Amendment 2 Questions 2.docx

Amendment 2 The purpose of this amendment is to answer questions.

1. Will the Government please provide a list of the types and brands of prefabricated foot orthotics and ankle foot orthotics you would like included in the quoter’s pricing? If you can provide product names and preferred brand names we can provide a more streamlined quote. For example, there are hundreds of commercial-off-the-shelf orthotics, so if Whiteriver IHS has preferred brands we will only include those brands in our quote and not exclude others.

We really don’t get off-the-shelf orthotics (like ones in boxes) from our current orthotic vendor. We order some prefabricated orthotics with specific (all in millimeters) heel widths, lengths, forefoot valgus, and arch heights. An example of this would be a 52 mm heel width, 168 mm length, 3 degrees of forefoot valgus, and 20 mm arch heights. These prefab 4.0 mm polypropylene orthotics (in multiple sizes and lengths) are often used to see if the patient can tolerate a more rigid device (at a fraction of the cost of a custom orthotic) prior to undertaking the expense of a custom pair of orthotics. Off the shelf orthotics are currently purchased by the Physical Therapy Department and then dispensed by the podiatrists.

1. Will the Government please provide a sample list of the types of orthotics Whiteriver IHS has historically ordered?

In addition to the prefab 4.0 mm polypropylene orthotics in specific sizes/widths/lengths mentioned above, we have traditionally ordered custom 2, 3, and 4 mm polypropylene and graphite orthotics (in various customized thicknesses) with customized topcovers and rearfoot posts, as well as geriatric types of custom devices

3. Can the Government provide an approximate ratio of the percentage of historic orders for foot orthotics compared to ankle foot orthotics (AFOs)? E.g., 90% of the Podiatry Clinic’s orders were for foot orthotics and 10% were for AFOs.

AFO’s are nearly exclusively made by the orthotist who comes to Whiteriver every other Tuesday for their dedicated shoe and brace clinic. In some cases, we do order custom Richie-type AFO’s, but the vast majority of orders are for custom foot orthotics (>90%).

1. Prescription AFO pricing varies by practitioner as multiple components comprise one AFO. For example, an AFO is comprised of a base code and add-on codes. Would the Government prefer we provide a price list of the most popular AFOs using a flat fee for each AFO, or would you prefer a breakdown of the base codes and add-on codes?

I currently do not have the specific government/military price breakdown as this is handled per the supply department. I am fairly sure that our current foot orthotic lab charges a single all-encompassing price which includes topcovers, rearfoot posting, etc. Again, AFO’s are nearly exclusively handled by our shoe and brace clinic which is run by the Physical Therapy Department, so you would have to ask them for their actual pricing.

1. Who at the Podiatry Clinic casts for custom prescription AFOs?

The podiatrists are the only providers that take negative impression plaster slipper casts for foot orthotics. As far as AFO’s go, again that is handled mainly by the shoe and brace clinic.

1. Is there an incumbent? If so, who is the incumbent?

KLM Labs is our current foot orthotic provider.

1. The Buy Indian Act (25 USC 47) provides the Bureau of Indian Affairs, and therefore IHS, with the authority to set aside procurement contracts for Indian-owned and controlled businesses. Acquisitions of supplies or services using either Commercial Item Procedures (FAR Part 12) or Simplified Acquisition Procedures (FAR Part 13) must be set aside exclusively for Indian Small Business Economic Enterprises (ISBEE) which is an IEE that is also a small business concern established in accordance with SBA small business criteria and size standards. (DIR 1480.503). In light of the Buy Indian Act and guidelines for IHS and other U.S. Department of the Interior agencies to set aside work for Indian Economic Enterprises (IEE), will IHS please revise the solicitation to be set aside for IEEs that are also small business concerns?

From our Market Research and using the Small Business Dynamic Search. We searched Native American Owned Small Business under NAICS Code 339113 we didn’t find two or more Native American Owned Small Businesses that had the capability to provide Custom and Over the Counter Foot and Ankle Orthotics. This requirement is set-aside to all small businesses in order to receive adequate competition.