36C24820Q0208-002.docx

STATEMENT OF WORK

1.0. General:

1.1. The Government requires Home Oxygen Services for VA Beneficiaries throughout the Miami VA Healthcare System (MVAHS) Catchment areas of Broward, Dade, and Monroe Counties. Prices quoted shall be all inclusive of deliveries and transportation within the MVAHS catchment areas, and equipment, safety inspections, repairs, maintenance, and in-service training for beneficiaries to include patient education.

2.0. SCOPE / OBJECTIVE:

2.1. The Contractor shall provide government owned concentrators and furnish contractor owned oxygen cylinders, install and service oxygen equipment to dispense oxygen and supplies ordered under this contract as requested by the Contracting Officer Representative (COR) or designee.

3.0. APPLICABLE DOCUMENTS:

3.1. The following laws, regulations, policies, and procedures in effect on date of contract issuance and all subsequent changes or updates apply:

3.1.1 Federal Acquisition Regulation

3.1.2 Veterans Administration Acquisition Regulation

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

3.1.4 American Society for Testing Materials minimum standards specification for electrically powered home care portable ventilators

3.1.5 Association for the Advancement of Medical Instrumentation

3.1.6 The Joint Commission Standard for Home Care, current year standard

3.2 Glossary. Acronyms used in this PWS are listed below for easy reference:

4.0. PERFORMANCE REQUIREMENTS:

4.1 General Requirements: The Contractor shall provide all supplies, materials, equipment, labor, supervision, management, transportation, safety management, infection control, repairs, maintenance, storage of Government-owned concentrators and in-service training for beneficiaries to include patient. The Contractor shall have a physical location prior to contract award which provides storage for the service office, warehouse, dispatch of vehicles and other functions related to the performance of services required within the MVAHS catchment areas.

4.2 New Patient Set-Ups of Oxygen Systems:

4.2.1 Initial set-ups are considered to be those beneficiaries who do not have a Government authorized oxygen therapy delivery system or ventilator and shall occur within 24 hours of the time the prescription notification. Orders for supplies and services will be placed by the COR or designee. Each order will contain the patient’s name, social security number, home address, Government’s plan of care for patient, as well as the physician’s prescription, which will specify the liters per minute each patient is to receive and delivery system. The Contractor shall adjust the regulator per the prescription. The liter flow shall be changed only when furnished a new prescription, however the Contractor shall check the liter flow during the monitoring visits to make sure the liter flow still matches the prescription. The Contractor shall be responsible for ensuring the patient(s) maintain an adequate supply of oxygen.

Patient Assessment:

4.2.2 The Contractor shall perform an assessment of the beneficiary’s home and environment in accordance with The Joint Commission (TJC) standards or equivalent accredited standards and maintain documentation of assessments in the individual patient file or folder.

4.2.3 The Contractor shall notify the COR during the home visit if 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.

4.2.4 The Contractor shall verbally notify the COR by the next business day (followed by written notification) of any unsafe conditions observed in the VA beneficiary’s home that precludes the installation or continuance of oxygen service. Unsafe conditions may include, but are not limited to: fire safety hazards, oxygen safety hazards, or any instance that places the patient or Contractor’s staff in immediate danger. The Contractor shall furnish written documentation of the safety hazard to the COR within five (5) business days of the incident.

4.2.5 The Contractor shall notify the COR within twenty-four (24) hours of any patient who is noncompliant with safety guidelines set forth in the education and orientation material and/or whose behavior poses a risk of self-harm or harm to others (e.g. smoking while on oxygen), despite warnings and ongoing educational interventions.

4.2.7 The Contractor shall verify the presence of the smoke alarms and instruct the patient to test all smoke alarms on a monthly basis. In any home where smoke alarms are not present, the Contractor shall notify the COR within twenty-four (24) hours for further review and potential action.

4.2.8 Initial Set-up Instructions to Patient and Caregivers: The Contractor shall provide education to each veteran at the time of initial set up, and assess the need for reinforcement during visits. This information shall be presented verbally in demonstration. The material covered shall be in written form to be left with the beneficiary/caregiver. The written material shall be in English. In the case of the beneficiary not speaking English the Contractor shall advise the COR.

4.2.8.1 If the oxygen set-up is performed by a technician only, the visit shall be limited to set-up and instructions solely focusing on the equipment use and safety and not providing instruction for the purpose of deriving the intended medical benefit.

4.2.8.2 If the set-up visit is performed by a Respiratory Care Practitioner, in addition to set-up and instructions in the use and safety of equipment, the patient shall receive patient education relevant to his/her medical condition, the prescription, and on the intended medical benefit of the applicable home oxygen treatment.

4.2.9 The Patient Instruction Booklet shall include connection, removal, emergency procedures and contact numbers (toll free or collect) of contractor for emergency repair. The Contractor shall have the patient demonstrate the instructions provided prior to leaving the home to ensure full understanding of the appropriate use of the equipment. The Contractor shall document the training and obtain patient signature for review by the Government upon request.

4.3 Equipment:

4.3.1 Equipment Specifications:

4.3.1.1 Oxygen Concentrators must be Underwriters Laboratory (UL) approved and must, at a minimum include the following specifications:

4.3.1.1.1 Oxygen Concentration Indicator (OCI)

4.3.1.1.2 Electrically powered (115 volts)

4.3.1.1.3 Must have a battery operated audible alarm to indicate a power failure.

4.3.1.2 Concentrators furnished by the contractor, as needed. The Contractor shall be responsible for furnishing, installing, and fully servicing all oxygen equipment to dispense oxygen and supplies ordered under this contract. All equipment is to be current state-of-art model, in new or like new condition (2 years) and all supplies are to be new.

4.3.1.3 Cylinders furnished by the Contractor shall be in accordance with the Interstate Commerce Commission Regulations, and transport cylinders in accordance with the Code of Federal Regulations (CFR) Part 49, U.S. Department of Transportation. `H’ cylinders furnished by the contractor shall include an `H’ safety stand at no additional cost to the Government. The stand shall remain Contractor-owned upon contract expiration.

4.3.1.4 Bidirectional 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 by the Home Oxygen Coordinator. The mandatory requirements for thermal fuses will be ordered as Inventory by Logistics through Prosthetic funding. The Home Oxygen Coordinator will demonstrate the recommended position of the thermal fuses to the contracted vendor. The completion of the demonstration will be signed by the Home Oxygen Coordinator and the contract vendor. The COR will keep a copy of the signed documentation as a record. The contract vendor will assure two thermal fuses are 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. The contracted vendor will insert two bidirectional thermal fuses per device including the ambubags in the recommended position demonstrated by the Home Oxygen Coordinator to the contracted vendor. At the time of installation, the contract vendor will provide patient education that describes 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. The contracted vendor will instruct the veteran on safety usage of the thermal fuses. The contract vendor will replace thermal at the end of their expected life per manufacturer’s guidelines and if actuated or involved in a fire. The contracted vendor will report any fires involving the home oxygen delivery system immediately to the COR or designee and include:

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? The contracted vendor will remove all old tubing and supplies from the home.

4.3.1.5 Comply with Universal Precautions when handling equipment. The Contractor shall comply with the manufacturer guidelines in the cleansing of recovered equipment.

4.3.1.6 Medical Gas systems must 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.

4.3.1.7 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 and liquid forms of gases 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.

4.3.2 Government -Owned Concentrators:

4.3.2.1 The Contractor shall deliver, setup, pick up, clean, store, and reissue oxygen concentrators owned by the Government, providing the same services as required for Contractor-owned concentrators as specified in this contract. The Contractor shall provide loaner concentrators for any Government-owned concentrator that is removed from the patient’s home for servicing, at no additional cost to the Government. In the event the Government equipment is deemed unserviceable, it will be returned to the government. The Contractor shall store Government-owned concentrators to be used for new set ups and exchanges in a climate and humidity controlled environment.

4.3.2.2 The Contractor shall have an adequate inventory control system for maintaining accountability of Government-owned equipment. Maintenance records on all Government-owned concentrators shall be housed at the Contractor’s office. Oxygen concentrators shall be provided from government stock of concentrators unless beneficiary requirements exceed the number of Government-owned concentrators. Contractor shall furnish the additional concentrators if needed. Government concentrators shall be labeled appropriately and stored separately from Contractors concentrators.

4.3.2.3 The Contractor shall provide maintenance and repair service of Government-owned concentrators in accordance with manufacturer’s recommendations. Maintenance inspection of Government-owned concentrators shall be invoiced on a monthly basis for the concentrators that were inspected in accordance with manufacturer guidelines.

4.3.2.4 The Contractor shall maintain a current log of hours on the Concentrators for preventative maintenance (PM). PM reports shall be provided to the Government upon request.

4.3.2.5 The Contractor shall provide all disposable consumable items that are usual and customary for each type of oxygen set-up.

4.3.3 Contractor Provided Concentrators:

4.3.3.1 The Contractor shall provide loaner concentrators for any concentrator that is removed from the patient’s home for servicing. The contractor shall provide complete high-pressure backup systems, nasal cannulas, tubing, permanent or disposable humidifiers as necessary, regulators, carts and all consumable supplies (as prescribed by approved VA Pulmonologist or Neurologist Physician) for all Government-owned concentrators.

4.3.4 Contractor Provided Oxygen Cylinders:

4.3.4.1 Stationary High Pressure Cylinder (compressed gas) with maintenance. System to include refills, regulators, flow meter, cylinder cart (or cylinder support base) cannulas/masks, permanent or disposable humidifiers as necessary if ordered by physician.

4.3.4.2 Oxygen cylinders shall be delivered in the quantities based on physician order and at such times as they are needed. The Contractor shall not deliver cylinders in excess of the prescribed quantities unless quantities are approved by the providing physician.

4.3.4.3 Cylinders not in use shall be stored in an approved storage rack. Each patient on a concentrator must have a minimum of 24-48 hours for backup oxygen according to flow rate.

4.3.4.4 Oxygen Tank Storage Carts:

4.3.4.4.1 Metal storage racks shall be provided in the veteran's home for storage of compressed gas cylinders for four (4) or more.

4.3.4.5 Non-Durable Equipment:

4.3.4.5.1 Wet pre-filled humidifier, when ordered by physician. The number of wet humidifiers should be sufficient to ensure that they are not depleted between re-supply visits.

4.3.4.5.2 Disposable oxygen cannulas for change on every Seventh (7th) day with three (3) in reserve always. Upon delivery of replacement tubing, the Contractor shall ensure that three (3) reserve cannulas are left with the patient in addition to the cannula that is connected to the equipment currently in use.

4.3.4.5.3 Disposable masks for change every seventh (7th) day with two (2) in reserve always (when masks are prescribed in lieu of nasal cannulas).

4.3.4.5.4 Oxygen connecting tubing shall be green in color of 5-7-14-25-50 feet. The tubing shall be replaced monthly with three (3) equivalent sections of tubing in reserve at all times (to be included in initial setup).

4.3.4.5.5 Tracheal collar with peripherals for change every seventh (7th) day with two (2) reserves always (to be included in initial setup).

4.3.4.5.6 The Contractor shall display a sign at the Veteran’s residence stating “Warning: Oxygen in Use”.

4.3.4.5.7 The Contractor shall not charge for a 2nd delivery in the event the Contractor was not able to provide the supplies and/or equipment at the requested time.

4.3.5 Ventilators:

4.3.5.1 The Contractor shall perform an assessment with the discharge planning team prior to delivery and set up of ventilators. The Contractor shall educate/train caregivers on ventilator and/or supplies that will be furnished to the patient. Ventilator must be easy to operate by beneficiary and/or caregiver. Primary controls shall be located on one 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.

4.3.5.2 Normal set-up should include the following:

4.3.5.2.1 Two (2) ventilators, (one as a backup, as prescribed by a physician).

4.3.5.2.2 Ventilator Circuits to be changed monthly/prn with two in reserve always.

4.3.5.2.3 Bacterial/humidifier filters to be changed monthly at a minimum with two in reserve always. Daily changes may be required based on the environment of care assessment.

4.3.5.2.4 One closed system suction catheter to be changed every day with one in reserve always. The Suction system must include a swivel adapter with Meter Dose Inhaler port. The System must also include one single suction catheter with one in reserve always and one Yankeur tip suction to be cleaned every seventh (7th) day with one reserve always.

4.3.5.2.5 One MDI Dispenser

4.3.5.2.6 One resuscitation bag with mask and oxygen tubing to be cleaned every seventh (7th) day with two in reserve at all times for continuous ventilation.

4.3.5.2.7 One suction pump with suction collection jar and four (4) canisters for weekly changes.

4.3.5.2.8 Tubing for suction pump to be changed every (7th) day with two in reserve at all times.

4.3.5.2.9 Non-sterile Gloves

4.3.5.2.10 Saline Solution

4.3.5.2.11 One Tracheotomy care kit per day with one in reserve with gauze for tracheotomy site.

4.3.5.2.12 Velcro tracheotomy tube holder to be changed daily/prn with two in reserve.

4.3.5.2.13 Once the patient is discharged from home, the Contractor shall provide home visits daily by the RRT for one (1) week and then every other day for one (1) week and then monthly.

4.4 Patient Education Responsibilities:

4.4.1 On each delivery, the Contractor shall set up, adjust and instruct the patient on all equipment and services that is being prescribed, in the proper use and care of equipment and supplies as necessary. Additional training may be requested for any veteran at no additional charge to the Government. Instructions given to the beneficiary and/or care provider shall include:

4.4.1.1 The safe and appropriate use of oxygen equipment and supplies

4.4.1.2 Basic electrical and home safety to include a fire evacuation route

4.4.1.3 Beneficiary’s rights and responsibilities

4.4.1.4 How and when the beneficiary can contact the Contractor for equipment problems(24 hour toll-free telephone number to be provided).

4.4.1.5 An emergency preparedness plan to prevent interruption of service.

4.4.1.6 Required maintenance of equipment (changing filters, tubing etc).

4.4.1.7 Cleaning, handling and storage of the equipment/supplies.

4.4.1.8 Identifying, handling and disposal of hazardous materials and waste.

4.4.2 Provide the Veteran with any/all required safety check list documenting contract performance for each service provided and include patient signature that he/she has been instructed and returned a demonstration on all oxygen equipment provided for his/her use. The Contractor as directed by COR or designee shall implement any new or revised education material. The Government shall determine whether the Contractor shall use their forms or forms supplied by the Government for documentation of services provided to VA beneficiaries.

4.4.3 The “Veteran” patient, their family members and/or care provider will be the persons authorized to inspect and accept equipment on behalf of the Government. Their family members and/or care provider shall be at least 18 years of age. The beneficiary or his/her representative must certify all deliveries. Failure to obtain a signature shall result in suspension of payment for these invoices.

4.4.4 Be required to promptly inform the COR of any unusual events, including but not limited to delivery problems, excessive damage, replacement equipment recommendations, and non-compliant patients.

4.4.5 Locate and test all existing smoke detectors in patient residence, to assure functionality. If smoke detectors do not exist or are malfunctioning, Contractor shall notify the COR immediately and document in the patient’s record.

4.4.6 Verify if the Veteran has a functional Fire Extinguisher. If not, the Contractor shall communicate to the veteran the necessity of having and/or replacing the malfunctioning unit, notify the COR and document in the veteran's record.

4.4.7 Complete all necessary documentation required by any accredited body such as TJC and/or the Government and submit all documentation of patient education and plan of care to the COR.

4.5 Plan of Care:

4.5.1 The Contractor shall develop a Plan of Care folder in compliance with HIPAA within five (5) workdays after initial setup. As a minimum the folder shall include:

4.5.1.1 Written confirmation for oxygen service and a copy of the oxygen prescription

4.5.1.2 Individualized plans of service

4.5.1.3 Patient education documentation

4.5.1.4 Safety inspections

4.5.1.5 Falls Assessment

4.5.1.6 Emergency contact number at a separate residence

4.5.1.7 Any other documentation required by TJC

4.5.2 All signed deliveries and/or maintenance shall be filed in the veteran’s Plan of Care folder/electronic medical record. Information in the folders, maintained by the Contractor, shall be held in confidentiality. Plan of Care folders are subject to review by designated Government officials and any accrediting body surveyors such as TJC on behalf of the Government during accreditation surveys or consultation and reviews may be done without having to give prior notice of doing so. The Plan of Care shall be made available to the COR within twenty four (24) hours of being requested. Upon request by the Government, the contractor shall provide access to and furnish case records of Government patients for whom claims have been submitted and that the Government may use any information so obtained for statistical, actuarial, scientific review or other reasonable purposes.

4.5.3 All beneficiary Plan of Care folders become the property of Government upon termination of contract. Contractor shall provide all beneficiary folders to the Government within thirty (30) days of date of contract termination. Failure to provide these folders shall result in withholding of final payment.

4.6 Customer Service:

4.6.1 If required by COR/designee contractor shall provide a Registered Respiratory Therapist (RRT) during home visits when a new patient is enrolled into the Miami VA Home Respiratory Care Program. This first visit is referred to as an Initial Set-up which shall be accomplished immediately but no later than the next business day unless mutually agreed upon by Beneficiary (or caregiver)/COR (or designee)/Contractor) after time of notification.

4.6.2 The Contractor shall be responsible for making every effort to establish appointments with beneficiaries when initiating set ups and deliveries. Deliveries shall not be left unattended at the beneficiary’s home. If the beneficiary chronically fails to meet appointments, the Contractor shall notify the COR or designee.

4.6.3 The COR or designee will contact the beneficiary and a corrective action plan will be implemented. The COR or designee will notify the Contractor of any changes. If the Contractor fails to perform and has not made valid and documented attempts to contact the beneficiaries for set-ups and or deliveries, the Government reserves the right to call in a third party and bill the Contractor for all costs.

4.6.4 Confirmed receipt of the requests shall be provided within two (2) working hours of notification. The Government will also provide notification if Government-owned equipment will be provided. All notifications will be by verbal, facsimile, secured email or other government approved electronic means.

4.6.5 Services provided shall be all inclusive of deliveries and transportation within the MVAHS catchment areas. The Contractor shall, upon government notification by the COR or designee, initiate individual beneficiary service requirements, including oxygen prescription, equipment and supplies.

4.6.6 The Contractor shall provide United States Pharmacopoeia (U.S.P.) oxygen. The Contractor shall deliver, provide, install and service medical oxygen equipment, high-pressure cylinder, government owned/concentrator and/or liquid systems, portable systems, emergency backup systems and supplies to eligible Veteran beneficiaries as required by the Government.

4.6.7 Inform patients of their rights and responsibilities and routinely conduct patient customer satisfaction surveys. The Contractor shall submit results of satisfaction surveys conducted to the COR quarterly.

4.7 Service Area:

4.7.1 The Contractor shall be responsible for deliveries to Government beneficiaries in the following Florida counties: Miami VA Healthcare System Catchment Areas- Average is 312. The COR will provide the Contractor with notification of the need for new services, or a change in existing services, as they develop.

4.7.1.1 Counties Estimated Number of Patient on Oxygen

4.7.1.1.a Broward 105

4.7.1.1.b Dade 199

4.7.1.1.c Monroe 8

4.7.2 Services shall be provided at the Veteran’s residence, MVAHS, and MVAHS Outpatient Clinics. The patient’s equipment needs are subject to change as determined by the prescribing physician.

4.7.3 Veterans may travel out of the service area and require travel oxygen and oxygen service at a temporary location. The Contractor shall be responsible for coordination of subcontracting for oxygen services for these patients. The contractor will coordinate with the COR or designee on all permanent moves/transfers out of the service area. The Government will be responsible for the first 30 days after veteran moves to another location. In cases involving vacation travel (via automobile, marine vessel, and/or air) contractor may provide Government-owned transport loaner concentrator for travel.

4.7.4 Provide Veterans travel equipment and shall be responsible for infection control and function/maintenance check prior to issue/reissue. Instructions shall be provided to the beneficiaries in writing and beneficiaries must agree that they will be financially responsible for any/all non-returned equipment taken outside the catchment area. The contractor shall also inform the patient that after the first 30 days of any permanent or extended stay outside of the service area it will be the patient’s responsibility and that the Government will stop all payments after the thirtieth (30th) day. The Contractor shall obtain the beneficiaries signature indicating that they agree to the terms. It shall be the Contractor’s responsibility to invoice the Government.

4.8 Confidentiality Information and Special Requirements:

4.8.1 Confidentiality Information: Government will provide the Contractor access to pertinent patient medical information, within the existing privacy rules and regulations, for the purpose of providing coordinated comprehensive primary care. The contractor shall ensure the confidentiality of all patient information. Patient information is Protected Health Information

(PHI).

4.8.2 Special Performance Requirements: Under the authority of Public Law 104-262 and 38 USC 8153, the contractor agrees to provide Health Care Resources in accordance with the terms and conditions stated herein, to furnish the services and prices specified in the Section entitled Schedule of Supplies or Services and Prices/Costs of this contract. The Contractor shall possess all licenses, permits, accreditations and certificates as required by law. The services to be performed by the contractor shall be performed in accordance with DVA policies and procedures and the regulations of the medical staff by laws of the VA facility. All costs associated with obtaining certifications, permits, and accreditations, licenses, training and cards/badges shall be the contractors’ responsibility.

4.9 Emergency Contingency Plan:

4.9.1 Contractor shall provide an emergency contingency plan approved by the state of Florida, each May of the calendar year for natural disasters (winter storms, tornadoes, hurricanes, floods) and power outages.

4.10 Emergency Services:

4.10.1 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 HOC and/or PSAS 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.

4.10.2 Emergency orders for initial set-up will be placed in writing, by fax, or by telephone, by the COR delegated that authority by the Contracting Officer. An emergency set up is a severe life-threatening situation and will be documented as such on the prescription prepared by the Pulmonary physician. If the Contractor is unable or refuses to meet the two (2) hour emergency response time; a written explanation as to why shall be provided to the COR by close of business the next day.

4.10.3 Emergency Response Time: If service is not furnished within the time frames listed above, the Government reserves the right to obtain the services from another source and to charge the Contractor with any excess cost which may result there from.

4.10.4 An adhesive label with the Contractor’s name, address and telephone number shall be placed on the equipment, on the patient’s telephone, or other obvious location agreeable to the patient, so that the patient and/or care giver know where to call to report emergency malfunctions.

4.10.5 Drop shipments shall be authorized on a case-by-case basis by the COR, and only for items which a patient and/or care giver would reasonably be able to remove from the packaging and begin to use without detailed instructions (i.e., tubing, cannula)

4.11 Back-Up Emergency Oxygen:

4.11.1 Minimum of one (1) H cylinder, three (3) E cylinders, or liquid systems, as prescribed by VA Pulmonary/Neurology physician per patient and 2 M tanks instead of E cylinders that last three (3) hours. Oxygen equipment and supplies shall comply with TJC standards.

4.11.2 Delivered tanks for preparation of hurricane season or other natural disasters shall be scheduled for pick up immediately once normal living conditions have resumed.

4.12 Site Visits and Inspections:

4.12.1 The Contractor shall permit on-site visits by Government personnel as well as TJC surveyors when accompanied by Government personnel to assess contracted services, i.e., adequacy, compliance with contract requirements, and record keeping. Routine visits by Government personnel may be unannounced any time between normal business hours (8:00 a.m.-4:30 p.m.) and may occur as frequently as monthly. Inspection reports will be provided to the contractor by the COR with any discrepancies and/or recommendations.

4.13 Transition Periods:

4.13.1. Phase-In Requirements: Phase-in of home oxygen services performed under a contract shall be completed within sixty (60) days of the contract Notice to Proceed. After award of the contact, the contractor shall coordinate for picking up existing government inventory from the previous/incumbent contractor’s storage within sixty (60) calendar days after the effective date of the Notice to Proceed. The contractor shall coordinate a smooth transition with the previous contractor of all home oxygen equipment, to maintain continuity of patient care. The contractor shall provide all VA patients prescribed oxygen equipment which is in acceptable working condition according to manufacturer guidelines.

4.13.2. Coordinate the schedule of initial patient visits with the COR. Prior to commencement of phase-in, the COR will provide the contractor with a list of current patients, to include:

4.13.2.1 Name

4.13.2.2 Address

4.13.2.3 Phone Number

4.13.2.4 Point of Contact if other than patient

4.13.2.5 List of contractors owned equipment at each patient’s residence

4.13.2.6 List of Government owned equipment at each patient’s residence

4.13.2.7 Current Prescription

4.13.3. Phase-Out Requirements: The contractor recognizes that the services under this contract are vital to the government and must be continued without interruption. Upon expiration, another contractor may be awarded the subsequent contract to continue these vital services. The Contractor shall arrange and coordinate with the present vendor/Contractor and each affected veteran the exchange of all rental equipment, ensuring that there is no disruption of service to the patient. The Contractor shall provide all necessary supplies at the time of exchange at no additional cost to the government. The Contractor shall notify previous Contractor and the COR once the exchange is made so that the previous contractor may recover their equipment. The contractor shall provide all necessary training at the time of delivery/exchange. The exchange shall be completed within sixty (60) days from effective date of contract. All cost of exchanging rental equipment and training shall be borne by the Contractor.

5.0 PERFORMANCE LOCATION AND HOURS:

5.1. This is a full-service contract providing services 24 hours per day seven (7) days per week, 365 days per year. The services covered by the contract shall be furnished by the contractor as defined herein: Miami VA Healthcare System (MVAHS) Catchment areas of Broward, Dade, and Monroe Counties.

5.1.1. Government Normal Business Hours: services under this contract shall be performed during normal business hours. The Contractor shall provide services through scheduled visits, Monday through Friday from 8:00 a.m. through 4:30 p.m., excluding Federal holidays.

5.1.2. The Government observes the following Federal holidays listed below:

New Year’s Day Labor Day President’s Day Veteran’s Day Christmas Day Martin Luther King’s Birthday Columbus Day Memorial Day Thanksgiving Day July 4th

6.0 DELIVERABLES:

6.1 Equipment Inventory.

6.1.1. The Contractor shall maintain an inventory record of all Government owned equipment held in storage. A copy of the inventory record shall be submitted monthly with Contractor invoice to the COR.

6.1.2. Provide a comprehensive oxygen tank inventory semi-annually at no additional cost. Inventory shall be by tank sizes, portable make, and portable model and shall include a breakdown for:

6.1.2.1 Number and size of tanks on hand at warehouse

6.1.2.2 Number and size of tanks at beneficiary home

6.1.2.3 Number and size of tanks being hydrostatic tested

6.1.2.4 Number and size of tanks to be refilled

6.1.2.5 Model number of portables on hand at warehouse

6.1.2.6 Model number of portables at beneficiary home

6.2. Contractor Invoices.

6.2.1. Invoices shall be submitted in an electronic format to the COR along with the following supplemental documentation such as: environmental assessment; communication of patient rights and responsibilities; instructions on the care use and maintenance of equipment. The invoices shall be accompanied by an alphabetically arranged consolidated listing of all veterans receiving services during the billing period.

6.2.2. The Contractor shall submit the invoices no later than five (5) working days after the end of each month to the COR. Billing should be calculated on a monthly basis; however, if a patient does not require usage of the contractor’s equipment for a complete month, the contractor shall prorate the rental fee prior to submission of the monthly bill/invoice.

6.2.3. All delivery receipts shall be signed by the patient or beneficiary or his/her representative.

6.2.4. Supplies and Equipment Invoices shall include, but not limited to: Veteran’s name and last four of social security number.

6.2.5. All disposable items issued shall be listed.

6.2.6. Liquid Oxygen Invoices shall include: The Veteran’s name, last four of social security number, and number of liquid pounds delivered minus pounds remaining in changed out reservoirs.

6.2.7. To constitute a proper invoice it shall contain at a minimum the following information:

6.2.7.1 Name of the business and the invoice date.

6.2.7.2 Contract and purchase order number or other authorization for rendering services.

(Failure to cite these numbers may cause a delay in processing payments.)

6.2.7.3 Description, price, and quantity of property and services actually delivered or rendered.

6.2.7.4 Cylinder sizes, (where applicable).

6.2.7.5 Unit prices

6.2.7.6 Equipment manufacture, model and serial number, indication of whether it is provided as new or refurbished.

6.2.7.7 Oxygen lot number

6.2.7.8 Concentrator hours (hours shall be checked on every delivery and reported to the COR with name, title, phone number, and complete remittance address to where payment shall be forwarded.

6.2.7.9 Patient’s Name and last four of Social Security Number with master worksheet and breakdown.

6.2.8. Invoices shall be sent to: COR (546/121), Miami VA Healthcare System (MVAHS), 1201 NW 16th Street, Miami, Florida 33125.

6.2.9. The contractor shall not submit bills to any other state, federal or third part agency for reimbursement or payment during the period the beneficiary is covered under this contract.

6.3 Monthly/Quarterly Reports

6.3.1. The following monthly/quarterly reports shall be provided by the Contractor to the COR:

6.3.1.1 Summary of all notifications within the reporting month and corrective actions taken.

6.3.1.2 All product recall, removal, required adjustment, or required modification that is suggested or mandated by the contractor, distributor, manufacturer, or any regulatory or official agency.

6.3.1.3 The information that shall be included in this notification includes:

6.3.1.3.1 A complete item description/identification.

6.3.1.3.2 Administrative identification data including contract number, order numbers and order date.

6.3.1.3.3 Reasons for recall, removal, adjustment, or modification.

6.3.1.3.4 Instructions for appropriate corrective action.

6.3.1.3.5 If an item has been discontinued by the manufacturer or out of stock, the contractor shall notify the COR within 24 hours in writing.

7.0 CONTRACTOR KEY PERSONNEL REPLACEMENT AND SUBSTITUTION:

7.1. The Contractor shall have the right to remove his personnel assigned to perform the tasks hereunder and to substitute other qualified personnel provided that the Contracting Officer is notified of (and in certain circumstances approves) such removal and replacement. The Contractor shall notify the Contracting Officer prior to such change, giving the new employee's name, security clearance and technical qualifications.

7.1.1 Any removals or replacements for the convenience of the Contractor shall be at no additional cost to the Government. Cost to be borne by the Contractor include but are not limited to time of travel, travel and training costs for replacement personnel.

7.1.2 Removals or replacements of Contractor personnel shall be considered for the convenience of the Contractor except when such removal is for:

7.1.2.1 Employees removed because of cancellation or completion of the contract

7.1.2.2 Employees replaced due to death or incapacitating illness or injury

7.1.2.3 Employees removed or replaced at the Government's request

7.1.3. If any employee removes him/herself from the employ of the Contractor, such removal will be at no additional cost to the Government.

7.2. Key Personnel requirements.

7.2.1. Certain experienced, professional and/or technical personnel are essential for successful accomplishment of the work to be performed under this contract. These are defined as “Key Personnel” and are those persons whose resumes were submitted for evaluation of the proposal and are listed in paragraph 7.3. below. The Contractor agrees that such personnel shall not be removed from the contract work or replaced without compliance with the following:

7.2.1.1 If one or more of the key personnel, for any reason, becomes or is expected to become unavailable for work under this contract for a continuous period exceeding 30 work days, or is expected to devote substantially less effort to the work than indicated in the proposal or initially anticipated, the Contractor shall, subject to the concurrence of the Contracting Officer or an authorized representative, promptly replace personnel with personnel of equal ability and qualifications.

7.2.1.2 All requests for approval of substitutions must be in writing and provide a detailed explanation of the circumstances necessitating the proposed substitutions. The request must contain a resume for the proposed substitute, and any other information requested by the Contracting Officer. The Contracting Officer shall promptly notify the Contractor of approval or disapproval in writing.

7.3. If the Contracting Officer determines that suitable and timely replacement of key personnel who have been reassigned, terminated or have otherwise become unavailable for the contract work is not reasonably forthcoming or that the resultant reduction of productive effort would be so substantial as to impair successful completion of the contract, the Contracting Officer may terminate the contract for default or for the convenience of the Government, as appropriate, or make an equitable adjustment to the contract to compensate the Government for any resultant delay, loss or damage. The follow positions are identified as key personnel: (Insert key personnel positions)

8.0 CONTRACTOR PERSONNEL AND MANAGEMENT:

8.1. Contractor Employee Certifications:

8.1.1. The contractor shall possess all licenses, permits, accreditations, and certificates as required by local, state and federal law. The Contractor shall meet or exceed The Joint Commission (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 of survey date, the outcome of the survey, and provide copies of new certificates as issued. Before contract award, the contractor’s facility (ies) will be inspected by the VA.

8.1.2. The contractor shall be responsible for employing technically qualified personnel to perform the work specified in this PWS. Shall maintain the personnel, organization and administrative control necessary to ensure that the work delivered meets the contract specifications and requirements. Develop, maintain, and make available for review, personnel folders on all employees performing under this contract.

8.1.3. The contractor shall provide and document background check, employee orientation, ongoing employee education, and ongoing assessment of employee competency for all employees involved with the delivery/recovery of equipment covered under this contract according to any accredited body such as TJC Standards.

8.1.4. The contractor shall provide the COR with a list of all employees currently competent to perform delivery/recovery and patient education services at the time the contract is awarded. COR will inspect employee files at the time of the inspection of Contractor premises and vehicles.

8.1.5. Only employees that have been properly trained and who have demonstrated competency shall perform equipment deliveries, recoveries, and patient education on the equipment.

8.1.6. The contractor shall be staffed and have sufficient supplies to render satisfactory and courteous service at all times to the beneficiary. The contractor shall be responsible for the acts and omissions of his/her employees, or satellite offices and their employees. Sub-contractors shall to the requirements of this contract.

8.1.7 The contractor shall provide continuing in-service education for each contract year and provide documentation to verify competency and certify training to the COR annually or when requested.

8.1.8. The contractor shall have at least three (3) years of experience in successfully administering basic home oxygen/ventilator to adult and geriatric patients. The Contractor shall coordinate, supervise and evaluate the services provided.

8.2. Safety/Security Requirements. The contractor shall comply with all applicable federal, state and local laws and ensure performance is secure while protecting material, equipment, and supplies from damage and loss. Government security personnel shall have the express right to inspect for security violations at any time during the term of the contract.

8.3. All information generated in performance of this contract becomes property of the Government and must be surrendered upon request and/or completion of the contract. The Contractor shall protect against the destruction and/or misplacement of all information produced under this contract, unless directed under local policy to destroy. This includes both hard and soft copies of data.

8.4. The contractor shall not release any information (including photographs, files, public announcements, statements, denials, or confirmations) on any part of the subject matter of this contract or any phase of any program hereunder without the prior written approval of the COR.

8.5. Standards of Conduct:

8.5.1. Conduct of Personnel. Conduct themselves in a professional manner (i.e. timeliness, communication; spoken and written etc.). The Contracting Officer may require the Contractor to remove from the job site any employee working under this contract for reasons of suspected misconduct, a suspected security breach, or suspected to be under the influence of alcohol, drugs, or any other incapacitating agent. Contractor employees shall be subject to dismissal from the premises upon determination by the Contracting Officer that such action is necessary in the interests of the Government. The hospital director or designated representative has the authority to bar individuals from the Government facility. The removal from the job site or dismissal from the premises shall not relieve the Contractor of the requirement to provide sufficient personnel to perform the services as required by this performance work statement. The Government shall not reimburse the Contractor for travel and other expenses associated with the removal of personnel.

8.5.2. Contractor personnel are not authorized to carry or possess personal weapons to include, but not limited to, firearms and knives with a blade length more than three inches, while assigned under this contract.

8.6. Working Attire and Appearance. Contractor personnel shall present a professional appearance commensurate with standards delineated for Government civilian personnel acting in similar capacities.

8.7. The Government reserves the right to review Contractor personnel qualifications; approvals for review and acceptance by the COR. The intent is verification purpose and not for the Government to become the hiring authority.

8.8. Contractor Personnel Policy:

8.8.1. Contractor employees shall wear visible identification, provided by the Contractor, always while on any assignment under this contract.

8.8.2. Parking at each VA facility is permitted only in designated areas. The VA will not invalidate or make reimbursement for parking violations under any conditions. Smoking is only allowed in designated areas per VA Policy. Possession of weapons and firearms on VA property is prohibited. Enclosed containers, including tool kits, shall be subject to search. Violations of VA regulations may result in citation answerable in the United States (Federal) District Court, not a local district, state, or municipal court.

8.8.3. The contractor shall follow all existing local, state, federal and/or union laws or regulations relevant to fringe benefits and premium pay for their employees.

8.8.4. All personnel working under this contract, for all purposes under this contract, shall be considered employees of the contractor. The contractor shall assume sole responsibility for payment of wages to personnel performing services under this contract. The contractor shall be responsible for protecting the personnel furnishing services under this contract. To carry out this responsibility, the contractor shall provide the following for these personnel:

8.8.5. Except in emergencies and as directed by the COR/HOC, the contractor shall not be required to perform services on Federal holidays. Any employee working over forty (40) hours a week will receive overtime compensation. The VA recognizes the following holidays and any other day declared a National holiday by the President of the United States: New Years Day, Martin Luther King Day, Presidents Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving Day and Christmas Day.

8.8.6. The COR shall not in any way be considered the supervisor of the contractor personnel for any reason.

8.8.7. Before entering a patient’s home, the contractor’s employees shall present an identification card/badge to the patient/primary caregiver. The contractor’s employee shall be required to request two forms of identification from the patient.