Technical Questions and Responses - 36C25626R0037.docx

Technical Questions (Round II) – Home O2 – 3-station

1. Multiple Award Clarification The revised PWS refers to both the “Contractor” and, in Section 4.4, the “new Contractor(s)” and “successful Contractor(s).”

Can the Government confirm whether it intends to make a single contract award covering all three VISN 16 stations, or whether the Government reserves the right to make separate or multiple awards by station, geographic area, or another grouping?

A. The government intends to make a single award covering the entire 3-station region.

2. Contractor Facility Requirements Section 1.2 states that contractors shall have “a facility or resources physically located in the geographic area in which they shall provide service.”

Can the Government clarify whether one contractor facility or distribution point may support more than one of the three stations when that facility is geographically located and staffed to meet all applicable response times and performance requirements for those service areas, or whether a separate facility/distribution point is required within each station's geographic service area?

A. The contractor is ultimately responsible for maintaining performance. A contractor will not be penalized for the location of their facilities so long as all performance metrics and timelines are adhered to and patient safety is maintained.

3. Technical Capability Statement Page Limitation Can the Government confirm whether supporting documentation including resumes, licenses, organizational charts, maps, certifications, and similar attachments count toward the twenty page limitation for the Technical Capability Statement, or whether such supporting documentation may be provided outside the twenty-page limitation?

A. The page limitation will not apply to mandatory submissions directed by the government, however, contractors submitting proposals should still endeavor to streamline their submissions to the maximum extent possible.

4. Proposal Packaging and Required Equipment Manuals.

Source: Original Solicitation 36C25626R0037, Addendum to FAR 52.212-1, pp. 84-85; Updated PWS, p. 12 §2.8 and p. 21 §3.1.

Question: The solicitation limits Volume 2, Technical Capability and Past Performance, to 20 pages, requires proposal volumes in PDF unless otherwise specified, and limits each proposal email to 7 MB. The updated PWS also requires the Contractor to provide the Government one Operation and Service manual for each type of equipment "with any proposals regarding this contract." Please confirm whether the required equipment manuals are excluded from the 20-page Volume 2 limitation and how VA would like the manuals submitted, for example as separate technical attachments/appendices and, if necessary, in separate emails.

A. Please see question 3 response above. Any required documentation will not count against the page limit, but contractors should take care to streamline their submissions to the maximum extent possible.

5. Updated Pricing Schedule - Base and Option Periods.

Source: Updated Attachment D.1, LIN Pricing Schedule, period rows throughout, including row 10; Original Solicitation SF 1449, p. 1.

Question: The updated Attachment D.1 pricing schedule lists the Base Year as November 1, 2026 through November 29, 2031, while Option Year One begins November 30, 2027 and subsequent option years follow annually through November 29, 2031. The SF 1449 states an estimated period of performance of November 1, 2026 through October 31, 2031. Please confirm the intended Base Year and option-year periods that offerors should use for pricing and evaluation, and provide a corrected pricing schedule if VA determines a correction is needed.

A. The anticipated Period of Performance will run November 1 – October 31.

6. Updated Pricing Schedule - LIN Identifiers and Cross-References.

Source: Updated Attachment D.1, LIN Pricing Schedule, rows 75, 171, 473, 479, 497 and 593.

Question: Please confirm the intended identifiers and cross-references for the following entries in the updated Attachment D.1 pricing schedule: (a) row 171, Fayetteville Heated Humidifier, LIN 020309; (b) rows 473 and 479, which both use Jackson LIN 08010 for different items; (c) rows 75 and 497, where Fayetteville LIN 02013 and Jackson LIN 08013 describe Liquid Oxygen per pound for CLIN #0011 and #0012; and (d) row 593, Jackson LIN 08029 Heated Humidifier, which does not show the parent-level "NSP" designation shown for the analogous Fayetteville and Little Rock parent items. Please confirm the intended LINs/references and issue any correction VA considers appropriate.

(a) row 171, Fayetteville Heated Humidifier, LIN 020309 Correct item number should be 02029

(b) rows 473 and 479, which both use Jackson LIN 08010 for different items Correct item number for 473 is 08009 Correct item number for 479 is 08010

(c) rows 75 and 497, where Fayetteville LIN 02013 Jackson LIN 08013 describe Liquid Oxygen per pound for CLIN #0011 and #0012 Update description for LIN 02013 to “CLIN #2011 and #2012” Update description for LIN 08013 to “CLIN #8011 and #8012”

(d) row 593, Jackson LIN 08029 Heated Humidifier, which does not show the parent-level "NSP" designation shown for the analogous Fayetteville and Little Rock parent items Row 893 should also reflect NSP designation

7. Attachment D.4 - Fayetteville Service Area.

Source: Attachment D.4, County and Parish Schedule, p. 1, Fayetteville AR VAMC Service Area.

Question: Attachment D.4 lists "Shannon" under the Kansas counties in the Fayetteville VAMC service area. Please confirm the intended county and state for this entry so offerors can apply the correct service-area, licensure, wage-determination, routing and coverage assumptions.

A. Shannon will be removed from the list, this was a typo as Shannon is a VA employee whose name accidentally got cut into the list.

8. Service Outside Attachment D.4 and the Greater-Than-150-Mile Fee.

Source: Updated PWS, p. 1 §1.2 and pp. 13-15 §2.11; Updated Attachment D.1, LIN Pricing Schedule, rows 189, 400 and 611.

Question: For a VA-authorized patient associated with one of the three VISN 16 stations or its supported CBOCs who is physically located outside the Attachment D.4 geographic area, please confirm: (1) whether the Contractor is required to provide the ordered service after making the immediate CO/COR notification required by PWS §1.2; (2) which pricing methodology/LIN applies; (3) how the "greater than 150 miles" delivery/pick-up fee in Attachment D.1 is measured, including the point of origin and whether mileage is one-way or otherwise; and (4) how that fee applies, if at all, to temporary relocation and authorized travel under PWS §2.11.

A. 1. Not required to setup immediately. Report to CO and COR as “extracontractual” for consideration of amendment or negotiation.

2. XXX01 LIN for one-time initial setup charge.

3. Roundtrip mileage from nearest county line on Attachment D.1 to destination and back to same county line.

4. The “greater than 150 miles” service charge does not apply to any location within the D.1 Schedule of Locations. This fee is only applicable if the required service is 150 miles or more (round trip) outside of the catchment area taken as a whole. Distances should be calculated from the nearest county line as stated above.

Fee would not apply to temporary relocation or authorized travel.

9. QASP Alignment to the Updated PWS and Telephone Metrics.

Source: Attachment D.5 QASP, p. 6, Performance Objectives Table; Updated PWS, p. 40 §4.14.

Question: Amendment 0002 replaces the original PWS, while Attachment D.5 QASP remains in the solicitation. The QASP performance-objective table references prior PWS paragraph numbers and includes the standard that 80% of a Medical Center geographical-area calls be answered within 20 seconds with an abandonment rate no greater than 5%. Updated PWS §4.14 describes required telephone-system functionality but does not state those numeric metrics. Please confirm that the QASP performance thresholds remain applicable under Amendment 0002 and identify the corresponding updated PWS sections/requirements to which the QASP objectives should be mapped.

A. 4.14 remains applicable.

Objectives:

Initial Setups and Education 2.3, 2.4, 3.3 PM/Tech & RT Home Environment Visits 2.4, 2.5, 2.7, 2.14 Patient Travel 2.11, 2.18 Emergency Services 2.6, 2.13

10. Emergency Response - Two-Hour Requirement and Six-Hour Outer Limit.

Source: Updated PWS, p. 10 §2.6.C; Attachment D.5 QASP, p. 6, Performance Objectives Table.

Question: For emergency maintenance/service performance, PWS §2.6.C states that the Contractor must be able to provide service at the patient's home or present location within two hours of a call, but in no case exceed six hours, and the QASP states a 100% emergency-service threshold within two hours, but in no case to exceed six hours. Please confirm the event VA will measure for the two-hour requirement and the six-hour outer limit, for example physical arrival at the patient location, restoration/replacement of therapy or another defined milestone, including the start and stop points used for QASP surveillance.

A. 2.13 SERVICE CALL: The Contractor shall respond to service calls (i.e., return call); to include, within two (2) hours to troubleshoot the cause, and shall resolve the service call within six (6) hours of request from the COR or designee (dependent on patient’s availability), to include after normal business hours, weekends, and holidays, and patient request for return call generated by the contractor’s automated return call response system. The Contractor shall also provide 24-hour emergency services and shall provide services at the patient’s place of residence within six (6) hours of a call.

H. If the Contractor is unable to respond to an emergency service call within six (6) hours, the Contractor shall be responsible for making arrangements with another supplier, who meets all JC standards, to provide oxygen at the Contractor's expense.

11. Ventilator Backup Requirement - Patient Population.

Source: Updated PWS, p. 11 §2.6.G; p. 26 §3.3.J.2; p. 29 §3.3.Q.

Question: Please confirm which ventilator patient population must have two ventilators on hand in the home. PWS §2.6.G states that the backup system for ventilator patients shall consist of two ventilators on hand; §3.3.J.2 specifically requires a backup ventilator for patients receiving invasive ventilation; and §3.3.Q states that Veterans on continuous mechanical ventilation require two ventilators on hand. Should offerors price and plan for two ventilators for all ventilator patients, only invasive/continuous mechanical ventilation patients, or another defined subset?

A. Backup ventilator in home for invasive ventilation patients only.

12. Non-Invasive Ventilator Failure - One-Hour Exchange Requirement.

Source: Updated PWS, pp. 26-27 §3.3.J.3 and §3.3.J.7.

Question: For non-invasive ventilator patients, PWS §3.3.J.3 requires a backup ventilator to be "available for exchange within one hour of notification of ventilator failure," while §3.3.J.7 requires a local CRT/RRT to be on call and available to respond to a patient's home within one hour of an emergency call. Please confirm whether "available for exchange within one hour" requires the replacement ventilator to be physically delivered and exchanged in the home within one hour, or whether the replacement must be staged/available for dispatch within one hour with field service then governed by the applicable emergency-response requirement.

A. Staged locally and available for dispatch.

13. Incoming Contractor Phase-In Period and Patient-Level Transfer.

Source: Updated PWS, pp. 34-36 §4.4, Incumbent Transition Period.

Question: PWS §4.4 requires the successful offeror to provide a detailed phase-in/phase-out plan upon award and describes patient-level changeover, Friday transition reporting, incumbent equipment pickup notification and billing beginning on each documented transition date. The 120-day language in §4.4 addresses phase-in/phase-out services after contract expiration. Please confirm the maximum period VA intends to allow the incoming Contractor to complete the initial patient/equipment phase-in after award, and confirm that operational responsibility and billing transfer on a patient-by-patient basis on each documented changeover date unless VA directs otherwise.

A. Below applies to both phase in or phase out.

The Contractor shall coordinate transition of equipment / services with the incoming contractor as soon as possible, but not to exceed one hundred and twenty (120) days from date of contract expiration. If additional transition time is required beyond contract expiration, the Contracting Officer must be notified to receive authorization. The Contractor shall be paid on a pro-rated basis at the prices established for the last period of performance. Prorated monthly rates are based on a 30-day month.

14. Transition Data Package and Government-Furnished Equipment.

Source: Updated PWS, pp. 34-36 §§4.4 and 4.6.

Question: To support the uninterrupted transition required by PWS §4.4, please identify the minimum patient/equipment data VA expects to provide to the successful offeror at or after award and the anticipated timing of that data. At a minimum, please confirm whether the transition data will identify the current prescription, patient contact/service location, equipment type/model/serial number and ownership, ventilator/high-risk status, most recent preventive-maintenance/home-visit information and incumbent pickup/coordination information. In addition, please confirm whether VA currently anticipates any Government-owned/furnished equipment at contract start, given PWS §4.6 states that Government-furnished property/equipment will be added only through contract modification.

A. There is currently no Government-furnished property anticipated at contract start.

As per below, phase in plan has not yet been finalized as it is determined by successful offerors plan and CO acceptance.

“Successful Offeror shall provide a detailed contract phase-in/phase-out plan upon contract award for COR approval.”

15. Ventilator Backup Requirements Reference: Performance Work Statement, Section 2.6, Emergency Services, Paragraph G.

The PWS states: “The backup system for ventilator patients shall consist of two (2) ventilators on hand.”

Please clarify whether this requirement calls for one primary ventilator and two backup ventilators (three ventilators total) or one primary ventilator and one backup ventilator (two ventilators total) for each ventilator patient.

Additionally, please clarify whether “on hand” requires the backup ventilator(s) to be maintained in the patient’s home or permits them to be maintained in the contractor’s inventory for delivery when needed.

A. Primary and backup (2) ventilators in the home for invasive ventilator patients. Backup ventilators for non-invasive patients available locally for immediate dispatch.

16. Home Assessment/Visit Pricing and Billing Units Reference: Attachment D, Pricing Schedule, LINs 00033, 00034, 02033, 02034, 08033, and 08034.

Please confirm whether the following interpretation of the pricing schedule is correct:

· LINs 00033, 02033, and 08033 — Ventilator–RT Home Environment Assessment/Visit (Monthly): Each completed monthly home environment assessment/visit performed by a CRT/RT for a ventilator patient constitutes one billable unit under the applicable LIN.

· LINs 00034, 02034, and 08034 — Technician Home Environment Assessment/Visit (Semiannually): Each completed semiannual home environment assessment/visit performed by a trained technician for a ventilator patient constitutes one billable unit under the applicable LIN.

If this interpretation is incorrect, please clarify the applicable unit of payment and billing basis for each service, including whether these visits are separately billable or included in another payment under the contract.

A. LINs 00033, 02033, and 08033 - RT Visit to ventilator patient constitutes one billable unit.

LINs 00034, 02034, and 08034 – Technician visit is only for oxygen and concentrator patients.

17. Pricing Schedule- LIN 08010 -SLIN A- Unit of issue is missing a quantity. Based on SLIN B-E, the quantity appears to be 45. Please confirm the correct quantity for this LIN.

A. Please amend quantity should be 43 rows 473 and 479, which both use Jackson LIN 08010 for different items Correct item number for line# 473 is 08009 Correct item number for line# 479 is 08010

18. Regarding CLINs 2030/0030 and 8030 – POC Battery (Additional), and CLINs 2031/0031 and 8031 – POC Desktop Battery Charger, are these CLINs intended to be priced as rental items or as purchased items?

A. Rental

19. Regarding Jackson CLIN 08010 – the Base Year quantity appears to be blank, while quantities are provided for the corresponding CLIN in the subsequent option years. Please confirm the intended Base Year quantity for CLIN 08010.

rows 473 and 479, which both use Jackson LIN 08010 for different items Correct item number for line# 473 is 08009 Correct item number for line# 479 is 08010

20. Does the Government require the successful prime contractor to provide all liquid oxygen CLINs exactly as currently listed in the solicitation, or would the Government consider an alternative coverage arrangement or other accommodation for the LOX portion of the requirement if commercially available home LOX service cannot reasonably be obtained within one or more of the required service territories?

A. Yes, all liquid oxygen CLINs must be provided as listed. The government cannot make an affirmative determination without more detail of an alternative coverage arrangement and/or other accommodations. Any alternative would need to be vetted to ensure patient safety and adherence to VA guidelines and standards.

21. 1.2 LOCATIONS/PLACE OF PERFORMANCE

The contractor shall service any patients that are treated at any of these facilities and all associated Community Based Outpatient Clinic (CBOC), supported therein (Clinic of Jurisdiction/Primary Services Area COJ/PSA), regardless of their physical location. The geographical boundaries described herein have been determined as the areas of responsibility for each local VA Medical Centers. If the contractor receives a request for services outside of the geographical area detailed in Attachment D.4, the contractor shall immediately notify the Contracting Officer and COR.

Question: Please clarify the geographic service requirement. The PWS states that the Contractor must service patients treated by the listed facilities and associated CBOCs “regardless of their physical location,” but also references geographic boundaries in Attachment D.4. Is the Contractor required to provide service to Veterans residing outside the Attachment D.4 service area if they are under the jurisdiction of one of the listed VA facilities, or is service limited to the geographic boundaries identified in Attachment D.4?

A. The locations provided in D.4 are exhaustive of the patients currently receiving home oxygen care. However, occasionally the VA has patients who live outside of this area who elect to receive care at a specific facility. Therefore, the requirement is that the contractor be prepared to provide services in adjacent counties and parishes if the need arises. The VA will attempt to ensure home oxygen services are provided by the closest available resource. Please see response to question number 8.

22. Regarding 2.4 HOME VISITS, Educational materials shall instruct patients who smoke, to remove the cannula, shut-off the oxygen supply, stand a minimum of twenty-five (25) feet away, and wait for oxygen to dissipate prior to smoking.

Question: Can the VA provide the basis for the 25-foot requirement? We note that various oxygen safety resources reference maintaining a minimum separation distance of 10 feet between oxygen equipment and open flames. Would the VA consider allowing a 10-foot minimum distance?

A. Yes,10 ft minimum distance is consistent with VA training.

23. If any modifications or preparations need to be made to equipment, these changes shall be coordinated with patient caregiver and made before the Patient arrives home from the hospital. Other items that shall be prepared ahead of time include:

a. Establishing designated Customer Service support phone line for patients to call for in home assistance

b. Posting all emergency numbers by each telephone

c. Marking the circuit breakers and fuses

Question: The Statement of Work requires contractors to post emergency numbers by each telephone and mark circuit breakers and fuses within the patient's residence. Given that many patients no longer maintain landline telephones and contractors may not have authority to modify or label electrical panels in patient residences, would the VA consider removing these requirements or allowing emergency contact information and patient education to satisfy this requirement?

A. This requirement should be adhered to to the maximum extent practical. If this requirement cannot be met due to lack of landline or lack of authority to modify/label, then the information should otherwise be provided to the patient, via refrigerator magnet or laminated information sheet.

24. 2.8 MANUALS

Contractor shall provide to the Government, one (1) copy of the Operation and Service manual for each type of equipment with any proposals regarding this contract.

Question: The PWS requires the Contractor to provide one Operation and Service Manual for each type of equipment “with any proposals.” Manufacturer operation and service manuals can be lengthy and may contain hundreds of pages and large electronic file sizes. Please clarify how these manuals are to be submitted with the proposal. Specifically, should they be submitted as separate electronic attachments, and are they excluded from the proposal page limitations and the 7 MB email size limitation? If the manuals exceed the allowable email size, please provide the approved alternative method of submission.

A. All required manuals can be digitally submitted in a separate package and do not count toward the page/size restrictions.

25. 2.11 (C) PATIENT TRAVEL & C (II) TEMPORARY RELOCATION

Additional costs incurred as a result of home oxygen support for Veteran travel, temporary relocation or to support infrequent instances of home oxygen supply shall be considered extracontractual, and shall be individually discussed with the CO/COR for potential contract modification.

C(ii) - If no subsidiary office is located near or at the temporary destination, it shall be the responsibility of the Contractor to locate an oxygen provider/source at the Veteran’s travel destination, make the appropriate arrangements and invoice the VA. The VA shall pay the contractor awarded the contract and will have no interaction with the oxygen provider at the travel destination.

Question: Please clarify how the Contractor will be reimbursed when a third-party vendor is required for Veteran travel or temporary relocation. Will these costs be paid through a separate purchase order, a designated LIN, or another established billing method? Please update the PWS and Price Schedule to reflect the applicable reimbursement process.

A. See question 26 below – these LINs are to be used for temporary relocation services/travel.

26. TRAVEL CONCENTRATOR STATIONARY & TRAVEL CONSERVING DEVICE LINS

LIN 0026, 02026, 08026 – Travel Concentrator Stationary LIN 0027, 02027, 08027 - Travel Conserving Device Question: Please clarify the intended use and billing methodology for these CLINs. Are these CLINs intended to be utilized when oxygen services are arranged through a third-party oxygen provider at a Veteran's temporary travel destination? If so, please clarify how contractors should develop pricing for these CLINs, as the actual costs may vary based on the location of travel and charges incurred from third-party oxygen providers.

A. If the vendor maintains a facility or otherwise provides service in the destination area of travel/relocation, then the vendor should bill at the rate described in the aforementioned LINs. For third party charges, the vendor will be reimbursed after submission of the 3d party receipt of services.

27. 2.11 PATIENT TRAVEL: (F i & ii) Emergency Travel: Emergency travel is defined as travel requested, for a family emergency (an unexpected occurrence that affects the health or safety of a family member), and with 48 hours or less notice. The Contractor shall accommodate the short notice request and shall arrange for home oxygen for Veterans requiring emergency travel.

1) During normal business hours, the Contractor shall contact Veteran to coordinate travel within one (1) hour of receipt of VA facility Travel Oxygen Approval form and/or VA prescription. The Contractor shall notify VA facility(ies) within 2 (two) hours, but not to exceed four (4) hours, of notification from Veteran(s). VA facility(ies) will respond to the contractor within two (2), not to exceed, four (4) hours.

2) In event of after-hours emergency travel request, Veteran shall contact Contractor directly to coordinate travel. The following business day, the Contractor shall coordinate with the Prosthetics and Sensory Aids Service (P&SAS) and/or Respiratory Therapy Services at the local VA facility.

Question: Please clarify how contractors are to bill and be reimbursed for emergency travel oxygen services, including any third-party vendor costs incurred to accommodate short-notice travel requests. We were unable to identify a specific CLIN for emergency travel services or emergency travel-related pass-through expenses.

A. See response to question 26.

28. 2.11 PATIENT TRAVEL: (G) LEISURE TRAVEL LIMITS

Leisure Travel Limits: Leisure travel is not considered an emergent/emergency travel. Patients receiving home oxygen and/or home ventilator services under this contract are authorized a maximum of thirty (30) days of leisure travel, with a maximum of two (2) set-up charges within a one (1) year period. Veteran, medically related travel, is excluded from the leisure travel maximum limit. Contractor shall not provide home oxygen or home ventilator services for leisure travel that exceed the maximum limits unless authorized to do so, in writing, by the local COR. If additional travel is authorized, the Contractor shall bill the Government at the then current contract rates shown in the Price Schedule, for home oxygen or home ventilator services that exceed the maximum limits. The Contractor shall monitor leisure travel usage, and notify COR, when limits are approached (upon second request for travel) and when they are exceeded by COR authorization. Contractor shall inform patient and/or caregiver of the maximum limits and VA authorization requirements, and that any other costs shall be the patient’s responsibility.

Question 1: Please clarify how contractors are to bill and be reimbursed for authorized leisure travel requiring services from a third-party oxygen provider at the Veteran's destination. If third-party vendor charges exceed the contract rates, what reimbursement mechanism should be utilized?

A. See response to question 26.

Question 2: Please clarify the reimbursement requirements for leisure travel that exceeds the 30-day maximum and is authorized in writing by the COR. If the Contractor receives VA authorization to provide travel services beyond the established limits, will all authorized services be reimbursed by the VA , or are there circumstances in which the Veteran would be responsible for any portion of the costs?

A. Any authorized costs will be covered by the VA. Unauthorized costs will be the responsibility of the veteran.

29. PRICING LINE 02032, 00032, 08032, : FEE FOR DELIVERIES/ PICK-UPS MADE GREATER THAN 150 MILES.

Question- Would this be billed for all deliveries / pick-ups over 150 miles from the ordering VA Medical Center?

A. Please see response to question 8.

30. 2.16 DISCONTINUATION OF SERVICE: (C)

Upon the death of a beneficiary the VA shall notify the Contractor via telephone and/or consult. Arrangement shall be made within two (2) business days to pick up all supplies and equipment. Additional billing shall not be honored after the patients date of death.

Question: The Statement of Work states that additional billing shall not be honored after the patient's date of death. Please clarify how contractors should bill when notification of a beneficiary's death is received after the date of death. Since contractors may not have knowledge of a patient's death until notified by the VA, many VA home oxygen contracts provide that billing ceases upon notification of the death rather than the actual date of death. Would the VA consider revising this language to clarify that billing ceases upon contractor notification of the death?

A. No. The VA’s position is that once a patient dies, there would be no services that could be provided since services are only required for living patients. Therefore, there should not be any charges incurred once a patient is deceased.

31. 2.18 REPORTS: (C)

Contractor shall provide a report on compliance with semi-annual (every six (6) months) and monthly home environment visit requirement for all home oxygen patients, and patients with prescription for Ventilators, respectively.

Question: Please clarify the required frequency of home environment visits and routine maintenance for home oxygen patients. Are home oxygen patients required to receive a home environment visit monthly, with routine equipment maintenance performed semi-annually, or are both the home environment visit and routine maintenance required semi-annually?

A. Semi-annual visits are required for all home oxygen patients. However, the vendor is required to provide monthly reports regarding these visits, IE which visits were completed during that month, or a justification as to why scheduled visits were not completed.

Monthly home environment visits are required for Ventilator patients.

Maintenance reports are required every month, or a report identifying why maintenance was not performed.

32. 2.18 REPORTS: (F)

Customer Satisfaction Report: The Contractor shall collect satisfaction data from patients and their families/Caregivers on a quarterly basis, in accordance with JC standards or current VA auditing agency. A copy of survey results shall be submitted to each station’s COR or designee in quarterly reports with an aggregate summary report to the VISN Prosthetics Rep or designee via VA approved PKI encrypted email. Contractor shall offer, during the quarter, the survey opportunity to 100% of patients with report reflecting number of patients participated.

Question: Please clarify the requirement to offer a satisfaction survey to 100% of active patients each quarter. Would the VA consider allowing a representative sample, such as 5–10% of active patients per quarter, consistent with Joint Commission requirements and standard home oxygen practices?

A. Any time a service is provided, we ask that the patient have the opportunity to participate in a survey. We would like 100% of patients serviced within the quarter to be surveyed, not 100% of all active patients.

33. 3.3 EQUIPMENT (J9-7)

Ventilator: The Contractor shall provide the following: g. Nasal or mask interface for non-invasive (to include NIOV).

Question: Please clarify the quantities and replacement frequencies for the non-invasive masks as no utilization assumptions were identified for these items within the solicitation.

A. At least a 30 day supply in accordance with manufacturer’s instructions.

34. PRICING LINE 02001, 00001,08001: 5LPM CONCENTRATOR WITH BACKUP FEE

Question: Please verify this charge is for the oxygen concentrator set-up fee?

A. Yes.

35. PRICING LINE 02004, 00004, 08004: 10 LPM CONCENTRATOR MONTHLY RENTAL

Question- This item is for the monthly rental of a 10 lpm oxygen machine. Originally, there was a line item for a 5 lpm concentrator rental. Will the VA provide a CLIN item for the rental of a 5 LPM oxygen machine as well?

A. Please see LIN 02002, 00002, 08002

36. PRICING LINE 00005, 08005, 02005: STATIONARY CYLINDER SET-UP SIZE M OR H.

Question- Is this item billed during a set-up in conjunction with the Oxygen concentrator set-up fee?

A. No. Only for patients whose primary system is stationary cylinder.

37. 3.3 EQUIPMENT (E)

Combined Stationary and Portable Units: Home Fill Stations: Concentrator base with compatibility for oxygen cylinder refill that allow a patient to fill their own high-pressure cylinders from a concentrator.

Question: The Statement of Work references "Home Fill Stations" described as a concentrator-based system that allows patients to refill portable oxygen cylinders. We noted the presence of a CLIN for "Oxygen Cylinder Refill Stations"; however, the terminology and descriptions do not appear to be identical. Please clarify whether the Oxygen Cylinder Refill Station CLIN is intended to satisfy the Home Fill Station requirement described in the Statement of Work. If not, please identify the applicable CLIN or advise whether an additional CLIN will be added.

A. They may be used interchangeably.

38. PORTABLE CONCENTRATOR LINS 08015, 02015, 00015

Question 1: Is this intended to be used as a setup fee?

A. Yes, the setup fee is included herein.

Question 2: Please clarify whether the backup system requirements apply to temporary/travel Portable Oxygen Concentrators, long-term Portable Oxygen Concentrators, or both.

A. Backup requirement does not apply to Portable Oxygen Concentrators. Prescriptions may call for specific backup requirements in unusual circumstances.

39. PORTABLE CONCENTRATOR MONTHLY RENTAL LINS 08016, 02016, 00016

Question 1: Please clarify whether this CLIN is intended for long-term Portable Oxygen Concentrator rentals, temporary/travel Portable Oxygen Concentrator rentals, or both.

A. Both.

Question: Can you please clarify how many batteries are included with this monthly rental?

A. Minimum of 2 based on patient requirements.

40. OXYGEN CYLINDER REFILL STATION LINS 00017, 08017, 02017

Question 1: Is the Oxygen Cylinder Refill Station CLIN intended to represent a one-time setup/delivery charge?

A. Yes.

Question 2: Please clarify the equipment associated with this CLIN and its intended use. Specifically, is this CLIN intended to represent a home-fill oxygen system that allows patients to refill portable oxygen cylinders from a stationary concentrator, or another type of oxygen cylinder refill equipment?

A. Home-fill oxygen system.

41. OXYGEN CYLINDER REFILL STATIONS MONTHLY RENTAL LINS 00018, 08018, 02018

Question: Please clarify whether these CLINs are intended to represent a HomeFill-type oxygen system that allows patients to refill portable oxygen cylinders from a stationary concentrator. If not, please provide a description of the equipment associated with these CLIN

A. See response to question 40.

42. PRICING LINE 00007, 08007, 02007, 00007: STATIONARY CYLINDER SET-UP -SIZE B/C/D/E/M6 This shall include Initial home environment assessment, delivery and set-up by a Technician, back-up system complete with regulator, Oxygen Thermal fuses (i.e. fire-safe, oxy-safe, or fire-break). Cannulas w/connector, supplies/resupply, tubing, cannulas, cylinder stand to support each cylinder delivered, and patient education on functionality/features of equipment/cylinders.

Question: Please clarify the intended use of this CLIN. The description states that the setup includes a "back-up system complete with regulator"; however, this CLIN appears to represent a stationary cylinder setup.

A. Even for stationary cylinder set-ups, patients are still required to be provided with extra oxygen to cover response times. Regarding this LIN, the back-up system would be additional tanks.

43. LIQUID OXYGEN EQUIPMENT CLINS

00011, 08011, 02011 – Liquid Oxygen System Fee 00012, 08012, 02012 – Portable Liquid Oxygen System Fee 00013, 08013, 02013 – Liquid Oxygen per pound 00019, 08019, 02019 – Liquid Oxygen Portable Helio System

Question 1: The pricing schedule includes CLINs for Liquid Oxygen System Fee, Portable Liquid Oxygen System Fee, Liquid Oxygen Per Pound, and Portable Helios Systems. However, the CLIN descriptions reference a "fee" rather than a monthly rental, and we were unable to identify a CLIN specifically associated with the stationary liquid oxygen reservoir required to support liquid oxygen therapy. Please clarify whether these CLINs are intended to represent one-time charges, recurring monthly equipment charges, or another billing methodology.

A. An additional CLIN has been added XX036 for liquid oxygen set-up fees. The existing CLINs, XX011, XX012, and XX019 are for monthly rentals.

Question 2: Please clarify the billing mechanism for the stationary liquid oxygen reservoir and whether it is included within an existing CLIN.

A. See above.

Question 3: Each Liquid Oxygen Per Pound CLIN contains a reference to another CLIN within the pricing schedule. Please clarify the relationship between these CLINs and how they are intended to be billed together, if applicable, so that contractors may accurately price and invoice liquid oxygen services.

A. The liquid oxygen per-pound references back to the monthly rentals of equipment for reach station. The liquid oxygen per-pound CLIN is for the actual usage of liquid oxygen and is billed independently of the monthly rental.

44. 3.3 EQUIPMENT (J)

Ventilator: Used to provide ventilation or ventilation assistance in patients with impaired ventilator drive. The Government must approve any ventilator suggested for use under this contract. The Contractor shall use the same ventilator for all patients covered under this contract.

Question- What brands of Ventilators are currently being used?

A. The contract does not specify a specific brand of ventilator, but they must meet contract specifications and the contractor should deploy the same ventilators for all patients unless otherwise specified by patient’s prescription.

45. 3.3 EQUIPMENT (J8)

Ventilator: The Contractor shall provide water chamber, large bore heated wire tubing, bacterial filters, sterile water and any other adapters, connectors, or interface items necessary for a closed system based on the ventilator in use.

Question: Please clarify the quantities and replacement frequencies for water chambers, heated wire tubing, bacterial filters, sterile water, and related ventilator accessories, as no utilization assumptions were identified for these items within the solicitation.

A. Replacement frequencies for the aforementioned parts/equipment should be in accordance with manufacturer and industry guidelines. All refer to ventilator and compressor supplies. Charge for rental of the compressor/ventilator including all needed equipment listed above.

46. 3.3 EQUIPMENT (K-1)

Cylinders: Heat Moisture Exchange (HME): Used to enhance humidification of inhaled gases by conserving moisture from exhaled gases.

a. The Contractor shall provide the patient or caregiver with enough supplies to change the humidification and moisture exchange device every 24 hours or as needed with two (2) in reserves at all times-thirty (30) day supply. The Humidification and Moisture Exchange Device (MDI) shall include the following:

b.Suction system shall include swivel adapter with Medium Dependent Interface (MDI) port

c. Twelve (12) to fourteen (14) French suction catheters for daily use d.Four (4) Yank Auer tips per month with one (1) in reserve, at all times

e. One (1) resuscitation bag with mask and oxygen tubing to be cleaned by the Patient and/or caregiver every seventh (7th) day, with one (1) in reserve, at all times for continuous ventilation

f. One (1) H or M size oxygen cylinder of oxygen or oxygen concentrator g.One (1) suction pump with suction collection jar and basin. Four (4) collection jars shall be provided per month, or more as necessary.

Question: The heading of this section references "Cylinders" and "Heat Moisture Exchange (HME)"; however, the requirements also include suction equipment and supplies, resuscitation bags, and oxygen cylinders or concentrators. Please clarify the intent of this section and identify the applicable CLIN(s) associated with these requirements, as multiple equipment and supply categories appear to be combined within a single section.

A. Like in question 45, the pieces of the equipment listed herein are peripheral and are covered under global rental fee.

47. 3.3 EQUIPMENT (M-O)

M: Large Volume Nebulizer: Used for aerosolized particle delivery N: High Flow Humidification System: Used for high flow heated molecular humidification.

O: Air Compressor: A high-volume air compressor capable of producing 15 liters of compressed air per minute Question: Please clarify the applicable CLIN(s) associated with this equipment so contractors may accurately price the requirement.

A. Like in question 45 and 46, the pieces of the equipment listed herein are peripheral to 00028, 02028, 08028, and are covered under global rental fee.

48. 4.12 PAYMENT AND INVOICING INFORMATION: (D-i) Invoices shall be sent to the respective VA facilities, using an Excel Spreadsheet format in alphabetical order by full last name, full first name no later than the 10th of each month, as well as a paper hard copy of the invoice in the same package All invoices shall include appropriate paperwork as specified within this contract.

Question: Please clarify whether electronic submission of invoices and supporting documentation is acceptable in lieu of a paper hard copy invoice package.

A. Yes. Electronic submissions are acceptable.

49. 4.13 ELECTRONIC SYSTEM (A)

Contractor shall have one Electronic System into which the VA can access patient information and input orders. Once orders are entered, the Contractor shall be responsible for contacting the specific locations to distribute the orders. If there are problems, the Contractor shall contact the ordering facility. The system shall have a listing of schedule maintenances done and attempts made, for each individual patient.

Question: Please clarify the specific requirements for this system and provide examples of acceptable platforms. Additionally, please clarify whether the VA requires direct order entry into a contractor-maintained system or whether existing order submission methods (e.g., consults, secure email, fax, or other approved methods) satisfy this requirement.

A. The VA requires access to direct order entry, however the VA typically uses secure e-mail or fax to input orders. Current vendor uses E-Intake. The government will not specify which system to use but it must be compliant with all applicable health information protection laws.

50. 4.15 MANDATORY REQUIRMENTS FOR USE OF THERMAL FUSES: (C)

The Contractor shall replace the FIRESAFE™ Cannula devices semiannually (every six (6) months), or if actuated or involved in a fire.

Question- Per manufacturers’ guidelines, Fire Safety Valves are good 4-5 years depending on the brand. Can this be changed to meet manufacturers’ guidelines?

A. No. There are several different sources who cite alternate timelines for these devices. Out of an abundance of caution, the VA prefers to stick with the existing requirement for 6 months.

51. PERMANENT RELOCATION LINS 00014, 08014, 02014

This shall include all supplies, equipment, delivery and coordination for Permanent Relocation Question: Please clarify the reimbursement methodology for permanent relocations requiring services from a third-party oxygen provider. If contractors are required to submit a fixed price for this CLIN, how will the VA reimburse third-party vendor charges that exceed the Contractor's fixed unit price?

A. See answer to question 26 above.

52. LIN 08010 – Demand Nasal Cannula LIN 08010 – Demand Pulse Conserver Fee Question: Please clarify the Jackson pricing schedule, which lists LIN 08010 twice—once for the Demand Nasal Cannula and again for the Demand Pulse Conserver Fee—while LIN 08009 is not listed. Please confirm the correct LIN number for each item.

A. Demand Nasal Cannula should be 08009.