A.09.03_W81K02-16-T-0018-0001.pdf

W40M PACIFIC RNGL CNTRG OFC

US MEDCOM HCAA

POC: LEE H. MIYASHIRO

160 KRUKOWSKI RD BLDG 160

HONOLULU HI 96819-1552

0010793572

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

Except as provided herein, all terms and conditions of the document referenced in Item9A 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

1. The purpose of this amendment is to increase the quantity of CLIN 2001 from "1" to "2."

2. Questions and Answ ers have been incorporated as Attachment 1.

1. CONTRACT ID CODE PAGE OF PAGES

J 1 3

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

16C. DATE SIGNED

BY 21-Jan-2016

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 W81K02-16-T-0018

X 9B. DATED (SEE ITEM 11)

14-Jan-2016

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 Item14. The hour and date specified for receipt ofOffer 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 1 copies of the amendment; (b) By acknowledging receipt ofthis amendment on each copy of the offer submitted;

or (c) By separate letter or telegramwhich 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. Ifby virtue of this amendment you desire to change an offer already submitted, such change may be made by telegramor letter, provided each telegramor 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.(Ifapplicable)

6. ISSUED BY

3. EFFECTIVE DATE

21-Jan-2016

CODE

W40M PACIFIC RNGL CNTRG OFC

USA MEDCOM HCAA

160 KRUKOWSKI RD BLDG 160

HONOLULU HI 96819-1552

W81K02 7. ADMINISTERED BY (Ifother than item6)

4. REQUISITION/PURCHASE REQ. NO.

CODE W81K02

FACILITY CODECODE

EMAIL:TEL:

W81K02-16-T-0018

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

The following items are applicable to this modification:

SECTION SF 1449 - CONTINUATION SHEET

SOC

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

SUPPLIES OR SERVICES AND PRICES

CLIN 2001

The pricing detail quantity has increased by 1.00 from 1.00 to 2.00.

The following have been added by full text:

QUESTIONS & ANSWERS

ATTACHMENT 1

QUESTIONS & ANSWERS

QUESTION: Under the scope of work it state that the following on page 39:

"The contractor will conduct a minimum of ONE survey assessment visit a year during “non-JC window” timeframe (defined as 1-23 months from previous survey) and TWO survey assessment visits during “TJC window” timeframe (defined as 24-35 months from previous survey) and be available for telephone and/or video teleconference consultative services throughout the contract period for all applicable services/departments within the healthcare facility."

- However in the section SF 1449 on page 3-8 - only one survey is indicated. It is not clear which year the TWO surveys will be required. Please provide this information so we can reflect the appropriate pricing.

ANSWER: We want to establish a multi-year contract to coincide with our first (Intra-Cycle Monitoring Profile), second (Mock Survey prior to Joint Commission Survey) anniversaries of our Joint Commission Survey to include any Staff Development Training (i.e. AMP Tracers, etc.).

The survey breakdown is as follows:

CLIN 0001 - 22 Feb 16 - 21 Feb 17 (Base Period) - 1 visit CLIN 1001 - 22 Feb 17 - 21 Feb 18 (Option I) - 1 visit CLIN 2001 - 22 Feb 18 - 21 Feb 19 (Option II) - 2 visits CLIN 3001 - 22 Feb 19 - 21 Feb 20 (Option III) - 1 visit CLIN 4001 - 22 Feb 20 - 21 Feb 21 (Option IV) - 1 visit

QUESTION: It is not clear form the statement of work the team composition (i.e. physician, registered nurse, behavioral health consultant, environment of care engineer, etc.) or the length of the visits required for the mock survey.

W81K02-16-T-0018

ANSWER: Recommend a composition for a Clinician (Behavioral Health Consultant), Engineering Background (Construction project scheduled through 2016), and Administrative Background/Experience (Staff Training/Patient Administration)

QUESTION: The statement of work does not provide any information about the facilities (the size, specialty, number of beds, number of clinics, types of clinics, services provided) in order for the contractor to determine the composition (i.e. physician, registered nurse, behavioral health consultant, environment of care engineer, etc.) of the team and the length of the visit.

ANSWER: MEDDAC-J Ambulatory Clinic Composition (170 personnel spread across four different sites on the Post)

1) Patient-Centered Medical Home (5 Teams -- No beds)

2) Behavioral Health (NOT surveyed separately -- surveyed under Provision of Care Chapter)

3) Optometry

4) Physical Therapy

5) Pharmacy

6) Public Health

7) Immunizations

(End of Summary of Changes)