Q201--VA North Texas VA HCS Denton Community Based Outpatient Clinic (CBOC)

The reason for amendment 0005 is to answer the questions received, replace the PWS and QASP, and extend the response date for receipt of proposals. a. Questions and answers are as follows: Question1: B.2 Schedule of Services: The Estimated Quantity goes from 8700 in the Base Year to 12023 in Option Year Nine. As the incumbent for this contract, the growth rate in Denton from Mar-21 to Feb-22 is 1.9%, 1.1% growth rate in 2021, and 1.7% in 2020. Will the VA please explain the rationale for the 3.7% year over year growth rate given the history of enrollment trends? Would the VA consider adjusting the growth rate more in line with current trends for a more accurate estimated cost? Answer to Question 1: Historical data for the past five years as well as projected growth in the veteran population as determined through the VA planning models was used to determine the estimated growth rate. No, the VA will not adjust the growth rate. Question 2: Section 2.2 Contractor s Physicians performing under this contract shall be board certified by the ABMS in Internal Medicine and/or Family Practice or the BOS in Internal Medicine and/or Family Practice. Is a board eligible physician also acceptable? Answer to Question 2: Section 2.2 refers to the Physician Director and the person serving in this role shall be board certified. Other physicians, as noted in section 2.3.1, shall be board certified or board eligible. Question 3: Section 2.8.3 The Telepresenter can be any clinically trained person assisting the provider in the presentation of the veteran using video-conferencing. Is the telepresenter in addition to the two telehealth techs? Who will provide the telepresenter, the VA or contractor? Answer to Question 3: The VA will provide 2 telehealth technicians as stated in Section 2.8. These technicians will also serve as the Telepresenter. The contractor shall provide trained staff to back up the VA telehealth staff as outlined in Sections 2.8. and 2.8.3. Question 4: Section 4.6.2.4.6 Emergency contraception (e.g. Levonorgestrel (Plan B) etc.) must be available to all women veteran patients in a timely manner (same day of their appointment) even if a provider has requested to opt out from providing emergency contraception to the patient because of a Rights of Conscience (ROC) Claim. Who is to provide the Levonorgestrel, the VA or contractor? Answer to Question 4: To ensure timely availability, the contractor shall stock Levonorgestrel on site - Section 4.6.2.3.6. Language in PWS revised accordingly: 4.6.2.3.6 Depo-Provera injections must be available to all women veterans in a timely manner (same day appointment). Emergency contraception (e.g., Levonorgestrel (Plan B) etc.) must be available to all women Veteran patients in a timely manner (same day of their appointment) even if a provider has requested to opt out from providing emergency contraception to the patient because of a Rights of Conscience (ROC) Claim. To ensure timely availability, the contractor shall stock these medications on site. Question 5: Section 4.6.3.1 Urgent/Emergent medications needed will be filled via the VA contracted local pharmacy for up to 10 days. Who pays for the 10-day emergent medications? Answer to Question 5: As stated in 4.6.3.1 The VA provides the contract for the authorized pharmacies for the urgent/emergent prescriptions and covers the cost of the medication. Question 6: Section 4.6.4.2.7 The Contractor shall meet all requirements for anticoagulation management. 4.6.4.2.8 The Contractor shall provide Quarterly and annual anticoagulation quality assurance summaries. 4.6.4.3 Clinical Pharmacy Services Clinical Pharmacy. Services shall be provided by the VA. If the VA is providing the CPS, wouldn t the VA be required to manage anticoagulation? Answer to Question 6: Yes, the VA manages anticoagulation therapy. The VA may provide quarterly and annual anticoagulation quality assurance summaries as outlined by the local Pharmacy and Therapeutics Committee. The contractor shall participate in performance improvement initiatives as indicated by the data in the summaries provided Section 4.6.4.2.8. Language in PWS revised accordingly: 4.6.4.2.8 The Contractor may receive quarterly and annual anticoagulation quality assurance summaries as outlined by the local Pharmacy & Therapeutics Committee. The contractor shall participate in performance improvement initiatives as indicated by the date in the summaries provided. For questions, please contact, POC, VA Anticoagulation Coordinator at contact@example.gov. Question 7: Section 4.7.1.3 Sending specimens to the VA Core Laboratory twice daily, prior to the Contractor s mid-day break period and after the close of business of the workday, except for those specified in this PWS. The RFP calls for twice daily courier service, currently this service is once daily, will the VA require twice daily courier service? Answer to Question 7: Yes, twice daily courier service is required as outlined in Section 4.7.1.3. Question 8: Section 5.11.2.11.31 To ensure the availability of outreach and referral services to homeless veterans, all contractor sites must designate at least one outreach specialist, usually a clinical social worker, to provide services to homeless veterans. Contractor sites with 10,000 or more patients shall have a dedicated specialist. Who is to provide the outreach specialist, the VA or contractor? Answer to Question 8: The VA will provide all Mental Health staff as stated in Sections 1.1.1. and 2.7. Question 9: Section 7. PACT space standards are found in the PACT Space Module Design Will the government please confirm if VA will provide the phone circuit and physical phones? Answer to Question 9: The contractor is responsible for the procurement, installation, and maintenance of all telecommunication lines, telephone systems, and telephones.- Section 7.5 d.i.1. Language in PWS revised accordingly: the installation of the network infrastructure line into the building for both the contractor and VA networks. The VA network line should be fiber optic cable. The contractor is responsible for the maintenance of the network infrastructure within the facility including, but not limited to, minimum Category 6A cabling located inside the walls of the structure and a secure communications closet space to house the patch panels and networking equipment Question 10: Section d.1 CAT 6 wiring Will the Government please confirm if CAT 6 wiring is preferred and not CAT 6A? Answer to Question 10: CAT 6A is required - Section d.i.1. and Section d.i.13.7. Language in PWS revised accordingly: d.i.1 to, minimum Category 6A cabling located inside the walls of the structure and a secure communications closet space to house the patch panels and networking equipment. 13.7 infrastructure installer should install Leviton CAT6A patch panels and connectors in the rack Question 11: Section Power Requirements four (4) L6-20 receptacles one (1) L6-30 receptacle in the closet Could the government please confirm the power requirements and if two 20-amp dedicated receptacles are acceptable? Answer to Question 11: Two 20-amp receptacles are not acceptable due to the current EHRM standards. The requirements are as stated in Section d.ii.12. Question 12: Section Racks - both racks will have 2 shelves on the bottom installed to hold IT computers Could the government please confirm if shelves are required? Answer to Question 12: No shelves are required. The racks are not to exceed six 48 port switches per rack - Section d.ii.13.6. Language in PWS revised accordingly: 13.6 racks are NTE six 48 port switches per rack. Question 13: Section Infrastructure installer should install Leviton CAT6 patch panels and connectors in the rack. Could the government please confirm if a comparable brand to Leviton will suffice? Answer to Question 13: The contractor is required to meet the PWS requirement as outlined in Section d.ii.13.7. Question 14: Section 7.5.d.5. the procurement, installation and maintenance of all printers, copiers, scanners, fax machines*, shredders, or other peripheral office equipment and all related and ongoing supplies (paper, toner, ink cartridges) required to operate the equipment in support of the facility under the specifications of this contract This section says that Contractor is responsible for the items listed above however, VA typically will not connect Contractor equipment to the VA network. Please advise the type of office equipment VA will supply for the daily operation. Answer to Question 14: The VA will supply all printers, copiers, scanners, and fax machines that connect to the VA network - Section d.i.5. PWS language revised accordingly: 5. the procurement, installation and maintenance of all telecommunication lines/telephone systems and telephones, printers, copiers, scanners, fax machines*, shredders, or other peripheral office equipment that do not connect to the VA network and all related and ongoing supplies (paper, toner, ink cartridges) required to operate the equipment in support of the facility under the specifications Question 15: Section 7.5.8 one small desktop color printer for printing patient education information Will the VA be providing a small color printer since equipment supplied by Contractor cannot be on a VA network? Answer to Question 15: Yes, the VA will supply the printer. The requirement for the contractor to supply the small desktop color printer has been removed from the solicitation requirements - Section d.9. PWS sentence below has been deleted: 9. one small desktop color printer for printing patient education information. Question 16: Section 11.2.2 The Contractor shall have 120 days from contract award to commencement of the provision of medical care to local veterans. Given the size of the Denton CBOC, would the VA consider 180 days from contract award to commencement of the provision of medical care to veterans? Answer to Question 16: The Contractor shall have 180 days from contract award to commencement of the provision of care as stated in Section 11.2.2. The solicitation has been revised as follows: 11.2.2: The Contractor shall have 180 days from contract award to commencement of the provision of medical care to local Veterans. However, the Contractor must have all start-up requirements in place and ready to commence operation NLT 180 calendar days from contract award. The final seven (7) days will be used for training and resolution of any last minute or unexpected technical or personnel related challenges. The Contractor shall comply with the following contract requirements prior to commencement of clinical operations Sub-factor (d) Geographic Location (Site visit may be conducted prior to award): 2. Describe location of proposed facility to be utilized under this contract. Include mailing address, street address, city, village, town and county as applicable. If Offer proposes to use a temporary location to meet the requirement that the successful Contractor begin providing services no later than 180 days after award, provide address of the proposed temporary location and plan to transition into the final VA approved location. Question 17: Section Instructions to Offeror Proposals shall be submitted via email to: contact@example.gov. and Hattie contact@example.gov Are there any email size restrictions when submitting the proposal electronically to Ms. Gutierrez? Answer: The solicitation is revised as follows: Proposal shall be submitted via email to contact@example.gov contact@example.gov. The file size limit is 40 MB for a single email. If the proposal exceeds this limitation, more than 1 email may be submitted as long as the subject line is clearly labeled. Question 18: Section Instructions to Offeror e. Proposal Format: Offeror shall submit their proposal assembled as follows: Factor 1 Technical Capability Sub-factor (a) Quality Sub-factor (b) Management experience, staffing Sub-factor (c) Transition Plan Sub-factor (d) Geographic Factor 2 Past Performance Factor 3 - Price Does the VA want each Factor (1 3) in separate documents? Answer to Question 18: Yes, each Factor shall be in separate documents. Question 19: How many VA staffed personnel will be providing services at the CBOC? Please list job title and number of days per month. Answer to Question 19: There will be a minimum of 10 full time mental health professionals, two telehealth technicians, two PACT social workers, one clinical pharmacist, and one dietician as outlined in Section 2.4. This will increase to 12 full time mental health professionals and up to 12 VA support staff over the life of the contract. Language in PWS revised accordingly: 2.4 DISCIPLINE SPECIFIC PACT TEAM MEMBERS (REQUIRED FOR ALL SITES): Discipline-specific team members are designated in PCMM for one or more PACT(s). Discipline- specific team members provide continuity of direct discipline-specific care to all patients assigned to PACT(s) for which the team member is designated. VANTHCS will provide a minimum of two (2) PACT social workers, one full time clinical pharmacy specialist and one full time clinical dietitian. The contractor will only be responsible to provide office space/consult rooms for these clinicians to conduct care. Any other needed discipline specific PACT team members will be provided by the VA for specific care and/or appointments. Question 20: Please list the required office space for each VA provided staff at the CBOC. List what type and size. Answer to Question 20: One counseling patient care room per 1000 projected enrollees is required for VA mental health staff, and one consult patient care room per 1000 projected enrollees is required for VA support staff including telehealth clinical technicians, PACT social workers, clinical pharmacy specialist and dietitians according to the most current PG-18-9, Space Planning Criteria, Chapter 25 - Section 7.1.6. Language in PWS revised accordingly: 7.1.6 Space requirements for VA provided staff include one counseling patient care room for VA Mental Health Providers per 1000 projected enrollees, and one consult patient care room per 1000 projected enrollees for VA support staff including telehealth clinical technicians, PACT social workers, clinical pharmacy specialist and dietitians. Also: Each consult room should be a minimum of 140 square feet as required by the PG-18-9, Space Planning Criteria, Chapter 25 as referenced in Section 7.2.b.xi.6 (https://www.cfm.va.gov/til/space/spChapter265.pdf) Question 21: How many contracted clerical support staff are required for the VA staff on-site? Answer to Question 21: The contractor is responsible for providing clerical support based on the PACT staffing model as outlined in Section 2.3.4 The additional clerical staff needed to provide appropriate support to all clinic operations as stated in Section4.6.4.3.1 and 5.10 is to be determined by the contractor. Question 22: Does the VA wish to use a security guard? Armed or Unarmed? Answer to Question 22: There is no requirement for a security guard. This decision will be left to the contractor. Question 23: Who is responsible for setting up a contract with a local ambulance company, the VA or the Contractor? Answer to Question 23: A contract with the local ambulance company is not a requirement. Question 24: Will the VA provide Naloxone for veterans who require it as a precaution? Answer to Question 24: The contractor is to provide Naloxone onsite at the clinic for emergency response. The VA will provide Naloxone for individual veterans who require a prescription for Naloxone as outlined in Section 4.6.3.1 Question 25: Are the on-stage/off-stage design features of the PACT Space Module Design Guide required? Answer to Question 25: Yes, the on-stage/off-stage design features are required. Please refer to the referenced VA design documents listed in Section 7.2.b.xi.1-6. Question 26: Are board eligible physicians acceptable? Answer to Question 26: Section 2.2 requires the Physician Director to be board certified. Other physicians, as noted in Section 2.3.1, shall board certified or board eligible. Question 27: Who is responsible for courier services VA or contractor? Answer to Question 27: The contractor is responsible for the courier services as stated in Section 4.7.1.3. Question 28: Will the VA provide the lab specimen tubes? Answer to Question 28: Yes. Question 29: What is the current size of the vested primary care patient roster for the clinic? How many are women veterans? Answer to Question 29: The current primary care patient roster is 8926. The percentage of women veterans is approximately 11.5% of the current primary care patient roster. Question 30: What is the current size of the vested mental health patient roster for the clinic? How many are women veterans? Answer to Question 30: Approximately 9% of the current primary care roster are engaged in PCMHI at the clinic. Vested mental health women information is not currently tracked by the VA. Question 31: On page 169, it states that transcripts are required for Nurse Practitioners. Is it acceptable to submit transcripts after award, as transcripts can take weeks to obtain? Answer to Question 31: Yes. This requirement has been removed from the Sub-factor (b) Management, Experience, Staffing, and Transition Plan of the Evaluation Factors and Criteria, to read as follows: 9. Providers: Provide copies of the Curriculum Vitae Nurse Practitioners List the number of 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. Question 32: Will the VA conduct a site visit of proposed sites? Answer to Question 32: Yes, the VA will conduct a site visit of proposed sites as part of the proposal evaluation process. Question 33: Paragraph 11.2.2 states, The Contractor shall have 120 days from contract award to commencement of the provision of medical care to local Veterans. - However, p. 170 references 160 days: the successful Contractor begin providing services no later than 160 days after award ) Please clarify how long after award the contractor will have to commence services. In consideration of the supply chain disruptions that have continuously occurred over the past year and the large size of this clinic, we respectfully request 150 days to meet all Solicitation requirements. Answer to Question 33: The Contractor shall have 180 days from contract award to commencement of the provision of care as stated in Section 11.2.2. The solicitation has been revised as follows: 11.2.2: The Contractor shall have 180 days from contract award to commencement of the provision of medical care to local Veterans. However, the Contractor must have all start-up requirements in place and ready to commence operation NLT 180 calendar days from contract award. The final seven (7) days will be used for training and resolution of any last minute or unexpected technical or personnel related challenges. The Contractor shall comply with the following contract requirements prior to commencement of clinical operations Sub-factor (d) Geographic Location (Site visit may be conducted prior to award): 2. Describe location of proposed facility to be utilized under this contract. Include mailing address, street address, city, village, town and county as applicable. If Offer proposes to use a temporary location to meet the requirement that the successful Contractor begin providing services no later than 180 days after award, provide address of the proposed temporary location and plan to transition into the final VA approved location. Question 34: Can vendors add the total cost of construction to the Base Year/ CLIN 0001? Answer to Question 34: The cost of construction can be built into the pricing for the base year as long as Offerors proposed pricing is based on a per member per month capitation methodology for base and all option years. Proposals cannot add a separate line item for construction/build out. Note, changing the solicitation terms will result in the offeror not being further evaluated or considered for award. Question 35: To ensure vendors can properly plan and develop a proposal that meets all of the solicitation s requirements can the proposal submission date be extended by 30 days from Q&A released? This will give us adequate time to obtain required documentation, develop clinical designs, and recruit the staffing / templet requirements. Answer to Question 35: Proposal submission date has been extended. Question 36: Please clarify if the VA or the contractor is responsible for the phones and phone lines. Will the government provide/ implement the call distribution system, or is this a vendor expense? Answer to Question 36: The contractor is responsible for the procurement, installation, and maintenance of all telecommunication lines, telephone system and telephones.- Section d.i.5 Language in PWS revised accordingly: 5. the procurement, installation and maintenance of all telecommunication lines/telephone systems and telephones, printers, copiers, scanners, fax machines*, shredders, or other peripheral office equipment that do not connect to the VA network and all related and ongoing supplies (paper, toner, ink cartridges) required to operate the equipment in support of the facility under the specifications of this contract.* Question 37: Will the government provide/implement the call distribution system, or is this a vendor expense? Answer to Question 37: This is a responsibility of the contractor as noted in Section 5.16.1. Question 38: Could the Government provide a projected start date for this contract? This information is necessary to coordinate among various vendors. Answer to Question 38: The contractor shall have 180 days from contract award to commencement of the provision of care. Question 39: Can the government provided historical lab draw numbers/ requirements? Answer to Question 39: This information is not currently tracked by the VA. Question 40: Can the government clarify who is responsible for PCHMI scheduling (contractor or government)? Is it required to staff clerks in addition to PACT administrative associates? Answer to Question 40: The contractor is responsible for providing clerical support based on the PACT staffing model as outlined in Section 2.3.4. The additional clerical staff needed to provide appropriate support to all clinic operations as stated in Section 4.6.4.3.1 and 5.10 is to be determined by the contractor. Question 41: Are 42 inch doorways be acceptable, as this doorway width is in line with the VA Barrier Free Design Standard? Answer to Question 41: Yes. Where patient beds, stretcher, and gurneys do not access a patient care delivery room, a minimum of 42 is required for the door width per the VA Barrier Free Design Standard. Question 42: Would the VA accept sliding doors only on the patient side of the exam rooms? Answer to Question 42: No. Per section 7.1.1, barn (sliding) doors shall be on both sides of the PACT exam rooms. Question 43: Will the procedure room if properly equipped count as a women's health exam room? Answer to Question 43: Yes. The PACT Space Module Design Guide allows for the procedure room to serve as one of the required women s health exam rooms. Question 44: How many women s health exam rooms required? Answer to Question 44: Per the most recent PG-18-9. Space Planning Criteria, Chapter 265, two women s health exam rooms are required for projected enrollment of 6001 to 12, 000 - Section 7.2.b.xi. Question 45: Are any consult rooms required in addition to the 3 exam rooms per PCT team? Answer to Question 45: As noted in the most recent PG-18-9. Space Planning Criteria, Chapter 265, one counseling patient care room for VA Mental Health Providers per 1000 projected enrollees, and one consult patient care room per 1000 projected enrollees for VA support staff including telehealth clinical technicians, PACT social workers, clinical pharmacy specialist and dietitians is required as outlined in Section 7.1.6. Language in the PWS revised accordingly: 7.1.6 Space requirements for VA provided staff include one counseling patient care room for VA Mental Health Providers per 1000 projected enrollees, and one consult patient care room per 1000 projected enrollees for VA support staff including telehealth clinical technicians, PACT social workers, clinical pharmacy specialist and dietitians. Question 46: Please explain the formula the VA used to create the enrollment growth used in the CLINs. Answer to Question 46: Historical data for the past five years as well as projected growth in the veteran population as determined through the VA planning models was used to determine the estimated growth rate. Question 47: Please provide the number of billable enrollees on the most current invoice. Answer to Question 47: The billable enrollees on the most current invoice is 8926. Question 48: Does the current CBOC meet the government s space requirements, and if not, will the location be grandfathered in and available for rebid as-is ? Answer to Question 48: No, the current location does not meet the government s space requirements and it will not be grandfathered in . Question 49: Please list all VA staff that will be onsite at the clinic and the approximate number of days per week they will be there. Answer to Question 49: There will be a minimum of 10 full time mental health professionals, two telehealth technicians, two PACT social workers, one clinical pharmacist, and one dietician as outlined in Section 2.4. This will increase to 12 full time mental health professionals and up to 12 VA support staff over the life of the contract. Language in PWS revised accordingly: 2.4 DISCIPLINE SPECIFIC PACT TEAM MEMBERS (REQUIRED FOR ALL SITES): Discipline-specific team members are designated in PCMM for one or more PACT(s). Discipline- specific team members provide continuity of direct discipline-specific care to all patients assigned to PACT(s) for which the team member is designated. VANTHCS will provide a minimum of two (2) PACT social workers, one full time clinical pharmacy specialist and one full time clinical dietitian. The contractor will only be responsible to provide office space/consult rooms for these clinicians to conduct care. Any other needed discipline specific PACT team members will be provided by the VA for specific care and/or appointments. Question 50: 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 to Question 50: The new contractor will inherit the billable roster based on patients who had qualifying visits from the preceding 12 months from the date the new contractor begins providing services. For example if we award the contract April 1st and the buildout is 120 days then the new contractor would be handed the billable roster and be entitled to start billing August 1st for all Veterans having qualifying visits from 12 months preceding August 1st. - Then each month after August 1st the new contractor will required to send an updated billable roster identifying any new additions or removals to the COR who will verify the updated roster is accurate based on the previous 12 months of qualifying visits preceding that month. - Question 51: Will the government be doing site visits prior to award? If so, how much advance notice will the contractor be given? Answer to Question 51: Yes, the VA will conduct a site visit of proposed sites as part of the proposal evaluation process. No less than one week s notice will be provided. Question 52: How many Mission Act referrals, for Primary Care, were made the past 12 months for enrolled veterans of the Greenville CBOC? Answer to Question 52: This question is not relevant to this solicitation. Question 53: Transcripts are required to be submitted for NP candidates with the proposal. Can these transcripts be submitted after award? Answer to Question 53: Yes. This requirement has been removed from the Sub-factor (b) Management, Experience, Staffing, and Transition Plan of the Evaluation Factors and Criteria Question 54: 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. Answer to Question 54: List of vaccines currently required is below. This list may change over time based on changing needs of the population served. The VA does not supply vaccines to the Denton CBOC and does not have accurate usage numbers for these vaccines in the past year. Pneumonia TDAP TD Zostavax Shingrix HPV PPD Twinrix (Hep A&B) Hep A Hep B Depo Influenza MMR Meningococcal Oligo/DIPH Conj Inj Meningococcal/Diphtheria Tox Question 55. Please confirm this is the VA s intention for the contractor to provide a phlebotomist and a lab tech for this contract. Answer to Question 55: The contractor is required to provide at least 2 full time phlebotomists. A lab technician is not required. PWS Section 2.6.2. Language revised accordingly: 2.6.2. PHLEBOTOMIST/LABORATORY TECHNICIAN: FTE Ratio Performance Standard: At least two FTE phlebotomist are required for the location. Qualifications: Certificate of completion of Phlebotomy course and/or two years experience as a phlebotomist within the past three years (preferred). Position Responsibilities: Responsible for performance functions to include but not limited to: recording specimens in the computer, collecting patient blood and/or urine specimens, labeling specimens, answering questions relative to patient specimens, instructing and assisting patients. Performs direct patient support work to include: collecting information from patients, providing personal patient care, and educating patients on pre-testing and post procedure activities. Functions as a resource for non-laboratory personnel on specimen collection requirements and patient preparation for provider, verifies identifiers such as patient identification, time of sample, type of test requested, and identifies unusual conditions and discrepancies which may cause erroneous results Question 56: Section 4.6.2.3.8 Medication Management. Please clarify if the Government will be creating and providing quarterly and annual reports since VA is responsible for Clinical Pharmacy Services? Answer to Question 56: Yes. The VA may provide quarterly and annual anticoagulation quality assurance summaries as outlined by the local Pharmacy and Therapeutics Committee. The contractor shall participate in performance improvement initiatives as indicated by the data in the summaries provided Section 4.6.4.2.8. Language in PWS revised accordingly: 4.6.4.2.8 The Contractor may receive quarterly and annual anticoagulation quality assurance summaries as outlined by the local Pharmacy & Therapeutics Committee. The contractor shall participate in performance improvement initiatives as indicated by the date in the summaries provided. For questions, please contact, POC, VA Anticoagulation Coordinator at contact@example.gov. Question 57: Laboratory Services Please confirm if the Contractor will be responsible for providing the courier services to transport labs twice per day? Answer to Question 57: Yes, the contractor is responsible for providing the courier services day as outlined in Section 4.7.1.3. Question 58: Section 4.7.1.2 Electrocardiogram Services, please confirm if the Contractor is responsible for the procurement of the GE 5500 EKG? Answer to Question 58: The VA will provide the EKG as stated in Section 4.7.1.2. Language in PWS revised accordingly: 4.7.1.2 ELECTROCARDIOGRAM SERVICES: MUSE-compatible GE 5000 EKGs with modem shall be used which are interfaced with the VA EHR Imaging....