W81K04-21-R-0004 Amendment 0003 - 16 Nov 2021.pdf

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 update Attachment 1, MTF Description_Workload Data, post a second set of Questions and Answ ers and correct a fromula on Attachment 3, Price Matrix, w hich is updated to Revision 2.

All other terms and conditions remain the same. The POC for this amendment is Mr. Rey S. Salinas at rey.s.salinas.civ@mail.mil.

1. CONTRACT ID CODE PAGE OF PAGES

J 1 6

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

16C. DATE SIGNED

BY 16-Nov-2021

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 W81K0421R0004

X 9B. DATED (SEE ITEM 11)

15-Oct-2021

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 1 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

16-Nov-2021

CODE

W40M USA HLTH CONTRACTING ACT

CTR FOR HEALTH CARE CONTR

2199 STORAGE ST BLDG 4197 STE 68

JBSA FT SAM HOUSTON TX 78234-5074

W81K04 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

W81K0421R0004

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

The following have been modified:

ATTACHMENT 1

ATTACHMENT 1 REVISION 1

Medical Treatment Facility - Description and Workload Data

1. General Description: William Beaumont Army Medical Center (WBAMC) is part of the Region Health Command Central (RHCC) of the Army of the US Army Medical Command. The hospital is located in El Paso, Texas, 79916 just off of Loop 375 and Spur 601.

1.1 The hospital is comprised of six distinct buildings; one seven-story hospital building, one five story administration building, two five story clinical buildings, and one three story Clinical Investigation Building, and the Central Utility Plant

1.2 The hospital footprint includes Inpatient Units, Outpatient Clinics, Command Suite, Operating Suites, Labor and Delivery Suites, Dental Clinic, Pathology, Radiology, Occupational Therapy, Physical Therapy, Emergency Rooms, Nutrition Care Division, Inpatient Service Activities, Outpatient Records, Inpatient Pharmacy, Outpatient Pharmacy, Admissions and Dispositions, Hospital Treasurer, Post Exchange Pharmacy, Chapel, Managed Care Division, Medical Research Laboratory and MRI.

1.3. In additional, the Medical Treatment Facility (MTF) maintains five off campus buildings for Soldier Readiness Processing, three Troop Dental Clinics, one Veterinary Health Clinic, one Family Integrated Services Clinic, one Family Advocacy Clinic, one WTU Case Management Clinic, one Medical Holdover Clinic, one Community Mental Health Clinic, one Resilience and Restoration Center, one Army Substance Abuse Program Building, one General Instruction Building, one Auditorium, one Blood Bank, one Blood Donor Center, two Preventive Medicine Laboratories, one Facilities Management Building, one Supply Chain Warehouse, two Administration Buildings, and one Dental Headquarters Building.

2. Outlying Buildings Include:

2.1. Soldier Family Medical Clinic (SFMC) located on Fort Bliss. It is staffed by both military and civilian medical professionals providing primary care and ambulatory medical services for the Air Defense Artillery (ADA), active duty population, as well as Army Reserve/National Guard service members attending annual training on the installation. A complete renovation of the facility was completed in May 2015.

2.2. The Embedded Behavioral Health Clinic provides multidisciplinary behavioral health care to Fort Bliss soldiers and their families, and operates in coordination with unit leaders to maximize diagnostic accuracy, remove barriers to care and improve treatment outcomes.

2.3. The Veterinary Clinic provides health care for government-owned animals and for animals of individuals authorized military privileges with an emphasis on wellness, preventive medicine, and outpatient services.

Preventative Medicine and the Occupational Health Clinics are located on Fort Bliss and provide overall management of preventive medicine services which include Army Public Health Nursing, environmental health, industrial hygiene and the nutrition clinic. Occupational Health activities focus on health promotion, protection, maintenance, restoration of health and preventive approach to health care. This includes early disease detection, health teaching, counselling, and work-site evaluations.

2.4 Hugo V. Mendoza Soldier Family Care Clinic is located on Fort Bliss, Texas. It is staffed by both military and civilian medical professionals providing primary care, pediatric services, behavioral health services, laboratory services, public health, and optometry services ambulatory medical services for the active duty population, their families, Army Reserve/National Guard service members attending annual training on the installation, and VA Retirees.

2.5 McAfee US Army Health and Dental Clinic located in White Sands Missile Range (WSMR), New Mexico. It is staffed by both military and civilian medical professionals providing primary care, ambulatory medical services, and dental services for the 2nd Engineers and their families.

2.6 East Bliss Health and Dental Clinic located on Fort Bliss, Texas. It is staffed by both military and civilian medical professionals providing primary care, ambulatory medical services, ancillary medical services, and dental services for the 1/1 Armored Division (AD), Headquarters of Headquarters Battalion of 1AD (HHBN), 86th Expeditionary Signal Battalion (ESB), and the Division Artillery (DIVARTY) active duty population. They are the only stand-alone Soldier Care Medical Home on the installation.

2.7. William Beaumont Army Medical Center: WBAMC and outlying buildings are staffed with military, civilian, contractor and volunteer employees.

Total number of buildings are 38

Bldg. 18508– Central Utility Plant Bldg. 18509 Clinical Investigation Building Bldg. 18511 (18511E, 18511W, 18511H, 18511A) – Main Hospital.

Bldg. 1025 – Behavioral Health Clinic (CAFAC) Bldg. 1026 – Behavioral Health Clinic (CAFAC) Bldg. 1030 – Child, Adolescent & Family Behavioral Health Bldg. 11148 – Soldier’s MEB Counsel Bldg. 11156 – Medical Warehouse Bldg. 11280 IDES &SHPE Bldg. 11282 IDES II Bldg. 11293 – Senior Leader Sustainment Clinic Bldg. 11334 – Dental Clinic #II Bldg. 11135 – Mendoza Soldier Family Care Clinic Bldg. 1363 – McAfee Health / Dental Bldg. 1611 – PX Pharmacy (Refill Pharmacy) Bldg. 21 – Preventative Medicine & Occupational Bldg. 21227 – East Bliss Health / Dental Clinic Bldg. 2485A – Family Advocacy Program Bldg. 2485B – Family Advocacy Program II Bldg. 2485D – Behavioral Health Administrative Facility Bldg. 2487 – Behavioral Health Group Therapy Bldg. 2489 – Lab/Blood Donor Clinic Bldg. 2496 – Soldier Family Medical Clinic Bldg. 2497 – Child, Adolescent, & Family Behavioral Health Bldg. 2901 – Dentac Company Headquarters Bldg. 2954 – Dental Clinic III Bldg. 48 – Behavioral Health / Intensive Outpatient Bldg. 49 – Behavioral Health / Addiction Med IOP (Army Substance Abuse Program) Bldg. 6077- Veterinarian Clinic Bldg. 805 – Warrior Transition Battalion Clinic Bldg. 9503 –TMC McGregor Range Bldg. L10735 – CBMH Rio Bravo Health Clinic Bldg. LCBMH2 – CBMH West El Paso Medical Home - Desert Sage

Day Shift: 7:00 AM to 3:30 PM Evening Shift: 3:30 PM to 11:30 PM Night Shift: 11:30 PM to 7:00 AM

BLDG Building Description Times & Day of Operation

Location Function

18508

New MTF-Central Utility Plant

0700-15:30 Monday-Friday

WBAMC

Patient Care

18509 New MTF-Clinical

Investigation Building

(CIB)

0700-1600 Monday-Friday

New

WBAMC

Research Development

18511 Main Hospital 0700-1600

Monday-Friday WBAMC Patient Care

18511A Hospital Administration 0700-1600

Monday-Friday WBAMC Administration

18511E Hospital East Wing 0700-1600

Monday-Friday WBAMC Patient Care

18511W Hospital West Wing 0700-1600

Monday-Friday WBAMC Patient Care

1025 Behavioral Health Clinic 0700-1600

Monday-Friday Main Post Patient Care

1026 Behavioral Health Clinic 0700-1600

Monday-Friday Main Post Patient Care

Child, Adolescent &

Family Behavioral Health 0700-1600

Monday-Friday Main Post Patient Care

11148 Soldiers MEB Counsel 0700-1600

Monday-Friday Main Post Administrative Support

Services

11156 Medical Warehouse 0600-1630

Monday-Friday East Bliss Area Medical Supply

Warehouse

11280 IDES & SHPE

0700-1600

Monday-Friday Main Post Patient Care

11282 IDES II

0700-1600

Monday-Friday Main Post Patient Care

11293 SLSC (Senior Leader Sustainment Clinic)

0700-1600 Monday-Friday

East Bliss Mendoza Area

Patient Care

11334 Dental Clinic #II 0700-1600

Monday-Friday Main Post Fort Bliss

Patient Care

11335 Mendoza Soldier Family

Care Clinic 0700-1600

Monday-Friday East Bliss

Mendoza Clinic Patient Care

McAfee Health/Dental

Clinic 0700-1600

Monday-Friday WSMR Patient Care

1611 Pharmacy Refill 0730-1630 Monday-Friday

Main Post Fort Bliss

Help understand Rx & promote the safe use of

Rx.

Preventive Medicine &

Occupational 0700-1600

Monday-Friday East Bliss

Mendoza Area Minimize disease threats and promote wellness.

21227 East Bliss Medical/ Dental

Clinic.

0700-1600

Monday-Friday Far East Bliss Medical Clinic

2485A Family Advocacy Program 0700-1600

Monday-Friday Main Post Patient Care

2485B Family Advocacy Program

II

0700-1600

Monday-Friday Main Post Patient Care

2485D Behavioral Health Admin 0700-1600

Monday-Friday Main Post Patient Care

2487 BH Group Therapy 0700-1600

Monday-Friday Main Post Patient Care

2489 Lab/Blood Donor Center 0700-1600

Monday-Friday Main Post Patient Care

Soldier Family Medical

Clinic 0700-1600

Monday-Friday Main Post Patient Care

Child, Adolescent, &

Family Behavioral Health 0700-1600

Monday-Friday Main Post Patient Care

2901 DENTAC Company HQ 0700-1600

Monday-Friday Main Post Fort Bliss

Administration Building

2954 Dental Clinic III 0700-1600

Monday-Friday Main Post Fort Bliss

Patient Care

Behavioral Health / Intensive Outpatient

0700-1600 Monday-Friday

Main Post Fort Bliss

Emphasizes readiness & personal responsibility.

Behavioral Health /

Addiction Med IOP (Army Substance Abuse Program) 0600-1630 Main Post

ASAP

6077 Veterinary Health Clinic 0800-1630

Monday-Friday Main Post Animal Care

Warrior Transition

Battalion Clinic 0700-1600

Monday-Friday Main Post Patient Care

9503 TMC McGregor Range 0700-1630 White Sands Patient Care

L10735 CBMH Rio Bravo Health

Clinic 0700-1600

Monday-Friday Far Eastside

El Paso Patient Care

LCBMH

CBMH West El Paso Medical Home Desert Sage

0700-1600 Monday-Friday

Northwest El Paso

3. Healthcare Statistics (Monthly Average)

Description FY2017 FY2018 FY2019 Total Operating Beds 138 138 138

Total Births 1525 1274 1173 Total Surgical Cases 17766 18291 17867

Total Admissions 8760 8760 8760 Operating Room Suites 13870 13870 13870

Occupancy Rate (Occupied Bed Days)

25827 25795 22464

Average Length of Stay 2.93 2.90 2.63 Outpatient Visits 3586 3586 3586 Total Discharges: 8791 8873 8514

Dental Clinic Visits 99648 101598 98029 Emergency Room Visits 50,005 48,603 50/334 Veterinary Clinic Visits 3,421 3,185 2,326

4. Environmental Services Statistics:

Approximate Annual Pounds of RMW collected 120,248.40

Approximate Annual Pounds of Linen Cleaned 882,192 Toilet Paper Dispenser (Psychiatric) (Scott & Kimberly Clark products) 19 Toilet Paper Dispenser 2-Roll Surface Mounted (Scott & Kimberly Clark products) 644 Paper Towel Dispenser Surface Mounted (Scott & Kimberly Clark products) 1265 Paper Towel (Patient Rooms) (Scott & Kimberly Clark products) 226 Hand Sanitizer Dispenser (Scott & Kimberly Clark products) 895 Soap Dispenser (Dial & Purell soap) 1686 Soap Dispenser (Outlying Clinics) Dial 3/1.2 ML Manual Dispenser FG

IDH#2176090

Windows SF 143,730

(End of Summary of Changes)