36C25218R1040-0001004.docx

5. PROJECT NUMBER (if applicable)

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8. NAME AND ADDRESS OF CONTRACTOR

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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

BY

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

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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) 11-21 -2018 None 36C252 Department of Veterans Affairs Great Lakes Acquisition Center (GLAC) 115 S 84th Street, Suite 101 Milwaukee WI 53214-1476 36C252 Department of Veterans Affairs Great Lakes Acquisition Center (GLAC) 115 S 84th Street, Suite 101 Milwaukee WI 53214-1476 To all Offerors/Bidders

36C25218R1040

X X X See CONTINUATION Page No change X The purpose of this amendment is three-fold. One is to extend the RFP open period. The RFP's closing date and time are hereby extended from the date and time listed on the RFP to a new closing date and time of November 30 at 1600 Central Time. The second is to provide answers to interested parties' questions. Those questions asked by interested parties and the Government 's answers are listed on pages 15-34 . The third and final purpose of this amendment is to provide a new CLIN structure for the RFP. The new CLIN structure is found on pages 2- 4.

Scott Ivy Contracting Officer

B.1 PRICE/COST SCHEDULE

ITEM INFORMATION

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Contract Period: Base POP Begin: 01-01-2019 POP End: 12-31-2019

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Contract Period: Option 3 POP Begin: 01-01-2022 POP End: 12-31-2022

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Contract Period: Option 4 POP Begin: 01-01-2023 POP End: 12-31-2023

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GRAND TOTAL

Additions/ Deletions/ Edits to the RFP:

1. On page 28 under 10. Ventilatory Monthly Rental, “Heated Circuits” is hereby added after “Hose/Circuit.”

Questions and answers posed to the Government during the question period of RFP 36C25218R1040. The Government’s answers are in red.

1. Is this a Respiratory only RFP, or full line DME RFP? If the provision of government owned DME is expected, will the VA award separate contracts for the Respiratory and DME portions?

This contract will cover all the requirements listed in the RFP. This RFP includes both DME and Respiratory requirements. This RFP will result in one award. However, offerors will have to submit a small business plan as outlined in FAR 52.219-9 pgs.78-87.

2. Will the VA accept bids, or award contracts, for separate areas of VISN 12? For example, the Northern Tier versus the Southern Tier?

No.

3. Can the VA specify which locations provide home Liquid Oxygen (LOX) systems to veterans, either contractor or VA owned?

The amount of LOX used is always changing, however the preponderance of its use is in the S. Tier. For offerors information, less than 1% (20) of all oxygen patients are using LOX.

4. On page 19, 1.A., the RFP indicates that the contractor shall transfer all government owned equipment within seven calendar days of award from the outgoing contractor. Is the contract award date the same as the contract period of performance start date? How would the outgoing contractor fulfill orders in the gap period if the incoming contractor has received all government owned equipment?

The current milestone plan calls for the award date and the start date of the period of performance to be concurrent with each other or at least very close in time. The government understands there will be a transition period. Until all items are replaced in the home and inventory moved to incoming vendor locations, the outgoing vendor is responsible to process incoming orders and, per FAR 52.237-3—Continuity of Services, furnish phase -in and phase -out services or up to to 90 days.

5. On page 20, D. VA Concentrator Management, second bullet point it indicates the contractor shall provide maintenance and upkeep of VA owned concentrators, including battery replacement. Is this referring to battery replacement on a standard concentrator, or does the VA own Portable Oxygen Concentrators that the VA expects the contractor to provide replacement batteries as needed?

No, the VA concentrators do not have batteries.

6. May the Government please clarify the timeframe for the completion of the retrieval of the VA Owned concentrators from the Hines, IL facility?

This should occur within one week of award.

7. May the Government please clarify if after the transition period, all replenishment of VA Owned concentrators, ventilators, etc., will be dropped shipped directly to the contractor from the VA and/or manufacturer?

After the transition period every effort will be made to drop ship equipment directly to contractor.

8. May the Government please clarify if the definition of “Initial setups” for setups at the VA facility, is to consist of all the items ordered on the prescription, (i.e. concentrator, cylinders, portable concentrator, regulator etc.) that should be delivered to the veteran at the VA hospital?

This primarily concerns portability aspects when veterans are discharged from a VA facility. This occurs when the patient may need to have oxygen for transport to the home but in some cases in the domiciliary areas (similar to apartments on VA grounds). There are also some requests to perform the set-ups in nursing homes settings.

9. May the Government please clarify if initial oxygen setups may be completed by a technician, followed up by a RT visit within 7 calendar days of the setup?

Yes, a technician may perform initial oxygen set-ups. All patients provided POCs will be evaluated and prescribed after initial set-up and the updated order will reflect the change from tank system to POC or transfill device. RTs, as stated above, should be delivering those when ordered post-initial set-up to ensure pulse dose and liter flow requirements correlate.

10. May the Government please clarify the initial setup timeframe, as the timeframes provided in section A and B appear to be contradicting.

The timeframe for all orders is within 24 hours except when it is communicated on the orders or verbally that the set-up needs to be expedited.

11. May the Government please clarify if the HCPCS for the rental of the ventilator will be updated to meet the above HCPCS as updated in Noridian?

No, it will not.

12. May the Government please clarify if the mask(s) to be provided during the initial setup of the PAP unit(s) are to be provided from VA or Contractor inventory?

VA inventory stored at contractor warehouses.

13. May the Government please clarify if Contractor follow-up visits will be required (i.e. quarterly, semi-annually, annually, etc.), and if so, will resupplies be from VA or Contractor inventory?

PAP re-supply will be provided from VA or from VA supplies stored at the vendor (if requested to deliver). Follow-up visits are not required for PAP patients unless ordered but if they have oxygen bled into PAP, follow-up is performed per category of “standard” (annual) or “high” fire risk (semi-annual) for this population.

14. If PAP masks and supplies are to be provided by Contractor, may the Government please consider adding a CLIN for Contractor owned PAP supplies?

Masks will be provided by the Government.

15. May the Government please clarify if the back-up ventilator is to be provided from VA or Contractor inventory?

VA unless requested per order for contractor to provide.

16. May the Government please clarify if the supplies to be provided during the initial setup of the VA owned ventilator(s) and monthly follow-up visits are to be provided from VA or Contractor inventory?

The contractor will provide supplies and accessories for all VA-owned or contractor-rented ventilators.

17. If it’s the Government’s intent for the initial supplies and monthly resupplies for the VA ventilators to be borne of the contractor, may the Government please consider adding a CLIN for the monthly RT Visit of VA Owned Ventilator, to include supplies borne of the contractor?

Yes, this is reasonable and 11.2 will be separate CLIN.

18. May the Government consider adding a CLIN for the shipping cost of POCs due to last minute travel requests?

The cost of shipping will be determined per invoice. However, those charges would be paid outside this contract.

19. May the Government please clarify if travel is only approved within the continental United States?

Travel is approved to all fifty states.

20. May the Government please clarify if the Contractor would bill for the LOX Stationary utilizing CLIN 0005, or will a new CLIN be created for the accountability and payment of the LOX provided at the VA facility?

The contractor will bill utilizing CLIN 0005.

21. May the Government please advise its interpretation of “Valid and Documented attempts”?

Verifiable and documented efforts should be reflected on the Daily Activity Report, and include but is not limited to: phone calls, visits to home, letters, requests to the Home Respiratory Coordinator for assistance, and may also include requests for alternate contact information. This is also verifiable via follow-up contact with the beneficiary by the local Home Respiratory Coordinator.

22. May the Government please clarify if the Government owned items listed above may be delivered by a Patient Service Technician?

Yes, if not specified in the statement of work that an RT must deliver.

23. May the Government please clarify if all equipment and supplies associated with the Feeding pumps and IV pumps will be provided by the Government?

Yes.

24. May the Government please clarify the extent of training to be provided to the veteran by the Contractor for the delivery of the Feeding and IV pumps?

The contractor will not be required to provide any training in regards to the feeding and IV pumps.

25. May the Government please clarify if it was its intent to state “see response 9.1-4”, as there does not appear to be an area 9. a. – d? May the Government please clarify if a CLIN will be added for the expedited rate referenced?

This statement was in error and based on volume, it is the expectation of the vendor to perform for one rate for all DME deliveries.

26. Is it the Government’s intent for Contractor personnel to move patient owned items (i.e. bed, dressers, furniture, etc.) for the DME prescribed equipment to be setup?

The family/caregivers are responsible to make the preparations necessary for DME ordered and this fact should be reinforced by the scheduler when making appointment prior to delivery.

27. May the Government please advise if a CLIN will be added to document the repair fees referenced?

These costs would be handled outside this contract and an estimate will be communicated to the Prosthetics section. Once the estimate is received the Prosthetics section will decide whether to fix the DME or whether the particular piece of DME should be disposed of.

28. May the Government please advise if a CLIN will be added to document the Labor charge fee referenced?

The labor rate would be part of the quote by the contractor to repair DME and communicated to Prosthetics to make a decision on whether to repair or dispose. The Prosthetics section would determine cost - benefit of repairs and direct vendor to repair for quoted price or dispose.

29. May the Government please confirm the email size limitation for package submission?

Currently the VA can accept email up to 30mb. The old limit was 10mb, however in the winter of 2017, that size limit was increased to 30mb.

30. May the Government please clarify if a copy of the RTs license and credential should be included with the proposal or is the Government simply asking for the offeror to submit a list of the RTs to service the contract?

Yes, licenses and credentials for state(s) servicing per RT that will be working on this contract.

31. May the Government consider extending the due date for the solicitation, based on the questions and responses being submitted for clarification?

Due to the timeline for award, we ask that contractors expedite their responses.

32. Does the VA own any Homefill compressors?

No.

33. Will the VA be providing the last PM date for equipment that must be monitored?

All concentrators are new in the box and it will be the responsibility of the vendor to create a new PM schedule at inception.

34. Is equipment owned by VISN 12 as a whole or by each VA facility?

The equipment is owned by VISN 12 but ongoing purchasing of additional units for inventory will be on a site-by-site basis.

35. Will equipment need to be separated by VA facility?

No, VA-owned concentrators do not need to be separated by location.

36. Can equipment from one VA facility be used for a patient serviced by a different VA facility?

No, except for VA-owned concentrators and ventilators.

37. Will equipment from more than one VA facility be stored in a single contractor location?

That is up to the vendor providing care and services but optimally the vendor would have locations within a reasonable distance to provide ongoing care and services per contract per patient population.

38. For what amount of time post-setup must the contractor provide free switch-outs/troubleshooting for equipment failures?

This pertains to initial set-ups and not testing equipment to ensure proper function prior to delivery – if the contractor fails to ensure proper working condition and the equipment does not work when delivered, follow-up visits to perform this are the responsibility of the vendor.

39. What is the age of existing VA-owned equipment in the field and warehouses?

Most if not all equipment utilized is new and if inventory is old and unusable, contact the VA Prosthetics section to determine whether inventory can be used or should be discarded.

40. Does the VA follow a standard schedule for replacing old VA-owned equipment with new?

No, replacement is decided on a case-by-case basis.

41. What are the current equipment switch-outs due to equipment failures by VA facility?

This data is not tracked and communication to resolve equipment issues or inventory is an ongoing process.

42. What oxygen interface options must be offered?

All interface options to meet the prescriptive requirements.

43. Is there a default/standard RT follow up schedule for oxygen patients?

All new oxygen patients must be visited within 7 days of initial set-up to create plan of care.

44. Pre-filled Humidifiers – what is the current utilization by VA facility?

The Government estimates that anywhere from 40-60% of the oxygen patient population has pre-filled humidifiers provided, furthermore there is a cyclical trend to these numbers for winter versus spring-summer-fall.

45. Are there different billable rates for standard oxygen concentrators (1-5 lpm) and high-flow concentrators (6-10 lpm)?

No.

46. How many of each concentrator type are currently being rented by VA facility?

250 10L and 3500 5 L.

47. Are there patients receiving tank refill deliveries to fulfill their portability modality? If so, how many?

Yes, but this will change significantly due to POC inclusion in the contract over the first year as they return for evaluation. Currently, approximately 1400 portable tank users average 14 tanks per month of various sizes.

48. If patients receive tank refill deliveries, are these to billed as part of the monthly rental/maintenance fee or billed separately?

Monthly portable rental charge to include as many tanks as needed to meet ADLs.

49. What is the monthly tank usage by tank type (E,D,C,B,M6)?

Based on the amount of other options in this contract for portability, we can provide some current numbers, but this will change significantly in the future. The numbers below are a per month average obtained in the past few years.

B - 500 C- 3000 D- 3600 E- 5600

50. How many VA-owned conserving devices are in patient’s homes? What are the make and model numbers? We have at least 4 different conserving devices Every patient currently on conserving devices has a VA provided oxygen conserving device. Approximately 30%-40% of the portable tank population or 400.

Easy Pulse 5, Respond C5, Bonsai Velocity Pneumatic and Drive medical evolution. The conserving devices utilized in the contract to extend tank duration is up to the contractor but must be able to function appropriately and be provided to the evaluative department at each site to ensure titration is performed and pulse dose accurately assessed.

51. Is the contractor billing a single monthly rental rate or per liquid vessel in patient’s home? Is contractor billing for refills or per liquid pound delivered? If so, how? How many pounds by month by VA facility are currently being delivered?

Single monthly rate for LOX to include contents per patient. No, one monthly rate to include contents per patient. Approximately 20-25 patients on LOX (mostly in the southern tier) and approximately 400 lbs on average per patient/mo.

52. Will patients prescribed portable oxygen concentrators also be receiving stationary concentrators?

Depends on the periodicity ordered. Patient ordered for just exertional use may not require stationary concentrator. It’s per order received per patient assessment.

53. Can patients get more than 4 home-fill tanks?

4 tanks to be provided per patient per size that meets ADLs. If the patient requires more portable tanks-the VA will make the decision to continue with transfilling unit or go to another portable device to meet their needs.

54. Air Compressor - Are supplies included in the monthly rental or billed separately?

Included with monthly rental.

55. Does the VA have a list of supplies and quantities by VA facility?

Estimate should be standard set-up for high humidity trach. patients with changeout per infection control standards. We have approximately 60 air compressor patients in VISN 12. Supplies to include those specified on p27-28 to include corrugated tubing, trach. masks/masks, water traps, oxygen inlet, distilled water, VA suction unit, suction supplies, resuscitator bag (Ambu) for preoxygenating prior to suctioning etc.

56. Are suction machines included in the monthly rental or billed separately?

These are VA supplied suction machines and will be stored at the vendor to supply to patients.

57. Are suction machines to be given to ventilator patients by default or when specifically ordered?

When ordered. If the vendor notices this is not on the order but required, they must correspond with the sending site’s HRC to update order.

58. Are suction machines contractor-owned or VA-owned? How many are VA-owned? Make and model?

All are VA owned but not standardized per site in VISN 12. Some of the makes and models are: DeVilbiss Vacu-Aide Compact w/Reusable Canister, PORTABLE, EASY GO VAC, #PM65 from Precision Medical.

59. Are vent. supplies included in the monthly rental or billed separately?

For vendor ventilator rental and for RT visit for VA-owned ventilators, all supplies and accessories for invasive ventilation are supplied by the vendor. There are currenlt twelve invasive ventilator patients on VA-owned ventilators in VISN 12.

60. What supplies and quantities will be ordered and given to patients?

It varies somewhat by patient application and will be stipulated on the order what the vendor is to provide. Please respond per industry standard for invasive vent. supplies per change-out schedule for infection control purposes. The VA will provide all accessories and supplies for non-invasive ventilator patients.

61. Is the backup ventilator to be included in the monthly rental or billed separately?

Usually the VA provides the ventilator and back-up but on occasion we ask the vendor to provide a ventilator during a PM period or in an emergent after-hours situation. If the VA rents a ventilator from the contractor and the patient is ordered for a back-up, this should be provided and billed separately and charged.

62. Are humidification systems to be included in the monthly rental or billed separately?

Humidification systems will be included in monthly rental of vendor-supplied ventilators and for RT visits for VA-owned invasive ventilator patients.

63. What make and model of humidification systems are being ordered/used? Quantities?

Fisher Paykel MR 810 and it varies by patient.

64. Are tracheostomies and supplies included in the monthly rental or billed separately? What make and model of trachs. are currently being used and quantities? What make and model of trachs. can be used and quantities?

The patient’s tracheostomy is provided by the VA. All other supplies and accessories are included in the monthly rental.

65. CPAP – Is the contractor supplying patients with regular resupply? Is there a resupply schedule? Is the resupply equipment contractor-owned or VA-owned?

No. The VA is providing all resupply for PAP patients.

66. Is contractor expected to maintain CPAP mask inventory? Are masks contractor-owned or VA-owned? Which masks does the VA intend utilize for CPAP patients by facility? What is the estimated volume at the most recent month-end by facility?

No. VA-owned. ResMed (All of northern tier and North Chicago) or Respironics brands (Jesse Brown and Hines). The Danville VAMC has a combination of supplies but their PAP units are ResMed. There are significantly more in the northern tier than the southern tier. The Madison VA Hospital currently has nearly 100 per month and the rest of the entire VISN has around 75.

67. Is contractor expected to fit patients for a mask at setup or will masks be specifically prescribed?

Both and will be performed per order.

68. Are(sic) the following equipment contractor-owned or VA-owned:

a. Nebulizers, Cough Assists, OPEP, Special Ventilators, Suction Machines, Chest Percussive Vests, High Volume Air Compressors? What are the estimated delivery quantities of each by VA facility?

The high-volume air compressor rental is a separate CLIN and all other items will be VA owned or purchased devices. The majority of these visits are in the northern tier and are approximately 60-75 RT visits per month. These visits involve performing triage or equipment set-ups.

69. How many patients are currently designated as Standard or High-Risk Fire Safety by VA facility?

VISN 12’s current high-risk patient population is broken down by facility below. The first number is the high-risk number, the second number is the total oxygen population.

Jesse Brown 18-369 Milwaukee 22-657 Iron Mountain 33-382 Hines 24-830 Madison 5-728

FHCC 18-307

Tomah 10-475

70. What is the expected volume of each? Must every patient be designated as one of the two categorizations or can patients be designated as neither?

Volume will be determined by the prescription. All oxygen patients will be designated either standard or high-risk.

71. Do all visit types require a reminder call 24-48 hours prior to visit? Does this apply to scheduled tank refill deliveries?

Yes, a reminder is required for all visits, including tank refills.

72. Does the contractor bill for travel equipment?

This will be determined on a case-by-case basis.

73. Can the VA provide a breakdown of DME deliveries by equipment type and VA facility?

A breakdown of equipment type isn’t possible at this time, but a breakdown by facility is below:

Jesse Brown – 52/ mo Hines – 41/ mo FHCC – 26/ mo Milwaukee – 33/ mo Madison – 25/ mo Tomah – 20/ mo Iron Mountain – 37/ mo Danville – 42/ mo

74. Can the VA provide an updated account of the quantity of Respiratory Therapist Visits currently being provided broken down by VA facility? Can the VA clarify the timeframe of provided quantities?

Jesse Brown – 20/ mo Hines – 20/ mo FHCC – 10/ mo Milwaukee – 40/ mo Madison – 80/ mo Tomah – 40/ mo Iron Mountain – 40/ mo Danville – N/A

75. Can the VA clarify the timeframe of provided quantities?

The quantities are per month.

76. Section B.2 Price/Cost Schedule (page 8) of the RFP does not include HCPC code-level detail for each CLIN description to ensure pricing based on VA’s specific requirements. Will VA provide the HCPC and other relevant codes that comprise each CLIN so that vendors can be certain pricing has not excluded any codes for services VA requires or included codes for services VA does not require?

The codes are below per CLIN:

77. Statement of Work, Section 1.18. EQUIPMENT SPECIFICATIONS (page 35) appears to mis-number(sic) subsections beginning with 19.1 Concentrators. Will VA confirm Section/Subsection numbering and content between Section I.18 and Section I.20 to ensure no material information has been lost?

What you caught was a formatting mistake, therefore nothing has been lost.

78. Section E. SOLICITATION PROVISIONS (page 127). Will VA provide a separate Excel workbook for offerors to complete and submit for the PACKAGE NO. 1 – PRICING INFORMATION submission?

No, offerors may do that of their own accord.

79. Statement of Work, Section 1.27. QUALIFICATIONS OF CONTRACTOR (page 40). The RFP refers to a criminal background check requirement for each employee assigned to this contract. Would VA confirm what is meant by “assigned” and how that differs from the requirement for NACI (page 69) and those employees accessing VA computer systems?

Assigned refers to any employee that may come in contact with either veterans or their patient identifiable information (PII). They refer to the same investigation.

80. Will performance require logical (technical) or physical access to VA information and/or VA information systems?

Performance will require both logical and physical access.

81. NACI (page 69) includes reference to certain non-VA staff accessing VA systems through VPN/PIV card access. Would VA clarify what security clearance is required and under what conditions VA would require non-VA employees to access VA systems, necessitating VPN/PIV card access?

In addition to employees performing the field work for this contract, the Contractor’s employees receiving and sending prescriptions from the VA will require NACIs that will enable them to have VPN/PIV card access.

82. The RFP includes a background check requirement and the cost of $210 for low-level investigations. The RFP includes a position sensitivity rating of “Low Risk”. Would VA confirm which non-VA employees would be required to go through the background check? (NACI, §d.5) Any employee who comes in contact with the veteran or their PII in the performance of the contract.

83. There are no specific instructions for a technical volume. Will the government please confirm that offerors may submit a technical volume in any format as long as the Documentation specified in PACKAGE NO. 2 – ADHERENCE TO SPECIAL STANDARDS OF RESPONSIBILITY AND TECHNICAL SUBMISSION is provided?

Offeror must submit information that adheres to FAR 52.212-1 “Instructions to Offerors.” This information can be in any reasonable format.

84. What documentation specifically does the government want offerors to provide in Package No. 2 with regard to having 5 years of experience?

Please provide contract references that will support evidence of the offeror’s “5 years of experience in contracts that have the same or similar requirements, patient volume of 3,800 or more oxygen patients, and service area at least as large as the VISN 12 catchment area.”

85. What documentation specifically does the government want offerors to provide in Package No. 2 with regard to respiratory therapists’ licensing, credentials, and proof of 2 years home health care experience?

Please provide proof of licensure and credentials in addition information showing the term so far served with your firm or another company in which they provided RT services in the outpatient sector.

86. This solicitation provision requires a QC process to be provided with Package No. 2, yet the SOW Section 34 states that “A draft QCP shall be submitted to the CO no later than the post-award conference. The final QCP shall be submitted to the CO no later than 30 days from the date of the post-award conference.” Will the government please confirm that the Quality control process that must be submitted with the offeror’s proposal is a broad, overarching description of the processes used and not an in-depth QCP?

Yes, a broad over-arching description is fine initially. But the detailed QCP shall be submitted to the CO within 30 days from post-award conference.

87. With regard to serial numbers, for whose inventory and what type of equipment is government requesting? What is the purpose of reporting the serial number of the equipment with the invoice?

The paperwork submitted for billing does not need to include make, model, serial number and device number. However, it must be recorded accurately and communicated to the sending site’s prosthetics HRC or designee in a timely manner for tracking, inventory control, and compliance related activities.

88. Will the government explain the purpose of submitting lot numbers with the invoice?

The billing information does not have to provide the lot numbers but the documentation on the patient paperwork must contain this information to assist if a recall occurs.

89. llliana Health Care System – Danville is a new addition to the VISN. What are the expectations for converting these veterans from one VISN to another? What types of equipment will be expected to be exchanged and what are the timelines?

The same phase-in/ phase-out procedures that will be used in the start-up of the main VISN 12 contract. All exchanges and timelines will be specified on the individual orders. Currently a sizable portion of Danville’s portability needs are being met through transfilling devices. The timelines for transitioning these patients should not exceed 90 days and will be communicated in advance prior to Danville’s inclusion in this contract.

90. Will there be additional compensation for the extended territory? Will fees be assigned to zones? Is pricing negotiable when a veteran lives outside the VISN and needs services?

As that work is outside the scope of this contract, the VA could choose to use the awardee of this contract or another vendor to perform this work. Pricing would be negotiated prior to work performance. No, DME deliveries are one price throughout VISN 12. Yes, see answer above.

91. With regard to pricing, will the government please explain if there is a line item for compressed tank contents?

No line item for contents – One cost for portability to include conserving devices if ordered after assessment.

92. What about a line item for liquid contents?

No line item for contents, price is for LOX stationary or portable device rental per month with an average of #400/patient per month. It is up to the vendor to provide more LOX stationary systems or not for logistical purposes.

93. What about shipping costs when VA requests shipping of VA-owned equipment?

UPS/FEDEX shipping rates will apply.

94. What about a line item for vendor-owned conserving device rental?

There is already a CLIN for this.

95. What about a line item for vendor-owned liquid conserving device?

There is already a CLIN for this.

96. What about line items for shipping of vendor-owned equipment when VA requests vendor’s equipment be taken with veteran out of service area until setup with another provider.

If the veteran currently has a device to utilize while traveling, the device will be paid at the current monthly rental rate and negotiated shipping costs will be paid to retrieve the device.

97. Does this line item (0013 Monthly H/M Tank Rental) include fee for backup oxygen for VA owned concentrators?

No, this is primarily for high-flow cluster headache population and the cost for back-up should be captured in the service line item charge per patient per month.

98. Will the government please provide on what supplies the government will be providing? Will the VA be purchasing DME items from the vendor as well? Example: mattresses, bedside tables, trapeze, slings.

The VA supplies numerous supply items to outpatients to meet their resupply needs, and if the vendor is to supply these, requests to the vendor will be made and pricing negotiated to provide off-contract. The VA will not be purchasing DME items from the contractor.

99. What are the expectations of this new addition to the VISN with respect to the transition of these veterans from previous provider?

The transition should take place quickly after award and is to be completed no more than 90 days from notification.

100. Does “outside the catchment area” include the 75-mile territory mentioned on page 7?

Yes.

101. Does VA-owned equipment and supplies need to be used for “Non-territory” orders? What qualifications does the 3rd party need to meet to service the VA population? Does this refer to traveling patients or only those residing outside the VISN permanently?

This will be decided on a case-by-case basis. The “3rd party” needs to meet or exceed the same standards of care as the contract holder. This refers to patients residing outside the VISN only.

102. Will the government please delineate what exactly it considers to be “supplies”? Does the VA-owned concentrator fleet have additional inventory to allow for equipment exchanges to be conducted with VA-owned concentrators in the event of equipment failure?

Supplies are normally consumable goods that need to be periodically replaced. Yes, the VA has additional concentrator inventory.

103. Will the VA concentrators need to be separated by VA(sic), or are they VISN-wide equipment?

The concentrators are a VISN-wide asset, so they do not need to be separated.

104. Since the monthly report indicates which veteran is assigned to specific assets, can the serial number required on the monthly invoice be eliminated to reduce length of invoices?

No.

105. Can the PM sheets and binders for VA-owned concentrators be electronic rather than manual in a binder?

Yes.

106. Is there a timeline when the VA wants notice when a concentrator can’t locate a VA-owned concentrator? What is the vendor’s liability for VA lost assets?

Whenever the Contractor is unable to retrieve after performing their due diligence to obtain equipment. As soon as is reasonable. The vendor is tasked with oversight and management of the VA’s equipment and should treat this like their own asset. The Contractor shall maintain communication to the VA when encountering incidents which result in loss or potential loss.

107. When shipping warranted concentrators to the manufacturer will the manufacturer or VA shipping account numbers be used or will there be a PO with authorization to bill the VA for shipping expenses?

The cost of shipping will be covered by the manufacturer for warranted items via the RMA process.

108. Does the government expect the vendor to manage government-owned equipment offsite?

Yes.

109. In regards to page 21 of the RFP and the Contractor storing and managing VA equipment, to receive, inspect, and fax within 2 hours of receipt is not logistically feasible under some circumstances. For example, some items such as beds may not be removed from packaging before being delivered to patients.

Items associated with the conduct of this contract will be covered under commercial warranties unless otherwise noted. When suitable for items to be unpacked and accepted/received upon their receipt the Contract shall complete that task. However, when such items are received and it is suitable for them to be stored unopened until they are needed, then the Contractor shall leave such items unopened.

110. To better understand the government’s intention for this two-hour requirement, please provide more information:

a. How will the vendor be notified of an upcoming delivery? The VA will notify the Contractor of an upcoming delivery.

b. Will the government please define inspection procedures? The Contractor shall perform all inspection and acceptance duties for the Government when shipments are sent directly to the Contractor’s property. Inspection and acceptance will include taking an inventory of the delivery to ensure all items were received, and inspecting the items for visual damage. If the shipment cannot be accepted by the contractor for any reason, then the contractor shall contact the COR by the close of business on the day of non-acceptance.

c. Will the government please define any non-inspectable items that are excluded from this requirement? The contractor will inspect everything that it receives.

111. Is the VA anticipating VA-owned concentrators to be delivered to the VAMC for veterans that are currently admitted to a VA facility?

Periodically in the domiciliary as they are considered outpatients.

112. Page 22 c. requires a semi-monthly inventory for concentrators. Please clarify what requires bi-monthly inventory submissions.

The concentrator inventory spreadsheet submission timeframe per 20 D. in monthly. All other VA equipment and supply reports are twice per month until inventory control processes have been confirmed, communication sufficiently assessed, and overall management and notification of reordering inventory as needed is verified.

113. The Joint Commission standard is using hand sanitizer in homecare. Is the VA requiring a deviation from this accreditation standard with soap and water hand washing at each veteran’s home?

No.

114. Does the VA anticipate the use of vendor(sic) for inpatient to increase with the use of VA-owned concentrators?

No increase is anticipated.

115. Should the Contractor be educating the veteran(s) to call vendor for supplies when they are down to 2 cannulas? Some patients may not want a full six months of supplies in their home at one time.

The vendor is to provide supplies as needed and have processes in place to ensure the requirement is met for the veterans to change supplies out for infection control purposes with reserve at all times.

116. If pre-filled humidifier is(sic) not requested then should not-prefilled humidifiers be dispensed as needed?

Only pre-filled humidifiers will be provided and can be requested by the VA or patient.

117. From section 1.D. is the VA asking for in-home inspections/testing results to be included in Maintenance Logs for the VA owned equipment?

Any PM or visit to inspect equipment shall be included in the maintenance logs. Testing of equipment prior to delivery is important and this testing should be also included whenever performed on a VA-owned concentrator.

118. Who pays for magnets - the VA or the vendor?

Vendor.

119. What about backup tanks for VA owned concentrators? Monthly rental and replacement of contents when/if used?

This is provided as part of service per month per patient line item # 0001. For 0012, if used is replaced at no cost as it’s captured in a monthly rental per patient per month.

120. Does this include extra tanks and tank refills? In other words, if the prescription calls for 30 oxygen tanks per month, is the cost of those 30 tanks included within the Portable Oxygen System monthly rental fee?

There will not be a reference to number of tanks provided on the order, just portable description of equipment to provide and if portable tank system ordered, then provide as needed for patient ADLs and refills per patient request to vendor – Not the VA.

121. Are oxygen contents included in this?

Yes.

122. If there is more than one unit, will the government reimburse separately?

No, one LOX portability charge/mo.

123. How does completion of an AMA form to state that the patient was notified the POC does not meet prescription needs relieve liability from vendor or its contractor?

For questions on legal liability, offerors are encouraged to seek the legal advice of their own attorney.

124. Can the government please verify that it intends to have the RT perform delivery, set-up within 7 calendar days?

Yes, unless otherwise indicated on order.

125. Does the government intend to have the vendor perform a monthly RT visit for all air compressor patients both with and without suction?

Yes, to assess inventory of supplies for infection control purposes, re-education, and plan of care updates conveyed to the VA if any issues present themselves that require attention to prevent recurrent admissions.

126. Is this a VA ventilator or vendor ventilator? In the case that it is a vendor ventilator, will additional reimbursement be made for back-up ventilator?

Vendor. Yes, if ordered.

127. In reference to the supplies listed on page 28 of the RFP, is the VA wanting these items included in rental? Do VAMC’s provide suction supplies out of the pharmacy? Are there plans to reduce or eliminate this practice?

Yes and possibly. The order will indicate what the vendor is to provide.

128. What steps will VA take to identify issues with initial training?

The VA is creating a form that will include items to be covered by the Contractor and will require signature by the patient or the patient representative and the Contractor’s personnel. +

129. Will VA be open to using electronic forms?

Yes, the VA may be open to using electronic forms.

130. Can vendor utilize compressed backup tanks as an option for liquid patients?

Yes.

131. In regards to patient travel on page 34, how does the VA want to be notified and is there some type of confirmation /approval process?

The VA site is notified by phone or email if another contractor is used to provide equipment for travel and pricing shared for the travel period. The cost is shared and options discussed to meet the patient needs while on travel.

132. What is the expected volume of OCD’s (oxygen conserving device) for the vendor to provide? Will these all require vendor to complete an RT assessment? Will the government please verify this means vendor is billing the facility for the liquid oxygen contents in this case?

The initial estimate is 30% of our portable tank system population have these hut with the other modalities of care provided, this may not reflect actual numbers required (POCs, Transfill etc). All OCD requirements will be assessed internally or externally on the devices provided by the vendor if order placed to perform. We cannot determine to what extent this will be used as there are other options for portable conserving devices.

133. Will the government please verify this means vendor is billing the facility for the liquid oxygen contents in this case?

We will pay the rental fee per month for this device and payment will be by separate credit card transaction.

134. If vendor is requested to deliver tank will vendor bill for delivery fee?

This will be captured in the monthly portable tank charges per patient/month.

135. What about assessing veterans for home fill systems? Normally, need to test veterans with the home fill tank rather than compressed gas tanks due to purity difference.

This can be accomplished by having tanks provided in which are filled by transfill device to the sites or provide a transfill device and concentrator (VA) to the sites to utilize for testing purposes.

136. Would a company ID or nametag worn or displayed be sufficient?

Yes.

137. Is the VA equipment that is lost or damaged due to the result of patients or VAMC employees the responsibility of the VA? What is the historical amount of such lost or damaged equipment? How is the value determined? How is willful negligence standard determined? Has there been a claim in the last 10 years? If so, please disclose history of claim dollar value for the previous 10 years. Does this include GFE equipment, not just contractor equipment?

Yes. Date purchased, purchase price, depreciation, and condition. The contracting officer will determine. There have been claims in the past 10 years and the history of claims is not relevant to this RFP.

138.