S06 36C24120R0014 0002.docx

36C24121R0014 0002

5. PROJECT NUMBER (if applicable)

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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 electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

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(REV. 11/2016)

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 letter or electronic communication, provided each letter or electronic communication 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:

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Contractor

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14. DESCRIPTION OF AMENDMENT/MODIFICATION

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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.

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(Number, 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.)

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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) 02/18/2022 None Department of Veterans Affairs VAMC Providence 830 Chalkstone Avenue Providence RI 02908 Department of Veterans Affairs VAMC Providence 830 Chalkstone Avenue Providence RI 02908 To all Offerors/Bidders

36C24120R0014 01-31-2022

X X X

X The above referenced solicitation as identified in block 9a is hereby amended to provide responses to vendor questions.

The RFI period is now closed.

All other terms and conditions remain unchanged.

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Attachments received on 2/9/22 Q: May the government consider extending the due date for the proposal to be submitted, due to the delay in posting the attachments?

Answer – The current due date for proposals remains 3-1-2022.

Cylinder Racks

· 3.3.9 “Cylinder racks shall be provided at no charge for all Veterans with a prescription for 3 or less tanks (cylinders) and for each emergency backup cylinder system.”

Q: May the Government please clarify if the cylinder rack provided for 3 or less tanks will be contractor owned or VA owned?

Answer – The cylinder rack is contractor-owned.

Disposable Supplies

· 3.3.6 “The Contractor will provide and install two fire safe cannula valves (also known as thermal fuses) during the oxygen set-up on the cannula near the patient and near the oxygen device for all new and existing oxygen patients and every 6 months at minimum thereafter (unless prescribed at a different time interval).”

· 3.3.6.1 “If VA stock of fire safe cannula valves is used, they will be provided to each new oxygen patient and every 6 months thereafter (unless prescribed at a different time interval) at no charge.”

Q: May the Government please clarify if the FSC will be purchased and stocked by the contractor or will they be supplied by the VA for the contractor to have in stock and distribute as required?

Answer – the contractor will provide the stock of fire safe valves. This does not prevent the VA from obtaining a stock of fire safe valves if it determines this is cost-effective.

Transition Timeframe

· 3.6 “All beneficiary switch-outs will be accomplished within the timeframe established as soon as possible after award, but not to exceed 45 days.”

· 3.19. “Transition Period: At the end of the contract period a transition period of 90 days will be required during which the incumbent Contractor will continue to provide services at the contract prices while the incoming Contractor is taking over. A copy of current patient prescription (Rx) will be furnished by the outgoing Contractor to the new Contractor. Outgoing Contractor will remove their equipment from Veteran’s home as the new Contractor sets up their equipment. During the transitional 45-day period, all new patients will be set up with new Contractor and billed the following month.”

Q: May the government please clarify if the transition period will be 45 or 90 days?

Answer – the goal is to have all of the patients transitioned within 45 days. But there are some patients that are travelling out-of-state, living at another location temporarily and/or may be difficult to reach. The VA allows up to 90 days for everything to be complete.

Emergency Services

· 3.7.1 “The Contractor shall have a well-established communication system, providing 24-hour emergency services and the ability to provide services at the beneficiary’s home within a maximum of 4 hours of a call. Most emergency services shall be provided within 2 hours of a call.”

· 3.7.2 “If the Contractor is unable to respond to an emergency service call within 6 hours”

· 3.32.4 “For all service calls, the Contractor will respond by phone and send a staff person to the patient’s home within 24 hours if the problem cannot be solved over the phone.:

Q: Is it correct to interpret all emergency service calls shall be responded to via telephone at a minimum of 2 hours, but not to exceed 6 hours?

Answer – This is correct.

Q: May the Government please confirm an in-person visit within 24 hours is only required for calls placed for emergency services when troubleshooting cannot be solved over the phone?

Answer – This is correct.

Performance, Delivery, Inspection and Acceptance

· 3.7.2 “The Contractor shall ensure all patients have at minimum a non-electrical oxygen supply to last four times the Contractors’ response time to a call.”

Q: May the Government please confirm a non-electrical oxygen supply is only to be provided for back up when a patient is prescribed an oxygen concentrator (back-up supply system would not apply to LOX only patients)?

Answer – This is incorrect. Non-electrical back-up oxygen applies to all oxygen patients.

· 3.7.2.1 “H/M Tanks are required for emergency back-up for all patients, unless the patient has specifically requested, and the Contractor has documented his/her desire to have smaller tanks for back-up. (The VA Clinical COR must approve the change to a smaller size tank.)” Q: May the Government please clarify if the patient requests the smaller tank for back-up, may the Contractor proceed in delivering the smaller tank or must the VA be contacted while in the home for approval? (i.e. the patient’s home environment may not allow for the distribution of an H/M tank) Answer – The contractor can provide the smaller tanks for back-up that equate to 4 times the contractor’s response to a call at the time of the visit, but the VA needs to be notified for confirmation the next business day.

Q: May the Government please clarify if a smaller tank is requested and the Contractor is unable to reach the VA for approval, may the Contractor proceed with delivering the smaller tank and notify the VA of the smaller tank delivered for back-up?

Answer – The contractor can provide the smaller tanks for back-up that equate to 4 times the contractor’s response to a call at the time of the visit, but the VA needs to be notified for confirmation the next business day.

3.9.5 Performance Improvement

· The Contractor will track all patients who receive 20 or more cylinder fills in a calendar month – and provide a monthly summary Q: May the Government clarify if patients will be limited to only 20 cylinders per month, and if so, will this be entered into the prescription received?

Answer – Some patients may have a prescription that limits the number of cylinders issued, but other patients do not. Each patient prescription is specific to that patient.

Preventative Maintenance

· “3.9.10 All VA-rented & purchased concentrators and portable oxygen concentrators will have a documented preventative maintenance every 12 months or completed according to the manufacturer’s recommendations. This will be documented and provided by written report each quarter – if requested prior to the period, it will be sent to the COR.”

· “HOME OXYGEN CONTRACT ROLES AND RESPONSIBILITIES - b. Patient Assessment Process, initial and ongoing” contractor will report maintenance every 3 months.

Q: May the Government please clarify if the preventative maintenance (PM) visits will be conducted every 12 months, from the issuance of equipment, or every 3 months?

Answer – Documented preventative maintenance is required every 12 months for all concentrators, unless otherwise specified by the manufacturer. The contractor will report to the COR a summary of all concentrator maintenance completed during the quarter every 3 months to document what has been accomplished.

VA Privacy-HIPAA and Privacy-Information Security Trainings

· 3.15.3.1 “VA Privacy-HIPAA and Privacy-Information Security Trainings are required for all Contractor employees for those working in VISN 1 and for those staff at other offices in the country that handle VA patient-specific information – at minimum on an annual basis.

Q: Is it the government’s intent to require all contractor staff servicing travel patients outside of the geographic area (i.e. patient travels from Maine to Florida, Florida location not being one of the original VISN 1 serving locations) to complete the trainings as well?

Answer – All clinical and administrative contractor staff based at locations in New England and at administrative (billing-order processing) centralized locations that process VISN 1 orders need to complete the annual trainings. Contractor staff who deliver oxygen to travel patients at an out-of-state destination are not included in this requirement.

Liquid Oxygen Systems (LOX)

· 3.25 “Liquid Oxygen Systems (LOX): Where applicable, the Contractor shall supply the VAMC with a liquid oxygen system (LOX) to support the home oxygen beneficiaries coming in for clinic appointments that have a Contractor supplied liquid system.”

Q: May the Government confirm it is licensed to distribute LOX at each facility?

Answer – Most VA locations will not require a liquid system to fill LOX; if requested, it will be located in a safe, designated, approved location on-site. VA locations generally prefer cylinders to be delivered to the VA location to cover on-site patient appointments.

3.24. CYLINDERS

· 3.24.1 “If the patient requires more than one regulator, the Contractor is obligated to provide an additional 1 or 2 regulators as needed – at no charge.”

Q: May the Government please confirm a maximum of 1 or 2 regulators will be provided, as prescribed?

Answer – Yes it would be unusual to go beyond that amount, unless the patient has several systems in his house and/or is at a very high liter flow.

Q: May the Government consider adding a billable line item should more than 2 regulators be prescribed?

Answer – At this time, no additional line item will be added because this situation is rare.

Ventilators

· 3.28 “A spare ventilator with accessories must always be present in the patient’s home and an additional ventilator is available at the Contractor’s location (for invasive ventilators, at minimum). Those accessories would include, at minimum: ambulation bag (manual resuscitation bag)” Q: May the Government please confirm a back-up ventilator is not required in the home when used in a non-invasive setting?

Answer – The VA clinician will determine if a back-up ventilator is required for a non-invasive patient. In most cases this is true; but, for example, if a patient is using the ventilator as a BiPAP for more than half the day, a back-up may be required.

Q: May the Government please confirm an ambulation bag (manual resuscitation bag) is only required to be provided when the ventilator is used in an invasive setting?

Answer – The ambulation bag will need to be available for any patient on a ventilator – for a non-invasive patient, this will be determined by the VA clinician.

· 3.28.3 “Airvo or other high flow nasal cannula oxygen (humidification) delivery devices, Non-invasive ventilation device, and Percussive Vest” Q: May the Government please confirm Airvo or other high flow nasal cannula oxygen (humidification) delivery devices, Non-invasive ventilation device, and Percussive Vest will be issued by the VA for the contractor to distribute as prescribed?

Answer – The VA may stock these devices or acquire them from another contractor. The contractor who is awarded the contract will have the opportunity to offer these items as well.

Q: May the Government confirm if the contractor may utilize a comparable NioV device (i.e. Luisa Vent) for CLIN 0025 “NioV (Non-Invasive Open Ventilation) Ventilator Rental?

Answer – If the VA clinician confirms this alternative is allowed, then it can be used but it would be appropriate for the vendor to have the devices noted in the contract available for use by VA.

3.30. Services Provided for each VISN 1 VA Medical Center (HO)/Services Provided to Veteran Patients (HO)

· 3.30.1 “The Contractor must have at least two (2) years of experience in successfully administering basic home oxygen and aerosol therapy to adult and geriatric patients.”

Q: May the Government please confirm the “Contractor” refers to the organization selected to service the VISN 1 contract, and not the individual employees (i.e. CRT/RRT) providing the in-home services?

Answer – Yes, the minimum of two years of experience applies to the contractor.

· 3.30.5 “The Contractor will provide and install fire safe cannula valves during the oxygen set-up and every 6 months at minimum thereafter (unless prescribed at a different time interval). If VA stock of fire safe cannula valves is used, they will be provided to each new oxygen patient and every 6 months thereafter (unless prescribed at a different time interval) at no charge.”

Q: May the Government please consider adding a billable line item for the replacement of FSC valves, when a patient disposes of the valves (i.e. throws the valves out in error) in-between the established change interval of 6 months?

Answer – The VA will not add a line item for this issue.

· 3.32.8.1 “For patients with a home fill system: The Contractor is required to provide a sufficient number of cylinders so that the patient can safely and effectively use the home fill system – generally, the minimum would be three cylinders.”

Q: May the Government please consider adding an additional line item for the provision of additional home-fill cylinders (i.e. patient receives more than three) as these items can be very expensive to replace?

Answer – The VA will not add a line item for this issue.

· 3.32.9 “For patients who own a concentrator from previous oxygen care, the Contractor will set-up the patient as a new patient with Contractor-owned equipment” Q: May the Government please confirm the contractor will not provide services to patient owned equipment?

Answer – The contractor will provide its own equipment and service its own equipment.

Q: Or is the intent of this language for the Contractor to service patient owned equipment that was not distributed by the Contractor or the VA?

Answer – The contractor will provide its own equipment and service its own equipment.

· 3.35 “Home Oxygen Program: Additional Lox Portable Vessels (HO). The Contractor shall provide additional LOX portable vessels to patients that require two portables.”

Q: May the Government please confirm patients will be provided a maximum of 2 LOX portable vessels, and this will be billed under CLIN 0005 “Additional RENTED liquid portable unit for patients requiring 2 portable units”.

Answer – The line item is correct. On a rare occasion the VA clinician could prescribe an additional portable beyond the two outlined but this situation would be rare.

Q: Should more than 2 units be prescribed, will the contractor utilize CLIN 0005 for the rental of each additional unit, or will the Government consider adding an additional line item to the schedule?

Answer – The contractor will use the same line item if more than 2 are prescribed.

3.36 CPAP/BiPAP/ASV/APAP Program (HO)

· “With the VA Denver Logistics Center beginning to provide equipment and accessories for the PAP program nationwide in 2021, the warranty and retrieval process for PAP devices and accessories will be determined and shared with the Contractor.”

Q: May the Government please clarify if the process for the delivery/ replacement of the CPAP/BiPAP/ASV/APAP units has begun from the Denver Logistics Center? If not, is there an expected date for the new process to commence?

Answer – The DLC has begun to deliver PAP units and supplies but are in short supply.

Q: May the Government please advise if the PAP devices are ordered from the Denver Logistics Center ROES system, will the PAP unit be shipped directly to the patient?

Answer – In some cases, the unit will be delivered directly to the patient; in other cases, units will be in stock at the contractor’s warehouse for set-up.

Q: May the Government please clarify if the patients are to contact the Denver Logistics Center directly or their respective VA facility for PAP resupplies and accessories?

Answer – If the patient is registered in ROES by the VA, resupplies will come from the DLC; if they are not registered in ROES or the DLC has a significant backlog, the contractor can be used for this service.

· 3.36.3 “Subsequent follow-up pulmonary assessments will be conducted by the Contractor according to the patient’s care plan as determined by the VA clinician for the specific patient. In general: every 12 months for a CPAP and 6 months for a BiPAP with rate - unless otherwise specified for the specific patient on the consult/prescription.”

Q: May the Government confirm the prescribed follow-up visits will be billed via CLIN 0010 or 0013?

Answer – CLIN 0010 is applicable for follow-up assessments for PAP patients. CLIN 0013 is applicable for follow-up assessments for oxygen patients.

3.37 Ventilator, Cough Assist, 50 PSI Compressor (HO), Suction Machine, Small & Large Volume Nebulizers and electric or battery-run nebulizer machines, Airvo or other high flow nasal cannula oxygen (humidification) delivery devices, Non-invasive ventilation device, and Percussive Vest

· 3.37.1 “Set up will be performed within 24 hours of receipt of signed physician order. Conduct the first follow up Certified or Registered Respiratory Therapist(RT) visit within 96 hours/4 days of initial set-up or as required by state law, whichever is less” Q: The above referenced specialized equipment requires a RT/Clinician to conduct the initial setup. May the Government please clarify if an additional RT/Clinician visit is being requested within 96 hours/4days, after the initial setup is completed by a RT/Clinician?

Answer – If the RT does the initial set-up then a 96 hour visit is not required. The VA clinician establishes the plan of care in the consult.

· 3.37.4 “Subsequent follow-up ventilator assessments will be conducted by the Contractor according to the patient’s care plan as determined by the VA clinician for the specific patient. In general: every 1 month for a ventilator patient - unless otherwise specified for the specific patient on the consult/prescription.”

Q: May the Government please clarify if the monthly ventilator RT/Clinician visit will be conducted for only invasive ventilator based patients, or both invasive/non-invasive patients?

Answer – The VA clinician establishes the plan of care in the consult. He/she will determine if a non-invasive vent patient will require a Q1 month follow-up schedule or a different follow-up schedule.

3.39 In Home Nocturnal Continuous Pulse Oximetry Test (HO)

· 3.39.1 “The Contractor can also provide a mail-out option for overnight oximetries from a centralized location – this would need to be approved by the COR to confirm the qualifications of the staff” Q: What qualifications are required for the mail-out option to be approved?

Answer – The contractor would need to outline the process being followed, the staff and their qualifications and how this would benefit the VA contract requirements.

Q: May the Government please clarify if this approval will be done on an individual basis, or can this be a blanketed approval?

Answer – If approved, the VA’s decision would affect all overnight oximetries ordered in the contract.

· 3.39.3.1 If the Contractor is consistently unable to meet the 30-day contract requirement (e.g. 10 or more oximetries delayed beyond the 30-day period for 2 months consecutively), the line item for overnight oximetries will be reduced by ten percent (10%) by the VA. If additional months of non-compliance continues, an additional five percent (5%) reduction by the VA is allowed.

Q: May the Government please confirm this reduction will only apply to outstanding oximetry testing orders prescribed (i.e. RXs received 1/1/2022, and not completed by 1/31/2022, a reduction of 10% would be applied to those orders only). This would not be an overall reduction of the negotiated CLIN price.

Answer – No, the reduction would be applicable to all current and future overnight oximetry orders.

Travel

· 3.68.4.1 “The VA views 7 days’ notice as adequate. The VA would view less than three days’ notice as expedited.”

Q: May the Government consider adding a line item for expedited travel coordination (i.e. notification of 7 days or less)?

Answer – The VA will not add a line item.

HOME OXYGEN CONTRACT ROLES AND RESPONSIBILITIES

· f. Discharge Planning (f.1) Discontinuing therapy - The Contractor will notify patient/family and arrange time for pick-up of equipment within 72 hours, unless otherwise designated by the Veteran or the VA.

· 3.14.2 The Contractor shall remove equipment from the beneficiary’s residence at the earliest possible time but no later than 5 business days unless approved by Prosthetics.

Q: May the Government please clarify the expected timeframe for the recovery of equipment upon discontinuation of services (72 hours or 5 business days)?

Answer – The goal is for the equipment recovery to be done within 72 hours but no more than 5 business days.

4.1.6.3 The Contractor shall ensure that its employees be industry knowledgeable in the following elements:

· Standard and power wheelchair competencies to perform assembly, regular maintenance and repairs.

· Competencies to perform assembly and repair for scooters

· 4.1.8.4.1 Repairs: The Contractor is granted the first right of refusal for the repair of DME. Before any repairs are made, the contractor agrees to submit an estimate of charges so that an order can be issued by the Contracting Officer.

Q: Some power wheelchairs and scooter delivery/maintenance/repairs require specialized certifications, not available to all vendors. May the Government please confirm the contractor will have the right to refuse the delivery/maintenance/repair of equipment requiring specialized certification?

Answer – If a special, unique certification that is not easily obtainable is required and the contractor does not have them, then the contractor can refuse it. It is expected the contractor will have staff that maintain basic certifications, at minimum and will make efforts to continually maintain and upgrade the knowledge and experience of its staff to meet the needs of the VA.

4.1.9 Delivery, Set-up, Repair, and Pick-up of Equipment and Provision of Patient Instructions (DME)

· 4.1.9.5.1 The Contractor shall make an attempt to accommodate the patient/family if adjustments are needed in the patient’s home and if the VA requests assistance for specific patients. This can include the moving or removing of other furniture or equipment so the VA equipment can be properly delivered and maintained and/or the transfer of those items to the Contractor’s location until final disposition is determined.

There is concern with the moving/removing of patient personal property. This may lead to claims (i.e. damage to the residence, property, etc.) and/or employee injury.

Q: May the Government consider eliminating the requirement to have the contractor/contractor employee(s) assist in moving/removing furniture/equipment at the patient residence?

Answer – At this time, the requirement will be kept in the SOW.

· 4.1.9.6.2 Similarly, the Contractor will be available to deliver and pick-up power wheelchairs and other specialized equipment for SCI/ SCD (Spinal Cord Injury/Spinal Cord Disorder) from/to the Veteran’s home from/to VAMC locations where SCI/SCD patients are located.

Some specialized equipment requires more than 1 individual to perform the task.

Q: May the Government confirm the contractor will be allowed to invoice accordingly (i.e. if 2 person team is required, the contractor will bill for CLIN 0027 Delivery/Setup Rates x 2 and/or CLIN 0028 Pickup Rates x 2?

Answer – No, the billing line items will remain x1.

· 4.1.9.11 DISPOSAL – The Contractor will dispose of single-use patient equipment following use according to established manufacturer’s guidelines and with VA COR approval. For multi-use equipment, the Contractor will follow the guidance of the VA COR/VA Representative in following proper VA procedures for the disposal of equipment. The Contractor is responsible for replacement if this guidance is not followed.

Q: May the Government consider adding a disposal fee to the CLIN structure, as the disposal of equipment can be quite costly?

Answer – No. The contractor will follow VA procedures regarding disposal.

· Will VA please provide the Price/Cost Schedule as an Excel spreadsheet? It would remain as is.

· Is it VA’s intention that prices for the term of the contract are fixed or may offerors have different pricing for different option periods? The contractor will determine if it wants to maintain the same charges or provide different pricing. It is in competition with other vendors who are bidding, and overall cost will be reviewed by Contracting.

· Will VA please provide the applicable HCPC related to each of the provided CLINs? If awarded, the VA can work with the contractor to outline the appropriate HCPCS code.

· CLIN 0024 appears to contemplate VA-purchased home transfilling systems. Will VA consider adding a CLIN for rental of a home transfill oxygen system? CLIN 0017 is part of the contract.

· Section 1.3, Proof of Delivery, requires a receipt bearing the beneficiary’s signature as a condition of payment. Given the ongoing PHE, will an electronic signature be sufficient to meet this requirement? Most patients do not have access to electronic signatures, unless the contractor has a system for the patient to use.

· Would VA be able to confirm out of the 3,900 O2 patients, how many require LOX (liquid oxygen)? Estimated patient totals are provided in the CLINs – no further estimates are available.

· Liquid Oxygen volume has a material effect on proposed contract cost. Would VA be able to confirm LOX volume is based on actual experience and/or adjust to best reflect actual Veteran LOX usage?

Liquid oxygen volume is estimated, as the number of patients on liquid is lower than previous years.

· Section 3.9.6 requests an administratively burdensome weekly Contractor staff list, including vacancies, and appears to infer a managerial VA employer-Contractor employee relationship with the Contractor’s staff, especially given weekly plans to fill vacancies. Would VA consider eliminating the weekly staff list and recruitment planning requirement or restate for intent, clarity, and less operationally invasive frequency? The frequency will remain the same. The VA wants to know the level of clinical and administrative staff for each location to ensure all facets of the contracts are covered and be aware of any staff changes/losses/ensure those on-board are current with their annual VA training requirements.

· Personnel Folders contain employee information outside the scope of this contract. Would VA please confirm that Section 3.15.1 reference to personnel folder availability refers only to employee training and/or licensure/certification? The subsection answers the question – training and licensure certification as well:

3.15.1.1 Contractor must provide and document employee orientation, ongoing employee education, and ongoing assessment of employee competency for all employees involved with the delivery/recovery of equipment covered under this contract according to The Joint Commission Standards.

· Veterans Preference (Volume/File III). Would VA please clarify or detail as to what “some consideration” will entail when compared to full/partial credit?

VETERAN PREFERENCE this will be evaluated by the Source Selection Authority (SSA) at the end after technical, past performance and price are completed.

Solely for purposes of price evaluation and implementation of the veteran’s first act, the proposed price of any CVE SDVOSB offeror shall be evaluated as if it were 3% less than the offerors actual proposed price so as to afford the SDVOSB a competitive advantage.

The proposed price of any CVE VOSB shall be evaluated as if it were 2% less than the actual proposed price so as to afford the VOSB a competitive advantage.

The proposed price of any vendor subcontracting with any CVE SDVOSB or VOSB shall be evaluated as if it were 1% less than the actual proposed price.

These price adjustments as solely and only for implementation of the preferences of the Veterans First Act and the price evaluation in the tradeoff phase. In the event an SDVOSB or VOSB is in line to receive an award, the actual award value, and the actual obligation to an SDVOSB or VOSB shall not reflect any such 3%, 2%, or 1% reduction but rather the true offeror proposed price.

Example:

A SDVOSB verified in CVE proposed a price of $5.00, the contracting officer applies the 3% preference and the offer is treated as if the proposed price were $4.85.

A Large Business proposed a price of $5.00.

Solely for purposes of applying the Veterans Preference; the SDVOSB’s price would be considered $4.85, i.e., lower than the Large Business.

If the SDVOSB receives award the contracting officer obligates the contract in the value offered of $5.00 to the SDVOSB.

· CLIN 0002, CLIN 0003, and CLIN 0004 all reference rental of liquid oxygen systems. Would VA please clarify if they intend to refer based on Helios systems versus non-Helios systems or based on liter flow? Patients are referred based on the VA clinician’s determination of what equipment and liter flows are needed. Helios is noted as it was a liquid portable used by other contractors.

· CLIN 0016 appears to combine two pieces of equipment (liquid low loss portable system and concentrator) into one rental item, which is not industry standard. Would VA consider splitting these into separate CLINs? The VA prefer the patient have the concentrator as well to use when home and to use at night vs the liquid systems and liquid contents alone.

· The VA requires specific timeframes for set-ups to be completed. Will the provider be penalized if the patient/caregiver requests delivery for a date/time that is outside of the required timeframes? Answer: If the patient/caregiver requests a different date/time, this is allowed as long as the contractor documents this occurrence in the patient’s record and informs the COR/provider of the change.

· 3.11.2, pg. 28, signature required for delivery. Has the VA implemented any safeguards as a result of the Public Health Emergency due to COVID, such as electronic delivery of educational materials, phone follow up visits, UPS/FedEx delivery for replacement/ disposable supply items? Answer: The VA understands the challenges of working in the COVID environment. This does not exclude the requirement for signature/acknowledgement of receipt. An electronic signature or e-mail that confirms delivery is acceptable.

· In some states there is a critical shortage of respiratory therapists due to the PHE/COVID. Not only are they not applying for open positions but also not enrolling in school to become one so vacant clinical positions are having to be filled by RNs & LPNs where applicable state law allows. Will the VA reconsider their requirement for respiratory therapists and allow RN/LPNs as needed? Answer: At the start of the contract, the RT requirement remains in effect. It would be inappropriate to project what may happen in the future.

· What counties do each of the VAMC offices (VAMC Bedford, VA Boston HS, VA Connecticut HS, VAMC Manchester, VA Central Western HS, VAMC Providence, VA Maine HS, VAMC White River Junction) cover? Answer: The facilities and CBOCs cover the local/regional areas where they are located. The Boston HCS is a regional referral center for Spinal Cord Injury and Cardiac Care, while the Connecticut HCS is a referral center for Blind Rehabilitation and Cochlear Implants. Additional information can be reviewed via the website: VA New England Healthcare System

· Invoicing, Section 1.3 – Requirement: Proof of delivery/ completion of service will be forwarded to the ordering VAMC Prosthetics Service at the time that the purchase card is processed for payment.

· Question : Does the VA require monthly proof of delivery on all patients with rental items or just on the initial delivery? Answer: Invoices and delivery tickets with signatures for each visit and delivery are required for billing – electronic confirmation is allowed in the era of Covid.

· Question: Is the VA purchase card a VISA or MasterCard Answer: It is a government purchase card – likely VISA but not definite.

· Educational Materials , Section: 3.8.1, 3.8.2, Requirement: The educational materials must be provided upon initial delivery and every 6 months hereafter.

Question: We have moved to using a tablet based electronic format for delivering educational materials and proof of delivery. Would the VA accept electronic delivery and electronic signature of their documents mentioned in Section 3.8? Answer: Patients/family members can receive training electronically but they need to have a hard copy (with any electronic copy) of the educational materials from the initial visit and the materials sent every 6 months to follow. Electronic signature is allowed but a copy/proof of signature must be provided.

· Reports, Section 3.9 - 3.11, Does the VA have a specific format that the required reports are supposed to be in? Answer: The COR will work with the contractor; the contractor can provide a sample report that meets the requirements and the COR will review and comment on the format before it is finalized.

· Delivery of supplies- is drop shipment acceptable as a method of delivery for replacement supply items/disposables (i.e., masks, tubing, filters, etc)? If acceptable, is delivery notification from UPS, FedEx, etc. acceptable as proof of delivery? Answer: Yes this is acceptable and delivery companies’ notification is acceptable for proof of delivery.

· Storage of Government owned equipment, Section 4.1.5 - How much storage space would be required to store Government owned equipment? Answer: The VA does not dictate a square footage requirement. The amount of space should take into account the requirements outlined in the solicitation for both VA-purchased oxygen and DME equipment, the requirements of the separation of clean and dirty equipment, a repair area, and a separate administrative space. Any contractor-owned equipment should be located separately and not mixed with VA-purchased equipment.

· Qualifications of Contractors, Section 3.52.7, The Contractor is able to accept and participate in the POVIDTS - Prosthetics Order Vendor Interface and Delivery Tracking Solution – software. The software is at no charge to the vendor. It allows VA to track purchase orders effectively and provides confirmations/tracking of shipments-deliveries. The vendor is able to accept or reject purchase orders and can input shipping tracking information. The software also sends e-mails to the VA and the Contractor regarding pending orders.

Question: What is this software and can we get its specifications prior to solicitation submission deadline? Answer: POVIDTS is a new software that was developed by Acumen Solutions (now part of Salesforce) and VISN 4 and is beginning use. VISN 1 is the second VISN to further its development – in process now and should be tested in May 2022. The VA will share more information about the program after the award process is finalized.

· Attachment J - PERFORMANCE STANDARDS, #4 – Incentives - Is the 5% taken for each line item that is below the acceptable level or 5% of the total? If the performance level is above the acceptable level, does the VA pay 5% over CLIN charges? What is the timeframe for each indicator? Answer: The 5% price reduction due to unacceptable performance is related to the specific line items involved. No additional payment will be paid for meeting the contract requirements. The VA will look at each monitor on a regular basis and make an effort to work with the contractor to ensure compliance – if efforts are unsuccessful, the Contracting Officer will review the situation and can institute a price reduction.