36C25619D0013-001.pdf

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A)

For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID: ___ =-36=C=2=Sc.::6-=-1=9'-'-A:....:.:_P---=0c.::0-=-9=-6---------------

1. Contracting Activity: Department of Veterans Affairs, VISN 16, Houston, New Orleans, Biloxi, Fayetteville, Jackson, and Little Rock Medical Centers

2. Nature and/or Description of the Action Being Processed: The VISN 16 Prosthetics and Sensory

Aids Service has requested a new interim contract for the continuity and consistency of the home oxygen service for Veterans to be approved for other than full and open competition . Contract 36C265-18-D-0129 for VISN 16 was awarded effective September 27, 2018 to start performance on

October 1, 2018, and on October 3, 2018 notice of a timely protest was received. Due to this protest, a new interim contract is required to continue services for three months from the current contractor Rotech Healthcare, Inc., 3600 Vineland Road, Ste 114, Orlando, FL 32811.

The proposed new interim contract is for three months with a period of performance from

November 1, 2018 through January 31, 2019, and will be a firm-fixed-price contract.

3. Description of Supplies/Services Required to Meet the Agency's Needs: The VISN 16 Prosthetics and Sensory Aids Service interim contract will encompass the rental of home oxygen equipment, to include but not limited to, compressor, portable oxygen machines, tanks, racks, and liquid oxygen systems. This contact will include the delivery, set-up, and resupply of oxygen as necessary to meet the medical needs and prescriptions for our veterans. The services include delivery, repair, and pick up of equipment, resupply of expendable supplies (nasal cannulas, hoses, etc.) and medical grade oxygen, and quarterly checks from a Certified Respiratory Therapist or a Registered Respiratory Therapist. An interim contract to continue home oxygen service for the Veterans serviced by Medical Centers in Houston, New Orleans, Biloxi, Fayetteville, Jackson, and Little Rock is therefore necessary with the current contractor, Rotech Healthcare, Inc. This contract will cover approximately 7,602 veterans per month for three months from November 1, 2018 through January 31, 2019, with the option for up to six more months of coverage if needed. The new contract type will be firm-fixed-price . The estimated cost for the interim contract to include the six months option period is $9,481,143.17 based on the estimated quantities needed and the current pricing. The Contracting Officer will enter into discussions if necessary to achieve a fair and reasonable price.

4. Statutory Authority Permitting Other than Full and Open Competition: 41 USC §3304(a){l), as implemented by FAR 6.302-2.

(X) (1) Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements per FAR 6.302-1;

( ) (2) Unusual and Compelling Urgency per FAR 6.302-2;

( ) (3) Industrial Mobilization, Engineering, Developmental or Research Capability or Expert Services per FAR 6.302-3;

( ) (4) International Agreement per FAR 6.302-4 ( ) (5) Authorized or Required by Statute FAR 6.302-5;

( ) (6) National Security per FAR 6.302-6;

( ) (7) Public Interest per FAR 6.302-7;

( } (6) National Security per FAR 6.302-6;

( ) (7) Public Interest per FAR 6.302-7;

FAR 13.5 Simplified Procedures for Certain Commercial Items: This procurement is for home oxygen for Veterans, and procedures in FAR 13.5 were used in accordance with 41 USC §1901 to promote efficiency and to avoid unnecessary burdens for the government and contractor.

5. Demonstration that the Contractor's Unique Qualifications or Nature of the Acquisition Requires the Use of the Authority Cited Above (applicability of authority): The Medical Centers in Houston, New Orleans, Biloxi, Fayetteville, Jackson, and Little Rock have been serviced by Rotech, Inc. under a contract that was awarded as a large business. The awarded contract 36C25618D0129 was protested and therefore an interim contract is required. An interim contract is needed to continue the vital service of home oxygen for Veterans, and is therefore necessary. Failing to provide home oxygen service would have an adverse impact to Veteran care .

The incumbent is the only company that can reasonably act in sufficient time and with reasonable cost to continue this service for the estimated four months that are needed for this contract. The typical transition period for the approximately 7,602 patients per month covered under this contract is 90 days. The needed coverage here is 120 days, which will allow for full transition to occur.

Any company, other than the incumbent, would be exposed to a large initial cost for equipment and would only have four months over which to recoup the investment and a reasonable profit. This would cause all companies, other than the incumbent, to have to charge a significantly higher price than the incumbent. This would not be in the best interest of the Government or the American tax payers. The incumbent already has equipment and personnel in place to provide this service for the additional time. Therefore, no additional resources are necessary for the incumbent to continue performance. This puts the incumbent in a unique position to be able to provide this service in a manner that no other competitor could.

6. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable: Under these circumstances, an offer will only be sought from the incumbent.

7. Determination by the CO that the Anticipated Cost to the Government will be Fair and Reasonable:

The Contracting Officer has determined the pricing of the interim contract to be fair and reasonable based on the current prices and rates that are currently in effect under the existing contract and historical home oxygen pricing. Should discussions be necessary, the Contracting Officer will conduct those with the information gained from a review of the new award, and current prices and rates as below.

CLINS Biloxi Fayetteville Houston Jackson Little New Current Current Current Current Rock Orleans

Price/rate Price/rate Price/rate Price/rate Current Current Price/rate Price/rate

1. lntitial Set- Up $100.32 $100.32 $100.32 $100.32 $100.32 $100.32

2. 10 LPM $100.32 $100.32 $100.32 $100.32 $100.32 $100.32

concentrator w/backup system fee

3. Cylinder - Size $19.00 $19.00 $19.00 $19.00 $19.00 $19.00 Mor H refill

4. Cylinder - Size $8.00 $8.00 $8.00 $8.00 $8.00 $8.00 E Refill

5. Cylinder - Size $8.00 $8.00 $8.00 $11.00 $8.00 $8.00 D Refill

6. Cylinder - Size $8.00 $8.00 $8.00 $11.00 $8.00 $8.00 B or M6 Refill

7. Demand Nasal $25.00 $25.00 $25.00 $25.00 $25.00 $25.00 Cannula

8. Demand Pulse $22.00 $22.00 $22.00 $22.00 $22.00 $22 .00 Conserver Fee

9. Liquid Oxygen $55.00 $75.00 $75.00 $90.00 $75.00 $55.00 System Fee

10. Portable $32.50 $55.00 $55.00 $32.52 $55.00 $32.50 Liquid Oxygen System Fee

11. Liquid Oxygen $0.90 $0.90 $0.90 $0.90 $0.90 $0.90 per pound

12. Delivery for $65.00 $65.00 $65.00 $65.00 $65.00 $65.00 Resupply and Relocation

13. Portable $95.00 $95 .00 $95.00 $95.00 $95.00 $95.00 Concentrator

14. Oxygen $173.09 $173 .09 $173.09 $173.09 $173.09 $173.09 Cylinder Refill Stations

15. Liquid Oxygen $135.00 $135.00 $135.00 $135.00 $135.00 $135.00 Portable Helio System

16. Ventilator $937.65 $937 .65 $937.65 $937.65 $937.65 $937.65 Equipment and Setup

17. No Shows $65.00 $65.00 $65.00 $65.00 $65.00 $65.00

18. Firesafe $7.39 $7.39 $7.39 $7.39 $7.39 $7.39

Cannula's

19. Portable $8.00 $8.00 $8.00 $8.00 $8.00 $8.00 gaseous system w/no stationary unit

8. Description of the Market Research Conducted and the Results, or a Statement of the Reasons Market Research Was Not Conducted: For this action, no market research was conducted. Under these circumstances stated above, an offer will only be sought from the incumbent. However, the newly awarded contract, which has been protested, for Home Oxygen services across VISN 16 was competed as an SDVOSB set-aside after appropriate market research.

9. Any Other Facts Supporting the Use of Other than Full and Open Competition: In addition to the budgetary arguments above, and the inability of any contractor to successfully com!J'=te a transition of service in time, there is one other consideration. It would be inconvenient and possible dangerous to conduct two transfers of this service in just a few months. To transfer this service, a new contractor must place equipment in the Veteran's home and the old equipment must be picked up by the outgoing contractor. There is no guarantee that the equipment used will be the same as the prior contractor, and therefore the Veteran or his or her caregiver must learn the new equipment and its use. If more than one transition should occur in short span, it could increase the possibility of accidental misuse of the equipment resulting in injury or death. While the risk of occurrence is low, the consequences if it occurs could be catastrophic. Therefore, the overall risk in transitioning services more than once in a few months must be rated no less than moderate and possibly high. Therefore, for this reason as well, it is in the best interest of the Veterans, and therefore the Government, to continue with the incumbent.

10. Listing of Sources that Expressed, in Writing, an Interest in the Acquisition: None.

11. A Statement of the Actions, if any, the Agency May Take to Remove or Overcome any Barriers to Competition before Making subsequent acquisitions for the supplies or services required : The protested contract 36C256-18-D-0129 was competed as an SDVOSB and awarded on September 27, 2018.

12. Requirements Certification: I certify that the requirement outlined in this justification is a Bona Fide Need of the Department of Veterans Affairs and that the supporting data under my cognizance, which are included in the justification, are accurate and complete to the best of my knowledge and belief.

Katy~avis Network Prosthetic Program Manager

VISN 16

October 16, 2018

Date

13. Approvals in accordance with the VHAPM Part 806.3 OFOC SOP:

a. Contracting Officer or Designee's Certification (required): I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief.

Ricky C. Weaver 351851

Ricky C. Weaver Contracting Officer

NCO 16

Digitally signed by Ricky C.

Weaver 351851 Date: 2018.10.17 11 :51 :22 -05'00'

Date

b. One Level Above the Contracting Officer (Required over SAT but not exceeding $700K): I certify the justification meets requirements for other than full and open competition.

ANDREW J Digitally signed by

ANDREW J RAISER 292563

RAISER 292563 ~~~~~~013

Andrew J. Raiber Division Chief NCO 16, Division II

Date

c. NCO 16 Director of Contracting Review and Approval: I certify the justification meets requirements for other than full and open competition.

AARON VILLALPANDO Digitally signed by AARON

VILLALPANDO 178014

178014 Date: 2018.10.18 14:02:09 -05 '00'

Aaron Villalpando Director of Contracting Network Contracting Office 16

Date

d. VHA SAO HCA Review and Approval : I have reviewed the foregoing justification and find it to be complete and accurate to the best of my knowledge and belief and approve for other than full and open competition .

Terry L. Spitzmiller Date VHA Head of Contracting Activity (HCA)

VHACINSpitzT Typewritten Text 10/23/2018

MARKET RESEARCH

VISN 16 Interim Home Oxygen Contract

MEMORANDUM FOR: Record

FROM: Ricky C. Weaver, Contracting Officer

SUBJECT: Market Research Not Conducted for Interim Contract

1. Due to the sole source nature of this requirement as demonstrated in the justification and authorization form filed under P03 in the acquisition plan briefcase, no market research was done in relation to this interim contract action. This contract will be awarded to the incumbent as the only responsible source due to the short-term nature of the need and the inability of any other contractor to perform successfully at a fair and reasonable price.

2. The market research for the solicitation VA256-17-R-0994, which resulted in contract 36C256-18- D-0129 being awarded, has been uploaded to show the current condition of the market. However, as noted above, no offeror other than the incumbent is capable of meeting the need for this interim period.

3. The point of contact for this memorandum is the Contracting Officer listed below at (601} 206-6945 or at Ricky.Weaver2@va.gov.

R. k ( W Digitally signed by Ricky IC y . eaver c. Weaver 351851

35 1851 Date: 2018.10.1711 :52:19 -05'00'

Ricky C. Weaver Contracting Officer

36C256-19-AP-0096 VISN 16 Interim Home 02 Contract BACKGROUND INFORMATION: On September 27, 2018, a contract was awarded for the replacement Home 02 services for all eight stations in VISN 16. On October 3, 2018, the Contracting Officer was notified that a timely protest had been filed with the Agency and the GAO. An immediate stay of performance was issued; however, services must continue without interruption for Veterans. Therefore, VISN 16 needs an interim contract for continued Home Oxygen services.

1. DATE PREPARED: October 10, 2018 2. PREPARED BY: Ricky C. Weaver

3. DESCRIPTION OF REQUIREMENT: The Department of Veterans Affairs (VA) has a requirement for home oxygen services for VA beneficiaries throughout Veterans Integrated Service Network (VISN) 16 comprised of the states of Arkansas, Louisiana, Mississippi and parts of Alabama, Florida, Missouri, Oklahoma and Texas. This need has been filled previously through Indefinite Delivery, Indefinite Quantity (IDIQ) type Fixed Price contracts. Due to the situation described above, the incumbent for the large business portion is the only company able to reasonably provide the services necessary during this four-month interim period.

4. PRODUCT OR SERVICE? Service 5.NAICS/FSC/PSC: 621610/Q999

6. REQUESTOR: Katy A. Davis, VPR 7. PHONE NO: 601-206-7030

8. PLANNED/ACTUAL DATE SUBMITTED: 9. PLANNED AWARD DATE: 10/18/2018

10/10/2018

10. ESTIMATED TOTAL COST: $9,481,143.17 11. ESTIMATED BASE PERIOD COST: $3,683,766.35

12. RISKS: The Cost risk for this action is moderate based on the short-term nature of the need and the sole source nature of the action. The Contracting Officer will combat this risk through the comparison of proposed costs with those in the existing contract and those given as part of the offers provided in response to the ongoing solicitation for replacement services. Performance risk is minimized where an incumbent contractor, which has equipment and personnel already in place and performing, is selected to continue performance in the interim.

Schedule risk is also minimized through the sole source award to the incumbent.

13. OTHER CONSIDERATIONS: As demonstrated in the Other Than Full and Open Contractingjustification in the acquisition plan briefcase, the incumbent is the only company that can reasonably provide the service in this interim period at a fair and reasonable cost.

14. COMPETITIVE? 15. REASON FOR OTHER THAN FULL AND OPEN

YES• NO ~ COMPETITION: Only one responsible source (See J & A)

16. POTENTIAL SOURCES: As demonstrated in the Other Than Full and Open Contracting justification in the acquisition plan briefcase, the incumbent is the only company that can reasonably provide the service in this interim period at a fair and reasonable cost.

17. DESCRIPTION OF MARKET RESEARCH EFFORTS CONDUCTED OR TO BE CONDUCTED (USE

RESULTS FROM: Due to reasons stated in the J&A, the incumbent is the only reasonable source for this need and no further market research was done in conjunction with this interim contract.

18. *SMALL BUSINESS PROGRAMS D Service-Disabled D Veteran-Owned D 8(a) Set-Aside

*VA must be cognizant of socioeconomic Veteran-Owned Business Business Set-aside Set-aside set-aside considerations, including the

For Official Use Only/Source Selection Sensitive Acquisition Planning SOP Pagel of 5 Revision: 06, Effective Date: 07/16/18

Veterans First Contracting Program/ 38 OHUBZone Set-Aside D Small Business D Women- Owned U.S.C. 8127's "Rule of Two." Set-Aside Small Business Set Aside

*See "Procurement Reguest and Bundling Reguirements" if applicable

19. PLANNED CONTRACT TYPE: This will be a Firm-Fixed Price, Indefinite-Delivery, Indefinite-Quantity Contract

20a. COMMERCIAL ITEM OR SERVICE? 20b. If NO, could the requirement be changed to

YES [8J NO• provide for commercial item or service?

YES • NO•

21. IF SERVICES, ARE INHERENTLY GOVERNMENTAL FUNCTIONS INVOLVED?

YES • N0[8J NIA •

22a. SUITABLE FOR PERFORMANCE- 22b. If performance-based unacceptable, provide explanation:

BASED?

YES [8J NO• NIA •

23a. OPTIONS: 23b. If YES, number and type:

YES [8J NO• 6 Months - Option to Extend Services. Authority, FAR 52.217-8

24a. GOVERNMENT PROPERTY TO BE 24b. If YES, describe (attach additional sheets, if necessary):

FURNISHED?

YES • NO [8J

25a. GOVERNMENT INFORMATION TO 25b. If YES, describe: For each patient, a prescription and medical BE PROVIDED? consult will be provided to the contractor. This information will

YES [8J NO • include PII and PHI which are protected under HIP AA and through the inclusion of the VA Information Security language in the contract. Contract employees are also subject to background investigations due to the PII and PHI included in these referrals.

26. ENVIRONMENTAL AND ENERGY CONSERVATION OBJECTIVES: This does not apply to the contract.

27. SECURITY CONSIDERATIONS: Contractor staff are already in compliance with the current contract. Those requirements will remain the same for this interim contract requiring all new personnel to receive a SAC investigation with favorable adjudication prior to performance on the contract.

28. EVALUATION FACTORS: This is a sole source contract to the incumbent, therefore there are no evaluation factors other than price.

29. MILESTONES: PLANNED DATE

a. Completion of acquisition package: 10/11/2018

- Purchase Request (VA Form 2237)

- Statement ofNeedl Statement of Work/Statement of Objectives

- Specifications

- Data requirements

- Evaluation factors

- Quality Assurance Plan b . Acquisition plan approvals 10/11/2018

c. Solicitation reviews completed 10/11/2018

For Official Use Only/Source Selection Sensitive Acquisition Planning SOP Page 2 of 5 Revision: 06, Effective Date: 07 /16/18

d. Issuance of combined synopsis/solicitation 10/11/2018

e. Quotes Due 10/12/2018

f. Evaluation of Quotes 10/17/2018

g. Contract preparation, reviews, and clearances obtained: 10/18/2018

h. Contract Award 10/18/2018

l. Acquisition plan approvals 10/11/2018

SIGNATURES OF APPROVAL IAW - VHAPM Part 807.1 Acquisition Planning SOP

Program Manager Name: Katy A. Davis Date:

Signature: A'abt.. A. Dt2AH4, October 16, 2018

Contracting Office~ame: Ricky C. Weaver Date:

Ricky C. Weaver Digitally signed by Ricky C.

Signature: Weaver 351851 351851 Date: 2018.10.17 11 :52:46 -05'00'

Reviewer Name (Division Chief or Designee): Andrew J. Raiber Date:

Title: Division Chief ANDREW J RAISER Digitally signed by ANDREW J RAISER

292563

Signature: 292563 Date: 2018.10.17 11 :57:08 -05'00'

For Official Use Only/Source Selection Sensitive Acquisition Planning SOP Page 3 of 5 Revision: 06, Effective Date: 07/16/18

VISN 16 Main Award (All stations other than Alexandria and Shreveport)

Price Three Months - November 1, 2018 to January 31, 2019

Biloxi $ 524,875.30

Fayetteville $ 829,997.77

Jackson $ 434,885.61

Little Rock $ 569,418.15

New Orleans $ 262,022.78

Houston $ 1,062,566.75

Total - Three and one half Months $ 3,683,766.35

6 Months - Option to Extend Service $ 5,797,376.82

TOTAL $ 9,481,143.17

Gulf Coast Veterans Health Care System - Biloxi, MS

CLIN Description Biloxi, MS 5 LPM Concentrator with Backup System Fee: This shall include the initial visit and set-up of the oxygen concentrator by a

Certified Respiratory Therapist (CRT) or a Registered Respiratory

1001 I Therapist (RRT), back-up system complete with regulator stand, tubing, cannulas, Filter(s), and humidifier as needed, four portable cylinders with wheeled cart, regulator and monthly supplies including cannulas, tubing, filter(s) and humidifiers.

1001a I Price: November 1, 2018 to January 31, 2019

Biloxi, MS 10 LPM concentrators with Backup System Fee: This shall include the initial visit and set-up of the oxygen concentrator by a

Certified Respiratory Therapist (CRT) or a Registered Respiratory 1002 1Therapist (RRT), back-up system complete with regulator stand, tubing, cannulas, Filter(s), and humidifier as needed, four portable cylinders with wheeled cart, regulator and monthly supplies including can nu las, tubing, filter(s) and humidifiers.

1002a I Price: November 1, 2018 to January 31, 2019

1003 I Biloxi, MS: Cylinder· Size Mor H Refill

1003a I Price: November 1, 2018 to January 31, 2019

1004 I Biloxi, MS: Cylinder· Size E Refill

1004a I Price: November 1, 2018 to January 31, 2019

1005 I Biloxi, MS: Cylinder - Size D Refill

1005a I Price: November 1, 2018 to January 31, 2019

1006 I Biloxi, MS: Cylinder - Size B or M6 Refill

Est Qty per Unit of

Month Issue

10011-Ll

Average

Monthly

Extended

Price {UP * Unit Price 30)

3.5 Month

Cost

1 s 223,312.32 1

- I s i3,105.6o 1 1 s 115,869.60

- Is ... 510.001 Is 1,995.00

- I s 800.00 1 I s 2,800.00 1

- 1 s 64.oo 1 1 s 224.oo 1

Price: November 1, 2018 to January 31, 2019

Biloxi, MS: Demand Nasal Cannula

Price: November 1, 2018 to January 31, 2019

Biloxi, MS: Demand Pulse Conserver Fee

Price: November 1, 2018 to January 31, 2019

Biloxi, MS: Liquid Oxygen System Fee

Price: November 1, 2018 to January 31, 2019

I Biloxi, MS: Portable Liquid Oxygen System Fee

I Price: November 1, 2018 to January 31, 2019

I Biloxi, MS: Liquid Oxygen per pound

[j>~ce: November 1, 2018 to January 31, 2019

I Biloxi, MS: Delivery for Resupply and Relocation I I Price: November 1, 2018 to January 31, 2019

I Biloxi, MS: Portable Concentrator

I Price : November 1, 2018 to January 31, 2019

I Biloxi, MS: Oxygen Cylinder Refill Stations

I Price: November 1, 2018 to January 31, 2019

I Biloxi, MS: Liquid Oxygen Portable Helio System

I Price: November 1, 2018 to January 31, 2019 ~~·· ~ ~J I Biloxi, MS: Ventilator Equipment and Setup ~·-~·· J

I Price : November 1, 2018 to January 31, 2019

1017 I Biloxi, MS: No Shows - In the event that the patient and/or caregiver fails to meet the Contractor at a scheduled delivery or visit

60l~Ll 1 s 8.oo 1 s 480.001 ~.1,680.00 I

1 s 25 .oo 1 $ 100:067 1 s 350.001

1 s 22 .001 s 6,050.001 1 s 21,115.00 1

1 s 55.oo 1 s no.oo 1 1 s 2,695.00 1 s 455.oo 1 1 s 1,592.50 1

9oolm 1 s o.9o 1 LS_~ili@ [1__~ 2,835]Q_j

1 s 65.oo 1 s 520.00 1 1 s 1,820.00 1

300l~Ll 1 s 95.oo 1 s 28,500.00 1 1 s 99,750.00 1

1 s 113.09 1 $ ~ 865.45 I I s 3,029.08 1

1 s 135.oo 1 $ 675.0_Q__J [s~ . 2,362 .50 I s 11,251.80 1 1 s 39,381.30 1

!Gulf Coast Veterans Health Care System: FIRESAFE Cannula's I Price: November 1, 2018 to January 31, 2019

1019 1 Gulf Coast Veterans Health Care System: Portable gaseous system with no stationary unit

1019a I Price: November 1, 2018 to January 31, 2019

1001~ll

J Ql~ll

Gulf Coast VHCS Totals

I November 1, 2018 to January 31, 2019 {$

1 s 65.oo 1 Is 325.oo 1 1 s 1,137.50 1

1 s 739.oo 1 1 s 2,586.50 1

1 s 8.oo 1 s 80.00 I I s -280.00 I

524,875.30

Veterans Health Care System of the Ozarks - Fayetteville, AR

Est Qty per Unit of

CUN Description Month Issue

Fayetteville, AR 5 LPM Concentrator with Backup System Fee : This shall include the initial visit and set-up of the oxygen concentrator by a

Certified Respiratory Therapist (CRT) or a Registered Respiratory

2001 !Therapist (RRT), back-up system complete with regulator stand, tubing, cannulas, Filter(s), and humid ifier as needed, four portable cylinders with wheeled cart, regulator and monthly supplies including can nu las, tubing, filter(s) and humidifiers.

2001a I Price: November 1, 2018 to January 31, 2019

Fayetteville, AR 10 LPM concentrators with Backup System Fee: This shall include the initial visit and set-up of the oxygen concentrator by a

Certified Respiratory Therapist {CRT) or a Registered Respiratory 2002 1 rherapist {RRT), back-up system complete with regulator stand, tubing, cannulas, Filter{s), and humidifier as needed, four portable cylinders with wheeled cart, regulator and monthly supplies including can nu las, tubing, filter{s) and humidifiers.

2002a I Price: November 1, 2018 to January 31, 2019

2003 I Fayetteville, AR: Cylinder - Size M or H Refill

2003a I Price: November 1, 2018 to January 31, 2019

2004 I Fayetteville, AR: Cylinder - Size E Refill

2004a I Price: November 1, 2018 to January 31, 2019

2005 I Fayetteville, AR: Cylinder - Size D Refill

2005a I Price: November 1, 2018 to January 31, 2019

2006 I Fayetteville, AR: Cylinder - Size B or M6 Refill

Average

Monthly

Extended Price

Unit Price (UP* 30) 3.5 Months mlllEI s 603,926.40 1

1 s 1,605.12 $ -5,617.92]

1 s 285.oo s 997.50 1

1 s 2,400.00 s 8,400.00 1

I s 2,400.o_Q___ s 8,400.00 1

Fayetteville, AR: Demand Nasal Cannula

Price: November 1, 2018 to January 31, 2019

Fayetteville, AR: Demand Pulse Conserver Fee

Price: November 1, 2018 to January 31, 2019

Fayetteville, AR: Liquid Oxygen System Fee

Price: November 1, 2018 to January 31, 2019

Fayetteville, AR: Portable Liquid Oxygen System Fee

Price: November 1, 2018 to January 31, 2019

I Fayetteville, AR: Liquid Oxygen per pound

I Price: November 1, 2018 to January 31, 2019

I Fayetteville, AR: Delivery for Resupply and Relocation

I Price: November 1, 2018 to January 31, 2019

[Fayetteville, AR: Portable Concentrator jPrice:- November 1, 2018 to January 31, 2019

[Fay~tteville, AR: Oxygen Cylinder Refill Stations ]

[Price : November 1, 2018 to January 31, 2019 - -]

[ Fayetteville, AR: Liquid _Oxygen_!)ortable Helio System ]

I Price: November 1, 2018_ to Jan_ll~ry31, 2019 j

I Fayetteville, AR: Ventilator Equipment and Setup 1 Price: November 1, 2018 to January 31, 2019

2017 I Fayetteville, AR: No Shows - In the event that the patient and/or caregiver fails to meet the Contractor at a scheduled delivery or visit

2017a I Price: November 1, 2018 to January 31, 2019 J

38ol~Ll

400,~Ll

1 s 8.oo 1 1 s 920.001 1 s 3,220.00 1

1 s 25.oo 1

1 s 22.001 , s 8,360.00 1 1 s 29,260.00 1

1 s 75.oo 1

1 s 55.oo 1

1 s o.9o 1

I s 650.001 I s 2,215.00 1 1 s 65.oo 1

1 s 95.oo 1 1 s 38,ooo.oo 1 1 s 133,ooo.oo 1

1 s 113.09 1 s 3,461.80 1 1 s 12,116.30 1

1 s 135.oo 1

1 s 5,625.90 $ 19,690.65

I s 65.oo 1 1 s 65.oo 1 LL 221.50 I

2018a

Veterans Health Care System of the Ozarks: FIRESAFE Cannula's

[ Price: November 1, 2018 to January 31, 2019

I Veterans Health Care System of the Ozarks: Portable gaseous system with no stationary unit

2019a I Price: November 1, 2018 to January 31, 2019

1001~Ll

0IEA I $ 8.00 I

VHS of the Ozarks Totals

[ November 1, 2018 to January 31,2019 j$ 829,997.77

I s 739.oo 1 1 s 2,s86.so 1

[J ____ 80.00 I Is_ _ 280.00

Michael E DeBakey VA Medical Center - Houston, TX

CLIN Description

Houston, TX 5 LPM Concentrator with Backup System Fee: This shall include the initial visit and set-up of the oxygen concentrator by a

Certified Respiratory Therapist (CRT) or a Registered Respiratory

3001 !Therapist (RRT), back-up system complete with regulator stand, tubing, cannulas, Filter(s), and humidifier as needed, four portable cylinders with wheeled cart, regulator and monthly supplies including can nu las, tubing, filter(s) and humidifiers.

3001a I Price: November 1, 2018 to January 31, 2019

Houston, TX 10 LPM concentrators with Backup System Fee: This shall include the initial visit and set-up of the oxygen concentrator by a

Certified Respiratory Therapist (CRT} or a Registered Respiratory 3002 I Therapist (RRT}, back-up system complete with regulator stand, tubing, cannulas, Filter(s), and humidifier as needed, four portable cylinders with wheeled cart, regulator and monthly supplies including cannulas, tubing, filter(s) and humidifiers.

3002a I Price: November 1, 2018 to January 31, 2019

3003 I Houston, TX: Cylinder - Size M or H Refill

3003a I Price: November 1, 2018 to January 31, 2019

3004 I Houston, TX: Cylinder - Size E Refill

3004a I Price: November 1, 2018 to January 31, 2019

3005 I Houston, TX: Cylinder - Size D Refill

3005a I Price: November 1, 2018 to January 31, 2019

3006 I Houston, TX: Cylinder - Size B or M6 Refill

Est Qty per Unit of

Month Issue

210011-LJ

I 10011-LJ

~1-Ll

~1-Ll

Average

Monthly

Extended Price

Unit Price (UP * 30) 3.5 Months

1 s 100.32 1 s 210,612.00 1 1 s 737,352 .00 1 ltlllBDJ

I s 10,032.00 $ 35,112.00

I s 16.001 s 266.00 1

I $ 16,00Q.~OQJ I s 56,ooo.oo I

I s 1,200.00 I 1 s 25,200.00 1

Houston, TX: Demand Nasal Cannula

Price: November 1, 2018 to January 31, 2019

Houston, TX: Demand Pulse Conserver Fee

Price: November 1, 2018 to January 31, 2019

Houston, TX: Liquid Oxygen System Fee

I Price: November 1, 2018 to January 31, 2019

[Ho-uston, TIC: Portable Liquid Oxygen System Fee

[Price: November 1, 2018 to January 31, 2019

[Houston, TX: Liquid Oxygen per pound

[ Price: November 1, 2018 to January 31, 2019

[Houston, TX: Delivery for Resupply and Relocation

[ Price: November 1, 2018 to January 31, 2019

[ Houston, TX: Portable Concentrator

[Price: November-1, 2018 to January 31, 2019

I Houston, TX: Oxygen Cylinder Refill Stations

I Price: November 1, 2018 to January 31, 2019

I Houston, TX: Liquid Oxygen Portable Helio System

I Price: November 1, 2018 to January 31, 2019

I Houston, TX: Ventilator Equipment and Setup

I Price: November 1, 2018 to January 31, 2019

3017 I Houston, TX: No Shows - In the event that the patient and/or caregiver fails to meet the Contractor at a scheduled delivery or visit

3017a I Price: November 1, 2018 to January 31, 2019 J

OIEA

1800 EA

500 lb

1 s 4,400.00 1 1 s 15,400.00 1

1 s 25.oo 1 1 s 87.50 1

1 s 39,600.00 1 1 s 138,600.00 1

I s 900.001 1 s 3,150.00

962.51

15751

1 s 1,950.00 s 6,825.00 1

1 s 1,425.00 s 4,987.50 1 cs:=9,37 6. 50 s 32,811.15 I

Is .. 390.00 1 s 65.oo 1 s 1,365.00 I

MEDV AMC: FIRESAFE Cannula's Price: November 1, 2018 to January 31, 2019 j 10011'-Ll

MEDV AMC: Portable gaseous system with no stationarr unit Price: November 1, 2018 to January 31, 2019

[ November 1, 2018 to January 31, 2019

J Qll'-Ll

MEDVAMC Totals

Is 739.oo I 1 s 2,s86.so 1

1 s 8.oo 1 s 80.001 I s 280.001

1,062,566.75

G.V. "Sonny" Montgomery VA Medical Center - Jackson, MS

CUN Description

Jackson, MS 5 LPM Concentrator with Backup System Fee: This shall include the initial visit and set-up of the oxygen concentrator by a

Certified Respiratory Therapist {CRT) or a Registered Respiratory

4001 !Therapist {RRT), back-up system complete with r~gulator stand, tubing, cannulas, Filter(s), and humidifier as needed, four portable cylinders with wheeled cart, regulator and monthly supplies including cannulas, tubing, filter(s) and humidifiers.

4001a I Price : November 1, 2018 to January 31, 2019

Jackson, MS 10 LPM concentrators with Backup System Fee: This shall include the initial visit and set-up of the oxygen concentrator by a

Certified Respiratory Therapist (CRT) or a Registered Respiratory 4002 1

Therapist (RRT), back-up system complete with regulator stand, tubing, cannulas, Filter(s), and humidifier as needed, four portable cylinders with wheeled cart, regulator and monthly supplies including can nu las, tubing, filter(s) and humidifiers.

4002a I Price: November 1, 2018 to January 31, 2019

4003 !Jackson, MS: Cylinder - Size M or H Refill

4003a I Price: November 1, 2018 to January 31, 2019

4004 I Jackson, MS: Cylinder - Size E Refill

4004a I Price: November 1, 2018 to January 31, 2019

4005 !Jackson, MS: Cylinder - Size D Refill

4005a I Price: November 1, 2018 to January 31, 2019

4006 !Jackson, MS: Cylinder - Size B or M6 Refill

Est Qty per Unit of

Month Issue

4056l~Ll

Average

Monthly

Extended

Price {UP*

Unit Price 30) 3.5 Months

1 s 120,083.04 1

- I s 501.60 1 I s 1,155.60 1

- Is 95.oo 1 1 s 332.50

- : s 32,448.oo 1 1 s 113,568.oo

4006a

4007a

4008a

Price: November 1, 2018 to January 31, 2019

Jackson, MS: Demand Nasal Cannula

Price: November 1, 2018 to January 31, 2019

Jackson, MS: Demand Pulse Conserver Fee

Price: November 1, 2018 to January 31, 2019

Jackson, MS: Liquid Oxygen System Fee

Price : November 1, 2018 to January 31, 2019 I

Jackson, MS: Portable Liquid Oxygen System Fee I Price: November 1, 2018 to January 31, 2019 I

Jackson, MS: Liquid Oxyg_e_n_p_er_eo_u_nd ____________ _ Price: November 1, 2018 to January 31, 2019

Jackson, MS: Delivery for Resupply and Relocation

Price: November 1, 2018 to January 31, 2019

Jackson, MS: Portable Concentrator

Price : November 1, 2018 to January 31, 2019

Jackson, MS: Oxygen Cylinder Refill Stations

Price: November 1, 2018 to January 31, 2019

Jackson, MS: Liquid Oxygen Porta_b_l_f:!_ti_f:!_lio S~y_st_e_m _______ ~ Price: November 1, 2018 to January 31, 2019

Jackson, MS: Ventilator Equipment and Setup

Price: November 1, 2018 to January 31, 2019

4017 !Jackson, MS: No Shows - In the event that the patient and/or caregiver fails to meet the Contractor at a scheduled delivery or visit

Ql~Ll 1 s 11.001

1 s 25.oo 1

1 s 22.001 s 220.001 Is no.oo 1

I s 90.001 1 s 315.oo 1 s 90.001

I s 65.o4 I 1 s 221.64

1 s o.9o 1

1 s 65.oo 1 Is 130.00 I 1 s 4ss~ooJ

1 s 95.oo 1 1 s 52,250.00 1 1 s 182,875.oo 1

1 s 115.oo 1 s 350.001 I s 1,225.00 1

1 s 32.001 $ 32.00 $ 112.ooJ

I s 2~812 .95 s 9,845.33 I

Price: November 1, 2018 to January 31, 2019 1 s 65.oo 1 1 s 130.001 1 s 455.oo 1

GVMVAMC: FIRESAFE Cannula's Price : November 1, 2018 to January 31, 2019 I 1001~ll 1 s 739.oo 1 1 s 2,586.so 1

GVMV AMC: Portable gaseous system with no stationary unit Price: November 1, 2018 to January 31, 2019 J Dl~ll

1 s 8.oo 1 1 s 80.001 I s 280.001

Sonny Montgomery VAMC Totals

I November 1, 2018 to January 31, 2019. j$ 434,885.61

Central Arkansas Veterans Health Care System - Little Rock, AR

CLIN Description Month Issue

Little Rock, AR 5 LPM Concentrator with Backup System Fee: This shall include the initial visit and set-up of the oxygen concentrator by a

Certified Respiratory Therapist (CRT) or a Registered Respiratory

5001 !Therapist (RRT), back-up system complete with regulator stand, tubing, cannulas, Filter(s), and humidifier as needed, four portable cylinders with wheeled cart, regulator and monthly supplies including cannulas, tubing, filter(s) and humidifiers.

5001a I Price: November 1, 2018 to January 31, 2019

Little Rock, AR 10 LPM concentrators with Backup System Fee: This shall include the initial visit and set-up of the oxygen concentrator by a

Certified Respiratory Therapist {CRT) or a Registered Respiratory

!Therapist (RRT), back-up system complete with regulator stand, tubing, cannulas, Filter(s), and humidifier as needed, four portable cylinders with wheeled cart, regulator and monthly supplies including cannulas, tubing, filter(s) and humidifiers.

5002a I Price: November 1, 2018 to January 31, 2019

5003 I Little Rock, AR: Cylinder - Size M or H Refill

5003a I Price: November 1, 2018 to January 31, 2019

5004 I Little Rock, AR: Cylinder - Size E Refill

5004a I Price: November 1, 2018 to January 31, 2019

SOOS I Little Rock, AR: Cylinder - Size D Refill

5005a I Price: November 1, 2018 to January 31, 2019

5006 I Little Rock, AR: Cylinder - Size B or M6 Refill

Average

Monthly

Extended Price

Unit Price (UP * 30) 3.5 Months

I s 338,830.80 1

- s so1.60 I I s 1,1ss.60 I

- s 1,900.00 1 1 s 6,6so.oo 1

- s 1,920.001 I s 6, no.oo 1

- $ 12,000.00 -$~~ 42,000.00]

Little Rock, AR: Demand Nasal Cannula Price: November 1, 2018 to January 31, 2019

Little Rock, AR: Demand Pulse Conserver Fee Price: November 1, 2018 to January 31, 2019

Little Rock, AR: Liquid Oxygen System Fee

I Price: November 1, 2018 to Jan\Jary 31, 2019

I Little Rock, AR: Portable Liquid Oxygen System Fee ]Price: November 1, 2018 to January 31, 2019

]Little Rock, AR: Liquid Oxygen per pound ]Price: November 1, 2018 to January 31, 2019

!Little Rock, AR: Delivery for Resupply and Relocation Price: November 1, 2018 to January 31, 2019

Little Rock, AR: Portable Concentrator Price: November 1, 2018 to January 31, 2019

Little Rock, AR: Oxygen Cylinder Refill Stations J Price: November 1, 2018 to January 31, 2019 ]

Little Rock, AR: Liquid Oxygen Portable Helio System

Price: November 1, 2018 to Ja nuary 31, 2019

Little Roc-k,AR:Ventilator Equipmert and Setup ~ 7 I Price: November 1, 2018 to January 31, 2019 I

5017 I Little Rock, AR: No Shows - In the event that the patient and/or caregiver fails to meet the Contractor at a scheduled delivery or visit

5017a I Price: November 1, 2018 to January 31, 2019 J

170011--Ll 1 s 8.oo 1 1 s 13,600.00 1 1 s 47,600.00 1

1 s 25.oo 1 1 s 475.oo 1 1 s 1,662.50 1

1 s 22.00 1 1 s 11,886.00 1 1 s 62,601.00 1

1 s 75.oo 1 Li_ 225_._oo_j [ $ -~8? .5Q_]

1 s 55.oo 1 I s 165.oo 1 I $ 577.50 I

200lm 1 s o.9o 1 I s 180.001 1 s 630.00

1 s 65.oo 1 I s 325.oo 1 1 s 1,137.50

1 s 95.oo 1 I s 2,375.00 1 1 s 8,312.50 :

1 s 113.09 1 i s 2,.s96.35 1 Is 9,081.23

I s 135.oo 1 $ 46Bm] 1 s 1,411.50 1 s 10,314.15 1 1 s 36,099.53 1

1 s 65.oo 1 s- ---195.oo l I s 682.50 l

CA VHCS: Portable gaseous system with no stationary unit

[ November 1, 2018 to January 31, 2019

CAVHCS Totals

Is 569,418.15

Southeast Louisiana Veterans Health Care System - New Orleans, LA

CLIN Description Month Issue

New Orleans, LA 5 LPM Concentrator with Backup System Fee: This shall include the initial visit and set-up of the oxygen concentrator by a

Certified Respiratory Therapist (CRT) or a Registered Respiratory

6001 !Therapist {RRT), back-up system complete with regulator stand, tubing, cannulas, Filter(s), and humidifier as needed, four portable cylinders with wheeled cart, regulator and monthly supplies including cannulas, tubing, filter(s) and humidifiers.

6001a I Price: November 1, 2018 to January 31, 2019

New Orleans, LA 10 LPM concentrators with Backup System Fee: This shall include the initial visit and set-up of the oxygen concentrator by a

Certified Respiratory Therapist (CRT) or a Registered Respiratory 6002 1

Therapist (RRT), back-up system complete with regulator stand, tubing, cannulas, Filter(s), and humidifier as needed, four portable cylinders with wheeled cart, regulator and monthly supplies including cannulas, tubing, filter(s) and humidifiers.

6002a I Price: November 1, 2018 to January 31, 2019

6003 I New Orleans, LA: Cylinder - Size Mor H Refill

6003a I Price: November 1, 2018 to January 31, 2019

6004 I New Orleans, LA: Cylinder - Size E Refill

6004a I Price: November 1, 2018 to January 31, 2019

6005 I New Orleans, LA: Cylinder - Size D Refill

6005a I Price: November 1, 2018 to January 31, 2019

6006 I New Orleans, LA: Cylinder - Size B or M6 Refill

Average

Monthly

Extended

Price {UP *

Unit Price 30) 3.5 Months s 131,610.00 1

- I s 4,514.40 I s 15,800.40 I

- Is 133.oo 1 s 46s.5o 1

- Is 680.001 I s 2,380.00 1

- I s__ 24.oo l Is 84.oo I

6006a

6007a

6008a

Price: November 1, 2018 to January 31, 2019

New Orleans, LA: Demand Nasal Cannula

Price: November 1, 2018 to January 31, 2019

New Orleans, LA: Demand Pulse Conserver Fee

Price: November 1, 2018 to January 31, 2019

6009a c

New Orleans, LA: Liquid Oxygen System Fee

Price: November 1, 2018 to January 31, 2019

6010a

New Orleans, LA: Portable Liquid Oxygen System Fee

Price : November 1, 2018 to January 31, 2019

New Orleans, LA: Liquid Oxygen per pound

Price: November 1, 2018 to January 31, 2019

!New Orleans, LA: Delivery for Resupply and Relocation

I Price : November 1, 2018 to January 31, 2019 I

I New Orleans, LA: Portable Concentrator I !Price: November 1, 2018 to January 31, 2019 I

!New Orleans, LA: Oxygen Cylinder Refill S!~tions I ~r-Jo~ember 1, 2Q.18Jo January 31, 2019.

!New Orleans, LA: Liquid Oxygen Portabie~HelioSystem

!Price: November 1, 2018 to January 31, 2019

!New Orleans, LA: Ventilator Equipment and Setup

I Price: November 1, 2018 to January 31, 2019

6017 !New Orleans, LA: No Shows - In the event that the patient and/or caregiver fails to meet the Contractor at a scheduled delivery or visit

I 8011-ll 1 s 640.001 I s 2,240._()QJ 1 s 8.oo 1

1 s 25.oo 1 1 s 125.oo 1 I s 437.501

28011-ll 1 s 22.00 1 I s 6,160.00 1 I s 21,560.00 I

I s 55.oo 1 s · 1,155.00 1 1 s 4,042.50 1 s 812.50 1 ! s 2,843 .75 1

264011• 1 s o.9o 1 $ 2,376.00 s 8,316.00 1

1 s 65.oo 1 s 195.oo 1 1 s 682.50 l£.5,225.oo I 1 s 95.oo 1 I s 18,281.50

1 s 113.09 1

1 s 135.oo 1 I s 210.001 Is 945.oo I s 14,064.75 1 I s 49,226.63 1

I6011a 1 Price : November 1, 2018 to January 31, 2019

Southeast Louisiana Veterans Health Care System: FIRESAFE Cannula's 6018

6018a I Price : November 1, 2018 to January 31, 2019

1 6019 1:; Southeast Louisiana Veterans Health Care System: Portable gaseous system with no stationary unit

6019a I Price : November 1, 2018 to January 31, 2019 J

SLVHCS Totals

I November 1, 2018 to January 31, 2019 j$

Is 130.00 I Is 455.oo I 1 s 65.oo 1

100lf-Ll I s 739.oo I 1 s 2,586.50 1

QI f.Ll 1 s 8.oo 1 1 s 80.001 1 s 280.00 l

262,022.78

Monthly Annual

Alexandria 280 3360 Fayetteville 1800 21600 Gulf Coast 659 7908 Houston 2041 24492 Jackson 640 7680 Little Rock 1063 12756 New Orleans 444 5328 Shreveport 675 8100 Total 7602 91224