This document is an amendment (0001) to Solicitation Number 36C24925R0056 for the Department of Veterans Affairs, Network Contracting Office 9 (90C) in Murfreesboro, TN. Issued on December 5, 2024, this amendment updates two attachments: Attachment D.9, which is revised to reflect an updated Wage Determination (WD 2015-4649 Rev 30 Dated 7.8.2025), and Attachment D.6 Deliverables-Reports Table, which now specifies that copies of all staff certifications and licenses are due upon award rather than with the proposal submission. The due date for questions remains unchanged, with a subsequent amendment anticipated to address all inquiries received. Offerors must acknowledge receipt of this amendment to ensure their offer is considered.

The Department of Veterans Affairs (VA) has issued a Presolicitation Notice, 36C24925R0056, for Community Based Outpatient Clinic (CBOC) Services in Dyersburg, Tennessee. This notice, which supersedes the previous RFP No. 36C24924R0058, outlines the upcoming opportunity for contractors to provide these services. The solicitation is set to close on January 16, 2026, at 10 AM Central Time, Chicago, USA. The contracting office is located in Murfreesboro, TN, and inquiries should be directed to Contract Specialist Laura Edelman via email at laura.edelman@va.gov, as phone calls will not be accepted. The Product Service Code is Q201 and the NAICS Code is 621498.

This government solicitation (36C24925R0056) from the Department of Veterans Affairs is an Indefinite-Delivery Indefinite-Quantity (IDIQ) contract for Community Based Outpatient Clinic (CBOC) services in Dyersburg, Tennessee. The contract has a one-year base period and nine option periods, with a guaranteed minimum of $500,000 and a ceiling of $47,000,000. Services include primary and mental healthcare, with payment based on a Per Member Per Month (PMPM) capitated rate. The contractor must provide a clinic facility in Dyersburg, within 10 miles of a hospital with emergency services. Staffing requirements mandate specific Patient Aligned Care Team (PACT) ratios and qualifications for physicians, advanced practice registered nurses, and physician assistants, with a focus on continuous care and adherence to VA performance and quality standards.

The Quality Assurance Surveillance Plan (QASP) for RFP 36C24925R0056 outlines the government's method for evaluating contractor performance for Outpatient Site of Care Service. This living document details what will be monitored, how, by whom, and how results will be documented. Key government roles include the Contracting Officer (CO), Carol Franklin, responsible for overall contract compliance, and the Contracting Officer’s Representative (COR), Christy Wright, who handles technical administration and surveillance. Performance standards are defined across domains such as Access, Quality of Care, Panel Management, Veteran Satisfaction, Coordination of Care, Environment of Care (EOC), and Pharmacy. Surveillance methods include dashboards, direct observation, and periodic inspections. The QASP specifies acceptable quality levels (AQLs) for each performance requirement, and failure to meet these may result in an equitable price reduction. Performance is documented through Contract Reports (CRs), which can lead to corrective action plans and inform Contractor Performance Assessment Reporting System (CPARS) ratings. CPARS ratings range from Exceptional to Unsatisfactory, with specific criteria for each. The QASP emphasizes objective and fair evaluation, with quarterly performance reporting by the COR to the CO.

The VA's 2015 PACT Space Module Design Guide outlines a new approach to primary care facility planning, transitioning to a patient-centered, team-based model. It introduces the PACT Space Module as a standardized planning unit to support operational flows, emphasizing three core design strategies: a collaborative work environment, separation of patient and staff flows, and modular, adaptable design. The guide details functional goals like bringing care to the patient, streamlining processes, and enhancing teamwork. It also covers practical aspects such as patient experience, clinic organization, and special considerations for interiors and technology. The document aims to standardize primary care space development across all VA facilities, improving efficiency, patient experience, and care coordination through flexible and integrated clinic designs.

The Small Business Subcontracting Plan template, effective September 10, 2021, guides federal prime contractors in formulating subcontracting plans per FAR 52.219-9(d). It outlines requirements for both individual and commercial plans, including specific goals for various small business categories such as veteran-owned, service-disabled veteran-owned, HUBZone, small disadvantaged, and women-owned small businesses. The plan details exclusions from subcontracting spend, methods for goal development and identifying potential sources, and requirements for including indirect costs. It also specifies the role of a program administrator, the flow-down clause for subcontractors, reporting obligations via the Electronic Subcontracting Reporting System (eSRS), and meticulous recordkeeping. Contractors must ensure equitable opportunity for small businesses, commit to utilizing those identified in bids, and adhere to prompt payment regulations for small business subcontractors. The document emphasizes compliance and good faith efforts to maximize small business participation.

The Department of Veterans Affairs (VA) Pharmacy Benefits Management Strategic Health Group has released its January 2023 National Formulary (VANF) for the Community Care Network. This comprehensive list details medications and medical supplies, including urgent emergent formulary drugs, national restrictions for antibiotics, and dosage-form-specific listings. The document outlines three levels of Prior Authorization (PA-N, PA-V, PA-F) to ensure appropriate medication use for Veterans. It categorizes a wide range of products, from oral solutions and tablets to injections, topical creams, and medical supplies like catheters and bandages. The formulary emphasizes specific dosage forms and includes various therapeutic classes, such as antivirals, antibiotics, pain relievers, and endocrine agents. Restrictions on antibiotics are determined at local or VISN levels, highlighting a decentralized decision-making process for certain drug classes. This document serves as a crucial guide for healthcare providers within the VA system, ensuring standardized yet flexible access to essential medications and supplies.

The Department of Veterans Affairs (VA) has issued staff-specific guidance for developing Suicide Prevention Safety Plans and completing Suicide Behavior and Overdose Reports (SBORs). A Safety Plan is a collaborative clinical intervention for suicidal crises, while SBORs collect data on suicidal behaviors and non-suicidal overdoses. Staff members can develop Safety Plans if their credentials are listed with a “Yes” in the provided table, the local Chief of Staff concurs, and safety planning is within their facility's scope of practice. Similarly, staff can complete an SBOR if their credentials are listed with a “Yes” and it's within their facility's scope of practice. The guidance provides a table of credentials, including MD/DO, Licensed Psychologist, Clinical Pharmacist Practitioner, LCSW/LMSW/LISW, LMFT, LPMHC, Addiction Therapist, RN, APRN, PA, and Rehabilitation Counselor, all of whom are authorized for both. LPNs, Peer Support Specialists, UAP, Psychological Technicians, Social Work Assistants, and Vocational Rehabilitation Specialists are not authorized. Trainees in authorized categories may complete these tasks with an appropriate co-signer.

The Department of Veterans Affairs (VA) has issued staff-specific guidance for its Suicide Risk Identification Strategy, detailing who is authorized to complete the Columbia-Suicide Severity Rating Scale Screener (C-SSRS Screener) and the Comprehensive Suicide Risk Evaluation (CSRE). The guidance specifies that a VHA Health Care Provider who is a licensed independent provider (LIP) or advanced practice provider employed in the job series associated with said license must complete the CSRE, which includes a detailed assessment and disposition. The document provides a comprehensive table outlining which staff — including MD/DOs, Licensed Psychologists, Clinical Pharmacist Practitioners, various licensed social workers and therapists, nurses, and physician assistants — are permitted to complete each assessment. While many roles can complete the C-SSRS Screener, fewer are authorized for the CSRE. Exceptions and specific conditions are noted for certain roles, such as Clinical Pharmacist Practitioners and Rehabilitation Counselors. The guidance also clarifies that trainees can complete steps marked with “Yes” under supervision, and emphasizes the need for adequate staff training in both assessments. Peer Specialists are exempt from the universal screen. This directive ensures appropriate qualifications for staff conducting suicide risk assessments within the VA.

This government file details a 12-month period's vaccine and medication usage, likely for an RFP, federal grant, or state/local RFP related to healthcare supply or service provision. The document lists various medications and vaccines with their respective quantities administered or utilized. High-usage items include Flu-7 (189), T-DAP (163), Zoster Vaccine (121), Ketorolac (128), RSV (102), Flu (65 ^ 113), Covid (51), Prevnar 20 (50), and Pneumovax (41). Several items like Aspirin, Ammonia, Abilify, Depo-medrol, Debrox, Epi Injection, Hep A, HPV, Ipratropium Bromide, Nitro, 1% Sulfa Cream, Dexamethasone, Haldol, Cyanocbalamine, Lidocaine w epi, Medroxy progesterone, Nalox-one hcl, and Risperdol show zero usage. This data is critical for understanding medical supply demands and can inform procurement decisions, resource allocation, and public health planning within a government healthcare context.

The REACH VET (Recovery Engagement And Coordination for Health - Veterans Enhanced Treatment) program outlines a six-step process for providers to manage high-risk Veterans. Providers receive notifications about identified Veterans, with an optional step to access a dashboard for clinical signals. The core of the process involves re-evaluating the Veteran's comprehensive care, including screenings, diagnoses, and treatment plans, to ensure access to evidence-based services. Providers are then directed to consider treatment enhancement strategies such as improved communication, safety planning, and increased monitoring. A crucial step involves outreach to the Veteran, guided by

This PBM Guidance outlines recommendations for integrating clinical pharmacy services at contracted Community-Based Outpatient Clinics (CBOCs) and rural locations, addressing a shortage of VA primary care physicians and medication management needs. It emphasizes that contracted pharmacists must adhere to state pharmacy practice acts regarding collaborative practice, prescriptive authority, and ordering diagnostic tests, which differ from the scope of practice for VA employees. Facilities must assess state laws before determining service provision, and the Chief of Pharmacy should be involved in the hiring, competency assessment, and ongoing oversight of contracted pharmacists. The document also suggests alternative service models, such as hiring VA clinical pharmacists or using telehealth, if state laws are restrictive. The goal is to ensure consistent, high-quality care for Veterans across all VA and contracted sites.

REACH VET is a Department of Veterans Affairs (VA) program that utilizes predictive modeling and Veterans Health Record data to identify Veterans at high statistical risk for suicide and other adverse health outcomes. The program aims to supplement clinical strategies by alerting facilities to Veterans within the top 0.1% risk category, providing a two-year health record summary to streamline clinical review, and offering an additional data point for treatment conceptualization. While identified Veterans are at high statistical risk, this doesn't indicate acute clinical risk, emphasizing the need for outreach and support. The REACH VET process integrates into existing workflows, promoting a holistic, multi-disciplinary approach to care. Studies show positive impacts, including increased outpatient appointments, reduced missed appointments, greater initiation of suicide prevention safety plans, and decreases in inpatient mental health admissions and documented suicide attempts. The program provides resources for support and information.

The document "36C24925R0056 – Dyersburg CBOC Attachment D.19 – Past Performance Survey" is a past performance survey form for federal government RFPs, specifically for outpatient clinic services or similar medical staffing. The purpose is to evaluate an Offeror's past performance through a structured questionnaire. Evaluators are requested to complete and submit the survey directly to Laura Edelman by January 9, 2026, at 10:00 AM CT; submissions from the Offeror will not be accepted. The survey uses a five-tier rating system (Outstanding, Above Average, Satisfactory, Marginal, Unacceptable) and requires detailed comments for Marginal or Unacceptable ratings. It assesses compliance, timeliness, management effectiveness, quality control, flexibility, reliability, responsiveness, and professional conduct. The survey also inquires about any past contractual issues, willingness to re-award, customer satisfaction, problem notification, and invoice accuracy. This comprehensive evaluation tool ensures that the government can make informed decisions based on a vendor's historical performance.

Attachment D.2 - 36C24925R0056 Dyersburg CBOC outlines the Contractor Certification for the Immigration and Nationality Act of 1952, as amended. The contractor must comply with all legal provisions of this act and related laws enforced by Homeland Security, Immigration and Customs Enforcement, and the U.S. Department of Labor, especially concerning non-immigrant foreign nationals working under contract for the Department of Veterans Affairs (VA). Key requirements include not knowingly employing, contracting, or subcontracting with illegal aliens or foreign nationals in violation of their status, and complying with all "E-Verify" requirements consistent with Executive Order 12989 and applicable Federal Acquisition Regulations. Failure to comply may result in the prohibition of foreign nationals from working on VA-related services and could lead to contract termination for breach. The contractor is also required to obtain similar certifications from its subcontractors. The certification warns against making false, fictitious, or fraudulent claims, which may lead to prosecution under 18 U.S.C. 1001.

Attachment D.3, titled "Organizational Conflict of Interest," is a certification statement for Solicitation #36C24925R0056, concerning Dyersburg CBOC Services for the Lt. Col. Luke Weathers, Jr. VAMC Veterans Administration. Contractors must certify that their key personnel and temporary emergency substitutions have no present, planned, or past financial, contractual, or organizational conflicts of interest related to the services provided under the solicitation. Alternatively, contractors can submit a detailed statement describing any such conflicts, including those involving consultants and subcontractors. The statement must also outline how the contractor's systems or actions would avoid or mitigate these conflicts. This document ensures transparency and ethical conduct in government contracting by requiring full disclosure of potential conflicts of interest, thereby upholding the integrity of federal procurement processes.

This document outlines the Department of Veterans Affairs (VA) Contractor Rules of Behavior, establishing terms and conditions for contractors accessing VA data, systems, and sites. Contractors must acknowledge no reasonable expectation of privacy and consent to monitoring by VA and law enforcement. Unauthorized access or misuse of federal systems is prohibited and subject to legal penalties. Contractors must comply with VA security directives, report incidents, and adhere to strict rules regarding system access, data protection, password management, and authorized software use. Personal use of VA systems is forbidden, and contractors must protect government property and sensitive information. Additional conditions apply to the use of non-VA IT resources, emphasizing direct network connections and prohibiting dual connections. Subcontractors are bound by the same security requirements. This agreement does not create legal rights against the U.S. Government but ensures contractor accountability for securing VA assets.

The document outlines the Department of Veterans Affairs (VA) patient enrollment system, which prioritizes Veterans for healthcare benefits based on their service-connected disabilities, special eligibility classifications, and income levels. It defines eight priority groups (PGs), with Group 1 comprising Veterans with 50% or more service-connected disabilities, those deemed unemployable due to service-connected conditions, or Medal of Honor recipients. Subsequent groups detail criteria for lower disability ratings, former POWs, Purple Heart recipients, catastrophically disabled Veterans, and those with varying income levels. The document also specifies eligibility for enhanced benefits for combat Veterans for five years post-discharge and clarifies sub-priorities for noncompensable 0% service-connected and nonservice-connected Veterans, including those enrolled before or after specific dates and whose income exceeds limits by 10% or less. It also identifies Veterans not eligible for enrollment, such as noncompensable 0% service-connected for non-SC conditions and nonservice-connected. This system ensures comprehensive healthcare access is structured and readily available based on established criteria.

Attachment D.6 outlines the detailed deliverables and reporting requirements for contractors and TVHS in compliance with contract terms, federal acquisition regulations, and VA policies. It serves as a guide, emphasizing that all items listed in the Performance Work Statement are mandatory, even if not explicitly in the table. Key submission categories include proposals (past performance, facility information, management plans, staffing, pricing, and cybersecurity certifications), post-award documentation (staff licenses, background checks, PIV cards, and accreditation), incident reports (patient complaints, adverse events, and malpractice claims), and ongoing submissions (time logs, QASPs, and annual reports). The document stresses accuracy, completeness, and timely submission for all required items to ensure compliance and effective contract management.

Attachment D.6 outlines the detailed deliverables and reporting requirements for contractors engaged with TVHS, particularly for federal government RFPs related to CBOC services. It serves as a guide, emphasizing that contractors are responsible for the accuracy, completeness, and timely submission of all reports, even if not explicitly listed in the provided table. Key deliverables include past performance references, descriptions of healthcare operations experience, proposed facility information, management plans (including quality control and staffing), continuity of care plans, staff certifications and licenses, subcontracting plans, pricing, OIG list comparisons, laboratory accreditations, and insurance. The document also details ongoing requirements such as cyber security training, patient complaint summaries, adverse event reporting, malpractice claims, and various annual and monthly reports like workload reports and AED device checks. Submissions are required at various stages: with the proposal, upon award, upon incident, and periodically throughout the contract term.

The Department of Veterans Affairs (VA) VHA Service Center Personnel Security provides comprehensive services for meeting contractor security requirements, aligning with OPM and federal regulations. This includes fingerprint submission and adjudication, verification of existing investigations for reciprocity, initiation of new investigations through Little Rock Special Investigations Center, and management of PIV Badges. The Contract Security Services Request form is crucial for initiating the security verification process, ensuring all listed individuals are fingerprinted, background investigations are current, and PIV badges are adjudicated. The process requires detailed contract and contractor employee information, including proof of citizenship for foreign-born individuals and three consecutive years of U.S. residency for PIV credentials. Various investigation levels are outlined, from Fingerprint Only (SAC) to high-level (Tier 4), with specific requirements for PIV-I and full PIV badges. The document also includes forms for fingerprint requests, the Optional Form 306 for Federal Employment, a supplemental form for large rosters, an authorization for release of credit information, and a Self-Certification of Continuous Service form. All submissions must adhere to specific naming conventions for PDF files.

The Department of Veterans Affairs (VA) Office of Construction & Facilities Management has developed a prototype for standardized design and construction of Community Based Outpatient Clinics (CBOCs). This initiative aims to reduce costs and schedules by utilizing standardized planning and design modules, potentially incorporating off-site construction methods. The prototype integrates the Patient Aligned Care Team (PACT) Space Module, supporting the VA's transition to a Patient-Centered Medical Home (PCMH) model of care. The study involved developing standard designs for three clinic sizes (20,000, 50,000, and 80,000 NUSF) for various functional areas and ensuring compatibility with modular construction. Key aspects include standard structural bay designs, universal room concepts for flexibility, and detailed conceptual diagrams illustrating patient and staff flow to optimize efficiency and patient experience. The project outlines growth options for CBOCs, including linear, L-shaped, and two-story configurations, to accommodate increasing patient loads and specialized services while maintaining operational efficiency.

This document, "STANDARDS ALERT 003C2B-SA-017R01b," dated August 1, 2021, introduces and details the Office of Information and Technology (OIT) Infrastructure Standard for Telecommunications Spaces v3.1. This new standard, developed by OIT Data Center and Infrastructure Engineering (DCIE), is mandated for planning, design, and construction of all VA facilities, serving as the primary technical guide for information technology infrastructure. The alert addresses known conflicts and issues between the OIT IS and existing Technical Information Library (TIL) Telecom Standards, covering aspects such as room names, minimum floor area, height, layout, HVAC configuration, and cable type. It outlines procedures for resolving conflicts, documenting solutions, and engaging DCIE. The purpose is to enhance project team awareness and access to the OIT IS, improving planning, reducing redesign costs, and ensuring VA IT infrastructure leverages technological advancements. The document also provides background on OIT's authority, revisions to the alert, and future plans for integrating OIT standards into the TIL.

The Department of Veterans Affairs (VA) IT Operations and Services has issued the "OIT Design Guide Templates" (dated December 27, 2018), which outlines design specifications for critical telecommunications spaces in both clinical and non-clinical environments. This guide, developed by Data Center and Infrastructure Engineering, provides detailed templates for various data center sizes (extra small, small, medium, large, extra-large), telecommunication entrance rooms, and telecommunication rooms. It includes requirements for electrical systems (e.g., outlets, bonding busbars, service panels, power busways with metered headends), mechanical/structural elements (e.g., air conditioning, floor composition, wall construction, lighting), and telecommunications infrastructure (e.g., plywood backboards, cable trays, racks, cabinets). The document also details power distribution schematics, including busway power distribution and Zone PDU power distribution, emphasizing redundancy and specific PDU unit specifications. The purpose of this guide is to standardize the design and implementation of IT infrastructure within VA facilities.

The document, identified as "36C24926D0006 Holly Springs CBOC," appears to be a repetitive identifier or title for a government procurement, grant, or solicitation. The repeated nature suggests it is a unique reference number for a specific project concerning a Community-Based Outpatient Clinic (CBOC) in Holly Springs. Given the context of federal government RFPs, federal grants, and state/local RFPs, this identifier would typically be used to track and manage all associated documents, bids, and contracts related to the establishment, operation, or renovation of the Holly Springs CBOC. The repetition emphasizes the project's singular focus and its official designation within a government agency's portfolio.