W81K00-19-Q-0209-0004.pdf

0011317364

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

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 (Type or print)

30-105-04EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

STANDARD FORM 30 (Rev. 10-83) Prescribed by GSA

FAR (48 CFR) 53.243

The purpose of this amendment is to provide responses to questions, revise solicitation to a Brand Name or Equial requirement and incorproate the changes as referenced in the See Summary of Changes.

The response date has NOT changed.

1. CONTRACT ID CODE PAGE OF PAGES

J 1 10

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

16C. DATE SIGNED

BY 24-Aug-2019

16B. UNITED STATES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR

(Signature of Contracting Officer)(Signature of person authorized to sign)

8. NAME AND ADDRESS OF CONTRACTOR (No., Street, County, State and Zip Code) X W81K0019Q0209

X 9B. DATED (SEE ITEM 11)

17-Jul-2019

10B. DATED (SEE ITEM 13)

9A. AMENDMENT OF SOLICITATION NO.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offer is extended, X is not extended.

Offer 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:

(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 telegram 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 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 telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

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

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

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 ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(B).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

10A. MOD. OF CONTRACT/ORDER NO.

2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

24-Aug-2019

CODE

W40M USA HLTH CONTRACTING ACT

REGIONAL HEALTH CONTRACT OFF CENTRAL

2539 GARDEN AVENUE

JBSA FT SAM HOUSTON TX 78234-0000

W81K00 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

W81K0019Q0209

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

SUPPLIES OR SERVICES AND PRICES

CLIN 0001

The CLIN extended description has changed from:

Enterprise User/ Formulary Management. Includes the following:Narcotic safe double column auxiliary tower with clear doorsNarcotic safe single column auxiliary tower with clear doorsNarcotic safe desktop PC with software

To:

Enterprise User/ Formulary Management. Includes the following:Narcotic safe double column auxiliary tower with clear doorsNarcotic safe single column auxiliary tower with clear doorsNarcotic safe desktop PC with software**THIS IS A BRAND NAME OR EQUAL REQUIREMENT BASED ON THEBRAND NAME "PYXIS

PRODUCT SCHEDULE FROM BD ".IF PROVIDING OTHER THAN BRAND NAME, VENDOR IS

REQUIRED TOADDRESS AND MEET ALL SALIENT CHARACTERISTICS LISTED INORDER TO BE

CONSIDERED.**

The following have been added by reference:

52.211-6 Brand Name or Equal AUG 1999

The following have been added by full text:

QUESTIONS AND ANSWERS

Question 1. Is it a requirement that the proposed solution utilize the MHS Application Access Gateway (MAAG) datacenter to host application servers and EHR interfaces per the DHA approved deployment model?

Response 1. The answer is yes, DHA has approved for BAMC to allow B2B from BD, however we're not currently using B2B. B2B phase I end of cycle was 30 Jun 2019 and they were starting a BOMBGARD phase II after 30 Jun. All vendors must establish a Phase 2 B2B connection to provide remote product support after 30 Jun 2019

Question 2. If a respondent is unable to connect to the MHS Application Access Gateway, does the cost of server deployment need to be included in the response?

Response 2. Refer to Response 1.

Question 3. CLIN 0003 indicates the desire to procure 37 Narcotic Vaults – each with a double column auxiliary tower and a single column auxiliary tower. It is common for a facility of this size to have 1-2 and possibly even 3 of these, but not 37. Please advise.

Response 3. SAMMC/BAMC has many wards/clinics that store refrigerated medication to include controlled substances. These “Vaults” control access to these refrigerators. BAMC also has multiple vaults in the Inpatient pharmacy used to store controlled substances to compounding products as well as resupplying hospital cabinets.

Question 4. Item No 0004 “Medstation 7 Drawer auxiliary” and item no 0005 “Medstation Single Column Tower” are not stand-alone items and are required to be attached to either Item No 0006 “Medication Station, Main, 2-drawer” or Item No 0007 “Medication Main with 6 Drawers”.

Please clarify the quantity of the combinations below.

a. Item No 0007 + Item No 0004

b. Item No 0007 + Item No 0004 + Item No 0004

c. Item No 0007 + Item No 0004 + Item No 0005

d. Item No 0007 + Item No 0004 + Item No 0004 + Item No 0005

e. Item No 0006 + Item No 0004

f. Item No 0006 + Item No 0004 + Item No 0004

g. Item No 0006 + Item No 0004 + Item No 0005

h. Item No 0006 + Item No 0004 + Item No 0004 + Item No 0005

Potential offerors may have larger cabinets vs multiple smaller cabinets as the most efficient means of storage. Without knowing how the requested qtys are intended to be combined, we cannot properly respond to the RFP.

Response 4. Each vendor will have a different solution for the workspace. The solicitation is based on the quantity and dimensions currently in place.

Question 5. Refrigeration notation in the solicitation eludes to locks that would work with current refrigeration vendor, but in salient characteristics it mentions refrigerators which is a specific to only one vendor. How will the DOD rework solicitation to afford other vendors the opportunity to bid?

Response 5. A refrigerator is a refrigerator as long as it has the ability for locking mechanisms that are controlled by medication pulls tied to patient orders/nurse initiated actions. Salient characteristics have been changed, accordingly.

Question 6 “Modifiable drawer layout” is implicitly referencing to one specific vendor and their solution which limits other vendor’s ability to supply a response. This is also deferred in clinical question below how the DOD views metal vs plastic in reference to drug safety. How will the DOD remedy this in order for other vendors to be afforded opportunity to bid?

Response 6. Modifiable layouts provide flexibility as not all products are the same size.

Solicitation has been changed to reflect secure, locking bins with mechanisms for detecting and alerting wrongful bin entry.

Question 7.The referenced solicitation does not imply “brand name or equal” given that the SOW is specifically designed for one vendor in mind. How will the DOD make modifications to SOW and solicitation to allow other vendors the opportunity to compete?

Response 7. The solicitation has been revised to a “Brand Name or Equal” requirement.

Question 8. Clarification on Clinical Capabilities: The following were identified as important clinical workflow and/or patient safety technologies during the clinical reviews afforded to all vendors. They are absent in this RFP. Given the errors as well as lack of detail provided in the RFP as noted above, we would like you to clarify which of these technologies you would like included in our response and which you don’t deem necessary for safe patient care.

Does Pharmacy and Nursing see any value in single-dose narcotic dispensing?

This technology saves nurses and pharmacists thousands of hours every year currently spent on countbacks, end-of-shift counts and resolving discrepancies. Furthermore, this is the absolute safest way to administer controlled substances as it decreases the risk of diversion as the nurse simply doesn’t have access. This technology was not mentioned in the RFP.

Response 8. Single-dose controlled substance dispensing has been added to the salient characteristics.

Question 9. For workflow efficiency, does nursing see value in remote medication queuing and wasting?

This technology allows nurses to remotely queue and waste medications from any computer, reducing lines at the cabinet and providing a safer environment to queue up meds next to the MAR. This was not mentioned in the RFP.

Response 9. Salient characteristics have been changed to address this.

Question 10. Are medication label printers being considered? This technology prints ISMP-approved labels for medications issued from the cabinet. This results in faster time to first dose as nurses can pull the med from the cabinet instead of waiting on pharmacy for a labeled one. This was not mentioned in the RFP.

Response 10. A future state enhancement yes for MHS Genesis compatibility/Barcode medication administration. Salient characteristics have been changed to address this.

Question 11. Was or is any software for handling patient specific medications being considered? With the current automation in place, 10-20% of medications still must be managed manually and pharmacy has no visibility to these medications after they leave the pharmacy. Meds stored in bins or hooks on the walls do not allow for barcode checking on dispense. Nurses are not prompted to remove discontinued meds either, putting patients at greater risk of med error. Nurses spend unnecessary time searching for missing doses and checking multiple different locations for their meds being stored outside of the automated dispensing cabinet. Software is available to bring these medications into the cabinet and bring full profiling and visibility to them. There is no mention of this software in the RFP.

Response 11. Software is not a desired function at this time. There are inherent solutions/policies for “Patient Specific Medications”.

Question 12. Will there be any specification or requirement in the solicitation around the advancement of technology in reference to product lifecycle and risk mitigation. Significant risk was identified in procuring cabinets from the current vendor as they have not had a hardware redesign in over 2 decades. However, there is nothing in this RFP requesting reassurance of development runway and longevity of technology.

Response 12. Each vendor should propose their own solutions.

Question 13. How does the DOD view metal locking bins for “Narcotic Security” vs. plastic that can be penetrated? Metal locking has been identified as the industry standard as well as safest and most secure way to secure narcotics that are not stored in the single-dose narcotic dispenser. This is not mentioned in the RFP.

Response 13. The salient characteristics have been revised to address this.

Question 14. What specification is the DOD implementing in the solicitation for guiding light technology for every single dose? Nursing and pharmacy recognized the importance of having light-guided picking, restocking and dispensing for every single dose administered. This was not mentioned in the RFP.

Response 14. Lights are not the important component, guided dispensing is. Solutions that guide every single dose is required, it does not need to be light driven.

Question 15. What is the DOD’s preference for remote host support DHA B2B or Bomgar?

Known issue last year in reference to some vendors and ransomware virus. DHA B2B host for remote access support has been advised as most practical and safest approach.

Response 15. Each vendor will abide by the RFM/ATO and B2B requirements established by DoD Information Assurance Division

SALIENT CHARTERISTICS-AMENDED

The following are the salient characteristics “All or None” for medication storage cabinets:

Clinical Application:

Medication Management, Processing, and Dispensing

Location/Region:

Systems Requirement Description

Minimum Requirement

Objective

1 Operating system Win 10 Win 10

System utilizes bi-directional information sharing with the Military Health System Application Access Gateway (MAAG).

Required

Support regional data alignment with other MHS health facilities

Interface and interoperability with pharmacy management system using the most current standardized language and protocols (i.e.

RxNORM, SNOMED-CT, HL7, etc.)

Uni-directional interface

Bi-directional interface

Modifiable drawer layout

Customizable drawer layout to accommodate unit medication needs

Maximize customization Available to meet local needs

Controlled Medication Management Workflow

Inventory validation via blind count method, Multi-user validation, Access restrictions, system Restricted access drawers/bins/ lids, etc.

Minimize diversion by implementing validation steps

Automatic user activity tracking for audits

Facilitates diversion and patient safety investigations

Barcode driven interface

System enabled barcode scanning for restocking

Barcode enabled restocking, issue, and administration with dose reconciliation tracking

Real-time remote inventory management

Support local user dynamic inventory adjustments, view, and modify PAR levels and drug files as needed

Support dynamic reporting and analytics

User level dynamic reporting system including analytics, auditing, and inventory management reports to support local needs

Multiple storage configurations

Support bulk, unit dosed, IV, and refrigerated medications

Supports a wide variety of medications volume, sizes, and storage requirements

24/7 Vendor Remote support and service

Required Responsive service and support available 24/7

Perpetual inventory management for inventory supply and expirations

System tracks inventory in real time and generates replenishment reports or expiration reports as defined locally

System enables transparency and accountability of POU managed inventory tracking medications from initial supply to final disposition

Biometric enabled login

Ensures ease and security of login;

system allows manual password/pin bypass as alternative sign-in

System Monitored Refrigerator with Integrated Locking Mechanism

Enables inventory control of refrigerated items and prevents diversion

Variable User Access Profiles

User level defined access profiles to enable or restrict functions to meet local needs

Pharmacy Profiling feature

Pharmacy must profile for medication orders in Order to be pulled from system

Allow pharmacist to verify orders before direct patient care staff can pull meds from system

Real Time Notification of Critically Low Inventory

System automatically generates critically low report to notify pharmacy staff to provide immediate actions

Single-dose controlled substance dispensing features

System include storage and retrieval options for dispensing single-dose controlled substances (e.g. tabs, syringes, unit does cups).

Inventory discrepancy tracking

Tracks variance between expected and observed inventory level for user defined medications/supply using blind counting, double counts, ad-hoc discrepancy reporting, user level discrepancy resolution, etc.

System controlled and monitored return bin

System monitored return bin for direct patient care staff to return unused doses to the POU in order to minimize waste and diversion

Dynamic Medication Profiles that enables local users to define POU tracked characteristics

User level customization to meet local needs and enables cost charging to the dose or package level

Large item storage capability

Integrated cabinet or Stand-alone cabinet controlled by system

Allows for storage of large volume IV’s, bulk packaging, etc.

Automated safeguards to ensure right medication selection

System assists staff in locating correct medications using correct drug location indicators to minimize wrong medication selection and administration

Anesthesia Oriented Workstation

Optimized automation offering to Support surgery cases with necessary supplies in a small customizable configuration that can be moved and sterilized in a small foot print

Optimize OR workflow which lends itself to increase medication safety, accountability, and inventory management

Clinical Decision Support System and Alerts

System provides alerts IAW locally managed settings and requirements

System provides clinical (i.e. allergies, interactions, age, etc.) and customized alerts IAW locally managed settings and requirements

Remote queuing and medication wasting

Ability for local site configuration to allow remote medication queuing and remote medication wasting

Patient specific label generation at the cabinet

Compatible/ configurable with label printers to generate barcode enabled, patient specific labels for medication administration.

Uninterruptible power supply for system for orderly shutdown of system in case of power loss

N/A

On-Site Vendor Support

Vendor support provided in a timely manner of no more than 1 business day, and automation strictly maintained IAW vendor service schedule as applicable

Training for Pharmacy Staff

Two sets of user manuals and two sets of service manuals

Required N/A

32 Site prep: Provide all cost information for turn-key installation for the new system

The following have been modified:

52.212-1 ADDENDUM

1. Provide the following items:

• Completed SF 1449: Blocks 12, 17 (to include CAGE code and DUNS number), 30A - C

• Point of Contact Information (Name, Telephone Number, Fax Number, and Email) Statement that the offeror will hold its quote firm for at least 120 days from the due date for receipt of quotes, subject to any changes that may occur as a result of discussions if applicable.

・Potential contractors must be registered in the System for Award Management (SAM) to be eligible for award. The SAM website is http://www.sam.gov. Offers are due by the date and time established in block 8 of the SF 1449 (Central Standard Time). Offers received after the deadline will be considered untimely and will not be eligible for award. The deadline for questions is on 24 July 2019,, 3:00 PM, Central Standard Time.

All questions must be submitted in writing to Lornia.j.villalobos.civ@mail.mil and jamie.m.brunner.civ@mail.mil. Offers shall be submitted via e-mail to Lornia.j.villalobos.civ@mail.mil and Jamie.m.brunner.civ@mail.mil

Please provide completed provisions, as listed in the solicitation. Alternately, complete all provisions in SAM and provide confirmation of completion with offer.

2. Technical Capability. Provide proof of Risk Management Framework (RMF)/Authority to Operate (ATO) accreditation and certification in accordance with Defense Health Agency guidelines. Explain in detail how the proposed items will meet the salient characteristics of the items as specified here in the solicitation.

Offerors shall demonstrate that the product proposed complies with the technical requirements described in the salient characteristics via the submission of a written capability statement, product literature, or other materials, with their offer. If providing an “equal” item(s), comply with FAR Provision 52.211-6, “Brand Name or Equal”, Offerors shall cross-reference their product to its “equal” in the solicitation via the use of part numbers or another methodology that clearly identifies what the submitted product is. Explain in detail how the proposed items meet the salient characteristics. Offerors shall ensure their proposed quantities result in the same number of tests required, as identified in the solicitation. NOTE: The proposed products must meet EACH of the salient characteristics.

3. Subcontracting plan. Submit a subcontracting plan in accordance with 52.219-9 and that has been previously approved by a government contracting officer.

4.Price. A unit price shall be submitted for each line item, as well as the extended price (i.e., unit price multiplied by quantity).

This is an "all or none" solicitation. Failure to provide a quote for any CLIN, unless it is specifically identified as "not separately priced" within the quote, will be construed to mean the offeror is not quoting that CLIN and thus, not eligible for award.

(m) The non-FAR Part 12 discretionary FAR and DFARS provisions included herein are incorporated into this solicitation either by reference or in full text. If incorporated by reference, see provision 52.252-1 herein for locations where full text can be found

52.212-2 ADDENDUM

52.212-2 EVALUATION--COMMERCIAL ITEMS (OCT 2014)

Award will be made using the lowest price technically acceptable (LPTA) source selection process. Award will be made to the responsible offeror on the basis of the lowest evaluated price of proposals meeting or exceeding the acceptability standards for non-cost factors. Award may be made without discussions with offerors (except communications conducted for the purpose of minor clarification). Therefore, each initial offer should contain the offeror's best terms from a technical and price standpoint. However, the Government reserves the right to conduct discussions if it is later determined by the contracting officer to be necessary.

Paragraph (a) is hereby replaced with the following:

The following evaluation factors shall be used to evaluate offers:

Technical Capability. The following adjectival ratings will be used in evaluating the offeror’s technical quote:

Acceptable – To receive this rating, offeror must submit proof of RMF/ATO accreditation and certification certified in accordance with Defense Health Agency guidelines. The offerors’ product shall meet each of the salient characteristics and required features set forth in the solicitation of brand name or equal. All salient characteristics must be met in order to be determined “Acceptable” for this factor.

Unacceptable – An unacceptable rating will be assessed on any offeror that presents items that demonstrate any of the following:

-Failure to submit verifiable proof of RMF/ATO accreditation and certification certified in accordance with Defense Health Agency guidelines

-Failure to meet each of the salient characteristics set forth in the solicitation.

-Failure to provide sufficient detail for the Government to determine whether the item satisfactorily meets the requirements of this solicitation.

Subcontracting Plan. Evaluation of the subcontracting plan will be subjective based on consideration of all relevant facts and circumstances. The subcontracting plan will be evaluated to determine if the plan meets or exceeds the requirements of FAR 52.219-9 and was previously approved by a government contracting officer.

Acceptable: Offerer provided a Government approved subcontracting plan

Unacceptable: Offeror did not provide a Government approved subcontracting plan

Price. Quoted prices will be reviewed to determine fairness and reasonableness.

(b) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer’s specified expiration time, the

Government may accept an offer (or part of an offer), her or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

(End of provision)

The following have been deleted:

APPENDIX A

SALIENT CHARACTERISTICS

(End of Summary of Changes)