36C26123Q0583 VACCHS.pdf

Special Notice

*= Required Field Special Notice

SUBJECT* Veterans Affairs Central California Home Oxygen Services

GENERAL INFORMATION

CONTRACTING OFFICE’S ZIP CODE* 89086

SOLICITATION NUMBER* 36C26123Q0583

ARCHIVE 30 DAYS AFTER THE RESPONSE DATE

RECOVERY ACT FUNDS N

PRODUCT SERVICE CODE* 6515

NAICS CODE* 532283

CONTRACTING OFFICE ADDRESS Department of Veterans Affairs

VA Sierra Pacific Network (VISN 21) VA Southern Nevada HealthCare System 8600 North Pecos Road North Las Vegas, NV 89086

POINT OF CONTACT* Contract Specialist Joel E Brown joel.brown6@va.gov

ADDITIONAL INFORMATION

AGENCY’S URL

URL DESCRIPTION

AGENCY CONTACT’S EMAIL ADDRESS

EMAIL DESCRIPTION

DESCRIPTION

Special Notice

DESCRIPTION

SPECIAL NOTICE 36C26123Q0583

Description: NOTICE OF INTENT TO AWARD A SOLE SOURCE

The Department of Veterans Affairs (VA), Network Contracting Office (NCO) 21, intends to issue a Fixed Priced contract under the authority of Federal Acquisition Regulation (FAR) 13.106-1(b)(1)(i), Soliciting from a single source. Award is anticipated to occur on or before May 20, 2023 to Apria Healthcare, LLC. The period of performance will be for three months, with one three-month option period after issuance of the notice to proceed. This requirement includes rental medical equipment, such as oxygen tanks and related supplies for home services and will cover the VA Central California Healthcare System (VACCHCS), CA service area. NCO 21 intends to non-competitively award this requirement to Apria Healthcare, LLC., since time is of the essence as the current contract is set to expire on May 31, 2023. In accordance with FAR 6.302-1(a)(2)(ii)(B) one responsible source can be used to avoid unacceptable delays in fulfilling the agency s requirements. As a result, any contractor other than Apria Healthcare, LLC., that would provide oxygen tanks rentals to the facility would unintentionally cause a delay in patient care. Unnecessary delays cannot be endured. The North American Industry Classification System (NAICS) code for this requirement is 532283 with the size standard of $41 Million. The applicable Product Service Code is 6515. This notice of intent is not a request for proposals or quotes. However, all responsible sources may submit an offer and technical capabilities/narrative that proves by clear and convincing evidence that a vendor is available that will provide sufficient home oxygen supplies and services. If said OFFER and technical capabilities/narrative is received within one calendar day of publication of this notice, the narrative will be considered by NCO 21. All responses must be submitted to the Government point of contact at the email address shown below. A determination by the Government not to open the requirement to competition based upon the responses to this notice is solely within the discretion of the Government. Information received will generally be considered solely for the purpose of determining whether to conduct a competitive procurement.

Contracting Office Address: Department of Veterans Affairs Network Contracting Office 21, 6900 North Pecos Road, North Las Vegas, NV 89086

Government Point of Contact: Joel Brown, Contract Specialist

Email: joel.brown6@va.gov

PAGE 1 OF1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. UEI: EFT:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

36C26123Q0583 05-08-2023

Joel Brown joel.brown6@va.gov 05-12-2023

12:00 PDT

36C261 Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Southern Nevada HealthCare System 8600 North Pecos Road North Las Vegas NV 89086-4400

X

532283

$41 Million

N/A

X

Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Central California HealthCare System

36C261

Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Southern Nevada HealthCare System 6900 North Pecos Road North Las Vegas NV 89086-4400

Department of Veterans Affairs FMS VA-9(101) Financial Services Center

PO Box 149971 Austin TX 78714-9971

See CONTINUATION Page

VA Central California Healthcare System Home Oxygen Services

BASE ORDERING PERIOD: 01 JUNE 2023 - 31 AUG 2023

OPTION ORDERING PERIOD: 1 SEP 2023 - 30 NOV 2023

See Item Schedule

See CONTINUATION Page

X

Victoria Torres

36C26123Q0379

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

B.3 DELIVERY SCHEDULE

SECTION C - CONTRACT CLAUSES

C.1 52.204-15 SERVICE CONTRACT REPORTING REQUIREMENTS FOR

INDEFINITE-DELIVERY CONTRACTS (OCT 2016)

C.2 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (DEC 2022)

C.3 52.216-18 ORDERING (AUG 2020)

C.4 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.5 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.6 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.7 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR

1984)

C.8 VAAR 852.201-70 CONTRACTING OFFICER'S REPRESENTATIVE (DEC 2022)

C.9 VAAR 852.212-71 GRAY MARKET AND COUNTERFEIT ITEMS (FEB 2023)

C.10 VAAR 852.212-72 GRAY MARKET AND COUNTERFEIT ITEMS—

INFORMATION TECHNOLOGY MAINTENANCE ALLOWING OTHER-THAN-NEW

PARTS (FEB 2023)

C.11 VAAR 852.211-72 TECHNICAL INDUSTRY STANDARDS (NOV 2018)

C.12 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020)..35

C.13 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.14 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.15 VAAR 852.204-71 INFORMATION AND INFORMATION SYSTEMS SECURITY

(FEB 2023)

C.16 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (MAR 2023)

C.17 MANDATORY WRITTEN DISCLOSURES

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (MAR 2023)

E.2 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.4 52.216-1 TYPE OF CONTRACT (APR 1984)

E.5 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.6 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION

(OCT 2018)

E.7 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.8 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.9 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (NOV 2021)

E.10 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (DEC 2022)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C261 Victoria Torres

Department of Veterans Affairs

VA Sierra Pacific Network (VISN 21)

VA Southern Nevada HealthCare System

8600 North Pecos Road

North Las Vegas NV 89086-4400

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

[] 52.232-33, Payment by Electronic Funds Transfer—System For Award Management, or

[X] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [x] Upon delivery and government acceptance

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

Department of Veterans Affairs

FMS-VA Financial Services Center

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO DATE

STATEMENT OF WORK

For

Home Oxygen Supplies and Services VA Central California Healthcare System

SECTION 1 - GENERAL REQUIREMENTS

1.1 Intent

The Intent of this solicitation is to establish one or more contracts with one (1) or more suppliers to provide all supplies, materials, labor, supervision, transportation, patient education, safety management and infection control for home oxygen services as described in this contract to beneficiaries of the VA Facilities listed in the pricing pages. Successful contractors shall provide service for all beneficiaries covered by the facilities they are awarded, at the contract rates, regardless of the physical location of the beneficiary.

1.2 Roles and Responsibilities

1.2.1 Clinician orders for providing Home Oxygen Healthcare Services, which includes the use home oxygen, home based life support systems (i.e., ventilators) and related respiratory equipment (C-PAP/Bi-Level, Nebulizers, Compressors, etc.) are processed through the Prosthetic and Sensory Aid Services (P&SAS) at the VA Medical Centers, and VA Healthcare Systems, listed on Pages 6 & 7. Initiation of treatment, delivery and pick up of equipment and, resolutions of problems related to equipment or patient care are under the direction of P&SAS and/or the Contracting Officer’s Representative (COR).

1.2.2 VA Clinicians have the exclusive responsibility for determining eligibility and necessity for admission to the Home Oxygen Program and for providing orders for admission. The Contractor has responsibility for providing the services, supplies and equipment as ordered, under the timelines specified.

1.2.3 VA Clinicians will complete initial and ongoing patient assessments.

1.2.4 The contractor Is responsible for coordinating, supervising, monitoring, and evaluating the care and service provided and must assure that the contracted services are performed according to the terms of the contract. The contractor must also assure that its personnel meet the requirements of the contract and are competent to do the jobs assigned them. The VA shall monitor the contractor's performance through contractor site visits, patient home visits, record checks, patient satisfaction/complaints, monthly review of invoices for accuracy. Monitors will focus on timeliness of equipment delivery; timeliness of maintenance visits; accuracy of required paperwork, and adherence to JCAHO standards.

1.2.5 VA sets timelines for the provision of services and the contractor must meet those timelines. It is the contractor’s responsibility to schedule the times and dates for the delivery of

SOW: Home Oxygen Supplies and Services VA Central California Healthcare System services within the timelines established. Deliveries shall not be left unattended at the beneficiary's home unless prior arrangements are made with the beneficiary.

1.2.6 VA providers determine the discharge plan from the Home Oxygen Program based on clinical assessment that may also include data submitted by the contractor.

1.2.7 In the event of damage to and/or theft of contractor's equipment due to patient negligence, contractor shall, within 10 calendar days of having knowledge of damage and/or theft of any contractor issued equipment under this contract, notify the respective facility COR, in writing, describing the damage and/or theft. Facility COR will notify the contracting officer to discuss a resolution to the issue.

1.3 Accreditation

The contractor shall meet or exceed all Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards for all services provided herein. Contractor shall submit proof of meeting or exceeding all JCAHO standards as part of its technical proposal. The JCAHO standards may be accessed at www.jcaho.org. Contractor shall be accredited by a nationally recognized organization and shall maintain that accreditation throughout the term of the contract.

1.4 Site Visits

1.4.1 On-site Contractor and VA beneficiary visits will be made on a scheduled and unscheduled basis. The Contracting Officer and/or the COR and, other VA employees as necessary, will conduct contractor site visits. The purpose of these visits is to monitor the Contractor's performance as it relates to the contract and commercial practices. The Contractor agrees to make available all records and documentation necessary during such visits.

1.4.2 In addition the Contractor agrees to visits by any accrediting body or other Government representative accompanied by the Contracting Officer, COR or designee necessary to review the contract services. These visits shall be allowed at no additional cost to the Government.

1.5 Delivery Orders

1.5.1 Delivery orders will be issued under the contract by the facilities listed on pages 6 & 7. An authorized representative of P&SAS or the appointed COR will place orders for supplies or services. Each order will contain the beneficiaries' name, social. security number, and home address as well as the type of supplies, services or oxygen system prescribed.

1.5.2 Orders may be placed by telephone, fax, PKI secured E-mail, or through a contractor owned and maintained secure website and as necessary, will be confirmed in writing and accompanied by the Home Oxygen Prescription. If a delivery order is placed verbally a written copy of the verbal delivery order will be transmitted to the Contractor within 48 hours of placing the order. Confirmations shall be required for any order placed.

NOTE: All delivery orders placed against this contract are to be paid by the VA Medical Center placing the order. Proper invoices shall be sent to the ordering facility. Delivery shall be made to the appropriate VA facility, nursing home, or patient's residence specified in the order.

1.5.3 Contractor shall provide a single source entry system/office for VA facilities to submit delivery orders, request discontinuation of service and, request travel arrangements for beneficiaries traveling or temporary relocating.

1.6 Emergency Service

The Contractor shall have twenty-four (24) hour, seven (7) day a week, 365 days per year emergency service capability. At a minimum, the Contractor shall have a company employee on duty or a twenty-four-hour answering service or, an employee within paging range to respond to emergency calls. Contractor shall respond within 30 minutes by telephone upon receipt of an emergency call and advise patient of the specific emergency procedure to be implemented.

Contractor shall have a backup procedure in the event they are unable to reach the patient by phone. This back-up procedure shall be specific to the geography and conditions of the area being serviced with a copy provided to the appropriate COR at the time of award. If the procedure Is updated a copy shall be sent to the COR within 3 business days.

1. 7 Documentation

The Contractor shall maintain documentation of all orientation programs and background checks for all employees involved in delivery/recovery of home oxygen equipment. As a minimum, topics should include safety and equipment management such as electrical requirement, back-up systems, equipment safety checks, troubleshooting, equipment set-up, infection control procedures, patient confidentiality and handling procedures. Annual competencies are required. Documentation shall be made available upon written request of the Contracting Officer or facility COR.

1.8 Solicitation of Beneficiaries

Contractor shall deal directly with the Contracting Officer, the facility COR, or the appropriate facility P&SAS representative relative to any aspect of the contract. Contractor agrees he/she shall not directly or through his/her dealers solicit the beneficiaries of the Department of Veterans Affairs. Contractor is to contact the patient or caregiver only to make arrangements for rendering services or supplies authorized by VA.

1.9 Demurrage Charges

Contractor agrees to provide cylinders without assessing demurrage charges to the Government. The Contractors further agrees that the free loan period of cylinders is indefinite but shall not exceed the term of the contract.

1.10 Product Substitutions

No product substitutions shall be made without prior approval of the treating facilities COR.

SECTION 2 -DEFINITIONS/ACRONYMS

Bilevel -A device used for the treatment of obstructive sleep apnea/hypoventilation syndrome while sleeping. Has two pressure settings.

CBOC -A VA Community Based Outpatient Clinic.

CPAP-Continuous Positive Airway Pressure. A device primarily used for the treatment of obstructive sleep apnea Has single pressure setting.

Concentrator - An electrical device used to deliver oxygen therapy in the home.

Contracting Officer -VA official with the authority to enter into, administer, and/or terminate contracts.

Contracting Officer’s Representative (COR) - VA official responsible for providing contract oversight and technical guidance to the Contracting Officer. Responsibilities Include certification of invoices, placing orders for services, and technical guidance.

FAR-Federal Acquisition Regulations

HCPCS-Health Care Procedure Coding System

IPV-Intrapulmonary Percussive Ventilation use for airway clearance therapy.

Joint Commission on Accreditation of Healthcare Organizations (JCAHO) – A national organization dedicated to improving the care, safety, and treatment of patients in a healthcare facility and environment.

Liquid Stationary System -A device used to store and dispense liquid oxygen.

Liquid Oxygen. -Oxygen in a liquefied state.

Nebulizer - A device used to dispense inhaled medication

Oxygen Tanks -Cylinders made of steel, light steel, and aluminum used to store oxygen in a compressed state.

P&SAS - Prosthetics & Sensory Aids Service.

Suction Machine - A device used to remove secretions from a patient's mouth or airways.

VA - Department of Veterans Affairs Medical Center, or Healthcare System.

VISN - Veterans Integrated Service Network.

Plan of Care - Medical care plan is a patient assessment initiated on each patient by VA clinician.

Plan of Service - Form initiated by Contractor that depicts patient's home environment, problems/needs, goals, and action.

SECTION 3 -GOVERNMENT FURNISHED PROPERTY

The following equipment will be issued or authorized by the VA in the performance of this contract, all of which remain the property of the VA:

All CPAP Devices which may Include masks, Non-heated humidifiers & heated humidifiers

All BIPAP Devices

Nebulizers (to include battery powered) Suction Pumps Air Compressors Intrapulmonary Percussive Ventilation System (IPV) Ventilators

The Government may from time to time, not furnish some of the above equipment. Contractor shall submit a price for providing any item listed in the schedule regardless of the above list.

Additional equipment or supplies may be added throughout the life of the contract.

SECTION 4 - CONTRACTOR FURNISHED PROPERTY

The contractor shall furnish the following list of equipment:

Concentrator Systems Liquid Oxygen Systems Portable Gaseous Systems Portable Gaseous Oxygen Systems Portable Liquid Oxygen Systems Ventilators and all appropriate prescribed equipment Air Compressors Aluminum Oxygen Tanks Steel Oxygen Tanks (Optional) Supplies (e.g., tubing, cannulas, masks)

In addition to the above list the contractor shall furnish all equipment necessary to comply with the requirements of the contract. Equipment furnished by the contractor shall remain property of the contractor unless purchased by the VA.

SECTION 5 - SPECIFIC TASKS

5.1 New Patient Set-ups – Oxygen Systems

5.1.1 Upon receipt of a VA prescription, the Contractor shall deliver and set up in the veteran's residence all equipment and supplies ordered. New set-ups shall be performed as described in Section 5.2.

Orders placed by VA and received by the Contractor two (2) hours prior to the ordering VA facility close of business shall be delivered the same day. Orders placed by VA and received by the Contractor less than two hours prior to ordering VA facility close of business shall be delivered the next day before 10:00am local time, unless the COR or P&SAS personnel have approved other arrangements.

5.1.2 In the event Contractor is unable to meet these delivery times, VA reserves the right to obtain the service from another source and to charge the Contractor with any excess cost which may result there from.

5.1.3 Contractor shall notify the ordering facility COR or P&SAS if the contractor is unable to contact the patient or caregiver, no later than 12 hours after receipt of the delivery order.

5.2

See addendum to Statement of Work, at the end of this document.

5.2.1 Initial Oxygen Follow Up Visit - Required when initial set-up is performed by a contractor qualified technician.

Performed by an RRT, CRT, or RN only, within 72 hours after initial set-up by a qualified technician.

Proof of initial set up, patient Plan of Service and Education Documentation sent to facility COR with the next monthly invoice.

If the initial home oxygen visit is performed by a contractor technician, an ART, CRT, or RN shall follow up within seventy-two (72) hours to perform the required patient education and develop a plan of service. Documentation of patient education, plan of service, and all visits shall be in compliance with the current JCAHO Home Medical Equipment (HME) Standards and shall be provided to the respective facility COR or designee with the next monthly invoice.

Failure to provide the required documentation by the 10th calendar day of each month will result in a 2% reduction for each day the documentation is late, applied to the monthly Invoice.

5.2.3 The initial oxygen equipment set-up in the home, shall address at a minimum, the following:

Name of the contractor's branch/division servicing the patient.

Date of Visit.

Recommendations and/or problems relating to the beneficiaries use of the oxygen equipment.

Proper name, social security number and phone number.

Review of prescription, verify percent of oxygen concentration.

Manufacturer's model, serial number, for Government Owned Equipment.

Review of safety and beneficiary education issued, and interventions taken and/or recommendations for equipment maintenance and safety.

Monitoring of all equipment for proper functioning (i.e., internal/external batteries, settings, humidifiers, suction machines temperature probes, and nebulizers).

Assessment of infection control procedures and the general home environment.

Evidence of smoking in the home.

Cleanliness of equipment/filters and home.

Check of function of smoke detectors in the patient's home.

Colored tubing that will contrast with home environment.

Providing a cylinder stand capable of holding a minimum of 12 cylinders, sizes E, D, C &

M-6 as appropriate.

In addition to the above list the contractor shall also provide review of on-site environmental conditions that includes a check of electrical sockets if powered equipment is provided, and make all appropriate site preparations (e.g., uncluttered area for free storage of standing tanks, fire safety notation of observable safety hazards, etc.) before placing oxygen equipment in the home.

5.3. lnitial Set-Up – CPAP/BiLevel

Performed by an RRT, CRT, or RN only.

Proof of initial set up, patient Plan of Service and Education Documentation sent to facility COR or designee with the next monthly invoice.

5.3.1 All VA issued CPAP/Bilevel's shall be delivered and set-up by an RRT, CRT, or RN within 72 hours of receipt of the VA prescription unless otherwise notified by the ordering facility. Set-up shall include the pressure setting(s), instructions, mask fitting, safety, and any other instruction necessary. Contractor shall provide sufficient supplies to last between maintenance visits.

5.4 Initial Set-Up - Ventilators

• Performed by an RRT, CRT, or RN only

• Delivery and aet up within 24 hours of receipt of VA Prescription

• Proof of initial set up, patient Plan of Service and Education Document sent to facility COR or designee with the next monthly invoice.

Set-up may consist of contractor and/or Government owned equipment with proper backup systems, and shall include pressure setting(s), mask fitting, safety, maintenance, and any other instructions necessary.

5.4.1 Contractor shall provide and install, at no extra charge, a three-prong adaptor when the patient's home outlets are not grounded.

5.4.2 Contractor shall notify the local VA COR or designee, verbally and in writing, if they are unable to set-up the prescribed oxygen system because of environmental or other safety issues immediately upon discovery of any of these issues. VA will work with the patient to abate the condition preventing set up of the originally prescribed oxygen system.

5.4.3 Any VA beneficiary refusing to accept oxygen equipment or supplies prescribed by P&SAS, must sign the visit documentation form, noting their refusal. The contractor shall also sign the form and immediately report the incident to the authorized P&SAS or COR, first by telephone followed by a facsimile of the signed form, or PKI secured E-mail message if electronically sent a scanned copy of the signed form.

5.4.4 Upon delivery of oxygen refills, the Contractor shall inspect the patients existing equipment and supplies, clean and sanitize or replace same whenever necessary. Oxygen refill visits shall be made as necessary to maintain continuous oxygen services. The Contractor shall report any apparent changes noted in beneficiary status, address, changes, and/or any problems that may warrant the attention of P&SAS or the appointed COR. The contractor shall report to the COR and or P&SAS after the contractor has made three attempts to deliver over five working days.

5.4.5 The Contractor shall provide two (2) signs for each VA beneficiary stating, "NO SMOKING OXYGEN IN USE", and assure they are posted in the patients home according to JCAHO standards. Contactor shall provide educational and/or warning information for patients and families on the hazards of smoking while oxygen is in use. The educational materials shall be provided upon initial delivery and every six (6) months thereafter. Non-compliant or at-risk patients are to be reported to the COR as soon as possible, but no later than the next business day. In the event patient is not using the oxygen as prescribed the COR or designee shall be notified as soon as possible, but no later than the next business day.

5.4.6 Contractor shall provide only aluminum/composite oxygen tanks for all patients using compressed gas for portability. Contractor may use aluminum or composite tanks for backup systems in the home. Safety holders/cylinder racks shall be provided for all veterans with a prescription for four (4) or more cylinders of multiple sizes.

5.4.7 Prior to entering a VA beneficiary's residence for monitoring visits, equipment checks, or any other required Contractor visits called for in the contract. Contractor personnel will present a photo identification badge to the beneficiary/primary care giver and verbally identify themselves.

5.5 Equipment Monitoring/Maintenance Visit Requirements and Time Frames

As part of the equipment monitoring visit the contractor shall assure the patient has adequate supplies (e.g., mask supplies, colored tubing, filters, water for humidification, etc.) to last between visits. Costs for supplies and the delivery of those supplies that are needed by the patient between visits shall be borne by the contractor.

5.5.1 Concentrators

Performed Quarterly not to exceed 90 calendar days after the initial visit or the previous maintenance visit.

Performed by a qualified technician.

Completed Maintenance visit form due to facility COR or designee with the next monthly invoice.

5.5.2 CPAP/BiLevels

Shall be performed by the contractor at the request of the facility.

Performed by a qualified technician.

Completed Maintenance visit from due to facility COR or designee with the next monthly invoice.

5.5.3 Ventilators

Performed every 30 calendar days after initial setup or the previous maintenance visit.

Performed by an RRT, CRT or RN only.

Completed Maintenance visit form due to facility COR or designee with the next monthly invoice.

5.5.4 Failure to provide the required documentation for any of the above equipment monitoring or maintenance visits by the 10th calendar day of each month will result in a 2 % reduction for each day the documentation is late, applied to the monthly invoice.

5.5.5 By use of the maintenance form the contractor shall at a minimum, cover the following items:

No Smoking signs are provided and/or posted.

Smoke alarm is present and alarms when tested.

Veteran has been instructed to remove the cannula, shut-off the oxygen supply, and wait for oxygen to dissipate prior to smoking.

Verification that the veteran has been Instructed to test all smoke alarms monthly.

Veteran and family or cohabitants are given educational materials regarding the hazards of smoking and using an open flame near oxygen.

Number of days since last equipment monitoring visit.

Average usage per day.

Assessment of equipment filters.

Evidence of compliance with physician orders (prescription) for equipment maintenance.

5.5.6 Contractor shall check each veteran's home regarding appropriately working smoke alarms. The presence of the smoke alarms must be verified, and the patient must be instructed by the Contractor to test all smoke alarms monthly. Contractor shall document and notify the veteran in the event smoke alarm(s) is not in working order. In any home where smoke alarms are not present, the Contractor shall notify the COR or designee for further review and potential action on the part of the VA.

5.5.7 The contractor shall report to the COR and or P&SAS after the contractor has made three attempts over five working days that they have been unsuccessful in performing a maintenance visit.

5.6 Emergency Protocol

5.6.1 Emergency calls made to the Contractor shall be considered life threatening with an immediate response to the site of the veteran beneficiary’s domicile, no matter the distance from the Contractor's place of business. An emergency exists if the appropriate P&SAS staff or COR informs the Contractor that he/she considers the situation an emergency, or if the VA beneficiary states in a telephone call to the Contractor that an emergency exists in regard to the function or use of the respiratory related equipment or use of the equipment.

For all patients with medical equipment providing partial or full ventilator support, a backup ventilator system shall be provided at no charge, which includes self-inflating resuscitation bag and a spare breathing circuit. As a minimum, the backup system shall provide continuing equipment function for forty-eight (48) hours. In addition to the ventilators, the contractor shall provide a twenty-four (24) hour backup system for all other Primary Oxygen Systems, including Government owned equipment.

5.6.2 In emergent situations, the Contractor shall provide service at no additional cost to the Government. In the event the Contractor is unable to meet the appropriate response times, the Government has the right to obtain the services from another source and to charge the Contractor any costs incurred over and above the contract price. A mandatory written justification detailing why emergency service was not available shall be provided by the Contractor to the facility COR and the Contracting Officer within twelve (12) hours from the original time the Contractor was called to provide the service.

5.6.3 The Contractor shall provide a written Emergency Contingency Plan for natural disasters, which provides for continued uninterrupted care and support in the event of an emergency resulting in an interruption of service. As a minimum the plan shall address such items as severe weather, power outages, loss of personnel, damage to the Contractor's site and communications. A copy of this plan shall be provided to each facility COR within thirty (30) days after award.

5.7 Discontinuation of Oxygen Services

5.7.1 Upon termination of oxygen service to the beneficiary, the Contractor shall pickup all oxygen equipment and supplies no later than forty-eight (48) hours after receipt of notification from the appropriate P&SAS staff or COR. Payment of services shall cease upon this notification. The final invoice shall be prorated from the date of notification. Final services shall be billed with the next scheduled invoice.

5.7.2 Upon the death of a beneficiary the appropriate P&SAS or COR will notify the Contractor as soon as the beneficiaries' death has been reported. The appropriate P&SAS authority will confirm termination of services and equipment pickups in writing. Arrangement shall be made within 48 hours to pick up all supplies and equipment. Additional billing will not be honored after the date of the cancellation notice.

5.7.3 In the event the contractor gains knowledge of the patient's death prior to the servicing VA, the contractor shall immediately notify the COR or appropriate P&SAS staff of the patient's death and the date the contractor was made aware of the death. Billing shall cease on the day the contractor becomes aware of the patient’s death. The final invoice shall be prorated from the date of notification.

5.8 Service Transition

5.8.1 In the event award(s) are made to other than the incumbent contractors, the new contractor(s) shall arrange with the incumbent Contractor for exchange of equipment ensuring that there is no disruption of supplies/services to veteran beneficiaries. Transition of services to the new contractor(s} shall be complete within (60) calendar days from the date of award of a new contract(s).

5.8.2 This period will be designated as the period for the transfer of VA veteran beneficiaries from the incumbent to the successor Contractor. The change shall, as a minimum, include oxygen care and instructions, usage, set-up, emergency service, etc. The transition shall be coordinated through the Contracting Officer, facility COR, and P&SAS staff. Any requirement for an RRT, CRT, or RN visit will be coordinated between the Contractor and COR. The appropriate VA facility shall provide the successful contractor(s) with an up-to-date prescription.

5.8.3 The successor Contractor shall provide the facility COR by 12:00 noon each Friday, during the transition period, a detailed listing of the VA beneficiaries whose Oxygen Service has been changed over from the incumbent to the successor Contractor. The list shall include the exact date of the change for each beneficiary. Along with this list the successor Contractor shall also provide documentation showing that the incumbent Contractor has been notified to pick up their equipment.

Payment to the incumbent contractor shall be made up to the day services were transferred to the successor contractor. Payment shall be pro-rated based upon the units’ prices in affect during the most recent contract year. Coordination during the transition period shall be accomplished at no additional expense to the Government.

5.9 Equipment Maintenance/Repair

5.9.1 Contractor shall provide all required service, maintenance, and repairs on all Contractor owned equipment in accordance with manufacturer standards and when required by this contract. Contractor shall also provide service and maintenance on all Government Owned equipment, as required by the CPAP, Bilevel, and Ventilator Line Items, no additional maintenance or repairs are required. Only technicians with documented training shall provide service to an of the equipment.

5.9.2 Equipment maintenance records, to include the serial number of the equipment being serviced shall be kept by the Contractor reflecting the above. Records shall be kept up to date and available for review by the facility COR and/or P&SAS staff.

5.9.3 Contractor shall send VA equipment to VA or manufacturer for repair/replacement as specified by COR.

5.9.4 The Contractor shall have an established procedure for Government Owned equipment pickup or exchanged for repairs. In the event that the equipment is no longer in use by a VA beneficiary, the cleaned, sanitized, and tagged equipment will be bagged and returned to either the VA facility that originally purchased the equipment or the contractor's facility as determined by the COR.

5.10 Reserve Supply

5.10.1 An adequate supply of aluminum/composite compressed 02 tanks, with regulator, and E-tank stands shall be provided and stored at each participating VA listed in the Schedule and their respective Outpatient Clinics as directed by the COR. Quantities, and sizes of tanks, will vary from site to site and shall be agreed upon by the Contractor and facility COR.

5.10.2 The reserve supply shall accommodate home oxygen patients who are either being discharged from the hospital or visiting (appointments, etc.) and require a supply of oxygen to enable the VA beneficiary to reach home. Adequate inventory shall be maintained by the Contractor. Reserve supply shall be provided at no additional cost to the Government.

5.11 VA Beneficiary Records

5.11.1 An individual beneficiary account record shall be maintained by the Contractor in compliance with the Privacy Act and HIPPA compliant. Copies of these beneficiary records shall be provided to the appropriate P&SAS authority or appointed COR upon request when a patient is discharged from the Home Oxygen Healthcare program or upon death. The Individual medical records shall be maintained in divided folders separated by the categories listed below and housed at Contractor's individual branch providing the Oxygen Service. As a minimum the record shall include the following:

Beneficiary identifying information (full name, SSN, home address, phone number of beneficiary care giver, and serial number and type of VA owned equipment). Emergency contact phone number at a separate residence other than the beneficiary.

Copy of physician's prescription (original or renewal).

Plan of Service as developed by Contractor.

Initial and ongoing documentation of home visits.

Initial and continuing verbal and written instructions to the beneficiary and/or care giver

(to include, but not limited to basic home safety, safe and appropriate use of equipment, handling, cleaning, precautions on smoking, and storage -universal precautions).

Patient complaints, accidents, injuries, and safety hazards identified, and corrective action taken.

Documentation of all beneficiary education to include course of action in emergency situations.

Infection control -Contractor will comply with standard precautions in the handling, storing, cleaning, and delivery of home oxygen equipment and will maintain a system for reporting, documenting, and evaluating records of infection among beneficiaries and Contractor staff.

5.12 Plan of Service

5.12.1 An initial plan of service shall be developed and implemented by RRT, CRT, or RN during the initial setup by the Contractor for each VA beneficiary and a copy shall be forwarded to the respective facility COR or designee with the monthly invoice. As a minimum the plan shall include the following:

A statement of the patients’ needs and problems.

Measurable Beneficiary goals.

Notation of the services recorded, and action taken.

The Plan of Service shall be signed by the visiting RRT, CRT, or RN and VA beneficiary or care giver. The beneficiary shall retain the original. The Contractor shall retain one (1) copy and forward a copy to the appropriate P&SAS or facility COR.

5.12.2 Revisions to the Plan of Service will not be initiated, set-in place, or changed without prior approval of the P&SAS or COR. A new plan of service will, as a minimum, be submitted when there is a change to the initial plan of service.

5.12.3 The Contractor shall maintain records of all visits for at least three (3) calendar years.

5.12.4 The Plan of Service for CPAP's and Bilevel's shall be requested at the direction of the COR. As a minimum, the assessment shall include the beneficiary’s tolerance and compliance to equipment, mask fitting, etc. This assessment shall be made at the time of the visits described in 5.3

5.13 Education/Instruction

5.13.1 Education regarding all equipment, supplies, and smoking shall be provided to the beneficiary/caregiver by the contractor in accordance with JCAHO standards. As a minimum, the Contractor shall document and provide instruction to the patient/care giver on the safe and appropriate use of the medical equipment including basic home safety, storage, handling, required maintenance, electrical safety, equipment hazards and malfunctions, infection control, emergency preparedness, and the beneficiaries' responsibilities in the care and use of all equipment.

5.13.2 The Contractor shall provide as part of the technical proposal all patient education materials to be used during the course of the contract. Updates and changes to the education materials must be submitted to the COR prior to making any changes.

5.13.3 The Contractor shall provide each new Home Oxygen beneficiary with a pamphlet depicting, “Patients’ Rights and Responsibilities”.

5.13.4 At the initial Home Oxygen Healthcare Service set-up, the Contractor will provide each beneficiary a copy of the Contractor's “Patient Instruction Booklet”. This booklet will be placed in a folder/binder with any appropriate information properly annotated before the booklet is given to the beneficiary. Instructions will cover the use of all equipment delivered. The patient/care giver and the Contractor shall sign the Home Oxygen Equipment Assessment and Patient Instruction Checklist, acknowledging that written and oral instructions have been provided.

These initial Instructions shall be provided by an RRT, CRT, or RN. A copy of the signed documents shall be submitted to the appropriate P&SAS or personnel or COR with the monthly invoice.

5.14 Traveling Beneficiaries

5.14.1 The contractor shall be responsible for arranging and coordinating all oxygen services for veterans who travel both within and outside their respective contracted jurisdiction, unless otherwise indicated. The veteran and/or respective VA will be responsible for notifying the contractor where the veteran is traveling to and the mode of transportation. Arranging and coordinating travel services shall be provided at no additional cost to VA.

5.14.2 Veterans traveling within the contractors' coverage area shall be provided all oxygen services under the contract at the contract rate.

If travel takes place within the areas covered by VISN's 19 & 21 but to another contractors' coverage area, the contractor currently providing oxygen services shall notify and arrange for oxygen services with the contractor whose area the veteran is traveling to.

5.14.3 For veterans traveling outside the areas covered by VISN's 19 & 21 and/or temporarily relocating, the contractor shall arrange for oxygen services at no additional cost to the VA. All Maintenance requirements of Section 5.5 are applicable to this section. All set up and maintenance forms shall be sent to the respective facility COR or P&SAS. Travel outside of VISN's 19 & 21 include the remaining United States and the Philippines. Other Foreign travel is solely the responsibility of the Veteran.

5.14.4 In the event the contractor has to use a subcontractor for Oxygen services related to travel, and additional costs are incurred, the contractor shall provide copies of all subcontractor invoices with the monthly invoice. The contractor will be reimbursed the contract rate plus the additional costs for providing the appropriate oxygen service.

SECTION 6 - EQUIPMENT SPECIFICATIONS

6.1.1 Oxygen Concentrator Systems: Systems shall include regulator/flow meter, up to 50 feet length of colored extension tubing, nasal cannula's, humidifier, distilled water, and can include, venti-masks, adult tracheostomy mask, transtracheal devices, emerging heaters for heated mist, trach T adapter with drainage bags, and a Liter Flow Restrictor and all oxygen delivery devices when prescribed by VA physician. Concentrator systems shall provide at a minimum 93% +/3% oxygen concentration at a flow of 0-10 liters per minute (lpm); allow operational simplicity and be equipped with a simple flow rate of oxygen; shall be equipped with a built-in “Alarm System” and be self-testing each time the unit is turned on. During normal operation, this alert system is to have the capability of notifying the VA beneficiary that it may be necessary to switch to an alternate source of oxygen. The size and weight of the unit shall allow the user to realize maximum mobility. The unit will be double insulated, and the compressor thermally protected.

Concentrator systems shall be in the range of 115 volts, 60 Hz, 15 amps/430 watts with household circuit current properly grounded and have UP approval. The alert system shall operate without degradable cells. Low Decibel concentrator units shall provide 95% +/-3% flow at 1-3 lpm, 92% +/-3% flow at 5 lpm and 90% +/-3% flow at 5 lpm.

The Contractor will provide a 48-hour emergency backup system in the event of a power failure or when it is necessary to shut down the concentrator. Each unit shall have an attached sticker with a correct vendor name and emergency telephone number, date with the serial number, and date including the hobb meter hours last serviced.

6.1.2 Portable 02 Cylinders: The portable cylinder system shall include: Oxygen Regulator/Flowmeter 0-8 or 0-15 lpm, Small Cylinder Yoke Connection, Carrying Bag, Electronic or Pneumatic conserver device, as requested by provider, and necessary consumables; E, D, C, and M-6 size cylinder; Mobile cart; Cylinder wrench; Cylinder stand; cart;

shoulder bag or backpack. All oxygen regulators shall use a metal-bound elastometric sealing washer to interface with cylinder valves as specified by the National Institute for Occupational Safety and Health as well as the FDA.

6.1.3 Valves: Valves shall comply with American National Standard 857.1-1965, “Compressed Gas Cylinder Valve Outlet and Inlet Connections". One-way Valves between CPAP units and the deliver tubing when oxygen is entrained.

6.1.4 Medical Compressed Air: Medical compressed air shall conform to compressed Gas Association Pamphlet G-7, “Standard for Compressed Air for Human Respiration, Type 1, Medical” which may be obtained from Compressed Gas Association, Inc., 1235 Jefferson Davis Highway, Arlington, VA 22202. The FDA's Compressed Medical Gases Guideline, revised February 1989, shall also be adhered to. Oxygen is to be furnished in cylinders and/or liquid dispensing systems that are in accordance with the requirements of the Interstate Commerce Commission Regulations and the specification set forth In the Code of Federal Regulations (CFR) 49. All oxygen provided shall be United States Pharmacopeia (USP) oxygen.

6.1.5 Cylinders and Containers: All cylinders and/or containers for gaseous and liquid forms of gases shall comply with Department of Transportation (DOT) specifications. They will be maintained, filed, marked, labeled, shipped, traced and/or other procedures, (e.g., recalls) to comply with current DOT regulations, (Title 49-Transportation, Code of Federal Regulations) on packaging, labeling, etc., for medical gases. Compliance is required with the Federal Food, Drug, and Cosmetic Act. All Cylinders will have a fixed flow regulator. The Contractor will maintain a log of cylinder lots and batch numbers, which will facilitate immediate location and identification for possible retrieval. In addition to marking of cylinders required by law, the marking shall comply with the American National Standard 248.1 - 1954(RI 971), Method of Marking Portable Compressed Gas containers to identify the material contained.

6.1.6 Portable Liquid Medical Oxygen Unit System includes nasal cannula, with sufficient length of nasal tubing as required, 75.1b. Reservoir including contents (when provided in the absence of a liquid stationary system rental) and one (1) lb portable container with shoulder straps and/or carrying case. Oxygen conserving devices or portable containers with built in oxygen conservation, e.g.