VISN 9 Tennessee Stations - Home Oxygen Questions _ Answers 6-30-2023.pdf

VISN 9 Tennessee VA Medical Centers Questions & Answers 36C24923R0026

1. Would VA please provide the associated HCPC(s) for each of the 21 provided

CLINs?

NOTE: CLIN 0009, 1009, 2009, 3009 and 4009 are officially revised as there will be no need for CRT/RRT visits except for ventilator patients. Therefore, there are now only 20 line items for each year.

Item no.

Description HCPC

1 Rental of Oxygen Concentrator 5 Liter E1390

Rental of Portable “E” system and/or M-6 system E0433

Rental of Oxygen Conserving Device:

Includes Demand Valve

VA111

4 Rental of Liquid Oxygen System E0440

5 Liquid Oxygen System Refills E0444

Rental of Liquid Oxygen Portable

Conserving Device: Including Demand

Valve

E0440

7 Contractor – Owned Ventilator Rental E1352

Government Owned Ventilator Set-Up and

Monthly Assessment (Vent Patient)

VA120

9 H Tank Rental E0443

10 H Tank Refill E0443

11 Compressors E0565

12 Fire Safety Valves VA186

13 Rental of Portable Concentrator E1392

14 Government Owned Property VA120

Ultra-Fill System (Brand Name or Equal)

Contractor Owned E0424

16 One Time Delivery Fee VA120

Ultra-Fill System (Brand Name or Equal)

VA Owned E0424

18 Portable E and/or M6 Tank Refills E0443

19 Rental of Oxygen Concentrator 10 Liter E1390

20 Emergency Visit VA120

2. What is the actual monthly utilization/volume for each of the 21 provided CLINs for each VAMC? Please refer to the “Estimated Workload Data” tables at the bottom of this document.

NOTE: CLIN 0009, 1009, 2009, 3009 and 4009 are officially revised as there will be no need for CRT/RRT visits except for ventilator patients. Therefore, there are now only 20 line items for each year.

3. Would VA please confirm ventilator-related CLINs are for non-invasive vents, only (see CLIN 0007 and CLIN 0008)? There will be both invasive and Non-invasive vents.

4. Would VA please define an “Emergency Patient Visit” (see CLIN 0021)? This is outlined in 7.3 of the SOW.

5. Section 6.15 of the SOW appears to indicate the Contractor is to stock a

“supply closet” of select CLIN items for each VAMC. Would VA please confirm what items are to be provided, in what quantity and frequency, and how those items are to be invoiced to VA? The items should be restocked weekly.

Invoicing would only happen after equipment is put into service with a patient.

Items quantities are as follows:

TVHS:

Nashville campus:

E-tanks – 12 Tank carts – 12 E-regulators – 12

Murfreesboro campus:

E-tanks – 8 Tank carts – 8 E-regulators – 8

Mountain Home:

E tanks – 24 C tanks – 6 M6 tanks – 24 E regulators (only) – 12 Conserving devices (only) – 12 Tank carts – 12 E regulator setup bags – 15 Conserving device setup bags – 15 M6 bags – 15 C bags – 15

High flow cannula – 8 Pendants – 2 Nasal cannula – 24 Wrenches and washers to be restocked each time other supplies are delivered.

Memphis:

Portable cylinders with oxygen regulators – 10 Conserving devices – 10 Carts – 10 Safety stands - 10 Accessory item – oxygen key – 10

6. Would VA please confirm that patients may be held financially liable for all lost, misplaced, or damaged equipment occurring through the beneficiary’s negligence? Historically, this has been, and will continue to be, the following terms and conditions as per Part 2, Definitions section of the SOW under Rental Property: “The Contractor shall be responsible for their equipment and therefore will be liable if equipment is lost and/or stolen. The VAMC will not pay for rental on equipment not being used by an authorized veteran during the performance of this contract or for equipment that cannot be found. Contractor-furnished equipment shall be maintained per manufacturer’s specifications.

Contractor-owned equipment shall be repaired or replaced at no cost to the Government.”

7. Would VA please confirm that all documentation required to be maintained in compliance with this contract or provided to VA in support of this contract, including the Patient Folder, shall be electronic? Yes, Electronic.

8. Would VA please add CLINs for the storing, cleaning, and repairing of government-owned equipment? Request denied.

9. Within the "Estimated Workload" section on solicitation page 41-44 we noticed quantities listed for the various CLINs; however, on the price schedule Attachment D.1 we don't see quantities listed for the various CLINs. Please confirm if the offerors are to use the quantities from page 41-44 or if a revised Attachment D.1 will be posted with quantities? Please see updated numbers for both the Estimated Workload Data shown below and in the updated Attachment D.1 Price Schedule.

10. Performance Work Statement (PWS), Section 8: Equipment Specification. Will you be adding additional descriptions of the CLIN # 18-21 on the PWS? It is a Statement of Work (SOW) and no further descriptions will be added.

11. SOW, Section 8, Equipment Specification, Page 25- Portable Units include

“E”/M-6/D/C Tanks. The pricing sheet only states for “E and M-6” sizes for rental on CLIN # 002, 1002, 2002, 3002, 4002, and the same for the Refills on CLIN # 0019, 1019, 2019, 3019, and 4019. Are there going to be any C or D tanks? Portable systems will include all the following. “E”/M-6/D/C Tanks

12. Paragraph 6.3.

a. All patients seen monthly by contractor representative

b. Vent Patients seen monthly by CRT/RRT

c. Trach patients with compressor: Quarterly by CRT/RRT

d. Oxygen Patients seen annually by CRT/RRT emergency assessment (page 26)

e. Question: Why is Trach Patients Quarterly, yet all other patients are monthly?

13. Ventilators: 6.3 is officially changed to now only require monthly CRT/RRT for ventilator patients only, no other type of patient is authorized for any CRT/RRT visits.

a. Are 2 ventilators plus batteries required for all ventilator patients? Yes.

b. Please explain what “Continuous Use Patients” is in this sentence. Ventilators: Ventilator patients, whether it’s a VA or Contractor owned ventilator, will be visited monthly by CRT/RRT for patient and equipment checks. Ventilators include heater, and circuits as applicable. For continuous use patients a backup ventilator shall be provided at no charge to the Government. As prescribed as continuous use.

c. Please clarify all supplies needed for ventilators, to include invasive and non-invasive. Ventilator circuits – Both heated circuit and non-heated circuit.

d. If a ventilator patient is provided a Government Owned piece of equipment, will the government provide 2 ventilators plus batteries for those particular patients? Yes.

14. Paragraph 6.11. Can the time be extended to pick up equipment from a deceased patient’s home up to 5 days? The equipment pickup time is now officially changed to five (5) days for deceased patients.

15. Paragraph 7.1 Phase-In (page 21): Would the VA be amenable to the incoming Contractor to purchase existing equipment from the incumbent as long as the equipment is tested to meet specifications and labeling on the equipment is changed to the new Contractor? Yes, as long as equipment meets the requirements in the contract.

16. Page 91, Rating table. Please articulate why the ratings are based on the number of patients per month and years. This appears to give a higher rating to larger companies with larger contracts. This is an extremely critical requirement. All competitors are SDVOSB, so all are under the same dollar threshold for the NAICS code of 621610, which is $19M. The Government seeks to award to the contractor that presents the least amount of performance risk, which would be a contractor who has provided service to more patients than what our requirement is. Additionally, the longer a contractor has performed, the more seasoned and capable they should be, having dealt with various issues and problems over the course of time which will increase their effectiveness and competency during any potential contingencies that might occur in the future. Given what this Nation has faced during the pandemic, experience matters.

In fact, based on revised estimates, the number of patients per month is now officially changed to the following:

17. Paragraph 18 Reports and Notifications (page 38 & 39): Patient Refusal of

Services: If a patient refuses services during a home visit and the contractor is unable to meet the VA 1 hour notification requirement due to Wi-Fi or other issues, will this be counted against the contractor? In some rural areas, Wi-Fi or hotspots do not always work. The Government is not clear as to why Wi-Fi or hotspots are needed for this requirement since most of the areas have cell phone service, or at least cell phone service is available within a one-hour distance of any patient’s home.

18. Discontinuation of Service: The requirement states that the list of equipment must be sent to VA within 48 hours - If equipment is picked up from a home after hours on a Friday night, is it OK to send the list of equipment on Monday?

Request denied. The list is required within 48-hours.

19. Excel Spreadsheet with CLINS: Please clarify what columns need to be filled out. Are we to update the quantities in the spreadsheet based on the Estimated Workload Data? The Attachment D.1 Price schedule has been updated with quantities and therefore only column O which is highlighted is required to be filled out.

20. How does the VA estimate inflation rates and increases in Health and Welfare Benefit? The Government fails to understand this question since no rates are being provided anywhere in the solicitation other than what rates would be applicable for the Department of Labor Wage Determinations. Regardless, there is no inflation or increase information contained in the solicitation.

21. Phase Out, Page 22, Replacement and Refill Tanks. What is the mix of cylinder types in this table? Does this include LOX or does that need to be added to the table? The mix of tanks is going to include all the portable tank types. Liquid oxygen is separate and has separate line items which are 0005, 1005, 2005, 3005 and 4005.

22. Page 41: Estimated Workload

a. Please clarify that the estimated quantity is an annual estimate versus monthly. All quantities are now updated to provide monthly estimates.

b. In comparing the quantities side by side for each Item number, the methodology does not appear to be consistent. Different sites have different requirements.

c. Line Item 1: Please specify what state of the art model means? The latest technology available.

d. Line Item 2: How many Portable tanks are required per patient? This will be on the prescription. This item specifies that a Conserving Device will be included. Only when prescribed.

e. Line Item 3: Item No. 3 calls for a conserving device in the tables but not in Line Item 3 on page 25. Simply an administrative error. Should this description be a Valve or conserving device? Conserving device.

f. Line Item 6: Line item 4 include a portable system. Is this in addition to what is included in Line item 4? Yes

g. Line Item 7: Please define partial ventilator support. Is the backup system another ventilator or just the spare breathing circuit and self-inflating resuscitation bag? All patients on a ventilator need a backup system.

h. Line Item 10: Is this for patients that have the H cylinder as their only modality (no other oxygen equipment is to be provided?) Correct.

i. Line Item 11: Does this apply to Line Item 1 when the cylinder needs refilled?

No, it refers to line item 10.

j. Line Item 12: Will all these units be Government Owned? No, contractor owned.

k. Line Item 13: Do the quantities listed cover 2 Fire Safety Valves for all oxygen equipment in the home? Yes.

l. Line Item 15: Can you please be specific as to what type of equipment this covers. Any, and all equipment.

m. Line Item 16: This item and item 18 appear to be the same. Transfill systems are rarely used now. Please confirm that is the modality actually needed. Yes, these are utilized on some patients.

n. Line Item 17: Please confirm this is the delivery fee for Item 16. Item 17 (page

28) appears that it should be delivering equipment to the VA Medical Center. Please clarify. No, this is for a one-time delivery of any equipment to a veteran.

o. Line Item 18: Duplicate of Item 16. The verbiage on Page 28 identifies invoices. Please clarify. Administrative error. Please refer to the verbiage in line item number 18 in the Estimated Workload Data table and Attachment D.1 Price schedule.

23. With regard to VOLUME 3 PRICE – page 86 – “Offerors shall submit pricing referenced at Section B.2 (Price Schedule), using Attachment D.1 (located in Section D) in Excel format only. This Excel spreadsheet has built-in formulas which shall not be altered by the Offeror. The Excel spreadsheet contains two (2) tabs—tab “LIN Pricing Schedule” includes individual line item pricing per location and period of performance, where Unit Prices and Estimated Annual Totals shall be entered by the Offeror. Tab “Total Schedule Estimates” shall be used by the Offeror to enter the estimated totals for each location and period of performance, along with the total estimated offer for the entire requirement. Firm fixed unit pricing shall be all-inclusive to provide required services. Description does not Match actual "Attachment D.1"Attachment provided has only one Tab "Items”. This was an administrative error. There is only one tab.