2- Performance Work Statement 36C248-22-Q-0162.pdf

PERFORMANCE WORK STATEMENT

1.0 - Scope of Services:

The Department of Veterans Affairs (VA) West Palm Beach VA Medical Center (VAMC) located at 7305 N Military Trail West Palm Beach, Florida has a requirement for Home Oxygen services. The Contractor shall provide all supplies, materials, equipment, labor, supervision, management, transportation, safety management, infection control, repairs, maintenance, storage of VA owned concentrators and in-service training for patients to include patient education. The Contractor shall maintain at the proposed servicing facility adequate licensed certified or registered respiratory therapy staff to provide all services, instructions, follow-up and/or emergency visits.

The Contractor shall furnish, provide, install and service medical oxygen equipment, high-pressure cylinder, VA owned/concentrator and/or liquid systems, portable systems, emergency back-up systems and supplies to eligible VA patients as required by the WPB VAMC. Services provided shall be all inclusive of deliveries and transportation within the seven (7) county catchment areas of Hendry, Glades, Indian River, Martin, Okeechobee, Palm Beach and St Lucie. Prices quoted shall be all inclusive of deliveries and transportation within the (7) county catchment areas, and equipment, safety inspections, repairs, maintenance, and in-service training for patients to include patient education. The WPB VAMC currently provides supplies to an estimated 610 oxygen using patients on a monthly basis.

The volumes or amounts shown in the solicitation are estimates only and impose no obligation on the VA either minimum or maximum. The contract shall be for the actual requirements of the VA as ordered by the VA during the life of the contract. The Contracting Officer’s Representative (COR) or designee will provide the Contractor with notification to initiate individual patient service requirements via fax or encrypted electronic means (telephonic for emergencies) and will also provide the Contractor with notification of VA initiated discontinuance of service. The notification may be made orally or by encrypted e-mail but will be received in writing to the Contractor within three (3) business days.

2.0 - Geographic Area of Coverage:

The Contractor is responsible for deliveries to VA patients in the following Florida counties:

Hendry, Glades, Indian River, Martin, Okeechobee, Palm Beach, St. Lucie.

MONTHLY AVERAGE: 610

Distribution of patients on West Palm Beach Home Oxygen will vary from month to month as patients are added and discharged from the program for a variety of reasons.

3.0 - Contractor Qualifications:

The Contractor shall possess all licenses, permits, accreditations, and certificates as required by local, state and federal law. The Contractor shall meet TJC standards. The Contractor shall meet or exceed Join Commission accreditation of healthcare standards. The VA in its on-going effort to ensure all patients are provided the highest quality care requires each VA facility to meet or exceed the standards of the Joint Commission. The VA also has a responsibility to ensure contractors meet the standards articulated by the Joint Commission. The Joint Commission standards can be accessed at www.jointcommission.org. The Contractor shall maintain this accreditation through the life of the contract and evidence of accreditation shall be submitted to the Contracting Officer (CO) and Contracting Officer’s Representative (COR) prior to contract award and at the time of option exercise. If the Contractor is resurveyed by an accrediting body during the contract term, the contractor shall notify the Contracting Officer of survey date, the outcome of the survey and provide copies of new certificates as issued. The Contracting Officer’s Representative (COR) shall be notified if a subcontractor is ever used within one (1) business day.

The Contractor shall have a physical location prior to the award of the contract which houses the service office, warehouse, dispatch of vehicles and other functions related to the performance of service within our catchment area and preferably within 30 minutes from the Medical Center at 7305 N Military Trail, West Palm Beach, FL 33410.

The Contractor shall have at least three (3) years’ experience in successfully administering basic home oxygen and aerosol therapy to adult and geriatric patients.

The Contractor shall replace all appropriate VAMC authorized equipment presently located in homes of patients with his/her own equipment as soon as possible after award, but not to exceed 45 calendar days. The change shall include delivery, setup instruction and shall be accomplished with the least disruption in service to the VAMC patient as possible. Cost will be prorated upon setup and discontinuance with equipment pickup no more than one billing cycle.

All services will be performed in the patient’s place of residence. The area of service shall be the West Palm Beach VAMC’s catchment area. The equipment needs are subject to change as determined by the prescribing physician.

4.0 - Work Hours:

The Contractor shall, at a minimum, provide services in performance of this contract through scheduled visits, Monday through Friday between the hours of 8:00am and 4:30pm EST. Exceptions shall include the case of emergencies.

The VA observes the ten (10) Federal Holidays listed below:

New Year’s Day, Martin Luther King’s Birthday, Presidents Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veteran’s Day, Thanksgiving Day and Christmas Day.

http://www.jointcommission.org/

5.0 - Emergency Services:

The Contractor shall have an established communication system that supports 24-hour emergency services seven days a week. The Contractor shall be able to provide services at the patient’s home within a maximum of six (6) hours of call.

The Contractor shall ensure all patients have a minimum of non-electrical oxygen supply to last three times the Contractor’s response time to a call. The minimum supply shall take into account each patient’s prescription flowrate and distance from the Contractor’s location; actual supply levels may differ from patient to patient, as long as each patient has oxygen supply to last a minimum of three times the Contractor’s response time. If the Contractor is unable to respond to an emergency service call within six (6) hours, it shall arrange for another supplier to provide oxygen at the Contractor’s expense. A written explanation of Contractor’s inability to provide emergency service shall be provided to the COR or designee within two business days. Liquid oxygen supply may be considered for backup oxygen; however, oxygen must be maintained at the minimum three times the Contractor’s response time, and the cost of any additional equipment such as extra stationary units used solely to maintain the minimum level of backup oxygen shall be borne by the Contractor.

The Contractor shall notify the COR or designee immediately in the event of a disaster, natural or otherwise, that may affect the services covered under the contract.

Contractor shall submit an Emergency Contingency Plan for natural disasters with a detailed proposal.

An updated Emergency Contingency Plan shall be provided annually to the COR and in addition, the Contractor will perform with the COR during yearly hurricane or natural disaster drills as decided by WPB VAMC leadership. Contractor shall provide names and phone numbers of suppliers that will provide services in the event of any disaster where the Contractor cannot meet the needs of VA patients.

6.0 - Patient Travel:

In some instances, the patients may travel out of the service area and require oxygen for travel. The Contractor shall be responsible for subcontracting for oxygen services for these patients. The Contractor shall instruct and inform patients in writing and patients must agree that they will be financially responsible for any/all non-returned equipment taken outside the catchment area. The Contractor shall obtain the patient’s signature indicating that they agree to the terms. It shall be the Contractor’s responsibility to invoice the West Palm Beach VAMC separate from the monthly billing charges to be paid on an individual basis. Invoices received directly from the sub-contractor shall be rejected. The WPB VAMC will be responsible for the first thirty (30) to sixty (60) days after a patient moves to another location. It will be the patient’s responsibility to enroll at the nearest VHA, make an appointment with Respiratory/Pulmonary for transfer of home oxygen services and receive a new prescription. In cases involving vacation travel (via automobile, marine vessel, and/or air) Contractor shall provide VA owned transport loaner concentrator for travel.

The Contractor shall be responsible for infection control and function/maintenance check prior to issue/reissue.

7.0 - Patient Assessment:

The Contractor will provide an in-home initial patient setup and installation of prescribed equipment within six (6) hours of notification. The Contractor will provide the patient a welcome packet and complete a Home Oxygen Equipment Check when required, per manufacturer’s instructions, or complete quarterly at a minimum. An adhesive sticker, depicting the date of inspection and the date of the next required inspection will be annotated using a permanent marker, on said equipment. If indicated by the COR (or designee), the Contractor will assess or reassess Home Oxygen Equipment and/or patient’s needs. The Contractor will document the patient receipt of all forms in their patient database.

The Delivery Driver or Contractor designee will immediately contact the WPB VAMC COR when one of the following occurs:

• Non-Compliance of prescription

• Any unsafe conditions observed which may preclude the installation or continuance of oxygen services.

The COR will inform the WPB Respiratory Care Section who will alert the WPB clinical provider and communicate appropriate interventions to the Contractor.

The Delivery Driver will provide the patient with a WPB “Home Oxygen Welcome Packet” on the first visit. This packet will include, but not be limited to, the following:

• WPB VAMC Patient Information Guide that includes information regarding Advance Directives, Patient’s Rights & Responsibilities, and other general information.

• Mission, Vision and Scope of Home Oxygen Care Services.

• Complaint Process.

• Emergency Preparedness Information.

• Emergency Contact Names and Phone Numbers.

• Consent for Participation in Home Oxygen Care.

• Pain Information.

**The presence of the “Home Oxygen Welcome Packet” shall be inspected upon each subsequent delivery to the patient and will be replaced if the packet is missing.

8.0 - Care Planning:

The WPB VAMC clinical staff will be responsible for initiation and directing the patient’s plan of care and prescription requirements.

The Pulmonologist will determine the individual prescription of the patient.

The Contractor will be responsible for providing documentation of the initial home installation, assessment and reassessment.

The Contractor is responsible for the patient’s individual home care plans. Each home assessment and reassessment will be reviewed, and an individualized plan of care will be implemented based upon the information gathered from the assessment/reassessment forms.

The Contractor’s initial care plan will be completed within seven (7) days of receipt of the Delivery Driver’s initial assessment.

9.0 - Quality Assurance, Coordination, Supervision and Evaluation of Care/Services:

WPB VAMC clinical staff will coordinate, supervise and evaluate the care and services required by outpatients to include initiation of prescriptions for home oxygen and various equipment items, devices or other appliances which may be medically indicated for the continuation of care in their home environment.

The COR will have oversight responsibility to ensure Contractor services are in compliance with the terms of the contract.

Chief of Prosthetics, COR or Prosthetic Representatives will make unannounced Contractor site visits at a minimum bi-annually.

Chief of Prosthetics, COR or Prosthetic Representatives will make random patient home visits on a quarterly basis. A Contractor’s representative might be expected to join the team on these visits and will be provided a seven (7) calendar day notification in advanced notice to participate. In addition, the Chief of Prosthetics, COR or Prosthetic Representatives may request to take part on a random day delivery schedule to accompany the Delivery Driver during their WPB VAMC delivery schedule. A minimum sampling of 5 of West Palm Beach VAMC home oxygen patients per quarter will be visited by VA staff annually. On a limited basis, it may be necessary to make an emergent visit which will be coordinated with the Contractor.

WPB VAMC Chief of Prosthetics, COR or designee will communicate with the Contractor to discuss high risk, problem-prone, and quality improvement issues. These issues shall be handled by Contractor within three (3) business days and assessment provided to the COR or designee in writing.

10.0 Scheduling Visits:

See the Provision of Services selection below for the Contractor’s responsibility for the scheduling of equipment installation, assessment, monthly reassessments and equipment pickup.

11.0 - Discharge Planning:

Discontinuation of any treatment or discharge from a treatment plan will be determined by WPB VAMC clinical staff. The Contractor shall not have any role and is relieved of any responsibility for the discharge of patients from the WPB VAMC Home Oxygen Program, however, the Contractor is responsible for notifying the COR or designee if a patient requests their equipment be picked up prior to discharge planning taking place. The Contractor shall be notified via consult requesting discharge of the Home Oxygen Program.

12.0 - Documentation:

All documentation associated with the above patient activities/encounters will be the responsibility of attending hospital clinical staff and will be entered into appropriate patient records on a recurring basis.

The Contractor shall keep on file a copy of the Home Oxygen Therapy Program checklist for all-initial assessments and reassessments. All documentation kept on file by the Contractor shall be accessible to the Chief of Prosthetics, COR or Prosthetic Representatives Site Visit team to ensure compliance of the Contractor.

13.0 - Infection Control:

The Contractor shall comply with TJC and WPB VAMC policies and procedures on infection control and infection surveillance. The Contractor employee health files shall contain a copy of the Contractor Staff Member’s annual TB test results and Hepatitis B vaccination documentation. If a Contractor staff member refuses to either test, such refusal shall be documented in writing and shall be maintained in their file. All Contractor staff involved in the delivery, pickup and storage of home oxygen will be instructed on the importance of infection control and personal hygiene and their responsibilities in the infection control program. Procedures shall address personal hygiene, aseptic procedures, staff health and transmitted infections and appropriate cleaning, sanitation and storage of equipment. Appropriate staff shall be instructed in the identification, handling and disposal of hazardous and/or waste materials in a safe and sanitary manner in accordance with applicable laws and regulations.

Contractor staff members with contagious illnesses shall have no contact with patients or clean equipment. Exceptions would be Contractor staff members with a mild cold or similar condition. In such cases, gloves will be worn, and contact will be extremely limited.

Contractor staff members responsible for the delivery, setup, cleaning, repairs and/or storage of medical equipment shall be instructed in the safe and appropriate use of said equipment. Upon delivery, they shall provide appropriate instructions to the patient and/or caregiver regarding the safe and appropriate use of the equipment and basic home safety matters in regard to said equipment. This instruction shall include a return demonstration from the patient/caregiver showing that they understand what they were shown.

Any accidents or injuries related to equipment and safety management will be investigated by the Contractor. Equipment malfunctions resulting in any sentinel event such as serious injury or death will be reported to the manufacturer and the Chief of Prosthetics or COR within forty-eight (48) hours of the Contractor’s knowledge of said event(s). The Contractor will promptly notify the PSAS of any hazards, defects or recalls by the manufacturer for any equipment purchased from the Contractor.

The Contractor shall have an Emergency Contingency Plan designed to provide continuing support appropriate to the services provided in the event of an emergency that would result in interruption of patient services. The Contractor shall have disaster plan and appropriate personnel who are aware of this plan and their roles/responsibilities in the event of a contingency.

14.0 - Provision of Services:

The VA is to furnish the Contractor a roster of current patients fifteen (15) calendar days prior to the preceding of the contract. All deliveries (if there is a change of vendors) must be in place and operational within thirty (30) calendar days of the start of the contract. All initial deliveries must be done in a methodical sequence. Contactor is to provide a plan of installation to the Contracting Officer within five (5) calendar days after the start of the contract.

Installations will be completed in a systematic and methodical manner, i.e., all patients in any two/three counties per week. Setup of all patients in any given area must be completed before the beginning installation in another area. Upon completion of installation each patient is to begin using the equipment and cease using the incumbent’s equipment. After completion of installation, the Contractor will immediately notify the WPB VAMC, who will, in turn, advise the incumbent Contractor to pick up their equipment.

Delivery/Setups are required to be made to the destination of the patient’s residence within five (5) hours after discharge from the WPB VAMC. New Home Oxygen Outpatient delivery/setups are required to be completed within twenty-four (24) hours after Contractor receives the script via fax. The Contractor must contact the patient within two (2) hours after the receipt of the fax.

Upon delivery of oxygen refills, the Contractor shall inspect the patient’s existing equipment and supplies, and clean, sterilize or replace same whenever necessary or required the awardee’s contract.

15.0 - Placement of Orders:

Individual orders for Home Oxygen services may be authorized by phone/fax/email by the following:

Home Oxygen Coordinator (COR)

• Chief of Prosthetics

• PSAS Staff Representative

• Clinical Program Leader Cardio-Pulmonary Services

16.0 - Hospital Discharge:

The Home Oxygen Coordinator will act as intermediary between discharging ward, oxygen contactor and patient/caregiver to facilitate time; date of oxygen delivery/setup in the patient’s residence.

Upon discharge from hospital, the patient will be provided a portable E system by PSAS to facilitate oxygen therapy while in transition to home. Portable system consists of one (1) E tank cylinder with regulator and nasal cannula. An established inventory of these items will be maintained in the PSAS area and replaced, as needed, by the Contractor. The prescription received by the Contractor will notify Contractor that patient has been discharged with equipment so that items can be incorporated into patient’s inventory of equipment/supplies.

Orders for supplies and services will be placed by the COR or designee. Prior to the delivery of equipment/supplies for the setup in the patient’s residence, the Contractor shall setup, adjust and instruct the patient and caregiver on all equipment and services that are being prescribed and instruct the patient in the proper use of equipment and supplies as necessary. The Contractor shall provide education to each patient and caregiver at the time of setup and assess the need for reinforcement during visits. This information is to be presented verbally, demonstrated and the material covered shall be in written form and left with the patient/caregiver and copies shall be kept at the Contractor’s facility.

17.0 - Safety:

At the time of initial setup and during home visits, the Contractor shall perform an assessment of the patient’s home and environment, including a Fall Risk Assessment, in accordance with TJC Standards, and maintain documentation of assessments in the individual patient’s file or folder. At the time of setup and during home visits, the Contractor shall ensure smoke alarms are present and instruct the patient to test smoke alarms monthly. In the event the Contractor finds no smoke alarms present in the home, the Contractor shall contact the COR or designee, in writing, so appropriate action can be taken.

The Contractor shall notify the COR or designee during any home visit if the Contractor’s staff determines that the presence of oxygen in the home presents such a danger that the oxygen must be removed, on in the initial case of setup, not placed in the residence.

The Contractor shall verbally notify the COR or designee by the next business day of any unsafe conditions observed in the VA patient’s home that preclude the installation or continuance of oxygen service. Unsafe conditions may include, but are not limited to, fire safety hazards, oxygen safety hazards, patient abuse by family and caregivers, or any instance that places the patient or Contractor’s staff in immediate danger. The Contractor shall furnish written documentation of the safety hazard to the COR or designee within one (1) business day of the incident.

The Contractor shall check the adequacy of the electrical outlets where any electrically powered oxygen equipment is plugged into in the patient’s residence and immediately report unsafe conditions to the COR or designee. It is the patient’s responsibility to have the appropriate electrical system in their residence. The WPB VAMC shall not be responsible or liable for any unsafe electrical conditions caused by the patient or the Contractor. Any alterations to the patient’s residence will be the responsibility of the patient/caregiver. If ordered equipment cannot be safely installed, the prescribing WPB VAMC physician shall be notified by COR after notification from the Contractor.

The Contractor shall conduct a Fire Risk Assessment of all new patients who smoke. A reassessment is to be conducted when renewing an oxygen prescription, or at any time there is a change in the patient’s oxygen prescription or equipment. The Government will alert the Contractor to those patients who are at high-risk for smoking while using oxygen. Checklists used by vendors for medical gas follow-up service must, at minimum, cover the following items:

“No Smoking, Oxygen in Use” signs are provided and posted

Smoke alarm is present and alarm sounds when tested

Patient has been instructed to shut off oxygen supply, remove cannula and wait for oxygen to dissipate from clothing, then go outside and smoke.

Verification that the patient has been instructed to test all smoke detectors monthly

Patient and family or cohabitants are given educational materials regarding the hazards of smoking and using an open flame near oxygen.

18.0 - Maintenance and Back-Up Equipment:

The Contractor is responsible for the inspection and maintenance of all equipment and supplies located in the patient’s home.

The Contractor shall comply with appropriate universal precautions in the cleaning and storage of oxygen systems and related equipment as required in the delivery, recovery and storage process.

The Contractor shall maintain a system for documenting the preventative maintenance, inspection, repair history of all equipment utilized for the provision of oxygen therapy.

The Contractor must provide, at no extra cost, a backup manual oxygen system, such as an “H” or “K” tank, for patients prescribed home oxygen to provide a source of oxygen during electrical power failure.

19.0 - Invoice Submission:

Bills for services rendered will be submitted monthly. The billing period will be from the first day of each month through the last day of the month. Invoices shall be submitted promptly to the WPB VAMC Prosthetics and Sensory Aids Service (PSAS) no later than the ten (10) calendar days of the month following the month in which the services were rendered. All invoices shall include the contract number, name of patient, last four of the patient’s social security number, services rendered and service date. Patient or patient representative shall sign receipt for oxygen services or equipment.

Invoices for oxygen services ordered by the WPB VAMC preferably will be provided by encrypted e-mail, paper mailed, or hand carried to the following address:

West Palm Beach VAMC Prosthetics & Sensory Aids Service (121) 7305 N. Military Trail West Palm Beach, FL 33410

No charge will be made by the Contractor after the effective date of expiration of the contract. If a change in vendors occurs, the Contractor shall have fifteen (15) calendar days to pick up their equipment. The fifteen (15) days will begin upon notification by the WPB VAMC’s COR.

The Contractor shall not deliver or bill patients for oxygen use or other services above what has been authorized. The Contractor is to notify the VA within two (2) business days of a possible change in the patient’s oxygen needs or additional services requested. Changes will not be provided without prior authorization by phone, fax or email with updated authorization.

Failure to make an oxygen delivery due to inability to access the patient’s residence because of missed appointment date/time will not result in added trip cost.

20.0 - Contractor Security Requirements:

Since access to the VA computer system is not required for the Contractor’s staff, there is no mandate for security/background investigations for this purpose. Nevertheless, the Contractor shall carry out sufficient investigation of their staff members, and subcontractors to reduce the risk of hidden criminal background, or substantiated incidents of patient abuse/security/ethics/substance abuse, of their duties. Patients must not be placed at any such potential risk, which could impact on the safety of patients and the peace of mind of their families.

The Contractor shall be required to install public-key infrastructure (PKI) on their computer systems for encrypted messaging. The Contractor will be assisted by WPB VAMC’s Information Security Officer (ISO) and PKI will be required for any email correspondence involving patient information.