36C25025R0061 0001.docx

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.

is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer) 10-23-2025 None Department of Veterans Affairs Network Contracting Office 10 24 Frank Lloyd Wright Dr.

Lobby M, Suite M2200 Ann Arbor, MI

48105 Department of Veterans Affairs Network Contracting Office 10 24 Frank Lloyd Wright Dr.

Lobby M, Suite M2200 Ann Arbor, MI

48105 To all Offerors/Bidders

36C25025R0061 09-25-2025

X X X ** HOUR & DATE for Receipt of Offers is EXTENDED to: 11-11-2025 15:00 EST See CONTINUATION Page X One (1) The purpose of this modification is to Answer questions received from Offerors and;

Issue a update price schedule.

Toni Waggoner-Boykin Contracting Officer

CONTINUATION PAGE

See attached document: UPDATED 36C25025R0061 LineItems 10 22 25.

Question: May the Government consider extending the due date for return of proposals beyond 10/27/2025?

Answer: Yes, the solicitation will be extended to 11/11/2025.

Question: Ordering Period - May the Government please confirm if the Ordering Period will be a base year plus four (4) one (1) year options?

Answer: The contract will be for five (5) ordering periods.

Question: May the Government please clarify the RFP number for submission, as the one referenced in the instructions differs from the SAM posting?

Answer: 36C25025R0061 is the Solicitation # for this requirement.

Question: May the Government please clarify if the proposals are to be submitted electronically via email, as the reference to “Subject area include” eludes to an email submission?

Answer: See Instructions to Offerors Page 115 – 4. Requires Hard Copies and 5. Requires electronic copies submitted by CD. No email submissions are allowed.

3.2 Initial Set-Ups

“Initial set-ups are services provided to those patients who have not been provided a VA authorized oxygen therapy delivery system to their place of residence on a previous occasion or have not used such a system continuously for the past 60 days”.

Question: May the Government please confirm the initial Oxygen set-ups are to be completed by a Patient Service Technician (PST)?

Answer: Yes, if the patient service technician is trained and checked off on the equipment. Only exception are the equipment requirements mentioned in the solicitation that must be setup by a Respiratory Therapist.

3.4 Patient Education Requirements

“The Contractor shall provide education to each patient at the time of set-up, and twice yearly thereafter, and assess the need for reinforcement during visits”.

Question: May the Government please confirm the semi-annual Oxygen visits are to be completed by a PST?

Answer: Yes, this may be completed by a PST unless the equipment needs to be set up by a Respiratory therapist, as indicated in the solicitation.

3.8 Traveling Patients

a. “The Contractor shall be responsible for coordinating all home oxygen for patients who travel both within and outside their respective contracted area of responsibility/jurisdiction, unless otherwise indicated”.

Question: May the Government please clarify if its intent is for the contractor to have physical locations throughout the Continental US to cover services for patients traveling outside of the geographical jurisdiction (i.e. Patient travels from Saginaw, MI to Houston, TX)?

Answer: No, it is not the intent of the vendor to have physical locations throughout the US. It is the responsibility of the vendor to work with and coordinate travel with other vendors to make sure the veteran is provided with the necessary oxygen travel needs.

4.0 Equipment Maintenance

“Twice yearly or as recommended by the equipment manufacturer, whichever occurs most often, the Contractor shall visit the patient to inspect equipment, checking for proper functioning and prompting patients to replace disposables, such as filters, tubing and nasal cannula as needed”.

Question: May the Government please confirm the visits are to be completed by a PST?

Answer: Yes, this may be completed by a PST unless the equipment needs to be set up by a Respiratory therapist, as indicated in the solicitation.

4.4 Ventilators

g.3 “When clinical respiratory services are provided to ventilator patients, education on trach changes, airway care and suctioning shall also be provided”.

Question: Is it the Government’s intent for the contractor’s RT to physically perform suctioning in the patient’s residence, or just provide education on the airway and suctioning process?

Answer: No, just provide the necessary education.

4.9 In-Home Nocturnal Continuous Pulse Oximetry Test

“Procedure shall include delivery, set up and pick up of rented oximeter”.

Question: May the Government please confirm the delivery, setup and pickup of the rented oximeter is to be completed by a PST?

Answer: Yes, if they have received proper training and have completed the necessary competency assessments for that specific equipment.

Question: May the Government please confirm the report is to be submitted electronically via email to the requesting facility?

Answer: 6.3 Summary report of services rendered: shall consist of an emailed report and the report provided on electronic media i.e. SharePoint.

4.10 Cough Stimulating Device

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

Question: May the Government please clarify if the Cough Stimulating Device will be borne of the contractor or Government?

Answer: The Contractor.

Question: If borne of the contractor, may the Government please update the Fee Schedule with the addition of the Cough Stimulating Device?

Answer: New Clin Schedule is posted with this modification.

Question: If borne of the Government, may the Government please update the Fee Schedule with a line item for an RT visit for the provision and follow-up visits of the Government Owned Cough Stimulating Device, as well as line item(s) for the disposable supplies requested?

Answer: Not borne by the Government.

5.2 Staffing and Employee Requirements

“Contractor shall employee at least one (1) Licensed Certified or Registered Respiratory Therapist” Question: May the Government clarify if a Registered Nurse (RN) may be used in lieu of a CRT or RRT?

Answer: No, this must be a Respiratory Therapist

5.6 Patient Education Requirements

“The Contractor shall provide education to each patient at the time of set-up, and every six months thereafter, and assess the need for reinforcement during visits. This information shall be presented verbally, in demonstration, and the material covered, shall be in written form to be left with the patient/care giver”.

Our organization has implemented an electronic maintenance record system. All documentation is completed via a tablet and stored in the patient’s electronic medical record (patients have access to view their individual records online.

Question: May the Government please confirm the electronic medical record system will meet the requirement, as the patients have access to view their records online (no physical forms)?

Answer: Yes, this is acceptable so long as the VA can receive copies, and the VA and/or patient can receive a physical copy as contractually required, if requested.

5.7 Qualification of Contractor

“b. Contractor employees assigned to VA’s contract shall complete the VA background investigation process successfully”.

Question: May the Government please confirm the contractor may provide confirmation of a successful background investigation completed by the contractor’s background investigation vendor?

Answer: No, Federal Background Check will be completed by the VA with all staff working under this contract.

5.8 Contractor’s Facility

“a. The Contractor shall maintain service location(s) that is (are) physically located within the geographic area covered by the area of responsibility/jurisdiction that the Contractor shall provide home oxygen services (specifically for performance of emergency service requirements)”.

Question: May the Government please clarify if the awarded contractor must have service location(s) in place at the time of award?

Answer: The Contractor shall have service location(s) in place no later than 30 days after award.

7.2 Federal Privacy and Confidentiality Statutes

“b. Each of Contractor’s employees providing services under this contract shall self-register in the Governments Talent Management System (TMS) and complete the VHA privacy and HIPPA training” Question: May the Government please confirm if the TMS and HIPPA training may be completed on physical forms?

Answer: No. See page 42 b. of the solicitation.

Price Schedule The PWS has an estimated patient count of 5,000 for all seven (7) facilities. In review of the estimated quantities, it appears there are approximately 2,600 oxygen patients.

Question: May the Government please confirm the oxygen count for all seven (7) facilities.

Answer: This is an estimate only, the approximate number of patients in any month is 4600.

Question: May the Government please confirm if the quantities listed in Column J reflect monthly or annual quantities?

Answer: Monthly

Past Performance Questionnaires “2. Past Performance Questionnaires are to be completed and sent directly to the Government by the evaluator completing the Questionnaire. It is the sole responsibility of the offeror to track the submission of Past Performance Questionnaires and ensure that the Government receives them AS SOON AS POSSIBLE BUT NO LATER THAN THE CLOSING TIME AND DATE OF THE SOLICITATION. It is also the sole responsibility of the offeror to inform the evaluators of any extensions the Government approves to the date and time proposals are due to be submitted” Question: May the Government please clarify how the offeror should track the submission Past Performance Questionnaire being received by the Government, as they are not allowed to view the questionnaire completed by the evaluator?

Answer: It is up to the offeror to decide how to track their submissions.

Question: May the Government please clarify if a new questionnaire is required to be submitted to the Government, should extensions be approved?

Answer: No – the date can be changed on the questionnaire to the extension date.

Section 4.4 – Ventilators Reference: 4.4(c)(i): "The patient shall always have two (2) ventilators on hand."

Reference: 4.4(f): "Patients may be on continuous or intermittent mechanical ventilation."

Question: For patients receiving nocturnal and/or intermittent mechanical ventilation, is it acceptable for such patients to maintain only one (1) ventilator in the home, rather than two?

Answer: No, all patients shall have (2) two ventilators in the home.

Section 4.5 – Portable Suction Machine Question: Would the Government consider the portable suction machine to be a rental item under this contract?

Answer: This item is monthly rental.

Section 4.10 – Cough Stimulating Device Question: Would the Government consider the cough stimulating device to be a rental item under this contract?

Answer: This item is monthly rental.

Request: If it is the Government’s intent that the contractor supply this device, we respectfully request that it be added to the pricing section of the solicitation.

Answer: New Clin Schedule is posted with this modification.

Section 4.11 – Positive Airway Pressure (PAP) Masks Question: Will the Government be responsible for supplying PAP masks to Veterans, or is the Contractor expected to provide them?

Answer: See 4.4.4, this is provided by the contractor

Section 4.12 – Positive Airway Pressure (PAP) Valve Reference: 4.12(a): "The Contractor shall furnish a PAP Valve to each Veteran on nocturnal oxygen bled into a PAP device when ordered by the VAMC."

Question: Is it the Government’s intent that all patients prescribed oxygen bled into a PAP device will be provided a PAP valve by the Contractor?

Answer: See 4.12, “The Contractor shall furnish a PAP valve to each Veteran on nocturnal oxygen bled into the a PAP device when ordered by the VAMC.”

Coverage and Pricing for Marion, IN Location Observation: The solicitation references a VA Medical Center and a Community-Based Outpatient Clinic (CBOC) located in Marion, IN. It also states that Marion and Fort Wayne cover the same counties. However, the pricing section does not include Marion, IN as a listed location.

Question: Could the Government please clarify whether services and pricing for the Marion, IN VAMC and CBOC should be included under the Fort Wayne, IN location, or if separate pricing for Marion, IN is required but was inadvertently omitted?

Answer: Northern Indiana Healthcare System (NIHCS) is one VA that includes both Marion, Indiana and Ft. Wayne Indiana. The price schedule is listed as NIHCS.

Pricing Proposal – Portable Cylinders and Refill Charges References:

Item D: Portable system ONLY – prescription does not include concentrator; includes cylinders (sizes “E”, “D”, “B” (M6), or “C” (M9)) with regulator, flow meter, handcart, pouch, and disposable supplies.

Items E–H: Refill charges for the corresponding cylinder sizes, with a note that regulators and conserving devices shall be included in the monthly rental price for all applicable equipment.

Items AA and AB: Standard concentrators.

Question: Could the Government please clarify whether standard portable cylinders (e.g., sizes E, D, B, or C) may also be used for patients who are issued a standard concentrator under Items AA and AB? If so, how should the corresponding refill charges be billed?

Answer: Per Joint Commission Standard EQ.01.04.01, any size small than an E cylinder would not meet the requirement.

Question: Would the VA consider revising the current pricing structure to allow Items E, F, G, and H to be billed as refill charges in conjunction with Items AA and AB?

Answer: No, this will not be revised.

Solicitation Number Correction – Past Performance Questionnaire Background: A question was submitted on October 9, 2025, referencing Solicitation 24R0147. We understand this was a typographical error and the correct solicitation number is 25R0061.

Question: Does the Government plan to issue an updated Past Performance Questionnaire reflecting the correct solicitation number (25R0061), or should contractors revise the existing version themselves? Alternatively, should we proceed with the questionnaire as currently written, using the incorrect solicitation number?

Answer: The government is not going to update the form – Contractor’s should change it to 25R0061.

CLIN 0001–0007: Oxygen Concentrators (5–10 LPM, High Flow) Issue: Quantities too low versus 5,000 patient load; unclear rental model.

Impact: The current pricing does not reflect true demand and may result in underestimation of total costs.

Question: Do CLINs 0001–0007 represent monthly averages, annual totals, or per-patient units? Should pricing extend through all five ordering periods?

Answer: These totals were specifically listed this way with the need to move towards portable concentrators vs stationery.

CLIN 0008–0015: Portable & Home Fill Systems Issue: No differentiation between portable gaseous, home-fill, and POC units.

Impact: Unclear whether VA prefers distinct pricing for each equipment type or a blended rate.

Question: Should pricing be separated by system type or a blended rate? Please specify preferred system by facility.

Answer: Pricing is separated, Clin AC/AD (Homefill system), Clin AE (Portable Gaseous refillable tanks), CLIN NA (POC units).

CLIN 0016–0024: Liquid Oxygen Systems Issue: No refill or delivery frequency provided; unclear cost basis for recurring fills.

Impact: Without estimated refill rates, it is not possible to calculate accurate recurring costs.

Question: Can VA provide estimated refill or cylinder replacement rates per patient per month to support pricing accuracy?

Answer: CLIN K – Rental of liquid system, CLIN L – cost per pound.

CLIN 0025–0029: Ventilators and RT Support Issue: Does not include backup ventilator or RT service requirements.

Impact: The PWS requires two ventilators per patient and recurring RT visits, both unpriced.

Question: Should pricing include both a primary and backup ventilator, and monthly RT visits as required by PWS §4.4(g)(i)?

Answer: Ventilator is listed under CLIN S-S2, RT visits are included in the cost for ventilator services.

CLIN 0030–0032: Ancillary Respiratory Equipment (PAP, Suction, Cough Assist) Issue: Quantities inconsistent with PWS; consumables not priced separately.

Impact: Recurring supply costs such as filters, cannulas, and saline bullets are missing.

Question: Should consumable supplies be priced as sub-CLINs under each equipment type or included in the monthly rental rate?

Answer: Refer to 4.4.1, Table 1.

CLIN 0033–0036: Oxygen Safety & Accessories (Fire Valves, Signage, Cannulas, Humidifiers) Issue: PWS §4.14 requires two fire-safety valves per unit, replaced regularly, but CLIN quantities only show single units.

Impact: Safety items are underrepresented and unpriced as recurring replacements.

Question: Should these safety items be priced as recurring consumables or included within each equipment CLIN as part of an all-inclusive rate?

Answer: This is not a recurring consumable as they are replaced per manufacturer recommendation. Refer to 4.14, CLIN T.

CLIN 0037: In-Home Nocturnal Pulse Oximetry Issue: Limited annual quantity inconsistent with PWS testing frequency.

Impact: Quantities do not reflect recurring testing requirements across all facilities.

Question: Should CLIN 0037 reflect recurring testing (monthly or quarterly) per facility as described in the PWS?

Answer: This number was estimated on past use of Overnight Pulse Oximetry testing by facility.

CLIN 00038: Transition-In Issue: No CLIN for transition-in despite a 120-day phase-in requirement under PWS §7.7.

Impact: Contractors will incur unpriced startup labor and logistics costs.

Question: Should transition-in costs be priced as a separate CLIN or included in the Base Year pricing?

Answer: This should be incorporated in the overall cost of the Contract.

CLIN 00039: Transition-Out Issue: Phase-out activities are required but not priced.

Impact: Without a defined CLIN, final retrieval and coordination activities cannot be billed.

Question: Should transition-out be separately priced to cover final retrieval, patient transfer, and data turnover activities?

Answer: This should be incorporated in the overall cost of the Contract.

CLIN 00040: Emergency Response / After-Hours Service Issue: 24/7 coverage required by PWS §3.6 but not priced separately.

Impact: Unclear if emergency response costs should be built into base CLINs or treated as a distinct reimbursable service.

Question: Should after-hours and emergency response services be priced as a distinct CLIN or included within monthly rates?

Answer: Emergencies are an included service and not priced separately.

Pricing Format (Excel Schedule) Issue: Section B.4 references 'See attached document: SCHEDULE,' but no editable Excel version is provided.

Impact: Without an Excel format, offerors cannot ensure accurate formulas or complete the schedule across 37+ CLINs.

Question: Will the Government provide the Price Schedule in Excel format, with editable CLINs, quantities, and totals for submission?

Answer: New Clin Schedule is posted with this modification.

Estimated Workload by Facility Issue: The solicitation references approximately 5,000 Veterans across seven VA Medical Centers, but only 1,256 total units are listed.

Impact: Quantities appear understated, potentially leading to misaligned pricing.

Question: Can VA provide estimated patient counts or workload data per facility (Ann Arbor, Battle Creek, Detroit, Ft. Wayne, Marion, Indianapolis, Saginaw)?

Answer: These totals are estimations only. There are approximately 4600 patients across all IN/MI VAs.

Historical Utilization Issue: No historical workload or utilization data provided.

Impact: Offerors cannot develop accurate cost projections without prior-year usage data.

Question: Can VA provide historical utilization data or average monthly patient counts by equipment type?

Answer: Provided data is historical estimates based on past quantities provided.

Ordering Periods Issue: Section B.4 references five ordering periods, but only a single Base Year appears on SF1449.

Impact: It is unclear whether offerors should price multiple years or only the base period.

Question: Please confirm the total number of ordering periods and whether pricing should be submitted for all five.

Answer: The contract will be for five (5) ordering periods. Pricing for all five (5) ordering periods shall be submitted.

Minimum and Maximum Quantities Issue: The solicitation lists only a $1,000 minimum and $45M maximum for the contract with no CLIN-level minimums.

Impact: Unclear if minimum applies to total contract or individual facilities.

Question: Should the minimum guarantee apply to the total contract value or be distributed among CLINs/facilities?

Answer: Total Contract Value.

Government-Furnished Equipment (GFE) Issue: The solicitation does not indicate whether any oxygen or ventilator equipment will be Government-Furnished.

Impact: Offerors cannot distinguish between rental and maintenance pricing obligations without clarity on GFE availability.

Question: Will the VA provide any oxygen or ventilator devices, or should all equipment be contractor-owned and maintained? If Government-Furnished Equipment will be provided, please include an inventory list by product type and quantity for each VA facility. This will allow offerors to differentiate between Contractor-Owned and GFE assets in the Price Schedule and ensure pricing reflects accurate ownership and maintenance responsibilities?

Answer: All equipment and services are borne by the Contractor.

Equipment Replacement Cycle Issue: The solicitation does not specify expected replacement intervals for rented equipment.

Impact: Different lifecycle assumptions may cause large pricing variances between offerors.

Question: Should pricing assume full lifecycle replacement (every 3–5 years) or continuous maintenance within the rental rate?

Answer: It is the Contractor's responsibility to have an established replacement/maintenance program to manage their own equipment.

Emergency Response Services Issue: The PWS (§3.6) requires 24/7 emergency response but does not specify billing treatment.

Impact: Offerors may include these costs differently unless clarified.

Question: Should emergency response services be priced separately as a sub-CLIN or included in base rates?

Answer: Emergencies are an included service and not priced separately.

Respiratory Therapist (RT) Visits Issue: PWS requires monthly RT visits for ventilator patients, but these are not listed as a separate CLIN.

Impact: Offerors cannot determine if RT labor costs are billable separately.

Question: Should RT visits be included within ventilator CLINs or separately priced as recurring services?

Answer: RT visits are an included service and not priced separately.

Transition Period Costs Issue: The PWS (§7.7) requires transition-in/out activities without defined pricing.

Impact: Contractors may incur unpriced costs for equipment exchanges and coordination.

Question: Should transition activities be included in the Base Year or priced under distinct CLINs (00038, 00039)?

Answer: This should be incorporated in the overall cost of the Contract.

Invoice Mapping Issue: Section B.2 requires monthly invoicing by CLIN but does not specify level of aggregation allowed.

Impact: Offerors may format invoices inconsistently without clarification.

Question: Should invoices align exactly to CLIN numbers or may they be summarized by patient type or equipment category?

Answer: Please refer to 7.6 Payments and Invoicing.

Traveling Veterans / Out-of-Area Coverage Issue: The PWS (§3.8) requires support for Veterans traveling across VISN’s but lacks pricing guidance.

Impact: Contractors could face unreimbursed expenses for out-of-area support.

Question: Should traveling Veteran and temporary oxygen support be separately billable or included in base pricing?

Answer: Please refer to 3.8 Traveling Patients

Data Reporting Requirements Issue: The solicitation does not define reporting level of detail.

Impact: Offerors cannot assess time or system costs without clarity on required data elements.

Question: Should monthly reports include patient-level details (device serials, setup dates) or summary counts by CLIN/facility?

Answer: Refer to 6.3 Summary Report of Services Rendered.

Recurring Rentals vs. One-Time Quantities Issue: The solicitation does not clarify whether pricing for concentrators, ventilators, and other rental equipment should be recurring or one-time.

Impact: Contractors cannot determine if the unit pricing represents a monthly recurring rental (MO) or a one-time annual charge (EA).

Question: Please clarify whether pricing for concentrators, ventilators, and other rental equipment should be based on monthly recurring rental quantities or one-time annual units. Additionally, please update the “Unit” column in the Price Schedule to clearly indicate “EA” (each) or “MO” (monthly) for each CLIN to ensure consistent pricing assumptions.

Answer: All items under this contract are rental items unless disposable or one time use item.

Workload by Category Issue: The solicitation does not provide historical data on set-ups, discontinuations, switch-outs, or emergency service calls per facility.

Impact: Offerors cannot accurately estimate staffing or response capacity without these workload details.

Question: Can VA provide historical data on monthly set-ups, discontinuations, switch-outs, and emergency service calls per facility to support accurate workload planning?

Answer: Pt. totals are estimations based on past use.

Travel Patient Volumes Issue: The solicitation references traveling Veterans but does not provide workload volumes.

Impact: Contractors cannot forecast cross-VISN coordination costs without historical data.

Question: What is the average monthly number of traveling Veteran requests requiring coordination outside VISN 10?

Answer: This varies.

IT Security Compliance (C.2) Issue: The solicitation references IT system access but does not specify cybersecurity requirements.

Impact: Contractors must know whether VA-specific controls such as FISMA review, POA&M; tracking, or VA Form 6500.6A compliance apply.

Question: Will VA require the contractor to implement VA-specific cybersecurity controls (e.g., annual FISMA review, POA&M; tracking, VA Form 6500.6A submission)?

Answer: No.

PII Data Transmission Issue: The PWS references 'PII-protected SharePoint delivery' but does not specify which system or compliance framework applies.

Impact: Offerors need clarity to ensure compliant secure data transfer of Protected Information (PII).

Question: Can VA clarify whether the 'PII-protected SharePoint delivery' refers to VA-managed SharePoint, or if contractors must establish a dedicated FedRAMP-compliant portal?

Answer: This would be a secured PII Protected SharePoint managed by the contractor with access provided to the VA.

Interface Requirements Issue: The PWS does not identify whether data integration with VA systems is required.

Impact: Unclear if contractor must support direct interface with VistA, CPRS, or RESPIRONICS systems.

Question: Will the contractor be required to integrate with VA’s VistA, CPRS, or RESPIRONICS cloud systems for compliance and patient data uploads?

Answer: No, the Contractor will not integrate with the VA systems. Data uploads are the responsibility of the Contractor and provided to the VA upon request or as indicated in the solicitation

Transition-In Deliverables Issue: The solicitation references a 120-day transition-in period but does not provide a deliverable checklist.

Impact: Without a formal template, contractors may submit inconsistent transition plans.

Question: Will VA provide a formal transition plan template or checklist to ensure standardized transition-in deliverables?

Answer: Outgoing Contractor shall provide Incoming Contractor with the Equipment List and all other necessary information to transition.

Transition-Out Coordination Issue: The solicitation does not define contractor responsibilities for VA-owned equipment during phase-out.

Impact: Contractors cannot plan for labor or logistics if required to test or redeploy VA-owned assets.

Question: Should the contractor assume responsibility for cleaning, testing, and redeploying existing VA-owned equipment during the transition-out period?

Answer: There will be no VA-owned equipment used in this solicitation, all equipment will be provided by the Contractor.

Disaster Preparedness / COOP Issue: The PWS references emergency operations but lacks detailed continuity planning requirements.

Impact: Contractors must plan for disaster staffing, emergency routes, and backup power but lack VA expectations.

Question: Will VA require a formal Continuity of Operations Plan (COOP) or disaster staffing matrix to support emergency operations?

Answer: Yes

Respiratory Therapist (RT) Credentialing Issue: The solicitation does not specify credential validation requirements for RTs.

Impact: Offerors must know whether state licensure, NBRC credentials, or Joint Commission files are required for compliance.

Question: What documentation will VA require to validate Respiratory Therapist competencies (state license, NBRC certification, or Joint Commission records)?

Answer: Follow Joint Commission and local state guidelines regarding licensing for Respiratory therapy and the state in which they are practicing. The VA will require updated copies of all competencies of the contractor staff Respiratory Therapist and a copy of their current license to keep on file.

Subcontractor Personnel Access Issue: The solicitation does not clarify security or background requirements for subcontracted staff.

Impact: Offerors must know if subcontractor personnel require full VA background checks and PIV cards.

Question: If subcontractors are used for remote areas, must their staff undergo full VA background checks and obtain PIV cards, or can access be limited to non-PII service delivery?

Answer: ALL staff working under this contract will require Federal Background Checks.

Training Verification Issue: The solicitation does not specify requirements for training validation documentation.

Impact: Unclear whether VA will accept contractor’s internal training records or require Joint Commission validation.

Question: Will VA require annual Joint Commission training validation, or will contractor in-house compliance documentation be acceptable?

Answer: In-house compliance documentation will be accepted.

Battery Life for Portable Oxygen Concentrators (POCs) Issue: The solicitation does not state whether pricing should include one or multiple batteries per POC.

Impact: Battery configuration directly affects equipment cost and runtime capability.

Question: Should offerors assume one battery per POC unit, or multiple batteries to ensure compliance with patient runtime requirements?

Answer: Refer to CLIN NB

Cylinder Ownership (VAMC On-Site Stock) Issue: The solicitation requires contractors to maintain portable tanks at VAMC facilities (§1.4) but does not define ownership.

Impact: Offerors cannot determine if these cylinders are VA property or part of contractor inventory.

Question: For portable tanks held on-site at VAMC locations, does VA retain ownership or are these cylinders considered part of contractor inventory?

Answer: Cylinders will be Contractor owned and maintained by the contractor

Equipment Age Limit Issue: The solicitation does not define maximum age for concentrators or ventilators in use.

Impact: Lack of age standards may lead to inconsistency in equipment quality and replacement assumptions.

Question: Will VA impose a maximum age limit on concentrators or ventilators (e.g., less than 5 years per Joint Commission standards)?

Answer: Please refer to 4.2.a – all equipment shall be the most current and supplies are to be new.

Patient Transfers Between Facilities Issue: The solicitation does not define billing process for Veterans transferring within VISN 10.

Impact: Contractors cannot ensure continuity of billing without clear transfer policies.

Question: When Veterans move between facilities within VISN 10, how should the contractor handle billing continuity and patient record transfer?

Answer: There should be no additional billing fees unless a permanent move occurs for patients moving within the IN/MI VISN 10 contracted areas. Refer to CLIN M

Documentation Delivery and Compliance Reporting Issue: The solicitation does not specify whether monthly reports must be submitted in hard copy or electronically.

Impact: Offerors need confirmation of acceptable submission format to ensure compliance.

Question: Will VA require both digital and physical submission of monthly reports, or will secure electronic submission alone suffice?

Answer: Electronic Submission will meet the requirement.

Maximum Contract Value: The maximum value of this contract shall be no more than $45,000,000.00 over the life of the contract.

Question: Is it the government’s intention for the RFP response to pricing to be less than $45,000,000.00 over the life of the contract? If yes, will the Government acknowledge that actual service delivery may exceed the $45,000,000.00 ceiling?

Answer: This contract is an Indefinite Delivery Indefinite Quantity (IDIQ) which is made to be flexible. These are estimates.

Question: The Government indicates that the maximum value of this contract shall be no more than $45,000,000.00 and is based on pricing of estimated quantities for service delivery. Will the Government clarify if the $45,000,000.00 is a hard ceiling or cap of funding or a number based only on estimates in the solicitation?

Answer: This contract is an Indefinite Delivery Indefinite Quantity (IDIQ) which is made to be flexible. These are estimates.

Question: Will the Government amend the ceiling ($45,000,000.00) through utilization of actual quantities listed in the solicitation for pricing purposes (thereby amending the “estimated” quantities listed for pricing) for services/goods associated with the actuals associated with current delivery of the contract?

Answer: This contract is an Indefinite Delivery Indefinite Quantity (IDIQ) which is made to be flexible.

Question: The Government requests pricing based on estimates with quantities far lower than what is necessary to support the delivery of the contract. How will the estimated pricing be validated against actual delivery numbers post award?

Answer: An estimation is used because actual numbers vary by site and equipment.

Question: The Government identified a ceiling for the life of the contract of $45,000,000.00 which would not allow effective delivery based on existing program requirements and demands (quantities required based on current beneficiaries supported). Will the Government amend or remove the maximum contract value?

Answer: Not at this time.

DISCONTINUATION OF SERVICE:

The Government shall notify the Contractor in the event of an order to discontinue oxygen service to any patient covered under this contract as soon as identified. Notification shall be by via secured email or facsimile. At least two (2) weeks prior to the scheduled termination of prescription the Contractor shall notify the VA designee and/or COR via secured email or facsimile, if removal of home oxygen may be detrimental to the patient. Payment shall be pro-rated based upon the notification date of discontinuance of service. In the event that the contractor is notified that a patient has moved out of the service area, or is deceased, the Contractor shall notify the VA designee and/or COR within one (1) business day of this discovery.

Question: There are current procedures in place for verifying/validating notifications of discontinued service, will the government continue utilizing the existing processes for validation and recommendations currently in place for this process?

Answer: Refer to 3.5 Discontinuation of Services.

Question: Will the government clarify if the contractor must provide any type of medical evaluation associated with the determination of risk to the patient from the discontinuing of service and removal of O2 devices/materials.

Answer: Please refer to 3.1 Home Visits, 3.3 Assessment requirements, and 3.4 Patient Education Requirements, and 3.5 Discontinuation of Service.

Question: Will the government allocate funding and create a CLIN for pricing to support the contractor maintaining a Medical Professional for assisting in the determination of risk to the patient scheduled for discontinuation or removal of O2 services or devices/materials?

Answer: No, only the VA can determine discontinuation of services. The contractor is responsible for their own staff.

Describe organization structure and management practices relative to the requirements contained in the PWS.

· Provide resumes or a spreadsheet describing the credentials, education, and/or experience of the primary home oxygen manager, assistant manager, and any other personnel.

Question: Are resumes and certifications/trainings required to be provided for Key Personnel Only or all Contractor Personnel that will be working under this contract?

Answer: Please refer to 6. Proposal Format, this would be for all staff working under this contract

Question: Will the government align different ratings or scores for proposal responses that offer resumes vs. a spreadsheet?

Answer: All proposals will be evaluated in accordance with Specific Instructions to Offerors regarding proposal preparation.

Question: Will the government specify that “any other personnel” applies only to individuals performing on this contract and does not include ALL members of our organization or corporate employees.

Answer: Only members performing on this contract.

SUBMISSION OF OFFER

e. Offerors that can meet the requirements of this RFP should take into consideration the complexity and extent of the services to be performed. Network Contracting Office 10 (NCO 10) intends on issuing an award to the Offeror whose proposal represents the best value to the Government and meets the needs set forth in this RFP. The information required shall be submitted by the Offeror in order to assure complete and proper understanding of the Performance Work Statement (PWS), however, the Offeror may include additional information, within the page limitations specified below, if necessary to more clearly define the Offeror’s capability of performing the services or furnishing the products as defined herein. Any additional information shall be clearly identified by Paragraph, Subparagraph, Section number etc. as further defined in the Instructions to Offerors. Failure to identify the submission could result in less than full consideration for award. Offeror may also provide any ‘value-added’ offerings, over and above the requirements or information requested or contained in the RFP. Any value-added offerings will be appropriately considered in the best-value determination. However, acceptance of any additional items submitted for consideration will be solely at the discretion of the Technical Evaluation Team and the Contracting Officer.

Value-Added Items. The offeror shall highlight in its submission these items that exceed the requirements requested by the government. The offeror shall identify and describe those capabilities and identify the added cost for those capabilities and whether the Home Oxygen services are available without those capabilities.

Question: Is there a specific location within the response structure that offerors should apply “Value-Added items”?

Answer: No – It should clearly identified.

Question: Is there a specific format that the “Value-Added Items” should be included as part of the offeror’s proposal.

Answer: Refer to Specific Instructions to Offerors regarding proposal preparation.

Page 24/25 - Section 4.10 cough stimulating device.

Question: Will the Government provide a CLIN for this item for pricing purposes. There is no CLIN associated with it in the current solicitation.

Answer: New Clin Schedule is posted with this modification.

Question: Given impact to contractors across the nation from the Government Shutdown, will the Government issue a 7 – 10 day extension making the suspense 11/14/2025.

Answer: Yes, the solicitation will be extended to 11/11/2025.

3.5 (a) DISCONTINUATION OF SERVICE:

At least two (2) weeks prior to the scheduled termination of prescription the Contractor shall notify the VA designee and/or COR via secured email or facsimile, if removal of home oxygen may be detrimental to the patient.

Question: What is the government considering termination of prescription? Will the contractor be receiving pre-notification of discontinue in order to fulfill the two week notification prior to termination?

Answer: Termination of prescription comes from the VA (or occasionally from the recommendation by the contractor due to unsafe conditions.) There will be no pre-notification.

3.5 (b) DISCONTINUATION OF SERVICE:

Billing of services ends at time of VA-issued notification to discontinue order and/or date of patient’s death.

Question: If the contractor is notified of death or patient request removal of equipment while conducting a visit, this would be considered the date of notification. Is the contractor required to wait until receiving a discontinue order from the VA before picking up the equipment and stop billing?

Answer: Refer to 3.5.b Billing of services ends at time of VA-issued notification to discontinue order and/or date of patient’s death.

4.0 (b-7) EQUIPMENT MAINTENANCE:

The report must include a patient list and associated scanned delivery/maintenance receipts with patient’s signatures, patient signed patient education notes and clinical notes associated with plan of care changes.

Question: Is this a clinical contract? If so, what type of clinical respiratory services are required? Will the government be updating the SOW and CLIN structure to support the Clinical Respiratory requirements?

Answer: This is a service contract. Education, instruction on use, etc. is provided.

3.8 (f) TRAVELING PATIENTS:

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

Question: Is Puerto Rico, Hawaii, Alaska and US Virgin Islands considered to be part of the continental USA?

Answer: The term continental United States means the continuous 48 states, to include the District of Columbia.

4.4 (g-3) VENTILATORS:

When clinical respiratory services are provided to ventilator patients, education on trach changes, airway care and suctioning shall also be provided.

Question: Is this a clinical contract? If so, what type of clinical respiratory services are required? Will the government be updating the SOW and CLIN structure to support the Clinical Respiratory requirements?

Answer: This is a service contract, education is provided, and instruction is provided.

4.4 (h-8) VENTILATORS:

Contractor Certified or Registered Respiratory Therapist Responsibilities/Competency shall include the following: Cough Stimulating Device Question: There is not a CLIN item for a Cough Stimulating Device. Will the government remove this competency requirement for the Respiratory Therapist?

Answer: New Clin Schedule is posted with this modification.

4.10 COUGH STIMULATING DEVICE:

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

Question: There is not a CLIN item for a Cough Stimulating Device. Will the government be adding a CLIN item for this or remove it from the SOW?

Answer: New Clin Schedule is posted with this modification.

4.12 (e) POSITIVE AIRWAY PRESSURE (PAP) VALVE:

Veterans shall be set up with a Positive Airway Pressure Valve when ordered by VA Staff.

Question: If a PAP device is found at the veteran’s home during a visit and their prescription allows for oxygen during sleep, is the contractor permitted to deliver the PAP valve and notify the VA or is an order required prior to delivery of this?

Answer: This requires clarification from the VA, contact the VA when a situation like this occurs for further guidance

SLIN (I) - Rental Demand Pulse Conserver Device; no less than a 5:1 ratio or 60 ML/pulse. VA111 SPECIAL NOTE: Conserving devices shall be included in the monthly rental price for all applicable equipment.

Question: If the conserving device is to be included in the monthly rental price of the equipment (according to other CLINS, cylinders only), why is there a CLIN for the conserving device? When would this CLIN be utilized?

Answer: This was removed.

SLIN (K) Rental liquid oxygen system (90 –100 lbs.) stationary reservoir per patient. E0439; AND Rental portable liquid oxygen system per patient E0434 Question: This CLIN is for a liquid oxygen system consisting of 1 stationary unit and 1 portable unit. If the VA orders 3 stationary units and 1 portable unit, how would the additional stationary units be billed? Would the VA consider splitting this into two different CLINS? The two requested CLINS would be “Stationary Reservoir” and “Portable Liquid Oxygen System”? This would allow each unit to be billed separately if the VA orders different quantities.

Answer: The VA would not order more than one (1) stationary system due to the safety of having that system in the home. Typical homes cannot support more than one 90-100lb system.

SLIN (L) Liquid oxygen per pound for portable liquid oxygen system under Item K. E0444 Question: Can the verbiage for this SLIN be changed to liquid oxygen per pound for the Stationary Liquid Reservoir? The reservoirs are filled with liquid oxygen from the provider, which is what will be billed. The provider does not fill the liquid oxygen portable system, as that is the responsibility of the veteran to fill from the liquid reservoir when needed.

Answer: This will remain as stated.

SLIN (M) Delivery for re-supply and/or relocation of equipment due to change in patient’s residence Question: When will this delivery fee for re-supply be used?

Answer: When a patient moves their permanent location within the contracted area, and equipment would need to also be moved.

SLIN (R) Ventilator Negative Pressure ventilator; portable or stationary; Rental negative pressure ventilator E0465 Question: What is being considered a negative pressure ventilator?

Answer: Ventilators that offer a negative pressure, e.g., Cuirass.

SLIN (S) Pressure support ventilator with volume control mode; June include pressure control mode; Rental pressure support ventilator E0465 Question: What type of ventilators are you considering as pressure support ventilators?

Answer: Ventilators that offer pressure support, e.g., Astral, Luisa, VOCSN, EVOs.

SLIN (Y) Tracheostomy care supplies – The contractor shall provide supplies needed to properly clean and maintain trach and stoma to ventilator patients only.