36C25521Q0307 0001.docx

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

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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

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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

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

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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) 05-1 -2021 36C255 Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway Leavenworth KS 66048 36C255 Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway Leavenworth KS 66048 To all Offerors/Bidders

36C25521Q0307 05- -2021

X X X

N/A X One (1) Durable Medical Equipment Services for the VISN 15 Medical Centers.

Addenda #0001 This addenda provides questions received and answers per the attached document.

Please see the updated Performance Work Statement (PWS), Schedule of Costs and Areas of Coverage (VISN 15 Facilities & Counties Covered). The Schedule of costs will replace the previous schedule in the original solicitation.

THERE ARE NO OTHER CHANGES

Philip Bouffard Contracting Officer ADDENDA #1 May 13, 2021

RFQ 36C25521Q0307

Durable Medical Equipment Services for the VISN 15 Medical Centers

QUESTIONS AND ANSWERS

1. Question #1: I noticed several Missouri and Illinois counties have more than one VAMC assigned to them and in one case, there are three. Is this overlap intentional? They are:

· Atchison County, MO

· Columbia, MO VAMC (I suspect this is a mistake, since Atchison County, MO is well outside their apparent service area – see the maps below)

· Leavenworth, KS VAMC

· Barry County, MO

· Columbia, MO VAMC

· Kansas City, MO VAMC

· Christian County, MO

· Columbia, MO VAMC

· Kansas City, MO VAMC

· Dade County, MO

· Columbia, MO VAMC

· Kansas City VAMC

· Douglas County, MO

· Columbia, MO VAMC

· Poplar Bluff, MO VAMC

· Fayette County, IL

· Marion, IL VAMC

· St. Louis, MO VAMC

· Greene County, MO

· Columbia, MO VAMC

· Kansas City, MO VAMC

· Harrison County, MO

· Columbia, MO VAMC

· Leavenworth, KS VAMC

· Jasper County, MO

· Columbia, MO VAMC

· Kansas City, MO VAMC

· Lawrence County, MO

· Columbia, MO VAMC

· Kansas City, MO VAMC

· McDonald County, MO

· Columbia, MO VAMC

· Kansas City, MO VAMC

· Ozark County, MO

· Columbia, MO VAMC

· Kansas City, MO VAMC

· Poplar Bluff, MO VAMC

· Randolph County, IL

· Marion, IL VAMC

· St. Louis, MO VAMC

· Stone County, MO

· Columbia, MO VAMC

· Kansas City, MO VAMC

· Taney County, MO

· Columbia, MO VAMC

· Kansas City, MO VAMC

Answer #1: Updated ‘VISN 15 Facilities and Counties covered’ included. Individual Facilities may service Veterans outside their local jurisdiction. The area of service shall be all patients serviced by VISN 15.

2. Question #2: I notice that the Farmington VA Clinic, one of the clinics of the Poplar Bluff’s Healthcare System is in St. Francois County, MO; but that county is not listed as a county within Poplar Bluff’s service area but under the Louis, MO service area. Is that correct?

Answer #2: Updated ‘VISN 15 Facilities and Counties covered’ included. Individual Facilities may service Veterans outside their local jurisdiction. The area of service shall be all patients serviced by VISN 15.

3. Question #3: On the same note, I notice the Marshfield VA Clinic is within the Columbia, MO VA Healthcare System, but the county it is in Webster County, is under the Kansas City, MO VA service area. Is that correct?

Answer #3: Updated ‘VISN 15 Facilities and Counties covered’ included. Individual Facilities may service Veterans outside their local jurisdiction. The area of service shall be all patients serviced by VISN 15.

4. Question #4: Am I correct in assuming the county name in the Poplar Bluff service area is “Cape Girardeau” and not just “Cape?”

Answer #4: Updated ‘VISN 15 Facilities and Counties covered’ included. Individual Facilities may service Veterans outside their local jurisdiction. The area of service shall be all patients serviced by VISN 15.

5. Question #5: Logically speaking, it looks like Newton County, MO should be in the Columbia, MO VAMC service area, was this an accidental omission?

Answer #5: Updated ‘VISN 15 Facilities and Counties covered’ included. Individual Facilities may service Veterans outside their local jurisdiction. The area of service shall be all patients serviced by VISN 15.

6. Question #6: The contract line item (CLIN) locations, the title locations, and the narrative locations do not line up. I understand that there are nine (9) VA facilities covered by this solicitation. However, in addition to the eight (8) VAMCs, on page 8 of the narrative includes the Evansville, IN VA Healthcare Center (part of the Marion IL Healthcare System) while the solicitation’s title description in beta.sam.gov mentions two in St. Louis, and the CLIN sheet only has seven (7) – I can ascertain that you lumped both Eastern Kansas VA Healthcare System’s hospitals into one CLIN. In looking at the St. Louis VA Healthcare System’s website, I notice a John Cochran Division. Is the ninth facility the Evansville, IN VA Healthcare Clinic or the John Cochran Division in St. Louis?

Answer #6: Updated ‘Schedule of Costs’ provided

7. Question #7: Just a point of clarification for how the VA will pay for repairs. If I read the solicitation correctly, if the vendor discovers (or is told by the VA) that a piece of VA-owned DME equipment needs repair, the vendor sends the VA an estimate and then the VA cuts a separate purchase order to cover the cost of the repair. Is this correct?

Answer #7: Yes

a. As a follow-on question to this, how does the VA plan on handling emergency repairs (those repairs which must be done to ensure the safe operation of a broken piece of DME which cannot wait until the next business day)? An after-the-fact purchase order? As a point of reference, a couple of the other DME bids cap this emergency repair charge at $500.

Answer #7a: A purchase order will be issued within 24 business hours of service. Section (e)(5)(iii) states, “Contractor shall submit a proper invoice along with the circumstances of the emergency repair/service…on the first business day following the emergency repair/service. Regarding the emergency repair charge Section (e)(5)(ii) under Emergency/Non-Duty Hours states, “Contractor has authorization for such repair, not to exceed $500 per occurrence.”

8. Question #8: I notice while there is a discussion for emergency deliveries of DME equipment, there is no mechanism for the vendor to charge the VA for this. Would the Government consider adding these emergency deliveries as a separate CLIN?

Answer #8: Updated Schedule of Costs provided

9. Question #9: Unlike several DME contracts MESA currently services, I notice that there are no grab bar installations listed as a CLIN. Was this intentional (e.g., grab bar installations would be covered under a separate solicitation) or does the Government plan on adding this service as an additional CLIN? As an observation, MESA has found that adding grab bar installations will help to decrease charges to the Government in other CLINs (due to economies of scale).

Answer #9: Grab bar installation is not part of the VISN 15 DME solicitation

10. Question #10: I notice the CLINS 0001 to 0007 have an end date of September 20th, 2022. I suspect this is a minor typo and the Government means September 30th, 2022. Is this correct?

Answer #10: Updated ‘Schedule of Costs’ provided

11. Question #11: Bariatric beds require more labor than a standard bed when delivering. Would the Government consider adding this item to the CLIN sheet?

Answer #11: No

12. Question #12: Perhaps the most important observation/question. The way the CLIN sheet is broken down is per DME item. What happens when the VA issues the vendor to deliver more than one DME item at a time to the same Veteran? The way the CLINs are currently structured the vendor would charge the VA a delivery/pickup fee for each and every item. For example, Veteran Jane Doe needs a hospital bed, mattress, overbed table, and overbed trapeze bar delivered to her home after discharge. For discussion’s sake, the vendor’s price for these CLINs is a flat $100 rate. This means the vendor would then charge $400 for the delivery, which is overcharging the Government for this service (while I want our company to make a profit on this bid, I don’t want to gouge the Government, either). Vendors could not just assume that they would be delivering more than one item per delivery, which requires them to calculate to cover those per item costs rather than an aggregate. A suggestion would be for the CLINS to reflect a straight delivery/pick up fee, which is in line with other DME contracts we have with other VISNs.

Answer #12: Updated ‘Schedule of Costs’ provided

13. Question #13: I would ask that the Government add language to the effect that the vendor cannot make any alterations to the Veteran’s home which would require the services of a general contractor. The vendor should not be installing ramps, moving electrical outlets, etc. in performance of this contract. This would be in line with other VISN DME contracts.

Answer #13: Section (e)(4)(v) states, “The Contractor shall be responsible for notifying the COR or their designee by telephone while in the Patient’s home, if any alteration to the Patient's home is necessary to accommodate the equipment, including electrical work.” Home alterations are not a covered item in this contract.

14. Question #14: Several of the other DME contracts limit the amount of furniture moving in the Veteran’s home the vendor is allowed to do – some of them quite bluntly state “the vendor is not a moving company.” MESA fully understand that sometimes we need to slightly move some furniture around to accommodate the safe and proper installation of DME equipment, the vendor should not be moving furniture in and out of rooms to install the DME equipment. Would the Government consider adding that clause to the statement of work?

Answer #14: Language added to Section (3) Delivery stating, “The Contractor may be required to move furniture to accommodate the safe and proper installation of DME equipment. The Contractor should not be moving furniture in and out of rooms or disassembling Veteran owned furniture.”

15. Question #15: Is there a warehouse size requirement or is the Government leaving it up to the vendor to determine via the stock levels found in the bid?

Answer #15: Warehouse requirements are not set in the contract. The warehouse space must be sufficient for the workload and meet all regulatory and Joint Commission requirements.

16. Question #16: A question I am getting is if oxygen would also be part of this or eventually bundled into it.

Answer #16: No, oxygen is a separate contract in VISN 15.

17. Question #17: The genesis of this question is to determine what would be considered in service area calls and out of service area calls.

In correlating and mapping out the service areas provided in the VISN 15 Geographic Area of Coverage spreadsheet provided, I discovered several counties which are serviced by more than one healthcare system, and a couple of counties which have facilities associated with one healthcare system but are physically located in another. Beside the narrative, I’ll also include some Google Earth maps which probably do a better job describing what I’m talking about. For simplicity’s sake, I’ll address the counties alphabetically (Missouri counties are in black, Illinois counties are in blue).

· Atchison County, MO

· Columbia, MO Healthcare System – although I think this is probably a typo because Atchison County is not geographically connected with the rest of Columbia’s service area.

· Leavenworth, KS Healthcare System

· Barry County, MO

· Columbia, MO Healthcare System

· Kansas City, MO Healthcare System

· Barton County, MO

· Columbia, MO Healthcare System

· Kansas City, MO Healthcare System

· Christian County, MO

· Columbia, MO Healthcare System

· Kansas City, MO Healthcare System

· Dade County, MO

· Columbia, MO Healthcare System

· Kansas City, MO Healthcare System

· Douglas County, MO

· Columbia, MO Healthcare System

· Poplar Bluff, MO Healthcare System

· Fayette County, IL

· Marion, IL Healthcare System

· St. Louis, MO Healthcare System

· Greene County, MO

· Columbia, MO Healthcare System

· Kansas City, MO Healthcare System

· Harrison County, MO

· Columbia, MO Healthcare System

· Leavenworth, KS Healthcare System – like Atchison County above, I suspect this is a typo because it is not contiguous with the rest of Leavenworth’s service counties

· Jasper County, MO

· Columbia, MO Healthcare System

· Kansas City, MO Healthcare System

· Lawrence County, MO

· Columbia, MO Healthcare System

· Kansas City, MO Healthcare System

· McDonald County, MO

· Columbia, MO Healthcare System

· Kansas City, MO Healthcare System

· Ozark County, MO – has three VAMCs associated with it

· Columbia, MO Healthcare System

· Kansas City, MO Healthcare System

· Poplar Bluff, MO Healthcare System

· Randolph County, IL

· Marion, IL Healthcare System

· St. Louis, MO Healthcare System

· Stone County, MO

· Columbia, MO Healthcare System

· Kansas City, MO Healthcare System

· Taney County, MO

· Columbia, MO Healthcare System

· Kansas City, MO Healthcare System

Answer #17: Updated ‘VISN 15 Facilities and Counties covered’ included. Individual Facilities may service Veterans outside their local jurisdiction. The area of service shall be all patients serviced by VISN 15.

18. Question #18: The Marshfield VA Clinic is associated with the Columbia, MO Healthcare System, but is physically located in Webster County, MO, which is a part of the Kansas City, MO Healthcare System. Is this an oversight?

Answer #18: Updated ‘VISN 15 Facilities and Counties covered’ included. Individual Facilities may service Veterans outside their local jurisdiction. The area of service shall be all patients serviced by VISN 15. 19. Question #19: Also, in looking at the map below, shouldn’t Newton County, MO be included in the Columbia Healthcare System’s service area?

Answer #19: Updated ‘VISN 15 Facilities and Counties covered’ included. Individual Facilities may service Veterans outside their local jurisdiction. The area of service shall be all patients serviced by VISN 15.

20. Question #20: In much of the same vein as the question above, the Farmington VA Clinic (shown in the map below) is listed as a facility under the Poplar Bluff, MO Healthcare System, but it is physically located in St. Francois County, MO, which is shown under the St. Louis VA Healthcare System. Is this intentional?

Answer #20: Updated ‘VISN 15 Facilities and Counties covered’ included. Individual Facilities may service Veterans outside their local jurisdiction. The area of service shall be all patients serviced by VISN 15.

21. Question #21: Also, on page 25 (viii) “Contractor shall have an individual certified technician by the Rehab Engineer and Assistive Technology Society of North America (RESNA) professional certification. This certification is needed to ensure compliance for set-up, delivery, patient fitting, and education of highly technical custom manual and power mobility devices.” Currently the VA has not wanted to do any patient fitting, only delivery and VA personnel do all fitting. Is this a new requirement that the VA is looking for in this contract?

Answer #21: There is not a new requirement. Please strike, “Contractor shall have an individual certified technician by the Rehab Engineer and Assistive Technology Society of North America (RESNA) professional certification. This certification is needed to ensure compliance for set-up, delivery, patient fitting, and education of highly technical custom manual and power mobility devices”, from the solicitation.

B.2 PERFORMANCE WORK STATEMENT

DME DELIVERY, PICKUP, SERVICE, REPAIR, AND STORAGE

(a). GENERAL INFORMATION (1). Title of Project: DME Delivery, Pickup, Service, Repair, and Storage

(2). Scope of Work: The Contractor shall provide all supplies, materials, equipment, labor, supervision, transportation, infection control, storage, cleaning, delivery, sanitization, installation, assembly/set-up, repair, pick-up and patient training/instruction-in-the-use of Government-owned, or purchased, Durable Medical Equipment (DME) in accordance with all terms, conditions, provisions, specifications and schedules herein. Contractor is to furnish all storage, labor, transportation and equipment required to provide durable medical equipment to eligible beneficiaries within the geographical area of VISN 15. This includes the provision of emergency DME repair and maintenance services. Contractor must meet Joint Commission Standards for services provided under the contract, to include cleaning, storing, maintenance, education, set-up, patient home safety, and inventory as required to meet the standards. Joint Commission standards can be found at http://www.jointcomission.org/.

(3) Location: All deliveries and pick-ups shall be performed in the place where the veteran will reside, or an identified location as specified by the VA. The area of service shall be all patients serviced by VISN 15. Contractors shall have facilities physically located in the geographic area of the VA Medical Center, in which they shall provide service. The geographical boundaries described herein have been determined as the areas of responsibility/jurisdiction for each local VA Medical Center (see VISN 15 Facilities and Counties covered, attached).

a. Harry S. Truman –VA Medical Center – Columbia, MO. (CO) 800 Hospital Drive Columbia, MO. 65201

b. VA Medical Center - Kansas City, MO. (KC) 4801 Linwood Blvd.

Kansas City, MO. 64128

c. Dwight D. Eisenhower - VA Medical Center – Leavenworth, KS. (LEA) 4101 S. 4th St.

Leavenworth, KS. 66048

d. VA Medical Center – Marion, IL. (MA) 2401 West Main St.

Marion, IL. 62959

e. John J. Pershing - VA Medical Center – Poplar Bluff, MO. (PB) 1500 N. Westwood Blvd.

Poplar Bluff, MO. 63901

f. Jefferson Barracks - VA Medical Center – St. Louis, MO. (STL) #1 Jefferson Barracks Dr.

St. Louis, MO. 63125

g. Colmery O’Neil - VA Medical Center – Topeka, KS. (TO) 2200 Gage Blvd.

Topeka, KS. 66622

h. Robert J. Doyle - VA Medical Center – Wichita, KS. (WI) 5500 E. Kellogg Drive Wichita, KS. 67218

i. Evansville – Health Care Center – Evansville, IN. (EHCC)

(4). Background: In FY 20 VISN 15 completed 3,954 deliveries, 724 pickups, 127 emergency deliveries, total excess mileage of 53,392 and 809 hours of labor.

Columbia VAMC completed 215 deliveries, 95 pickups, 1 emergency deliveries, 8,343 excess miles, and 160 hours of labor;

Kansas City VAMC completed 826 deliveries, 167 pickups, 38 emergency deliveries, 3448 excess miles and 49 hours of labor;

Eastern Kansas (Topeka & Leavenworth) completed 193 deliveries, 115 pickups, 9 emergency deliveries, 2,140 excess miles and 36 hours of labor;

Wichita VAMC completed 330 deliveries, 26 pickups, 34 emergency deliveries, 7,909 excess miles and 301 hours of labor;

Marion VAMC completed 818 deliveries, 24 pickups, 39 emergency deliveries, 23,484 excess miles and 18 hours of labor;

Poplar Bluff VAMC completed 240 deliveries, 124 pickups, 1 emergency deliveries, 4,607 excess miles and 147 hours of labor;

St. Louis VAMC completed 1,329 deliveries, 173 pickups, 34 emergency deliveries, 3,461 excess miles and 98 hours of labor.

(5). Period of Performance: The Contractor shall commence performance of the contract on the effective date in the resulting award document (Standard Form 1449, Block 20, Schedule of Supplies/Services).

(i) A 60-day phase in/phase out period, effective on the contract commencement date, is required to facilitate a potential change in Contractor upon expiration of the current contract and to ensure continuity of service for Veteran care. This period shall be designated as a period for the transfer of Veterans from the incumbent to the successor contractor. A transition schedule shall be provided to both the incumbent and the successor contractor. During the phase in/phase out period, the successor contractor shall contact the COR with a list of Veterans the successor contractor has set-up each day. The successor contractor shall notify the incumbent contractor of these Veterans. The successor contractor shall provide the Veteran’s residence and current prescriptions. The successor contractor shall not receive any payment for the Veteran until it is confirmed that they have completed the set-up of DME requirements. The cost of relocating existing inventory from the incumbent VA contract storage place to the successor contract’s facility shall be borne by the successor contractor. This includes any deficiencies the incumbent contractor may or may not have accomplished. Therefore, itis advised that the contractor view the storage site. Both contractors shall work closely together to assure a smooth easy transition for the Veteran.

(6). Type of Contract: Firm-Fixed-Price, Indefinite Delivery/Indefinite Quantity (IDIQ).

(b). CONTRACT AWARD MEETING. The Contractor shall not commence performance on the tasks in this PWS until the CO has conducted a kickoff meeting or has advised the Contractor that a kickoff meeting is waived.

(c). EQUIPMENT TO BE STORED, DELIVERED, PICKEDUP: The Contractor is required to deliver, set-up and provide beneficiary/caregiver education on various pieces of Durable Medical Equipment.

(d). GENERAL REQUIREMENTS.

(1). Ownership of medical equipment: The DME will be purchased by the VA and will be dropped shipped to the Contractor’s facilities for storage and distribution. Title to all VA owned medical equipment shall remain with the VA. The Contractor must have the capability to receive motor freight.

(2). Instructions to beneficiaries and caregivers: Instructions to beneficiaries and their caregivers shall include proper use of the equipment and supplies, proper care and cleaning of the equipment and safety precautions. Initial set-up of equipment will be accomplished by a Contractor furnished certified DME Technician in the assembly and function of each item included in the contract.

(e). SERVICES TO BE PROVIDED.

(1). Hours of Operation: The Contractor shall maintain business hours of operation at the Contractor’s facility between 8:00am – 4:30pm, local time, Monday thru Friday, except Federal Holidays.

(i) Contractor shall provide a full-time accessible employee with phone available during business hours. Should a Veteran pick-up equipment/supplies from the Contractor’s facility, no delivery charges shall apply.

(ii) Contractor shall have a well-established communication system providing 24-hour a day emergency service. The Contractor shall provide emergency repair or delivery services within 4-hours of notification, or if there is a safety issue that requires resolution prior to the next business day.

(iii) Contractor shall maintain an answering service to take emergency calls after hours. The answering service shall inform the patient that the Contractor shall call the patient within 1-hour. The Contractor shall respond to the patient within 1-hour of the initial patient call, regardless of whether they are using an answering service.

(iv) Federal Holidays: The ten holidays observed by the Federal Government are: New Year’s Day, Martin Luther King’s Birthday, President’s Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veteran’s Day, Thanksgiving, Christmas and any other day specifically declared by the President of the United States as a Federal Holiday.

(2). Storage and inventory: The Contractor shall maintain a stock of VA owned equipment. The Contractor shall perform weekly on-hand stock-level inventories. Documented inventories shall be submitted weekly via the agreed upon communication method, showing the inventory of all VA-owned equipment in storage to the Prosthetic Service at the designated VA Medical Center by close of business (4:30 PM local time) on Tuesday afternoon each week showing the inventory on-hand at the close of business on the preceding Friday. An additional inventory of equipment shall be provided to the same Prosthetic Service upon receipt of stock replenishment for updating purposes. The inventory will include item description, manufacturer/brand, quantity and serial numbers. The VA will establish an initial stock level of each item and a re-order point where the Contractor is required to immediately notify the VAMC, Prosthetic Representative, Inventory Management Specialist, or designee for stock replenishing via fax, email or agreed upon method of documentation.

(i). Contractor shall maintain a system of control to protect and preserve all Government property. A log of all VA owned equipment will be maintained by the Contractor which will facilitate immediate location and identification for possible retrieval.

(ii). Contractor shall provide adequate storage for VA and beneficiary items at Contractor facility at no additional charge to the VA. All VA owned home medical equipment shall be stored at the Contractor’s facilities, by the Contractor, until delivered to the requested location. The Contractor must maintain physical facilities and must maintain a visible sign with posted hours of operation. The location must be accessible to the public and staffed during posted hours of business. Contractor shall provide a secure, contained area, with adequate space, for the storage of Government owned supplies and equipment covered under this contract. The storage shall be climate controlled throughout the year relevant to proper temperature and humidity for the equipment being stored, (to protect against deterioration of cartons and rusting of metal equipment caused by dust, moisture, and/or temperature extremes), clean, pest/rodent free in well secured area. The Contractor shall provide clean, separate and secure storage for all VA owned equipment and supplies apart from all other contractor-owned equipment. The VA may utilize system created barcode labels to label VA owned inventory at the Contractor location. Clean storage area must be furnished that is segregated from any dirty storage area; both areas must be clearly identified. Clean and dirty storage areas are in accordance to Joint Commission standards. The VA owned material storage space will be segregated from all non-VA owned material in the storage space. The Contractor facility must be of sufficient size to store and maintain the minimum quantities of VA-owned DME. The storage area must meet or exceed all applicable state, local and national fire protection (NFPA) codes.

(iii). The Contractor facilities shall have the ability to receive DME deliveries when shipped by vehicles (e.g. trucks, vans, tractor-trailers, etc.) that may or may not have lift gates or similar assistive devices. The Contractor is responsible for providing loading and unloading systems and methods.

(iv). Prior to award of this contract, the Contractor’s proposed facilities shall be inspected by representatives of the VA Medical Center. Failure to provide acceptable facilities that meets the standards specified will be cause for rejection of an offer. Designated VA Medical Center representative(s) shall be provided access to the Contractor facilities during normal working hours (8:00 a.m.-4:30 p.m., Monday through Friday) for the purpose of inspecting VA-owned DME.

(v). Upon commencement of the contract, an inventory of VA equipment currently stocked at the current contractor’s storage area will be conducted jointly by the Contracting Officer or his/her designee and the Contractor and will be signed by both parties. This inventory will include items and the conditions thereof. The new Contractor shall pick up all VA-owned equipment from the previous Contractor within seven workdays after contract award, at no cost to the Government.

(vi). The VA reserves the right to add durable medical equipment items routinely provided for home care patients.

(3). Delivery: The Contractor shall make delivery/pickup of all equipment, supplies, or services specified within 24 hours, or the next business day, of notification. The Contractor shall not make deliveries when a beneficiary or an authorized representative is not at the residence or nursing home. Scheduling of deliveries will be at a time that is mutually acceptable to the Contractor and beneficiary, but shall, as much as possible, meet with the beneficiary’s requirements. The equipment will be set up in an area of the beneficiary’s choice. The Contractor shall adequately prepare the site, unpack and assemble equipment in a fully operational condition.

(i). Delivery and pickup of equipment between the Contractor and VA will be at no charge.

(ii). Upon completion of delivery and set-up service the Contractor shall submit written proof of delivery to the Prosthetic Service, which will include the documentation.

(iii). Prior approval by the Prosthetic Representative or designee is required before any permanent installation of equipment to wall, ceiling, floors, etc., at the beneficiary’s premises is scheduled or accomplished. All installation supplies and labor will be billed outside of this contract via a separate authorization and invoice.

(iv). In special situations the Contractor shall provide emergency setup within 4 hours of notification or on a weekend or Holiday. These may be due to short notice discharges of beneficiaries requiring durable medical equipment and outpatient treatment in lieu of admitting the beneficiary.

(v). The Contractor will issue returned VA owned inventory first. Returned VA owned inventory are medical equipment which have been returned from VA beneficiaries, have been cleaned and are ready for reissue. Acceptance of returned VA owned medical equipment is determined by the local Facility.

(vi). Returned foam mattresses will not be reissued but will instead be disposed of by the Contractor. Only new foam mattresses will be provided to beneficiaries.

(viii) One VAMC may ship equipment to any contractor awarded under this solicitation to be delivered to a beneficiary which resides within the jurisdiction of another VAMC. Delivery of that equipment will be completed at the same rates as outlined for the jurisdiction where the beneficiary will reside, and any excess mileage will be computed from the nearest VAMC. The delivery orders will be from the ordering facility and billing will be made to that facility.

(ix). The Contractor shall notify the COR or designee via email and provide justification as to why they are unable to deliver the required services in accordance with the Government’s required delivery date. The VA reserves the right to exercise all remedies that it has at its disposal including, but not limited to, making arrangements with an alternate vendor. Failure to deliver for reasons caused by the beneficiary or authorized caregiver shall not be held against the Contractor, however failures shall be documented and are subject to review and determination by the Contracting Officer.

(x). The Contractor may be required to move furniture to accommodate the safe and proper installation of DME equipment. The Contractor should not be moving furniture in and out of rooms or disassembling Veteran owned furniture.

(4) Home Safety Inspection/Beneficiary Education:

(i) Contractor is responsible for ensuring the beneficiary has a safe home environment in accordance with Joint Commission standards. When equipment is delivered to a Veteran’s home, the Contractor shall review on-site environmental conditions This includes addressing basic home safety, safe and appropriate use of equipment, handling, cleaning, storage, universal precautions, noting observable fire, tripping, or safety hazards and providing appropriate patient education related to fire/safety hazards. Upon delivery/set up the contractor is responsible for ensuring the home and electrical system shall support all requirements of the equipment being provided.

(ii) The Contractor shall provide education, training and instructions to each Veteran at the time of set-up or repair. This information is to be presented verbally, in demonstration and in addition, the material covered shall be left with the beneficiary or caregiver. Beneficiary or caregiver education shall be performed on the proper utilization for the issued equipment to include the following:

(1) Proper equipment usage, care/handling, cleaning and maintenance. Including a demonstration of correct use and observing a return demonstration by the beneficiary/caregiver.

(2) Basic home safety, electric/fire safety, storage and who to call in case of an emergency.

(3) Infectious control and precautions.

(4) Emergency preparedness.

(5) All education material provided by the Contractor shall be reviewed and approved by the Veteran's Affairs contract evaluation team.

(iii) The Contractor shall notify the COR or their designee during the home visit if the Contractor's staff determines there are unsafe conditions which may include, but are not limited to, fire safety hazards, beneficiary abuse, or any instance that places the beneficiary, Contractor's staff or others, in immediate danger. The Contractor shall contact the COR or designee by phone during the home visit and furnish (via encrypted email or fax) written documentation of the safety hazard to the COR or their designee within five (5) business days of the incident.

(iv) Contractor shall provide the beneficiary a magnet which contains the vendor’s name and emergency 24-hour toll-free phone number for service/repairs.

(v) The Contractor shall be responsible for notifying the COR or their designee by telephone while in the Patient’s home, if any alteration to the Patient's home is necessary to accommodate the equipment, including electrical work.

(vi) The Contractor shall provide equipment user guides for the specific equipment issued. This shall include basic operation instructions such as connection, removal, emergency procedures, care and maintenance, and equipment specific precautions. Emergency instructions for manual operation of hospital beds shall be laminated on a card and affixed directly to the hospital bed.

(vii) The Contractor shall provide the Veteran and review the following documents during all set-ups and repairs: DME Delivery Checklist, Patient’s Rights and Responsibilities, and Patient Satisfaction Survey. The Contractor is responsible for maintaining a copy of all documentation in the Veterans file. All or any part of the delivery documentation may be requested by the VA upon request for all Veteran.

(5) Emergency/Non-Duty Hours: On occasion, there may be a need for emergency services during non-duty hours. Emergency services may be requested by an authorized ordering official for delivery and set-up of VA stock equipment. An example would be a hospital bed delivery for a patient being discharged during non-duty hours.

(i) The Contractor shall use reasonable, sound judgement in determining whether a true emergency exists which requires immediate attention to constitute an emergency visit or whether the problem can be resolved by telephone troubleshooting with the Veteran or caregiver.

(ii) Emergency repairs during non-duty hours shall be limited to equipment or repairs previously provided or issued by VA, and instances where there is clear indication of a safety issue for the Veteran that needs to be addressed before the next business day. In the event and emergency repair is required, Contractor has authorization for such repair, not to exceed $500 per occurrence. Repairs above the preauthorized amount must have authorization of the VAMC Prosthetics Department. Repairs shall not be authorized for convenience or situations where there was not safety issue necessitating an immediate repair.

(iii) The Contractor shall submit a proper invoice along with the circumstances of the emergency repair/service to the COR, or delegate, on the first business day following the emergency repair/service.

(6). Pickup: All pickups will be accomplished within 24 hours. Scheduling of pickups will be left to the Contractor, but shall, as much as possible, meet with beneficiary’s requirements.

(7). Equipment return: The Contractor shall have written policies governing equipment handling and cleaning in accordance with Joint Commission standards.

(i). All equipment suitable for reissue will be disinfected, cleaned, tagged, bagged and returned to inventory within 48 hours.

(ii). Repairs to VA owned equipment: The Contractor will inspect all returned equipment and perform repairs as needed. All repairs done to the VA owned equipment will be completed in accordance with manufacturer’s recommendations by an individual certified by the manufacturer to perform such repairs. Certification of training by technicians performing work on VA owned equipment will be required. The Contractor will ensure technicians receive appropriate training on any equipment they currently are not certified to repair, within 90 days of award of this contract.

(iii). Returned equipment that the Contractor has been authorized by the Prosthetics Department to pick up shall be inspected and tested for satisfactory operation. Returned equipment shall be disinfected, cleaned, bagged, tagged and in good condition for reissue to another beneficiary before being placed in inventory for reissue. Bagged equipment will be tagged showing date of cleaning and date placed in storage. VA representatives determine when equipment shall be returned/picked-up for reuse. For this purpose, it will be necessary for the Contractor to maintain a sufficient amount of repair and/or replacement parts on hand to assure prompt and expeditious repairs. For repairs the Contractor will contact the Prosthetic Service and a separate purchase order will then be issued, on a case by case basis. Before any repairs are made the Contractor agrees to submit an estimate of charges to the Prosthetic Service.

(iv). Items that are returned, which the Contractor determines to be non-serviceable, will be set aside and tagged for inspection and final determination by VA personnel. A list of all non-serviceable equipment will be prepared by the Contractor, to include serial numbers, and presented to the COR during the quarterly site visit. VA will approve disposition and maintain a copy for VA record. The Contractor will properly dispose of all non-serviceable equipment, in accordance with state and local laws, at no additional cost to the Government. Foam mattresses, which are returned, will be properly disposed of in accordance with state and local laws, by the Contractor, upon receipt, at no additional cost to the Government.

(8) Repairs: During duty hours, the Contractor agrees to submit an electronic estimate to the Prosthetics Department. Verbal estimates may be accepted if the Contractor is out in the field and is unable to provide an electronic estimate. The verbal estimate shall be followed with an electronic estimate within one business day.

(i) Contractor shall attempt to resolve problems in an initial service call. It is expected that needed supplies for routine repairs shall be taken along to the Veteran’s home so that routine repairs can be accomplished in one (1) visit.

(ii) If work cannot be completed in the initial service call, Contractor shall send the Prosthetics Department, via email, an estimate broken down to include a list of required parts, manufacturer, stock/part number, cost, delivery charge as well as length of time required for repair.

(iii) For all repairs except emergencies required during non-administrative hours, the Contractor shall receive an order from the Prosthetics Department on the next VA administrative workday prior to performing any work.

(iv) The VA reserves the right to compete all repairs over the micro-purchase threshold for services. The VA also reserves the right to purchase required parts and have them delivered to the Contractor. In the event the Contractor is authorized to provide parts for repair, the Contractor shall provide the part(s) at the Contractor’s cost +15% markup.

(9) Special notifications: All accidents, malfunctions, injuries, death, and equipment recalls related to the provision, delivery and use of durable medical equipment shall be immediately (within 24 hours of occurrence) reported to the Contracting Officers Representative (COR) or his/her designee and to the manufacturer of the equipment.

(10). Standard precautions shall be used at all times when handling all contaminated equipment/items. Gloves shall be worn when handling items soiled with blood and/or body fluids. Hands shall be washed before and after visiting each patient and when gloves are removed. Contaminated equipment will be separated from clean equipment.

(11). Source of Information: The Contractor will transact business only with the appropriate offices of VA Medical Center and in no case deal directly with or solicit beneficiaries of the VA. The Contractor shall not recommend to patients, caregivers, and/or family members served under this contract additional products, services, or opinions not offer to supply products or services at either participating VAMC or patient’s expense.

(12). Warranty: Contractor warrants all work performed for a period of 30 calendar days barring equipment abuse. The Contractor will also verify with the manufacturer for warranty coverage for repairs prior to billing VA. The Contractor shall not be compensated by VA or the Veteran for any work performed under warranty.

(13) Incomplete Work: In the event there are unforeseen conditions (i.e. Veteran passes away/moves, acts of God, etc.) after the Contractor has begun authorized work on behalf of the beneficiary, the Contractor shall immediately inform the Prosthetics Department prior to completion of the work. Prosthetics will determine if work shall be completed, discontinued, or changed at that time, and disposition of equipment and parts shall be determined by the Prosthetics Department. If the Contractor is instructed not to complete the work by the Prosthetics Department, the Contractor shall be reimbursed for the portion of the job that has been completed. The Contractor shall be required to certify to these circumstances for invoicing purposes in lieu of written proof of delivery.

(f). MILEAGE FACTORS: Service delivery and pricing for this contract is based upon mileage from each of the VA Medical Facilities (VAMC) identified in the Price and Delivery Schedules.

(i). The Contractor’s storage and repair facility shall be within the county of each individual VAMC or a border county.

(ii). Delivery and pickup mileage will always be calculated between the ordering VAMC and beneficiary’s address, NOT between the Contractor’s physical storage facilities and the beneficiary’s address.

(iii). If the beneficiary’s delivery address is anywhere inside of a fifty (50) mile radius of the ordering VAMC, the delivery or pickup will be at the firm-fixed-price per trip charge specified in the Price Schedule.

(iv). If the beneficiary’s delivery address is anywhere outside of a fifty (50) mile radius of the a VAMC , the delivery or pickup will be priced at the firm-fixed-price per trip charge specified in the Price Schedule plus the mileage price specified in the Price Schedule for that portion of the trip (one way) that is outside of the fifty (50) mile radius.

(v). Mileage between the nearest VAMC and the beneficiary’s address will be calculated utilizing the internet site https://maps.google.com The shortest distance between the two addresses will be utilized for computation.

(vi). Computed mileage will be rounded to the nearest whole mile.

(g). ELECTRICAL REQUIREMENTS:

(1). It is the responsibility of the Contractor to ascertain that the electric service in the residence is capable of handling the additional power load caused by installation and use of the equipment.

(2). It is the responsibility of the Contractor to assure the determination of the capability of the electrical service to handle the additional load is made by persons qualified to do so.

(3i). Equipment shall not be delivered to sites where there is improper wiring, outlets, or any other readily visible safety problems. In those cases, the Contractor should abort the delivery and notify the Prosthetic Representative or designee. The Prosthetic Representative or designee will notify the prescribing physician.

(4). If the Contractor installs the equipment under this contract and the electrical service in the residence is not able to handle the load, the repair of any and all resultant damage will be the sole responsibility of the Contractor.

(h). RIGHTS AND RESPONSIBILITIES: The Contractor shall furnish each beneficiary with a written statement of Patients’ Rights and Responsibilities. Contractor shall review the patient rights document with all delivery, set-up, and repair personnel to help ensure these rights are honored. The beneficiary or caregiver will sign the form provided by the Contractor reflecting that rights and responsibilities are understood. This service is included in this contract at no additional charge to the VA.

(i). DME CHECKLIST: The Contractor shall provide a DME Checklist document at the time of each delivery to each VA beneficiary. This document serves as a place to document the VA beneficiary signature of receipt of the items being delivered, receipt of manufacturer’s written instruction-in-use, and understanding of how to safely use and care for the equipment. The DME checklist shall include information to the VA beneficiary regarding procedures to follow in order to contact the VA in the event of emergency services are needed in relationship to delivered equipment. Once copy of the DME checklist shall be left with the VA beneficiary. The Contractor shall provide a signed copy of the DME checklist to the VA Prosthetics Department within 3-business days of completion of work.

(j). POLICIES AND PROCEDURES: The Contractor shall have written policies and procedures to include:

a. Incident Reporting System: A process for notification of equipment hazards, defects and recalls and an effective written recall plan. This plan shall be available at each Facility and available for CO/COR inspection on demand. All product recalls including required or recommended removal, adjustments or modifications associated with equipment delivered or repaired under this contract shall be reported to the COR, in writing within 24-hours after occurrence. Any items subject to a recall shall be discontinued from use until otherwise authorized by the COR. The Contractor shall provide the following information to the COR within 24-hours after occurrence:

1) A complete item description and identification

2) Administrative identification data including contract number, order numbers and order date

3) Reason for recall, removal, adjustment, or modification

4) Instructions and Contractor recommendations for appropriate corrective action.

b. Contractor shall have in place written procedures for delivery, recovering, receiving, segregating, and cleaning DME which is appropriate to the equipment according to the manufacturer’s instructions, and disinfection of items which are stored/reused. Written procedures shall be in place for disposal of equipment or supplies designed for single Veteran use only, i.e. foam mattress.