Q201--664 - 36C262-24-AP-4043 VASDHS New Escondido CBOC Procurement _ Base plus 9 Option Years

Response to Question:

The following is an answer to a question received in response to the solicitation:

Q 1: Can you please clarify the page allowance per site submitted if multiple sites are proposed?

A 1: Per section E.4, Addendum to FAR 52.212-1 Instructions to Offerors, paragraph 3c, Factor 3-Proposed Site, Offerors shall provide the full address of the Offeror s proposed CBOC site and provide a narrative in no more than 1-page describing the proposed CBOC site and the area surrounding the proposed site. Up to four (4) pictures of the proposed site may be included in addition to the 1-page narrative.

Offerors who wish to propose more than one CBOC site location MUST SUBMIT A SEPARATE COMPLETE CONFORMING PROPOSAL (meeting all certification and proposal submittal requirements for each proposal) for each proposed CBOC site location. Offerors may not combine multiple proposals in a single email submittal and must submit each alternative proposal in a separate email from each of its other proposals clearly identifying the proposal as an alternative proposal.  All solicitation instructions and requirements apply individually to each alternative proposal an offeror submits. VA will evaluate each alternative proposal submitted as a stand-alone proposal. VA will reject any proposal that fails to conform to the solicitation requirements and will not piece together the content of multiple alternative proposals to create a conforming proposal.Â

Amendment 0002 to RFP 36C26224R0121

1. The solicitation is amended as follows:

a) Section B.3 Performance Work Statement (PWS), paragraph 11 Space Requirements, section titled Mental Health is hereby amended to read:

The clinic reception area will include two Mental Health reception windows with the administrative area behind the windows separated from the primary care check in admin space. However, all windows will be accessible from the main waiting area.

b) Section B.3 PWS, paragraph 13 EQUIPMENT, OFFICE SUPPLIES AND TECHNICAL SUPPORT is hereby amended to read:

VA OIT will provide the primary data, voice circuit read, and physical desktop phones."

2. The following are answers to questions received in response to the solicitation:

Q 1: Does the government mandate a specific type of phone system to be used?

A 1: No.

Q 2: Is it necessary to install phones in the exam rooms?

A 2: Yes.

Q 3: Are tables required in the group therapy rooms?

A 3: Yes, please review B.3 PWS, paragraph 11 Space Requirements, section titled Mental Health:

The contractor shall provide furniture for all mental health space.

Q 4: Is there a specified integration system for the phone systems?

A 4: No.

Q 5: If the contractor is supplying the phone system, should the cabling be divided and housed in separate IT closets?

A 5: Please review amendment 1. b) above.

Q 6: Does the VA desire a dedicated corridor leading to the 8 VA Mental Health offices listed in the space requirements with an access point to the primary care patient care rooms in case of necessity. MH offices would not be included in the PACT module.

A 6: Yes.

Q 7: Please clarify the role of the clinical pharmacist who is not a practitioner to be provided by the contractor. What are the licensing requirements? What are the job duties? What type of workstation will they require? What support staff are required. Are PACT staff able to perform the support functions, or are added staff required? If additional staff is required, please list the staff members (MSA, LPN, RN).

A 7: Please review B.3 PWS, section 5.3 Pharmacy Services. Furthermore, the clinical pharmacist doesn t require support staff like a CPP (i.e. pharmacist provider) would. They should ideally have a private office with a phone, double monitor and sit stand station to work.

Q 8: Does the VASDHS prefer to have a separate receptionist office to exclusively have the two VA Mental Health check-in stations, or should the contractor include two additional VA Mental Health check-in stations within the same room as the primary care check in stations?

A 8: Please review amendment 1. a) above.

Q 9: Is this to only provide physicians or do we also have to provide the clinic.

A 9: Please review B.3 PWS, paragraph 1.1:

Services Required: The VA San Diego Healthcare System (VASDHS); requires primary care through a Community-Based Outpatient Clinic (CBOC) dedicated solely to Veterans, primarily residing in Escondido, California. The parent facility for this clinic is the VA San Diego Health Care System (VASDHS) in La Jolla, California. Unless otherwise noted hereafter within this document, singular terms such as CBOC or Contractor s facility shall refer to the Escondido CBOC. The Contractor shall provide a community-based outpatient clinic solely dedicated to Veterans. Primary Care shall provide a continuum of care from prevention to diagnosis and treatment, to appropriate referral and follow-up. Those patients needing specialty or follow-up care shall be referred to VASDHS.

Q 10: Is there an incumbent?

A10: The current incumbent contractor is: CRAssociates, Inc., contract number 36C26223D0031.

Amendment 0001 to RFP 36C26224R0121

1. The solicitation is amended as follows:

a) Section B.3 Performance Work Statement (PWS), paragraph 2.8. License and Accreditation is amended to read:

The contractor shall not permit any staff to begin work at an outpatient site of care prior to confirmation from the VA that the individual s background investigation has been reviewed and released to the Office of Personnel Management (OPM), by the Security and Investigations Center (SIC), and that credentialing and privileging requirements have been met. A copy of licenses shall be provided by the awarded contractor as part of the onboarding procedures and will be updated annually. Any changes related to the providers' licensing or credentials will be reported immediately to the VA Credentialing Office. In accordance with FAR 52.212-4 Contract Terms and Conditions Commercial Products and Commercial Services failure to comply with these terms and conditions may result in all rights and remedies provided by law.

b) Section B.3 PWS, paragraph 12 ENVIRONMENT OF CARE (EOC) is amended to read:

Contractor shall meet VHA standards regarding EOC and shall provide EOC management plans addressing safety, security, hazardous materials, hazardous waste, emergency preparedness, life safety, medical equipment, infection control, and utility systems within 15 calendar days after contract award.

c) Section B.3 PWS, paragraph 13 EQUIPMENT, OFFICE SUPPLIES AND TECHNICAL SUPPORT is amended to read:

The installation and maintenance of the network cabling infrastructure within the facility including all cabling located inside the walls and plenum space of the structure, cabling racks, network equipment racks, patch panels, wall ports, and a secure communications closet space to house the networking equipment. Cabling infrastructure and closet design shall adhere to American National Standards Institute (ANSI)/Independent Technical Authority (ITA)-568, International Organization for Standardization (ISO)/International Electrotechnical Commission (IEC) 11801, and VA EHRM standards, per attachment DX EHRM rack power specs.

d) Section B.3 PWS, paragraph 13 EQUIPMENT, OFFICE SUPPLIES AND TECHNICAL SUPPORT amended to read:

VA OIT will provide the primary data and voice circuit read." The Contractor is responsible for providing the circuit and physical phones.

e) Section B.3 PWS, paragraph 13 EQUIPMENT, OFFICE SUPPLIES AND TECHNICAL SUPPORT is amended to read:

Having a contingency plan for computer downtime that defines the processes to ensure continuity of patient care and maintenance of the integrity of the patient s medical record during periods of loss of computer functions. The contingency plan for computer downtime must be reviewed and approved by the Contracting Officer prior to performance. In addition, a contingency plan template that designates criticality of application/system, estimate of impact, locations of equipment, and contact persons will be provided to the contractor for completion after award of the contract. The contingency plan shall mirror VA OIT DevSecOP s COOP plan.

f) Section B.3 PWS, paragraph 5.3 Pharmacy Services is amended to delete the section:

The contractor shall meet all requirements for anticoagulation management outlined in VHA Directive 1108.16 Anticoagulation Therapy Management (or subsequent revisions thereto) as well as local policy related to the management of patients on anticoagulation. Local policy is included in Section D (attachments). The contractor shall provide quarterly, and annual anticoagulation quality assurance summaries as outlined by the local Pharmacy & Therapeutics Committee.  For questions, please contact, POC, VA Anticoagulation Coordinator Elizabeth.gramer@va.gov.

g) Section B.3 PWS, paragraph 18 SPECIAL CONTRACT REQUIREMENTS is amended to read:

The contractor shall have 180 calendar days from contract award to commencement of the provision of medical care to VA parent facility patients.

Section E.4. ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES, EVALUATION FACTORS AND CRITERIA, b. FACTOR 2: ACTIVATION PLAN is amended to read:

This factor will be used to assess the Offeror s plan to commence services to the patients who will be assigned to the Escondido CBOC within the 180-day period required in the Performance Work Statement for this procurement. Offerors shall provide the following in response to this evaluation factor:

1. A narrative describing the Offeror s plan to activate the CBOC proposed for this procurement. Offerors must describe the specific risks and mitigation strategies anticipated to establish and make ready for operations a CBOC for this procurement within 180 days of contract award, including risks associated with build out, permitting, and clinical staffing.

i) Section E.5 52.212-2 EVALUATION COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (NOV 2021), FACTOR 2: Activation Plan is amended to read:

This factor will be used to assess the Offeror s plan to commence services to the patients who will be assigned to the Escondido CBOC within the 180-day period required in the Performance Work Statement for this procurement.

The solicitation Section D Contract Documents, Exhibits, OR Attachments is amended to include:

D.19 DX EHRM RACK POWER SPECS. Please see attachment.

2. The following are answers to questions received in response to the solicitation:

Q1: 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.

A2:

Please see additional questions and answers in attached Excel Spreadsheet: Amendment 0001 - RESPONSE TO QUESTIONS: SOLICITATION 36C26224R0121 - ESCONDIDO CBOC PRIMARY CARE SERVICES.