VA257-17-R-0506-A00002014.docx

Questions/Answers- Granbury CBOC 4/12/18

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2.

AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

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OF PAGES

10A. MODIFICATION OF

CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

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Offers 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:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(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 electronic communication 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 is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV.

11/2016) is required to sign this document and return ___________ copies to the issuing office.

is not, 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 ITE M 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES

SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR

43.103(b).

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 letter or electronic communication, provided each letter or electronic communication makes r eference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS

ENTERED INTO

PURSUANT TO AUTHORITY OF:

D. OTHER

BY

Contractor

16C. DATE SIGNED

14.

DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

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

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

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

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

11. THIS ITEM ONLY APPLIES TO AMENDMENTS

OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer) ne A00002 04-25-2018 N/A 36C257 Department of Veterans Affairs Network Contracting Office 17 11495 Turner Road El Paso TX 79936-1372 36C257 Department of Veteran Affairs Network Contracting Office 17

To all Offerors/Bidders

VA257-17-R-0506

04-02-2018

X X X ** HOUR & DATE for Receipt of Offers is EXTENDED to:

05/11/2018 at 5:00 PM EST N/A X

a) Issuance of amendment A00002: The purpose of this amendment is to answer vendor questions submitted on 04/12/2018. The deadline for follow-up question and clarifications to this amemdment is Monday, 5/30/18 by 5pm EST.

b) see CONTINUATION PAGES 2-9

c) All other terms and conditions remain unchanged.

Valeria Gutierrez Contracting Officer

1. What is current number of enrolled veterans at the Granbury CBOC? Answer: 1617

2. How many veterans are currently on the billable roster? What is the most recent number of billable enrollee? What is the current number of invoiced veterans to the current vendor? Answer: 1617

3. How many woman veterans are in the geographic area? Answer: Approximately 300

4. What is the assumed growth rate for the Granbury CBOC? Answer: 2-3%

5. Does the current space meet the new contract requirements? Does the current Granbury CBOC location meet the requirements of the new contract? Answer: No

6. Under the new Granbury CBOC contract, is the Granbury CBOC a “veteran only” clinic? Answer: Yes

7. What was the cause of drop in veteran enrollment from 1579 to 373 during the time from of December 2015 to March 2016 with a recovery in April 2016? Answer: There was none.

8. Regarding the Clinical Pharmacy Services:

a. a. Can you confirm that all clinical pharmacy services will be provided by the VA via telehealth? Answer: Yes it will be.

b. We note that Paragraph 2, p. 17, states “The CPS shall be provided the same support staffing given to other providers on the team when they are working in the capacity of a mid-level provider.” Is the Contractor required to provide support staff for VA pharmacists providing services via telehealth? If so, could the Government clarify exactly how many pharmacists will be supporting the Granbury CBOC and exactly what staff must be provided by the Contractor? Answer: Contractor is responsible for staff to support the telecare rooms.

c. Could the VA please confirm what support staff is required for the CPS. Is there to be an RN Care Manager, Clinical Associate, and Clerical Associate provided for each CPS? If so, is this to be provided by the contractor? Answer: Contract is responsible for administrative support/clerk.

9. Paragraph 4.6.12 states, “All PCMHI and Mental Health will be provided on-site by VA Staff.” Could the Government indicate exactly how many and PCMHI and MH staff will be performing on site and what the space requirements are for the Contractor? Answer: 3 staff, standard patient care rooms

10. Is Mental Health via telehealth only? Answer: No

11. What is the position of each VA Mental Health Staff member? Answer: Unknown at this time, the mix can change based on need.

12. What is the number of VA Staff that will be on-site for Mental Health Care? Answer: 3

13. Page 152, paragraph 6.c.i requires the submission of transcripts for Nurse Practitioners. Would it be acceptable to submit transcripts with credentialing packets after Contract Award due to the fact that many qualified personnel do not keep transcripts, and the timelines for obtaining official transcripts can take several weeks, depending on the university? Answer: Yes

14. How many IT closets are required? Answer: 1

15. Regarding wiring and jack specifications: Answer: See attached VA Handbook 0730-4

a. Does the VA IT require wire baskets or are J-hooks OK?

b. Does the VA IT have any specific color combination for wiring and jacks?

c. Does VA IT want regular two post Rack or a locking cabinet rack in IT room?

d. Does the VA IT have any specific requirement for Brand for jacks and rack?

e. What are the jack requirements per drop location? 2 data/ 2 voice or 2 data and 1 voice?

f. What size CAT wiring is required?

g. Is there a specific color of wire needed for data and voice wiring?

16. Page 63 indicates that two (2) tele-health rooms are required for the following services: TeleDerm, Telepharmacy, TeleMental Health, Tele Retinal. There are then two other sections in the tables on pages 63-64 that require rooms for tele-health services but do not specify the room quantity. Can the Government clarify the number of tele-health that are required for the services of TeleDerm, Telepharmacy, TeleMental Health, Tele Retinal? Answer: 2 telehealth rooms and a group room.

17. In regard to episodic care for unassigned / unenrolled patients; how many home visits were conducted in FY 15 and FY 16 for nurse only and provider visits? Answer: None

18. In regard to episodic care for unassigned / unenrolled patients; how many monthly telehealth visits were conducted in FY 15 and FY 16? Answer: None

19. Can an NP see patients in the CBOC if they are supervised by CBOC Physician from another location? Answer: No

20. Will the government be doing site visits prior to award? If so, how much advance notice will the contractor be given? Answer: Yes, please provide a point of contact for the site visit. One week advance notice.

21. Will the VA or the Contractor be financially responsible for the cost of 10-day bridge medications? Answer: VA will be responsible for 10 day urgent supply of medications.

22. Will the contractor or the VA be responsible for paying for POC equipment, validation and supplies? Answer: Contractor

23. Will the new contractor inherit the patient’s last vesting visit and be allowed to bill for one year from that date upon contract award? Answer: The new contractor will receive the current vesting registrar and be responsible for all healthcare needs of those Veterans. The contract will be allowed to continue to bill for each Veteran as long as the Veteran has had a comprehensive physical within the last 12 months. Upon month 13, if no comprehensive physical has been completed the Veteran will no longer be billable.

24. Please explain why the VA believes the enrollment at the clinic will increase while VetPop shows a declining Veteran population in the catchment area. Please indicate which zip codes or counties the VA expects to grow during the life of the contract. Answer: Hood and Parker counties do show a slight decrease in Veteran populations all projection show an increase in Veteran utilization.

25. How many VA staffed personnel will be providing services at the CBOC? Please list by job title and number of days per month.

Answer:

3 Mental Health – full time 1 SW – 12 days a month 1 PharmD - 12 days a month 1 Dietician - 12 days a month

26. Please confirm that the courier service costs will be borne by the contractor. Answer: Contractor will be responsible for this service.

27. What is the veteran population in the catchment area by zip code?

Answer:

North Texas Market Enrollees by County and Zip

28. How will PCMHI be provided? In person or via telehealth? Answer: In person

29. Will the government confirm who is responsible for supplying ALL of the following vaccines? Are there any additional vaccines required to be supplied by the contractor? TDAP, Pneumovax 23, Prevnar 13, TD, Flu, High dose flu, Shingrix, Twinrix (hep a &b) Hep A, Hep B, HPV, Tubersol (PPD) (not a vaccine) Answer: Contractor is responsible. B12, Depo,

30. What is the current PM/PM rate at the existing CBOC? Answer: Not relevant to the new RFP

31. Are existing employees under a collective bargaining agreement? Answer: No

32. Does the current PC floorplan meet the requirements of the RFP or does the VA require the PACT design of Onstage/Offstage? Answer: No

33. In light of the increase incidence of Veteran related violence and prevention of the same, is the government or the contractor responsible for hiring a security guard? Armed or Unarmed?

Answer: This is not included in the current PWS. Upon Security risk assessment, this could be amended.

34. Does the VA require the contractor to purchase a refrigerated centrifuge? Answer: No

35. Is the VA supplying the phones and phone system? Answer: No

36. Does the clinic need a DEA number? Answer: Yes

37. How many consultation rooms are required per PACT team? Answer: 1 per each PACT team

38. How many procedures rooms does the contract require? Answer: None are required.

39. Can the group care room be used for the BH group room as well or do they need to be separate rooms? Answer: Yes

40. In total, how many group rooms are required for this facility and what are the size requirements? Answer: One is required, minimum of 200 sf

41. Please confirm the VA would like 6 patient care rooms for the clinic instead of the standard 2.5 exam rooms per PACT team. (page 60) Answer: the government would like 3 rooms per PACT team.

42. Please confirm the VA would like patient care exam rooms to be 180-240 square feet each instead of the VA standard 125 square feet. (page 60) Answer: 125 is the standard requirement.

43. Please indicate if the government is requiring doors on exam rooms to be sliding barn style doors or traditional swinging type doors. Please specify if both doors to each exam room are to be the same. Answer: VA will accept either.

44. Please confirm that the VA would like the telehealth rooms to be 180-240 square feet instead the VA standard size. (page 63) Answer: minimum 145 sf

45. Please confirm the VA is only requesting 2 telehealth rooms for telehealth services to include tele-derm, tele-pharmacy, tele-mental health and tele-retinal and not 2 rooms for each service. Answer: 2 rooms for telehealth services.

46. Please confirm the VA would like 2 restrooms in the clinic to be 550 square feet each. (page 64) Answer: Restroom requirement is 75 sf. Provide two restrooms per PACT team.

47. Please confirm that the VA is requesting 2 bathrooms to be 550 sq. ft. as this seems excessive for similar request for bathrooms in the CBOCs? Answer: 75 sf each

48. Who will provide radiology services? Onsite or contracted out? Answer: VA will provide

49. How many telemedicine visits happen per year? Answer: None in FY17

50. Define "active" patient. (section 2, page 17 in the RFP - Staffing and Qualifications). Answer: An active patient is an eligible Veteran who receiving care at the clinic and meeting all of the terms as defined in the contract.

51. Define "working in the capacity of mid-level provider." Clinical Pharmacy Services: The CPS shall be provided the same support given to other providers on the team when they are "working in the capacity of the mid-level provider." (section 2, page 17 in the RFP - Staffing and Qualifications) Answer: defined as working within his or her scope.

52. Please confirm that the government projects 50 traveling Vets per year. What is the current number of traveling Vets per year? Answer: Yes, this is a new element to the PWS.

53. May we have the anniversary date for each current incumbent employee of the current contract? This will allow us to bid properly per the Service Contract Act (SCA). Answer: VA does not employ the current staff, we do not have their HR records.

54. Factor (1) Technical Capability, Sub-factor (a) Quality, point 5: If contractor is not accredited by the Joint Commission, Contractor shall provide Infection Control Plan, Blood borne Pathogen Plan and Tuberculosis Control Plan. Does the Government want the contractor to include copies of these entire plans (nearly 100 pages) or would a summary plan suffice for inclusion in the proposal with the full plans being submitted upon award? Answer: A summary plan will suffice; full plan at time of award.

55. Page 145 requests four (4) hard copies of the Technical Proposal, but there is no requirement provided for the submission of hard copies of the Price Proposal. Could the Government clarify if there are any hard copy submission requirements for the price proposal? Answer: Provide one electronic copy of the price proposal to Marisela.Galarza@va.gov Would the VA consider beginning the startup period on the day that the protest period has expired as opposed to the date of the contract award? Answer: The VA has a requirement with the startup period listed in the solicitation

56. Is the $6 million the absolute cap? Will bids above $6 million be considered?

Answer: The Government will award a contract to an offeror submitting a proposal that is determined by the Government to be the most advantageous (best value) to the Government. NOTE: A competitive range may be established from the most highly rated proposals.

57. Addendum to 52.212-1 Instructions to Offerors, 1. General Instructions for Proposal Submission: 2. Part 1 - Requirements for Technical Proposals - Instructions indicate one electronic copy of the technical proposal plus our printed copies. Does Government want an electronic copy on CD/flash drive included with the printed copies OR emailed to the contracting office?

Answer: Flash drives will not be accepted. Due to the file size, submit one copy of the technical proposal on a CD-ROM. The electronic files on the CD-ROM should be in Portable Document Format (PDF) and named as follows: Vendor Name – Part No. –VA257-17-R-0506 – Granbury CBOC. If file size necessitates breaking a section into more than one file, please append File X of X to the end of the file name. CD-ROM shall be in an envelope clearly labeled “VA257-17-R-0506 – Granbury CBOC”. Mail CD-ROM and printed copies to the following address:

Department of Veterans Affairs Network Contracting Office 17 (NCO 17) Attn: Marisela Galarza, Contract Specialist 11495 Turner Road El Paso TX 79936-1372

58. Addendum to 52.212-1 Instructions to Offerors, 1. General Instructions for Proposal Submission: 2. Part 1 - Requirements for Technical Proposals - ...."no notebooks and/or special binding methods". Does Government want the technical proposal in a 3-ring binder notebook or just binder clipped together? Answer: 3-ring binder

59. Addendum to 52.212-1 Instructions to Offerors, 1. General Instructions for Proposal Submission: 2. Part 1 - Requirements for Technical Proposals - There does not appear to be any page limitations listed. What are the page limitations for the Technical Proposal, and what are the page limits for each of the sub-factors within the Technical Proposal? Answer: There are no page limitations.

60. Addendum to 52.212-1 Instructions to Offerors, 1. General Instructions for Proposal Submission: 2. Part 3 - Requirements for Factor 3 Price Proposals - the instructions provide for one electronic copy to be emailed to Ms. Galarza. In what format does the Government want this submission? (pdf, excel, word) Answer: Part 3 Price Proposals- Email one electronic copy in pdf format.

See attached document: D. 23 VA Handbook 0730 Physical Security Requirements and Options.

End of Document