3- Solicitation 36C24822Q0162 Amendment 0002.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. 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

36C24822Q0162 11-15-2021

Malcolm Davis 561-517-1793 06-25-2022

1500 EDT

36C248 Department of Veterans Affairs Network Contracting Office 8 (NCO 8) West Palm Beach VA Medical Center 7305 North Military Trail Palm Beach Gardens FL 33410-6400

X 100

X

Y

621610

$16.5 Million

N/A

Department of Veterans Affairs West Palm Beach VA Medical Center 7305 North Military Trail

Palm Beach Gardens FL 33410-6400

36C248

Department of Veterans Affairs Network Contracting Office 8 (NCO 8) West Palm Beach VA Medical Center

Palm Beach Gardens FL 33410-6400

Department of Veterans Affairs Financial Services Center

P.O. Box 149971 Austin TX 78714-9971

See CONTINUATION Page

This solicitation is in accordance with Federal Acquisition Regulation (FAR) Part 15.

This solicitation is issued for the acquisition of home oxygen delivery for the Department of Veterans Affairs (VA) Veterans Integrated Service Network (VISN 8) West Palm Beach locations.

This will be a single award solicitation. Only one vendor will be awarded.

All request for clarification is due no later than June 22 2022 at 12:00 PM ET.

See CONTINUATION Page

X 1

Malcolm Davis Contracting Officer

36C24822Q0162

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 STATEMENT OF WORK

B.3 PRICE/COST SCHEDULE

ITEM INFORMATION

SECTION C - CONTRACT CLAUSES

C.1 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (NOV 2021)

C.2 52.212-2a Addendum to 52.212-2 BASIS FOR CONTRACT AWARD

C.3 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (NOV 2021)

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 52.222-19 CHILD LABOR—COOPERATION WITH AUTHORITIES AND

REMEDIES (JAN 2022) (JUL 2020) (DEVIATION)

C.8 VAAR 852.219-78 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—

CERTIFICATE OF COMPLIANCE FOR SUPPLIES AND PRODUCTS (SEP 2021)

(DEVIATION)

C.9 52.232-18 AVAILABILITY OF FUNDS (APR 1984)

C.10 52.233-3 PROTEST AFTER AWARD (AUG 1996)

C.11 52.233-4 APPLICABLE LAW FOR BREACH OF CONTRACT CLAIM (OCT 2004)

C.12 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.13 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)109

C.14 52.246-2 INSPECTION OF SUPPLIES—FIXED-PRICE (AUG 1996)

C.15 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.16 IT CONTRACT SECURITY

C.17 52.219-14 LIMITATIONS ON SUBCONTRACTING (SEP 2021)

C.18 52.222-3 CONVICT LABOR (JUNE 2003)

C.19 52.223-6 DRUG-FREE WORKPLACE (MAY 2001)

C.20 MANDATORY WRITTEN DISCLOSURES

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.2 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.3 52.216-1 TYPE OF CONTRACT (APR 1984)

E.4 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (NOV 2021)

E.5 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (NOV 2021) (JUL 2020)

(DEVIATION)

E.6 52.215-14 INTEGRITY OF UNIT PRICES (NOV 2021)

E.7 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.8 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.9 VAAR 852.219-10 VA NOTICE OF TOTAL SERVICE-DISABLED VETERAN-

OWNED SMALL BUSINESS SET-ASIDE (JUL 2019) (DEVIATION)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1.1 AUTHORIZED REPRESENTATIVES

1.1.1 The primary Contracting Officer for this proposal is:

Malcolm Davis, Contracting Officer Department of Veterans Affairs West Palm Beach VA Healthcare System

West Palm Beach FL 33410

1.2. POST AWARD PERFORMANCE CONFERENCE

A post award conference shall be scheduled with the contractor if deemed necessary for orientation purposes.

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

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.

5. FSC MANDATORY ELECTRONIC INVOICE SUBMISSION: Contractors are required to submit payment requests in electronic form in accordance with the submission instructions below.

TUNGSTEN ELECTRONIC INVOICE SUBMISSION

FSC e-INVOICE PROGRAM THRU AUSTIN PORTAL

FSC MANDATORY ELECTRONIC INVOICE SUBMISSION FOR AUSTIN PAYMENTS

a. Vendor Electronic Invoice Submission Methods:

Facsimile, e-mail, and scanned documents are not acceptable forms of submission for payment requests. Electronic form means an automated system transmitting information electronically according to the accepted electronic data transmission methods below.

1. VA’s Electronic Invoice Presentment and Payment System – The FSC uses a third-party contractor, Tungsten, to transition vendors from paper to electronic invoice submission.

Please go to this website: http://www.tungsten-network.com/US/en/veterans-affairs/ to begin submitting electronic invoices, free of charge.

2. A system that conforms to the X12 electronic data interchange (EDI) formats established by the Accredited Standards Center (ASC) chartered by the American National Standards Institute (ANSI). The X12 EDI Web site (http://www.x12.org)

b. Vendor e-invoice Set-Up Information:

Please contact Tungsten at the phone number or email address listed below to begin submitting your electronic invoices to the VA Financial Services Center for payment processing, free of charge. If you have question about the e-invoicing program or Tungsten, please contact the FSC at the phone number or email address listed below.

1. Tungsten e-Invoice Setup Information: 1-877-489-6135

2. Tungsten e-Invoice email: VA.Registration@Tungsten-Network.com

3. FSC e-Invoice Contact Information: 1-877-353-9791

4. FSC e-invoice email: vafsccshd@va.gov

See https://www.fsc.va.gov/einvoice.asp for more information.

B.2 STATEMENT OF WORK

STATEMENT OF WORK

Home Oxygen Services

West Palm Beach Veteran’s Affairs Healthcare System

1.0 DEFINITIONS/ACRONYMS:

• Against Medical Advice (AMA)

• Code of Federal Regulation (CFR) https://www.archives.gov/federal-register/cfr

• Contracting officer's representative (COR): A representative from the requiring activity appointed in writing by the Contracting Officer to perform surveillance and to act as liaison to the contractor. Such designation will be in writing and will define the scope http://www.tungsten-network.com/US/en/veterans-affairs/ http://www.x12.org/ mailto:VA.Registration@Tungsten-Network.com mailto:vafsccshd@va.gov https://www.fsc.va.gov/einvoice.asp and limitations of the designee’s authority. A COR appointment letter will be furnished to the Contractor.

• Department of Veterans Affairs (VA) https://www.va.gov/

• Electronic Protected Health Information (EPHI)

• Government-Furnished Equipment (GFE)

• Health Insurance Portability and Accountability Act (HIPPA) https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html

• Joint Commission: (http://www.jointcommission.org)

• National Fire Protection Association (NFPA) http://www.nfpa.org/

• Occupational Safety and Health Administration (OSHA) https://www.osha.gov/

• West Palm Beach Veteran Affairs Healthcare System (VAHCS) https://www.west

Palm Beach.va.gov/

• Preventive maintenance inspections (PMI)

• Privacy Act of 1974 https://www.justice.gov/opcl/privacy-act-1974

• Prosthetics and Sensory Aids Service (PSAS)

• Protected Health Information (PHI)

• Respiratory Care Practitioner (RCP)

• Quality Assurance Surveillance Plan (QASP)

• Underwriter Laboratory (UL) http://www.ul.com/

• United States Pharmacopoeia (USP) http://www.usp.org/about-usp

• Veterans Affairs Healthcare System (VAHCS) http://www.jointcommission.org/ http://www.ul.com/ http://www.usp.org/about-usp

2.0 SCOPE

The Department of Veterans Affairs (VA) West Palm Beach VA Medical Center (VAMC) located at 7305 N Military Trail West Palm Beach, Florida 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 patients 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, VA owned/concentrator and/or liquid systems, portable systems, emergency back-up systems and supplies to eligible VA patients as required by the WPB VAMC. Services provided shall be all inclusive of deliveries and transportation within the seven (7) county catchment areas of Hendry, Glades, Indian River, Martin, Okeechobee, Palm Beach and St Lucie. Prices quoted shall be all inclusive of deliveries and transportation within the (7) county catchment areas, and equipment, safety inspections, repairs, maintenance, and in-service training for patients to include patient education.

The WPB VAMC currently provides supplies to an estimated 610 oxygen using patients on a monthly basis. The volumes or amounts shown in the solicitation are estimates only and impose no obligation on the VA either minimum or maximum. The contract shall be for the actual requirements of the VA as ordered by the VA during the life of the contract. The Contracting Officer’s Representative (COR) or designee will provide the Contractor with notification to initiate individual patient service requirements via fax or encrypted electronic means (telephonic for emergencies) and will also provide the Contractor with notification of VA initiated discontinuance of service. The notification may be made orally or by encrypted e-mail but will be received in writing to the Contractor within three (3) business days.

2.1 Geographic Area of Coverage: The Contractor is responsible for deliveries to VA patients in the following Florida counties: Hendry, Glades, Indian River, Martin, Okeechobee, Palm Beach, St. Lucie.

2.2 Monthly Average: 610: Distribution of patients on West Palm Beach Home Oxygen will vary from month to month as patients are added and discharged from the program for a variety of reasons.

2.3 The Contractor must have the capability to support workload increase and expand services.

Those requirements will be negotiated when and if required. The quantities given in the solicitation are estimates only and impose no obligation on the VA either minimum or maximum. The contract shall be for the actual requirements of the VA as ordered during the life of the contract. This is a non-personnel service contract. The Government shall not exercise any supervision or control over the contract service providers performing the services herein.

2.4 The Contractor shall manage Government-Furnished Equipment (hereafter GFE – if applicable) and all other oxygen equipment for use in the performance of this requirement by providing storage and maintenance of high-pressure cylinders, concentrators, oxygen refill systems, emergency backup systems and supplies to eligible VAHCS beneficiaries as required by the VAHCS. The Contractor shall provide delivery and set-up of same to VAHCS patients. Services provided shall be all inclusive of deliveries, transportation, and delivery/set-up of equipment, in-service training for beneficiaries/care providers to include patient education, safety inspections and preventive maintenance inspections (PMI) service appointments.

2.5 The VAHCS reserves the option of renting or purchasing GFE (Concentrators, Conservers, Oxygen systems) at any time during contract period.

Period of Performance:

Period of performance shall be date of award through 12 months, with four (4) 12-month options. Options will be exercised at the discretion of the Government.

Type of Contract: The Government intends to award multiple fixed price Indefinite Delivery contracts as a result of this solicitation.

All services shall be provided either at VAHCS, the veteran’s residence, or in a nursing home where the veteran resides. All efforts in support of this requirement are carried out in accordance with Joint Commission standards. The use of the terms “beneficiary”, “Veterans”, “Patients”, and “Patient” are used interchangeably and refer to the recipient of required services inclusive of incidental supplies and equipment.

The Contracting Officer reserves the right to designate a representative to furnish technical guidance and advice or generally monitor the work to be performed under this contract. Such designation will be in writing and will define the scope and limitations of the designee’s authority. A copy of the designation will be furnished to the Contractor no more than 5 days after notice of award.

The COR or other personnel specifically authorized in the contract (hereafter authorized personnel), will notify the Contractor by phone, secure fax or email to initiate service: the beneficiary’s oxygen prescription, the services, equipment, and supplies 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 or authorized personnel will provide notification if government owned equipment has already been provided. The COR or authorized personnel will also provide notification of government-initiated discontinuance of service. The notification may be made orally but will be confirmed in writing within 24 hours.

Contractor’s physical location shall have a service office and warehouse within two (2) hours of the West Palm Beach VAMC’s catchment area and shall accommodate walk-in services. The location must house the service office, warehouse, dispatch of vehicles and other functions related to the performance of home oxygen services. Contractor shall maintain on-site inventory to provide a comprehensive range of respiratory products and services. Contractor shall have the capability, technology, and resources to respond to service calls or walk-ins and other functions related to the performance of services. Contractor is subject to Joint Commission and/or VA inspections.

2.2 The Contractor shall manage Government-Furnished Equipment (hereafter GFE) and all other oxygen equipment for use in the performance of this requirement by providing storage and maintenance of high-pressure cylinders, concentrators, oxygen refill systems, emergency backup systems and supplies to eligible VAHCS beneficiaries as required by the VAHCS. The Contractor shall provide delivery and set-up of same to VAHCS patients. Services provided shall be all inclusive of deliveries, transportation, and delivery/set-up of equipment, in-service training for beneficiaries/care providers to include patient education, safety inspections and preventive maintenance inspections (PMI) service appointments.

3.0 GENERAL

3.1 The Contractor shall maintain an inventory record of all stored Government Furnished Equipment (GFE). The Contractor shall re-issue used items that are acceptable for issue in lieu of new equipment in storage. Before placing equipment in the storage area, all recovered equipment shall be cleaned, checked for proper operation, function, safety and serviceability and wrapped in accordance with accepted standards to maintain cleanliness. Equipment shall be protected from damage (i.e., weather, insects, rodents) while stored at Contractor facility.

Cleaned equipment shall be separated from dirty equipment at all times. Government Furnished Equipment (GFE) should be stored separately from contractor’s owned equipment.

Veterans with a prescription for an oxygen concentrator shall be provided with an appropriate backup system consisting of a compressed gas source and regulator with stand, humidifiers, cannulas/mask for use during the event of a power failure or mechanical problem and necessitating the use of backup cylinder. The cost for the above-mentioned backup system shall be borne by the Contractor when a concentrator is rented from the Contractor. When a government-furnished concentrator is issued a monthly rental fee for the back-up system will apply. Contractor shall provide documentation to COR if the patient declines the oxygen back-up system or any prescribed oxygen equipment. Deliveries shall be as designated per prescription. The Contractor shall not change or alter a beneficiary’s oxygen prescription or equipment requirements without a new prescription from the VA Pulmonary Department.

Any and all records and documentation, paper and/or electronic form relating to VAHCS patients serviced under this contract are the property of the VAHCS and shall be returned to VAHCS by the Contractor no later than 30 days after contract expiration.

3.2 The veteran patient, their family members and/or care provider are authorized to inspect and accept equipment on behalf of the VAHCS. Family member(s) and/or care provider shall provide state issued photo identification to demonstrate they are at least 18 years of age to accept and sign delivery forms.

3.3 In accordance with the prescription received from the VAHCS, the Contractor shall provide the beneficiary with the following items:

a. Humidifiers and water traps when ordered. The number of humidifiers must be sufficient to ensure that they are not depleted between re-supply visits. The number of traps will be based on the patient’s flow rate.

b. Disposable oxygen cannulas on hand for a change every two weeks with a supply of two in reserve at all times until the Contractors next scheduled visit.

c. Disposable masks for change/wash every two weeks with a supply of two in reserve at all times until the Contractors next scheduled visit.

d. 25ft of oxygen connecting tubing shall be replaced monthly with one section of tubing in reserve at all times (to be included in initial setup) until the Contractors next scheduled visit.

e. Trach Collar and accessories (e.g., tubing and large volume nebulizer) with a supply on hand allowing for change every three (3) days and a supply of 5 in reserve at all times until the Contractors next scheduled visit.

f. Safety holders for cylinders will be provided at no charge for all veterans.

g. FireSafe Valves (Thermal Fuses):

VAHCS fuses must be provided for all patients on home oxygen therapy unless there is a documented clinical contraindication. If thermal fuses are not provided due to clinical contraindication, this must be documented in the patient’s medical record.

Contraindications:

1. Heated humidity

2. Flow rates in excess of 25 liters per minute

3. Patients with behavioral conditions that make use of thermal fuses impractical.

4. Or any identified clinical or physical contraindication

• 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.

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

• 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).

• 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.

• 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.

• Thermal fuses must be replaced at the end of their expected life per manufacturer’s guidelines (every 4 years).

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

• Contractor shall connect Thermal Fuses to each home delivery system

(concentrator and/or portability) in conjunction with 2” tubing (one at the patient end and one proximal to the oxygen source). The contractor shall provide a nasal cannula with 2” tubing to attach to Thermal Fuse. The contractor shall provide oxygen tubing to connect the Thermal Fuses.

3.4 Initial set-ups are defined 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. Contractor shall provide a home oxygen packet. Switch-outs are defined those beneficiaries who are presently using an oxygen delivery system or have used such a system continuously within the past 60 days.

3.5 The Contractor shall provide the initial set-up within 12 business hours (unless ordered emergently by the provider) of request from the COR or other authorized personnel, to include weekends and holiday; this shall also apply to service calls. The Government 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 12-hour response time.

3.6 The Contractor shall provide switch-outs by staff with documented competency training on the manufacturers’ recommended assembly, use, and maintenance of the equipment used under this contract. All beneficiary switch-outs shall be accomplished as soon as possible after award but shall not exceed 120 days after contract award. Failure to perform the switch-outs as specified shall result in a forfeit of payment to the provider currently used for every day thereafter until switch out is complete. Payments will be assessed based on that provider’s established rate and prorated from setup date.

The Contractor shall make every effort to establish appointments with VAHCS beneficiaries when initiating set ups and deliveries.

Deliveries shall not be left unattended at the beneficiary’s home. If the VAHCS beneficiary chronically (2 attempts to deliver) fails to meet appointments the Contractor shall document the attempts and notify the COR or authorized personnel. The COR or authorized personnel will contact the VAHCS beneficiary, and a corrective action plan will be implemented. The COR will notify the Contractor of any changes. If the Contractor has not made valid and documented attempts to contact the VAHCS beneficiaries for set up and or deliveries the Government reserves the right to call in a third party and bill the Contractor if the Contractor fails to perform for any due month.

3.7 The Contractor shall notify the COR or authorized personnel 60 days prior of expiration of prescriptions that are due to expire. The Contractor shall submit the prescription expiration report with the monthly billing.

3.8 The Contractor shall confirm receipt of VAHCS prescriptions for requests for services via email in password protected Excel report or via secure fax within two (2) working hours. The information shall include patient last, first name, last 4 SSN and type of request (new setup, renewal and/or cancellation).

3.9 Special Requirements/Special Services for Mechanical Ventilators

a. Once a veteran is identified as a candidate for home ventilation the contractor will receive an order for the Respiratory Care Practitioner (RCP) to perform a home inspection of the veteran's residence. This inspection will review; electrical capacity, physical space, cleaning and toilet facilities to determine ability to provide for veteran's needs upon discharge.

b. VAHCS COR will provide information to contractor as requested so that contractor can make a decision to accept or decline the veteran into their home ventilator program. If the contractor declines the case, the government reserves the right to hire another provider to service the veteran.

c. Once accepted into the home ventilator program the contract vendor will receive preliminary ventilator prescription. As soon as the ventilator is available the vendor's RCP will provide training to all Caregivers and the veteran in the hospital at the bedside on the use and maintenance of the home ventilator. This training will include alarms and their response, circuit changes, emergency back-up systems, etc.

d. Contractor shall provide a Trilogy checklist for caregiver training which the contractor will assist with completing (See Trilogy 100 Ventilator/Caregiver Competency Checklist, Item #36.0).

e. At time of discharge a final set of orders will be provided with current ventilator settings as well as requests for any additional equipment needed. The RCP from the contractor will follow the patient to their home and assist in getting the veteran settled into their home environment with the ventilator oxygen and any other respiratory related equipment.

f. Required visitation schedule for home visitation after initial ventilator set-up is daily visits for a week then weekly visits X three then monthly visits.

g. The RCP will perform monthly inspections of each ventilator. This inspection will include.

• Respiratory Rate • internal and external battery operation

• Tidal Volume • internal and external battery level

• Flowrate • change intake and output filter

• PEEP • back-up system function

• Pressure Support

Settings • verify audible alarm function

• FiO2 / Oxygen flow • Hours of use

• date of visit • veteran’s name

• serial number for each ventilator

• location

• current ventilator settings

• Signature of veteran or caregiver

h. The Contractor will provide the COR with a list of any ventilator order inconsistencies and document the corrective action by the Respiratory Therapist.

i. Back up for this life support equipment will include at minimum:

i. A complete second ventilator system with complete circuit attached.

ii. Secondary power source i.e., battery external to the ventilator able to provide not less than 8 hours of ventilation in the event of a complete poser failure.

iii. DC power cords if available to allow use of ventilator on power wheelchair or in a vehicle.

j. A label will be affixed to the ventilator with last date of inspection and inspector’s signature and date and hours due for next.

k. and to have the veteran/caregiver in case of an emergency call 911

l. Peripherals include disposable vent circuits; all necessary cables and disposables (mask, tubing, filters, humidifiers, 31 HME’s per month, etc.).

3.10 HOSPITAL DISCHARGES

Hospital discharges during normal VA Home Oxygen clinic operating hours:

Contracting Officer Representative (COR) or other personnel specifically authorized in the contract (hereafter authorized personnel), will notify VA Contractor by secure fax, or email to initiate service. The Contractor shall confirm receipt of the request within two (2) working hours of notification.

VA and Non-VA hospital facilities after hours hospital discharge process: West palm Beach VA Healthcare System (VAHCS) WHEN Hours Delegation of Authority policy 121-06.

• VAHCS Respiratory therapist will submit an officially signed home oxygen order to contractor via facsimile. Contractor shall confirm receipt of oxygen script within approximately 30 mins. Contractor shall make oxygen delivery arrangements once oxygen prescription settings and parameters are confirmed. Contractor shall contact patient/caregiver to arrange home oxygen delivery and set up. Contractor shall establish services at beneficiary’s home with a maximum of (4) four hours of receipt of required documentation.

• VA facility discharges: Upon discharge from VA facility, Respiratory will provide patient with a Contractor owned oxygen tank(s), regulator and nasal cannula or any other required interface. The number of cylinders provided to the patient will be sufficient to provide enough oxygen for home travel and allow enough time for equipment delivery and setup. Documentation received by the Contractor will indicate if the patient has been issued inventory of equipment/supplies. Contractor shall deliver stock of oxygen tanks to the VA facility Respiratory Department per Respiratory requested.

• Non-VA facility discharges: Home oxygen contractor shall deliver an oxygen tank (if required) to non-VA facility for home travel.

• The Contractor shall setup, adjust and instruct the patient and caregiver on all equipment that is being prescribed and instruct the patient in the proper use of equipment and supplies as necessary. The Contractor shall provide education to each patient and caregiver at the time of setup and assess the need for reinforcement during visits. This information is to be presented verbally, demonstrated and the material covered shall be in written form and left with the patient.

3.11 Provision of Vendor Equipment at VA sites:

The contractor shall, upon request by the facility, stock portable set ups at the VA to send home with patients. The contractor shall, upon request by the facility, stock replacement cylinders, regulators, carts, carrying bags and oxygen conserving devices (if applicable). When these units are sent home with a patient, documentation will be provided to the contractor to include patient names, last 4 SSN, equipment/tanks issued (size and lot number) for contractor inventory management purposes.

The contractor shall provide stock delivery to VAHCS and other CBOC sites such as Viera and Daytona Prosthetics and Sensory Aids Services (PSAS) per request.

4.0 CONFIDENTIALITY

VAHCS 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). The term “Protected Health Information” or the abbreviation “PHI” shall include the term” Electronic Protected Health Information” and the abbreviation “EPHI”.

The contract shall be subject to the regulations issued by the Department of Health and Human Services, as mandated by the Health Insurance Portability and Accountability Act (HIPAA) of 1996 Business Associates Agreement (BAA) in accordance with IL 049-03-7 and the Privacy Act of 1974. Federal Acquisition Regulations 52.224-1 Privacy Act Notification and 52.224-2 Privacy Act are provided in full text in the Addendum to FAR clause 52.212-4. The Contractor shall not release any medical record information nor maintain after contract completion. The VA is the sole entity authorized to release this information upon written request from the patient.

5.0 WORK HOURS

The Contractor shall provide services in performance of this contract between the hours of 8:00 A.M. and 8:00 P.M., Monday – Friday, to include weekends and Federal holidays. Exceptions shall be made in the case of emergencies. The Contractor shall schedule the appointments to the beneficiary’s home 24-48 hours prior to the appointment. On each scheduled setup/delivery the Contractor shall reassess the need to instruct the beneficiary on the use and care of the equipment and supplies as necessary.

Federal holidays observed by the VA are New Year’s Day, Martin Luther King’s Birthday, Presidents Day, Juneteenth, Memorial Day, Independence Day, Labor Day, Columbus Day, Veteran’s Day, Thanksgiving Day and Christmas Day.

6.0 EMERGENCY SERVICES:

a. The Contractor shall have an established communication system that supports 24-hour emergency services. The Contractor shall be able to provide services at the beneficiary’s home within a maximum of 4 hours of a call.

b. The Contractor shall ensure all patients have a minimum of non-electrical oxygen supply to last three times the Contractor’s response time to a call. The minimum supply shall take into account each patient’s prescription flowrate and distance from the Contractor’s location; actual supply levels may differ from patient to patient, as long as each patient has oxygen supply to last a minimum of three times the Contractor’s response time. If the Contractor is unable to respond to an emergency service call within 4 hours, the contractor shall arrange for another supplier to provide oxygen at the Contractor’s expense. In the case where the contractor is unable to personally respond provide emergency call(s), the contractor will provide a written explanation and a plan for overcoming the inability to respond to emergency call(s). The written explanation and remedy will be provided to the COR or appointed government representative within two business days of occurrence. Liquid oxygen supply may be considered for backup oxygen. However, the oxygen supply must be maintained at the minimum three times the Contractor’s response time, and the cost of any additional equipment such as extra stationary units used solely to maintain the minimum level of backup oxygen shall be borne by the Contractor. The cost of liquid oxygen used solely for backup purposes shall be borne by the Contractor.

c. The Contractor shall notify the COR or authorized personnel immediately in the event of a disaster, natural or otherwise, that may affect the services covered under this contract.

d. Contractor shall submit an Emergency Contingency Plan for natural disasters with a detailed proposal. During a disaster or other emergency, the contractor is responsible to ensure all veterans are contacted at initiation, during and post response of the emergency.

Updates on veterans contacted, those not contacted, contingency plans, response effort and other information will be provided to the VAHCS upon request.

A Post Emergency Plan activation report shall be provided at the end of the response.

Additional back-up equipment and supplies will be provided for as long as the emergency lasts to ensure veteran’s prescription needs are met. These excess deliveries will be annotated on the next month’s invoice as “Disaster Response for, i.e., Hurricane Smith” for appropriate reimbursement. Failure to annotate the invoices accordingly will result in non-payment by the VAHCS.

Contractor shall develop Special Equipment Identification Codes to identify VAHCS owned equipment and services to veterans from other catchment areas provided as a result; of hurricanes, acts of God and/or emergency situations. Invoice to list veteran, location, equipment, service provided and type of emergent situation.

The contractor shall provide and complete a safety/emergency checklist signed by the veteran or his/her caregiver and retained in the beneficiary account file.

An updated Emergency Contingency Plan shall be provided annually to the COR. In addition, the Contractor will participate during yearly hurricane or natural disaster drills as decided by VAHCS leadership. Contractor shall provide names and contact information of suppliers that will provide home oxygen in the event of any disaster where the Contractor cannot meet the needs of the VAHCS patients.

Contractor shall have at least two mobile phone numbers that will be available to the VA during any emergency. Contractor shall provide phone numbers of supervisory staff that can be accessed 24 hours a day, 7 days a week, during emergencies. Contractor shall appoint one employee to attend quarterly meetings at the Emergency Operation Centers (EOC) for Orange, Brevard, and Volusia counties, with the VAHCS Home Oxygen Coordinator.

e. The Contractor shall provide to the veteran warning signs to post on all entrances into the residence. Signs shall state, “Warning Oxygen in Use - No Smoking” or similar verbiage that clearly states smoking is not permitted due to oxygen being present. Contractor shall document that the beneficiary/caregiver is instructed in the safe use of oxygen and equipment per OSHA.

7.0 REPORTS

a. The Contractor shall provide a written quarterly report of all Joint Commission Standards for improving organizational performance (the Joint Commission standards may be accessed at www.jointcommission.org). The COR may request the reports at any time during the contract period.

b. The Contractor shall provide the following emergent patient safety reports within five (5) business days of occurrence.

c. The Contractor shall provide the following emergent patient safety reports throughout the contract period. Unless otherwise specified, notification shall be by written report of contact and faxed to the patient’s appropriate site.

• Sentinel Events – The Contractor shall inform the COR by the close of business the day of a sentinel event (as defined by Joint Commission) that occurs during the performance of this contract that involves VAHCS beneficiaries.

• Refusal of service – All beneficiaries have the right of refusal of service. In the event a beneficiary refuses service or prescribed equipment to be removed from the home, the Contractor shall comply with the beneficiary’s wishes and have them sign the Against Medical Advice (AMA) form as refused. The Contractor shall notify the COR not later than the close of business the same day of the details of refusal. The signed documentation shall be submitted within two days. If the refusal occurs during a home visit, the Contractor’s staff shall notify the COR or authorized personnel via fax or encrypted electronic means (telephonic for emergencies) of the refusal during the course of the home visit.

d. The Contractor shall report suspected incidents of abuse or neglect of the patient by family members or caregivers. Suspected incidents shall be reported immediately (within 24 hours during business hours) to the COR or authorized personnel and Social Worker and/or Florida HRS Hotline. The Contractor shall follow all state and local laws in reporting suspected incidents of abuse or neglect.

Incident Report – Reporting special incidents found or occurring during a home visit, to include:

i. Finding patients in need of emergency medical assistance.

ii. Safety hazards that do not fall into the category of presenting immediate life-threatening danger to the patient.

iii. Contractor staff’s inability to contact a patient within a reasonable period of time.

iv. Any other incident meeting the Contractor’s written policy for incident reporting according to accreditation standards.

e. The Contractor shall report non-compliant behavior with fire safety guidelines set forth in the patient education and re-assessment material and/or behaviors which pose a risk of self-harm or harm to others to the Home Oxygen Coordinator or authorized personnel during the home visit, if Contractor determined compliance is not improving after education on the fire hazard of smoking when oxygen treatment is provided. Noncompliant behavior and any follow-up actions (e.g., education) will be documented and reported to the COR immediately.

f. FireSafe Valves (Thermal Fuses) Mandatory Requirements for Reporting fires involving home oxygen delivery systems:

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?

g. The Contractor shall notify the COR or authorized personnel by telephone at time of setup if any alteration to the beneficiary’s home is necessary to accommodate the oxygen equipment, including electrical work.

h. Customer Satisfaction – in accordance with Joint Commission standards the Contractor shall collect data on service satisfaction from contracted patients and their families from each facility on a quarterly basis. A copy of survey results shall be submitted to COR or authorized personnel in Quarterly reports.

i. Infection Control/Communicable Diseases – Report will include data related to the Contractor’s ongoing Infection Control Program. A copy of the results shall be submitted to COR or authorized personnel in Quarterly reports.

j. Performance Improvement – The Contractor shall collect data on important processes and outcomes related to patient care and organization functions. A copy of the results shall be submitted to COR or authorized personnel in Quarterly reports.

8.0 INFECTION CONTROL/COMMUNICABLE DISEASES REQUIREMENTS

The Contractor shall:

a. Have a current plan for surveillance, prevention, and control of infection. The plan shall meet current Joint Commission standards.

b. Provide a list of names to the COR or authorized personnel of all veteran patients exposed to communicable diseases by contracted staff during an identified incubation period. The type of exposure will also be identified. The COR or authorized personnel will consult with VA infection control staff regarding the need to contact exposed patients and/or complete any needed medical follow up.

c. Follow accepted infection control practices, including CDC hand hygiene guidelines and standard and transmission-based precautions.

d. The Contractor shall comply with TJC and WPB VAMC policies and procedures on infection control and infection surveillance. The Contractor employee health files shall contain a copy of the Contractor Staff Member’s annual TB test results and Hepatitis B vaccination documentation. If a Contractor staff member refuses to either test, such refusal shall be documented in writing and shall be maintained in their file. All Contractor staff involved in the delivery, pickup and storage of home oxygen will be instructed on the importance of infection control and personal hygiene and their responsibilities in the infection control program. Procedures shall address personal hygiene, aseptic procedures, staff health and transmitted infections and appropriate cleaning, sanitation and storage of equipment. Appropriate staff shall be instructed in the identification, handling and disposal of hazardous and/or waste materials in a safe and sanitary manner in accordance with applicable laws and regulations. Contractor staff members with contagious illnesses shall have no contact with patients or clean equipment. Exceptions would be Contractor staff members with a mild cold or similar condition. In such cases, gloves will be worn, and contact will be extremely limited.

e. Contractor staff members responsible for the delivery, setup, cleaning, repairs and/or storage of medical equipment shall be instructed in the safe and appropriate use of said equipment. Upon delivery, they shall provide appropriate instructions to the patient and/or caregiver regarding the safe and appropriate use of the equipment and basic home safety matters in regard to said equipment. This instruction shall include a return demonstration from the patient/caregiver showing that they understand what they were shown.

f. Any accidents or injuries related to equipment and safety management will be investigated by the Contractor. Equipment malfunctions resulting in any sentinel event such as serious injury or death will be reported to the manufacturer and the Chief of Prosthetics or COR within forty-eight (48) hours of the Contractor’s knowledge of said event(s). The Contractor will promptly notify the PSAS of any hazards, defects or recalls by the manufacturer for any equipment purchased from the Contractor.

g. The Contractor shall have an Emergency Contingency Plan designed to provide continuing support appropriate to the services provided in the event of an emergency that would result in interruption of patient services. The Contractor shall have disaster plan and appropriate personnel who are aware of this plan and their roles/responsibilities in the event of a contingency.

9.0 HOME ASSESSMENT REQUIREMENTS

a. The Contractor shall perform an assessment of the beneficiary’s home and environment in accordance with Joint Commission standards and maintain documentation of assessments in the individual patient file.

b. The Contractor shall notify the COR, authorized personnel, or prescribing physician during the course of the home visit if the Contractor 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 be placed in home.

c. The Contractor shall verbally notify the COR or authorized personnel by the next business day of any unsafe conditions observed in the VAHCS beneficiary’s home that preclude the installation or continuance of oxygen service. Unsafe conditions may include, but are not limited to, fire safety hazards, oxygen safety hazards, patient abuse by family or caregivers, or any instance that places the patient or Contractor in immediate danger. The Contractor shall furnish written documentation of the safety hazard to the COR or authorized personnel within one business days of the incident.

d. The Contractor shall document and report to the COR any patient who is non-compliant 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.

e. The Contractor shall check the adequacy of the electrical outlets in the patient’s home and immediately report unsafe conditions to the COR or authorized personnel. The Government is not responsible or liable for any unsafe electrical conditions caused by the Contractor. The Contractor shall not make any alterations to patient residence;

alterations shall be the sole responsibility of the patient. If ordered equipment cannot be safely installed, the COR or authorized personnel may approve an alternative oxygen delivery system until new prescription can be obtained. If no alternative is available, the prescribing VA physician shall be notified by the COR.

f. The contractor shall verify the presence or absence and working order of smoke detectors and fire extinguishers when oxygen is delivered, as well as on all subsequent visits. The contractor shall encourage the patient to test their smoke detector and check the condition

(charge level) of their fire extinguishers every 30 days. This information shall be documented and encouraged at every visit. In any home where smoke detectors and fire extinguishers are not present the contractor shall document and encourage the patient to have a functional smoke detector and functional fire extinguisher and provide the patient with information concerning where the absent items can be purchased. This documentation shall be included in the patient’s Plan of Service file.

10.0 INVENTORY

The Contractor shall conduct monthly inventories of all GFE in storage, to include, as a minimum, make, model and serial number. A copy of the inventory record shall be submitted monthly with Contractor invoices, and/or submitted upon request by the COR.

11.0 DISCONTINUATION OF SERVICE

a. The Government will notify the Contractor in the event of an order to discontinue oxygen service to any beneficiary…