Q201--10 Year Williston/Dickinson CBOC

Closed Solicitation Posted Jul 27, 2023

This opportunity was awarded. See the award notice from Feb 29, 2024.

Solicitation number: 36C26323R0027
Agency: Veterans Integrated Service Network 23 Veterans Health Administration, Department of Veterans Affairs
Responses due: Sep 5, 2023, 11:00 AM ET
Set-aside: No set-aside

Opportunity facts

NAICS code: 621498 All Other Outpatient Care Centers
PSC: Q201 Medical- Managed Healthcare

Notice details come from SAM.gov. Updated Aug 22, 2023.

Notice text

3 versions

Update #3 · Latest · Aug 22, 2023

Question: States For Description/Specifications through Contract Clauses sections, the offeror shall submit only the pages that require a fill-in. It s not clear where the Description/Specifications section is located. Will the Government please provide the page/section numbers for the Description/Specifications ?

Answer: please reference 52.212-1 starting on page 171, 52.204-24 on page 179, 52.209-7 on page 181, and 52.212-3 starting on page 194.

Question: On page 3 of the Q&A Amendment, there are two questions that allude to proposal requirements for including transcripts for NPs and proof of BLS/ACLS for Physicians. However, these requirements do not appear anywhere in the RFP. Can the government please confirm that those are not required with proposal submission and the only items that are required for the Key Personnel section are found in the below RFP requirements:

Provide a list of the names and titles of qualified physicians, physician assistants, nurse practitioners, nurses, and other primary care provider staff intended to be utilized in the performance of this contract, taking into consideration the enrollment numbers for the clinic and the minimum staffing requirements. Also provide the name and title of the Medical Director to oversee the clinic. The PACT staffing proposed for the location should match the requirements listed in the staffing grid in the solicitation.

Provide copies of CAP, CLIA, or Joint Commission accreditation and current applicable state licensing and/or Center for Disease Control (CDC) accreditation or proof that such documents are being processed for Laboratory Services.

List the administrative support staff and describe the level of training and experience that will be utilized to meet the administrative support functions of this contract, including such functions as patient scheduling, medical record documentation, record processing and reporting, grievance system, and quality assurance and performance improvement.

Identify processes to ensure retention of qualified key personnel.

Answer: Correct, not required for the proposal submission and the items that are required for the Key personnel section are found above.

Question: Respectfully requesting further clarification, the solicitation states 0.05 MD for each location and the PACT providers can be MD, NP or PA. The 1 FTE MD requirement in the Q&A is significantly different than what is in the RFP. Is this what the government is intending?

Answer: A minimum of 1 FTE MD in person is required between the two locations.Â Other providers can be NP or PA.Â If a PA is provided they would fall under the contracted MD supervision.Â AÂ provider needs to be present on site during normal business hours. Director must be an MD and can be remote.

Question: Can the government please provide the definition or a list of all primary care approved procedures?

Answer: Contractor should perform procedures that are common in Primary care.Â Supplies needed for procedures would be provided by contractor.Â List below isn t all inclusive. Examples- skin biopsies, joint injections, wound care, battlefield acupuncture, inserting/removing foley catheters, cryotherapy, superficial abscesses, tick removal, tapping a joint, Women s health procedures. Etc.

Question: Can the government please provide a list of all medication the contractor is required to order and administer onsite?

Answer: Contractor needs to provide any and all medications administered in the clinic.Â Any routine outpatient meds (meds used at home) will use our mail order system provided by the VA.Â No list is available.Â

Question: Can the government please provide list of all anticipated primary care procedures?

Answer: List below isn t all inclusive. Examples- skin biopsies, joint injections, wound care, battlefield acupuncture, inserting/removing foley catheters, cryotherapy, superficial abscesses, tick removal, tapping a joint, Women s health procedures. Etc.

Update #2 · Aug 21, 2023

Question: Please explain why the CLINs are flat, and the government does not expect a decline in enrollees at the clinic over the next 10 years, corresponding to Census estimates.

Answer: These are estimates.

Question: Please provide the number of billable enrollees on the most current invoice.

Answer: July 2023: Williston= 958, Dickinson=856

Question: Is the current number of veterans on the Primary Care billable roster an accurate reflection of what the starting billable roster will be under the new contract?

Answer: Yes

Question: Is the incumbent required to move to either of the current facilities?

Answer: No

Question: Please confirm the new CBOC facilities must be designed with the on/Stage-Off/Stage concept as laid out in the PACT Design Guide.

Answer: Yes

Question: On page 189 of the solicitation the government asks for the latest copies of state or local inspection codes for the building. If these are not available, can they be provided prior to clinic opening?

Answer: Yes before opening we would need a certificate of occupancy and a certificate from the Fire Marshall

Question: How many VA staffed personnel will be providing services at the each CBOC? Please list by job title and number of days per month.

Answer: Hud Vash, Mental Health(on site daily)

Question: How many offices will be needed at either CBOC for the VA provided staff (by position/function) identified in question 7?

Answer: We believe this is in reference to question 8. 2 offices please refer to Attachment 9 of Space and Equipment Requirements.

Question: Will the new Contractor inherit the patients last vesting visit and be allowed to bill for one year from the date upon contract award?

Answer: Yes they would inherit the last 12 months

Question: Will the government be making site visits prior to the award? If so, how much advance notice will the contractor be given?

Answer: Yes, 24 hours

Question: How many Mission Act referrals, for Primary Care, were made in the past 12 months for enrolled veterans of the CBOC?

Answer: Dickinson= 42, Williston= 44

Question: Transcripts are required to be submitted for NP candidates with the proposal. Can these transcripts be submitted after the award?

Answer: No

Question: Proof of ACLS and BLS are required to be submitted for Physicians with the proposal. Can these be submitted after the award?

Answer: No

Question: Please list the vaccines the contractor is responsible for purchasing and provide information on how many of each vaccine were used at the clinic in the past year.

a. Pneumovax 23

b. Prevnar 13

c. TDAP

d. TD

e. Zostavax

f. Shingrix

g. HPV

h. PPD

i. Twinrix (Hep A&B)

j. Hep A

k. Hep B

l. Depo

m. Influenza

n. MMR

o. Meningococcal Oligo/DIPH Conj Inj

p. Meningococcal/Diphtheria Tox

Answer: All vaccines would need to be provided by the contractor including Covid 19. No data available on vaccines given last year.

Question: Are there any additional Vaccines, other than those listed in question 18 above.

Answer: Possibly, all vaccines are provided by Contractor. Some additions but not inclusive:

Prevnar 20Â (This replaced Prevnar 13)

Respiratory Syncytial Virus (RSV) ArexvyÂ

-Haemophilus influenzae type b (Hib)Â

4.6.4.1 PRESCRIPTION FULFILLMENT: Remove language: with the exception of vaccines for COVID-19.

Question: Please advise how mental health will be managed in the clinic (is contractor or VA providing, or will it be referred to VAMC)

Answer: VA Providing

Question: Section 2.8 Telehealth Clinical Services Staff

Can the Telehealth technician be a certified medical assistant?

Answer: Yes

Question: Section 4.6.5.4.3 Anticoagulation

Will the VA provide the A1C equipment?

Answer: Yes

Question: Section 4.9.1 Space requirements

There is a requirement for a manager s office in the space requirements but no mention of a requirement for a manager being required in the staffing requirements, is a manager required, if so, what are the requirements for a manager?

Answer: Yes, a clinic manager is required for each location. List of duties isn t all inclusive: Manage QASP, Clinic Assess, Staffing, Facility Maintenance Management, Reports, etc.

Question: Section 4.11.3

Who is responsible for providing telephones for the clinic? Please confirm if the VA will supply the telephones and will the existing number be rolled over to the new contractor?

Answer: VA will provide phone and VA intends to use existing number if possible

Question: Section 6.1.2 Start Up Requirements

6.1.2 states the contractor must allow for 7 days of training prior to the start of the contract. Scheduling training is typically two weeks long, will the VA provide reimbursement to the contractor if scheduling staff need to be brought in prior to the start date to complete scheduling training?

Answer: No

Question: 4.6.4 PHARMACY SERVICES: 4.6.4.1 PRESCRIPTION FULFILLMENT- The Contractor will provide all medications that are to be administered to patients in the clinic

Question:Â Please provide a specific list of all medications that the contractor is responsible to provide (not just the list of vaccines)

Answer: Contractor needs to provide any and all medications administered/used in the clinic. Any routine outpatient meds will use our mail order system provided by the VA. Vaccines will all be purchased and administered by contractor including Covid 19. Historical usage is unable to be provided.

Question: 4.6.3.4.7 Contractor shall provide all equipment necessary to provide comprehensive women s health services.

Question: Will the VA supply the pap kits?

Answer: VA will provide Thin Prep, paddle/brush

Contractor will provide disposable speculums and any other items needed.

Question: 2.2.1PHYSICIAN DIRECTOR (MANDATORY FOR ALL SITES): FTE Ratio Performance Standard: 0.05 FTE per PACT Responsible Party: Shall be provided by Contractor.

Question: is the contractor required to have an on-site medical director at 0.05 FTE. If so, does the physician have to be on-site or can this be a remote physician? Another question:Â in lieu of a physician director, could a LIP NP be the director instead?

Answer: 1FTE MD must be on site at one of the locations.

Director must be an MD and can be remote.

Question: 2.2.3 Medical Assistant

Question: are medical assistants permitted to administer immunizations? If so, which immunizations?

Answer: No

Question: OPTION 4: Health Care Technician (HCT)

Question:Â are HCT permitted to administer immunizations? If so, which immunizations?

Answer: No

Question : Is a full-time Clinic Manager required in each site and if so, do they need to be a Registered Nurse?

Answer: Yes full time clinic manager is needed at each site and they need to be RN.

Question: Does the VA want 1 FTE Physician to cover both Dickinson and Williston CBOCs, or does the VA want 1 FTE Physician in each CBOC?

Answer: A minimum of 1 FTE MD in person is required between the two locations. Other providers can be NP or PA.

Question: Will the VA allow a 1 FTE Nurse Practitioner or Physician Assistant to work independently on-site with an off-site Physician providing oversight? If so, given the rural area, the socioeconomic conditions, the local talent pool, and the labor market, will the VA allow the Medical Director to collaborate with the mid-level provider remotely and see patients remotely via telemedicine?

Answer: If a PA is provided they would fall under the contracted MD supervision. A provider needs to be present on site during normal business hours.

Question: Will all CPS Anti-Coagulation services be provided by VA staff?

Answer: contractor will provider INR testing and VA will provider anticoage adjustments from CPS.

Question: RFP states Providing one small desktop color printer for printing patient education information. Will the Government please confirm that the VA will supply the small desktop color printer for patient education documents?

Answer: OIT will provide the desktop colored printer.

Question: Will the VA provide a list of all medications and vaccines that are to be provided by the Contractor and their historical usage?

Answer: Contractor need to provide any and all medications administered in the clinic. Any routine outpatient meds will use our mail order system provided by the VA. Vaccines will all be purchased and administered by contractor including Covid 19. Historical usage is unable to be provided.

Question: Will the new Contractor inherit the patient's last vesting visit and be allowed to bill for one year from that date upon contract award?

Answer: yes

Question: Is the Contractor required to submit a CAD drawing with the proposal or is the CAD (or other acceptable file type) drawing required after contract award? If it is to be submitted with the proposal, what other file types are acceptable? Is PDF acceptable?

Answer: Initial drawing can be done in another program than CAD as long as it can show plan meets space requirements. If contracted a CAD drawing would be required as industry standard.

Question: Will the Government please confirm if CAT 6A cabling is preferred and not CAT 6e?

Answer: 6A is acceptable.

Question: VA IT Closet - Will the Government please confirm the 170 sq. ft. is a typo and should be 100 sq. ft.?

Answer: 170 SF is the new requirement.

Question: RFP states: VA IT Closet Power Requirements - four (4) L6-20 receptacles one (1) L6-30 receptacle. Will the Government please confirm the Power Requirements and if two or four 20-amp dedicated receptacles are acceptable?

Answer: Power to the network racks is 3-phase 208V. No 120V single-phase power distribution is specified. Note that IEC 60320 C13/14 and C19/20 power cords are required for all installed active equipment. For TRs with only one network rack: A/B redundant L21-20 circuits, with A/B redundant Rack PDUs to distribute power in the rack. See OIT Design Guide Templates (2) L6-30 receptacle four (4) L6-20.

Question: Should the proposal be emailed to Sara.hanson@va.gov?

Answer: Yes

Question: Does the VA want the Subcontracting Plan to be submitted in Part II - Technical Proposal?

Answer: Yes

Question: With the two page limitation, is it acceptable to the VA if we attach all the letters, metrics, customer surveys, independent surveys, etc., and not have it count towards the 2-page limitation?

Answer: Yes

Question: Will the VA please provide the historical billed enrollment for the Dickinson and Williston CBOCs for the past five years?

Answer:

Year

Month

Williston

Dickinson

2019

JUNE

1125

923

2019

JULY

1144

920

2019

AUG

1140

928

2019

SEPT

1155

929

2019

OCT

1151

925

2019

NOV

1149

935

2019

DEC

1162

937

2020

JAN

1136

952

2020

FEB

1126

979

2020

MAR

1118

971

2020

APRIL

1132

945

2020

MAY

1127

952

2020

JUNE

1134

959

2020

JULY

1117

958

2020

AUG

1115

965

2020

SEPT

1090

961

2020

OCT

1090

955

2020

NOV

1083

949

2020

DEC

1078

942

2021

JAN

1062

932

2021

FEB

1056

918

2021

MAR

1056

916

2021

APRIL

1042

919

2021

MAY

1037

909

2021

JUNE

1036

909

2021

JULY

1037

904

2021

AUG

1024

909

2021

SEPT

1027

912

2021

OCT

1023

910

2021

NOV

1041

916

2021

DEC

1039

891

2022

JAN

1035

888

2022

FEB

1011

887

2022

MAR

1007

873

2022

APRIL

1005

854

2022

MAY

994

823

2022

JUNE

991

793

2022

JULY

982

812

2022

AUG

959

749

2022

SEPT

944

715

2022

OCT

930

709

2022

NOV

920

703

2022

DEC

933

741

2023

JAN

944

786

2023

FEB

939

822

2023

MAR

965

840

2023

APRIL

957

851

2023

MAY

948

851

2023

JUNE

961

850

2023

JULY

958

856

Question: Will the Government please confirm if the VA will provide the phone circuit and physical phones?Â

Answer: OIT will provide phone circuit.

Question: Do the existing Dickinson and Williston CBOC facilities meet the requirements of this solicitation?

Answer: The terms of this solicitation represent the VA s requirements for CBOC services in this region upon expiration of the existing contracts and is not an indication of the terms of the existing contracts.Â

Question: If so, how does the VA intend to ensure that evaluations can be done fairly if the incumbent has a competitive advantage?

Answer: All offers will be evaluated in accordance with the terms of the solicitation.

Question: Can the cost of the facilities be provided separately and not be included in the evaluation factors which would create a level playing field for all bidders?

Answer: Per FAR 52.212-1(e) Multiple Offers, offerors may submit alternate price proposals for consideration, which may include alternative line items for buildout of space. Â The evaluation factors include price, which necessitates evaluation of any alternate price proposals.

Question: The Dickinson, ND and Williston, ND contract clinic sites shall be ONE PROVIDER/TEAMLET PACT spaces, not the ONE PACT MODULE noted in the VA PACT Design Criteria. This equates to less required space and staff at these VA contract clinics. It is expected that the contractor s layout shall meet VA PACT Design Criteria, but it shall be modified to a ONE PROVIDER/TEAMLET PACT set up. Where do we find the design specifications for the ONE PROVIDER/TEAMLET PACT space?

Answer: Sufficient back up staff would need to be provided for any leave, absences, vacancies. Please see section 4.9 Space requirements: PACT Space Module Design Guide at http://www.cfm.va.gov/til/dGuide/dgPACT.pdf design specifications Section 4.0 page 21.

Question: NOTE: ALL WALLS AROUND THE PERIMETER AND WITHIN THE CLINIC (ALL ROOM WALLS) SHALL BE CONSTRUCTED FROM STRUCTURAL FLOOR SLAB/DECK TO STRUCTURAL DECK ABOVE WITH ALL WALL PERIMETERS AND PENETRATION SEALED. THE WALL CAVITY SHALL BE FILLED FULL HEIGHT, WIDTH AND DEPTH WITH MINERAL WOOL INSULATION. MINIMUM ROOM TO ROOM STC SHALL BE 45. Do the existing Dickinson and Williston CBOC facilities meet this requirement?

Answer: Yes

Question: For the Veteran s Self Service Kiosks and Education areas: Our standard is 1 data/1 phone jacks per computer station. Will the VA please confirm if this is acceptable?

Answer: 3 Data and 1 Voice is the current Fargo VA Standard.

Question: For the Reception desk and Staff work area: Our standard is 1 data/1 phone jacks per computer station. Will the VA please confirm if this is acceptable?

Answer: 3 Data and 1 Voice is the current Fargo VA Standard.

Question: For the Reception desk and Staff work area: Will the VA please confirm if the contractor is supplying the computer system?

Answer: Dual Screen is not a requirement. Fargo OIT will provide all OIT equipment.

Question: For the Reception desk and Staff work area: Our standard is 1 data/1 phone jacks per computer station. Will the VA please confirm if this is acceptable? Our standard has been no phone jack next to each of the following - printer, fax, and copier. Will the VA please confirm if this is acceptable?

Answer: 3 Data and I Voice is the current Fargo VA Standard.

Question: For the PACT Exam Room: Our standard is 1 data jack on two walls in all Exam Rooms with no phones. Will the VA please confirm if this is acceptable?

Answer: 3 Data and I Voice is the current Fargo VA Standard.

Question: For the Telehealth Rooms: Our standard is 1 data/1 phone jacks per computer station. Will the VA please confirm if this is acceptable? Our standard is 2 data jacks for Telehealth equipment. Will the VA please confirm if this is acceptable?

Answer: 3 Data and I Voice is the current Fargo VA Standard.

Question: For the Alcove height/weight station, handicap accessible: Our standard is no data/phone jacks in height/weight station area. Will the VA please confirm if this is acceptable?

Answer: 3 Data and I Voice is the current Fargo VA Standard.

Question: For the Multipurpose Group Conference Room: Our standard is 1 data/1 phone jacks with HDMI Connection per computer station for presentations onto a TV. Will the VA please confirm if this is acceptable?

Answer: 3 Data and I Voice is the current Fargo VA Standard.

Question: For the PACT Team Work Area: Our standard is 1 data/1 phone jacks per computer station. Will the VA please confirm if this is acceptable?

Answer: 3 data and 1 voice is the current Fargo VA Standard.. Multi-functional devices won t be provided by VA and need to be supplied by Contractor.

Question: Is the Contractor responsible for the fax machine?

Answer: Contractor is responsible for the fax machine.

Question: Is the Contractor responsible for the Colored Printer?

Answer: Contractor is responsible for colored printer.

Question: Will the government allow a non PIV card reader badge system?

Answer: No

Question: For the Laboratory: Our standard is 1 data/1 phone jacks per computer station. Will the VA please confirm if this is acceptable? Our standard is one or two station plates with 4 data jacks each for lab equipment and printers. Will the VA please confirm if this is acceptable?