36C25726Q0488 0002.pdf

5. PROJECT NUMBER (if applicable)

CODE 7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER 3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO. 1. CONTRACT ID CODE

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Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office. is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER 16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30 PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243

(Type or print) (Type or print)

(Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code)

(If other than Item 6)

(Specify type of modification and authority)

(such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer)

1 48

None

36C257

Department of Veterans Affairs Network Contracting Office (NCO) 17 Central Texas Veterans HCS 1901 Veterans Memorial Dr.

Temple TX 76504

36C257

Department of Veterans Affairs Network Contracting Office (NCO) 17 Central Texas Veterans HCS 1901 Veterans Memorial Dr.

Temple TX 76504

To all Offerors/Bidders

36C25726Q0488

X

X X

** HOUR & DATE for Receipt of Offers is EXTENDED to: 06-12-2026 10:00 CDT

See CONTINUATION Page

1. The purpose of this amendment is to post answers to questions submitted by vendors.

2. See attached Consolidated Questions document with answers included.

3. See attached revised Price/Cost Schedule.

4. See attached revised Statement of Work (SOW).

5. See attached revised Instructions to Offerors.

6. Quotes are due No Later Than 6/12/2026 at 10:00 AM CST via email only to jennifer.stringer@va.gov.

Jennifer Stringer Contracting Officer

CONTINUATION PAGE

Questions from Vendors RE Solicitation 36C25726Q0488

El Paso Home Oxygen 8-month Bridge

QUESTION SET 1:

May we have the last 2 historical awards for this contract, please?

*Note: CO to provide previous contract documents as amendments.

QUESTION SET 2:

Pg. 7 of 80

• VISN 17 currently serves an estimated 3,000 oxygen-using Patients. The volumes or amounts shown in the Contract Line-Item Numbers (CLINS) are estimates only and impose no obligation on the VA.

o Q: May the Government please provide clarification on the volume expected for the El Paso VA facility?

VISN 17 currently serves an estimated 3,000 oxygen-using patients. The volumes or amounts shown in the Contract Line-Item Numbers (CLINS) are estimates only and impose no obligation on VA. As of today, we have 900 O2 patients, we estimate roughly 1200 in total; estimate 300 new patients.

• Evaluations shall occur prior to discharge from the hospital. The results of the evaluation will be provided to the local VA Prosthetics Department, who will then notify the COR, Patient, and Contractor.

o Q: Is it the Government’s intent for the contractor to complete a home evaluation for every home oxygen patient, prior their hospital discharge? Yes, Contractor shall have a policy statement and program in place for patient evaluation. VA medical staff evaluation is required to ascertain if the Contractor is able to care for each individual patient and determine if that patient is suitable for care in a home setting, immediate a home setting. Evaluations shall occur prior discharge from the hospital. The results of the evaluation will be provided to the local VA Prosthetics Department, who will then notify the COR, Patient, and Contractor. Initial setup(s) for Home Oxygen Patients and Ventilator Patients shall be performed by the Contractor’s certified respiratory therapist (CRT) or registered respiratory therapist (RRT) or Registered Nurse (RN) that is licensed in accordance with the governing standards of where the services are to be provided. A qualified service technician can be substituted for a CRT, RRT or RN for the set-up of Home Oxygen only. Staff performing ventilator setup shall arrive at the home 1 hour from the receipt of evaluation (preferably before the patient arrives) and shall perform ventilator setup immediately upon patient and caregiver arrival. Caregiver education shall be provided by the Contractor on the specific supplies or equipment required by evaluation and performed prior to discharge and concurrently with setup. Setup of Home Oxygen includes setting up and ensuring the appropriate oxygen system is operational, instruction and training of patient and/or caregiver, and home environment safety check.

Pg. 8 of 80

• 2.3 Ongoing Services o ii. Home visits shall be performed within 72 hours of setup and quarterly by the RRT/CRT/RN for all Patients that utilize home oxygen services.

Q: May the Government please confirm the 72 hour follow up visit by an RT is required only if a technician completed the home oxygen setup? Confirmed: Home visits shall be performed within 72 hours of setup and quarterly by the RRT/CRT/RN for all Patients that utilize home oxygen services.

Pg. 10 of 80

• H. The Contractor shall bill for mileage required for services on a rate-per-mile basis according to the following criteria… o Q: May the Government please confirm the Contractor may bill for a trip charge for every service that is completed to the patient’s residence (i.e. New setup, routine delivery, etc.)? This is correct.

• J. The Contractor shall coordinate any modifications or preparations… o iii. Marking the circuit breakers and fuses

Q: May the Government please consider removing this requirement from the SOW, as an electrician is required to complete the marking of circuit breakers and fuses? DME providers do not hold this certification. This is to be removed, as items such as these are on the veteran’s responsibility for home maintenance.

• 2.10 Patient Travel o 1. The Contractor shall coordinate all home oxygen and durable medical equipment with incidental services for veterans who travel within the geographical area covered by this contract.

Q: The SOW does not include durable medical equipment (i.e. hospital beds). May the

Government please clarify the equipment being referenced in this statement? Durable Medical Equipment (i.e. hospital beds) to be taken off SOW. Currently, focusing only on Home O2 services/Ventilators and equipment.

o 3. The Contractor shall provide equipment setup by the Contractor’s licensed CRT/RRT/RN at designated travel destinations for Veterans receiving care at a covered geographic area within VISN 17.

Q: A clinician is not utilized for travel services as this may be subcontracted to a provider who will not have a clinician as it is not required by the state. May the Government consider updating this to state “The Contractor shall provide equipment setup by the Contractor’s technician at designated travel destinations for Veterans receiving care at a covered geographic area for El Paso. “The Contractor shall provide equipment setup by the Contractor’s licensed CRT/RRT/RN, or designated tech.”

Pg. 16 of 80

• 2.16 Contractor Visits o 4. Slacks or khakis shall be worn. Blue jeans are not allowed.

May the Government please reconsider allowing the use of blue jeans? Slacks or khakis can easily be damaged due to the equipment being delivered by the technicians. When conducting home visits the Contractor’s representatives shall present a professional appearance and adhere to the following as a minimum:

1. An ID badge shall be affixed to clothing above the waist with the Company name, employee name, and photograph to the front and clearly visible.

2. Shoes shall be clean and in good condition (open toe shoes are not acceptable).

3. Shirts, blouses, etc. shall be uniform and contain the companies name and/or logo.

4. Slacks, khakis, or jeans shall be worn. Must be free of rips, frays, distressing, and whiskering.

5. Mid-calf dress slacks or trousers shall not be denim, reveling, provocative, spandex or similar tight-fitting fabrics

6. Socks, stockings, or hosiery shall be worn at all times.

7. Skirts shall be at or below knee length.

Pg. 19 and Pg. 20 of 80

• 2.24 Periodic Performance Review Report o The Contractor shall provide a written, quarterly report addressing all Joint Commission Standards for improving organizational performance (The Joint Commission standards may be accessed at www.JointCommission.org ).

• 2.28 Performance Improvement Report o The Contractor shall collect, trend, and report on important processes and outcomes data related to Patient care and organizational functions to the COR or designee on a quarterly basis for each contract performance period via encrypted email and fax. The quarterly report is due to the COR within the 5th working day at the conclusion of the quarter.

Q: May the Government please clarify if the Performance report is to be provided quarterly or annually? This report is to be sent quarterly.

Pg. 22 of 80

• h. FIRESAFE™ Cannula from LifeGas (this item will be provided to the Contractor by the VAMC):

o Q: May the Government please confirm the FIRESAFE Cannula valves will not be borne from the

Contractor owned inventory? This item has not or is not provided by the VAMC. We are billed with all other equipment issued to patients.

Pg. 25 of 80

• 3.9 Oxygen Cylinder Refill Stations o Q: May the Government please confirm a maximum of two (2) self-fill cylinders are to be provided with each system? Depending on the Liter Flow in the prescription, it should be max of 6, with provided replacement tanks per visit.

Pg. 26 of 80

• 3.14 Government Owned Equipment The Contractor shall return Government-owned equipment to the VA in terminally cleaned condition for repairs, replacement, or disposal as appropriate. Government furnished equipment shall be handled in accordance with FAR 52.245-1 Government Property.

o Q: May the Government please clarify what Government Owned Equipment is expected for this short-term bridge contract? There is to be no Government Owned Equipment for this contract. All equipment is to be vendor owned.

Pg. 36 – 45 of 80

• Quantities reflect “8” per CLIN o Q: May the Government please clarify the quantities for all line items, as this may assist the Contractor in providing an accurate proposal. Answer: Unit for those CLINs is MO for Months, so each CLIN reflects 8 Months of whatever service/delivery is stated on the CLIN.

• Item 0003 Rental portable concentrator setup with backup system consisting of compressed gas source, regulator, stand (nasal cannula or mask and humidifier, when specified.) Concentrator shall have a flow rate capacity up to

10LPM

o Q: This line item appears to be a duplicate of Item 0002. May the Government please confirm if this is a separate requirement? Answer: CLINs 0002 and 0003 were copied from the previous contract (36C25723D0059) and should read as follows:

o 0002 with HCPCS E1390 is for a stationary concentrator which offers a liter flow of up to 10

LPM.

o 0003 appears to have the incorrect HCPCS. It should be HCPCS E1392 for a portable oxygen concentrator.

• Item 0004 Rental Portable Concentrator System consisting (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 o Q: May the Government please clarify this requirement, as a POC is not a compressed gas source?

Compressed gas is provided via a cylinder/tank. Portable Oxygen Concentrator is battery operated.

Portability is to be the compresses gas cylinders with conserving device. See revised Price/Cost Schedule.

• Item 0005 Rental Self-Filling Oxygen Concentrator: Single piece concentrator with capability to refill portable oxygen cylinder.

o Q: May the Government please confirm a maximum of two (2) self-fill cylinders are to be provided with the system? Yes. Only for Liquid O2 patients. See revised Price/Cost Schedule.

• Item 0009 to 0012 o Cylinder, size refill for A0008 above. Aluminum (or metal of equivalent weight) tanks required.

Q: May the Government please consider updating to state “Cylinder, size refill for A0007 above.

Aluminum (or metal of equivalent weight) tanks required” as the items 0009 to 0012 are for use with the rental of the portable system. Change to be made as suggested. See revised Price/Cost Schedule.

Q: May the Government please confirm line items 0009 to 0012 are to be billed as a unit of “EA” (each) and not as a unit of “MO” (month)? It should read as “EA” as this is how we accept in system. See revised Price/Cost Schedule.

• Item 0020 Nebulizer Compressor with four handheld nebulizers o Q: May the Government please confirm if the nebulizer provided will be borne of the contractor or delivered from VA stock? Nebulizers are provided directly by the VA to the Veteran from VA stock. The vendor will not be responsible for delivering nebulizers. Item 20 will be removed from Price/Cost Schedule. See new Price/Cost Schedule attached. See revised Price/Cost Schedule.

• Item 0024 Liquid oxygen per pound o Q: May the Government please confirm the line item is to be billed as unit of “EA” (each) and not as a unit of “MO” (month)? It should read as “EA” as this is how we accept in system. See revised Price/Cost Schedule.

• Item 0030 Contractor Setup VA Provided CPAP/BIPAP (new) (DME Delivery).

o Q: May the Government please clarify the setup timeframe for the VA Owned PAP equipment, as this is not outlined in the SOW? This is to be removed, as CPAP is provided directly from VA owned stock, and VA staff evaluating patients. See revised Price/Cost Schedule.

• Item 0031 Semi Annual RT/RN Assessment & Maintenance of CPAP/BIPAP.

o Q: May the Government please clarify the requirements for the visit of the VA Owned PAP equipment, as this is not outlined in the SOW? This is to be removed, as CPAP is provided directly from VA owned stock, and VA staff evaluating patients. See revised Price/Cost Schedule.

• Item 0032 Set up Contractor Owned CPAP/BIPAP Setup (new) (DME Delivery).

o Q: May the Government please clarify the setup timeframe for the Contractor Owned PAP equipment, as this is not outlined in the SOW? This is to be removed, as CPAP is provided directly from VA owned stock, and VA staff evaluating patients. See revised Price/Cost Schedule.

o NOTE: CPAP/BIPAP items will be taken out of the SOW, solicitation, and Price/Cost Schedule as the VA sets CPAP/BIPAP up within the clinic or remotely.

• Item 0033 Suction Machine Invacare.

o Q: May the Government please clarify the setup timeframe for the Suction Machine, as this is not outlined in the SOW? Remove line item as suction machines are provided by outside source, and same day access is provided.

o Q: May the Government please clarify if the unit provided is borne of the contractor or Government? N/A o Q: If borne of the Government, please clarify if this line item is to be used as a delivery fee and the billable unit is an “EA” (each)? Item being removed.

o See revised Price/Cost Schedule.

• Item 0035 to 0038 “Trip Charge Areas” o Q: May the Government clarify if the delivery and pickup of government owned DME: beds, wheelchairs, walkers and lifts, included in this contract? It is our understanding that the current provide does DME, but DME is not included on this contract other than this trip charge. Please clarify the plan for DME under this contract? DME outside of Home O2 and/or Ventilators is to be taken out of this contract.

• Item 0039 Labor Rate per Hour o Q: May the Government please clarify the intent of this line item, as this line item is typically only used for the repair of Government Owned Equipment. Is the repair of government owned equipment included in this contract? This item will be removed; this can be taken off contract as we have other resources for this. See revised Price/Cost Schedule.

• TAA-Made in America o Can you please confirm the VA only wants TAA compliant or USA made concentrators and ventilators used for this contract. Both TAA and USA made.

QUESTION SET 3:

1. SOW 2.1 VETERANS SERVED: “VISN 17 currently serves an estimated 3,000 oxygen-using Patients.”

o Question: How many Home Oxygen Patients and how many Ventilator patients are serviced under this solicitation for just the El Paso VAMC? As of today we have 900 O2 patients, we estimate roughly 1200 total; estimate 300 new patients.

2. Both Government owned equipment and VA owned equipment are listed in the SOW.

Question 1: Can we please have a breakdown on the number of home oxygen patients and the number of ventilator patients that are on government owned equipment? For this contract, all ventilator and oxygen patients are on contractor-owned equipment. No patients have government owned O2/ventilators. For home oxygen patients, we also need to know the number of patients on 5 lpm concentrators, 10 lpm concentrators, homefill systems, liquid systems, etc… There is equipment for 900 oxygen patients and about 300 ventilator patients. This number will vary (at least monthly); Liter flow per patient varies from 2 liters/min and up.

Question 2: In the past I believe this contract mainly was to service VA-owned equipment. Very little equipment was contractor-owned. Is the government in the process of switching from a VA-owned equipment model to more of a Contractor-owned model? The El Paso contract is not the same as the rest of the VISN. All oxygen and ventilator equipment is contractor-owned.

3. SOW – “H. The Contractor shall bill for mileage required for services on a rate-per-mile basis according to the following criteria:

a. Trip Charge Area A: 0-50 miles from nearest Contractor office

b. Trip Charge Area B: 51-100 miles from nearest Contractor office

c. Trip Charge Area C: 101-200 miles from nearest Contractor office

d. Trip Charge Area D: 200+ miles from nearest Contractor office”

Question: Please provide clarity on when we will bill for mileage. Is it for any trip or delivery to a patient’s home, scheduled or unscheduled? Answered previously. Previous answer recorded here.

o Q: May the Government please confirm the Contractor may bill for a trip charge for every service that is completed to the patient’s residence (i.e. New setup, routine delivery, etc.)? This is correct.

4. SOW - 2.4 PERIODIC EQUIPMENT EVALUATION: “The Contractor shall have a CRT/RRT/RN visit the Patient to reassess equipment compliance and educational needs for Home Oxygen Patients at least once every 90 days and once every 30 days for Patients on ventilators”

Question: Is this performance requirement to be billed under line item 0026 – “Additional Certified Respiratory Therapist (CRT) Registered Respiratory Therapist (RRT) or Registered Nurse (RN) visit.”? If not, then how will we bill for the 90-day visits and 30-day visits? Yes. This will fall under “Additional Certified Respiratory Therapist (CRT) Registered Respiratory Therapist. Line Item 0026, which included RRT and RN. See revised Price/Cost Schedule.

5. SOW - 2.15 SERVICE OF EQUIPMENT:

“1. The Contractor shall furnish, install and service all equipment and supplies ordered under this contract, including ancillary disposable ventilator-related equipment as determined to be required by evaluation.”

Question: This statement says the contractor will be furnishing all the equipment ordered under this contract. That contradicts previous language in section 3.14 GOVERNMENT-OWNED EQUIPMENT. This also corresponds with my question number 2. Please clarify. Answered previously, as follows:

o Q: May the Government please clarify what Government Owned Equipment is expected for this short-term bridge contract? There is to be no Government Owned Equipment for this contract. All equipment is to be vendor owned.

6. SOW – “h. FIRESAFE™ Cannula from LifeGas (this item will be provided to the Contractor by the VAMC):”

Question: Will the VA be providing the FIRESAFE valves? Answered previously, as follows:

o Q: May the Government please confirm the FIRESAFE Cannula valves will not be borne from the

Contractor owned inventory? This item has not or is not provided by the VAMC. We are billed with all other equipment issued to patients.

7. SOW – “1. Phase In: The Contractor shall replace all appropriate VA authorized (Incumbent-owned) equipment presently located in residences of beneficiaries with the Contractor’s equipment as soon as possible after award, but not to exceed forty-five (45) days from date of contract award. Contractor shall coordinate with the Incumbent during the transition period relating to the removal of the Incumbent’s equipment from the Patient residence.”

Question: Since the patients are already on a 90-day assessment schedule, wouldn’t it make more sense to have a 90-day transition? And that the switch-outs would simply occur on the next scheduled 90-day assessment? I feel this would be more efficient. The current equipment belongs to the incumbent contractor, and we cannot assume that the incumbent will sell the equipment to the new contractor. What makes sense on an 8-month bridge contract is for the transition to be as quick as possible and to disrupt our Veterans as little as possible.

8. B.3 PRICE/COST SCHEDULE

Question: Why is every CLIN listed with an estimated quantity of 8? Because the units are MO or “months”. This is an 8-month bridge contract. Thus, there is a quantity of 8 (eight) with units of Months.

9. CLIN 0003 – “Rental portable concentrator setup with backup system consisting of compressed gas source, regulator, stand (nasal cannula or mask and humidifier, when specified.) Concentrator shall have a flow rate capacity up to 10LPM (High Liter Flow).”

Question: Portable oxygen concentrators (POCs) do not currently exist that deliver 10 Liters Per Minute (LPM) of continuous flow; 10 LPM devices are stationary home concentrators weighing 30–50+ lbs. Can you please clarify what you are requiring with this line item? This should read “Rental stationary concentrator to be up to 20 LPM. Back up, is to be tanks that can sustain 10 LPM.

10. CLIN 0004 – “Rental Portable Concentrator System consisting (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 compressed gas source would be a cylinder, not a portable concentrator. Can you please clarify what you are requiring with this line item? This is to be “equivalent to compressed gas source.

11. CLIN 0005 – “Rental Self-Filling Oxygen Concentrator: Single piece concentrator with capability to refill portable oxygen cylinder.”

Question 1: What size cylinders are your requiring with this line item? “H” tanks, “E” tanks, and/or “M” tanks. See revised Price/Cost Schedule.

Question 2: How many cylinders are required under this line item? One “E” tank for back up, and it’s hard to identify the number of tanks will be needed. This is to be identified against the prescription sent in; LPM.

12. CLIN 0006 – “Stationary setup. Cylinder, size H, K, M60, or J set-up consisting of regulator, flow meter, safety stand, humidifier, and disposable supplies (emergency back up system or as primary).”

Question: This is a monthly rental line item, correct? This is correct. See revised Price/Cost Schedule.

13. CLIN 0009 – “Cylinder, size “B(M6)” refill for A0008 above. Aluminum (or metal of equivalent weight) tanks required.”

Question: You say, refill for A0008 above, but I believe you meant to say refill for 0007 above. Am I correct? Same question for line items 0010, 0011 & 0012. Instead of A0008, the verbiage should indicated that line items 0009, 0010, 0011, and 0012 are refills for Line Item 0007 above. See revised Price/Cost Schedule.

14. CLIN 0017 – “8 Cylinder Safety Rack.”

Question: Is this line item a purchase or a rental? This is a rental. See revised Price/Cost Schedule.

15. CLIN 0018 – “E Tanks at VAMC.”

Question: Is this line item referring to one E system, complete with a regulator and a cart? Same question for CLIN 0019.

This is the required “E” tanks for urgent situations at the facility. No rack nor cart needed. See revised Price/Cost Schedule.

16. CLIN 0020 – “Nebulizer Compressor with four hand held nebulizers.”

Question: Is this line item a purchase or a rental? This would not be a rental; this item is stocked locally at VA; line item can be removed. See revised Price/Cost Schedule.

17. CLIN 0024 – “Liquid oxygen per pound.”

Question: I believe the unit of measure should be pound (LB) versus Month, correct? Correct. It is per pound; however, the “per pound” is part of the description, and the unit will be EA. See revised Price/Cost Schedule.

18. CLIN 0026 – “Additional Certified Respiratory Therapist (CRT) Registered Respiratory Therapist (RRT) or Registered Nurse (RN) visit.”

Question: I believe the unit of measure should be hourly (HR) versus Month, correct? Correct. See revised Price/Cost Schedule.

19. CLIN 0030 – “Contractor Setup VA Provided CPAP/BIPAP (new) (DME Delivery).”

Question: Is it a requirement that a CRT, RRT or RN perform this setup? Yes, vendor certified staff, but we have a dedicated clinic for this, so it can be taken out. Removed. See revised Price/Cost Schedule.

20. CLIN 0032 – “Set up Contractor Owned CPAP/BIPAP Setup (new) (DME Delivery).”

Question: Is this a setup only line item? Or is this also a monthly rental line item? If it does not include a monthly rental, another CLIN will need to be added for the Rental of a CPAP/BiPAP. This line can be taken off contract, as we have a dedicated clinic for this and set up. Removed. See revised Price/Cost Schedule.

21. CLIN 0033 – “Suction Machine Invacare.”

Question: Is this line item a purchase or a rental? Remove line item as suction machines are provided by outside source, and same day access is provided. See revised Price/Cost Schedule.

22. CLIN 0034 – “Travel Tank.”

Question: Can you please provide a description of what you are requesting with this line item? Travel tank is if a veteran is in need of a tank whether “e” “m” or whichever for local travel.

23. CLIN 0039 – “Labor Rate Per Hour (vehicle operation, equipment setup, services performed in accordance with

SOW).”

Question: Can you please provide a description of what you are requesting with this line item? Also, please explain when we would bill for this line item. This item will be removed; this can be taken off contract as we have other resources for this. See revised Price/Cost Schedule.

24. CLIN 0040 – “Storage Per Square Feet for GFE in excess of 800 sq ft.”

Question: I believe the unit of measure should be square feet (SF) versus Month, correct? Correct, but the “square foot” is stated in the description, and the unit will be EA.

25. CLIN 0041 – “Ventilators (primary and backup) including all supplies.”

Question: This is a rental line item, correct? Rental for the machine, and purchase from vendor for supplies.

26. “II. OFFER SUBMITTAL INSTRUCTIONS: 4) Contract Pricing and Performance Periods: All pricings shall be invoiced on a monthly basis as stated in the PWS. The contract performance period is one, 8-month period (07/01/2026 to 02/28/2027). Monthly pricing should be based on estimated number of patients.”

Question: The estimated number of patients has not been provided, so how can our monthly pricing be based on the estimated number of patients? As of today we have 900 O2 patients, we estimate roughly 1200 total; estimate 300 new patients.

27. “II. OFFER SUBMITTAL INSTRUCTIONS: 5) Offeror must submit a technical proposal including a transition plan for transitioning out incumbent vendor’s equipment.”

Question: Can you please provide the amount and type of equipment the incumbent provides so we can plan our transition accordingly? The amount and identification of equipment would be at the time identified transition initial period. This would be any O2 DME provided by the vendor.

28. “II. OFFER SUBMITTAL INSTRUCTIONS: and E.4 52.212-2 EVALUATION—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (NOV 2021) (DEVIATION OCT 2025)”

Question: What is required in the submittal instructions do not align with the evaluation of quotations. If we are going to be evaluated based on the evaluation factors for award, then the OFFER SUBMITTAL INSTRUCTIONS should reflect what is being evaluated. Can you please clarify the OFFER SUBMITTAL INSTRUCTIONS so it matches what is being evaluated for the award? See attached: INSTRUCTION TO OFFERORS_revised 5.15.26

29. Can you please provide the amount and type of equipment the incumbent provides so we can plan our transition accordingly? There is equipment for 900 oxygen patients and about 300 ventilator patients.

SOW 2.3 (ii) Ongoing services: “Home visits shall be performed within 72 hours of setup and quarterly by the RRT/CRT/RN for all Patients that utilize home oxygen services.”

Question: In SOW 2.2B Initial setups, it allows for a qualified technician to perform the setup of home oxygen. Can a qualified technician perform ongoing service visits for home oxygen patients as well? Technicians do perform services when repair and replacement is required.

30. SOW 2.4 Periodic Equipment Evaluation: “The Contractor shall have a CRT/RRT/RN visit the Patient to reassess equipment compliance and educational needs for Home Oxygen Patients at least once every 90 days and once every 30 days for Patients on ventilators”

Question: Can a qualified technician perform the periodic equipment evaluation for home oxygen patients? For oxygen only patients, a qualified technician may perform the periodic evaluations; however, for combined oxygen and ventilator patients, a clinician is required to complete the periodic evaluations.

31. SOW 2.5 (3) Emergency Services: “The Patient will first call the Contractor in an emergency equipment situation as described in the previous sentence. The Contractor shall have a well-established communication system, providing 24-hour emergency services and the ability to provide services at the Patient's home within one (1) hour of a call. Person receiving the call shall be a certified respiratory therapist (CRT) or registered respiratory therapist (RRT) or relay the call to a CRT or RRT for response.”

Question: Some patients reside at locations more than one hour from the VA facility, which may impede the ability to provide emergency services within the specified one-hour response requirement. This presents challenges in maintaining compliance with established service standards for timely emergency support. Additionally, SOW 2.5 (4) states that patients must have a non-electrical oxygen supply sufficient for three times the contractor's response time, which appears inconsistent with the one-hour service mandate. Revised SOW 2.5 language:

SOW 2.5 (3) Emergency Services Response Time The Contractor shall maintain a 24-hour emergency communication system. Upon receipt of an emergency equipment call, a certified respiratory therapist (CRT) or registered respiratory therapist (RRT) shall answer the call or be immediately available for clinical response.

The Contractor shall provide in-home emergency service within one (1) hour for Patients residing within a one-hour travel radius of the Contractor’s designated service hub. For Patients residing beyond a one-hour travel radius, the Contractor shall provide in-home emergency service as soon as practicable and no later than the established maximum response time designated for that geographic area in the Contractor’s service plan, which must be approved by the VA.

To ensure continuous access to oxygen therapy, Patients shall be supplied with a non-electrical oxygen source adequate to support at least three (3) times the Contractor’s approved maximum response time for the Patient’s location. This requirement supersedes the one-hour standard where longer response times are VA-approved due to geographic or travel constraints.

*See Revised SOW.

Revised PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

8.00 MO __________________ __________________

Rental Concentrator with backup system consisting of compressed gas source, regulator, stand (nasal cannula or mask with 2 firesafe cannula valves (or equivalent); and humidifier (when specified.) Concentrator shall have a flow rate capacity up to 5LPM. HCPCS: E1390 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027 PRINCIPAL NAICS CODE: 621610 - Home Health Care Services PRODUCT/SERVICE CODE: Q201 - Medical - Managed Healthcare

Rental Concentrator setup with backup system consisting of compressed gas source, regulator, stand (nasal cannula or mask and humidifier, when specified.) Concentrator shall have a flow rate capacity up to 10LPM (High Liter Flow). HCPCS: E1390 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

Rental stationary concentrator setup with backup system consisting of compressed gas source, regulator, stand (nasal cannula or mask and humidifier, when specified.) Concentrator shall have a flow rate capacity up to 20 LPM. Back up tanks should sustain 10 LPM. (High Liter Flow).

HCPCS: E1390

Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

Rental Portable Concentrator System consisting of (equivalent to compressed gas source); shall provide a minimum of 92% (+/- 3%) oxygen concentration at all flow settings. POC should be battery operated. Portability is provided by compressed gas cylinders with conserving device. Weight <20 lbs w/Power. FAA approved for flight.

HCPCS: E1392

Contract Period: Base POP Begin: 07-01-2026

POP End: 02-28-2027

Rental Self-Filling Oxygen Concentrator: Single piece concentrator with capability to refill portable oxygen cylinder (cylinder sizes: H tanks, E tanks, and/or M tanks). Max of 2 cylinders required. One E tank for backup. For Liquid O2 patients only. HCPCS: K0738 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

Stationary setup. Cylinder, size H, K, M60, or J set-up consisting of regulator, flow meter, safety stand, humidifier, and disposable supplies (emergency back up system or as primary). *Note: This is a monthly rental line item. HCPCS: E0424 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

Rental Portable system consists of “E”, “D”,"C" or “B” (M6) size aluminum (or equivalent weight metal) cylinder with regulator, flow meter, handcart, pouch and disposable supplies. Not included with concentrator set-up. HCPCS: E0431 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

Rental Demand Pulse Conserver Device (not included with any above set-up rate) not less than a 5:1 ratio or 60ML/pulse. HCPCS: E1399 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

5,393.00 EA __________________ __________________

Cylinder, size “B(M6)” refill for Line Item 0007 above. Aluminum (or metal of equivalent weight) tanks required. HCPCS: E0443

POP Begin: 07-01-2026 POP End: 02-28-2027

1,750.00 EA __________________ __________________

Cylinder, size “C” refill for Line Item 0007 above. Aluminum (or metal of equivalent weight) tanks required. HCPCS: E0443 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

132.00 EA __________________ __________________

Cylinder, size “D” refill for Line Item 0007 above. Aluminum (or metal of equivalent weight) tanks required. HCPCS: E0443 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

5,738.00 EA __________________ __________________

Cylinder, size “E” refill for Line Item 0007 above. Aluminum (or metal of equivalent weight) tanks required. HCPCS: E0443 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

Cylinder, size M60 refill. HCPCS: E0443 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

Cylinder H refill. HCPCS: E0443 Contract Period: Base POP Begin: 07-01-2026

Cylinder, size K refill. HCPCS: E0441 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

Cylinder, size J refill (1320mm x 229mm diameter, full weight 78 kg, normal contents is 6800L.). HCPCS: E0441 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

8 Cylinder Safety Rack. Rental line item. HCPCS: E1355 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

E Tanks at VAMC. (Required E tanks for urgent situations at the facility.

No rack nor cart needed.) HCPCS: E0443 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

B (M6) Tanks at VAMC. HCPCS: E0443 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

Nebulizer Compressor with four hand held nebulizers. HCPCS: E0570

POP Begin: 07-01-2026

Rental liquid oxygen system (90 –110 lbs) with stationary reservoir with ancillary supplies per beneficiary.. HCPCS: E0439 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

Rental portable liquid oxygen system consists of the portable unit that is filled from the reservoir. HCPCS: E0434 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

Rental portable liquid oxygen system with conserving devise and consists of large reservoir and portable unit that is filled from the reservoir.

HCPCS: E0434

Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

2,670.00 EA __________________ __________________

Liquid oxygen per pound. HCPCS: E0442 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

Emergency Set up within 4-hour discharge from hospital (for expedited services). HCPCS: E1399 Contract Period: Base POP Begin: 07-01-2026

2,803.00 HR __________________ __________________

Additional Certified Respiratory Therapist (CRT) Registered Respiratory Therapist (RRT) or Registered Nurse (RN) visit. HCPCS: E1399 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

Travel Coordination (O2 and equipment) fee per trip (not including cost of equipment/supplies). HCPCS: E1399 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

Concentrator Set-up by RT/RN @ hotel. HCPCS: E1399 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

Concentrator Pick-up @hotel. HCPCS: E1399 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

Travel Tank. Based on Veteran need--E or M tank for local travel.

HCPCS: E1399

Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

Trip Charge Area A (0-50 miles). HCPCS: E1399

POP Begin: 07-01-2026 POP End: 02-28-2027

Trip Charge Area B (51-100 miles). HCPCS: E1399 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

Trip Charge Area C (100-200 miles). HCPCS: E1399 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

Area D Mileage Charge Per Mile Beyond 200 Miles. HCPCS: E1399 Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

Ventilators (primary and backup) including all supplies. *Note: This is a rental line item for the machine and purchase of supplies from contractor.

HCPCS: E0450

Contract Period: Base POP Begin: 07-01-2026 POP End: 02-28-2027

GRAND TOTAL __________________

STATEMENT OF WORK

STATEMENT OF WORK

EL PASO VA HEALTHCARE SYSTEM

1. SCOPE: This Statement of Work (SOW) defines the effort required for the setup, installation, and management of Home Oxygen services and Ventilation, in accordance with Joint Commission (JC) standards, to Veteran beneficiaries serviced by VISN 17. This SOW includes the associated program management, human engineering, and logistic support planning requirements. The use of the terms “beneficiary”, “Veterans”, “Patients”, and “Patient” are used interchangeably and refer to the recipient of required supplies, equipment, and incidental services required under the contract. It is anticipated that one firm-fixed price Indefinite Delivery Indefinite Quantity contract will be awarded in order to ensure coverage to all locations.

1.1 BACKGROUND: The acquisition of Home Oxygen services is being initiated to provide Home Oxygen services to Veteran beneficiaries serviced by VISN 17 for only El Paso VAMC. VISN 17 does not have the capacity to provide these services, so a contract has been sought for the provision of home oxygen and all associated products and services.

1.2 LOCATIONS: All services shall be performed in the veteran's place of residence or in a nursing home housing the veteran. The geographic area of service shall be all patients serviced by VISN 17, including catchment areas, regardless of where Patient resides. The equipment needs are subject to change as determined by the prescribing physician. Contractors shall have a facility or resources physically located in the geographic area in which they shall provide service. Non-territory requests will be required from time to time, and the Contractor shall accept these "non-territory" veterans at that

Contractor’s awarded price. VA reserves the right to assign these Patients to any contractor. The geographical boundaries described herein have been determined as the areas of responsibility/jurisdiction for each VA Health Care System (VAHCS).

For each listed VAHCS, Contractor shall provide setup, installation, and management of Home Oxygen and/or Ventilation services to any Patient that are treated at the main VAHCS Medical Center (VAMC) and all Community Based Outpatient Clinics (CBOCs) and Outpatient Clinics (OCs) supported therein (Clinic of Jurisdiction/Primary Service Area COJ/PSA), regardless of their physical location. The listing of counties in the PSA for each VAHCS 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 VAHCS. Some counties are served by more than one VAHCS.

A. EL PASO VA HEALTH CARE SYSTEM (EPVAHCS):

VAMC: 5001 N Piedras, El Paso, TX 79930

COUNTIES IN TEXAS: Culberson, El Paso, Hudspeth, Reeves--(Region 2).

COUNTIES IN NEW MEXICO: Dona Ana, Eddy, Grant, Lincoln, Luna, Otero, Sierra—(Region 1).

2. SERVICE SPECIFICATIONS:

2.1 VETERANS SERVED: VISN 17 currently serves an estimated 3,000 oxygen-using Patients. The El Paso Veterans Healthcare System currently serves and estimated 900 oxygen (O2) patients with approximately 300 ventilator patients. Expected new patients number around 300. The volumes or amounts shown in the Contract Line-Item Numbers (CLINS) are estimates only and impose no obligation on the VA. The contract shall be for the actual requirements of the VA as ordered by the VA during the life of the contract. The Contracting Officer’s Representative (COR) or designee will provide (via encrypted email and fax) the contractor with notification to initiate individual Patient service requirements, including the Patient's oxygen prescription, equipment, supplies and services to be provided including date and place of delivery. The Contractor shall confirm receipt (via encrypted email and fax) of the request within one (1) working hour of notification. Per Facilities discretion the COR or designee will also provide (via encrypted email and fax) notification if VA owned equipment is to be provided. The

COR or designee will also provide notification (via encrypted email and fax) to the contractor of VA initiated discontinuation of service. The discontinuation notifications will be made (via encrypted email and fax) within 24 hours. The written documents will include the authorizing official's signature, electronic or written.

2.2 INITIAL SETUPS: Initial set-ups are considered to be those beneficiaries who do not already have a VA authorized oxygen therapy delivery system or ventilator. Two ventilators shall be delivered to each patient home when prescribed.

A. Contractor shall have a policy statement and program in place for Patient evaluation. VA medical staff evaluation is required to ascertain if the Contractor is able to care for each individual patient and determine if that patient is suitable for care in a home setting, immediately a home setting. Evaluations shall occur prior discharge from the hospital. The results of the evaluation will be provided to the local VA Prosthetics Department, who will then notify the COR, Patient, and Contractor.

B. Initial setup(s) for Home Oxygen Patients and Ventilator Patients shall be performed by the Contractor’s certified respiratory therapist (CRT) or registered respiratory therapist (RRT) or Registered Nurse (RN) that is licensed in accordance with the governing standards of where the services are to be provided. A qualified service technician can be substituted for a CRT, RRT or RN for the set-up of Home Oxygen only. Staff performing ventilator setup shall arrive at the home 1 hour from the receipt of evaluation (preferably before the patient arrives) and shall perform ventilator setup immediately upon patient and caregiver arrival. Caregiver education shall be provided by the Contractor on the specific supplies or equipment required by evaluation and performed prior to discharge and concurrently with setup. Home Oxygen setup includes installation and verification of the prescribed oxygen system, patient and/or caregiver training, and a home environment safety check.

2.3 ONGOING SERVICES: The contractor shall perform the following tasks:

i. Home visits shall be performed monthly by the RRT/CRT/RN for all Patients that utilize the ventilator either continuously, for nocturnal concerns, or for intermittent ventilation.

ii. Home visits shall be performed within 72 hours of setup and quarterly by the RRT/CRT/RN for all Patients that utilize home oxygen services.

iii. Documentation shall be provided (via encrypted email and fax) to the ordering facility’s COR documenting a thorough review of the Patient's equipment, to include all equipment records, and any re-education of the patient and/or caregiver, if necessary.

iv. Documentation shall be provided (via encrypted email and fax) to the ordering facility’s COR for all home visits within five (5) business days of the visit.

v. Patient or caregiver education shall be performed on the proper utilization for the issued equipment to include the following:

a) Proper equipment usage

b) Equipment function and operation system

c) Equipment knobs, controls, buttons, outlets, and inlets

d) Equipment power source: electric, battery, compressor air, oxygen, and UL approved

e) Proper utilization of oxygen with the prescribed ventilator

f) Troubleshooting the equipment and system alarms

g) Equipment and equipment settings that have been prescribed

h) Proper equipment exchange/replacement, for example: ventilator tubing/circuit

i) Proper utilization of a Passy Muir Valve (PMV) Speaking Valve while in use with the ventilator

j) How to attach the resuscitation bag to the oxygen source

k) How to complete the home ventilator monitor record

l) Emergency Procedures and how to respond to:

1) Power failure

2) Equipment failure

3) Ventilator users and their caregivers must be prepared for equipment failure, disconnects, and power outages, especially if using 24-hour ventilation

m) Practicing regular safety drills helps prepare for emergencies

n) Keeping a manual resuscitator, such as a bag valve mask (Ambu bag).

o) Infection control and Patient supply storage

p) Cleaning or exchanging the oxygen tubing, ventilator tubing/circuits, and humidifier

1) Cleaning or exchange of the resuscitation bag and supplies

2) Cleaning or exchange of all equipment and accessories

A. Provide continuing education in use as needed or directed by a licensed and privileged Department of Veteran Affairs Physician. All education material provided by the Contractor shall be initially reviewed and approved by the Veteran's Affairs Pulmonary or Respiratory Chief/ Director/Supervisor or designee within the Pulmonary/Respiratory Section. Any changes to educational materials will need to be reapproved prior to providing the aforementioned documentation to Patients.

B. The Contractor shall provide a signed document (via encrypted email and fax) to the ordering facility COR verifying the following:

1) Patient has a safe home environment in accordance with Joint Commission standards.

2) Patient received proper education and instructions

3) Competency has been accomplished with the Patient and caregiver on the proper use of the ventilator, oxygen equipment, and other home medical equipment upon initial set up, and re-verified annually.

C. The Contractor…