36C24925R0036_1.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

486-26-1-3000-0001

36C24925R0036 06-10-2025

Elizabeth Trimm 615-225-5613 07-10-2025

3PM CDT

Department of Veterans Affairs

Network Contracting Office 9 (90C)

NCO 9

1639 Medical Center Parkway, Suite 204

Murfreesboro TN 37129

X 100

X

621610

$19 Million

N/A

X

Beneficiaries of VISN 9 Medical Centers

90C

Network Contracting Office 9

Department of Veterans Affairs

Network Contracting Office (90C)

1639 Medical Center Parkway Suite 204

90C

FSC e-Invoicing Payment http://www.fsc.va.gov/fsc/einvoice.asp

Invoice Setup Information 1-877-489-6135

Invoice must be submitted electronically

Setup 1-877-489-6135

See CONTINUATION Page

Contractor shall provide Durable Medical Equipment (DME)

Services as described in the Statement of Work (SOW).

Contractor shall be responsible for correct wages, titles, and compliance with all applicable wages and hours law.

Period of Performance shall be October 1, 2025 through

September 30, 2030.

See Section E.1.1 for Instructions for Submission of

Proposals.

All questions shall be submitted in writing by 12pm on

June 17, 2025.

VA reserves the right to make single or multiple awards.

Offerors may submit offers for one or more VAMCs.

See CONTINUATION Page

X X

Elizabeth Trimm

Contracting Officer

36C24925R0036_1

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

B.4 DELIVERY SCHEDULE

B.5 IT CONTRACT SECURITY

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (NOV 2023)

C.2 52.216-18 ORDERING (AUG 2020)

C.3 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.4 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.5 52.216-32 TASK-ORDER AND DELIVERY-ORDER OMBUDSMAN (SEP 2019) ... 62

C.6 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.7 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.8 52.203-6 RESTRICTIONS ON SUBCONTRACTOR SALES TO THE

GOVERNMENT (JUN 2020) ALTERNATE I (NOV 2021)

C.9 52.222-49 SERVICE CONTRACT LABOR STANDARDS—PLACE OF

PERFORMANCE UNKNOWN (MAY 2014)

C.10 VAAR 852.219-73 VA NOTICE OF TOTAL SET-ASIDE FOR CERTIFIED

SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESSES (JAN 2023)

(DEVIATION)

C.11 VAAR 852.219-75 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—

CERTIFICATE OF COMPLIANCE FOR SERVICES AND CONSTRUCTION (JAN 2023)

(DEVIATION)

C.12 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS

(NOV 2018)

C.13 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020) . 70

C.14 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

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

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (JAN 2025) (DEVIATION FEB 2025)

C.16 MANDATORY WRITTEN DISCLOSURES

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

ATTACHMENT 1 - QASP - DME

ATTACHMENT 2 - SAMPLE DME INVENTORY LIST

ATTACHMENT 3 - BAA SAMPLE

ATTACHMENT 4 - WDOL 2015-4647 Rev 27 12.23.24

ATTACHMENT 5 - WDOL 2015-4673 Rev 28 5.6.25

ATTACHMENT 6 - WDOL 2015-4683 Rev 28 12.23.24

ATTACHMENT 7 - WDOL 2015-4717 Rev 29 5.6.25

ATTACHMENT 8 - WDOL 2015-4641 Rev 24 12.23.24

ATTACHMENT 9 - CONTRACTOR CERTIFICATION IMMIGRATION AND

NATIONAL ACT OF 1952 AS AMENDED

SECTION E - SOLICITATION PROVISIONS

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

COMMERCIAL SERVICES (SEP 2023)

E.1.1 ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

INSTRUCTION FOR THE PREPARATION OF PROPOSALS

E.2 52.201-1 ACQUISITION 360: VOLUNTARY SURVEY (SEP 2023)

E.3 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.4 52.204-29 FEDERAL ACQUISITION SUPPLY CHAIN SECURITY ACT

ORDERS—REPRESENTATION AND DISCLOSURES (DEC 2023)

E.5 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.6 52.216-1 TYPE OF CONTRACT (APR 1984)

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

E.8 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

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

1998)

ADDENDUM to 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES

E.10 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (MAY 2024) (DEVIATION

FEB 2025)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C249 Elizabeth Trimm

Network Contracting Office 9 (90C)

NCO 9

1639 Medical Center Parkway, Suite 204

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

[] 52.232-33, Payment by Electronic Funds Transfer—System For Award

Management, or

[X] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Paid by GPC after Delivery/Install

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

Requests.

Payment will be made via Government Purchase Card (GPC)

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

AMENDMENT NO DATE

B.2 STATEMENT OF WORK

INTRODUCTION/BACKGROUND INFORMATION:

VISN 9 has an ongoing requirement to provide suitable DME to beneficiaries of the Department of Veterans Affairs (VA) at their residences. Orders for the specified services will be placed by five (5) VA facilities in VISN 9 using Government Purchase Cards (GPC). This contract does not include purchase or rental of DME by the Government from the contractor. All DME shall be

Government-owned or provided by the Prosthetics and Sensory Aids Service (PSAS). This requirement shall consist of taking the item from the Contractor’s storage facility and delivering it to the Veteran or may require pickup at the VA facility and subsequent delivery to the beneficiary’s home.

SECTION 1: SCOPE/PERFORMANCE REQUIREMENTS:

Scope:

The contractor shall provide all supplies, materials, equipment, labor, supervision, transportation, infection control, storage, cleaning, delivery, sanitization, assembly/set-up, repair, pick-up and Veteran training/instruction in the use of Government-owned DME. This includes the provision of emergency DME repair and maintenance services. The contractor shall develop mechanisms and methods to register complaints, resolve emergencies, issue approval of Veteran Rights and Responsibilities, and provide pertinent documentation of performing all tasks as identified herein. The Veterans under this contract are served by five (5) VISN 9 VA

Medical Centers in Memphis TN, Tennessee Valley Healthcare System (TVHS) comprised of

Nashville & Murfreesboro TN, Louisville, KY, Lexington, KY and Mt Home, TN. The area of service shall be all Veterans serviced by these five (5) VISN 9 VA Medical Centers, including surrounding areas, regardless of where Veteran resides. Should a Veteran(s) be located within a zone that is not listed for that particular VA Hospital, but is within a zone listed through a separate VA Hospital, the Government reserves the right to purchase the services from the contractor awarded the contract for the zone that the Veteran resides in. The geographical boundaries have been detailed in Section 2 herein and have been determined as the areas of responsibility/ jurisdiction for each local VA Medical Center.

1. Response Times:

The contractor shall contact the Veteran for an appointment within 24 hours of notification from the individual VAMC's Contracting Officer Representative (COR) request for service (VA

Purchase Order) and shall be delivered and/or picked up no later than 48 hours from date of order to deliver, unless the Veteran requires a later date which will be noted in the Veteran record. Documentation/records annotating Veteran requests for delivery/repairs outside the normal response times must be provided at time of billing/invoicing.

Emergency Procedures: The contractor will provide emergency service 24-hours a day, seven days a week, including holidays. The contractor shall accept emergency telephone calls from the COR and/or the Veteran. The contractor shall respond to the emergency phone call within one (1) hour of notification. Service shall be completed within 8 hours after notification. If the

Veteran is requesting the emergency, or service call on an equipment problem, the contractor shall notify the appropriate COR thereafter of this request during VA's’ normal working hours.

2. Standard of Care:

The contractor shall meet/ exceed the Centers for Medicare & Medicaid (CMS) Durable Medical

Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Quality Standards (the most current update, or any subsequent accreditation standards adopted by the VA) in the performance of this contract. Standards include employee training in infection control, equipment selection, delivery, setup, storage, inspection, maintenance and repair; Veteran education, instruction, and privacy, Veteran and equipment file management; etc. Written documentation must be provided to support this requirement.

The contractor shall be responsible for also obtaining all necessary permits and/or licenses required to perform services under this contract. The contractor shall abide by the State laws and regulations in which services are performed. The contractor shall comply with Department of Transportation (DOT) www.dot.gov/regulations.com, Federal Drug Administration (FDA) http://www.fda.gov/default.htm, National Fire Protection Transportation (NFPA) www.nfpa.orgicodes-and-standards.com, Occupational Safety and Health Association (OSHA) regulations www.osha.gov, and all current standards for suppliers of DME in the most current annual publication titled, "Accreditation Manual for Home Care" www.jointcommission.org/accreditation/home care.org.”

The contractor shall be responsible for verifying that education and training are consistent with applicable legal and regulatory requirements and hospital policy; that the employee is licensed, certified or registered and that the individual is knowledgeable for his or her assigned responsibilities. The contractor must provide the COR evidence of these requirements. New employee licenses, certifications, or competency must be submitted within 30 days from date of certificate, then annually. All subcontractors are subject to the same requirements as the prime contractor.

3. Transition Period:

A phase-in/phase-out period, effective on the contract commencement date, is required in order to facilitate a potential change in contractor upon expiration of the current contract and to ensure continuity of service for Veteran care. The transition phase shall not exceed 45 days. This period shall be designated as a period for the transfer of Veterans from the incumbent to the successor contractor. A transaction schedule shall be provided to both the incumbent and successor contractor.

During the phase-in phase-out period, the successor contractor shall contact the COR with a list of Veterans the successor contractor has set up each day. The successor contractor shall notify the incumbent contractor of these Veterans. The successor contractor shall provide the

Veterans name, address and telephone number of the Veteran, list of government-owned equipment at Veteran residence and current prescriptions. The successor contractor shall not receive any payment for the Veteran until it is confirmed that they have completed the set-up of

DME requirements. The initial month of service will be prorated. The cost of relocating existing inventory from the incumbent VA contract storage place to the successor contractor's facility shall be borne by the successor contractor. This includes any deficiencies the incumbent contractor may or may not have accomplished. Therefore, it is advised that the contractor view the storage site. Both contractors shall work closely together to assure a smooth easy transition for the Veteran. The square feet listed are estimates only and it is advised that the contractor visit the site(s) in order to obtain exact estimate.

4. Storage and Inventory Management

The contractor shall provide and maintain adequate storage to accommodate VA-owned DME equipment including items picked up for repair. The contractor shall be directly responsible and accountable for all government property while it is under his/her possession and shall establish and maintain a system to control, protect, preserve, and maintain item(s) in optimal condition.

The government property shall be used only for performance under this contract.

http://www.dot.gov/regulations.com http://www.fda.gov/default.htm http://www.nfpa.orgicodes-and-standards.com/ http://www.osha.gov/ http://www.jointcommission.org/accreditation/home%20care.org

The estimated cost for warehouse storage usage will be included in the Rate for

Individual Trips to Zone unit cost. The government estimated net usable square footage is 3000 sq. ft. of warehouse space dedicated for VA DME. The contractor shall be responsible for determining the amount of storage space required. I t is recommended that the site be reviewed, and the actual square feet ascertained by the contractor. After storage site is determined, the contractor shall contact the CO and COR for approval.

a. The stored equipment shall be maintained in a safe, clean, dry, climate controlled, well -secured and orderly arrangement to prevent damage and to facilitate periodic unannounced inventory inspections accomplished by VA officials. This storage shall be provided separate and apart from all other contractor-owned equipment and supplies. Contractor shall maintain at least 10 feet of separation between contractor-owned equipment and VA owned equipment.

b. The contractor shall be capable of accepting drop shipments of DME at its facility that has been ordered by PSAS from various manufacturers and distributors. The contractor shall be able to accept shipments delivered by large trucks without lift gate capabilities. Upon receipt of the drop shipment, the contractor shall remove the DME from its packing/shipping cartons and inspect the DME for damages. The contractor shall notify PSAS of any damaged items within eight hours of signed receipt. If PSAS is unable to pursue a claim submission because of untimely inspection and notification of a damaged item, then the contractor shall be held liable for full replacement of the damaged items. Following inspection of received

DME, the contractor shall communicate with the ordering facility (Email with PO# in Subject) and provide the following information: (i) Specific Item Received, (ii) Quantity of that Item

Received with proper Unit of Receipt, (iii) Date of Receipt, and (iv) signed copy of packing list or name of individual receiving items. If a packing slip is not provided by the courier, written description of items received with quantity and unit of receipt may be provided by the contractor.

c. The contractor’s storage and repair facility shall be within the county of each individual medical center or a border county, due to requirements for frequent VA inspections and pickups at the medical centers. The storage facility shall be a storefront facility.

d. Six (6) clearly delineated areas shall be designated:

(1) Staging (IN) Area, - all VA owned equipment going to the contractor's facility shall be unloaded from the delivery truck into the (IN) staging area and sorted. New items shall be unpackaged, inspected for damage, and placed into the appropriate action area. All other recovered, used equipment shall be placed in the Pending

Assessment area.

(2) Pending Assessment Area - The equipment shall be inspected and evaluated to determine whether the equipment is worthy of reissue.

(3) Repair Area - Should repairs be needed the contractor shall submit an estimate of charges to the COR/designee and will not proceed with work unless a separate purchase order/credit card authorization is issued. Quotes shall be itemized with parts, prices, labor, time, and whether a FIVE (5) business day turnaround for repair can be met. Quotes shall be returned to the COR/designee within 2 business days from time of evaluation. No charges shall be made for the estimate. Payments for labor on repairs shall be made in accordance with the price schedule for the hourly rates in the schedule. The contractor will be responsible for incidental ($20 or less) parts, not for major parts. Travel shall be included under the trip charge.

(4) Junk/Scrap Area - All equipment which cannot be re-issued, based on excessive repair costs or being obsolete shall be kept in this area. During periodic site visits, the COR shall assess the equipment in this area to determine final disposition. Upon direction by the COR items that are determined to be scrap/junk shall be returned to the VA. The contractor shall contact the COR for time/date to deliver scrap/junk equipment. The VA shall dispose of in accordance with VA disposal procedures.

(5) Ready for Issue Area - All equipment in this area will be cleaned, disinfected, in excellent working condition and ready for issue to the Veteran. This equipment shall be tagged and stored awaiting instruction from the COR. Government property shall be identified and tracked within an electronic inventory system that can identify items by item, model, serial number, etc.

(6) Staging (OUT) area - All equipment ready for delivery to the Veteran shall be placed in this area pending loading.

e. The above areas must house items in contractor’s immediate location and shall provide a full-time accessible employee with phone available from 8:00 a.m. to 4:30 p.m. Monday through Friday, excluding government holidays. The storage facility shall be wheelchair accessible. Should the Veteran pick up equipment/supplies from the contractor's facility when authorized by the COR, no delivery charges shall apply.

f. The storage facility shall be equipped with adequate electrical outlets for testing of electrical equipment.

g. The Contractor shall maintain an electronic detailed real time inventory system accounting for all items in storage at the current time in the contractor's possession. The listing shall be legible and formatted to show type of equipment by brand name, model, serial, Item Master

File Number (IMF), and condition of the equipment in the following categories: Medical

Equipment, Ambulation Aids, and Miscellaneous. An electronic copy of the current weekly inventory shall be submitted electronically to the COR, or designee, of the applicable VA medical center no later than COB Friday, or day as determined by facility, of each week.

The inventory list shall include all items issued to beneficiaries by beneficiary name, address, date of delivery and serial number, if applicable. The inventory shall separately list equipment that is ready for issue, equipment that requires repair, and equipment to be salvaged with appropriate Veteran nomenclature. The equipment repair inventory shall include an itemized cost estimate for each piece of equipment. The electronic detailed real time inventory system (approved by each COR of each VA facility prior to start of contract) shall be made available to VA personnel conducting inspections and verifying inventory of equipment storage facility.

h. The contractor/subcontractor must store, transport, or transmit VA sensitive information in an encrypted form, using VA-approved encryption tools that are, at a minimum, FIPS 140-2 validated.

Contractor must have Public Key Infrastructure (PKI) compatible with VA systems to facilitate and receive the secure electronic transfer of VA sensitive information. This includes encryption and/or sender authentication of e-mail messages.

5. Vehicle Requirement/Shipping:

a. The Contractor shall have a covered vehicle to make pick-up and deliveries to Veterans.

The vehicle shall be clearly marked easily identifying the contractor.

b. The vehicle shall be decontaminated with appropriate cleaning solution. Decontamination will be recorded and available for COR viewing at request. The vehicle shall be clean at all times and subject to an unannounced inspection by COR of the applicable VA medical facility. It shall also be equipped to separate clean equipment from dirty. Each side shall be clearly marked as “Clean” or “Dirty”. Clean equipment shall be kept in clear plastic bags.

Dirty equipment shall not be kept in plastic bags. The vehicle shall be maintained as required by The Joint Commission Accreditation requirements.

c. In no event shall the contractor transport partial loads to the storage warehouse while leaving items for storage behind. The VA Chief Warehouse, or designee, shall verify, initial, and date these loads for the contractor.

d. All delivery trucks shall maintain a sufficient stock of essential and frequently used parts to facilitate repair in the home, especially repairs of manual/electric beds, Veteran lifts and low air loss mattresses.

e. If equipment is drop-shipped to a Veteran home from the equipment manufacturer, the contractor may be issued a task order to perform set-up/assembly and provide training.

6. Delivery/Removal of Equipment:

a. The COR shall initiate trips for pick-up and delivery with the contractor, by means of a VA pickup and delivery form which will be submitted by each individual medical center. The

Government may fax the request or may send via e-mail with PKI encryption. The contractor shall be furnished the name, last four of the Veteran beneficiary's social security number, address and phone number of the individual to whom deliveries/pick-ups are intended. The contractor shall be responsible for verifying the address of the Veteran and ensuring that Veteran/caregiver is home when delivery is scheduled. The VA assumes no liability for additional trips required if the Veteran is not at home when deliveries are attempted. The contractor shall maintain a trip log enabling the COR to verify trips scheduled on a given day. Trip log will contain a listing of all deliveries for each day listing name of Veteran, items delivered, confirmation of delivery, prior delivery notification call confirmation, and notice of delayed delivery. Trip log will be provided with weekly electronic inventory. Trip cost shall be determined at the time the delivery/pick-up authorization is prepared and provided to the Contractor. Items for delivery shall be picked up at the VA

Medical Center warehouse and/or Contractor’s place of storage. Occasionally, it shall be necessary for the Contractor to pick-up equipment from the Veteran’s residence and deliver it back to the Medical Center/place of storage.

b. Trips requiring either delivery or pick-up, the cost is based upon the CLIN listed in the pricing schedule. For trips requiring delivery and pick-up at the same residence, only one delivery/pick up fee will be paid for. Delivery/pick up charges includes all mileage.

c. The contractor shall pick-up government-owned equipment from the VA designated area and store the equipment within the place of business at no additional pickup/delivery charge. When orders for the same beneficiary are received prior to scheduled delivery, the contractor agrees to coordinate such delivery/pick up with the VA and charge for a single delivery/pick up fee. Delivery/pick up charges includes all mileage.

d. After removal of DME from a Veteran's residence, the Contractor may return the equipment to the contractor’s storage facility or the VA facility but only after performing any required service, such as cleaning/ disinfection/ repair of DME.

e. All deliveries/pickups for the Veteran shall be made between the hours of 8:00 a.m. to 6:00 p.m. Monday through Saturday, unless prearranged by the Veteran or authorized representative with the contractor. Telephone calls to schedule appointments shall also only be made between the hours of 8:00 a.m. to 6:00 p.m. Prior to each delivery or pickup arrangements shall be made with the Veteran, advising him/her of the approximate time of arrival (4-hour window.) If an unforeseen situation arises that shall delay the contractor's time of arrival, contact shall be made with the Veteran notifying his/her of the same.

Deliveries shall not be left unattended at the beneficiary’s home. If the pick -up/delivery call is made more than 24 hrs. in advance, the Contractor must make a reminder call within 24 hrs. of the scheduled pick up/delivery.

f. The Contractor personnel shall wear photo identification badges and vehicle identification when providing services or making deliveries to Veteran's home. Such badges shall show the company name, employee's name, and the employee's picture and shall be displayed visibly. The Veterans served by this facility may have significant physical disabilities or chronic illnesses that in many cases influence their behavior and lifestyle. It is of the utmost importance that the highest level of professionalism be demonstrated when

Veteran/caregiver contact is made. The contractor is expected to demonstrate concern, compassion, and patience with each contact. The contractor should incorporate special training on working with older Veterans for all staff providing services under this contract.

The contractor shall ensure that all personnel providing services under this contract are properly trained and have demonstrated an acceptable level of skill in setting up and instructing Veterans and caregivers in its safe and proper use. Training shall be incorporated into annual employee competencies provided to COR annually.

g. The Contractor will transact business only with the appropriate offices of VA Medical Center and in no case deal directly with or solicit beneficiaries of the VA. The Contractor shall not recommend to Veterans, caregivers, and/or family members served under this contract additional products, services, or opinions nor offer to supply products or services at either participating VAMC or Veteran’s expense.

h. The contractor shall set up/install DME equipment per manufacture instructions. The area of set up is the Veteran’s preference. The contractor is responsible for removing all packing materials that are on-site. No additional charges shall be made for installation of new equipment or supplies. Items of equipment requiring no assembly shall be removed from the carton at no cost to the Government. The Contractor shall ensure that all parts and pieces of the equipment are present and proper working condition before attempting delivery. Failure to do so may forfeit claim for payment of related trip to complete the delivery. The contractor is not expected to relocate Veteran’s furniture to make space for equipment being delivered. The Contractor shall provide a signed copy of

Veteran’s rights/responsibilities package along with the invoice and return to the applicable purchase card holder within 48 business hours from delivery.

i. Contractor shall report all unsafe conditions observed in the home such as safety hazards, patient abuse, or staff abuse events associated with the provisions, delivery and use of

DME equipment.

j. The contractor shall check the adequacy of the electrical outlets in the Veteran’s home.

Electrical outlets will be inspected and tested to ensure that voltage level is adequate for the item being installed, polarity is correct, ground is present, and the outlet is in good physical condition. Unsafe electrical conditions shall be immediately reported to the COR.

If the home cannot accommodate the electrical requirements for the DME in accordance with manufacturer specifications, delivery shall be deferred until identified electrical deficiencies may be corrected. No electrical equipment shall be installed or left in the

Veteran’s home without specific instructions from the COR. The Veteran shall be informed of the need to have the electrical system evaluated and upgraded/repaired by a qualified electrician.

k. Permanent installation to walls, ceilings, floors, etc. is specifically excluded from this contract. The contractor shall not proceed with the work unless authorization is issued from the COR. No charges shall be made for the estimate. The VA reserves the right to reject the Contractor’s estimate and may procure these services from a separate contractor. The contractor’s staff shall be alert to structural or environmental problems which might make installation unsafe. The contractor shall provide written documentation and acknowledgement by Veteran of any unsafe condition that cannot be corrected.

l. If, through no fault of the Contractor, the Veteran refuses acceptance of the equipment being delivered after the Contractor has made the trip, payment shall be made on the same basis as though delivery had been made. Contractor shall notify the Veteran/Caregiver of specific equipment that will be delivered to the home prior to delivery. The Contractor shall contact the COR immediately for re-authorization in all cases prior to re-delivery for all refusals. The contractor shall obtain the Veteran/caregiver signature of refusal, state the reason for refusal and submit it with the invoice.

m. In the event there are unforeseen conditions (i.e. Veteran passes away/moves, acts of God, etc.) after the Contractor has begun authorized work on behalf of the beneficiary, the

Contractor shall immediately inform the Prosthetics Department prior to completion of the work. Prosthetics will determine if work shall be completed, discontinued, or changed at that time, and disposition of equipment and parts shall be determined by the Prosthetics

Department. If the Contractor is instructed not to complete the work by the Prosthetics

Department, the Contractor shall be reimbursed for the portion of the job that has been completed. The Contractor shall be required to certify to these circumstances for invoicing purposes in lieu of written proof of delivery.

7. Veteran Education:

a. The contractor shall set up, assemble, adjust, and instruct the Veterans and/or caregivers in the use and care of the equipment using TJC standards, or any subsequent accreditation standards adopted by the VA, as defined in the most current Comprehensive Accreditation

Manual for Home Care. The contractor shall provide instructions, in the form of a handbook, to the Veteran and/or caregiver in the safe and appropriate use of the medical equipment being supplied. Instruction shall include basic home safety, Veteran rights and responsibilities, when and how to contact the contractor for repairs and emergencies, storage and handling of the involved equipment, and electrical safety. A copy of the instructions shall be signed by the Veteran or caregiver to certify that the instructions were provided and were clearly understood. Copy of signed documents will be provided to COR or designee with delivery ticket.

b. The contractor shall provide an Emergency Preparedness Plan to prevent interruption of services, universal precautions and proper cleaning and storing of the DME. Provide copies of pertinent literature concerning those items with significant safety hazards. A file copy of the above shall be provided to the COR of each applicable VA Facility.

c. The contractor shall provide a demonstration of correct use and must observe a return demonstration from the Veteran/caregiver. Copy of signed Veteran education form shall be returned with final documentation.

d. The contractor shall provide Veteran’s rights/responsibilities package to Veteran/caregiver.

The top cover sheet shall be signed and returned with the VA facility's applicable invoice.

8. Contractor Policies and Procedures

a. The contractor shall have in place written procedures for delivery, recovering, receiving, segregating, and cleaning DME which is appropriate to the equipment according to manufacturer's instructions, and disinfecting of items which are stored/reused. Written procedures shall be in place for disposal of equipment or supplies designed for single

Veteran use only, i.e., egg crate mattresses. All equipment shall be labeled or tagged and dated to document such procedure.

b. The contractor shall maintain inspection reports of vehicles and various written plans and procedures used in performance of this contract such as and be available for review by VA:

(1) Permits, licenses as necessary

(2) Education training records of personnel, orientation and ongoing.

(3) Accident and incident reporting

(4) Veteran education rights and responsibilities

(5) Quality improvement – standardize processes and structure to monitor and improve care.

(6) Equipment management – including equipment inventory, maintenance, and cleaning management.

(7) Fire and emergency preparedness planning

(8) Handling Veteran complaints

(9) Recall procedures

(10) Infection Control, including care/service

(11) Universal precautions (policy and procedures) including personal hygiene, precautions, aseptic techniques and communicable infections.

(12) Safety and occupational health proceedings

(13) Electrical safety process

(14) Veteran care record, satisfaction, survey, and confidentiality

c. The contractor shall maintain an equipment management file for all VA issued equipment.

These records shall remain the property of the VA. The file shall include but is not limited to:

(1) The serial number, and model number of the delivered item.

(2) Any present/prior history of repairs to the item

(3) Who currently has possession of the item(s)

(4) Documentation of decontamination, if applicable

d. All policies and procedures, and all employment orientation records for each employee involved in work under this contract, certificates of education, background checks, copies of all in-service training, position descriptions, and performance appraisals will be submitted to the COR and available for review by the VA. The contractor shall ensure the documentation exists to support job assignments, training, orientation, and experience of all staff. The contractor shall provide training letters of personnel as to certification of installing and repairing of hospital beds, manual and powered wheelchairs, Veteran lifts, specialty mattresses, etc.

9. Veteran Records

Veteran files shall be set up on each Veteran receiving any durable medical equipment. These files remain the property of the VA and returned to the VA at the expiration of the contract.

These files shall be kept separate from and not mixed with other vendor business and/or client files.

a. The contractor shall maintain a VA beneficiary account file in compliance with the Privacy Act and Health Insurance Portability and Accountability Act (HIPAA). All beneficiary files are subject to review by the COR or Contracting Officer and accreditation surveyors on behalf of the VA during accreditation surveys or consultation. As a minimum the beneficiary file shall adhere to current Joint Commission and CMS standards for Veteran record keeping.

b. Copies of all Veterans' records shall be made available to the COR upon request.

c. This file shall contain identification of the Veteran, name and telephone number of the family member or authorized caregiver to be contacted in the event of an emergency or death. This file will include but not be limited to:

(1) Documentation of set up and delivery

(2) Documentation of Veteran receipt of Veteran rights/responsibilities.

(3) Documentation of Veteran education and safe home environment - required safety measure to protect Veteran from injury.

(4) Documentation of plan of service/care.

(5) Recall plan

(6) Assessments

(7) Invoices

(8) Individualized plan of treatment by Veteran physician or other individual as allowed by law and organization policy.

10. Contractor Rights and Responsibilities

a. All formal training required shall be administered/instructed by the contractor by persons who are certified as being qualified to instruct or teach the specific subjects or topics required whether by the appropriate manufacturer or a person who is a trained trainer of the manufacturer. Certifications shall be in the form of a certificate issued by an accredited institution of learning (school, college, university); a governmental (Federal, State, County) educational certification body (agency, board, commission). Any documentation other than the above must be approved by the COR to assure that the person instructing has sufficient experience with the subject to be able to instruct the subject in an authoritative, practical, and current manner. The certificate should note the name of the employee individually who has been trained.

b. The contractor shall have employees providing services under this contract who have certification of repair training from at least one major supplier of each for Veteran lifts, specialty mattresses and electrical beds. The contractor shall be asked to furnish proof of such certification. Within fifteen (15) calendar days after award of the contract, the contractor shall provide the Contracting Officer with a list of all employees involved in any portion of this contract. Each employee’s listing shall indicate all training applicable to this contract. Photocopies of training certificates for each current employee(s) shall be provided with the employee list.

c. If a new, or reassigned employee, begins any involvement with equipment covered under this contract, the contractor shall notify the Contracting Officer in writing within seven (7) calendar days of that involvement and submit the required photocopies of documentation of training.

d. Training must include adequate site preparation of the home environment. This includes infection control, standard precautions, personal protective equipment, hazard assessment, equipment recovery, cleaning and repair processes, routine servicing equipment function and operating checks, Veteran relations and performance improvement. This certification shall be retained in the contractor's local office from which services are provided and available for review by VA.

e. The contractor must track and trend employee health protection (i.e., PPD's, Hepatitis B, etc.)

f. This certification shall be retained in the contractor's local office from which services are provided. The VA shall have access to these tests results. Contractor shall provide this information to VA every 6 months.

g. After equipment is returned from a Veteran's residence, all equipment that is dirty shall be tagged to indicate clean/dirty and if it is or is not ready for Veteran issue. Likewise, equipment ready for issue shall be tagged with a tag indicating equipment is ready for issue.

The contractor shall tag each piece of equipment with the name of the VA applicable.

h. The contractor shall sanitize/disinfect all picked up equipment including that used by

Veterans with infectious diseases before it is placed in Contractor storage for reissue.

i. The contractor shall comply with “universal precautions” in the cleaning of recovered equipment as required by the VA in the recovery, delivery, and storage process. (BSI - Body

Substance isolation). The contractor shall wash in detergent/disinfecting solution, or equivalent. The items will be placed in plastic bags and labeled with a tag indicating date of cleaning and returned for storage in a non-contaminated storage area for future re-issuance.

Documentation of cleaning may be written on a removable tag provided by the contractor.

The tag shall indicate the name of the Veteran to whom item was issued, date tagged, that the equipment has been checked for unsafe conditions and function. Clean/disinfected equipment will be covered while in storage (i.e., plastic) to protect from dust accumulation, etc.

j. All items of Home Medical Equipment not in manufacturer's cartons shall be placed in plastic bags to maintain a "contamination free" condition. All items of Home Medical Equipment being delivered to beneficiaries’ homes shall be kept in plastic bags until they are actually delivered to the Veteran's home.

k. In the event the Veteran has expired, the Contractor shall notify the COR before close of business on the next working day. The VA will adhere to the same timeframe should the VA be advised first. The Contractor shall be informed of the same as the VA is advised.

11. Quality Improvement:

a. A continuous quality assurance plan shall be established and available for review by the

VA. Veteran satisfaction and Veteran education/safe home environment shall be quality assurance monitors. Quality assurance monitors shall be assessed on a quarterly basis and forwarded to the COR at that time. Results shall be forwarded quarterly.

b. The contractor shall have an on-going quality assurance program designed to objectively and systematically monitor and evaluate the quality and appropriateness of Veteran care, resolve identified problems, and pursue opportunities to improve Veteran care. The contractor shall provide a quarterly report of all findings, corrective actions, improvements and Veteran outcomes to the COR.

c. The contractor shall collect, trend, and report data on important processes and outcomes related to Veteran care and organizational functions as required by the Joint Commission

Accreditation as specified below:

Veteran Focused Functions Organizational Functions

Rights and Ethics (RI) Improving Organizational Performance (LD)

Assessment (PE) Environmental Safety and Equipment

Management (EC)

Care, Treatment and Services (TX) Management of Human Resources (HR)

Education (PF) Continuum of Care and Service (CC)

Surveillance, Prevention and Control Management of Information (IM) of Infection (IC)

d. The contractor shall collect, trend, and report on data about the Veterans' and families' needs and expectations and staff views of current performance and opportunities for improvement and assess and improve requirements. Important processes and outcomes are measured on a continuing basis.

e. The contractor shall make a written report of all inquiries, complaints, or requests received from Veterans/caregivers and furnish a copy to the designated VA official. The written report shall contain at a minimum the nature of the inquiry/complaint/request, the person initiating the contact, the contractor's decision/action, basis for the decision, and the outcome. The report shall be signed by the contractor's employee receiving the initial contact and the contractor's official who reviewed it for appropriate action, disposition, etc.

The final written report will be submitted to the COR for review and approval upon completion.

f. The contractor shall comply with all provisions of the privacy act when performing services under this contract.

g. The contractor shall conduct Veteran Satisfaction Surveys on a minimum of 5% or 10, whichever is greater, of contract Veterans from each facility on a quarterly basis. The results shall be submitted to the COR quarterly.

h. Contractor shall meet Quarterly with COR to review performance and quality service and provide meeting minutes.

12. Site Visits

The contractor shall permit unannounced on-site visits by VA personnel and JC surveyors accompanied by VA personnel to assess contracted services, i.e., adequacy, compliance with contract requirements, record keeping, etc. Site visits will occur no less than

Quarterly. A written report of deficiencies as determined by the COR along with any recommendations, shall be submitted immediately to the contractor. Corrective action report shall be submitted to COR within 7 workdays.

13. Equipment Safety Checks and Troubleshooting:

a. Basic safety checks performed on all equipment with appropriate resources for problem solving and troubleshooting. The contractor shall provide a written checklist of safety information and assure that manufacturer's instructions are incorporated into the checklist for safe and appropriate use of the equipment in the beneficiary's home, and access to supervisory input and manufacturer's written materials.

b. All accidents, malfunctions, injuries, deaths, and equipment recall, related to the provision, delivery and use of Home Medical Equipment shall be immediately reported to the COR and to the manufacturer of the equipment within twenty-four hours after the contractor is informed of any incident. If the contractor receives notification from the COR of the above, the contractor shall investigate the incident at the Veterans’ home and provide a written report of findings to the COR within twenty-four hours.

c. When a physician order is required for equipment safety checks or troubleshooting, evidence in the form of a written signed physician order shall be obtained, and a demonstration that the equipment/supplies are provided according to physician order(s).

d. If recertification of the equipment is required for the Veteran to operate the equipment safely, the contractor shall be notified by the COR/designee to visit the Veteran’s home.

14. Repairs:

a. Repair service is defined as the labor, parts, and material to restore to first class operating condition.

b. The contractor shall guarantee all materials and workmanship for a period of ninety (90) calendar days from the date of the repair or reissue. The Contractor will also verify with the manufacturer for warranty coverage for repairs prior to billing VA. The Contractor shall not be compensated by VA or the Veteran for any work performed under warranty.

c. The hourly rate for labor for repairs after approval has been received from the COR from the applicable VA medical center, shall be as specified in the price schedule. Any additional time less than a full hour shall be prorated in 15 minutes increments. Labor charges will be computed from the time work commences until work is completed, regardless of whether the work is performed at the contractor’s site or at the beneficiary’s residence.

d. If equipment needs repairs before it can be reissued, the contractor agrees to submit an estimate of charges to the COR of the applicable medical center within 72 hours. Repair estimates shall include the name and social security number of the Veteran from whom the items were picked up.

e. The contractor shall make incidental repairs which will be included in the hourly cost. If a major repair is required as specified by the COR, a separate purchase order shall be issued after approval of the repair for major parts. However, the VA reserves the right to make the repairs or order the repairs from a separate source. Do not proceed with repairs of major parts without a separate purchase order number.

f. The equipment and/or accessories are to be placed in first class condition suitable for reissue within five (5) calendar days after date of pick-up, or when parts are involved, within a time mutually acceptable with the COR. If equipment delivered is not in working condition, the contractor shall not be reimbursed for delivery.

g. Repairs shall be performed in accordance with the manufacturer's instructions by appropriately Certified trained personnel. The contractor shall maintain a local repair service at each branch or agent where used Government owned property will be stored at that branch or agent.

h. Combined repair and setup/disassembly charges are not permitted in the same job.

However, if a manual hospital bed requires replacement by an electric hospital bed because the semi-electric bed is no longer medically suitable, then setup/disassembly charges may be authorized.

15. Contractor Invoicing Requirements:

a. The…