W9114F-18-R-0001-0001.docx

W9114F-18-R-0001

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 30 - BLOCK 14 CONTINUATION PAGE

The following have been added by full text:

PURPOSE

The purpose of this amendment is to:

a. Post Questions and Answers

b. Extend the offer due date from 10 January 2018 2:00 PM Germany Local Time to 12 January 2018 at 5:00pm Germany Local Time

c. PWS Para 3.6.5. was modified to read: Contract service providers may be required to report to work as scheduled during emergencies, disasters or during adverse weather conditions. Contract services will still be required during these situations if contract service provider is considered mission essential personnel. This Position is designated Mission Essential for weather and emergency purposes. The contract service provider for this position is required is required to report for duty on time or continue on duty during inclement weather and emergencies despite delayed reporting, early release, or closure for other non-mission essential personnel. The hourly rate to be paid shall be the same hourly rate specified in the contract line item number listed on the 1920 hours.

d. PWS Para 3.24 United Kingdom (U.K.) Civilian Component Stamp, was replaced by Para 3.24 United Kingdom (U.K.) Logistical Support provision.

e. Revised PWS Para 3.9.3. & 3.13.1.

f. Changed PWS Para 5 to ‘Reserved’

g. Renumber PWS Para 5.8, Call Back and Standby Hours, to Para 3.6.6.1.1.

h. Attachment 1 Specialty Qualifications, Para 25.2. Removed Section C-4 reference and replaced by, "HCPs will utilize their own POVs in performance of the contract."

Questions and Answers:

1. Is this a new contract or an existing one?

ANSWER 1: This is a follow-on to ADCMS Generation II W9114F-13-D-0002 IDIQ contract.

2. If this is an existing one, what is the name of the current Contractor?

ANSWER 2: Sterling Medical Associates, Inc.

3. Please provide the option year prices for the contract.

ANSWER 3: We cannot provide option year prices for the current contract. You may submit a FOIA request to: usarmy.jbsa.medcom.list.medcom-foia-users@mail.mil

4. Is this a multiple award?

ANSWER 4: Reference Addendum to 52.212-1 Para 1.0(a) and FAR 52.216-1 Type of Contract. The Government contemplates a single award Indefinite Delivery/Indefinite Quantity contract resulting from this solicitation.

5. Who is the current incumbent contractor and what is the value of the current contract?

ANSWER 5: Incumbent: Sterling Medical Associates, Inc. Contract value: $96,256,960.72

6. (a) Is teaming (prime and subcontractor) permitted under this contract? (b) Can a prime include a subcontractor in its proposal?

ANSWER 6: (a) Yes. Reference PWS Para 3.17. Subcontracting – Teaming arrangements or Joint Ventures are not considered subcontracting; (b) No

7. (a) Could you please provide the incumbent contract number? (b) If not, is this a new requirement?

ANSWER 7: (a) See Answer 2 (b) See Answer 1

8. I would like to request clarification in reference with Key Personnel mentioned in the solicitation. Paragraphs a and b in RFP section Information to Offerors (ITO) and Instructions for Proposal Preparation, 1.0 General Instructions, (h) PROPOSAL FORMAT, I. Factor 1: Technical, Subfactor 1: Personnel, refer to “key personnel.” However, a listing of key personnel could not be found. Please kindly provide clarification.

ANSWER 8: The Contract Line Item Numbers (CLINs) and Attachment 2 Location List identify the specialties/positions to be filled.

9. RFP Page Number/ Section 390/52.212-1 1.0 (h) Subfactor 1: Personnel

9a. “Ability to provide and meet the qualifications of key personnel to be used in the execution of this contract, or those personnel recruited to fill those positions in accordance with the qualification requirements of the PWS.” Please define key personnel and list all key personnel titles ANSWER 9a: Key personnel in this solicitation are the full-time equivalent healthcare providers that are identified in the Contract Line Item Numbers (CLINs) and listed on Attachment 2 Location List.

9b. We are requesting that the required key personnel based in Germany be removed. From all appearances, this favors the incumbent.

ANSWER 9b: Factor 1 Technical, Subfactor 1 Personnel (b) Existing capability to perform in Europe such as key personnel who are already in country, will not be removed as Technical Subfactor.

9c. Existing capability to perform in Europe such as key personnel who are already in country. May we ask that this requirement be removed?

ANSWER 9(c): See Answer 9(b)

10. The current solicitation, # W9114F-18-R-0001, for ADCMS Services, includes the following clause, under Section 3.24:

“3.24. UNITED KINGDOM (U.K.) CIVILIAN COMPONENT STAMP. The Contractor shall be responsible for ensuring their company is registered with the Office of the Special United States Liaison Officer, American Embassy London, U.K. to establish eligibility for Status of Forces Agreement Civilian Component passport stampings, under the terms of the Special Memorandum of Understanding, dated 7 July 1987. If Civilian Component status is not achieved, the Contractor could be held responsible for payment of British income tax, British council tax, and import tax on privately owned vehicles. Other taxes could also pertain.”

The above provision implies that healthcare professionals furnished under the upcoming contract may qualify for SOFA status under the terms of the Special Memorandum of Understanding, dated 7 July 1987. However, a reading of the Special Memorandum of Understanding makes it very clear that none of the healthcare staff furnished under the upcoming contract that will result from Solicitation # W9114F-18-R-0001 will in no way qualify for SOFA status. In particular, the Special Memorandum states that it is applicable to “persons working for United States and corporations under contract to agencies of the Department of Defense who are engaged in intelligence work at specific sites within The United Kingdom.”

For reference, a copy of the Special Memorandum has been furnished to contracting under separate cover.

Can all offerors be made aware of this fact, so that they do not incorrectly believe that the Special Memorandum, cited in Section 3.24 as providing for SOFA status for U.K. contractor employees, is applicable to healthcare providers, when it is not?

ANSWER 10: Solicitation W9114F-18-R-0001 was changed by replacing Para 3.24, UNITED KINGDOM (U.K.) CIVILIAN COMPONENT STAMP with Para 3.24 UNITED KINGDOM (U.K.) Logistical Support provision

11. The current solicitation includes a provision which appears to indicate that contractor employees in The United Kingdom may be able to attain SOFA status, and therefore not be responsible for payment of British income tax, British Council Tax, and import tax on privately owned vehicles.

The provision that appears to indicate that contractor employees will not be subject to British income tax provides as follows:

“3.24. UNITED KINGDOM (U.K.) CIVILIAN COMPONENT STAMP. The Contractor shall be responsible for ensuring their company is registered with the Office of the Special United States Liaison Officer, American Embassy London, U.K. to establish eligibility for Status of Forces Agreement Civilian Component passport stampings, under the terms of the Special Memorandum of Understanding, dated 7 July 1987. If Civilian Component status is not achieved, the contractor could be held responsible for payment of British income tax, British council tax, and import tax on privately owned vehicles. Other taxes could also pertain.”

May all offerors be made aware that the Special Memorandum of Understanding will not apply to healthcare providers furnished under the upcoming contract, as the applicability of the Special Memorandum of Understanding is limited to persons engaged in “intelligence work”, and that moreover, in order for the Special Memorandum of Understanding to apply, the salary paid to the intelligence workers must be paid directly from the appropriate U.S. Department of Defense agency?

ANSWER 11: See Answer 10

12. Section 3.24 as it currently appears, might appear to indicate that SOFA status may be granted to contractor employees furnishing healthcare service under the upcoming contract, so that British income taxes would not apply, may all offerors be informed of the actual text of the Special Memorandum limits the grant of an exemption from British income taxes to those contractor employees that are engaged in “intelligence work” and that also are paid under the specific compensation arrangements set forth in the Special Memorandum.

The Special Memorandum indicates that any grant of SOFA status is limited to workers “engaged in intelligence work at specific sites” and that the compensation to such employees, in order to qualify for British tax exemption, must “be paid directly by the United States Government” in accordance with the pay annex of the Special Memorandum.

The pay annex of the Special Memorandum states that all individuals performing intelligence work, in order to qualify for the special passport stamp and SOFA status must be engaged in intelligence work and also “shall receive payment of emoluments directly from the appropriate Department of Defense (DOD) agency. Such payment shall be effected by the appropriate DOD agency via electronic funds transfer to each individual’s account in a financial institution…”

The pay annex further states that: “the various U.S. contractor corporations shall continue to maintain their own pay records and shall furnish the appropriate DOD agency with net pay statements, in arrears, for each individual employee.”

Will the Government clarify if it would ever pay net compensation directly to contractor employees, on the contractor’s behalf, in order to render the Special Memorandum potentially applicable to workers under this contract?

Section 3.24 of the Solicitation, # W9114F-18-R-0001, for ADCMS Services, references the Special Memorandum of Understanding dated 7 July 1987. For reference, a copy of the Special Memorandum has been furnished to contracting under separate cover.

May the Special Memorandum be provided to all offerors so that all offerors are made aware of its contents? (This would be particularly appropriate because the Special Memorandum is mentioned in the Solicitation but is not furnished to offerors).

ANSWER 12: See Answer 10

13. The Special Memorandum of Understanding dated 7 July 1987 details the only types of contract employees that can receive SOFA status in the U.K. and that thus would be exempt from U.K. income taxes. Specifically, the Special Memorandum only applies to individuals “who are engaged in intelligence work” on behalf of Government contractors whose net payment was deposited into their account directly by the US Government.

Will this special exemption apply to employees under the upcoming contract, who will not be engaged in intelligence work?

ANSWER 13: See Answer 10

14. The following labor categories in the U.K. are to be provided under Solicitation # W9114F-18-R-0001 for ADCMS Services:

OB/GYN Registered Nurse, Lakenheath, U.K.

Women’s Health Nurse Practitioner, Lakenheath, U.K.

Pain Management Anesthesiologist, Lakenheath, U.K.

Pharmacy Technician, Lakenheath, U.K.

Lactation Consultant, Lakenheath, U.K.

PDHR Physician Assistant, Lakenheath, U.K.

Medical Case Manager, Lakenheath, U.K.

Internal Medicine Licensed Practical Nurse, Lakenheath, U.K.

Pain Management Licensed Practical Nurse, Lakenheath, U.K.

Referral Management Licensed Practical Nurse, Lakenheath, U.K.

Pediatrics Licensed Practical Nurse, Lakenheath, U.K.

OB/GYN Licensed Practical Nurse, Lakenheath, U.K.

Family Health Licensed Practical Nurse, Lakenheath, U.K.

Referral Management Clerk, Lakenheath, U.K.

Medical Administrative Technician, Lakenheath, U.K.

Surgery Technician, Lakenheath, U.K.

Physical Therapist, Lakenheath, U.K.

Physical Evaluation Board Liaison Officer, Lakenheath, U.K.

Pharmacist, Lakenheath, U.K.

Emergency Room Physician, Lakenheath, U.K.

Family Services Coordinator, Lakenheath, U.K.

The Special Memorandum of Understanding dated 7 July 1987 details the only types of contract employees that can receive SOFA status in the U.K. and that thus would be exempt from U.K. income taxes. Specifically, the Special Memorandum only applies to individuals “who are engaged in intelligence work” on behalf of Government contractors whose net payment was deposited into their account directly by the US Government.

Are any of the above labor categories viewed as being involved in intelligence work so that the Special Memorandum would apply, so that these healthcare specialists were for any reason to be considered exempt from U.K. income taxes?

ANSWER 14: None of the specialties listed in this solicitation will be involved in intelligence work. See Answer 10.

15. The Special Memorandum of Understanding dated 7 July 1987 details the only types of contract employees that can receive SOFA status in the U.K. and that thus would be exempt from U.K. income taxes. Specifically, the Special Memorandum only applies to individuals “who are engaged in intelligence work” on behalf of Government contractors whose net payment was deposited into their account directly by the US Government.

Will this special exemption apply to U.K. employees under the upcoming contract? Are any of these providers intended to be engaged in intelligence work?

ANSWER 15: None of the specialties listed at Lakenheath will be involved in intelligence work. See Answer 10.

16. The following ADCMS labor categories and CLIN numbers, for ADCMS providers in the U.K., under the current Solicitation are currently furnished by us as incumbent providers under the current ADCMS Contract:

The Special Memorandum of Understanding dated 7 July 1987 details the only types of contract employees that can receive SOFA status in the U.K. and that thus would be exempt from U.K. income taxes. Specifically, the Special Memorandum only applies to individuals “who are engaged in intelligence work” on behalf of Government contractors whose net payment was deposited into their account directly by the U.S. Government.

Would ADCMS services be considered “intelligence work” under the current Solicitation, so that there would be a United Kingdom income tax exemption for contract employees under the contract resulting from the current Solicitation?

ANSWER 16: See Answer 10. None of the specialties listed in this solicitation will be involved in intelligence work.

17. All individuals residing and fulfilling employment in the U.K. are required, under U.K. law, to pay taxes on all earned income.

According to Her Majesty’s Revenue and Customs (“HMRC”), all income from full, part-time and temporary employment “counts as taxable income.” According to the HMRC website:

“What counts as taxable income? Income from employment. Includes income from full, part-time and temporary employment.”

(“Income Tax rates and Personal Allowances-GOV.U.K.,” website, http://www.gov.U.K./income-tax-rates)

The PAYE tax liability for each individual varies depending upon his/her taxable income.

PAYE taxes are assessed as follows in the U.K.:

45,000£

(“Rates and thresholds for employers,” HM Revenue & Customs website http://www.hmrc.gov.U.K./paye/rates-thresholds.htm)

Does the Government expect that the contractor will comply with United Kingdom income tax law with respect to its employees unless SOFA status was to apply and the employees were, due to grant of SOFA status, exempt from United Kingdom income taxes?

ANSWER 17: Yes. See Answer 10.

18. The general obligations of employers to withhold U.K. income tax and U.K. National Insurance, for all individuals employed in the United Kingdom, are established in the following U.K. laws: Income Tax (Earnings and Pensions) Act 2003 and the Social Security Contributions and Benefits Act 1992.

As incumbent contractors furnishing healthcare staff in the United Kingdom, we do withhold required British income taxes on all U.K. employee earnings.

Will it be an expectation that the incoming contractor will comply with U.K. law in the tax treatment of its employees and withhold and pay British income taxes on the earnings of employees in the U.K.?

ANSWER 18: Yes. See Answer 10.

19. It is our understanding that SOFA status is not provided in the U.K. for contractor employees furnishing medical services and that U.K. work permits must be obtained, with British income tax deducted and paid, for such contract medical service employees.

Can you please confirm that this is the case under the current solicitation? In other words, can you please clarify if the successful contractor should comply with local U.K. law and pay British income and council taxes, as SOFA status will not furnished in the U.K. for contract medical service employees?

ANSWER 19: The successful contractor shall comply with local U.K. law and pay British income and council taxes, as SOFA status will not furnished in the U.K. for contract medical service employees. See Answer 10.

20. Can individuals providing medical services on behalf of a Government contractor in the U.K. obtain SOFA status and, therefore, an exemption from British income and Council taxes on the employee’s earnings in the U.K.?

ANSWER 20: See Answer 10.

21. If a SOFA exemption is not available, must US Government contractors pay British income taxes on the earnings of their employees in the U.K.?

ANSWER 21: Yes. See Answer 10.

22. The general obligations of employers to withhold British income tax and British National Insurance, for all individuals employed in the United Kingdom, are established in the following U.K. laws: Income Tax (Earnings and Pensions) Act 2003 and the Social Security Contributions and Benefits Act 1992. As incumbent contractors for the current contract, we do withhold required British income taxes on all U.K. employee earnings.

Will it be an expectation that the incoming contractor will comply with U.K. law in the tax treatment of its employees and withhold and pay British income taxes on the earnings of employees in the U.K.?

ANSWER 22: Yes. See Answer 10.

23. If SOFA status is not available to individuals furnishing medical service on behalf of the US Government in the U.K., will employees also be subject to payment of Council tax in the U.K.?

ANSWER 23: See Answer 10.

24. Under the current ADCMS Contract, we are the incumbent contractor, and employer in the U.K., for the following labor categories and locations positions in the U.K. that are fully enrolled on Her Majesty’s Revenue rolls for payment of U.K. income tax and are currently having their salary withheld for income tax payments in the U.K., each under their own United Kingdom tax identification number for U.K. income tax:

None of these individuals currently furnishing service under the above positions received SOFA status in the U.K., and all are paying U.K. income taxes on their salaries in the United Kingdom.

Does Section 3.24 “UNITED KINGDOM (U.K.) CIVILIAN COMPONENT STAMP” indicate that any of the incumbent employees, who are healthcare providers, and not “engaged in intelligence work”, will cease to be responsible for U.K. income taxes under the upcoming contract?

ANSWER 24: See Answer 10

25. Under the current ADCMS Contract, we are the incumbent contractor, and employer in the U.K., for the following labor categories and locations positions in the U.K. that are fully enrolled on Her Majesty’s Revenue rolls for payment of U.K. income tax and are currently having their salary withheld for income tax payments in the U.K., each under their own United Kingdom tax identification number for U.K. income tax:

All of the above individuals are paying U.K. income taxes on their salaries in the United Kingdom.

Is the Government implying, by including Section 3.24 that any of the contractor employees furnishing service in the U.K. that are currently fully subject to U.K. income taxes will have their status change so that they are newly exempt or not required to pay such U.K. income taxes?

ANSWER 25: See Answer 10

26. For Italy and Germany, the government has clearly outlined how visas/host nation approvals will be obtained. The only clause concerning immigration in the U.K. is 3.24.:

UNITED KINGDOM (U.K.) CIVILIAN COMPONENT STAMP. The Contractor shall be responsible for ensuring their company is registered with the Office of the Special United States Liaison Officer, American Embassy London, U.K. to establish eligibility for Status of Forces Agreement Civilian Component passport stampings, under the terms of the Special Memorandum of Understanding, dated 7 July 1987. If Civilian Component status is not achieved, the Contractor could be held responsible for payment of British income tax, British council tax, and import tax on privately owned vehicles. Other taxes could also pertain.

If individuals are employed in the U.K. and not engaged in “intelligence work” and not subject to SOFA status, would Section 3.2.4 apply, as passport stampings could not be obtained under the Special Memorandum?

ANSWER 26: See Answer 10

27. Our company is the current incumbent under Contract # W9114F-13-D-0002, for ADCMS Services, with over 50 healthcare providers currently furnished under that Contract in the U.K. We have never been able to obtain a Status of Forces Agreement Civilian Component passport stamping for any of the healthcare providers that we have furnished, and we have been informed by the Office of the Special United States Liaison Officer, American Embassy London, U.K., that such passport stampings are not available for healthcare providers. As a result, no healthcare providers placed by us in the U.K. have ever obtained SOFA status, and we have had to obtain ordinary work permits for all U.S. staff that has relocated to the U.K. for service as a healthcare provider.

Can the Government clarify whether any individual furnishing healthcare services has ever been able to obtain a Status of Forces Agreement Civilian Component passport stamping or SOFA status in the U.K.? If this has never occurred, can a provision indicating that United Kingdom work permits will need to be obtained if SOFA status cannot be granted?

ANSWER 27: See Answer 10

28. Assuming that the U.K. Civilian Component Passport Stamp referred to in Section 3.24, “UNITED KINGDOM (U.K.) CIVILIAN COMPONENT STAMP” is unavailable, a number of additional costs must be planned on by contractors. As incumbent contractor for 36 positions in the U.K., we have never been able to obtain a U.K. Civilian Component Stamp, as none of the providers who we employ are engaged in intelligence work, and as we compensate our providers directly. As a result, we not only are responsible for British income tax, British counsel tax and import tax on privately owned vehicles, but also the obtaining of regular work visas for all employees that are not accompanied by an active duty spouse, and must maintain payroll services in the U.K.

Are additional expenses necessary to provide and administer British income tax withholding in the U.K. the responsibility of the contractor, if the United Kingdom Civilian Component Stamp, and SOFA status, is not available for the contractor’s employees?

ANSWER 28: See Answer 10

29. Section 3.25 states as follows:

“The Contractor is responsible for ensuring all country clearances, passports, visas, and accreditations required by the Host Nation are obtained prior to employment of individuals under this contract. In the event a proposed contract employee is denied Host Nation approval, accreditation and/or permission, the Contractor shall submit like documentation for another nominee.”

a. If the contractor is responsible for ensuring all visas and accreditations required by the Host Nation, would this mean that the contractor must obtain a visa and work permit for employees being relocated by the contractor to the U.K., if SOFA status is not available in the U.K. for healthcare professionals to be relocated by the contractor?

ANSWER 29(a): Yes. See Answer 10.

b. Does the Government intend to provide assistance to the contractor in obtaining visas or work permits in the United Kingdom, since SOFA status is not available to employees relocated by the contractor that are not engaged in intelligence work?

ANSWER 2(b): No

30. Can the Government clarify whether the ADCMS providers being solicited in the U.K. are involved in intelligence work, as required for SOFA status in the U.K. under the Special Memorandum of Understanding between the United States and the United Kingdom of Great Britain and Northern Ireland, dated 7 July, 1987?

ANSWER 30: See Answer14

31. If the ADCMS providers in the United Kingdom do not receive SOFA status, will the contractor or the Government be responsible for British income taxes on the salaries of these providers?

ANSWER 31: The contractor. See Answer 10.

32. We note that Section 3.17 states as follows:

“Subcontracting. European countries are no longer granting exemptions for prime contractors to conclude contracts with subcontractors to fulfill contractual obligations. Therefore, the prime contractor shall provide all of the employees for support to the United States Forces stationed in Europe. Subcontracting is not authorized in accordance with Article 72 of the Supplemental Agreements to the NATO SOFA. Teaming arrangements or Joint Ventures are not considered subcontracting.”

Does this provision mean that subcontractors will not be permitted to subcontract staff to the prime contractor under the upcoming contract?

ANSWER 32: Yes

33. U.S. Government Contract # FA5613-13-D-0009, pursuant to which the following labor categories were performed in the U.K.– Speech Language Pathologist Lakenheath U.K., Clinical Child Psychologist Lakenheath U.K., Early Childhood Special Educator Lakenheath U.K., Pediatric Occupational Therapist Lakenheath U.K., Pediatric Physical Therapist Lakenheath U.K., Early Childhood Special Educator Alconbury U.K., Pediatric Occupational Therapist Alconbury U.K. – was originally solicited under Solicitation # W9114F-13-R-0004.

Under Solicitation # W9114F-13-R-0004, the Government provided the following answer in the Q&A:

“Contractors performing under this requirement would not fall under the status of the Status of Forces Agreement between the US/U.K. Governments. Contractors and their employees would be required to comply with U.K. labor and taxation laws as applicable.”

If the current contract does not fall under the Status of Forces Agreement between the US/U.K. Governments, will the contractor and its employees under the upcoming contract be required to comply with U.K. labor and taxation laws as applicable?

ANSWER 33: Yes. See Answer 10

34. We are currently the incumbent provider under the current ADCMS Contract for the following labor categories in the UK that are being solicited under the current ADCMS Solicitation:

We do not receive a British income tax exemption for any of the providers currently furnishing service under these labor categories in the UK. As a result, British income tax is withheld and paid for these providers. In order to withhold and pay British income tax, we must furnish the tax amount withheld in UK pounds to Her Majesty’s Revenue and Custom Service. Her Majesty’s Revenue and Custom Service does not accept payment of withheld income taxes in U.S. Dollars, but these amounts must be converted to UK Pounds for payment.

a. If the incumbent providers under the ADCMS Contract continue to be subject to British income taxes, because they do not qualify for a British tax exemption under the Special Memorandum referred to in the Solicitation under Section 3.24, will the contractor or the Government be responsible for the payment of required British income tax on employee salaries?

ANSWER 34(a): The contractor. See Answer 10.

b. If the incumbent providers under the ADCMS Contract continue to be subject to British income taxes, because they do not qualify for a British tax exemption under the Special Memorandum referred to in the Solicitation under Section 3.24, will the contractor or the Government be responsible for administrative expenses necessary to maintain payroll services in the UK and or implement a system of withholding British income tax?

ANSWER 34(b): The contractor. See Answer 10.

35. Solicitation Due Date 10 January 2018. Given the upcoming federal holidays and typically lower manning hours during this period, would the government extend the proposal submittal due date by at least two weeks to allow offerors opportunity to respond effectively in a timely manner?

ANSWER 35: The offer due date was extended from 10 January 2018 2:00 PM Germany Local Time to 12 January 2018 at 5:00pm Germany Local Time

36. PWS Section 3.0 SCOPE OF WORK. Paragraph 3.1.4 mandates non-compete provisions in employment agreements not prevent employees from being vetted by, or accepting job offers from the new Contractor on the follow-on contract. Is such a mandate currently in place for incumbent employees on the existing contract with the existing contractor?

ANSWER 36: Yes

37. PWS Paragraph 3.1.8 U.S. Citizens. We understand that several of the positions, such as some Patient Liaisons, Referral Management and Beneficiary Service Representatives are Local Nationals. If no exception is authorized, these experienced and otherwise qualified individuals will no longer be able to be employed. Also, given the high level of Language expertise required, recruiting, hiring and retaining these positions with U.S. citizens only will be challenging and may not be necessarily in the best interest of the government from a pricing perspective.

Will the government make exceptions to this requirement on a case by case basis for Non- TCSA eligible positions?

ANSWER 37: No. Reference Para 3.20.1. Authorized Contract Provider. An individual who has (1) been hired as a consequence of this contract or of a predecessor contract, (2) is a full-time 40 hour per week or more employee, (3) is employed at a foreign location under contract, or (4) is a national (citizen) of/or an ordinary resident of the US provided that the contract provider is not also a foreign national of the host country (i.e., a dual citizen).

38. PWS Paragraph 3.4.3 Annual Training Requirements. It is understood that the cost of Continuing Education will not be reimbursed by the government. Is time taken to complete mandatory Continuing Medical Education billable to the Government or must the HCPs take either PTO (where they only have a total of 80 hours available) or unpaid leave in order to complete these requirements?

ANSWER 38: HCPs shall take PTO or unpaid leave when completing mandatory Continuing Medical Education.

39. PWS Sections 3.5 MTF HOURS OF OPERATION and 5.0 TASKS. Paragraph 3.5.1 states:

“Duty on weekends and outside normal clinic hours may be required based on mission requirements.” Paragraph 3.1.5.2 states: “All contractor personnel shall have the ability to…work some evenings and weekends as needed (per call schedule).” Paragraph 5.28 under “Call Back and Standby Hours” states: “These hours are authorized in the event a provider(s) are required to report to duty after normal work hours. In the event of a surge requirement occurring or other mission essential requirement for needing any specialty to report after hours, call back and standby hours will be separately negotiated and incorporated into the contract.” Paragraph 3.6.6. states: “After hours and weekend on-call duties are assigned by inclusion of the contract service provider in on-call duty rosters.

39a. Only the Anesthesiologist at LRMC and the ER Physician at Lakenheath have Standby and Callback Hour CLINs. Should we expect that any other HCPs will be expected to work standby, callback, or other hours outside of normal hours of operation?

ANSWER 39a: Call back and Stand by Hours for other HPCs will be identified on case by case basis and shall be added to the contract via modification.

39b. We would ask the government to reconsider the requirement of not allowing backfill or part-time HCPs to work in conjunction with call back and standby hours, at a minimum, from a patient safety perspective.

ANSWER 39b: No changes will be made because this contract is based on FTEs at 1,920 hours per year and part-time HCPs to backfill FTEs are not part of this requirement.

40. PWS Section 3.6 HOURS OF PERFORMANCE. Paragraph 3.6.1 states: "The contractor shall provide full coverage for the required hours of performance.” Are backfills required when individuals take regular vacation?

ANSWER 40: No backfills are required.

41. PWS Section 3.17. SUBCONTRACTING. This section states: “European countries are no longer granting exemptions for prime contractors to conclude contracts with subcontractors to fulfill contractual obligations. Therefore, the prime contractor shall provide all of the employees for support to the United States Forces stationed in Europe. Subcontracting is not authorized in accordance with Article 72 of the Supplemental Agreements to the NATO SOFA. Teaming arrangements or Joint Ventures are not considered subcontracting.”

41a. If we are a team of two or more companies, for positions that are not eligible for Troop Care status under Article 72 of the Supplemental Agreements to NATO/SOFA (i.e., not one of the 20 designated pre-approved services for Troop Care Status Accreditation), please confirm that these positions/employees can be allocated to any one of the team partners IAW FAR 9.602.

ANSWER 41a: Reference Para 3.17. Subcontracting. The prime contractor shall provide ALL of the employees for support to the United States Forces stationed in Europe.

41b. If a potential employee is fully qualified for the position but determined to be Ordinarily Resident (OR) in Germany and therefore not eligible for Troop Care status, please confirm that they may still be hired to support the contract requirements as long as they are in compliance with all host nation laws and regulations (i.e., have an approved host nation work visa and pay all required host nation taxes).

ANSWER 41b: Refer to Technical Subfactor 2 Corporate Knowledge: Relevant Corporate knowledge of host nation country (Germany) requirements, i.e. understanding the process for obtaining individual troop care status approval under the Status of Forces Agreement. This Subfactor is looking for a company to answer if your company understands how to get their employees processed through DOCPER to obtain SOFA Status (Full Logistics support).

41c. If we are a partner team of two or more companies, must each company sign off on the DD1449 and submit separate Representations and Certifications for each team member? Which 'Cage Code' should be used in block 17a of the DD1449?

ANSWER 41c: The Prime contractor’s Cage Code shall be used in Block 17a of SF1449

41d. If we are a team, can one company be the actual employer of the HCPs and another company provide administrative support (such as recruiting, credentialing, DOCPER processing, onboarding, employee sponsorship, local office support, etc.)?

ANSWER 41d: See Answer 42a and reference Technical Subfactor 2 Corporate Knowledge

41e. Please clarify if this paragraph applies only to Article 72 TCSA eligible/approved services.

ANSWER 41e: See Answer 42a

41f. Please verify that the “no subcontracting” specification applies to all European countries.

ANSWER 41f: Subcontracting does not apply to United Kingdom; however, the Government, as with the previous contracts in 2008 and the current contracts expiring in2018, did not authorize Subcontracting. There will be no change with this proposed contract regardless of DOCPER.

42. PWS Section 3.20 LOGISTICAL SUPPORT. Access to Housing Services privileges are not provided for in this solicitation.

We understand the contract HCPs are not eligible for Government Housing however, it is our experience that under some circumstances, Off Post Housing Referral support is provided. Would the government consider allowing employees to utilize IMCOM USAG Off-post Housing services or similar for reliable housing and leasing, inspection, and other referral services that may be difficult to navigate in the host nation?

ANSWER 42: The Housing Office will not provide support to contractor employees; however, contractor employees may search www.homes.mil for vacancies in specific areas around military communities.

43. TRAINING. Some training is stipulated as being paid for, or unpaid, by the government.

However, there is other training which is not designated as paid/unpaid, such as PWS Section.6.2: “Annual Training: The patient liaison shall attend Government provided annual training which will include but is not limited to topics such as safety, QA/RM/Process Improvement, infection control, fire protection, security, patient sensitivity training.” Will the government elaborate which training will be either paid for or unpaid?

ANSWER 43: Reference Para 3.4.4. Government unique training. The Government may elect to provide unique Government training to contract HCPs who are performing services under this contract. If the Government elects to provide such training, the Government will provide such training at no additional expense to the contractor. When directed by the KO, contract HCPs shall attend all such training in a paid status as part of the normal services required and billed under the contract.

44. Attachment 1 Specialty Qualifications, Section II Patient Liaison Services, Section 22 Beneficiary Service Representative, Section 25 Patient Liaison Officer.

44a. In paragraph 11.1, a “Preferred Diploma, associate's degree or bachelor's degree” is required. What does the term ‘preferred’ diploma encompass?

ANSWER 44a: Associate’s degree is the minimum requirement. A bachelor’s degree is preferred.

44b. In reference to the language requirements in paragraphs 22.3 and 25.4, given how limited a candidate pool for a trilingual/multilingual employee with the required experience and qualifications is to be found, would the government consider changing this requirement to an English/German, English/Dutch, or an English/French requirement or a similar requirement where a lower proficiency level in Dutch or French is considered?

ANSWER 44b: No, language requirement cannot be changed

44c. Please verify the actual Patient Liaison requirements in terms of both the number of Patient Liaisons required and the actual skills/qualifications required.

ANSWER 44c: Refer to Attachment 2; Location List and CLIN descriptions. Refer to PWS Para 25 for skills/qualifications.

44d. With regard to all Patient Liaisons, are there 'Stand By/On-Call' and 'Call Back' requirements for any of them?

ANSWER 44d: No stand by and call back for Patient Liaisons.

44e. With regard to paragraph 25.2, can the government please clarify the requirement for supplying a vehicle? The paragraph references “section C-4” but there is no section C-4 within the solicitation.

ANSWER 44e: HCPs will utilize their own POVs in performance of the contract. Section C-4 reference was removed from Para 25.2

45. PWS Paragraph 3.6.3.1 Absences and Leave and page 392 of the solicitation. PTO is explained as “Paid Time Off (Leave): “In accordance with PWS paragraph 3.6.3.1, only 10 days (80 Hours) of Paid Time Off (PTO) is authorized under the contract. Therefore, your compensation plans submitted with your proposals shall reflect only 80 hours of PTO - no more, no less. For clarification, "Leave" is all types of leave (Annual/Vacation/Sick).” Health Care Industry amount of PTO is typically 120 hours. Given that GS and military personnel also have significantly more leave, the 80-hour limitation makes it more challenging to recruit and retain highly qualified HCPs. If USAFE clinics are closed up to 9 days per year for designated ‘down’ days and if the HCPs must take PTO in order to complete CEUs, the 80 hours are already used for what is essentially mandatory time off. This may then not afford a contract HCP to take any extended vacation which could be detrimental to performance, morale, recruiting and retention.

ANSWER 45: PWS Paragraph 3.5.3 specifically states “The Contractor shall be compensated only for actual hours worked by the Contractor’s employees. During anticipated closure of the facilities due to Presidential Executive Orders, Command-declared training holidays, administrative leave granted the entire staff, or other closure, the contractor personnel shall not perform work and no hours will be billed to the Government for those days unless otherwise stated on the task order.” Essentially, they would be in a Leave Without Pay status for the clinic that is closed on a USAFE “Down” day.

46. Given the industry norm is a minimum of 80 hours for vacation time alone, and other possible factors such as maternity leave, extended illness, mandatory clinic closures, German labor laws that mandate unlimited sick leave, this could seriously inhibit contractors from recruiting and retaining quality HCPs and offering a competitive benefits package: will the government consider expansion of PTO (to include sick time hours) to a minimum of 120 hours?

ANSWER 46: The Government MEDCOM requirement is 1,920 billable hours per year for one FTE. Only 80 hours of PTO is authorized with no exceptions.

47. CLAUSE 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR

(APR 1984). This clause states: “Funds are not presently available for performance under this contract beyond 8 December 2017.” When is it anticipated that funds will become available?

ANSWER 47: Upon approval of the Congress. The Continuing Resolution has currently extended the Government funding until 22Dec2017.

48. Reference CLINs 0001AE and 0025AA and PWS para 3.20. The referenced CLINs are for part-time Physician Assistants and paragraph 3.20 of the PWS states that Logistical support, if granted, will only be provided to authorized, full time (40 hours per week) HCPs and authorized dependents.

Is it correct to assume that these part-time Physician Assistants will not be given Troop Care status and will therefore not be provided individual logistical support? If that is the case, can the government confirm that the part-time Physician Assistants must be hired under Host Country laws and regulation (including obtaining necessary work visas and paying the appropriate local government taxes).

ANSWER 48: Refer to Technical Subfactor 2 Corporate Knowledge: Relevant Corporate knowledge of host nation country (Germany) requirements, i.e. understanding the process for obtaining individual troop care status approval under the Status of Forces Agreement. For Logistical support, reference Appendix A - Compensation Plans tab for 0025AA – PA (PTE) BMEDDAC for what the contractor shall provide per PTE.

49. Reference Addendum to 52.212-4 (iRAPT) - Submitting invoices. Shall invoices be submitted only once per month or is it possible to submit two (or more) per month?

ANSWER 49: It is the contractor’s discretion on when to submit invoices.

50. Reference PWS para 3.9.3 and para 3.13.1 Personal Security Investigation requirements (CNACI/NACI procedures). There appear to be several inconsistencies between these two paragraphs. For example, 3.9.3 states that ‘all background clearance requests shall be submitted by the contractor prior to the start of work’ and para 3.13.1 states that ‘The contractor shall apply for the NACI within three (3) workdays after start of performance’ and then goes on to say ‘and ensure each HCP has completed the NACI process prior to relocation/work under the contract.

ANSWER 50: Para 3.9.3. & 3.13.1 revised.

51. Can the government please clarify the PSI requirements, processes and time lines?

ITEM 16: Reference PWS para 3.19.1.1 and para 3.19.22 Relocation. There appear to be inconsistencies between these two paragraphs. For example, 3.19.1.1 states that ‘In the event that a HCP does not repatriate back to CONUS 90 days after termination of employment, … the Government will not pay for relocation costs.’ and para 3.19.22 states that ‘The Government will not reimburse the contractor for any employee that relocates back to CONUS beyond the 12 months.’

Can the government please clarify whether the HCP has 90 days or 12 months to repatriate back to CONUS after contract termination before the contractor no longer gets reimbursed for relocation costs?

ANSWER 51: Para 3.19.1.1. In the event a HCP does not repatriate back to CONUS 90 calendar days after termination of employment, either less than or more than 3 years, the Government will not pay for the relocation costs. - - This paragraph applies when the HCP elects to stay in country 90 days after termination of the employment under the contract, the Government will not pay for the relocation costs.

Para 3.19.22. When the contract expires or any task order written beyond the contract expiration date expires, the contractor has 12 months to complete relocation of their employees back to CONUS. The Government will not reimburse the contractor for any employee that relocates back to CONUS beyond the 12 months. - - This paragraph applies when the contract expires or when a task order is written “beyond” the contract expiration date.

52. Reference PWS para 5. Tasks. It is not clear where the Peri-Operative Consultant position is required and it is not listed in Attachment 1 or Attachment 2. It is not clear whether or not the subsequent paragraphs (5.2 to 5.28) apply to the Peri-Operative Consultant or to other HCPs. Can the government please clarify the requirements and applicability of Para 5.

ANSWER 52: All references to “Peri-Operative” were deleted. Para5 was changed to “Reserved”.

SECTION SF 1449 - CONTINUATION SHEET

SOLICITATION/CONTRACT FORM

The required response date/time has changed from 10-Jan-2018 02:00 PM to 12-Jan-2018 05:00 PM.

The following have been modified:

PWS

3.PERFORMANCE WORK STATEMENT

1.0. INTRODUCTION.

1.1. This contract is issued in support of the Military Treatment Facilities (MTFs) within the US Army Medical Command (MEDCOM) in Europe and other Department of Defense (DoD) agencies having similar requirements.