Q-A_for_Release_12-8-(clean)-kk.pdf

Date: December 7, 2017

W15QKN-18-R-1000

Response to Industry questions received prior to and upon completion of Industry Day.

These responses are to questions received prior/after industry day, however not all questions have been responded to as of this date. Additional responses to industry questions will be issued within 10 calendar days of this notice.

1. As part of the RFP process, will offerers have the opportunity to observe a group event or attend a site visit to the current RHRP call center?

**Response: Offerors will not have the opportunity to observe a group event or attend a site visit to the current Reserve Health Readiness Program (RHRP) call center.

2. Would the Government consider dividing RHRP into regions, similar to TRICARE, and award to multiple companies by region?

**Response: The contract will remain a single award for all regions.

3. Does the DHA intend to reduce the contracting burden and seek economies of scale by incentivizing the National Guard to use the RHRP program?

**Response: The RHRP supplements the various medical readiness resources available to the Service Components. There are currently no plans to incentivize the National Guard to use the

RHRP.

4. How many RHRP-like local contracts were awarded outside of the central program in FY 15 and FY 16 and what was the estimated dollar value?

**Response: RHRP contracts awarded at state level are not tracked at the Federal Government Level. The number of RHRP-like local contracts is therefore unknown.

5. What is the total annual cost per Reserve Service-member to maintain medical readiness?

Please include the Total Reserve Force—all Services and the National Guard. Of the total cost, how much is expended through the RHRP, how much in local RHRP – like contracts, how much in the Direct Care system, and how much using organic medical assets.

**Response: The total annual cost per Reserve Service member to maintain medical readiness is not known.

6. What if any data from RHRP must be entered into MHS Genesis?

Response: When Military Health System GENESIS is accessible, data collected for RHRP will be entered into it. It is anticipated that the United States Coast Guard will adopt an Electronic Health Record at some point during the RHRP-3 contract, and that RHRP data will need to be entered into it.

7. We understand that RHRP was recently audited. Can you please share any OIG audit information that is available?

**Response: RHRP has not been recently audited.

8. The DHA has published a draft RFQ for the TRICARE Dental Readiness and Wellness (TDRAW) contract that would eliminate dental from the scope of RHRP. Does the DHA anticipate additional large-scale scope changes that will impact the future RHRP effort?

**Response: The draft RFQ for a TRICARE Dental Readiness and Wellness contract is dependent upon legislative change to move forward. There are no other potential large scale scope changes anticipated.

9. Will the Government allow additional questions to be submitted for response after the Pre-proposal Conference, November 6, 2017?

**Response: The Government will allow for an additional set of questions, once the final solicitation is released.

10. Please clarify this statement. "Year One shall consist of a 12 month transition-in period and include procedures, followed by four 12-month option periods.” Is this an incomplete sentence? What procedures are you referencing?

**Response: The transition-in period may be up to 12 months, therefore if the successful Offeror takes the full 12 months, then no actual services will commence, such as examinations, group events, etc. If the successful Offeror completes the transition period in less than 12 months, they may start to provide procedures. The procedures are the types of services provided for in the Attachment 0004 Price Matrix.

11. If the incumbent is not selected, please explain the incumbent’s transition out timeline as it relates to the awardee's 12 month transition in period?

**Response: If the incumbent is not selected, the incumbent will continue to provide the full range of services until the successful Offeror has successfully completed their Transition-In period.

12. If the incumbent is not selected, please explain the incumbent’s transition out timeline as it relates to the awardee's 12 month transition in period?

**Response: If the incumbent is not selected, the incumbent will continue to provide the full range of services until the successful Offeror has successfully completed their Transition-In period.

13. PWS 1.2 -Please clarify this statement, "Historically, up to two trips annually have been requested for services in Germany?" What exactly does this mean? Doe this speak to the historical workload of two centralized events per year in Germany?

**Response: There was one year when the United States Army Reserve (USAR) requested RHRP provide services twice at a group event in Germany. The last Germany group event was in the spring of 2016.

Services provided included Periodic Health Assessments (PHA), EKGs, immunization, optometry, and dental services. Since then the military treatment facility there has provided the services. Historical data was provided in case the need re-emerges.

14. PWS 1.2 - Will the Government define the new requirements for the expanded increase to 18,000 call per month?

**Response: The new Department of Defense (DoD) PHA incorporates the Mental Health Asssessment (MHA) and Service Components will increasingly use the Call Center as the means to accomplish the MHA.

15. PWS 2.6.1 - What specific RHRP technology, processes, and assets are considered Government owned and available to the awardee for analysis?

**Response: There are no RHRP technology, processes, and assets which are considered Government owned and available to the awardee for analysis. The Government will be working closely with the successful Offeror and incumbent during the transition period to share non-proprietary information as needed. ,

16. PWS 2.8.2.5 - Please clarify the process and cost for attending the DOEHRS-HC software technician certification. Also, please specify which Service Components (SCs) do, and do not, use DOEHRS-HC.

**Response: All SCs except the Coast Guard use DOEHRS. The cost of attending the Air Force training at Wright-Patterson Air Force Base in Dayton, Ohio is approximately $3500.

17. PWS 4.2.14.5 - Please clarify if mental health assessments are required to be uploaded into databases beyond the SCs' readiness database.

**Response: The Coast Guard will require MHA to be uploaded into the Service Treatment Record.

Entry of the date and type of assessment (MHA) may also be required to be entered into SC databases.

18. PWS 4.5.4.2 – Please specify what is meant by the term, “electronic repository” in the following task, “The Contractor shall provide digitization of medical and dental records as approved by the SC POC. This service shall include scanning and indexing the entire record into an electronic repository linked by the SM’s SSN, DOD ID number, or unique identifier.”

**Response: “Electronic repository” is a generic term encompassing SC and MHS databases.

19. Attachment 0005- Will the Government confirm that Mental Health Assessment (MHA) services are included in the term “health care”?

**Response: Yes, MHA services are included in the term “health care” used in Attachment 0005 directing the Offeror to submit references “for each major subcontractor specialties in health care, dental, and laboratory service…” Offerors should note that the vast majority of the medical readiness services are not mental health.

20. Attachment 0011 - Please clarify if mental health assessments are required to be uploaded into databases beyond the SCs' readiness database.

**Response: The Coast Guard will require it be uploaded into the Service Treatment Record. Entry of the date and type of assessment (MHA) may also be required to be entered into SC databases.

21. Attachment 0011 - Please specify what is meant by the term, "electronic repository" in the following task, "The Contractor shall provide digitization of medical and dental records as approved by the SC POC. This service shall include scanning and indexing the entire record into an electronic repository linked by the SM's SSN, DOD ID number, or unique identifier."

**Response: “Electronic repository” is a generic term encompassing SC and MHS databases.

22. PWS 1.2 - The number of Behavioral Health calls are expected to increase from approximately 8,500 calls per month to 18,000 per month. Does the Government anticipate there will be 18,000 beginning with the first month of the new contract?

**Response: Yes, the Government anticipate there will be 18,000 beginning with the first month of the new contract that the awardee assumes responsibility for the procedures.

23. PWS 1.1 - Group events while typically over a weekend can last anywhere from one day to 31 days at a single location. How many group events on average during the course of a year were longer than 10 consecutive days?

**Response: During FY17, there were 71 group events of three days, four group events of four days, two of five days, one of seven, and one of 14 days.

24. PWS 1.2 - The number of Behavioral Health calls are expected to increase from approximately 8,500 calls per month to 18,000 per month. Does the Government anticipate there will be 18,000 beginning with the first month of the new contract?

**Response: Yes, the Government anticipate there will be 18,000 beginning with the first month of the new contract that the awardee assumes responsibility for the procedures.

25. PWS 1.1 - Group events while typically over a weekend can last anywhere from one day to 31 days at a single location. How many group events on average during the course of a year were longer than 10 consecutive days?

**Response: During FY17, there were 71 group events of three days, four group events of four days, two of five days, one of seven, and one of 14 days.

26. PWS 2.8.1 -The PWS refers to adherence with State Licensing regulations. Does the Vendor and its Subcontractors that deliver dental services need to adhere to the respective State licensing requirements?

**Response: Yes, Prime vendor and subcontractor providers need to adhere to the State licensing requirements.

27. PWS 2.8.2.5 - Audiometric testing shall be entered into DOEHRS, if that database is used by the SC.

What other databases are used by other SC’s to enter audiometric testing if not DOEHRS?

**Response: The Coast Guard does not use an electronic database to record audiogram results. The paper audiogram output is sent to the Coast Guard designee. Ultimately, the output may need to be scanned or uploaded into an Electronic Health Record. The United States Navy Reserve has data entered into the Medical Readiness Reporting System (MRRS). The other Service Components have the data entered into

DOEHRS.

28. PWS 2.8.2.5 - How long is the Air Force or DOD course required for DOEHRS-HC? Is this a new requirement?

**Response: The Air Force course is four days. Completing the training is a new requirement.

29. PWS 2.12.1.1 Calls with customers shall be recorded and kept available for review by Government personnel for a minimum of 6 months. Is every customer encounter to be recorded or only as relates specifically to scheduling?

**Response: Every customer encounter is to be recorded.

30. PWS 4.1.8.1 - “The Contractor shall be responsible for the sign-off of the PHA”. Will the Government credential all Contractor Providers with CAC and respective database access (as applicable) or do the PHAs get uploaded with the Contractor’s credentials naming the Provider that completed the PHA?

**Response: Providers entering the CAC into the database will require CACs and they will sign off by entering their name and credentials on the PHA. The provider who actually conducted the PHA must have the name and credentials annotated on the PHA.

31. PWS 4.4.4.3 - Reporting. Exhibit 14c provides the format for the reporting required. The last tab of the Exhibit provides data for the US Navy Reserve for the FY 2016. Can the same data be provided for the rest of the tabs? It would provide an estimate of the monthly volume of services requested by SC.

** Response: Exhibit 14c is the report referenced in PWS paragraph 4.4.4.17, FY On-Site Services by Service Date. The historical data by major categories of procedure types for FY16 is presented below.

RHRP Service Category USAR ARNG MARFORRES

AC

ARMY

TPR USCG USNR ANG AFRC

PHA

145,244

32,829

19,757

8,423

11,847

9,006

IMMUNIZATIONS

369,763

36,993

2,794

1,317

LAB SVCS

259,835

34,539

4,837

10,600

28,884

DENTAL ASSESS SVCS

315,206

118,223

38,568

2,670

18,520

6,186

MHA

151,832

32,843

16,495

8,883

1,126

15,552

PDHRA

4,662

2,878

1,917

5,992

2,270

AUDIO SVCS

294,352

159,356

45,011

6,504

2,474

1,782

VISION SVCS

165,137

33,167 3

8,611

DENTAL TRTMT SVCS

60,424

24,240

32. PWS 2.8.4 - In the occupational health services standards and certification section, The PWS states that PHA record reviewers shall be either a PHA provider, Registered Nurse or LVN. In Section 3.1 (Definitions), the PWS defines Health care personnel as “HCP, nurses including LVNs or equivalent to military medics”. In Section 4.1 (PHA), it states “the second is a review of medical records by health care personnel who have received PHA-specific training”. Based on the definition of Health care personnel and the use of that definition in section 4.1, can the contractor use “or equivalent to military medics” or does the contractor adhere to Section 2.8.4 that states no less than an LVN?

**Response: The record reviewer can be the equivalent to military medics (with the appropriate documentation of the equivalency). The PWS 2.8.4 has been modified to reflect this.

33. PWS 2.12.2 - For ARNG and USAR, the contractor shall access the Automated Voucher System (AVS), and identify IMR services which are needed”. It does NOT reference Medpros which the contractor currently uses for USAR. Will the contractor no longer utilize Medpros for readiness eligibility/confirmation?

**Response: The Contractor will access Medpros, per the chane to PWS 2.12.2.

34. PWS 2.12.2 - US Coast Guard is not mentioned in this section. The contractor currently utilizes MRRS to identify IMR requirements. Will US Coast Guard be “generating a needs list and sending it to the Contractor for scheduling of services” similar to USNR, AFRC and MFR?

Response: The Coast Guard will identify the services to be provided to the member. If a Coast Guard member contacts the Contractor requesting a specific (non-PHA) service, the Contractor should review MRRS to see what other services the member requires and these should be scheduled as well. The PWS has been changed to reflect this in PWS 2.12.2.1.

35. PWS 4.2.7.3.1.1 - The solicitation states that for in-clinic eyewear services, the contractor shall mail the eyewear directly to the address provided by the Service member. Please clarify that the contractor will enter the Service member’s preferred mailing address in SRTS for NOSTRA to ship.

**Response: Yes, the Contractor will enter the Service member’s preferred mailing address in SRTS for NOSTRA to ship. The PWS section 4.2.7.3.1.1 has been revised to clarify this.

36. PWS 4.2.7.3.1.2 - For eyewear resulting from Group Event, the Contractor shall mail the eyewear directly to the address designated by the Group Event’s military point of contact. Please clarify that the contractor will enter the address in the SRTS ordering process so that NOSTRA will send to the designated military point of contact?

**Response: Yes, the Contractor will enter the Service member’s preferred mailing address in SRTS for NOSTRA to ship. The PWS section 4.2.7.3.1.1 has been revised to clarify this.

37. PWS Section 5.10.3 - Please confirm that this requirement applies only to remote support by Government personnel.

**Response: This requirement is to enable government inspection of all electronic transmissions entering and exiting DoD data boundaries. This requirement applies to Contractor encryption keys, backdoor algorithms and procedures used by the Contractor in meeting the PWS requirements.

38. PWS Section 5.5.2 - Is the categorization being provided by the government for the confidentiality, availability, and integrity Confidentiality: Moderate, Availability: Moderate, and Integrity: Moderate?

**Response: The categorization is Confidentiality: Moderate; Integrity: High; and Availability: Moderate.

The PWS, para. 5.5.2 has been modified to clarify the categorization.

39. The solicitation says that if the place of performance includes, in whole or part, at a Government location the offeror will specify in their proposal all personnel who currently have a Government identification badge and the badge #. Does the Government intend for the contractor to identify all personnel who currently hold a Common Access Card’s and only work at Contractor’s location? Please confirm this list should be included in Vol. V.

Response: “identification of Work performed at a Government Location” has been removed from the final solicitation posted on FBO.

40. The clause FAR 52.245-2 (Government Property Installation Operation Services) is included in the solicitation. In the clause, it provides a section for the Government to list the property. Can the Government provide such list?

**Response: There is no Government furnished property to be provided at this time.

41. What are the minimum small business subcontracting participation goals for Contractors for this solicitation?

**Response: refer to attachment 0006 Factor 4 “ Small Business Participation, paragraph e: “The extent of participation of small business prime Offerors and small business subcontractors in terms of the percentage of the value of the total acquisitions. The Government will evaluate the extent to which the Offeror attempts to meet or exceed the goals. Goals for this procurement are -- Small Business: {25%} of the total contract value; Small Disadvantaged Business (SDB): {10%} of the total contract value; Woman-Owned Small Business (WOSB): {7%} of the total contract value;

Historically Underutilized Business Zone (HUBZone) Small Business: {1%} of the total contract value; Veteran Owned Small Business (VOSB): {3%} of the total contract value; Service Disabled Veteran Owned Small Business (SDVOSB): {2%} of the total contract value. (Note, for example, that a participation plan that reflects {7%} of the contract value for WOSB would also count towards the overall Small Business Goal; and percentages for SDVOSB also count towards VOSB)”.

42. Attachment 0004 - Please clarify how the ODC CLIN will be utilized.

**Response: This will be a not to exceed amount and cost-reimbursement (no fee). The solicitation has been revised to clarify that the ODC Clin is for non-Government provided vaccinations only. Revised PWS 4.2.3.1.1.2, “ The contractor shall purchase and use influenze vaccine that will be used by DoD for the upcoming flu season and change no more than the current CHAMPUS Maximum Allowable Cost rate.”

43. Attachment 0005 - Do cover pages count toward page count?

**Response: Yes, cover pages count toward page count as per Attachment 0005 “All pages of each volume hall be appropriately numbered and identified by the complete company name, date and solicitation number in the header and/or footer.”

44. Attachment 0005 - What’s the difference between the Small Business Participation Plan and Small Business Subcontracting Plan?

**Response: As per attachment 0005 a small business participation plan is submitted with your proposal and evaluated in accordance with attachment 0006 basis of award. A subcontracting plan is to be submitted with your proposal and will be evaluated in accordance with Army Federal Acquisition Regulations Supplement. (AFARS) and will be incorporated into the contract.

45. Attachment 12 – Clarify if the requirement is 7 or 8 business days and the Performance Requirements Standards have been changed to reflect that.

**Response: The requirement is eight business days and the Performance Requirements Standards have been changed to reflect this.

46. Attachment 12 – Clarify if the requirement is 10 or 12 business days.

**Response: The requirement is 12 business days and the Performance Requirements Standards have been changed to reflect that.

47. SF1449 - The range of services to be provided for the RHRP-3 opportunity includes medical and dental services as well as mental health services. In addition, the services are delivered primarily at group event gatherings of Service Members at SC-designated sites (e.g., armories, drill halls) as well as through the contractor's call center (mental health) and within the contractor's nationwide network of clinic providers (medical and dental). NAICS Code 621112 only encompasses mental health services within a medical office or facility. Therefore, it is recommended that the NAICS Code be revised to 621498 to align more closely to the RHRP-3 requirements.

**Response: The Government determined 621112 is applicable based upon the requirement.

48. PWS 1.1 - How often will group events last more than a weekend? Up to 31 days per event. For most recent data, how often has group events lasted more than one weekend (e.g. more than three days)? And on average how many days are group events?

**Response: On average, group events are one to two days. During FY17, there were 71 group events of three days, four group events of four days, two of five days, one of seven, and one of 14 days.

49. PWS 1.2 - What, of the new requirements, is the primary reason behind the expected increase to 18,000 BHS monthly calls from 8,500?

**Response: The new DoD PHA incorporates the MHA and Service Components will increasingly use the Call Center as the means to accomplish the MHA.

50. PWS 1.2 - Please provide data for services performed, e.g. PHAs, dental exams and immunizations, in

Germany for the past year or most recent period data is available.

**Response: There was one year when the USAR requested RHRP provide services at group events twice in Germany. The last Germany group event was in the spring of 2016. Services provided included Periodic Health Assessments, EKGs, immunization, optometry, and dental services. Since then the military treatment facility there has provided the services. Historical data was provided in case the need re-emerges.

51. PWS 1.2 - The DRFP provided some historical data in regards to volume. It also provided volume ranges for an average month that included large variances.

Questions:

1. What is the average size (e.g., # of completed PHAs, dental exams and immunizations) for the group events each month performed in the last 12 months?

**Response: For FY17, at a group event, an average of 80 dental exams, 60 immunizations, and 87 PHAs were performed. Offerors should note that these statistical averages may be misleading, e.g., immunizations are provided at a much higher rate during the flu immunization than at other times of the year. See PWS 1.2.

2. Over the last 12 months, how many events were performed that lasted longer than the standard 2-day weekend?

**Response: For the period of July 2017 through February 2018, there were 471 events scheduled for three days, nine for four days, one for five days, one for 10 days, and one for 15 days.

3 What were the volumes for the “surge” weekends for the last three years? Including # of locations, which states and territories and the estimated # of staff the contractor utilized?

**Response: Attachment 0007 -Scenario 1 of the basis of award, Technical Factor is reflective of the volumes and states and territories which may be involved in a surge weekend. The number of staff is determined by Contractor plans and methodology, however for reference, the PWS 1.2 Historical data paragraph provides the number of professional and administrative staff on the busiest weekend in RHRP history. In 2017, the largest weekend was in 186 locations with 19,000 dental exams and 17,000 PHAs. In 2016, the largest weekend was with 216 locations with 16,000 dental exams and 16,000 PHAs.

4. Please provide the volume for in-clinic services (e.g., PHA, dental, immunization, audio, vision, etc.) for the last three calendar years.

**Response: For in-clinic services:

PHA: FY15 93,709; FY16 93,373; FY17 96,511

Dental (includes exams, x-rays, treatment) : FY15 352,232; FY16 362,836; FY17 367,886

Immunizations: FY15 72,331; FY16 74,472; FY17 79,060

Audio: FY15 88,876; FY16 92,757; FY17 99,430

Vision: FY15 70,380; FY16 74,230; FY17 82,249

5. Please provide the volume for call-center services (i.e., PDHRAs and MHA) for the last three calendar years.

**Response: The call center volume for PDHRAs and MHAs for FY15 was approximately 79,800; for FY16, approximately 124,300; and for FY17, it was approximately 146,300.

52. PWS 1.2 - Group events taken place in Germany, how much notice does the government give the contractors prior to the event? And what types of services have been provided to the SMs in the last three years?

**Response: There was one year when the USAR requested RHRP provide services at group events twice in Germany. The last Germany group event was in the spring of 2016. Services provided included Periodic Health Assessments, EKGs, immunization, optometry, and dental services. Since then the military treatment facility there has provided the services. Historical data was provided in case the need re-emerges.

The Government gave the Contractor at least three to four months advance notice prior to the event.

53. PWS 1.2 - On average, Behavioral Health Specialists (BHSs) have been involved in approximately 8500 calls per month to assess and intervene but that number is expected to increase to 18,,000 per month for RHRP-3 due to new requirements. Question: Based on the above, should we expect the “Government Estimated Quantity” to approximate the expectation stated above? Currently, the “Government Estimated Quantity” for procedure number E1 “PHA Behavioral Health Specialist, call center, price per call” is only 10. Why is there a significant difference in volume?

**Response: Procedure E1 is when during a PHA group event there is a mental health concern requiring calling a Behavioral Health Specialist. That happens quite rarely. The 18,000 number relates to conducting call center MHAs or involvement with call center PDHRAs.

54. The PWS states, "To conduct the Mental Health Assessment, providers must have passed the training and subsequent quiz either at (url provided) or the training cited in 2.8.6.4 and training required by the SC. Also, in Section 4.0 Specific Tasks, 4.1.1.1., the PWS states, "To streamline the process, the Contractor PHA provider shall when possible, also conduct the MHA after taking the DoD training and, if applicable, Service MHA training." Can it be inferred from these references that Contractors can use HCPs with this training in lieu of separate Behavioral Health Specialists to perform the MHA portions of the PHA?

**Response: Providers who are an independently licensed mental health professional or a trained and certified physician, physician assistant, nurse practitioner, or advanced practice nurse can conduct the MHA portions of the PHA. PWS paragraph 4.2.14 has been modified to clarify this.

55. PWS 2.10 - What is the average no show % for the different types of group events over the last 12 months? PHA, Dental, PDHRA, Physical Exams, BHS, MHA, Audio, Vision, Immunization, Lab, Dental Treatment with Vehicle.

**Response: To maximize efficiencies for the Service Components, group events typically include multiple types of service. Average no show percentages for services at the group events for FY17 were 12-13% for PHA, 15-16% for dental exams, 18-19% for PDHRAs, 12-13% for MHAs, 10-11% for Audio, 8-9% for Vision, 28-29% for immunizations, 25-26% for blood draws, and 22-23% for dental treatment. No show rates specific to dental treatment with vehicle are not available. There are no group events for Behavioral Health Specialists.

56. PWS 2.10 - No-Show Cancellation Policy. Please indicate who the governing entity is for handling disputes regarding valid appointment cancellations and determining exception validity? What is the process for collecting cancellation fees; i.e., will the Contractor be required to provide a billing system to track this?

**Response: If a dispute regarding valid appointment cancellations cannot be resolved between the Contractor and Service Component, the decision will be made by the COR or Contracting Officer. Yes, the Contractor is required to track cancellation fees.

57. PWS 2.10.2 - SMs are allowed two re-scheduling’s after confirmed initial appointment. After that, an in-clinic cancellation fee will be assessed. Question: Allowed two RS within 90 days that the voucher is good from the original appointment?

**Response: Two re-schedulings are allowed within 90 days after an initial appointment is confirmed. PWS

2.10.2 has been clarified.

58. PWS 2.10.2.1.1 - Exception; An emergency situation beyond the SM’s control (e.g., accident, illness, family emergency, bad weather). Question: Is this still only within the 90 days of the voucher/order?

Response: Yes, vouchers/orders are valid for only 90 days. PWS 2.10.2 has been clarified.

59. PWS 2.10.3.1 - The SC/Unit Group Event POC has until 14 calendar days prior to the scheduled Group Event date to change or cancel the event with no fee. Before scheduling a group event within 14 calendar days of the start date, the SC must provide written approval. Question: If SC schedules less than 14 days the contractor must still get written approval from SC before scheduling an event within 14 days of the start date?

**Response: The SC must approve a group event when scheduled within 14 days of the event start date.

60. PWS 2.10.3.3 - Changes five calendar days or less prior to the group event date and completion of the event are subject to a no-show fee per service type. Question: If the SM shows up to the group event, are contractors are allowed to bill for both the service delivered and the no-show fee? Or subject to no-show fee only for services that are less than the last approved number and types of services?

**Response: The SC is subject to a no-show fee if the number of SMs decreases within five calendar days.

No show fees are based on the number of SMs, not whether individual SMs are present. The Contractor will be allowed to bill for either a no-show fee or the service, not both.

61. PWS 2.10.3.4.2 Contractor accepts a revised vouchers/order for services equal to or greater than the original voucher/order request for services. Question: Does this comment specifically mean that if an event gets cancelled or no-showed we will receive another event request the same size or greater?

**Response: If the change accepted by the Contractor is to an event of the same or greater size, there will be no cancellation or no-show charges for the original event. Cancellation of an event within the specified period without a rescheduling at that time will result in cancellation or no-show charges.

62. PWS 2.12.4.2.1 - The Contractor shall schedule the SM for the needed in-clinic service within 15 business days of the SM’s first day of availability. Question: What if the SM gives us availability that will cause the voucher to expire? e.g. scheduled at 80 and RS would take out past 90 days.

**Response: The voucher/order for service is valid for 90 days. If the service is not provided within the window, the voucher/order is cancelled.

63. PWS 2.12.4.2 - After receiving a SC request to schedule SMs for an in-clinic appointment, the Contractor shall attempt to reach the SM within one business day. The Contractor shall attempt to contact the SM to schedule all approved services with a minimum of three attempts to each valid phone number, email, or text, depending upon SM preference. Question: Will the SC provide the preferred method of contacting the SM? The way we read this today is 3 attempts on each valid method. Is this accurate?

**Response: The SM shall be asked for the preferred and alternate method of being contacted. The Contractor shall attempt to contact the SM a minimum of three times to the preferred and alternate methods.

If the SM has not provided that information, the Contractor shall attempt to contact the SM with a minimum of three attempts to each valid phone number, email, or text that the Contractor has.

64. PWS 2.12.4.5 - The Contractor shall contact the SM 72 hours in advance of the scheduled in-clinic services to remind the SM of the time and location of the scheduled services. Question: Can contact with SM be via voice, secure portal email, automated scheduling reminder, or text?

** Response: The SM shall be asked for the preferred and alternate method of being contacted, including voice, secure portal email, automated scheduling reminder, or text. The Contractor shall attempt to contact the SM via the preferred and alternate methods.

65. PWS 2.12.4.6 - In-clinic services shall be scheduled within a 50 mile driving distance of the SM’s residence, place of duty, or civilian place of business. The choice between the SM’s residence, place of duty, or civilian place of business as a proximity point shall be given to each individual SM. If the SM expresses concern about the distance, the Contractor shall see if a closer network provider is available.

Question: This is a contradiction in the RFP language. If the contractor has a provider with the most available appointment within 50 miles and is compliant with the above language does the contractor required to still have to look for a provider closer than 50 miles?

**Response: The Contractor may offer the SM an appointment within the 50 mile driving distance.

66. PWS 2.15.4 - The Contractor shall be present at a minimum of one day prior to the event start. It is our assumption that this is to support setup activities and includes only the associated required staff and no services are performed on this day. Is this assumption correct? If not, please clarify.

Response: The Contractor presence a minimum of one day prior to the event start is to support setup activities and includes only the associated required staff. No services are performed on this day. PWS paragraph 2.15.4 has been clarified.

67. PWS 2.18.2 - The Contractor shall return the original hard copy of assessments to the SM’s home unit or Command as requested by the SC POC. Question: If assessments are done electronically does the contractor have to print paper copies to give to the home unit or command as requested by the SC POC?

**Response: If assessments are done electronically and entered into the SC-requested electronic repository, hard copies are not required unless requested by the SC.

68. PWS 2.18.3 - Contractor providers shall maintain their medical and dental records according to State and Federal laws and regulations. Question: We the contractor will maintain the records for the providers. Do the providers need to maintain separate copies?

**Response: Providers need to follow their state licensure laws and regulations regarding services they provide.

69. PWS 4.1.1. - The PWS states that "SCs may elect to not require a person-to-person evaluation during the non-MHA portion of the PHA provider section, but currently most SCs require a face-to-face."

Please clarify the difference between "person-to-person" versus "face-to-face."

**Response: As defined in section 3.1. Person-to-person. Face-to-face, telephone, or video teleconference dialogue with an individual that is conducted in a private setting to foster trust and openness in discussing sensitive health concerns. Face-to-face. An encounter when the individuals are physically in the presence of each other.

70. PWS 4.1.1 Section states that, “SCs may elect to not require a person-to-person evaluation during the non-MHA portion of the PHA provider section, but currently most SCs require a face-to-face.” In addition, Section 4.2.14.2 states, “The Contractor shall be able to conduct telephonic or electronic outreach to SC-identified members who need to complete the MHA, including attempting to reach the SM three times and sending a postcard to the SM if unsuccessful.” How does the contractor effectively distinguish between critical, priority and routine categories for MHA assessments without the benefit of face-to-face encounters?

**Response: Critical, priority, and routine categories are based on the SM responses to their section and SC-provided algorithms regarding SM responses.

71. PWS 4.1.2.4 - The electronic PHA self-assessment provides targeted health education to the SM based on their individual responses. The SM is responsible for downloading or emailing the health education, including if completing within the Contractor’s system. Question: Will we be given the contingent of health education that needs to be delivered to the SM?

**Response: If the SM is completing the PHA within the Contractor’s system, the Contractor will be provided the contingent health education.

72. PWS 4.1.4 - Is the provider conducting the MHA for responses to the Behavioral Health portion required to meet the BH Licensure requirements outlined in 2.8.5, page 6?

**Response: Providers other than Behavioral Health Specialists with the specified training and qualifications can conduct the MHA portions of the PHA.

73. PWS 4.1.3.1 - When the Contractor is conducting the Record Review, if medical records are missing, the Contractor shall notify the SM or, per SC guidance, the holder of the Service Treatment Record (STR). For SCs other than Army and USCG/R, if there are no records, the PHA will be delayed.

Question: How long will the delay be?

**Response: For SCs other than Army and USCG/R, if there are no records, the PHA will be delayed until records are available or the SC directs the PHA to be conducted. There is no set timeframe.

74. PWS 4.1.3.2 - Currently, the AFRC, USNR, MARFORRES, and USCG/R will conduct the record review portion of the PHA. Question: 4.1.3.1 states that contractor will conduct record review for USCG/R but 4.1.3.2 states SC will conduct record review. Please clarify.

**Response: Unless the USCG/R changes its policy, they will conduct the PHA record review. PWS para.

4.1.3.1 has been modified to clarify this

75. PWS 4.1.3.3 - For group events, if USGC/R SMs ha ve not completed the SM portion, they will not be able to complete the PHA that day since the SC will not have done the record review Question: Will this count as a cancellation and contractor will be paid a cancellation fee?

Response: If the requested number of SMs completing their PHA in a group event has not completed the SM portion and therefore the Contractor has not completed the requested number, the SC will be subject to a no-show fee. The contractor will not be paid a cancellation fee.

76. PWS 4.1.6.1 - For ARNG, per SC direction, PHA documents and review comments in memorandum format should be uploaded into HRR and an electronic copy will be forwarded to the requesting unit authority. Questions: Can we get an electronic copy of the memorandum format? This format is not required in the PHA, correct?

**Response: The ARNG will provide an electronic copy of the memorandum format. That memorandum and format are not required in the PHA per se.

77. PWS 4.1.6.6 -MARFORRES and USNR will use the Periodic Health Assessment website https://data.nmcphc.med.navy.mil/pha to obtain completed records. Per SC guidance, if the website is unavailable, the Contractor may make the PHA available through a portal Question: Can the contractor make the PHA available on the portal at all times and push completed PHA back to appropriate system?

**Response: When the Periodic Health Assessment website is not available and the Contractor and SC systems allow, the Contractor can make the PHA available on the portal and push completed PHA back to the appropriate system.

78. PWS 4.1.7.2 - The SC will provide a roster of SMs expected to attend the event and the Contractor shall attempt to contact the SM, advising the SM to register for the group event and complete the SM portion of the PHA before the event through either the SC system or the Contractor portal. Question: Can this call be automated advising the SM through a script?

**Response: When the SC provides a roster of SMs expected to attend the group event, the Contractor may use an automated system using a script to advise the SM to register for the group event and complete the SM portion of the PHA before the event. The contact must be verifiable. PWS para 4.1.7.2 has been clarified.

79. PWS 4.2.1.4 - What percentage of MHAs are done as part of the PHA vs. standalone?

**Response: The DoD PHA which will be in existence for RHRP-3 has not yet been instituted sufficiently to provide this data.

80. PWS 4.2.3.1.3 - The Contractor shall provide access to a nationwide network such as Walgreens or

CVS. Question: Is the intent to provide vaccines outside of in clinic or group events? Will these vaccines only be provided in conjunction with an applicable voucher?

**Response: The intent of the Contractor providing access to a nationwide network such as Walgreens or CVS is to provide vaccines outside of the in-clinic or group event settings. The vaccines are to be provided only in conjunction with a voucher/order per SC guidelines.

81. PWS 4.2.3.6.1- The Contractor shall record yellow fever and polio immunizations for the ARNG and USAR on the CDC 731, International Certification of Immunization form and all immunizations in MEDPROS. Question: How will we record on CDC 731 if the SM does not bring it or if the appointment is done person to person?

**Response: All immunizations are provided face-to-face. If the SM does not bring their CDC 731 form to an appointment, the Contractor may enter the CDC-required information into the appropriate SC database.

In group events, the Contractor shall have a supply of the CDC 731 forms on hand. PWS para 4.2.3.6.1 has been modified for clarification.

82. PWS 4.2.4.3 - The Contractor shall have a mechanism to detect abnormal and critical lab values and to notify SMs and responsible unit personnel, the former both telephonically and by mail within 24 hours of notification of the critical lab value receipt. The Contractor shall attempt to telephonically contact the SM two additional times in the following consecutive days if unable to reach the SM. Question: Can we contact via secure portal for record of contact and faster response? If so, can we post critical values to secure portal for SM to download and take to PCP in lieu of mailing for faster response? Can we push critical results to SC portal for record of communication?

**Response: The method of contact the Contractor chooses is flexible, giving priority to the SM’s preferred and alternate method of being contacted, as long as it is within 24 hours of the critical lab value receipt and the SM receipt of the information is verified.

83. PWS 4.2.5- Tuberculin Skin Test (TST) Question: Can TB testing be read virtually using telemedicine or teleconference capability?

**Response: The TB test shall be read in person, not using telemedicine or teleconference capability. The PWS 4.2.5 has been clarified.

84. PWS 4.2.8.7.2 - Diagnostic testing shall be performed by a licensed Audiologist. Question: Earlier in

2.8.2.5 stated that a certified technician could administer the test, but here the DRFP states the above.

Can we have a certified technician perform the tests?

**Response: Certified technicians can perform basic audiograms. Diagnostic testing for the Comprehensive Audio Evaluation testing shall be performed by a licensed Audiologist.

85. PWS 4.2.9.3.5 - The Contractor shall attempt at least three times telephonically, emailing, and texting to contact SMs who were on rosters but failed to complete the DD Form 2795.Question: Do we need to attempt three times to each modality or three total times?

**Response: The SM shall be asked for the preferred and alternate method of being contacted. The Contractor shall attempt to contact the SM a minimum of three times to the preferred and alternate methods.

If the SM has not provided that information, the Contractor shall attempt to contact the SM with a minimum of three attempts to each valid phone number, email, or text that the Contractor has. The PWS 4.2.9.3.5 has been clarified

86. PWS 4.2.9.4 - Question: Section states that, “ANG and AFRC members need to complete the DD Form 2795 face-to-face.” Will the Government permit these face-to-face encounters through a telehealth appointment?

**Response: Per the definitions in PWS section3.1, face-to-face does not include a telehealth appointment.

87. PWS 4.2.10.6.1 - For USAR, the Contractor shall send physical exam, supporting documentation, and review comments in memorandum format in an electronic file to HRR. Question: Will contractor have interfacing capability to all systems (e.g. HRR)?

**Response: When meeting the appropriate DoD security requirements, the Contractor’s system(s) will have interface capability to the necessary systems.

88. PWS 4.2.13.2.2 - Per SC guidance, the Contractor shall use a roster provided by the SC of SMs who need to complete their DD Form 2900. The Contractor shall attempt to reach the SM three times and send a postcard to the SM if unsuccessful in reaching the SM Question: Can we send a trackable letter to call us to complete the 2900? This will establish a record that we attempted to communicate with the

SM.

**Response: The method of contact shall be the SM’s preferred and alternate method of being contacted.

The Contractor shall attempt to contact the SM a minimum of three times to the preferred and alternate methods. The Contractor has the option to also send a trackable letter to call to complete the 2900. The Contractor is expected is to have a means of tracking contact attempts with the SM.

89. PWS 4.2.14.1 - MHAs are completed in phases. The SM completes the first phase and, if the SM’s responses exceed certain thresholds, the SM then completes the second phase which provides an expanded question set. Contractor shall complete the third phase with the HCP review of the document, discussion with the SM, and completion of the provider portion of the form. Question: Can we get an official writeable working copy of the 3024 to see the behavior of the form during exceeded thresholds to model triggering questions/needs.

**Response: Please see the Attachment entitled PHA qnr master specs_03May2016 which provides the behavior of the form.

90. PWS 4.2.14.1 - Question: Section states that, “Contractor shall complete the third phase with the HCP review of the document, discussion with the SM, and completion of the provider portion of the form.”

Since this section is addressing the MHA, what are the licensure requirements for the Health Care Provider review and discussion with the SM? Since this is essentially a specialty care encounter for mental health, should this review require having a licensed BHS available?

**Response: Providers other than Behavioral Health Specialists who are an independently licensed mental health professional or a trained and certified physician, physician assistant, nurse practitioner, or advanced practice nurse with the specified training and qualifications can conduct the MHA portions of the PHA.

The PWS paragraph 4.2.14 has been modified to clarify this

91. PWS 4.2.14.2. The Contractor shall be able to conduct telephonic or electronic outreach to SC-identified members who need to complete the MHA, including attempting to reach the SM three times and sending a postcard to the SM if unsuccessful. Questions: Is it acceptable to send a trackable letter format to record attempted communication? How long do we hold after three attempts and postcard/letter and no contact?

**Response: The Contractor shall attempt to contact the SM a minimum of three times to the preferred and alternate methods. The Contractor has the option to also send a trackable letter to call to complete the MHA. The Contractor is expected is to have a means of tracking contact attempts with the SM. If the SM has not contacted the Contractor within seven calendar days of the postcard or trackable letter, whichever is later, the Contractor may assess a SC-requested outreach fee.

92. PWS 4.2.15.2 -If a SM meets the agreed upon criteria for immediate BHS interaction, can this be provided telephonically?

**Response: If a SM meets the agreed upon criteria for immediate BHS interaction and a BHS is not physically available, this can be provided telephonically. The PWS para 4.2.15.2 has been modified to clarify this.

93. PWS 4.3.2.3.4 - The Contractor shall perform a digitization of analog radiographs and enter them as well as digital radiographs into DENCLASS (the electronic repository for ARNG/USAR) and other SC system per SC guidance. Question: Are we the contractor expected to digitize other historical analog xrays? Or are we only required to digitize (as necessary) contractor current xrays?

**Response: The Contractor is only required digitize x-rays within the scope of the contract. Digitization may include current contractor x-rays or historical x-rays (procedure Q6).

94. PWS 4.4.6 Question: Section addresses Annual Reports and states, “The Contractor shall submit the following annual reports in electronic form to the COR NLT 45 calendar days after end of the FY.”

What is the current electronic format provided to the Government for these reports? Can the Government provide more clarity on the preferred electronic forms that would be provided?

**Response: The format of reports provided to the Government are and should be in pdf., Excel, Word, or other MS Office compatible format. The Contractor and Government will agree to the format for each report during the transition period.

95. PWS 4.4.4.26 - 4.4.4.26 Appointments Offered Beyond 50 Miles. The Contractor shall post for the USAR, the name, unit, and location of USAR SMs offered an in-clinic appointment beyond 50 miles of their location and whether the offer was accepted or declined.