36C24521Q0407 08052021.pdf

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. DUNS: DUNS+4:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 116

36C24521Q0407 08/10/2021

Crystal Hinton, Contracting Officer 410-637-1530 08/24/2021

36C245

Department of Veterans Affairs

VA Maryland Health Care System

Crystal Hinton, Contracting Officer (90C)

209 West Fayette Street, Suite 611

Baltimore MD 21201

X 100

X

532283

$35 Million

N/A

X

36C688

Department of Veterans Affairs

VA Maryland Health Care System

Crystal Hinton, Contracting Officer (90C)

50 Irving St, NW

Washington DC 20422

36C512

Department of Veterans Affairs

VA Maryland Health Care System

Crystal Hinton, Contracting Officer (90C)

PAYMENT WILL BE MADE BY

FSC e-Invoice Payment

Invoice must be submitted electronically http://www.fsc.va.gov/einvoice.asp

Invoice Setup Information 1-877-489-6135

See CONTINUATION Page

Home Oxygen Services for VA Medical Center, Washington, DC

Contractor Performance Period: 5-Year IDIQ

Period of Performance: 10/01/2021-09/30/2026

Scope of Contract and Performance Work Statement, page 5.

Price/Cost Schedule, page 37-43.

See CONTINUATION Page

X X

X X

Crystal S. Hinton

36C24521Q0174

Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PERFORMANCE WORK STATEMENT

B.3 PRICE/COST SCHEDULE

ITEM INFORMATION

B.4 IT CONTRACT SECURITY

B.5 SUBCONTRACTING COMMITMENTS--MONITORING AND COMPLIANCE (JUN

2011)

B.6 CONTRACTOR’S RESPONSIBILITY – CONTRACTORS PERFORMANCE

ASSESSMENT REPORTING SYSTEM (CPARS)

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (OCT

2018)

C.2 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.3 52.203-16 PREVENTING PERSONAL CONFLICTS OF INTEREST (JUN 2020) ..62

C.4 52.216-18 ORDERING (AUG 2020)

C.5 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.6 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.7 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.8 52.227-14 RIGHTS IN DATA—GENERAL (MAY 2014)

C.9 52.237-3 CONTINUITY OF SERVICES (JAN 1991)

C.10 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA

ACQUISITION OF COMMERCIAL ITEMS (APR 2020)

C.11 VAAR 852.212-72 GRAY MARKET ITEMS (APR 2020)

C.12 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(OCT 2019)

C.13 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020)

C.14 MANDATORY WRITTEN DISCLOSURES

C.15 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (NOV 2020)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.204-16 COMMERCIAL AND GOVERNMENT ENTITY CODE REPORTING

(AUG 2020)

E.2 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (OCT 2020)

E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.4 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (JUN 2020) 91

E.5 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014)

E.6 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL ITEMS (OCT 2020)

36C24521Q0174

E.7 52.216-1 TYPE OF CONTRACT (APR 1984)

E.8 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.9 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.10 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION

(OCT 2018)

E.11 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.12 VAAR 852.273-70 LATE OFFERS (JAN 2003)

E.13 VAAR 852.273-74 AWARD WITHOUT EXCHANGES (JAN 2003)

36C24521Q0407

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR _________________________________

b. GOVERNMENT: Crystal S. Hinton, Contracting Officer 36C245

Department of Veterans Affairs Contracting Officer (90C)

Post Award Orientation: The Contracting Officer will schedule a post award orientation for contract orientation purposes as required by Procurement Policy memorandum (PPM) 2019-01.

https://www.va..gov/oal/docs/business/pps/ppm201901.pdf

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

[X] 52.232-33, Payment by Electronic Funds Transfer—System for Award Management, or

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] (Monthly in arrears)

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment

Requests.

PAYMENT WILL BE MADE BY

FSC e-Invoice Payment Invoice must be submitted electronically http://www.fsc.va.gov/einvoice.asp Invoice Setup Information 1-877-489-6135

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO DATE

http://www/

B.3 PERFORMANCE WORK STATEMENT

B.2.1 DEFINITIONS AND ACRONYMS

AQL: Acceptable Quality Level

Acceptable Quality Level: An AQL is the maximum allowable degree of deviation from the standard and it is expressed as either a percentage of deviation from the performance standard or as an absolute number; an AQL with a deviation of zero, for example, means that no deviation from the standard is acceptable.

Bi-Level Positive Air Pressure (Bi-PAP): A type of noninvasive ventilation used to provide two pressure levels—inspiratory and expiratory positive air pressures—of ventilation of a patient.

Caregiver: An individual providing or assisting the Veteran patient with personal care. This may also be a family member.

CDR: Contract Discrepancy Report

Concentrator: An electrical device that produces oxygen by physical separation of oxygen from ambient air.

Continuous Positive Air Pressure (C-PAP): A type of noninvasive ventilation used to provide continuous ventilation of a patient.

Contract: An agreement between two or more parties that is legally binding.

Contract Discrepancy Report: Formal documentation of a contractor’s failure to some aspect of a contract that explains why performance was unsatisfactory, how performance will be returned to satisfactory levels and how recurrence of the problem will be prevented in the future.

CO: Contracting Officer

COR: Contracting Officer Representative

Contracting Officer: A Government official with designated authority to enter into, administer, and terminate a contract and to make related determinations and findings on behalf of the Government.

Contracting Officer’s Representative: A Government official designated by the CO that’s responsible for providing contract oversight and technical guidance to the Contracting Officer.

Contractor: The entity that enters into a contract with the government.

FAR: Federal Acquisition Regulation.

F.O.B. Destination: Free on Board at Destination. The seller or consignor pays for the cost of shipping and assumes risk of loss.

Home Oxygen: See Home Respiratory Care

Home Respiratory Care: The provision of home oxygen/respiratory care services necessary to assist the eligible person (i.e., Veteran patient) with home respiratory care. There are 3 primary methods of providing oxygen therapy in the home: (1) oxygen concentrators; (2) compressed gas;

and (3) liquid oxygen.

HIPAA: Health Insurance Portability and Accountability Act.

IAW: In accordance with.

VAMC: VA Medical Center

Liquid Oxygen: Medical oxygen dispensed by the pound.

Liquid Stationary System: A device used to store and dispense liquid oxygen therapy and generally consists of large reservoir and portable unit that is filled from the reservoir. A standard reservoir holds 110 pounds of liquid oxygen and a portable unit holds 3-5 pounds of liquid oxygen.

Liters per Minute: A unit of measurement that indicates the volumetric flow rate of a gas.

LPM: Liters per minute.

Nebulizer: A device used to dispense medication with the use of an electrically operated compressor.

Oxygen Conserving Device: An electric or pneumatic -powered device that limits oxygen flow to inspiration only and thereby increases the duration of the oxygen supply.

Oxygen Tank: A metal, cylindrical container used to store and dispense oxygen in a gaseous state.

Patient: Veteran who is authorized by VHA Prosthetics and Sensory Aids Service (PSAS) to receive health care services as a VA beneficiary.

Practice of Respiratory Care: The practice of respiratory care means the practice of respiratory care, and any part of respiratory care, by a licensed person and shall be limited to that which has been learned through formal or special training including performance evaluation to evaluate competence. The practice of respiratory care includes, but is not limited to:

1. Delivery of respiratory care using devices such as positive pressure and negative pressure devices (e.g., CPAP, BiPAP, Intrapulmonary Percussive Ventilation, etc.).

2. The administration of pharmacological, diagnostic therapeutic agents related to respiratory care procedures necessary to implement a treatment, disease prevention, pulmonary rehabilitative or diagnostic regimen prescribed by a physician.

3. Transcription and implementation of written or verbal orders of a physician or other legally authorized person with prescriptive authority, pertaining to the practice of respiratory care.

4. Observing and monitoring signs and symptoms, general behavior, general physical response to respiratory care treatment and diagnostic testing, including determination of whether such signs, symptoms, reactions, behavior or general response exhibit abnormal characteristics.

5. Implementation of respiratory care protocols or changes in treatment pursuant to the written or verbal orders of a person with prescriptive authority.

PSAS: Prosthetics and Sensory Aids Service.

PSAS Representative: VHA Employee of the Prosthetics and Sensory Aids Service.

Quality Assurance Surveillance Plan (QASP): A written document that’s used by the Government to monitor a contractor’s quality assurance program.

Respiratory Therapist (RT): A person that is licensed to practice respiratory care by the appropriate State Agency. A licensed Respiratory Therapist can either be Certified (a CRT) or Registered (RRT).

Sentinel Event: A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. Serious injury specifically includes loss of limb or function. The phrase, "or the risk thereof" includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome. Such events are called "sentinel" because they signal the need for immediate investigation and response.

Solicitation: A request to submit offers or quotations to the government.

Task Order: An order for services placed against an established task order contract.

Task Order Contract: A contract for services that does not procure or specify a firm quantity of services and that provides for the issuance of orders for the performance of tasks during the period of the contract.

TJC: The Joint Commission

The Joint Commission: An organization that sets standards by which health care quality is measured.

The Schedule: The following portions of a contract are the schedule: contract form (SF 1449), supplies or services and prices or costs, specification or statement of work, packaging and marking, inspection and acceptance, deliveries or performance, contract administration data, and special contract requirements.

B.2.2 OBJECTIVES

To provide Veteran patients with the most efficient and medically appropriate system for providing oxygen in his/her residence as determined by the prescribing physician and based on the patient’s daily period of usage and desired flow rate (per minute).

The Home Oxygen Services Contractor and Washington, DC will partner to increase the efficiency of the Home Oxygen program and both parties will collaborate to discover opportunities for service improvement and increased efficiency, consistently evolving to meet or exceed VA and commercial healthcare standards.

B.2.3 SCOPE

The Department of Veterans Affairs Medical Center in Washington DC (DC VAMC) at 50 Irving Street NW, Washington, DC 20422 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 beneficiaries 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, concentrator, portable systems, emergency backup systems and supplies to eligible VA beneficiaries as required by the DC VAMC. Services provided shall be all inclusive of deliveries and transportation within the Washington, DC, Prince Georges County (MD), Montgomery County (MD), Arlington (VA), Alexandria (VA), Falls Church (VA), Fairfax (VA), Charles County (MD) Manassas (VA) Prince William (VA), Stafford (VA), Spotsylvania (VA), Fredericksburg (VA), Fauquier (VA), Warren (VA), Clarke (VA), Jefferson (VA), Loudon (VA), Frederick (MD) and Calvert County (MD) catchments. Prices quoted shall be all inclusive of deliveries and transportation within the catchments, and equipment, safety inspections, repairs, maintenance, and in-service training for beneficiaries to include patient education.

1. CONTRACTOR QUALIFICATIONS

The Contractor shall possess all licenses, permits, accreditations, and certificates as required by

Local, State and Federal law. The Contractor shall meet Joint Commission on Accreditation of

Healthcare Organizations (TJC) standards. The Contractor shall meet or exceed TJC standards and be an accredited organization at the servicing location prior to contract award as evidenced by the submission of their accreditation/certificate and also must maintain this certification for the duration of the contract. If the Contractor is re-surveyed by an accrediting body during the contract term, the Contractor shall notify the Contracting Officer

(CO) of survey dated, the outcome of the survey, and provide copies of new certificates as issued. Before contract award, the Contractor’s facility(ies) may be inspected by the VA.

Subcontractors shall follow TJC standards and shall be monitored by the Contractor for compliance. The Contracting Officer Representative (COR) shall be notified if a subcontractor is utilized.

The Contractor shall have a physical location, prior to the period of performance of this contract, which houses the service office, warehouse, dispatch of vehicles and other functions related to the performance of services within the DC VAMC’s catchments. Catchments include Washington, DC, Prince Georges County (MD), Montgomery County (MD), Arlington (VA), Alexandria (VA), Falls Church (VA), Fairfax (VA), Charles County (MD) Manassas (VA) Prince William (VA), Stafford (VA), Spotsylvania (VA), Fredericksburg (VA), Fauquier (VA), Warren (VA), Clarke (VA), Jefferson (VA), Loudon (VA), Frederick (MD) and Calvert County (MD).

The Contractor shall have at least three (5) years of experience in successfully administering basic home oxygen and aerosol therapy to adult and geriatric patients.

The Contractor shall coordinate, supervise, and evaluate the services provided.

2. SERVICE AREA & PRESCRIPTIONS

The Contractor shall deliver oxygen to VA beneficiaries within the catchments. The number of veterans being served by this agreement will change, as patient care needs fluctuate. The

Government will endeavor, but cannot guarantee, to provide the Contractor with advance notification of need for services, as new additions are made to this agreement. The COR shall provide the Contractor with notification to initiate individual beneficiary service requirements, including the beneficiary's oxygen prescription, equipment, supplies and services to be provided, including date and place of delivery; the Contractor shall confirm receipt of the request within two (2) working hours of notification; the COR shall also provide notification of VA initiated discontinuance of service. The notification may be made orally but shall be confirmed in writing within three (3) working days. The written documents shall include the authorizing official's signature.

Services shall be provided either at the DC VAMC, the veteran’s residence, VA Community- Based Outpatient Clinics (CBOC), or in a nursing home where the veteran resides.

Individual equipment needs are subject to change, as determined by the prescribing physician. The Contractor shall at no time change or alter a beneficiary’s oxygen prescription or equipment requirements without a new prescription from the beneficiary’s physician.

Mileage is not reimbursable.

3. CONTRACTOR PROVIDED ITEMS

The Contractor shall provide three (3) modes of oxygen equipment (concentrators, cylinders, and supplies to include all equipment and its maintenance in accordance with manufacturers’ specification and TJC, or their appropriate professional accreditation agency standards, inclusive of parts and labor, training, education, safety inspections and repairs for the equipment.

4. EQUIPMENT & OXYGEN SPECIFICATIONS

Contractor-furnished equipment shall be maintained per manufacturer’s specifications.

Contractor-owned equipment shall be repaired or replaced at no cost to the Government when breakdown or malfunction is due to normal usage or due to the fault of the Contractor.

The Contractor shall maintain records that shall reflect new or refurbished equipment, and notify the COR, in writing, if any equipment is exchanged in the veteran's residence.

All electrically powered equipment used in performance of this contract shall be Underwriter Laboratory (UL) approved and shall be the most recently developed in the field at the time of use.

Oxygen provided shall be United States Pharmacopoeia (U.S.P.) oxygen.

Medical Gas systems shall comply with National Fire Protection Association (NFPA) Pamphlet 56F, Non-Flammable Medical Gas Systems and conform to standards prescribed in the Pharmacopoeia of the United States when converting volume measurement (i.e., cubic feet to gallons). Density data and volume measurement published in Compressed Gas Association Pamphlet `P-6 titled Standard Density Data, Atmospheric Gases and Hydrogen, or in applicable Federal or Military specifications shall be used in case of conflict use factors in C6AP-6. Air, Compressed Medical: Shall conform to Compressed Gas Association, Pamphlets G-7 (which can be obtained from Compressed Gas Association, Inc., 1235 Jefferson Davis Highway, Arlington, VA 22202, 1 Standard for Compressed Air for Human Respiration, Type I, Medical.) Also, FDA’s Compressed Medical Gases Guideline, revised February 1989 shall be adhered to.

Cylinders and other containers for gaseous shall comply with the Department of Transportation specifications and shall be maintained, filed marked, labeled shipped, traced and other procedures in accordance to current DOT regulations.

Fire safety valves will be installed at both supply end and patient end of Oxygen tubing. Fire safety valves will be supplied by the contractor.

OXYGEN CONCENTRATORS shall be furnished by the Contractor, as needed. The Contractor shall be responsible to furnish, install, and maintain all oxygen equipment to dispense oxygen and supplies ordered under this contract. All equipment shall be current, state-of-art model, in new or like new condition and all supplies shall be new. Oxygen concentrators shall be UL approved and must, at a minimum meet the following specifications:

1. Electrically powered (115 volts)

2. Shall include a battery-operated audible alarm to indicate a power failure

3. The oxygen concentrator shall not perform below the manufacturer’s specification

4. The oxygen concentrator shall contain an hour meter and oxygen concentration indicator

(OCI)

5. The oxygen concentrator shall be grounded internally or plug into a three-prong wall outlet appropriate for the patient’s home (outlet adaptors are not acceptable).

1. 1.5 LPM Concentrator- electrical device that employs sieves and physical separation to deliver 90% or higher concentration of oxygen at flow rates up to 5 LPM

Concentrators that meet the following specifications:

A) Deliver 90% oxygen at flow rates up to 5LPM.

B) Operate on 120 VAC, 60 Hz.

C) Have thermal protector for compressor.

D) Be double insulated and have two prong plugs.

E) Have pressure compensated flow meter.

F) Have high-low pressure alarm.

G) Have power failure alarm.

H) Weight 60 pounds or less.

I) Be mounted on wheels for easy movement by patient/caregiver.

J) Must meet FDA QSR standards.

K) Minimum of three-year warranty on concentrator and compressor.

L) Sound level of 60db or less.

Note: Concentrators that have oxygen sensing devices are preferred.

2. 10 LPM Concentrator - electrical device that employs sieves and physical separation to deliver 90% or higher concentration of oxygen at flow rates up to 10 LPM.

Concentrators must meet the following specifications:

A) Deliver Oxygen flow rates: (I) 95% to 92% @ 1/2 - 7 LPM flow (II) 95% to 90% @ 7-10 LPM flow (O2 Pressure: 7 PSIG (48 KPA) normal)

B) Alarms for the following failures required: Power Failure, O2 Concentration (Optional), and Irregular Pressure C) Size: 26.0 H x 14.7 W x 19.1 Deep (in) 28.4 H x 39.4 W x 47.0 Deep (cm)

D) Weight: 57 lbs. (26kg) (10 LPM unit) 110 volt; 60 cycle

E) Be double insulated and have two prong plugs

F) Have power failure alarm.

G) Be mounted on wheels for easy movement by patient/caregiver.

H) Must meet FDA QSR standards.

I) Minimum of two-year warranty on concentrator and compressor.

J) Sound level of 60 DB or less.

Note: Concentrators that have oxygen sensing devices are preferred.

3. Oxygen Conserving device - electric or pneumatic powered device that limits oxygen flow to inspiration only and thereby increase the duration of the supply (all tank sizes outlined in the contract).

a) Pneumatic units - must meet the following specifications:

A) Flow settings from .25 to 6.

B) Have easy to read content gauge.

C) Conservation ratio of 3:1 or higher.

D) Have alarm for low oxygen pressure level.

E) Have alarm for “no inspiration taken”.

F) Have continuous flow setting.

G) Have at least 2-year warranty.

H) Weight less than 30 oz.

1) Pneumatic conservers use double lumen cannula. (higher cost, additional inventory item)

2) Conserving ratios are based on a breath rate of 20 bpm.

3) Danger of patient desaturating on exertion due to decreased size of bolus at higher bpm.

b) Electric units - must meet the following specifications:

I) Flow settings from .5 to 6.

J) Have easy to read content gauge.

K) Conservation ratio of 5:1 or higher.

L) Bolus delivered per breath of at least 10cc per setting.

M) Have alarm for low oxygen pressure level.

N) Have alarm for “no inspiration taken”.

O) Have continuous flow setting.

P) Have at least 2-year warranty.

Q) Weight less than 30 oz.

CYLINDERS furnished by the Contractor shall be in accordance with the Interstate Commerce Commission Regulations, and transport cylinders in accordance with Code of Federal Regulations (CFR) Part 49, U.S. Department of Transportation. M60 cylinders furnished by the Contractor shall have a M60 safety stand at no additional charge to the Government. This stand shall remain contractor owned.

VENTILATORS furnished by the Contractor shall be provided, as prescribed for beneficiaries.

Ventilator shall be easy to operate by beneficiary and/or caregiver. Primary controls shall be located on one (1) face and labels/displays must be clear and visible. The controls must be protected against accidental setting changes. The line cord shall be secured to the ventilator and UL approved. Normal set-up shall include the following:

1. Two (2) ventilators with backup batteries.

2. Ventilator tubing to be always changed every seventh (7th) day with two (2) in reserve.

3. Bacterial/humidifier filter to be always changed monthly with two in reserve.

4. One (1) closed system suction catheter to be changed every day with one (1) in reserve at all times; suction system must include swivel adapter with MDI port include; one (1) single suction catheter with one (1) in reserve at all times; one (1)

Yankauer tip suction to be cleaned every seventh (7th) day with one (1) in reserve at all times.

5. One (1) resuscitation bag with mask and oxygen tubing to be always cleaned every seventh (7th) day with one (1) in reserve for continuous ventilation.

6. One (1) M60 cylinder of oxygen or oxygen concentrator.

7. One (1) suction pump with suction collection jar, non-sterile gloves, basin, normal saline solution.

8. One (1) trach care kit per day with one (1) in reserve with gauze for tracheotomy site; one (1) Velcro tracheotomy tube holder to be cleaned every seventh (7th) day with one in reserve.

9. Operation and service manual shall be provided to the user. The manual shall contain information on operation, maintenance, and troubleshooting for clinicians, users, caregivers and service technicians. The standards and guidelines are as follows:

a. The American Respiratory Care Foundations for Respiratory Equipment Used in the Home.

b. American Society for Testing Materials (ASTM) minimum standards specification for electrically powered home care portable ventilators.

c. Association for the Advancement of Medical Instrumentation (AAMI).

d. TJC standards for Home Care, current year standard.

The trained driver or Registered Respiratory Therapist shall be competent professionals familiar with the life-sustaining nature of the equipment involved and fully qualified under the laws of the state in which the services are being rendered. Installation shall be consistent with local Fire and Safety Codes in the respective area of the State and shall conform to NFPA 99/101 (Life Safety Codes) NFPA (Oxygen Cylinder Requirements). The Contractor shall provide a safety/emergency checklist to be completed, then signed by the veteran or his/her caregiver and retained in the beneficiary account folder, with copy provided to the VA. The Contractor shall conduct a check of the concentrator using a certified oxygen analyzer that is calibrated according to the manufacturer standards.

5. INSTALLATION

The installation of all machines and equipment by the Contractor shall be performed by a competent professional familiar with nature of the equipment involved and fully qualified under the laws of the State in which the services are being rendered. Installation shall be consistent with local Fire and Safety Codes in the respective area of the State and shall conform to NFPA 99/101 (Life Safety Codes) NFPA (Oxygen Cylinder Requirements). The Contractor shall provide a safety/emergency checklist to be completed, then signed by the veteran or his/her caregiver and retained in the beneficiary account folder. The Contractor shall ensure that all equipment is checked at manufacturer recommended intervals. A Contractor’s staff member shall conduct a check of the concentrator using a certified oxygen analyzer that is calibrated according to the manufacturer standards. Maintenance on equipment shall be done by a manufacturer’s checklist. It shall include compressor inlet pre-filter changes and compressor inlet bacteria filter changes according to the manufacturer recommendations. The alarm battery shall be tested at each maintenance check, changed as indicated but at least annually.

The Contractor shall be responsible for tracking and documenting maintenance of equipment in accordance with manufacturer specifications and providing these records for review upon request. The Contractor shall furnish parts and labor for routine maintenance. The Contractor shall have recall procedures for equipment and supplies.

6. EMERGENCY PLANNING & BACK-UP SYSTEMS

For respiratory equipment, supplies, and services, the Contractor shall provide respiratory services twenty (24) hours a day, seven (7) days a week as needed by the patient. The Contractor shall provide 24-hour emergency services including replacement and/or back-up equipment when necessary. The Contractor shall have an emergency preparedness plan designed to provide continuing care and support appropriate to the care provided in the event of an emergency that would result in the interruption of patient services. This plan shall be effective throughout the term of the contract. A large label with the Contractor’s name, address and telephone number shall be placed in an obvious location on the equipment to facilitate timely reporting of emergency malfunctions by the patient/caregiver in the home. At the time of set-up, the Contractor shall provide beneficiaries with a telephone number to call if there are any questions or additional information is required. Special detailed instructions should also be provided to the patient/caregiver on how to contact the Contractor in case of an emergency during other than normal working hours.

Veterans with a prescription for an oxygen concentrator shall be provided with an appropriate back-up system consisting of M60 cylinder and regulator with stand, humidifiers, cannulas/mask for use during the event of a power failure or mechanical problem and necessitating the use of the M60 cylinder. The equipment is part of each patient’s set-up and there shall be no additional costs associated with it. Any cost incurred due to its’ use as a back-up system shall be borne by the Contractor. The cost of replacement of equipment damaged, lost or misplaced not through beneficiary's negligence shall be borne by the Contractor.

7. PHASE-IN REQUIREMENTS

The Contractor shall schedule and replace all equipment and supplies presently located in homes of beneficiaries with his/her own equipment as soon as possible after award, but not to exceed thirty (30) days. The change shall include delivery, set-up and instruction, and shall be accomplished with the least disruption in service to the VA beneficiary as possible. Contractor shall inventory and stack all current equipment and supplies together neatly for easy pick up by outgoing supplier. The inventory sheet shall be placed with the equipment with a copy mailed to the VAMC and a copy to the veteran patient. Contractor shall notify outgoing supplier within twenty-four (24) hours of the transition. The awarded Contractor shall assume the responsibility for damaged equipment.

8. PHASE-OUT REQUIREMENTS

At the end of the contract period, a transition period shall be required during which the incumbent Contractor shall continue to provide services at the contract prices while the incoming supplier is taking over. The incoming supplier shall notify the Contractor within twenty-four (24) hours of the close-out transition.

9. SAFETY REQUIREMENTS:

In the performance of this contract, the Contractor shall take such safety precautions as the Contractor determines to be reasonably necessary to protect the lives and health of all persons affected by this contract. In addition, the Contracting Officer or the COR may require that the Contractor take additional safety precautions if the Contracting Officer or COR determine the Contractor’s safety precautions are inadequate. The Contracting Officer or COR will notify the Contractor of any noncompliance with the foregoing provisions and the action to be taken. The

Contractor shall, after receipt of such notice, immediately correct the conditions to which attention has been directed. Such notice, when served on the Contractor or his/her representative at the site of the work, shall be deemed sufficient for the purposes aforesaid. If the Contractor fails or refuses to comply promptly, the Contracting Officer may issue an order stopping all or any part of the work and hold the Contractor in default.

Mandatory requirements for use of thermal fuses are as follows:

a. Thermal fuses must be provided for all patients on home oxygen therapy unless there is a documented clinical contraindication (e.g., patients using heated humidity, patients with flow rates in excess of 25 Liters per minute, patients with behavioral conditions that make use of thermal fuses impractical). If thermal fuses are not provided due to clinical contraindication, this must be documented in the patient’s medical record.

b. Two thermal fuses must be provided and installed in each home oxygen delivery system (one at the patient end and one at the oxygen source). This must be done for the patient’s primary oxygen therapy equipment as well as any portable oxygen therapy equipment.

c. Thermal fuses are not required for portable pulse dose/intermittent oxygen therapy equipment when the equipment does not have a continuous flow setting.

d. Thermal fuses provided must work regardless of their orientation in the oxygen tubing (bidirectional) or have a design that prevents them from being installed in the wrong orientation (e.g., source end of thermal fuse has threads or bayonets that make backwards installation impossible).

e. Existing unidirectional thermal fuses that are capable of being installed in the wrong orientation must be replaced at the next scheduled home oxygen visit or sooner if possible.

f. At the time of installation, education must be provided to the patient describing the proper use. And placement of thermal fuses, including that a thermal fuse does not make it safe to smoke, be near people who are smoking, or be near any source of sparks or flame while using oxygen.

g. Thermal fuses must be replaced at the end of their expected life per manufacturer’s guidelines.

h. Thermal fuses must be replaced if actuated or involved in a fire.

All incidents of fires involving home oxygen delivery systems shall be reported using the VHA Patient Safety Information System. Do not include patient or provider identifiable information in the report.

When classifying incidents of fires related to home oxygen delivery systems in JPSR, the following classification must be used in the Event Classification section.

Event Type: Environmental Events

Event Sub-Type: Burn incurred from any source in course of patient care process

Event Detail: Burn or fire related to home oxygen delivery system

The following information must be collected and reported by the VHA facility when a home oxygen fire occurs.

Section 1: To be collected by the home oxygen vendor and provided to the local VHA facility.

a. What was the reported cause of the fire (primary ignition source)?

b. Where did the fire originate (e.g., kitchen, bedroom, vehicle, patio, store)?

c. What date and time did the fire occur?

d. What was the first item that ignited (e.g., nasal cannula, clothing, bedding)?

e. Describe the extent of injury to the patient, family, and others.

f. Describe the extent of property damage.

g. How many thermal fuses were in use and where were they installed in the home oxygen delivery system or tubing?

Section 2: To be collected by the local VHA facility.

h. Has the patient experienced a home oxygen related fire before?

i. Provide the patient’s full problem list from the electronic health record.

j. Provide the patient’s full medication list (medication names) from the electronic health record.

k. Describe any other information that contributes to understanding of the event.

10. SERVICE HOURS & DELIVERY REQUIREMENTS

The Contractor shall be notified by Prosthetics Service to deliver/pickup oxygen equipment/supplies in accordance with a Prosthetic Electronic Consult (PEC) (per-computerized physician’s prescription) or prosthetic fax. The PEC shall contain:

a. Diagnosis of the patient’s condition

b. Liter flow or concentration of oxygen, both at rest and ambulatory, when applicable

c. Mode of administration by cannula or mask

d. Modality of oxygen (gas)

e. Oxygen equipment (concentrator, cylinder, or portable)

f. Patient demographics

The Contractor shall provide twenty-four (24) hour emergency service, seven (7) days a week, fifty-two (52) weeks per year, and report, in writing, to the Prosthetic Treatment Center, any emergencies provided during non-duty hours. Non-duty hours are 4:30 p.m. to 7:00 a.m. Monday through Friday, Saturdays, Sundays and Federal Holidays as noted below.

The Contractor shall visit the beneficiary’s residence in performance of this contract by appointment only and between the hours of 8:00 a.m. and 8:00 p.m., except in emergency cases. The Contractor shall document date, time, and name of person contacted on all efforts to establish appointments with DC VAMC beneficiaries. While every effort shall be taken to ensure that patients are available for their regularly scheduled monthly visits, circumstances beyond the patient’s control may result in a visit that shall have to be rescheduled; the Contractor shall provide monthly service, replenishment of cylinders and supplies even if it requires making a special or non-scheduled visit to the patient’s home. Before the close of business of the next working day, the Contractor shall inform the COR(s) of deaths or inability to locate a veteran due to change in address.

Federal Holidays observed by the DC VAMC and CBOCs are:

New Year Day Labor Day Martin Luther King Day Columbus Day Presidents’ Day Veterans’ Day Memorial Day Thanksgiving Day Juneteenth Christmas Day Independence Day

This also includes any other day specifically declared by the President of the United States to be a national holiday.

It should be noted that if a holiday falls on Saturday, it is observed on Friday. If a holiday falls on Sunday, it is observed on Monday.

11. ROUTINE DELIVERIES & REPORTS

Contractor shall provide a driver trained in the installation and set-up of Home Oxygen equipment and/or Registered Respiratory Therapist to deliver prescribed supplies/cylinders as required to each beneficiary, as needed. There shall be at least 20 workdays between scheduled replenishing (supplies/cylinders) visits and under no circumstances should more than 35 days elapse between visits or a successful telephone contact call, with documented results.

There shall be at least 80 days between scheduled equipment assessment visits and under no circumstances should more than 90 days elapse between visits. When prescribed by a physician, patients shall be clinically assessed by a Registered Respiratory Therapist, with the interval determined by the physician.

If the findings of the therapist/driver indicate a medical emergency, 911 or EMS shall be activated, and the COR notified. If the findings of the therapist/driver require immediate medical attention, the Contractor shall notify the Home Oxygen Coordinator and the Chief of Prosthetics during normal business hours, within one (1) hour of recognizing the circumstance. If at the end of the workday (4:30PM local time), contact the Medical Administrative Assistant (MAA) at the DC VAMC for medical emergencies within one (1) hour of recognizing the circumstance. Contact information shall be provided on award of Home Oxygen contract.

A report(s) shall be developed, signed and dated by the therapist/driver as appropriate and the beneficiary/care giver and a copy shall be left with the beneficiary. The report(s) shall be legible and attached to the invoice. All reports shall be submitted to the COR in alphabetical order, with the monthly bills by the 10th day of the month following service. The report shall consist of the following minimum requirements:

a. The Contractor's assessment form shall include the diagnosis of the veteran in order for the visiting driver/therapist to provide ongoing education, assess equipment and supplies, and to submit a monthly report. The report shall include the following data:

i. Name and social security number (SSN) of beneficiary using the equipment.

ii. Review of prescription (Liters Per Minute, hours per day).

iii. Type, serial number, and hours on concentrator.

iv. Number of days since last inspection.

v. Average usage of oxygen per day monitored through concentrator hour usage and actual observed setting of liter flow rate.

vi. Inspection results of liter flow rate in monitoring patient compliance (as compared to prescription).

vii. Inspection results of intake filters (exchange or clean).

viii. Inspection/change of bacterial filters.

ix. Clinical assessment (if ordered, see below for requirements).

b. A Clinical Assessment, if ordered, shall include the following:

i. The patient’s diagnosis.

ii. Vital signs to include blood pressure, heart rate, respiratory rate, and temperature.

iii. Oxygen saturation by pulse oximetry (if ordered) on room air and on the oxygen liter flow prescribed.

iv. Assessment of the lung sounds.

v. Monitoring of respiratory medications, which includes a complete medication profile.

vi. All requirements for clinical assessments and documentation according to TJC standards.

12. INITIAL DELIVERY & SET-UP

Initial set-ups are considered as those beneficiaries who have not been provided an oxygen therapy delivery system in the residence or nursing home on a previous occasion or have not used such a system continuously for the past 60 days.

The Contractor shall provide initial set-ups within twenty-four (24) hours of request from the COR or designee, to include weekends and holidays. At the initial delivery and set-up, the area of the home where oxygen equipment is located must be checked, reviewed, and documented as suitable and safe by the Contractor before leaving equipment at the home. This acknowledgement shall be kept in the beneficiary folder, with a copy provided to the appropriate DC VAMC. The Contractor shall check the safety of the electrical outlets in the beneficiary's home prior to installing any electrical item. Outlets shall be inspected and tested to ensure that voltage level is adequate for the item being installed (a voltmeter is to be used), polarity is correct, ground is present, and the outlet is in good physical condition. Any unsafe electrical conditions shall be immediately reported to the COR or designee for further instructions and documented in the beneficiary folder, with a copy to the DC VAMC. If any alteration to the beneficiary's home is necessary to accommodate the oxygen equipment, including electrical work, the Contractor shall be responsible to notify the COR or designee by telephone at time of set-up and note the call with comments on the delivery paperwork, which shall be signed by the beneficiary, with a copy to the DC VAMC.

Initial set-ups by a qualified technician shall be followed within 24 to 72 hours by a Registered Respiratory Therapist visit to reinforce education and perform a basic home assessment. In the event a therapist was not available at the time of initial set-up (outside normal business hours, weekend or holiday), a basic home assessment shall be conducted within three to five (3-5) working days of the initial set-up by a certified respiratory therapist.

NOTICE: The DC VAMC reserves the right to obtain the service from another source and to charge the Contractor with any excess cost, which may result there from, if the Contractor is unable to meet the twenty-four (24) hour response time.

13. STANDARD SET-UP

In accordance with the prescription received from the DC VAMC, the Contractor shall provide the beneficiary with the following items:

a. Humidifiers and water traps, when deemed necessary by the prescribing physician. The number of humidifiers must be sufficient to ensure that they are not depleted between visits. The number of traps will be based on the patient’s flow rate, but on the average one per week.

b. Disposable oxygen cannulas for change on every two weeks with two (2) in reserve.

c. Disposable mask/s for change every two weeks with two (2) in reserve (when masks are prescribed in lieu of nasal cannulas).

d. 25-50 ft. of oxygen connecting tubing with one (1) equivalent section of tubing in reserve.

e. Trach collar with trach collar holder for change/cleaning weekly with two (2) Reserves.

f. Disposables for suction machine to include connecting tubing, suction catheter, and Yankauer suction instrument where applicable.

g. Thermal fuses

14. POSTING OF SIGNAGE

The Contractor shall provide and post on all entrances into the residence, a sign stating, "Warning Oxygen in Use, No Smoking" and document that the beneficiary/care giver is instructed in the safe use of oxygen and equipment. This posting/refusal of posting shall be noted on the signed delivery documents signed by the patient/caregiver.

15. TRANSITION DELIVIERIES

The Contractor shall provide transitional deliveries (set-up) to beneficiaries who are presently using an oxygen delivery system or have used such a system continuously within the past sixty

(60) days. Transition shall be accomplished with a trained driver or Registered Respiratory Therapist with documented training on the manufacturer’s recommended assembly, use, and maintenance of the equipment used under this contract. If any alteration to the beneficiary's home is necessary to accommodate the oxygen equipment, including electrical work, the Contractor shall be responsible to notify the DC VAMC by telephone at time of set-up and note the call with comments on the delivery paperwork, which shall be signed by the beneficiary. All beneficiary transitions shall be accomplished within thirty (30) calendar days of notification (order).

Offeror shall know their proposed approach to the start-up and transition phase of the contract which shall be given significant weight in the evaluation of their technical approach. The Government requires a concise summary of the Offeror’s understanding and approach to this tasking area. Failure to adequately address this important phase of the requirement could negatively impact the Offeror’s evaluation in the area of technical approach.

NOTICE: Failure to perform the set-up, as specified, shall result in a forfeiture of rental payment to the provider currently used and every day thereafter until set-up is complete.

16. FAILED DELIVERIES

The Contractor shall notify the Chief, Prosthetics Service at the VA of failed deliveries no later than forty-eight (48) hours from the time of occurrence via FAX or e-mail of those beneficiaries they were unable to contact for their scheduled assessment/delivery. Prosthetic Service shall also be notified (by FAX or e-mail) the day after a beneficiary failed to keep a scheduled appointment. The Contractor shall document date, time, and name of person contacted on all efforts to establish appointments with DC VAMC beneficiaries.

17. PROMPT DELIVERY

The Contractor shall provide prompt delivery within eight (8) hours, or sooner, to the patient.

Coordination of exact delivery times between the Contractor and patient shall be the Contractor’s responsibility. Address and telephone number of the patient shall be provided by the COR or designee.

18. PROMPT PICK UP

The Contractor shall provide prompt pick-up from patient’s home of equipment within two (2) days rented or purchased under this contract after being advised by the CO, COR or designee of an order cancellation or expiration of the patient. Contractor shall pick up and deliver all Government-owned equipment to the VA Medical Center, 50 Irving St, NW Washington, DC 20422. Additional billings shall not be honored after notice of cancellation has been given. This cancellation shall be in the form of a written and telephonic notification by the CO or the COR.

19. DELIVERY TICKETS

The Contractor shall have all delivery tickets signed by the patient or custodian in receipt of all equipment and oxygen. One copy shall be forwarded along with the invoice to the COR and the Home Oxygen Coordinator.