36C24724R0054.docx

36C24724R0054

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.

UEI:

EFT:

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. NOV 2021)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

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

Payment via 1358 36C24724R0054 04/ /2024 Leonard Robinson 5/24/2024

0800 EST

36C247 Department of Veterans Affairs VISN 7 Network Contracting Office LaVista Business Park - Bldg. A 2008 Weems Road Tucker GA 30084 X 532283 $41 Million N/A X See Delivery PWS

36C247 Department of Veterans Affairs VISN 7 Network Contracting Office LaVista Business Park - Bldg. A 2008 Weems Road Tucker GA 30084

Department of Veterans Affairs

FMS-VA-2(101)

Financial Services Center PO Box 149971 Austin TX 78714-9971 See CONTINUATION Page Home Oxygen Service for the Department of Veterans Affairs, Birmingham Veterans Medical Center.

Services are as described in the Performance Work Statement for Birmingham VAMC.

Wage Determination No: 2015-4591 Revision No: 25 Date of Last Revision: 12/26/2023 This is a five-year contract with five one-year pricing periods. Total Contract performance: 08-01-2024 - 07-31-2029 See CONTINUATION Page x X x Thomas Nichols Contracting Officer Table of Contents

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: Contracting Officer 36C247 Department of Veterans Affairs VISN 7 Network Contracting Office LaVista Business Park - Bldg. A 2008 Weems Road Tucker GA 30084

3. INVOICES: Invoices shall be submitted 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.

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

B.2 PERFORMANCE WORK STATEMENT (PWS)

HOME OXYGEN SERVICES

VISN 07-Station 521-BIRMINGHAM VETERANS AFFAIRS MEDICAL CENTER

1. SCOPE: This Performance Work Statement (PWS) defines the effort required for the setup, installation, and management of Home Oxygen and Ventilation, in accordance with Joint Commission (JC) standards for Homecare, to Veteran beneficiaries serviced by VISN 7-Staion 521-Birmingham Veterans Medical Center (BVAMC). This SOW includes the associated program management, human engineering, and logistic support planning requirements. The use of terms, “beneficiary”, “Veterans”, “Patients”, and “Patient” are used interchangeably and refer to the recipient of required supplies, equipment, and services required under the contract.

1.1 BACKGROUND: The acquisition of Home Oxygen is being initiated to provide Home Oxygen to Veteran beneficiaries serviced by VISN 7 BVAMC. VISN 7 BVAMC does not have the capacity to provide these supplies, so a contract has been sought for the provision of home oxygen and all associated products and services.

1.2 VETERANS SERVED: The Department of Veterans Affairs Medical Center (VAMC) in Birmingham, Alabama currently serves an estimated 900 oxygen-using patients. The Contracting Officer’s Representative (COR) or designee shall provide (via encrypted email, fax, or VA-approved portal) the contractor with notification to initiate individual Patient delivery requirements, including the Patient's oxygen prescription, equipment, supplies, and incidental services to be provided including date and place of delivery. The Contractor shall confirm receipt (via encrypted email, fax, or through VA approved portal) of the request within one (1) working hour of notification; Per Facilities discretion the COR or designee shall also provide (via encrypted email, or fax or through VA approved portal) notification if VA owned equipment is to be provided; the COR or designee shall also provide notification (via encrypted email, or fax, or VA approved portal) to the contractor of VA initiated discontinuation of service. The discontinuation notifications shall be made (via encrypted email, fax, or VA-approved portal) within 24 hours. The written documents shall include the authorizing official's signature, electronic or written.

1.3 LOCATIONS: The Contractor shall provide Home Oxygen within a defined area of responsibility/jurisdiction to the patients’ residence, or other location as indicated on the order for Home Oxygen. The area of responsibility/jurisdiction for each VA facility includes the counties identified (See below within this section for specific counties covered by the BVAMC) as applicable to the area of responsibility/jurisdiction.

(Birmingham VAMC Alabama catchment area by county) Counties: Autauga, Baldwin, Barbour, Bibb, Blount, Bullock, Butler, Calhoun, Chambers, Cherokee, Chilton, Choctaw, Clarke, Clay, Cleburne, Colbert, Coffee, Conecuh, Coosa, Covington, Crenshaw, Cullman, Dale, Dallas, DeKalb, Dothan, Elmore, Escambia, Etowah, Fayette, Franklin, Geneva, Greene, Hale, Henry, Houston, Lamar, Lee, Lowndes, Macon, Marengo, Marion, Mobile, Monroe, Montgomery, Perry, Pickens, Pike, Jackson, Jefferson, Lamar, Lauderdale, Lawrence, Lee, Limestone, Lowndes, Macon, Madison, Marengo, Marion, Marshall, Montgomery, Morgan, Perry, Pickens, Randolph, Russell, Shelby, St. Clair, Sumter, Talladega, Tallapoosa, Tuscaloosa, Walker, Washington, Wilcox, Winston.

Note: The catchment area is defined by the place of residence for the beneficiary/veteran/patient to whom the BVAMC provides services. Where these services fall outside the above counties, then the contractor is still obligated to coordinate these services to the beneficiary/veteran/patient.

A. VETERANS AFFAIRS MEDICAL CENTER (VAMC) LOCATED IN BIRMINGHAM, ALABAMA, AND ALL COMMUNITY-BASED OUTPATIENT CENTERS (CBOCS): Contractor shall provide delivery, setup, installation, and management of services/supplies ordered by Home Oxygen to any Patients that are treated at the Birmingham VA Medical Center and all Community-Based Outpatient Centers (CBOC’s) supported therein (Clinic of Jurisdiction/Primary Service Area COJ/PSA), regardless of their physical location. The listing of these counties does not exclude other counties. This includes Patients who reside near bordering states' catchment areas but prefer to be seen at the Birmingham VAMC. Portable cylinders, regulators, regulator keys, and 02 carriers shall be delivered to the BVAMC within one (1) business day of request to accommodate Home Oxygen beneficiaries who are visiting the VA or being discharged and require a tank of oxygen to go home. This shall be provided at no additional charge.

1.4 PORTABLE EQUIPMENT AT VA MEDICAL CENTERS: A stock of twelve (12) portable cylinders, regulators, regulator keys, nasal cannulas, fire safety valves (two (2) per tank), and 02 carriers shall be continuously maintained by the Contractor at the VA Medical Center located in Birmingham, Alabama. These cylinders shall be used only to accommodate Home Oxygen beneficiaries who are visiting the VA or being discharged and require a tank of oxygen to go home. This service shall be provided at no additional cost to the Government. VA shall furnish storage space and maintain all security for this equipment. The contractor shall be permitted access to the space and equipment when requested, by telephone, with 24 hours’ notice to the VA Medical Center’s Respiratory Therapy Department. The contractor shall maintain an updated inventory of all equipment on a quarterly basis.

NOTIFICATION AND DELIVERY:

2.0 ORDERS: The Contracting Officer Representative (COR) or VA designee shall provide the Contractor with the orders/prosthetic consult, via facsimile, secured email, and/or through a VA-approved portal in addition to phone contact to initiate individual patient service requirements. This shall include the patient’s oxygen prescription, oxygen prescription expiration date, equipment, supplies, and services to be provided including the date and place of delivery. The Contractor shall confirm receipt of the request within two (2) working hours of notification. The contractor shall confirm by facsimile, secure email, and/or documentation in the VA-approved portal to the VA designee/designated staff for all Home Oxygen initiations, plan of care changes, and discharges. The VA designee shall also provide notification of VA-initiated discontinuance of service via facsimile, email, and/or entry in VA approved portal. All changes to patient care shall be confirmed in one of the above mechanisms. The prescription is terminated the day the patient expires.

2.1 NOTIFICATION TO VA REGARDING STATUS OF DELIVERY OF HOME OXYGEN

SERVICES:

a. The contractor shall notify the appropriate VA designee and/or COR monthly of the initial delivery of home oxygen equipment by sending copies of individual delivery tickets via FedEx/UPS/USPS or similar. The delivery ticket shall be signed and dated by the patient or their designated representative. This notification shall be made when a patient requires changes in medical equipment or equipment switch-outs.

b. The Contractor shall notify the appropriate VA designee and/or COR by secure email or facsimile within one (1) working day if the expected delivery of medical equipment is not completed. This notification shall include the reason/explanation as to why the delivery was not able to be completed; and a plan of action to resolve delivery failure.

c. The Contractor shall notify the appropriate VA designee and/or COR by secure email, facsimile, and/or documentation in VA approved portal within one (1) working day if the patient refuses delivery of medical equipment and/or signs the Contractor’s AMA (American Medical Association) form. A copy of the AMA form signed by the patient shall be included in this notification.

2.2 DELIVERY OF MEDICAL EQUIPMENT:

a. The Contractor shall deliver and set up in the patient’s residence all equipment and supplies ordered. This contract is a full-service contract. Set-up shall include the establishment of operational parameters of equipment to VA prescription, ensuring purity of O2, Veteran training on system operations, review of safety checks, and discussion of home safety issues. Services are required to be provided 24 hours a day, seven (7) days a week, including holidays, including all emergency service calls. Contract prices are all-inclusive. The Contractor shall not be reimbursed for costs incurred more than the contract prices in the Schedule of Supplies/Services for services provided in accordance with the Schedule of Supplies/Services.

b. Patients shall be notified of expected delivery times by the Contractor. Veterans shall be provided with a four (4) hour delivery time window for an expected time of delivery.

c. Deliveries of medical equipment and supplies shall be made in full. If the contractor is unable to fulfill the full prescribed medical equipment and supplies list, they may choose partial delivery. The contractor shall notify the VA Designee and/or COR via secured email or facsimile or entry in VA approved portal within one (1) calendar day in the event of a partial delivery. In such cases where a partial delivery is made, the remainder of the delivery will be made within one (1) calendar day. Payment shall only be issued for full deliveries. The contractor shall maintain sufficient stock (or have it available) to ensure all deliveries can be made within the contractual timeframes. The cost for additional deliveries to complete the order shall be at no additional cost to VA.

d. The Contractor shall deliver portable oxygen equipment to previously established and new patients being discharged to their homes from non-VA Facilities and other facilities as requested by VA Staff per the needs of the Veteran. Equipment shall be delivered within four (4) hours of the request.

2.3 EXCESS DELIVERY: The Contractor shall not deliver supplies and/or equipment more than those prescribed, and the Contractor shall not be paid for any excess deliveries or equipment that is not prescribed.

2.4 EXCESS DELIVERY: The Contractor shall not deliver supplies and/or equipment more than those prescribed, and the Contractor shall not be paid for any excess deliveries.

2.5 NON-SCHEDULED DELIVERIES: The contractor shall provide non-scheduled deliveries in the event the patient requires “an additional” delivery to the routine delivery.

2.6 ORDERING & INVOICES: Per VHA Directive 1173.13(1) Home Oxygen Program. The prescribing provider is responsible for completing the annual prescription for home oxygen after the need is determined. Only credentialed staff are authorized via VA access controls to access and complete the prescriptions via the prosthetic consult module. The prosthetic consult is the order. Prosthetics and Sensory Aids Service (PSAS) and the Contracting Officer’s Representative (COR) or designee shall notify the Contractor via facsimile, email, or VA-approved portal in addition to a phone call to initiate individual patient service requirements. The consult includes the patient’s oxygen prescription, oxygen prescription expiration date, equipment, supplies, and services to be provided including the date and place of delivery. The Contractor shall confirm receipt within two (2) working hours of notification. The Contractor shall confirm by facsimile, secure email, and/or documentation in a VA-approved portal to COR or designee for Home Oxygen and Respiratory Service initiations, plan of care changes, and discharges.

Invoices shall be submitted monthly upon completion of complete delivery/pickup/setup. Invoices shall be submitted using the CLIN structure, i.e., CLIN #, Descriptions, Quantity, Unit Price, Units, and Total Price. Invoices not following the CLIN structure will be rejected.

SERVICE SPECIFICATIONS:

3.1 PRESCRIPTION CHANGES: The Contractor shall not change and/or alter a patient’s oxygen prescription and/or equipment requirements without a new prescription from the patient’s VA physician.

3.2 HOME VISITS:

a. The Contractor shall visit patients’ residences for regularly scheduled maintenance visits in performance of this contract by appointment only; between the hours of 7:00 a.m. and 7:00 p.m. Exceptions shall be made in the cases of emergencies.

b. The Contractor is responsible for scheduling the appointments at the patient’s home 24-48 hours prior to the appointment.

c. On each scheduled set-up/delivery the Contractor shall reassess the need to instruct the patient on the use and care of the equipment and supplies as necessary. The Contractor shall perform and document a home safety assessment that will include assessing for fall risk, evidence of smoking around oxygen equipment, working smoke detectors, and posted “No Smoking” signs in addition to all other Joint Commission (JC) requirements for home safety assessments.

d. Contractor shall re-instruct patient, family, and/or caregivers as necessary without formal order from the VA.

3.3 INITIAL SET-UPS: Initial set-ups are services provided to those patients who have not been provided a VA-authorized oxygen therapy delivery system to their place of residence on a previous occasion or have not used such a system continuously for the past 60 days. Once the initial set-up has been completed, the Contractor shall develop a regular delivery schedule for home oxygen and supplies to patients. All Initial 50 PSI setups shall include all disposables, large bore tubing, large volume nebulizers, drain bags, and masks.

a. Initial set-ups shall be completed within eight (8) hours of request. Failure to deliver within the required time shall result in the VA obtaining oxygen from another source. Any costs in excess of contract pricing for services provided shall be billed to contractor or credited to the next invoice at the discretion of the ordering facility. The Contractor shall notify the appropriate VA designee and/or COR via secured email, facsimile, and/or documentation within one (1) calendar day if expected delivery is not completed. This notification shall include the reason why the delivery was unable to be completed.

b. Switch-outs are services provided to those patients who are presently using an oxygen delivery system or have used such a system continuously within the past 60 days. The Contractor shall provide equipment switch-outs by staff with documented competency training on the manufacturer’s recommended assembly, use, and maintenance of the equipment used under this contract.

c. Switch outs are to be completed within two (2) calendar days. Failure to complete the switch out within the required time shall result in the VA obtaining oxygen from another source. Any costs more than contract pricing for services provided shall be billed to the contractor or credited to the next invoice at the discretion of the ordering facility, COR, and/or designee.

d. Failure to perform the switch-outs as prescribed by VA prescription shall result in no cost to the government. Payment shall be made once switch-outs are completed as prescribed. Payments shall be assessed based on the provider’s established rate and pro-rated from the set-up date. Medical equipment switch-out requested to increase the patient’s quality of life or due to changes in the patient’s oxygen requirement shall be made at no additional charge to the government.

e. Set-up of Home Oxygen includes setting up and ensuring the appropriate oxygen system is operational, instruction and training of patient, and/or caregiver, and home environment safety check. Failure to deliver within the required time shall result in the VA obtaining oxygen from another source. Any costs more than contract pricing for services provided shall be billed to the contractor or credited to the next invoice at the discretion of the ordering facility, COR, and/or designee.

f. The Contractor is responsible for establishing appointments with patients when initiating set-ups, switch-outs, and deliveries.

3.4 ASSESSMENT REQUIREMENTS:

a. The Contractor shall perform an assessment of the patient’s home and environment in accordance with Joint Commission (JC) accreditation standards for Homecare and maintain documentation of assessments in the individual patient file or folder.

b. The Contractor shall notify the VA designee and/or COR during the home visit if the Contractor’s staff determines that the presence of oxygen in the home presents such a danger that the oxygen must be removed, or in the case of an initial set-up, not placed in the home.

c. The Contractor shall notify the VA designee and/or COR by telephone or email within two (2) hours if any unsafe conditions are observed in the patient’s home that preclude the installation or continuance of oxygen service. Unsafe conditions shall include fire safety hazards, oxygen safety hazards, patient abuse by family or caregivers, or any instance that places the patient or Contractor’s staff in immediate danger. The Contractor shall provide written documentation of the safety hazard to the VA designee and/or COR within one (1) business day of the incident.

d. The Contractor shall check the adequacy of the electrical outlets in the patient’s home and while still in the patient’s residence, report any unsafe conditions to the VA designee and/or COR during the initial assessment. VA shall not be responsible or liable for any unsafe electrical conditions caused by the Contractor. Any alterations to the patient’s residence shall be the responsibility of the patient. If the ordered equipment cannot be safely installed, the VA designee and/or COR shall provide an alternative oxygen delivery system after the VA physician’s approval until a new prescription can be obtained. If no alternative is available, the prescribing VA physician shall be notified by the VA designee and/or COR.

3.4 PATIENT EDUCATION REQUIREMENTS:

a. The Contractor shall provide education to each patient at the time of set-up, and every six (6) months thereafter, and assess the need for reinforcement during visits. This information shall be presented verbally, and in demonstration and the material covered shall be in written form to be left with the patient/caregiver. The written material shall be in English as well as the foreign language of the patient, should the patient not speak English. In the case of such an occurrence the Contractor is to advise the VA facility to facilitate adequate instructions. All patient education material must be presented in written form to the VA designee and/or COR for approval prior to distribution to patients. The Contractor shall implement any new or revised education material as directed by the VA designee and/or COR. The VA shall determine whether the Contractor shall use his/her forms or forms supplied by the VA for documentation of services provided to patients. Regardless of whether the VA provides a VA Patient Rights & Responsibilities document and/or forms to the Contractor, and/or the Contractor uses his/her VA Patient Rights & Responsibilities and/or forms, the Contractor is responsible for duplication of the documents/forms when copies are needed to give to patients.

b. Patients shall be provided a copy of VA Patient Rights & Responsibilities, and Advance Directives as appropriate. The Contractor shall document that the patient/caregiver has been instructed in accordance with JC Standards for Homecare.

3.5 DISCONTINUATION OF SERVICE:

3.6 EMERGENCY SERVICES:

a. The Contractor shall provide emergency services on a 24-hour basis, and the contractor shall provide services at the patient’s home no more than four (4) hours after receiving a call. If the Contractor is unable to respond to an emergency service call within four (4) hours, the Contractor shall be responsible for making arrangements with another supplier to provide oxygen, and the Contractor shall be responsible for any excess cost above the contract reimbursed price. A written explanation of why the Contractor was unable to respond to the emergency must be provided to the VA Designee and/or COR within one (1) business day. Time constraints in 3.7(a) do not apply to non-emergency requests.

b. An emergency exists if the VA Designee and/or COR informs the Contractor that he/she considers the situation an emergency, or if the patient states in a telephone call to the Contractor that an emergency exists regarding the function of the home oxygen equipment or use of the equipment. The Contractor shall provide written details of the patient emergency to the VA Designee and/or COR within one (1) business day of notification by the patient. This written report shall contain the time of initial call and time contractor arrived at the patient’s house with any other details requested by the VA COR and/or designee.

c. The Contractor shall maintain a telephone number for emergency purposes so that the VA and patients who have been authorized to receive home oxygen may contact the Contractor outside of normal business hours. The Contractor shall provide the telephone number to all patients.

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

e. The Contractor shall be prepared to provide services on an emergency basis. Contractor shall provide initial setups and emergency service seven (7) days a week, twenty-four (24) hours a day, this includes holidays. Patient discharges requiring initial setups after 7:00 pm shall be completed that same day.

3.8 SIGNAGE: The Contractor shall provide the patient signs for all entrances into the patient’s residence, stating “Warning Oxygen in Use, No Smoking” or other verbiage that No Smoking is allowed due to oxygen being present and document that the Patient/Caregiver is instructed in the safe use of oxygen and equipment per OSHA regulations. The Contractor shall attach patient education and expectations placards to all concentrators and liquid oxygen stationary systems.

3.8 TRAVELING PATIENTS:

a. The Contractor shall be responsible for coordinating all home oxygen for patients who travel both within and outside their respective contracted area of responsibility/jurisdiction, unless otherwise indicated. The VA designee and/or COR shall be responsible for notifying the Contractor where/when the patient is traveling to and the mode of transportation. The Contractor is responsible for coordinating with the patient when travel has been completed.

b. Traveling patients shall be provided with a Federal Aviation Administration (FAA) approved portable concentrator for travel purposes at the request of the VA designee and/or COR. These units shall not be standard for long term use.

c. Invoices for travel patients shall be provided to the VA with the next monthly invoice.

d. Patients traveling within the Contractor’s area of responsibility/jurisdiction shall be provided all home oxygen under the contract at the contract rate. Patients traveling within contracted areas of responsibility/jurisdiction covered under other VA contracts for home oxygen, but not within the Contractor’s area of responsibility/jurisdiction, shall be provided all required oxygen services at whatever contract rate that applies to the area the patient is traveling. The Contractor currently providing home oxygen shall work with the VA designee and/or COR, the Home Oxygen Coordinator, and the Prosthetic Representative to notify and arrange for home oxygen with the contractor whose area the patient is traveling.

e. For patients traveling outside the areas of responsibility/jurisdiction covered by other VA contracts for home oxygen, and/or temporarily relocating, the Contractor shall arrange for home oxygen from an area provider. The Contractor shall obtain pre-approval from the Contracting Officer or designee on pricing if it is above the contract price on the Contractor’s contract. If approved, the Contractor shall be reimbursed the contract rate plus the additional cost incurred for providing appropriate home oxygen.

f. Home oxygen for travel outside of the continental USA, overseas travel, and cruises are the responsibility of the patient.

g. Patients not travelling but are permanently relocating outside of established contracted area of coverage will be provided up to 90 days of continuation of services.

EQUIPMENT SPECIFICATIONS AND ASSOCIATED REQUIREMENTS:

4.0 EQUIPMENT MAINTENANCE:

a. Twice annually or as recommended by the equipment manufacturer, whichever occurs most often, the Contractor shall visit the patient to inspect equipment, checking for proper functioning and prompting patients to replace disposables, such as filters, tubing and nasal cannula as needed. During the visit the Contractor shall also reassess equipment compliance, provide educational needs, perform equipment inspection and maintenance in accordance with manufacturer’s recommendations and perform an environmental survey. All equipment ordered shall be inspected. A written report shall include at minimum the following data:

1. Name and last four digits of social security number (SSN) of patient using the equipment.

2. Monitor compliance on prescription (Liters Per Minute (LPM), hours per day). Report will reflect hours of all equipment ordered.

3. Type of equipment, hours on concentrator (Serial numbers for the rented equipment shall be the Contractor’s responsibility and kept on file in the Contractor’s main office).

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

5. Inspection compliance of intake filters (exchange or clean by the patient); follow-up education and/or reinforcement of compliance documented.

6. Revised plan of service as needed.

7. A delivery report shall be developed by the Contractor, signed, and dated by the contract staff and the patient/caregiver and a copy shall be left with the patient. The reports shall be legible and attached to the invoice. All reports shall be submitted to the VA designee and/or COR in alphabetical order, with the monthly invoices by the 10th business day of the month following service. The report must include a patient list and associated scanned delivery/maintenance receipts with the patient’s signatures, patient-signed patient education notes, and clinical notes associated with the plan of care changes. The report shall be submitted by the Contractor in both hard copy and on electronic media (DVD or CD). Format to be approved by VA. Changes to the format shall not constitute a need for a contract modification.

4.1 NECESSARY EQUIPMENT AND SERVICES:

a. In accordance with the prescription received from the VA facility, the Contractor shall provide the patient with the following items:

1. Humidifiers and water traps, when the liter flow is equal to or greater than four (4) liters per minute, or if prescribed. The number of humidifiers must be sufficient to ensure that they are not depleted between re-supply visits. The number of traps shall be based on the patient’s flow rate. Humidifiers and water traps are always changed every two weeks with a supply in reserve sufficient to last until the contractor’s next visit.

2. Twelve (12) disposable oxygen cannulas on hand for a change every two (2) weeks with a supply in reserve always until the Contractor’s next scheduled visit.

3. Twelve (12) disposable masks for a change/wash every two (2) weeks with a supply in reserve at all times (when masks are prescribed in lieu of nasal cannulas).

4. 25-50 feet of oxygen connecting tubing shall be replaced every 30 days with an equivalent section of tubing in reserve at all times (to be included in the initial setup) until the Contractor’s next scheduled visit.

5. Tracheotomy collar and accessories (e.g., tubing, and large volume nebulizer, drain bag) with a supply on hand allowing for change every three (3) days and a supply of five (5) each in reserve at all times until the Contractor’s next scheduled visit.

6. Safety holders shall be provided at no charge for all patients with a prescription for cylinders.

4.2 CONTRACTOR OWNED CONCENTRATORS:

• The American Association for Respiratory Care for Respiratory Equipment Used in the Home. http://www.rcjournal.com/cpgs/pdf/08.07.1063.pdf

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

https://my.aami.org/aamiresources/previewfiles/HA6060101011_1508_preview.pdf

• Joint Commission (JC) Standard for Home Care.

http://www.jointcommission.org/accreditation/home_care.aspx

4.3 CYLINDERS:

a. The Contractor shall furnish cylinders required under this contract that are 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. ‘H’ or “M” cylinders furnished by the Contractor shall have ‘H’ or “M” safety stand(s) at no additional charge to the Government. This stand shall remain Contractor-owned.

b. Oxygen Cylinders provided must be United States Pharmacopoeia (U.S.P.) oxygen.

4.4 VENTILATORS: (Invasive ventilators)

4.5 VENTILATOR EQUIPMENT AND SUPPLIES:

Equipment, disposables, and trach care supplies shall be provided to patients receiving home ventilator service as described in Table 1 below. These items are to be provided to ventilator patients only.

Table1:

Ventilator Equipment and Supply Delivery Schedule

60 (monthly) 3ml Unit Dose Saline Bullets

60 (monthly) Trach Drain Sponges

60 (monthly) Basic Tracheostomy Care Kit

1 (monthly) Tracheostomy Tube

30 (monthly) Tracheostomy Disposable Inner Cannula

Options when medically necessary

For all non-invasive ventilator patient, i.e. Trilogy or equivalent, the contractor shall provide a monthly compliance downloaded report from the device and send to the VA Chief of Respiratory Therapy.

4.6 CLOSED SUCTION CATHETERS:

Contractor shall provide four (4) closed suction catheters to each ventilator patient each month. Patients shall have a replacement catheter each week. Catheters shall be replaced as needed during monthly visit by contractor RT. This item is to be provided to ventilator patients only.

4.7 INLINE HME:

The Contractor shall provide an inline heated moisture exchanger (HME) to Veterans receiving invasive mechanical ventilation in order to provide optimal levels of heat and moisture to the patient’s airway. HME’s should not be used in conjunction with a heated humidifier and should mainly be used when the patient is traveling. This item is to be provided to Invasive ventilator patients only.

4.8 FULL FACE PAP MASK:

The Contractor shall provide a full-face mask to Veterans receiving non-invasive mechanical ventilation. This item is to be provided to non-invasive ventilator patients only.

4.9 HEATED HUMIDIFIER:

The Contractor shall provide a heated humidifier to Veterans receiving mechanical ventilation to provide optimal levels of heat and moisture to the patient’s airway. This item is to be provided to all ventilator patients.

4.10 NEBULIZER WITH COMPRESSOR:

The contractor will provide a nebulizer with compressor to ventilator patients as ordered by the VA. Monthly price shall include spring loaded T-adapter, neb cups, tubing, masks, trach masks. This item is to be provided to all ventilator patients when ordered.

4.11 PORTABLE SUCTION MACHINE:

The Contractor shall provide a portable suction machine equipped with an internal battery for use during transport. This item is to be provided to invasive ventilator patients or non-invasive ventilator patients when ordered.

a. Vacuum adjustment allows for 80–550 mm Hg and a free flow of 27 Liters per minute

b. Meets American Association for Respiratory Care (AARC) guidelines

c. Switch mode power supply allows operation on any AC voltage 100 V 240 V

d. Integrated bacterial filter

e. Automatic float shut-off to prevent overflow into the unit

f. Uses a rechargeable battery with 60 minutes run time

1. Electromagnetic Compatibility Test

2. Drop Test and Shock Vibration

3. Excessive Temperature Test

4.12 AIR COMPRESSORS:

a. Contractor shall provide and maintain 50-PSI compressors to run large volume nebulizers and other various respiratory needs. Setup shall include all disposables large bore tubing, large volume nebulizers, drain bags and masks.

b. All subsequent supplies and disposables for air compressors to include large bore tubing, large volume nebulizers and masks shall be provided by the Contractor and included in the monthly rental price of the unit.

c. Supplies and disposables shall be replaced according to infection control policy of the VAMC.

d. Contractor shall perform equipment maintenance check on 50 psi air compressors and suction machines in accordance with manufacturer guidelines or as determined by COR and Contractor.

4.13 SUCTION MACHINE:

a. Suction machine will be provided to aid in removal of mucous and secretions from patient’s airway.

b. Contractor shall provide suction machine and all supplies and disposables required for patient to operate the unit.

c. Machine supplies and disposables to be incorporated in the monthly rental price of the unit.

4.14 PORTABLE OXYGEN CONCENTRATORS: Portable oxygen concentrators shall include a suitable carrying device, such as a handcart or carrying pouch, to be determined by the size and weight of the portable oxygen concentrator along with the patient’s physical ability.

a. Portable Oxygen Concentrator (Pulse Dose Only) weight </= 6 lbs.

1. Contractor shall provide FAA approved portable concentrators to beneficiaries. Portable concentrators shall be suitable for airline travel and extended and / or multi-destination land travel.

2. Provide 2 batteries, wall and car charger.

3. Deliver portable oxygen concentrator (POC) in accordance with prescription.

4. Should malfunctioning occur during beneficiaries’ travel, Contractor is responsible to make arrangements for replacement portable concentrator at beneficiaries’ place of travel.

b. Portable Oxygen Concentrator System (Continuous up to 2 (LPM) with pulse dose settings) weight </= 10 lbs.

1. Contractor shall provide FAA approved portable concentrators to beneficiaries. Portable concentrators shall be suitable for airline travel and extended and / or multi-destination land travel.

2. Must have pulse dose and continuous flow capabilities.

3. Provide 2 batteries, wall and car charger.

4. Deliver portable oxygen concentrator (POC) in accordance with prescription.

5. Should malfunctioning occur during beneficiaries’ travel, Contractor is responsible to make arrangements for replacement portable concentrator at beneficiaries’ place of travel.

2. Must have pulse dose and continuous flow capabilities.

3. Provide 2 batteries, wall and car charger.

4. Deliver portable oxygen concentrator (POC) in accordance with prescription.

5. Should malfunctioning occur during beneficiaries’ travel, Contractor is responsible to make arrangements for replacement portable concentrator at beneficiaries’ place of travel.

4.15 IN-HOME NOCTURNAL CONTINUOUS PULSE OXIMETRY TEST: Contractor shall provide in-home nocturnal continuous oximetry testing after receipt of VA physician order. The Contractor will make (3) three attempts (on different days, no less than four (4) days apart) to contact the patient for setup, if the Contractor is unable to make contact, they are to report the information back to the VA designee and/or COR for follow up and direction on how to proceed. Procedure shall include delivery, set up and pick up of rented oximeter. Data from the oximeter shall be downloaded and a written report be furnished to the VA designee and/or COR within 48 hours of pick up. This process shall be completed within 30 days of the initial order.

4.16 COUGH STIMULATING DEVICE: The Contractor Respiratory Therapist shall deliver a Cough Stimulating Device to the patient; provide instruction on use of device, with return demonstration by patient and/or caregiver, along with applicable patient education and equipment maintenance training.

a. All Cough Stimulating Device setups shall include all supplies,…