Williston and Dickinson North Dakota CBOCs

5. PROJECT NO. (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NO.

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NO.

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NO.

9B. DATED

PAGE

OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NO.

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers 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:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ 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 AC-

KNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY

is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 10-83)

is required to sign this document and return ___________ copies to the issuing office.

is not,

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.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES

SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

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.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

BY

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

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

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

NSN 7540-01-152-8070

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243

(Type or print)

(Type or print)

(Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(No., street, county, State and ZIP Code)

(If other than Item 6)

(Specify type of modification and authority)

(such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign)

(Signature of Contracting Officer)



1

2





A00003

11-28-2016







none



Department of Veterans Affairs

NCO 23 - Minneapolis

708 S. Third St., Suite 200E

Attention: Scott E. Hendrix

Minneapolis MN 55415







Department of Veterans Affairs

NCO 23 - Minneapolis

Attention: Scott E. Hendrix

708 S. Third St., Suite 200E

Minneapolis MN 55415

To all Offerors/Bidders























VA263-17-R-0013

10-24-2016









X



X



X

1





































Pursuant to FAR 15.201 Exchanges with Industry Before Receipt of Proposals, the attached document addresses those

questions in which answers have been received as of this date (see attached Summary of Amendment A00003).



All other solicitation terms and conditions remain unchanged.

















Scott E. Hendrix

Contracting Officer













CONTINUATION PAGE





Summary Amendment A00003



Vendor Questions and Answers:



Q - Will the VA accept a Clinical Pharmacy Specialist that can be split to service both the Dickinson and Williston CBOCs? Or is the expectation that a CPS must be placed full time in both clinics?



A Yes. In fact, the Handbook 1101.10 states that there should be approximately 1 CPS per 3 teamlets, or about 3600 patients. In other words, neither location merits a full-time CPS. It would be closer to 0.3 FTE each.



Q - Can the CPS be connected to support the CBOCs remotely, through telehealth/telephone/remote CPRS access?



A Yes

5. PROJECT NO. (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NO.

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NO.

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NO.

9B. DATED

PAGE

OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NO.

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers 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:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ 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 AC-

KNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY

is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 10-83)

is required to sign this document and return ___________ copies to the issuing office.

is not,

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.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES

SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

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.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

BY

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

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

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

NSN 7540-01-152-8070

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243

(Type or print)

(Type or print)

(Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(No., street, county, State and ZIP Code)

(If other than Item 6)

(Specify type of modification and authority)

(such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign)

(Signature of Contracting Officer)



1

7





A00002

11-22-2016







none



Department of Veterans Affairs

NCO 23 - Minneapolis

708 S. Third St., Suite 200E

Attention: Scott E. Hendrix

Minneapolis MN 55415







Department of Veterans Affairs

NCO 23 - Minneapolis

Attention: Scott E. Hendrix

708 S. Third St., Suite 200E

Minneapolis MN 55415

To all Offerors/Bidders























VA263-17-R-0013

10-24-2016









X



X

X



1



12/06/2016 1:00pm CST

































Pursuant to Federal Acquisition Regulation (FAR) 15.206 Amending the Solicitation, this amendment hereby accomplishes

the following: See Summary of Solicitation Amendment A00002.



Pursuant to FAR 15.201 Exchanges with Industry Before Receipt of Proposals, the attached document addresses those

questions in which answers have been received as of this date.



All other solicitation terms and conditions remain unchanged.











Scott E. Hendrix

Contracting Officer













CONTINUATION PAGE





SUMMARY OF AMENDMENT A00002



Performance Work Statement (PWS) paragraph 1.4.18 which currently reads:





1.4.18. VHA Directive 2010-027 "VHA Outpatient Scheduling Processes and Procedures http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2252



Is now changed to read:



1.4.18. VHA Directive 1230 "VHA Outpatient Scheduling Processes and Procedures http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3218





Performance Work Statement (PWS) paragraph 4.4.24 REGISTRATION, ENROLLMENT, CO PAYMENTS AND EPISODIC CARE REGISTRATION AND ENROLLMENT - Financial Assessments (page 59 of the solicitation) which currently reads:



FINANCIAL ASSESSMENTS



CONTRACTOR RESPONSIBILITY: For some veterans, an annual assessment of household income (and sometimes assets) must be completed by the veteran prior to being seen by the Contractor's provider. The Contractor shall provide a blank VA Form 10-10EZR (Renewal Application for Health Benefits) to the veteran; and the veteran will fill it out completely, including the financial information on side two of the form. The demographic and financial assessment information will be input into VISTA and maintained by the Contractor. For some veterans, a financial assessment is not required (VA pensioners, service-connected veterans receiving VA compensation, etc.).

VA RESPONSIBILITY: Means Testing Forms will be provided and can be mailed or staff faxes them to Eligibility office in Fargo same number as above: 701-232-3241 ext 3427 or 3428



Is now changed to read:



FINANCIAL ASSESSMENTS



CONTRACTOR RESPONSIBILITY: For some veterans, an annual assessment of household income should be completed by the veteran.  The Contractor shall provide a blank VA Form 10-10EZR (Health Benefits Update Form) to the veteran and fax any completed 10-10EZR s submitted to the Eligibility and Enrollment office within 48 hours.

VA RESPONSIBILITY: Means Testing Forms will be provided and can be mailed or staff faxes them to Eligibility office in Fargo same number as above: 701-232-3241 ext 3427 or 3428.



Performance Work Statement (PWS) paragraph 4.4.24 REGISTRATION, ENROLLMENT, CO PAYMENTS AND EPISODIC CARE REGISTRATION AND ENROLLMENT - ENROLLMENT VERIFICATION AND EPISODIC CARE FOR UNASSIGNED/UNENROLLED PATIENTS (page 60 of the solicitation) which currently reads:



ENROLLMENT VERIFICATION AND EPISODIC CARE FOR UNASSIGNED/UNENROLLED PATIENTS



CONTRACTOR RESPONSIBILITY: The Contractor shall confirm eligibility of all patients presenting for care at the Contractor s site.

Contractor shall provide at no additional cost approximately 150 per year nurse-only visits and 150 per year provider visits to Veterans who are not enrolled (assigned) for care at the outpatient site of care. These visits occur when an unassigned Veteran, but who is an otherwise eligible Veteran, comes to the clinic seeking limited episodic care that cannot be provided by the Veterans assigned primary care provider/team at their preferred facility.  The clinic shall ensure that the Veteran is triaged by a nurse and that any basic care that can be provided by the nurse and/or provider is provided. 

Telehealth support for Patients Not Assigned at the Outpatient Site of Care At no additional cost the contractor shall provide approximately 150 per year specialty telehealth visits with the VAMC parent for Veterans who are not enrolled (assigned) for care at the Outpatient Site of Care. These visits occur when a Veteran (not assigned to the site), but who is an otherwise eligible Veteran, requires a specialty telehealth visit with the parent VAMC (vs. requiring the patient traveling to the parent VAMC). The Contractor shall support the scheduling and visit management as per requirements and normal routine as defined in the PWS.



Is now changed to read:



ENROLLMENT VERIFICATION AND EPISODIC CARE FOR UNASSIGNED/UNENROLLED PATIENTS



CONTRACTOR RESPONSIBILITY: The Contractor shall confirm eligibility of all patients presenting for care at the Contractor s site.

Contractor shall provide at no additional cost approximately 150 per year nurse-only visits , 150 per year provider visits, and 150 per year lab visits to Veterans who are not assigned for care at the outpatient site of care. These visits occur when an unassigned Veteran, but who is an otherwise eligible Veteran, comes to the clinic seeking limited episodic care that cannot be provided by the Veterans assigned primary care provider/team at their preferred facility. The clinic shall ensure that the Veteran is triaged by a nurse and that any basic care that can be provided by the nurse and/or provider is provided.

Telehealth support for Patients Not Assigned at the Outpatient Site of Care at no additional cost the contractor shall provide approximately 150 per year specialty telehealth visits with the VAMC parent for Veterans who are not assigned for care at the Outpatient Site of Care. These visits occur when a Veteran (not assigned to the site), but who is an otherwise eligible Veteran, requires a specialty telehealth visit with the parent VAMC (vs. requiring the patient traveling to the parent VAMC). The Contractor shall support the scheduling and visit management as per requirements and normal routine as defined in the PWS. It is the Contractor s responsibility to track these additional visits as no further reimbursement will be provided for unassigned Veteran patients above and beyond the visits described above.



PWS Paragraph 4.4.10 PHARMACY SERVICES (PRESCRIPTION FULFILLMENT) which currently reads:



4.4.11. PHARMACY SERVICES (PRESCRIPTION FULFILLMENT)

VA RESPONSIBILITY: Routine prescriptions will be dispensed by the VA and mailed to the veteran. The VA Pharmacy must approve and procure all medications and supplies that are stocked at the outpatient site of care location. The VA Pharmacy will provide the Contractor with a limited supply of routine vaccines for administration. An order for the vaccine must be entered into CPRS by the provider.

CONTRACTOR RESPONSIBILITY: Must keep all vaccines, in a secure and locked location, refrigerated and monitor temperatures of vaccines and other refrigerated drugs via constant electronic monitoring (i.e. Checkpoint system). If a temperature variation is identified by the contractor, the contractor should determine the appropriate disposition for the refrigerated medications. The contractor must not accept, store or distribute pharmaceutical samples and storage of pharmacy items must meet VA policy requirements.

Is now changed to read:



4.4.11. PHARMACY SERVICES (PRESCRIPTION FULFILLMENT)

VA RESPONSIBILITY: Routine prescriptions will be dispensed by the VA and mailed to the veteran. The VA Pharmacy must approve and procure all medications and supplies that are stocked at the outpatient site of care location.

CONTRACTOR RESPONSIBILITY: The Contractor must provide routine vaccines. Routine vaccines are defined as those vaccines that are recommended on a routine schedule by CDC (i.e. Flu, pneumococcal, etc.). Foreign vaccines would be considered non-routine. Must keep all vaccines, in a secure and locked location, refrigerated and monitor temperatures of vaccines and other refrigerated drugs via constant electronic monitoring (i.e. Checkpoint system). If a temperature variation is identified by the contractor, the contractor should determine the appropriate disposition for the refrigerated medications. The contractor must not accept, store or distribute pharmaceutical samples and storage of pharmacy items must meet VA policy requirements.



PWS Paragraph 4.4.13 CLINICAL PHARMACY SERVICES which currently reads:



4.4.13. Clinical Pharmacy Services

Clinical pharmacy. These services should be provided by a CPS with appropriate knowledge, skills, and abilities (KSAs) to perform comprehensive medication management as described previously. The CPS will function in the capacity of a mid-level provider (through a SOP) or CPA as their primary duty is to collaborate with providers to provide comprehensive medication management to patients.



The provision for clinical pharmacy services and expertise of a CPS should be available to all patients managed by the contractor. This service may be provided by the VA pharmacy or through the contractor depending on the location.



If the services are provided by the VA, the contractor shall provide ample space, support staffing, and ancillary support to allow for the provision of clinical pharmacy services. The support services shall be consistent for the CPS as with other prescribers for each Contractor s scheduled clinic to include but not limited to intake vitals by LVN/LPN, Unlicensed Assistive Personnel (health tech or nursing assistant), or similar, downloading of blood sugar from meters, POC INR testing and downloading, teaching patients how to use BP monitors at home, calling patients for lab reminders, scheduling patient visits and contacting patients who no-show for rescheduling.

VA RESPONSIBILITY: The PACT CPS and Contractor providers will receive support from VA to handle routine outpatient medication activities such as prescription verification, refill, renewal, and extension of medication, therapeutic substitutions and conversions, and other general pharmacy issues.

Core privileges shall be established in the SOP or CPS to include medication prescriptive authority, assessments, laboratory and other test ordering privileges in the most common Primary Care disease states (chronic diseases including, but not limited to, diabetes, hypertension, hyperlipidemia, smoking cessation, pain management, hepatitis C, osteoporosis).



Is changed to read:



4.4.13. Clinical Pharmacy Services

Clinical pharmacy. These services should be provided by a CPS with appropriate knowledge, skills, and abilities (KSAs) to perform comprehensive medication management as described previously. The CPS will function in the capacity of a mid-level provider (through a SOP) or CPA as their primary duty is to collaborate with providers to provide comprehensive medication management to patients.



The provision for clinical pharmacy services and expertise of a CPS should be available to all patients managed by the contractor. This service will be provided by the contractor.



The support services shall be consistent for the CPS as with other prescribers for each Contractor s scheduled clinic to include but not limited to intake vitals by LVN/LPN, Unlicensed Assistive Personnel (health tech or nursing assistant), or similar, downloading of blood sugar from meters, POC INR testing and downloading, teaching patients how to use BP monitors at home, calling patients for lab reminders, scheduling patient visits and contacting patients who no-show for rescheduling.



VA RESPONSIBILITY: The PACT CPS and Contractor providers will receive support from VA to handle routine outpatient medication activities such as prescription verification, refill, renewal, and extension of medication, therapeutic substitutions and conversions, and other general pharmacy issues.

Core privileges shall be established in the SOP or CPS to include medication prescriptive authority, assessments, laboratory and other test ordering privileges in the most common Primary Care disease states (chronic diseases including, but not limited to, diabetes, hypertension, hyperlipidemia, smoking cessation, pain management, hepatitis C, osteoporosis).



Vendor Questions and Answers:



Q - On page 44 paragraph 4.4.11 PHARMACY SERVICES (PRESCRIPTION FULFILLMENT) VA RESPONSIBILITY in the RFP it states, The VA Pharmacy will provide the Contractor with a limited supply of routine vaccines for administration. What vaccines will the VA supply and will the Contractor be responsible for any vaccines in this contract?



A This paragraph is changed per solicitation amendment A00002.



Q - On page 47 paragraph 4.4.13 Clinical Pharmacy Services in the RFP it states, If the services are provided by the VA, the contractor shall provide ample space, support staffing, and ancillary support to allow for the provision of clinical pharmacy services. Will the VA or the Contractor be responsible for the CPS?



A The CPS will be provided by the Contractor. This paragraph is changed per solicitation amendment A00002.



Q - On page 59 of the RFP under FINANCIAL ASSESSMENTS and CONTRACTOR RESPONSIBILITY it states, The demographic and financial assessment information will be input into VISTA and maintained by the Contractor. The incumbent Contractor does not currently input financial assessment information into VISTA, what requirements are needed by staff? Will the VA provide training for the Contractor to accomplish this effort?



A This paragraph is changed per solicitation amendment A00002.



Q - On page 60 of the RFP under ENROLLMENT VERIFICATION AND EPISODIC CARE FOR UNASSIGNED/UNENROLLED PATIENTS under CONTRACTOR RESPONSIBILITY it states, Contractor shall provide at no additional cost approximately 150 per year nurse-only visits and 150 per year provider visits to Veterans who are not enrolled (assigned) for care at the outpatient site of care. And on page 60 under the same section it states, Telehealth support for Patients Not Assigned at the Outpatient Site of Care At no additional cost the contractor shall provide approximately 150 per year specialty telehealth visits with the VAMC parent for Veterans who are not enrolled (assigned) for care at the Outpatient Site of Care. Will lab visits for Veterans not enrolled for care be counted towards the 150 nurse-only visits? What happens after we exceed the 150 per year of each of these types of visits?



A - This paragraph is changed per solicitation amendment A00002.



Q - With reference to the QASP in Attachment 1 of the RFP, how is the QASP tasks measured (what formula is used)? Which VISTA/CPRS/other reports are used specifically in monitoring the measures? Does the Contractor have the ability to monitor internally with access to the reports/data? Is there clinic specific data available for both the Dickinson and Williston CBOCs? If not, how would the Dickinson CBOC be measured for compliance?



A - Yes reports are available for each clinic. Dickinson will have station identifiers in December 2016. There currently is a way to get data for both sites separately. The contractor will have the ability to monitor this using VSSC data and would have access to clinic specific data.



Q - In Attachment 1 QASP on page 7 under Appointment Cancellations it states, 100% of patients seen within 2 weeks of the original cancelled appointment date. How are appointment cancellations measured (what is the formula to calculate the score)? Which VISTA/CPRS reports are used to monitor specifically? Does the Contractor have access to these reports to monitor internally? For auditing, who conducts the audits on QASP compliance and how often do these audits occur? What happens if the Contractor makes every attempt to get the patient in, but the patient refuses or is unable to come in for more than 2 weeks? If even one patient refuses to reschedule their appointment within 2 weeks, this measure would not be met. Would the VA consider revising this measure to state, 100% of patients rescheduled within 2 weeks of the original cancelled appointment or patient s preferred date. ?



A See VHA Directive 1230 Outpatient Scheduling Processes and Procedures. This Directive added in solicitation amendment A00002. See Attachment 1 QASP for audit frequency.



Q - In Attachment 9 of the RFP on page 1 it states, Information on the ONE PACT MODULE criteria is available under the CBOC Prototype section of: http://www.cfm.va.gov/til/spclRqmts.asp#CBOC. This design guide includes information on recommended rooms, sizes, adjacencies, clinic layout, individual room layouts, equipment, furniture, and expected mechanical, electrical, and low voltage requirements. VA will expect the contract site to generally comply with this design guide. In the referenced website above starting in Section 6.0 CBOC Prototype Equipment Layouts Overview of the Standardized Design and Construction of CBOC's it states that each exam room shall have 1 data outlet and 1 phone outlet. Each office area shall have 2 data outlets and 1 phone outlet. However, in Attachment 9 of the RFP on page 7, under Other General Room Requirements for PACT Exam Rooms it states, Phone/data outlets (3 data and 1 phone jack per outlet) as required, to include, but not limited to two each at each staff area modular workstation desk within the space, 1 phone/data jack at each of the following equipment locations: one per remaining wall without a phone/data jack (one of these should be placed between the instrument/supply cart and exam table). Furthermore, this same statement is listed for each office/room area in Attachment 9. This equates to over 12 data jacks and 5 phone jacks per exam room and office. Will the VA please clarify how many data /phone outlets are required per exam room and office area?



A As stated in the question, the design guide includes recommended rooms, sizes, adjacencies, clinic layout, individual room layouts, equipment, furniture, and expected mechanical, electrical, and low voltage requirements. Attachment 9 of the RFP states the requirements for this solicitation.

SUMMARY OF AMENDMENT A00001



Performance Work Statement (PWS) paragraph 2.5 TRAINING (ACLS / BLS/VA MANDATORY) which currently reads:



2.5. TRAINING (ACLS / BLS/VA MANDATORY): Contractor staff shall complete VA mandatory training as requested and complete AHA ACLS/BLS training and keep ACLS/BLS certifications current throughout the life of the contract. Copies of current certifications shall be provided to the COR.



Is now changed to read:



2.5. TRAINING (ACLS / BLS/VA MANDATORY): Contractor clinical staff shall complete VA mandatory training as requested and complete AHA ACLS/BLS training and keep ACLS/BLS certifications current throughout the life of the contract. Copies of current certifications shall be provided to the COR.



PWS paragraph 4.4.7 WAIVED TESTING REQUIREMENTS which currently reads:



4.4.7. WAIVED TESTING REQUIREMENTS



VA RESPONSIBILITY: The VA will provide the test systems/instruments and reagents for contractor waived testing with the exception of fecal occult blood testing cards and developer. The Contractor must contact the VA Ancillary Testing staff prior to purchasing fecal occult blood test kits to ensure consistency of methodology/ manufacturer. If the VA changes fecal occult blood testing methodology/ manufacturer, the Contractor must comply with the change to maintain the same standard of care. All of these test systems/instruments are from manufacturers that have received 510(K) clearance from the FDA. The VA will provide test procedures and training materials, initial training, and annual competency assessment. The Ancillary Testing staff will make periodic visits to the Contractor s site and monitor the quality control and test results to ensure accuracy and, consistency, and adherences to VA policies and requirements.



All waived testing at the Contractor s site will be under the oversight of the VA Ancillary Testing Program. The Contractor is required to use the same test systems/instruments; quality control and reagent lot numbers used for waived testing performed at the VA (see attached Ancillary Testing in Section D). When the VA Ancillary Testing Program upgrades waived test systems /instruments, the VA will furnish the Contractor with the new test systems/instruments to maintain the same standard of care. The Ancillary Testing staff will arrange for repair/ maintenance in the event of system/instrument failure. If required, the Contractor shall provide a courier to transport instruments and/or reagents to the Contractor or the VA Ancillary Testing staff for linearity/correlation studies and minor repairs. The VA will purchase proficiency testing materials for the Contractor, and the Contractor must comply with the Pathology and Laboratory Medicine, CAP and TJC requirements/regulations for testing proficiency materials and submitting results.



Is now changed to read:



4.4.7. WAIVED TESTING REQUIREMENTS



The contractor is responsible for the procurement of proficiency testing materials for all waived testing performed under this contract. Fargo VA Ancillary Testing staff will provide oversight for the procurement and testing of proficiency testing materials. The Contractor must comply with the Pathology and Laboratory Medicine, CAP and TJC requirements/regulations for testing proficiency materials and submitting results.



E.2 ADDENDA TO 52.212-1 PROPOSAL PREPARATION INSTRUCTIONS is hereby removed and replaced with the following:



E.2 ADDENDA TO 52.212-1 PROPOSAL PREPARATION INSTRUCTIONS



This section provides general guidance for preparing proposals as well as specific instructions on format and content of the proposal. The Offeror s proposal must include all data and information requested herein, and must be submitted in accordance with these instructions. Non-conformance with the instructions provided herein may result in an unfavorable proposal evaluation. Proposals shall be clear, concise, and shall include sufficient detail for effective evaluation and for substantiating the validity of the stated claims. The proposal should not simply rephrase or restate the Governments requirements, but shall address how the Offeror intends to meet these requirements. Offerors shall assume that the Government has no prior knowledge of their abilities and experience, and will base its evaluation on the information presented in the Offeror s proposal. Elaborate brochures or documentation, binding, detailed art work, or other embellishments are unnecessary and are not desired. Offerors are required to meet all solicitation requirements, including terms and conditions, representations and certifications, and technical requirements.



SOLICITATION QUESTIONS: Questions concerning the solicitation will be accepted from the solicitation posting date until 1:00pm CST October 31, 2016. Questions will only be accepted by email at scott.hendrix@va.gov.



INFORMATION REGARDING SUBMISSION OF PROPOSAL: Faxed proposals will NOT be accepted. Proposals will be accepted by mail or hand carried delivery to:



Department of Veterans Affairs

Network Contracting Office 23 (NCO 23)

Attn: Scott Hendrix

708 S. Third Street, Suite 200E

Minneapolis, MN 55415



Offerors proposals are to be submitted in three parts: (1) a price proposal (the Price Proposal ), (2) a technical proposal (the Technical Proposal ), and (3) Past Performance. The offeror shall include only one copy of each part. Pricing information shall be entered into the Schedule of Services section of the RFP (Paragraph B.5 Schedule of Services); no other version of a pricing schedule will be accepted. All envelopes shall be clearly marked with the RFP number at the lower left-hand corner. Each envelope shall be identified as "PRICE PROPOSAL , "TECHNICAL PROPOSAL", and PAST PERFORMANCE .



The sealed envelope or package used to submit your proposal must show the time and date specified for receipt, solicitation number and name address of the offeror.



Specific Instructions:



1. PART I PRICE PROPOSAL Submit one copy.



(a) Complete blocks 12, 17a and b, and 30a through c of the RFP, page 1, Standard Form (SF) 1449, and all fill-ins in the Contract Administration Data section of the solicitation. In doing so, the offeror accedes to the contract terms and conditions as written in the solicitation in its entirety.



(b) Insert proposed unit prices for each Contract Line Item Number (CLIN) including all option periods. All price proposals must be submitted using the Schedule of Services section of the RFP. The proposal must be submitted for a base year plus four (4) option years.



(c) Complete the necessary fill-ins and certifications in the Contract Clauses section. Representations and Instructions section shall be returned in its entirety. For Description/Specifications through Contract Clauses sections, the offeror shall submit only the pages that require a fill-in.



(d) The Contractor must return a signed: Contractor Rules of Behavior, Immigration and Nationality Act Certification, Organizational Conflict of Interest, QASP, and VHA Compliance Information (See Attachments 1- 5)



(e) Return any solicitation amendments to the original solicitation documents, signed by the same official authorized to sign the SF 1449.



2. PART II TECHNICAL PROPOSAL Submit one copy



(a) Section 1 Cover letter. Shall be a maximum two-page Cover Letter and shall include the name and address of the organization submitting the proposal, together with the name, address, e-mail address and telephone number of the contact person who has the actual power to legally bind the offeror and make representations relative to the offeror s proposal and any resultant contract, for the offeror.

(b) Section 2 Table of Contents. Shall be a detailed Table of Contents and shall include an outline of the proposal, identified by a sequential page number and be section reference and section title.

(c) Section 3 Narrative Response to Evaluation Factors. In order to evaluate each proposal, it is necessary that each offeror respond to all items in the same order as presented herein. Offers shall be organized with sections appropriately identified. Offerors are to propose how they intend to fulfill the requirements of this solicitation and how their total offer will meet the minimum needs of the specifications. The response should be concise and provide sufficient information to demonstrate the offeror s capability to satisfactorily perform the objectives. The narrative response shall be typed not less than 12 pitch and be presented in the order of the technical evaluation factors. The offeror will use 8 ½ x 11 paper except for fold-outs used for charts, tables, or diagrams, which may not exceed 11 x 17.

3. PART III PAST PERFORMANCE Only references for same or similar type contract. Submit one (1) copy.



PAST PERFORMANCE QUESTIONNAIRES: Each offeror shall send out Past Performance Questionnaires (Attachment #8) to each of the offeror s past performance references identified in those contracts listed in the contractor s Past Performance Information. The responsibility to send out Past Performance Questionnaires rests solely with each offeror IT SHALL NOT BE DELEGATED TO ANY OTHER ENTITY.



1. Complete Section A, General Information, of the Past Performance Questionnaire (Attachment #10) and mail, fax or email Past Performance Questionnaire to all past performance references listed in the contractor s Past Performance Information. Evaluators are only allowed to use the Attachment #10, Past Performance Questionnaire. Altered or substituted questionnaires will not be evaluated. Offerors are responsible to ensure questionnaires are transmitted to their references, and to indicate which references (from paragraph c. above) the questionnaire was sent to.



2. Once the Past Performance Questionnaires are completed by the evaluator s POCs, the information contained in the Questionnaires shall be considered source selection sensitive and not released to you, the offeror. Questionnaires shall be sent directly to the Government.



3. Past Performance Questionnaires are to be completed and sent directly to the Government by the evaluator completing the Questionnaire. It is the sole responsibility of the offeror to track the submission of Past and Present Performance Questionnaires and ensure that the Government receives them AS SOON AS POSSIBLE BUT NO LATER THAN THE CLOSING TIME AND DATE OF THE SOLICITATION. It is also the sole responsibility of the offeror to inform the evaluators of any extensions the Government approves to the date and time proposal are due to be submitted.



4. The evaluator shall e-mail questionnaires to Scott Hendrix at scott.hendrix@va.gov. If the questionnaires cannot be e-mailed, fax to (612) 333 3667.



5. If the offeror claims there is no past performance, then that status must be identified to the Contracting Officer not later than the date/time proposals are due from all offerors.





VENDOR QUESTIONS AND ANSWERS:



Q - Will the Contractor be allowed to bill for all currently enrolled patients in the first month under the new contract?



A Yes.



Q - On page 28 paragraph 2.1.5.1.1 under minimum staffing requirements in the RFP it states, Telehealth Clinical Technicians (TCT) - minimum of 1.0FTE dedicated TCT/Lab Tech with back up TCT/Lab Tech for absences of dedicated TCT. Does the 1.0FTE TCT/Lab Tech provide all telehealth services including tele-mental health, tele-retinal, and teledermatology, and the backup TCT/Lab Tech is only needed for absences of the dedicated TCT/Lab Tech?



A - Yes- the requirement is for a minimum of 1 full time TCT additional staff may be necessary to cover the lab demands, the backup staffing is needed to cover both gaps in telehealth and in the lab setting.



Q - On page 28 paragraph 2.1.5.1.1 Minimum staffing requirements in the RFP it states, Minimal staffing requirements include 1 MSA, 1 provider (MD), 1 nurse (LPN or RN), 1 TCT at all times within the clinic as part of the contractual obligations. Is the VA requiring a physician at each site, or can a physician from one site oversee the mid-level at the other site, or can a physician oversee mid-levels at both sites?



A The requirement is for an MD at each site no midlevels are supported in the sites due to CHOICE requirements.



Q -On page 32 paragraph 2.5 in the RFP it states, Contractor staff shall complete VA mandatory training as requested and complete AHA ACLS/BLS training and keep ACLS/BLS certifications current throughout the life of the contract. Is ACLS and BLS training required for all staff in the clinics?



A - Required for all clinical staff not MSA s. Paragraph changed per Solicitation Amendment A00001.



Q - On page 41 paragraph 4.4.6 in the RFP it states, The Contractor is responsible for the ordering and purchasing of required CAP proficiency testing (PT) materials. However, on page 42 paragraph 4.4.7 it states, The VA will purchase proficiency testing materials for the Contractor. Who provides the proficiency testing and purchases the proficiency testing materials, the VA or the Contractor?



A Paragraph 4.4.7 is removed and replaced in Solicitation Amendment A00001.



Q - On page 57 of the RFP under Women Veterans Health Care its states, completion of a Women s health mini Residency program is required for all contract providers serving in this role. Will the VA consider years of experience instead of a women s health residency program and if so how many years of experience is required? If a candidate does not have enough women s health experience, can the Contractor send the women s health candidate to the VA Women s Health Training?



A No, only years of experience in women s health is counted, not years of experience in general. Yes the contractor can send the candidate to Va Women s health training but it will be paid for by the contractor.



Q - On page 118 #3 Part III Past Performance in the RFP it states, Limited to no more than two (2) pages per contract listed. Only references for same or similar type contract. Submit one (1) copy. And on page 126 under Factor 2 Past Performance it states we need to, Provide a narrative identifying the type and scope of practice for the past (3) years addressing professional background, experience, and level of professional competence. Provide any information currently available (letters, metrics, customer surveys, independent surveys, etc.) which demonstrates customer satisfaction with overall job performance and quality of services provided for same or similar type contract. In addition, explain any corrective actions taken in the past, if any, for substandard performance and any current performance problems. Is the contractor/company narrative separate from the 2 page limit per contract? Can the letters, metrics, customer surveys, independent surveys, etc. be provided as an attachment and not included as part of the 2 page limit?



A E.2 ADDENDA TO 52.212-1 PROPOSAL PREPARATION INSTRUCTIONS is removed and replaced by Solicitation Amendment A00001; removing the 2 page limit in question and correcting the submission address.

This is a Solicitation for commercial items prepared in accordance with the format in FAR 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only Solicitation; proposals are being requested and a written Solicitation is included in this posting. The solicitation number is VA263-17-R-0013 and is issued as a request for proposal (RFP). This requirement is unrestricted.



The associated North American Industrial Classification System (NAICS) code for this procurement is 621498, All Other Outpatient Care Centers, with a size standard of $20.5 million.



To be considered for award of a Government contract, the offeror must be currently registered in System for Award Management (SAM) at www.sam.gov. Offerors are encouraged to go to the SAM database www.sam.gov and start the registration process as soon as possible to avoid possible delays should the contractor be selected as a prospective awardee.



The Department of Veterans Affairs, Network Contracting Office 23 is soliciting proposals for two Community Based Outpatient Clinics (CBOC). The resulting contract will require the contractor to provide Primary Care and telehealth support services for two Community Based Outpatient Clinics (CBOC), in accordance with the specifications, terms and conditions of the solicitation. One CBOC is to be located within the city limits of Williston, ND and the other CBOC is to be located within the city limits of Dickinson, ND. The contractor shall establish two separate locations to provide the required services specified under this contract.



Veterans to be serviced under the Williston, ND contract reside primarily in the North Dakota Counties of: Williams, McKenzie, Mountrail, Divide, Burke and Dunn and the Montana Counties of Sheridan, Roosevelt and Richland but are not restricted to those counties. Veterans to be serviced under the Dickinson, ND contract reside primarily in the North Dakota Counties of: Golden Valley, Billings, Stark, Hettinger, Slope, Bowman, Adams and the South Dakota counties of Harding, and Perkins.



CBOC services will be provided to beneficiaries of the Fargo VA Health Care System. Payment for services will be based on a monthly Capitated Rate.



The anticipated period of performance will be from March 1, 2017 (or date of award) through February 28, 2018 for the Base Year, with four (4), one year option renewal periods. Option periods are exercised at the sole discretion of the Government.



The date for receipt of proposals is no later than November 15, 2016, 3:00 p.m. Central Standard Time.

Proposals must be submitted to:



Department of Veterans Affairs

Network Contracting Office 23

ATTN: Scott Hendrix

708 South Third Street, Suite 200E

Minneapolis, MN 55415



For additional information and proposal submittal instructions, please see attached solicitation and solicitation attachments.



Prospective offerors should not expect notification of issuance of amendments other than via the Federal Business Opportunities website and are responsible for obtaining all amendments as posted. Questions from potential offerors are encouraged to resolve any possible ambiguities; inquiries shall be in writing only and addressed to Scott Hendrix at scott.hendrix@va.gov.

This is a PRE-SOLICITATION NOTICE - The US Department of Veteran Affairs Medical Center, Fargo, North Dakota, hereinafter referred to as VA FHCS, requires contractor to provide Primary Care Services for two contract clinics, in accordance with the specifications, terms and conditions of the solicitation. One clinic is to be located within the city limits of Williston, ND and the other clinic is to be located within the city limits of Dickinson, ND. The contractor shall establish two separate locations to provide the required services specified under this contract. Veterans to be serviced under the Williston, ND contract reside primarily in the North Dakota Counties of: Williams, McKenzie, Mountrail, Divide, Burke and Dunn and the Montana Counties of Sheridan, Roosevelt and Richland but are not restricted to those counties. Veterans to be serviced under the Dickinson, ND contract reside primarily in the North Dakota Counties of: Goden Valley, Billings, Starck, Hettinger, Slope, Bowman, Adams and the South Dakota counties of Harding, and Perkins.

Primary Care services will be provided to patients enrolled to the clinic by the VA FHCS. Payment for services will be based on a monthly Capitated Rate.

The NAICS code assigned to this procurement will be 621498 with a size standard of $20.5 million. The VA will award a single or multiple firm, fixed-price, PMPM commercial services contract(s). Contract use will be limited to VA FHCS only. The solicitation will contain requirements for a 12-month base year with four (4) 12-month options to renew. Service will begin on or about April 1, 2017 through March 31, 2018 for the Base Year. The solicitation is scheduled to be issued on or about October 24, 2016 and will be issued via FedBizOpps Electronic Posting System at http://www.fedbizopps.gov.

Once the solicitation is issued, questions regarding this solicitation must be in writing and may be sent via email to: scott.hendrix@va.gov.