36C25719R0027-0001 Responses to Questions 8 March 2020.pdf

36C25719R0027-0001 Questions and Answers # 1 8 March 2020

Solicitation questions:

1. Page 4, 9, 15, 26,27 F:

Page Section Subject 4 Billing Weekly 9 Billing Monthly 15 Billing Quarterly 26 Billing shall be Weekly or Monthly 27 F Vent Monthly

Q: What is the Billing Schedule? There are multiple annotations;

Answer: Monthly. Billing has been updated in RFP.

2. Page 9, b. Disposable oxygen cannulas on hand for a change once weekly in 4-foot and 7-foot lengths for concentrator and portable cylinders with a one change supply in reserve at all times until the Contractors next scheduled visit based upon prescription and equipment type.

g. FireSafe/FailSafe valves to decrease likelihood of fire if Veteran or family members are smoking around oxygen. Two valves (bi-directional or if uni-directional, the direction of flow clearly indicated) should be provided per oxygen source (concentrator and mobile conserving device) when Veteran is initially set up with home oxygen.

Veteran is to be advised how to remove and reapply the valves when changing their tubing. Replacement valves are to be provided if patient inadvertently disposes of the valves when changing tubing. Re-education shall occur on proper reapplication of the valves when tubing is replaced. This replacement cost will be extended to the VA at CLIN pricing. Valves should last once a year per manufacturer’s literature.

Q: Clarification on Fire Safety Valve and Cannulas with extension tubing; The contract states that cannulas are to be the all in one; cannula and extension tubing format in 4’ and 7’, however the manufacturer’s recommendation is that the Fire Safety Valves go at the source and the patient cannula. Is it the VA’s intent to use the Fire Safety Valves at the source and at the end of the all in one cannulas’ extension tubing of 4’ or 7’?

Answer: No mention of “all-in-one” cannula and extension tubing found in contract. However, Fire Safety Valves are to be placed at both the source and patient end. See updated language in PWS.

Q: The contract also states that the Fire Safety Valve is to be exchanged annually or replaced as needed for damaged or lost. The manufacturer states that they are good for 5 years. Does the VA want to replace items within operational warranty if not lost or stolen?

Answer: Replacement should be supplied when damaged or lost and regularly per manufacturer’s guidelines.

Valves shall be replaced at the end of their expected life per manufacturer’s guidelines or when actuated or involved in a fire. See update language in PWS.

3. Page 11, 9. WORK HOURS The services covered by the contract shall be furnished by the Contractor as defined herein:

At a minimum, Contractor will provide services for Initial Set ups and scheduled visits, Monday through Friday from 8:00 a.m. through 6:00 p.m. Patient visits are required as indicated per clinical prescription and equipment type, unless the Clinical Home Oxygen Coordinator/COR determines a different time is required by their healthcare system.

Page 25, d) The Contractor shall visit beneficiaries' residences in performance of this contract by appointment only, between the hours of 8:00 a.m. and 5:00 p.m., five (5) days per week, exceptions will be made in the cases of emergencies. The Contractor is responsible for scheduling the appointments to the beneficiary’s home 24-48 hours prior to the visit. On each scheduled setup/delivery, the Contractor shall reassess the need to instruct the beneficiary on the use and care of the equipment and supplies as necessary Page 26, 28. The Contractor shall provide a clean, separate and secure storage space located within each healthcare system’s primary service area. The Contractor must protect the territorial integrity of the VA storage area from encroachment. All VA owned items shall be stored in an orderly arrangement to allow for ready access to any item and its components. In addition, the Contractor must, regardless of the size, weight or frequency of shipments have the capability to accept and receipt for respiratory equipment freight deliveries from all sources. Normal delivery hours shall be Monday to Friday, 8:00 a.m. to 5:00 p.m.

Q: Please clarify contractor work hours?

Answer: 8:00 am – 6:00 pm (Updated in PWS)

4. Page 21, b) Contractor must provide staff with documented competency training to deliver prescribed CPAP/BiPAP/NIV/Ventilator/Oxygen respiratory equipment/supplies as required to each beneficiary as needed. All established patients will be visited quarterly for transfill oxygen units and/or portable concentrators and monthly for all other patients and assigned a routine delivery/service day on the same day of the same week as determined by equipment prescribed/provided. The Contractor will schedule home visits within a two-hour window and advise the patient of either morning or afternoon delivery. This notification will be documented in the patient file as well as part of the billing cycle. This is accomplished by telephone contact by the Contractor with the patient prior to each visit to ascertain the needs of the patient. While every effort will be taken to ensure that patients are available for their regularly schedule visits, circumstances beyond the patient’s control may result in a visit that will have to be rescheduled; the Contractor is still required to provide that service, maintenance, replenishment of cylinders and supplies even if it requires making a special or non- scheduled visit to the patient’s home. Prior telephone contact with the patient by the vendor should reduce the number and frequency of the unscheduled visits. Any patient missing two consecutive scheduled visits should be immediately reported to the Home Oxygen Coordinator/COR for follow up. VA will monitor patient compliance and missed scheduled visits. All equipment in the home must be maintained as recommended by the manufacturer. Patient, caregiver, or adult over age 18 years must be available with no “drop off” of equipment/supplies allowed.

Page 14, i. Incident Report – Reporting special incidents found or occurring during a home visit, to include finding patients in need of emergency medical assistance, safety hazards that do not fall into the category of presenting immediate life-threatening danger to the patient or Contractors staff, inability to contact a patient within a reasonable period of time, and any other incident meeting the Contractors written policy for incident reporting according to accreditation standards. Usually includes not switching out supplies as instructed, not using equipment as prescribed, not following no smoking policy, smoke alarms not being present or tested, failure to keep scheduled appointments-two consecutive missed or any other unsafe situation or circumstances counter-productive to the Veteran’s home treatment goals.

Q: Define two consecutive appointments; Would you better define or clarify the “two consecutive missed appointment” statements? Do you mean a patient missing two scheduled appointments in one month (route day visit and rescheduled visit)? Are you meaning two months in a row? Are you meaning two missed appointments in a quarterly visit? (missed, seen and missed or missed, missed, seen)

Answer: Any two scheduled visits, length of time between the scheduled visits does not matter.

5. Page 13, iii. Infection Control/Communicable Diseases – Quarterly report will include data related to the Contractor’s ongoing Infection Control Program, which include recent hospitalizations where a patient was discharged with infectious disease.

Q: Who will notifying us of the infectious? Are we to take a patient’s word that they were just discharged with pneumonia? Is the VA Hospital or discharging hospital going to tell us?

Answer: Recent hospitalization inquiries should be a regular question during the monthly/quarterly visit. If informed by the Veteran as to a hospitalization due to an infectious/communicable disease, the vendor shall notify the VHA immediately. A current list may be provided by incumbent during the transition period, if any.

Language updated in PWS.

6. Page 14, iv. The Contractor shall immediately notify the Clinical Home Oxygen Coordinator of patients who are non-compliant with smoking.

Q: Can you please clarify “noncompliant with smoking”? Are you meaning patients that are smoking, smoking on oxygen, smoking on or off oxygen but around equipment?

Answer: If there is evidence/suspicion that smoking while wearing/near oxygen is occurring.

7. Page 21, b) Contractor must provide staff with documented competency training to deliver prescribed CPAP/BiPAP/NIV/Ventilator/Oxygen respiratory equipment/supplies as required to each beneficiary as needed. All established patients will be visited quarterly for transfill oxygen units and/or portable concentrators and monthly for all other patients and assigned a routine delivery/service day on the same day of the same week as determined by equipment prescribed/provided. The Contractor will schedule home visits within a two-hour window and advise the patient of either morning or afternoon delivery. This notification will be documented in the patient file as well as part of the billing cycle. This is accomplished by telephone contact by the Contractor with the patient prior to each visit to ascertain the needs of the patient. While every effort will be taken to ensure that patients are available for their regularly schedule visits, circumstances beyond the patient’s control may result in a visit that will have to be rescheduled; the Contractor is still required to provide that service, maintenance, replenishment of cylinders and supplies even if it requires making a special or non- scheduled visit to the patient’s home. Prior telephone contact with the patient by the vendor should reduce the number and frequency of the unscheduled visits. Any patient missing two consecutive scheduled visits should be immediately reported to the Home Oxygen Coordinator/COR for follow up. VA will monitor patient compliance and missed scheduled visits. All equipment in the home must be maintained as recommended by the manufacturer. Patient, caregiver, or adult over age 18 years must be available with no “drop off” of equipment/supplies allowed.

c) Depending on type of equipment prescribed/provided, the Contractor will visit the VA beneficiaries to reassess equipment compliance, educational needs, etc. Patients prescribed transfill equipment and/or portable concentrators will be visited quarterly and all other patients with traditional tanks and concentrators will require monthly visits. The Clinical Home Oxygen Coordinator/COR can authorize a different time frame depending on the needs of the healthcare system. Written documentation to be submitted with each patient invoice will include at a minimum the following:

Q: We understand that home visits are to be quarterly for transfill and POC and monthly for all others. To clarify further are you meaning that sleep only, exercise only, cluster headache. oxygen bleed into PAP or ventilator are all to be monthly? As well, prescriptions for tank only, concentrator only, Concentrator with standard tanks, liquid and PAP/Ventilator are to be monthly?

Answer: Patients prescribed transfill equipment and/or portable concentrators will be visited quarterly, patients with traditional tanks will be visited monthly, and all other patients such as sleep only, exercise only, and/or cluster headaches will be seen quarterly. PWS has been updated.

8. Page 22, c) Depending on type of equipment prescribed/provided, the Contractor will visit the VA beneficiaries to reassess equipment compliance, educational needs, etc. Patients prescribed transfill equipment and/or portable concentrators will be visited quarterly and all other patients with traditional tanks and concentrators will require monthly visits. The Clinical Home Oxygen Coordinator/COR can authorize a different time frame depending on the needs of the healthcare system. Written documentation to be submitted with each patient invoice will include at a minimum the following:

• Immediate notification of compliance with switching out supplies.

Q: Would you please clarify this item? Do you mean call from the home or file within 24 hours compliance training report?

Answer: Notification within 24 hours. Updated in PWS.

9. Page 26, 29. Contractor shall have a storefront (storage) facility accessible to the disabled and meeting ADA requirements with regard to wheelchair access to allow Prosthetic Staff, Clinical Home Oxygen Coordinator, VA patients, and/or beneficiaries to pick-up items from the Contractor’s facility when so authorized.

Q: Do you mean that a warehouse location has to have an office area to allow for meetings and pick-up or are you meaning a true retail store front type floor layout/showroom for products & equipment to be displayed?

Answer: A facility meeting the ADA requirements will suffice. PWS updated.

10. Page 6, B.2: Services and Geographic Area; The listing of counties in the PSA for each VA HCS does not exclude the provision of services in other counties. This includes Patients who reside near bordering state’s catchment areas but prefer to be seen by a VISN 17 VA HCS provider.

Q: For patients outside of the VISN 17 catchment, do all time specifications still apply? Can CLIN be added to account for an out of the catchment area delivery?

Answer: Yes, time specifications will still apply. At this time, no CLIN will be added for this low volume need.

11. Page 8: From time-to-time, the number of Veterans served by this contract will change. VISN 17 currently serves an estimated 6,868 oxygen-using patients, an estimated 55 ventilator patients and an estimated 8 non-sleep related

CPAP/BiPAP/NIV/Ventilator/Oxygen patients. The volumes or amounts shown in the solicitation are estimates only.

The Government is not obligated to any specified number of products and/or services but shall be obligated to provide payments for all items/services requested in accordance with the contract. The task orders will be for the actual requirements of the VA as ordered by the VA during the life of the contract. The Contracting Officers

Representative (COR) or designated ordering officers will provide the Contractor with notification to initiate individual beneficiary service requirements, including the beneficiary’s oxygen prescription, ventilator prescription, equipment, supplies, and services to be provided including date and place of delivery. The Contractor will confirm receipt of the request (prescription) within two working hours of notification; the COR or designated ordering officers will also provide notification of VA initiated discontinuance of service. The notification may be made orally but will be confirmed in writing within two (2) working days. The prescription will include the authorizing physician’s signature.;

Q: With the potential of vent patients residing in Texas, Oklahoma and New Mexico is there any way we can obtain specifics of where they are located and how many patients there are to allow us to project necessary RT staffing levels. Do you need me to obtain RT licensure in all three states?

Answer: Due to the progressive nature of some conditions our Veterans are affected by, data around ventilator patients is ever changing and inconsistent. There will be a need for licensure and/or dual licensure in boarding states.

Attachment 7 – Rough Estimate Patient Count has been added for planning purposes.

14. Page 26: 30. The Contractor will account weekly for all VA owned equipment shipped to, stored at and/or set up in the patient’s home. Inventory list shall be legible and formatted to show type of equipment by brand, model, serial/lot number, tag number, condition of the equipment; and quantity on hand as well as issued to patients. This information will be provided electronically to the COR.

Q: Please clarify whether weekly inventory for all VA owned equipment will be the requirement for the new contract?

Answer: Inventory has been updated to monthly. Updated in PWS.

15. Page 28: 35. VEHICLES: The vehicles used in the performance of this contract must be licensed and meet the minimum requirements as mandated by each state/county/city in which performance occurs. Vehicles must bear the Contractors name on the vehicle in such a fashion that the Veteran can identify the Contractors Company and purpose. Contractor employees must wear contractor identification badges.

Q: “Vehicles must bear the contractors name on the vehicle..” Are magnets or stickers acceptable?

Answer: Yes, as long as they are identifiable from a distance such as the home. Clarified in PWS.

16. Page 32: 3. Liquid oxygen system - consists of large reservoir and portable unit that is filled from the reservoir.

Standard reservoir holds 110 pounds of liquid oxygen and portable unit holds 3-5 pounds of liquid oxygen. The standard reservoir weighs 165 pounds full and the portable unit weighs 6-8 pounds full.

Q: Please provide the number of liquid patients in the VISN for cost estimates to service these veterans?

Answer: Estimated to be less than 20 patients VISN wide.

17. Page 5, Section B, B.2 PERFORMANCE WORK STATEMENT;1. VISN 17 desires to establish one or more base year with four one (1) year option period Home Oxygen Indefinite Delivery-Indefinite Quantity (IDIQ) contract(s) for the stations listed below. These contracts will cover VISN 17 as outlined below. No more than one contract per station.

Contracts may include all or some of the stations

Page 8, El Paso, Amarillo, and West Texas VHCS are under a separate contract until 10/31/2021. These facilities will not be active on this contract until 11/01/2021.

Answer: Clarified in PWS. See also “Term of the Contract” on page 34.

Page 93, Section E, E.13, Factor 4, page 93 B.The Government will evaluate the offeror’s ability to successfully perform the services based on demonstrated past and present experience under recent and relevant contracts.

Relevancy is defined as contracts performed in the last three (3) years involving:

• Experience with Home Oxygen Service contracts

• Demonstrated management of experienced/qualified professional staff and administrative support personnel

• Demonstrated ability providing home oxygen services in a large geographical area with at least 5,500 patients.

Page 94, Section E, E.13, Factor 5, S-2 S-2: Demonstrated capability and capacity to effectively and efficiently accept, process and deliver PWS required products/services simultaneously to more than seven (7) customer facilities

Q: The Performance of Work Statement, referenced above, indicate the initial contract award/s will result in a contractor having fewer patients than the stated requirement of 5500. Consider revising.

Answer: Demonstrated ability to meet the needs of the patient population for which the offeror is submitting a proposal for. Updated in proposal.

Q: The Performance of Work Statement, referenced above, also indicates the initial award/s will require a contractor to service fewer customer facilities simultaneously than the seven (7) stated above.

Consider revising.

Answer: RFP Revised.

1.) As the number of patients were published in 2019, are there any updates to the number of patients served – oxygen, ventilator and non-sleep related CPAP/BiPAP/NIV/Ventilator/Oxygen?

Answer: No changes, estimate of volume based on historical data and future growth of the Home Oxygen program

2.) Any updates on Houston being included with the VISN 17 contract?

Answer: Houston is not part of VISN 17 and therefore will not be included.

3.) Are contractors required to have a physical office location near each station listed?

Answer: The Contractor shall provide a clean, separate and secure space located within each healthcare system’s primary service area. These can be strategically located within the catchment area to ensure timely coverage of the service area.

• SF1449 (page 1 of 95) o 8. Offer Due Date/Local 03-09-2020 11:59 PM CST

▪ Q: May the Government consider an extension on the due date based on the timeframe allowed for the questions to be submitted?

ANSWER: Yes – Date shall be extended.

• Patient Estimate (page 8 of 95) o Q: May the Government provide an estimated patient volume for each VA facility, as the “Home

Oxygen Price Worksheet” reflects an estimated quantity of 1 for each CLIN?

ANSWER: Government does not currently have a breakout of all equipment listed in the price worksheet. Attachment 7 – Rough Estimate Patient Count has been added to RFP for additional assistance.

• Home Visits (page 10 of 95):

o 5. Home visits are required when a new patient is enrolled into the VISN 17 Home Respiratory Care

Program. This first visit is referred to as an Initial Set up which should be accomplished immediately but no longer than 24 hours… New Set-Up will include a monthly visit for the first 3 months to ensure patient is compliant with equipment and equipment is working properly.

▪ Q: May the Government please clarify the setup timeframe for Oxygen (Concentrator, POC and LOX) patients?

ANSWER: Within 24 hours for new patients

▪ Q: May the Government please clarify the setup timeframe for Oxygen patients

(Concentrator, POC and LOX)?

ANSWER: Within 24 hours for new patients

▪ Q: May the Government please clarify the follow-up schedule for Oxygen (Concentrators, POC and LOX)?

ANSWER: Monthly after initial set up for the first three months

▪ Q: May the Government please clarify if the monthly visits for the first 3 months are only for patients provided with a trans-fill unit, or is it intended for all home oxygen patients provided with a concentrator regardless of a trans-fill unit?

ANSWER: Intended for all new set-ups

▪ May the Government please confirm oxygen transfill and portable concentrators are to be serviced quarterly for maintenance visits?

ANSWER: Quarterly

▪ May the Government please confirm tank resupply and oxygen concentrator patients are to be serviced monthly?

ANSWER: Monthly

▪ May the Government please confirm PAP and Ventilator patients are to be serviced monthly?

ANSWER: Monthly o 6. Home visits are required by a Respiratory Therapist when a new ventilator and/or

CPAP/BiPAP/NIV/Ventilator/Oxygen patient is identified. The first visit is referred to as Initial Set up which should be accomplished immediately but no longer than 4 hours…

▪ Q: May the Government please clarify if the initial setup visit within 4 hours is intended for

Ventilator and/or patients requiring both PAP and Ventilator services?

ANSWER: Either requires 4 hours for initial setup

▪ Q: May the Government please clarify if Oxygen is to be setup within 4 hours as it contradicts Section (5) above?

ANSWER: Oxygen only is 24 hours. See updated language in PWS.

▪ Q: May the Government please clarify follow-up schedule for CPAP/BiPAP/NIV Ventilator patients?

ANSWER: Follow up will occur between Contractor and patient or caregiver 24 hours after set-up, 72 hours after set-up and one week after initial set up.

▪ Q: May the Government please clarify the setup timeframe for CPAP/BiPAP/NIV Ventilator patients?

ANSWER: 4 hours for initial setup

• 17. Discontinuation of Service (page 18 of 95):

o c. Patients relocating out of VISN 17’s primary service area will be allowed to take all equipment, cylinders and supplies with them to their new place of residence…The Contractor will coordinate with the local Contractor in the new area for the return of Contractor owned equipment, shipping and related charges at no additional cost to the government…

▪ Q: May the Government please provide clarification on the relocation process to follow when a patient has Government Owned equipment?

ANSWER: Same for Government as Contractor owned.

• 20. Equipment Specifications (page 21 of 95) o Government-owned equipment will be terminally cleaned, maintained and repaired by Contractor.

COR will be notified when VA owned equipment can no longer be repaired.

o CLIN 0023, 0024, 0031 and 0032: …send equipment back to manufacturer or authorized repair source…

▪ Q: May the Government please confirm Contractor will be required to do repairs?

ANSWER: Contractor will be required to repaired by contractor. When capabilities exceed in-house capabilities, third party repair may be requested. See PWS for details.

CLINS updated to reflect minor/complex repairs. In addition, new CLIN added for complex repairs.

▪ Q: May the Government please define the type of “repair” work to be completed by

Contractor for all Government owned equipment, or if it is to be sent to the manufacturer for repairs?

ANSWER: See updated language in PWS.

▪ Q: May the Government consider adding a CLIN for repair work to be completed?

ANSWER: Fair and reasonable quotes shall be submitted for repairs prior to work for approval.

• 23. Traveling Patients (page 23 and 24 of 95) o a) The Contractor shall be responsible for coordinating all services for Veterans who travel outside jurisdiction of this contract.

▪ Q: May the Government please clarify if this includes travel outside of the continental U.S.

(i.e. Hawaii, Alaska, Puerto Rico, etc.)?

ANSWER: Yes. Contractor will need to work with patient for travel needs.

o b) Privately owned vehicles – The Contractor shall assist the Veteran in preparing a travel plan, identify locations, etc. (logistics) along Veteran’s route where oxygen refills can be obtained and coordinate billing for services and refills as appropriate. There shall be no fee for this logistical service.

▪ Q: May the Government please clarify if the billing for services and refills incurred by the patients during their travel via vehicles, is to be reimbursed by the Government to the

Contractor, or if the patient is liable for payment?

ANSWER: Cost will be initially incurred by the vendor and billed to the VA under the existing line items for any particular equipment needed.

o e) …The Contractor shall keep on file the latest prescription for oxygen. Upon return, beneficiaries shall be responsible for contacting the Contractor to re-establish oxygen services. The Contractor shall immediately notify the COR or designated ordering officers of the beneficiary’s return.

▪ Q: May the Government please clarify if its intent is for the patient to leave their Government owned equipment at their primary residence when traveling to a temporary residence?

ANSWER: Whatever is most economical for the government and beneficial for the

Veteran. Should a portable be approved by the VA, it will be charged to the appropriate line item.

▪ Q: May the Government please clarify if the Contractor is to provide Contractor owned equipment at the patient’s temporary residence, even if a Contractor owned physical location is not available?

ANSWER: No, but contractor is responsible for working with a local company to provide necessary equipment and/or supplies during the Veteran’s stay which shall be billed under the travel expense line item.

• 24. Patient Education Requirements (page 25 of 95) o d) The Contractor shall visit beneficiaries' residences in performance of this contract by appointment only, between the hours of 8:00 a.m. and 5:00 p.m., five (5) days per week… o 9. Work Hours (page 11 of 95)

▪ At a minimum, Contractor will provide services for Initial Set ups and scheduled visits, Monday through Friday from 8:00 a.m. through 6:00 p.m.

• Q: May the Government please clarify the hours for services to be rendered?

ANSWER: 8:00am to 6:00 pm. Updated in RFP.

• Equipment Descriptors (pages 30-34 of 95) and all CLIN o Q: May the Government please clarify if it has already purchased the equipment to be utilized for the contract?

ANSWER: Yes, equipment has been purchased or will be purchased.

o Q: If the equipment has not yet been purchased, may the Government please advise when it anticipates purchasing the equipment?

ANSWER: N/A

o Q: May the Government please provide an estimated quantity of VA Owned equipment vs.

Contractor Owned equipment to be utilized?

ANSWER: Quantities very depending on location and current contracts. West Texas facilities still under a separate contract do not utilize VA owned equipment at this time. The majority of the volume at the other four locations under a different contract utilize VA owned equipment.

o Q: May the Government please provide the make/model of the VA Owned equipment to be provided?

ANSWER: Current models are UltraFill units, however, these will be replaced in the near future. New models are unknown at this time.

• Attachment 6 – Sample Task Order o Q: May the Government please clarify if Fire Safe Cannulas will be billed as a separate CLIN

(currently not listed separately)?

ANSWER: Fire Safe Thermal Fuses added to CLIN 0025

• Instructions to Offers – Technical Factors Information (page 89):

o T-2: Provide home oxygen/ventilator equipment services which meets all applicable

Standards/Specifications identified in the PWS

▪ Q: May the Government please clarify if the intent for this response should consist of a listing of Contractor owned equipment that may be utilized under the performance of this contract, if awarded? Or, should this response include details of how the Contractor will provide the services to be completed in accordance to the PWS?

ANSWER: Response should include details of how the Contractor will provide the services to be completed in accordance to the PWS.

1. Page 8 – “VISN 17 currently serves an estimated 6,868 oxygen-using patients, an estimated 55 ventilator patients and an estimated 8 non-sleep related CPAP/BiPAP/NIV/Ventilator/Oxygen patients.”

Question: Please provide the number of oxygen patients per VA HCS in VISN 17. As we plan for the required personnel, facilities, vehicles, oxygen equipment, etc… it is vital to have accurate information. It would be better if you simply put the estimated quantities on Attachment 1 Home Oxygen Price Worksheet.

Answer: The RFP states, “VISN 17 currently serves an estimated 6,868 oxygen-using patients, an estimated 55 ventilator patients and an estimated 8 non-sleep related CPAP/BiPAP/NIV/Ventilator/Oxygen patients.” This is the most current estimated quantity of Veterans serviced. This is a revolving number and will change regularly based on Veteran needed.

2. Page 18 – c) The Contractor will provide COR or designated ordering officers with a list of all Employees currently competent to perform licensed respiratory therapy services, delivery/recovery and patient education services at the time the contract is awarded. COR or designated ordering officers will inspect employee files at the time of the inspection of Contractor premises and vehicles.

Question: How much time will be provided after contract award to produce these files? Or, are these files due before the contract award?

Answer: Within 90 days after award during transition period if applicable.

Question: When will this inspection take place? Before or after contract award?

Answer: Within 90 days after award during transition period if applicable.

3. Page 24 - All patient education material must be presented in written form to the COR for approval prior to the award.

Question: Is this to be submitted in the proposal? Or will this be requested from the apparent awardee prior to contract award?

Answer: With the proposal for review. Added as T-11 under Factor 2: Technical Capability.

4. Page 25 - 25. DEMURRAGE CHARGES: The Contractor agrees to provide cylinders without assessing demurrage charges on the Government. The Contractor further agrees that the free loan period of cylinders is indefinite but shall not exceed the term of the contract.

Question: Please clarify what the free loan period of cylinders is referring to.

Answer: Loan period includes length of contract.

5. Page 89: T-10: Provide a clear, logical transition plan per the PWS. The plan shall address the offeror’s coordination with the incumbent contractor during the transition period relating to the removal of the incumbent contractor’s equipment from the Patient residences. The plan shall include delivery, setup, and instruction, and shall be accomplished without disruption in ALL ENCOMPASSING services to the veteran or the

VA. The plan shall note the proposed transition methodology/process date of each beneficiary, to include the transfer of responsibility regarding Government Furnished Equipment (GFE) (if applicable) as well as the transition date of all GFE currently in possession of the incumbent contractor.

Question: Without having specific information on every patient currently being serviced on the current contract we will not be able to provide a transition date of each beneficiary in our transition plan. Consider revising this requirement.

Answer: Requirement for a “date” has been removed. Attachment 7 – Rough Estimate Patient Count has been added to assist in planning for a potential transition.

6. Page 93 – Past Performance - D. To be determined technically acceptable, offeror must provide evidence to support at a minimum a “Satisfactory Confidence” rating meaning that based on the offeror’s recent/relevant performance record, the Government has a reasonable expectation that the offeror will successfully perform the required effort.

Question: What are the possible performance confidence ratings?

Answer:

Rating Description

Substantial Confidence

Based on the offeror’s recent/relevant performance record, the Government has a high expectation that the offeror will successfully perform the required effort.

Satisfactory Confidence

Based on the offeror’s recent/relevant performance record, the Government has a reasonable expectation that the offeror will successfully perform the required effort.

Limited Confidence Based on the offeror’s recent/relevant performance record, the Government has a low expectation that the offeror will successfully perform the required effort.

No Confidence Based on the offeror’s recent/relevant performance record, the Government has no expectation that the offeror will be able to successfully perform the required effort.

Unknown Confidence (Neutral)

No recent/relevant performance record is available or the offeror’s performance record is so sparse that no meaningful confidence assessment rating can be reasonably assigned.

Question: What “evidence” will support a minimum of a “Satisfactory Confidence” rating?

Answer: Past experience, staffing, overall technical proposal, etc. as outlined in the RFP. See evaluation factors and submission instructions.

Question: Is a Neutral Confidence rating considered technically acceptable?

Answer: As stated in page 93 under paragraph “D”, to be determined technically acceptable, offeror must provide evidence to support at a minimum a “Satisfactory Confidence” rating meaning that based on the offeror’s recent/relevant performance record, the Government has a reasonable expectation that the offeror will successfully perform the required effort.

7. Page 93 - S-1: Historical demonstrated ability to retain Key Personnel more than 24 months after contract awards

Question: In the eyes of the VA, what personnel do you consider Key Personnel?

Answer: Lead management of the company – CEO, CFO, Branch Manager, etc. RFP updated.

8. Page 94 - S-2: Demonstrated capability and capacity to effectively and efficiently accept, process and deliver

PWS required products/services simultaneously to more than seven (7) customer facilities.

Question: What is required from the contractor in order to demonstrate capability and capacity to effectively and efficiently accept, process and deliver PWS required products/services simultaneously to more than 7 customer facilities?

Answer: It is up to the contractor to outline within the proposal how they will meet all requirements of the PWS to meet the needs of the amount of patients’ offeror is proposing to support. Language in this section has been updated.

Question: What does the VA consider "customer facilities"? are CBOCs also considered customer facilities?

Answer: Yes

9. Page 94 - S-3: Ability to deliver all PWS requirements in new market areas.

Question: What does the contractor need to provide in order to show ability to deliver all PWS requirements in new market areas?

Answer: It is up to the contractor to outline within the proposal how they will meet all requirements of the PWS to include new market areas as a result of patient expansion within the VISN 17 AOR.

10. Page 94 - S-4: Capability to provide adequate staffing in rural areas.

Question: What does the contractor need to provide in order to show capability to provide adequate staffing in rural areas?

Answer: It is up to the contractor to outline within the proposal how they will meet all requirements of the PWS and ensure adequate staffing in rural areas.

11. Page 93 - Special standards of responsibility are unique experiences that have demonstrated unusual expertise or specialized facilities that are needed for adequate contract performance (per FAR 9.104-3). For an Offeror to meet this standard, Offerors shall include supporting documentation to show that they meet the requirements of FAR Part 9.104-1 and the below mentioned FAR Part 9.104-2, Special Standards:

Question: Please clarify if offerors shall include supporting documentation to show that they meet the requirements of FAR Part 9.104-1 AND the below mentioned FAR Part 9.104-2, Special Standards. I have included FAR Part 9.104-1 below for quick reference:

9.104-1 General standards.

To be determined responsible, a prospective contractor must-

(a) Have adequate financial resources to perform the contract, or the ability to obtain them (see 9.104-3(a));

(b)Be able to comply with the required or proposed delivery or performance schedule, taking into consideration all existing commercial and governmental business commitments;

(c) Have a satisfactory performance record (see 9.104-3 (b) and subpart 42.15). A prospective contractor shall not be determined responsible or nonresponsible solely on the basis of a lack of relevant performance history, except as provided in 9.104-2;

(d) Have a satisfactory record of integrity and business ethics (for example, see subpart 42.15);

(e) Have the necessary organization, experience, accounting and operational controls, and technical skills, or the ability to obtain them (including, as appropriate, such elements as production control procedures, property control systems, quality assurance measures, and safety programs applicable to materials to be produced or services to be performed by the prospective contractor and subcontractors). (See 9.104-3(a).)

(f) Have the necessary production, construction, and technical equipment and facilities, or the ability to obtain them (see 9.104-3(a)); and (g)Be otherwise qualified and eligible to receive an award under applicable laws and regulations (see also inverted domestic corporation prohibition at 9.108).

Answer: Offerors shall provide supporting documentation to show they meet both FAR Part 9.104-1 and the Special Standards listed under Factor 5 on page 93 and 94.

12. Attachment 6 – Sample Task Order

Question: For each of the 8 items on Attachment 6 – Sample Task Order, please provide the associated line item number from Attachment 1 – Home Oxygen Price Worksheet. For some items it’s unclear which line item numbers they are associated with.

Answer: Sample Task order removed and replaced with Attachment 7 – Historical Data.

Question: For contractors that price each facility differently on Attachment 1 – Home Oxygen Price Worksheet, please provide instructions on completing Attachment 6 – Sample Task Order.

Answer: Sample Task order removed and replaced with Attachment 7 – Historical Data.

13. Attachment 1 – Home Oxygen Price Worksheet, Line item 33 - Transition Phase-In/Phase-Out Services IAW

52.237-3 Continuity of Services: Costs associated with transitioning from incumbent contractor to new contractor. While not an all inclusive list, items to consider are equipment transfers, inventory transfers, recruitment, background/badging, training, etc.

Question: Please clarify that offerors will be able to charge this line item for each VHCS they are awarded.

Answer: Description clarified to reflect overall cost for each station.

14. Attachment 1 – Home Oxygen Price Worksheet, Line item 7 - Rental portable concentrator system (compressed gas source) shall provide a minimum of 92% (+/-3%) oxygen concentration at all flow settings. Weight <20 lbs. w

Power. FAA approved for flight.

Question: a portable concentrator system is a battery powered concentrator, not a compressed gas source. Consider revising.

Answer: Revised Price Worksheet to remove “compressed gas source”.

15. Please clarify that contractors have the option to not bid every VHCS listed in the solicitation. In other words, can we bid on just one VHCS location if we choose to do so?

Answer: Section B.2 (1) on page 5 has been updated to reflect clarification.

16. If contractors have the option to not bid every VHCS listed in the solicitation, then the estimated quantities on

Attachment 6 – Sample Task Order will be incorrect. What are the instructions for completing Attachment 6 –

Sample Task Order if you are bidding less than the entire VISN?

Answer: Sample Task order removed and replaced with Attachment 7 – Historical Data.

17. Page 88 - Factor 2: TECHNICAL CAPABILITY - The Offerors technical proposal response will primarily determine the acceptability or unacceptability of technical, business and management qualifications, capabilities and capacity to furnish the services called for by this solicitation. It should be specific, complete and comprehensive in every detail. The proposal should be concise and provide sufficient information to demonstrate the offeror’s capacity to satisfactorily perform the tasks outlined in the PWS. The Government will review responses to this solicitation to ensure Offerors have addressed the requirements outlined in the PWS and the responses are adequate/sufficient in detail and clarity to allow the Government to determine whether the Offerors services and technical and management approach are acceptable. The response shall be concise, thorough and describe the processes, procedures and methodologies to be used to accomplish, at a minimum, the below mentioned

Solicitation/Performance Work Statement requirements.

Question: “and the responses are adequate/sufficient in detail and clarity to allow the Government to determine whether the Offerors services and technical and management approach are acceptable” - Please define what the VA is considering adequate/sufficient in detail and clarity. In other words, complete the following sentence. To be determined technically acceptable for Factor 2 Technical Capability, offeror must provide… Or if you prefer, complete the following sentence instead, Technical Acceptability Standards are met when… Answer: It is up to the contractor to outline within the proposal how they will meet all requirements of the PWS.

Criteria considered are items such as past experience, staffing, etc. as outlined in proposal from contractor

18. Page 89 - Factor 3: QUALITY CONTROL PROGRAM - The offeror’s QC program will be evaluated for relevance, depth, and the degree to which major QC program elements address the requirements set forth in the PWS.

Programs must be certified to a recognized industry standard. The offeror’s QC program will be evaluated to determine whether the plan was developed to provide for an understanding of the Government’s needs, as well as the degree to which the offeror understands quality control and quality control techniques.

Question: It is very unclear how contractors will be found technically acceptable for this Factor. Please complete the following sentence. To be determined technically acceptable for Factor 3 Quality Control Program, offeror must provide… Or if you prefer, complete the following sentence instead, Technical Acceptability Standards are met when… Answer: It is up to the contractor to outline within the proposal how they will meet all requirements of the PWS.

Criteria considered are items such as past experience, staffing, etc. as outlined in proposal from contractor

19. Page 90 - Factor 4: PAST PERFORMANCE -

The Government will evaluate the offeror’s ability to successfully perform the services based on demonstrated past and present experience under recent and relevant contracts. Relevancy is defined as contracts performed in the last three (3) years involving:

• Experience with Home Oxygen Service contracts

• Demonstrated management of experienced/qualified professional staff and administrative support personnel

• Demonstrated ability providing home oxygen services in a large geographical area with at least 5,500 patients.

Question: Given the fact that upon contract award only 4 of the 7 VHCS regions will be required to transition, relevancy of contractors past performance should be evaluated lower than the 5,500 listed here. I request the last bullet to be rewritten as follows:

• Demonstrated ability providing home oxygen services in a large geographical area with at least 4,000 patients.

Answer: Demonstrated ability to meet the needs of the patient population for which the offeror is submitting a proposal for. Updated in proposal.

20. How many days after posting the answers to our questions will we have to submit follow-on questions?

Answer: Follow-on questions will be due no later than 12:00 PM CT on March 12, 2020 for any changes made as a result of the questions only. Please review the questions and answers, the highlighted portions of the RFP and any updated documents. No questions will be allowed on any other aspect of the RFP as those questions should have been received by February 21, 2020 NLT 5:00 PM CST.