closing date of the solicitation has been extended. Please see ADDENDUM TO 52.212-1 INSTRUCTIONS TO OFFERORS: paragraph A.6.

65. Regarding the estimated Life Cycle Costs (LCC) in the Price Volume, is there a specific format in which you want this information presented? Do you want a breakdown of estimate costs for each of the required values in the LCC formula?

Response: No breakdown of the information is required. Offerors shall provide the completed formula and LCC total.

66. Regarding the Time Phased Project Plan, how detailed of a plan do you want offerors to provide? Can you please provide greater detail on the information you seek in terms of “schedule, interdependencies, and milestones?”

Response: It is each offeror’s discretion as to how they choose to propose all the Technical requirements within the 50 page limitation. The purpose of the Time Phased Project Plan is for the offeror to demonstrate understanding of the requirement and to convey the offeror’s plan to achieve the solution. In addition, the offeror shall propose estimated prices that crosswalk to the completion of specific tasks identified in the Time Phased Project Plan submitted with Volume II in accordance with ADDENDUM TO 52.212-1 INSTRUCTIONS TO OFFERORS: C. Evaluation Criteria – Instructions, Volume III –Business/Price paragraph c.

67. Can you please provide a full list of the required rooms/facilities (e.g. Operating Room, 6 Bed Acute Care, ICU, x-ray, etc.) that make up the objective nine TEU “medical capability”?

Response: No, the Government expects and desires industry innovation to achieve a solution to meet the specified performance objectives.

68. Please confirm which MIL-M-81957(AS) standard is required as per section 4.1.8. A search of the Assist website revealed the list of standards below, but none contain the standard with the "AS" ending as referenced in 4.1.8. Please advise.

Response: This question will be addressed in the next amendment.

Exhibit/Attachment Table of Contents

22-MAY-2017

22-MAY-2017

R2E 100% Project Solution

FFP

Role 2 Enhanced (R2E) Medical Facility 100% Project Solution includes the Narrative Response, 100% completed Design Drawing, Time Phased Project Plan, and a Cybersecurity Discussion.

FOB: Destination

NET AMT

R2E Medical Facility

FFP

Marinized rigid-wall container based Role 2 Enhanced (R2E) Medical Facility capable of being assembled and employed to provide primary surgery, resuscitative trauma surgery, emergency medicine, and associated ancillary capabilities.

NET AMT

STATEMENT OF OBJECTIVES

1.1 Overall Objective: This Request for Proposal) is to engage industry to design an innovative outfitting assembly and configuration solution for a complete marinized rigid-wall container based Role 2 Enhanced (R2E) medical facility capable of being assembled and employed to provide primary surgery, resuscitative trauma surgery, emergency medicine, and associated ancillary capabilities. The overarching objective of the rigid-wall Containerized Medical Capability is to provide a medical capability that delivers a fully functional, immediately employable upon emplacement, responsive, deployable, modular and scalable expeditionary medical capability that is clinically effective, incorporating material alternatives into rigid-wall containers afloat and ashore.

1.2 Expectation: The contractor will prepare a written proposal for review by the Government based on the performance objectives and constraints as stated in sections 3 and 4 of the Statement of Objectives.

2.1 Background: The US Navy intends to accomplish an evolutionary modernization of the current Expeditionary Medical Facility-150 bed (EMF-150) capability into a modular and scalable capability called “Capabilities-Based Medical Treatment Facility” (CB-MTF). CB-MTF is a family of capabilities that delivers rapidly deployable, task organized and scalable expeditionary health service support in the afloat or ashore environments in order to support designated combatant command (CCMD) missions across the full range of military operations. The CB-MTF is clinically effective and comprised of a small number of Medical Standard Force Packages (MSFP) that are manned, trained, equipped and certified ready for operations. Inherent in the full CB-MTF capability (known as CB-MTF Major Combat Operations (MCO)), is a Role 2 Enhanced (R2E) capability, the subject of this RFP, that can operate, either afloat in the hold of an available cargo ship or ashore with a host unit. CB-MTF R2E is a Role 2 Enhanced medical facility as defined in Joint Publication 4-02, Health Service Support (http://www.dtic.mil/doctrine/new_pubs/jp4_02.pdf ).

2.2 Vision: Under the CB-MTF Concept of Operations (CONOPS), the R2E is envisioned as a modular capability established in rigid-walled containers that can be configured as necessary to operate afloat in the cargo hold of select Military Sealift Command (MSC) ships or ashore. The R2E capability operating afloat or ashore shall be dependent on the host platform or unit for utilities (power, water, waste handling/disposal, etc.) and staff hoteling services (berthing, messing, laundry, hygiene, etc.). The R2E will have 2 operating room tables to support up to 7 surgeries per day, and have the capability to hold at least 10 post-surgical patients including 4 Intensive Care Unit (ICU) patients, until they can be moved to a higher level of care. The R2E will stand up and operate with medical supplies for up to 15 days without resupply.

2.3 The Role 2 Enhanced (R2E) facility is a CB-MTF Core Attribute: The CB-MTF MCO design is comprised of four separate modular MSFP components. These four components are Role 2 Light Maneuver, R2E, Role 3, and a 100 ward bed augment package. Each MSFP is capable of being transported and operated independently of the others. The CB-MTF provides a scalable capability that will enable the MSFP components to transition from light to heavy casualty throughput by connecting, complexing or snapping one or more MSFP components together to incrementally increase capability and capacity culminating in all components combining to provide the CB-MTF MCO capability. They are configurable to suit major operations or campaigns, crisis response and limited contingency operations, military engagement, and security cooperation missions. The CB-MTF is centered on clinical effectiveness to assure positive outcomes and survivability of the patient. It shall conform to clinical practice guidelines for surgical and other health service support, which includes stabilization, triage, treatment, evacuation and conformance to clinical practice. The CB-MTF deployable capability relies on a standardized universal component rigid-wall container design; allowing for flexibility, ease of transport, compatibility with rapid intermodal handling platform (air, sea, truck and rail) and adaptability of operating afloat or ashore.

3.1 Performance Objectives: The performance objectives described herein are the basis for offerors to understand the overall scope of this requirement from the Government’s perspective. It is expected that the offeror will take the Performance Objectives and propose their best technical approach to meeting the objectives described herein. Core Role 2E Functions include:

3.1.1 The rigid-wall containerized medical capability design shall include a fully functional, clinically effective Operating Room (OR) with two tables, accomplishing up to 7 surgeries per day. It shall have 4 ICU beds and a 6 bed acute care ward capability with sufficient supplies to be sustainable for 15 days before resupply. It shall also have a patient/casualty receiving capability sufficient to assess a minimum of six (6) patients/casualties simultaneously.

3.1.2 The rigid-wall containerized medical capability shall contain the necessary medical equipment and supplies to be able to stabilize post-surgical cases for evacuation to definitive medical care.

3.1.3 The rigid-wall containerized capability shall allow for unencumbered reception of patients, casualties, and free-flow movement for staff and patient transport via standard military patient carrying items such as field litter, gurney, wheelchair or stretcher throughout the structure. The minimum passageway and doorway must be able to accommodate a 33.5 inch wide gurney that is wheeled with the side rails up.

3.1.4 The rigid-wall containerized capability shall have the information technology hardware and communications to support current, Theater Medical Information Program Maritime (TMIP-M), and future, Joint Operational Information System (JOMIS) theater medical information systems. These systems create, edit, store and transmit data regarding patient location, patient status, telemedicine diagnosis and therapy, medical regulation and medical logistics via external communication connections provided by the host ship/unit.

3.1.5 The rigid-wall containerized capability shall be capable of maintaining voice communications with supported units’ evacuation and command nets via external communications connections provided by the host unit/ship.

3.1.6 The rigid-wall containerized capability shall provide connectivity to shore via Secret Internet Protocol Router Network (SIPRnet) and Non-classified Internet Protocol Router Network (NIPRnet) sufficient for patient movement and patient regulation activities. The rigid-wall containerized capability must connect to the Theater Medical information Program Maritime (TMIP-M) network and TRANSCOM Regulating and Command & Control Evacuation System (TRAC2ES).

3.1.7 The rigid-wall containerized capability shall provide uninterruptible power supply (UPS) backup sufficient for powering emergency lighting in all containers independent of each other for at least 12 hours in the event host ship/unit power is interrupted. The UPS shall be able to operate in the same conditions as specified in 4.1.6.

3.1.8 The medical capability shall be packed, loaded and transportable in the fewest number, with an objective of no more than nine, 20 foot equivalent units (TEU’s), not including TEU’s necessary for storage of 15 days of supply. Transport platforms include aircraft (C-130, C-17 or C-5), train, ground or ship.

3.1.9 Packing and methods of preservation shall be marinized to protect material against environmentally induced corrosion and deterioration, physical and mechanical damage and other forms of degradation during storage and multiple handling as well as when employed.

3.1.10 The entire rigid-wall containerized medical capability shall be capable of being rapidly erected and set up to begin medical operations within 30 consecutive hours by the fewest number of individuals feasible in both the afloat and ashore environments. Ground leveling capability for the containers is required for when employed ashore.

3.1.11 The rigid-wall containerized capability modules shall have a scalability component that will allow it to be complexed together with other configurations increasing its capacity and capability. Ships being considered to host this capability include the Bob Hope, Watson, and Gordon Classes of MSC cargo ships. There is variation between and within these classes of ships and, therefore, the flexibility of multiple configurations is required. The R2E capability shall allow for the greatest possible flexibility in reconfiguration or complexing variations in order to improve the ability to meet various ship board designs. Each rigid-wall container of the R2E capability must be capable of securing to the deck of the ship for sea worthiness.

3.1.12 The rigid-wall containerized medical capability shall provide no less than (93% +/-3%) portable oxygen. The rigid-wall containerized capability shall have portable medical oxygen generation capability sufficient to support 7 surgeries per day, 10 post-surgical patients (up to 4 ICU patients), and filling oxygen bottles for evacuation of up to 2 patients per day.

3.1.13 The rigid-wall containerized communication capability shall provide network display capability (monitors) to review medical information throughout the R2E medical facility.

3.1.14 The rigid-wall containerized capability shall have an internal intercom system, external public announcement capability, and internal phone system.

3.1.15 The rigid-wall containerized medical capability shall provide Basic Laboratory procedures in hematology, urinalysis, microbiology, and serology, limited Blood Banking capability (storage for up to 60 units in some combination of packed red blood cells and fresh frozen plasma); no frozen red blood cells capability will be required.

3.1.16 The rigid-wall containerized capability shall provide other ancillary services to include a pharmacy equipped to securely store and dispense medications including controlled substances, radiology equipment consisting of a mobile radiographic x-ray unit, and a portable ultrasound system.

3.1.17 The rigid-wall containerized capability shall be equipped with 208V, 30 amp 3 phase capability and water recovery technology to support sterilization procedures.

4.1 Constraints: The Role 2E rigid-wall containerized medical capability employed afloat/ashore shall conform to following criteria without Government Furnished Equipment (GFE); all included equipment should be new.

4.1.1 The rigid-wall containerized capability shall provide basic secondary health care, built around primary surgery, an intensive care unit, and acute care ward beds.

4.1.2 The rigid-wall containerized capability may be comprised of any combination of non-expandable or expandable quad-, tri-, bi-, and 20’ International Standard Organization (ISO) containers, but must meet the ISO (1496/1) standards. No container (including expandable containers when closed) may exceed 20 feet in length, 8 feet in width, and 8 feet in height to allow intermodal freight transport (rail, ship, truck and air).

4.1.3 The rigid-wall containerized capability shall meet International Convention for Safe Containers (CSC) certification. For storage and transport it will be certified stackable 9 high. If a CSC certified container is structurally modified in any way, it must be recertified prior to government acceptance.

4.1.4 The rigid-wall containerized capability shall meet all applicable American Bureau of Shipping (ABS) and United States Coast Guard (USCG) requirements.

4.1.5 The rigid-wall containerized capability shall have a minimum of two each removable tie-down rings with required cables, straps and connectors (per expandable wall) and four each cables, straps and connectors (one per ISO post) to allow for securing it to the deck of a ship and/or securing to the ground with ground anchors during operation underway or in high winds. These rings and cables shall not interfere with the capability for multiple complexing configurations or entry, exit ramps into and out of containers within the design.

4.1.6 When not in storage/transport configuration, but configured for employment as a Role 2E MTF, rigid-walled containers providing patient care areas may not be stacked. However, rigid-walled containers providing non-patient care areas (e.g., medical supply, administration, etc.) may be stacked up to three high, with approved scaffolding.

4.1.7 The rigid-wall containerized capability (packed out ready for storage/transport) shall not exceed maximum weight of 20K pounds per TEU in its closed position ready for transportation. Below is a list of the container operational requirements:

4.1.8 Below is a list of the container operational requirements:

or 75 lb./ft. 2 uniform snow load (minimum)

0.25 BTU/hr. ft. 2/°F (maximum rate of loss)

4.1.9 The rigid-wall containerized capability, when expanded, shall have the capability of securing all equipment, furniture, etc. by way of tie-downs, secure tracks or other technology that allows for continued operations afloat while underway at sea.

4.1.10 The rigid-wall containerized capability tie downs, secure tracks or other technology to secure equipment, furniture, etc. design shall have the flexibility to support various configurations to support scalability and complexing (i.e., snapping together) of multiple MSFPs. For example, a container initially outfitted with equipment to support a specific function (e.g., radiology, laboratory, etc.) may be repurposed to support a different function simply by relocating the equipment from one container to another.

4.1.11 The rigid-wall containerized capability shall have the capacity to store all medical equipment, as well as 15 days of supply of medical, surgical, and pharmaceutical consumables to include a combination safe to secure controlled narcotics and administrative supplies. The safe should be at least large enough to hold controlled narcotics sufficient for the operation of the R2E capability for 15 days.

4.1.12 The rigid-wall containerized capability shall be capable of being cooled or heated independently or as part of the integrated grouping capable of operating in temperatures ranging from 25°F to 140 °F.

4.1.13 The rigid-wall containerized capability to the greatest extent possible shall be outfitted with prefabricated lighting, multiple 60 Hz/120V outlets, and shelving/cabinets for storing during normal operations.

4.1.14 The rigid-wall containerized operating room shall have high-efficiency particulate air (HEPA) filtration, effective operating room lighting as part of its prefabricated design and meet the National Fire Protection Agency applicable national standards for safe Operating Room practice.

4.1.15 The rigid-wall containerized capability shall provide monitored refrigeration capability to store up to 60 Packed Red Blood Cells or liquid plasma units, pharmaceuticals and other medical supplies at 1 to 6°C, and separate monitored refrigeration for food and other perishables.

4.1.16 The rigid-wall containerized capability shall have a singular standalone space to support morgue operations with storage capacity for up to 6 remains. Container should be able to refrigerate at standard morgue temperatures of 34 to 40 degrees Fahrenheit or 1.1 to 4.4 degrees Celsius.

4.1.17 The rigid-wall containerized capability shall meet all ABS standards for fire alarm notification system that can be integrated with existing ship alarm systems and vice versa; each container shall meet all ABS standards for operable mounted 10B NFPA fire extinguishers and carbon monoxide detectors.

4.1.18 All medical equipment that receives, transmits, creates, edits, and stores data regarding patient information shall conform to the Risk Management Framework (RMF) for DoD Information Technology (IT).

4.1.19 The rigid-wall containerized capability shall have organic internal communication (phones, radios, intercom) that must integrate with host unit/ship general and emergency communications systems and shall be designed with multiple ports for server and network connections; a minimum of 2 stations per container.

4.1.20 The rigid-wall containerized capability shall be capable of receiving and distributing power from the host ship or unit to the entire complex to include electrical cabling, plugs, adapters, power panels, central digital monitoring and the necessary redundant equipment for independent operations or scaled to increase capacity.

4.1.21 The rigid-wall containerized capability power reception and distribution capability shall be able to receive and convert ship or host unit power, 440V and 220V, to standard “clean” 120V/60Hz and distribute to the R2E. Sufficient power is defined as the ability to operate one piece of equipment that would require 208V 3 phase 30 amp and all additional equipment which requires a standard 120vac/60Hz vac. Voltage regulation is required.

4.1.22 The rigid-wall containerized capability shall have universal component interlocking capability to connect or disconnect allowing for multiple complexing configurations within the design, consistent with envisioned operations within the hold of a cargo ship. Patients and staff shall be able to transition from one location to another without exiting the rigid-wall container capability. Envisioned operations are defined as the ability to receive patients in a temporary containerized medical system within the space of a multi-purpose platform. On the multi-purpose platform the containerized system design is limited to accessible space, capability to reposition or reconfigure containers based on that square footage availability, equipment requiring secure locking mechanisms to prevent mishap while underway and modifications necessary to align with the platforms service capabilities (i.e., water, power, waste water, etc.). Deployed ashore, the square footage requirements are generally unrestricted for both the configuration and the container movement.

4.1.23 The rigid-wall containerized capability shall provide central laundry service (capable of washing soiled medical linen, scrubs, gowns and the like (Center for Disease Control min 160 degrees Fahrenheit-25 mins), bathroom and shower service for a minimum of 10 patients. Approximately100 pounds per day.

4.1.24 The rigid-wall containerized capability shall have the means to receive and distribute potable water from host ship/unit as well as to transfer hazardous/medical waste (estimated at 45 ppd) and grey/black water to the host ship or unit for collection and/or disposal.

4.1.25 The rigid-wall containerized capability shall include spaces for administration, medical logistics, biomedical repair, and Command and Control sections. A minimum of a 3 network drops, monitors, furniture and workstations for each section are required.

4.1.26 The rigid-wall containerized capability shall have non-skid entry / exit ramps into / out of containers that are able to be maneuvered and positioned by no more than 6 personnel.

5.1 Additional Contract Requirements

5.1.2 The Contractor shall maintain compliance with DoD Information Assurance Requirements, the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and the provisions of The Privacy Act of 1974 and its DoD applications. In addition, the Contractor shall comply with DODI 8510.01, Risk Management Framework (RMF) for DoD Information Technology (IT) (or current version) and Special Publication 800-37, Guide for Applying the Risk Management Framework (RMF) to Federal Information Systems, National Institute of Standards and Technology. A copy of the instructions may be obtained via these links: http://www.dtic.mil/whs/directives/corres/pdf/850001_2014.pdf http://csrc.nist.gov/publications/nistpubs/800-37-rev1/sp800-37-rev1-final.pdf

5.1.3 Cybersecurity. The contractor shall provide a written document that will discuss their approach to cybersecurity.