S06 VISN 1 Home Oxygen DME Services Solicitation 36C24120R0014 Questions 2-4-22.docx

VISN 1 Home Oxygen & DME Services Solicitation 36C24120R0014 Questions

1. On Page 17, 1.4 under Setup Procedures for DME states : “For emergencies, the Contractor must make delivery within 4 hours.” It also states “The Contractor has 72 hours to complete annual valves Delivery Orders.

Question : There does not appear to be a line item in the Price / Cost Schedule for emergency delivery / pickup / repair? Will there be any consideration to adding a line item to the Price / Cost Schedule for this? What percentage of all DME delivery / pickup / repair are done on an emergent basis? ANSWER: VISN 1 will not add a line item for emergent DME deliveries/pickups/repairs. This has occurred in rare situations with an urgent inpatient discharge.

2. On Page 19, under B.5 Statement of Work III Home Oxygen / Respiratory Care Services Standards of Performance states “Disposable supplies – VA is not required to purchase these supplies from the Contractor. Any required, mandated VA / Federal contracts or supply arrangements through the VA DLC / Denver Logistics Center will take priority over VISN supply agreements.” Also, on Page 30 under Oxygen Equipment 3.16, states “The Contractor shall furnish, install and service all oxygen equipment and supplies ordered under this contract.”

Question : Is VISN 1 planning to purchase oxygen supplies through the VA DLC / Denver Logistics Center? If yes, will VISN 1 VA staff ship supplies directly to patient homes? Or will the supplies be shipped directly to Contractor warehouse facilities for Contractor staff to deliver to home oxygen patients when visits are completed? Also, I attempted to click on Disposable Supplies – Ancillary Supplies List (Attachment 2) on Page 93 to view and was unable to do so. Please advise.

ANSWER: This contract includes both oxygen and PAP care – as well as DME. The vendor would provide O2 supplies needed for the safe and effective operation of the equipment – such as tubing, regulators and firesafe valves. The DLC is providing PAP equipment and supplies – to include masks and accessories, not oxygen supplies. The DLC equipment & supplies can go directly to patient homes and/or to a contractor’s warehouse. The disposable items attachment will be added separately by Contracting.

3. On Page 20, Under B.5 Statement of Work III. Home Oxygen / Respiratory Care Services Standards of Performance 3.3.6 in regard to fire safe cannula valves (thermal fuses) states “The charge for the valve will be no greater than the lowest FSS (Federal Supply Schedule) price available at the start of the contract.” 3.3.6.1 states “If VA stock of fire safe valves is used, they will be provided to each new oxygen patient and every six months thereafter (unless prescribed at a different time interval) at no charge.”

Question : Is VISN 1 planning to purchase the fire safe cannula valves (thermal fuses) through VA DLC / Denver Logistics Center? If no, and VISN 1 plans to purchase the thermal fuses from the Contractor, there is not line item in the Price / Cost Schedule for the Contractor to bill for the fire safe cannula valves (thermal fuses)? Please advise. ANSWER: The VA intends to purchase them from the vendor – the firesafe valves’ line item is listed on the disposable items attachment.

4. It appears from the language throughout the SOW that Respiratory Therapists are required to complete ALL new home oxygen setups that involve oxygen concentrators, emergency backup system, portable oxygen system or liquid oxygen system? If yes, in current contracts we manage, Qualified Technicians are authorized to do new set-ups involving all of the aforementioned home oxygen equipment. We have found it is very difficult to recruit and retain Respiratory Therapists if they are required to do the “heavy lifting” involved with all these heavy items. All of our current contracts allow the Qualified Technicians to complete these setups but require a Respiratory Therapist follow up visit within 72 hours of the initial setup. Please advise. ANSWER: The VA allows qualified technicians to do oxygen set-ups, though it does not release the vendor from completing the RT follow-up visit within 96 hours of set-up in VISN 1, except in the state of Massachusetts where the requirement is within 48 hours.

5. On Page 24, 3.9.5 Performance Improvement states “All patients who have portable systems that require refills or replacements (e.g. liquid deliveries, cylinder fills) will have a set delivery schedule that meets the patients schedule.” On Page 26, 3.91.0 states “All VA rented & purchased concentrators and portable oxygen concentrators will have a documented preventive maintenance every 12 months or completed according to manufacturer’s recommendations.” On Page 27, 3.10.2.1 states “If a patient is prescribed oxygen deliveries and he/she does not request them or refuses them for an extended period of time (maximum 6-8 weeks), the facility Home Oxygen Coordinator will be notified about the on-going situation with pertinent details regarding the patient’s response(s).

Question : Quite a few date timelines are referenced throughout the SOW in regard to patient visits but nowhere did I see any specific requirement (i.e. monthly, quarterly) for home oxygen visits for patients with concentrators and corresponding systems. Please advise. ANSWER: The VA clinician who prescribes the oxygen treatment enters a plan of care for the patient on the VA consult prescription, where he/she states the RT follow-up schedule. The consults are transmitted to the vendor for completion.

6. On Page 33, under Oxygen Conserving Devices states “Contractor will provide an oxygen conserving device when ordered. Devices must be approved by VAMC and furnished to the VAMC at no charge so patients can be titrated accordingly. Contractor will provide at no cost to the VAMC an oxygen conserving device(s) so patients can be titrated on actual unit before he/she goes home.

Question / Concern : This has the potential to be an expensive, “hidden cost” for prospective contractor. What % of current home oxygen patient population are prescribed an oxygen conserving device? ANSWER: The VA acknowledges this is a cost for the vendor and will need to plan appropriately in its billing structure and for sufficient supply. There is no mechanism to determine a percentage of patients requiring conserving devices, though it is clear not all oxygen patients require a conserving device.

7. Page 33, 3.24.1 Cylinders states “If the patient requires more than one regulator, the Contractor is obligated to provide an additional 1-2 regulators as needed – at no charge”

Question / Concern : Again, this has the potential to be an expensive, “hidden cost”, for prospective contractor. What % of current home oxygen patient population has more than one regulator? ANSWER: There is no mechanism to determine a percentage of patients requiring multiple regulators, though it would generally be a smaller figure.

8. On Page 34, Continuous Positive Airway Pressure (CPAP) / Bi-Level Positive Airway Pressure (BIPAP) states “VA will utilize the Denver Logistics Center / DLC for contract PAP machines and supplies starting in 2021.” Then goes on to say “Depending upon the service staffing, inventory and administrative processes in place and how the DLC project is implemented, some VAMC’s may provide supplies and some may not. The Offeror should be prepared to provide VA prescribed supplies when and where ordered. The Offeror and the VA Contracting Officer will negotiate reasonable charges for replacement supplies for PAP/ASV patients if VA-DLC stock is not used, and the charges will not exceed the current Federal Supply Schedule (FSS) price.

Question : There is quite a bit of contrasting information in terms of whether the VA or Contractor is responsible ANSWER: Following implementation of the DLC PAP Project in 2021, this was also at the same time as the worldwide Supply Chain disruptions on computer chips required for PAP devices - in combination with the effect of the Respironics PAP recall not only on its supply distribution but also on the supply of its chief competitor, ResMed, which VISN 1 uses. The language above reflects the need for flexibility by the VA to use all means – DLC, vendor, other federal contract sources – to meet the demand for PAP supplies. The disposable items attachment lists a number of PAP supplies that the VA requests pricing - this will provide the VA the ability to use the vendor for supplies, if needed.