36C26126Q0452 Questions and Responses.pdf

1. Please identify all documents that are part of this solicitation package. At present, the package appears to include the solicitation document, the Quality Assurance Surveillance

Plan, and the Past Performance Questionnaire. Please confirm whether any additional attachments, exhibits, maps, utilization schedules, incumbent inventories, or transition data exist.

Response: These are all documents at this time plus the requested spreadsheet below.

2. Please provide an editable Microsoft Excel version of the full price schedule for this solicitation.

Response: Will be included with the amendment. This spreadsheet is to input unit pricing only and shall not be edited.

3. Please provide actual utilization by Contract Line Item Number for the incumbent contract, by month, for at least the prior twenty-four months and year-to-date, in

Microsoft Excel format.

Response: These numbers change due to our Veterans needs. This is why the quantities are estimated. No additional data will be provided.

4. Please provide the current number of unique active patients by major modality, including portable oxygen concentrator, gaseous oxygen, stationary liquid oxygen, portable liquid oxygen, suction, ventilator, government-owned ventilator setup, CPAP, BiLevel, and nebulizer, if applicable.

Response: These numbers change due to our Veteran’s needs. This is why the

5. Please provide patient distribution by island and, if possible, by ZIP code or service area cluster, so offerors can price travel, staffing, inter-island logistics, and transition requirements accurately.

Response: Please see page 49 of the RFQ for locations required.

6. Please provide the current number of ventilator patients by invasive versus non-invasive modality and identify whether any patients are dependent on government-furnished equipment.

7. Please identify the incumbent contractor for this catchment area and confirm whether the incumbent is currently using contractor-owned equipment, government-owned equipment, or a mixed inventory.

Response: The incumbent is Apria Healthcare LLC (36C26124D0062). As for the second part of your question, please see the line items and PWS.

8. Please identify all VA facilities, clinics, Community Based Outpatient Clinics, or other locations within the VA Pacific Islands Health Care System that will place orders, coordinate care, or otherwise require contractor interaction under this contract, including any neighbor-island locations.

Response: Islands of Hawaiʻi, Maui, Oʻahu, Kauaʻi, Molokaiʻi, Lānaʻi. [VA Clinical

Centers: 459 - VA HONOLULU, 459GA – MAUI, 459GB – HILO, 459GC – KONA, 459GD – KAUAI, 459GG – KAPOLEI, 459QA – LANAI, 459QB – MOLOKAI, 459QC – WINDWARD]

9. The Performance Work Statement states that non-territory requests will be required from time to time and that the VA reserves the right to assign such patients to any contractor.

Please provide historical volume, patient counts, locations, and ordering assumptions for non-territory patients or requests under the incumbent contract.

Response: California, Oregon, Washington, Arizona. Approximately 48 patients on official and leisure travel to continental United States.

10. Please provide historical actual utilization for all Contract Line Item Numbers, including line items presently shown as zero quantity, because quantities are estimates only and several line items appear materially understated, unused, duplicated, or ambiguous.

Response: These numbers change due to our Veteran’s needs. This is why the quantities are estimated. No additional data will be provided. The “0” quantity reduces the need for a modification delaying the Veterans needs when the time arises.

11. Please confirm whether zero-quantity Contract Line Item Numbers must still be priced and, if so, whether those prices will be evaluated for reasonableness or only retained for possible future use.

Response: As stated on page 4 of the RFQ “Each item requires a quoted price even if the item reflects a quantity of zero (0).”

12. Please confirm that the line-item descriptions, HCPCS codes, and units are internally consistent across the full schedule, and please identify and correct any drafting errors or unintended duplications.

Response: Reviewed. No changes.

13. Please clarify the intended distinctions among potentially duplicate or ambiguous line items, including CLIN 0006 ("React V + C as Requested" with a suction-pump description), CLINs 0015 and 0016 (government-owned ventilator set-up), and the option-year air-compressor lines 1010 and 1011, 2010 and 2011, 3010 and 3011, and

4010 and 4011.

Response: These items are not included with this contract.

14. Please confirm whether the maximum ceiling of $9,000,000.00 for this solicitation is based on historical actual utilization, a budget cap, a planning estimate, or another methodology.

Response: This is based on historical data and IGCE, which will not be provided.

15. Please clarify whether the Government intends to evaluate extended prices using the estimated quantities shown in the schedule, notwithstanding the statement that quantities are estimates only.

Response: Please see RFO clause 52.217-8 on page 87 of the RFQ.

16. Please provide a schedule showing historical annual spend under the incumbent contract, by base year and option year if available, to explain the relationship between historical utilization, historical award values, and the current maximum ceiling.

17. Please confirm whether delivery charge Contract Line Item Number A9901 is intended only for deliveries not otherwise compensated through monthly rental line items, and please provide historical utilization for that line item.

Response: Confirmed. Utilized for items necessary but not available locally or contracted items such as equipment necessary for trach patients.

18. Please confirm whether Respiratory Therapist visit line item VA120 applies only to

Government-requested visits outside the standard statement of work cadence or whether it may also apply to additional medically necessary visits requested by the facility.

Response: Confirmed. Not historically utilized.

19. Please confirm whether offerors may propose equivalent equipment and supplies meeting the required function and performance characteristics wherever a particular branded or specifically named item appears in the schedule or narrative. If so, please revise the schedule and solicitation to state "or equal" or "same/similar" as appropriate.

Response: No particular brand has been stated.

20. Please confirm whether maintenance of government-owned ventilator systems is limited to listed model(s) or whether other government-owned ventilator makes and models may be issued during performance.

Response: No current/historical government-owned ventilator systems.

21. Please provide the current population, historical usage, and expected ordering assumptions for government-owned ventilator setup and maintenance Contract Line Item

Numbers.

22. Please confirm the correct product/service code for this solicitation.

Response: W065 is correct.

23. Please confirm that the option-year CLIN schedules are complete and free of unintended duplications, omissions, or carry-forward errors, and please identify any planned amendment to correct the schedule.

Response: These are ordering periods and not option periods.

24. Please confirm whether quoted unit prices are required to include all inter-island transportation, air cargo, ferry or barge charges, hazardous-material handling, remote delivery surcharges, and similar logistics costs, or whether any such costs may be billed separately.

Response: All inclusive price.

25. The Performance Work Statement requires monthly home visits for ventilator patients and every ninety days for home oxygen patients, but the Quality Assurance Surveillance

Plan appears to measure only a ninety-day assessment and report. Please revise the

Quality Assurance Surveillance Plan so it aligns with the Performance Work Statement and includes ventilator-specific surveillance metrics.

Response: Updated QASP attached to reflect SOW.

26. The Performance Work Statement requires quarterly infection control and performance improvement reports due by the fifth working day after quarter-end, while the Quality

Assurance Surveillance Plan appears to refer to semiannual reports due by the eighth calendar day of the sixth and twelfth months. Please identify which requirement governs and revise the documents to eliminate the discrepancy.

27. The Quality Assurance Surveillance Plan appears to reference patient refusals, patient decline of back-up systems, emergency service not provided within six hours, ninety-day assessment and report, and semiannual reports, but does not expressly measure order confirmation timeliness, same-day setup, ventilator setup, monthly ventilator home visits, or local after-hours coverage. Please confirm whether the Quality Assurance Surveillance

Plan will be amended to match the full statement of work.

28. The Quality Assurance Surveillance Plan appears to provide that the Contractor shall be given two hours after notification to correct unacceptable performance. Please clarify how this cure concept applies to completed service failures that cannot be retroactively corrected, such as a missed same-day setup or missed emergency response timeline.

29. Please confirm whether the home visit report requirement in the Performance Work

Statement, including date of last home visit, due date of next home visit, incomplete visits, action plan, and individual visit reports within five business days, will be incorporated into surveillance metrics or otherwise enforced only through statement of work compliance.

30. Please clarify whether the Contractor is responsible only for equipment-related assessment and education or whether the Government expects broader clinical reassessment functions. The Quality Assurance Surveillance Plan states that patient assessment and plan of care are solely provided by Department of Veterans Affairs staff, while the Performance Work Statement requires extensive Respiratory Therapist activity.

Response: Updated QASP attached to reflect SOW. While this contract reviews education requirements of the contracted vendor, this does not absolve VA clinicians from educational responsibility in regards to plans of care.

31. Please confirm the required timing for order confirmation. The ordering section states that confirmations are required for any order placed, but does not specify a uniform deadline. Please define the required acknowledgment timeframe for routine, urgent, and emergency orders.

Response: Follow 3.2D, orders are expected to be confirmed same day if received by

3PM local time, within 24 hours if received after 3pm local time.

32. Please confirm whether "same day when the prescription is received by 3:00 PM local time" governs across all days, including weekends and holidays, and whether that same standard applies to ventilator setups or only oxygen and service calls.

Response: VAPIHCS is an outpatient-only facility. Same-day standards adhere to the administrative hours of PSAS Service and COR; Mon-Fri 0800-1500. This standard applies to ventilator patients as well.

33. Please clarify how the requirement for a facility or resources physically located in the geographic area within fifty miles of each medical center applies to this Hawaii solicitation, where services span multiple islands but the main VA facility is in Honolulu.

Please confirm whether the Government expects on-island resources sufficient to meet response times on Oahu, Kauai, Maui County including Molokai and Lanai, and Hawaii

Island.

Response: Apria Healthcare maintains facilities on the islands of O'ahu, Maui, and

Hawai'i. The Government expects on-island resources sufficient to meet response times specified. Historically there have not been any past issues in response times.

34. Please confirm whether the emergency response requirement of service within two hours and, in no case, more than six hours is measured at the patient location on each island, and whether the Government will permit compliance through subcontracted on-island resources where the prime does not maintain employees or inventory on every island.

Response: Yes, response time is measured at patient location, however the

Government will permit compliance through subcontracted resources when necessary, including during unmitigated weather/disaster occurrences.

35. Please confirm whether the required emergency management plan must address inter-island flight, ferry, barge, or freight disruption and island-specific events such as volcanic activity, hurricanes, tsunamis, wildfires, or port closures, and whether the Government expects pre-positioned backup oxygen inventory on each island.

Response: The emergency management plan must address disruptions, as they are real potential, and the Government expects pre-positioned backup inventory.

36. The current phase-in period is up to ninety days after award. Given the need to safely transition oxygen patients, ventilator patients, government-furnished equipment, incumbent-owned equipment, and inter-island operations without interruption, please extend transition-in to a minimum of one hundred eighty days.

Response: No change.

37. If the Government will not extend transition-in to one hundred eighty days, please provide the rationale for a ninety-day phase-in and identify the assumptions underlying that timeline, including expected patient volume by island, incumbent cooperation, inter-island logistics, and the number of ventilator patients.

Response: 90-Days is an acceptable timeframe.

38. Please clarify whether the incoming contractor is expected to replace all contractor-owned incumbent equipment within ninety days even where the incumbent equipment remains clinically appropriate and no patient-safety issue exists.

Response: The incoming contractor is not expected to replace all contractor-owned equipment as this equipment is already contractor-owned.

39. Please provide a transition roster showing current active patients by modality, island, and equipment type, including identification of government-owned equipment and any ventilator-dependent patients.

Response: Provided after award to awardee.

40. Please confirm whether the Government will require a formal transition plan as part of the technical submission and, if so, please provide evaluation criteria or a template.

Response: There is no formal transition plan as this is the current contractor for oxygen services.

41. Please clarify how proration will be handled when the incumbent remains in place during phase-in, including the treatment of partial-month rental, Respiratory Therapist visits, and delivery line items.

Response: The Government may exercise RFO 52.217-8.

42. Please identify whether the Government will facilitate joint transition meetings among the incoming contractor, incumbent contractor, Contracting Officer’s Representative, Prosthetic and Sensory Aids Service, and clinical leadership, including any island-specific care teams as applicable.

Response: Yes

43. Please confirm whether the incumbent must continue service beyond contract expiration under Federal Acquisition Regulation 52.237-3 Continuity of Services if transition is incomplete, and please identify whether that clause will be expressly incorporated in the awarded contract.

Response: Yes

44. Please identify whether the Government anticipates any patient populations that will require delayed transition, such as ventilator patients, skilled nursing facility residents, neighbor-island patients with limited transport options, or patients using unique home modifications.

Response: Will be discussed after award with the awardee.

45. Please identify whether the Government expects the incoming contractor to establish or evidence on-island inventory, service technicians, respiratory therapists, or subcontracted support on each island before the transition begins.

Response: The Government does not expect this as this is a continuation of the same contractor.

46. Please clarify what documentation is sufficient to establish capability to meet contractor qualifications in Performance Work Statement section 5.2, including licenses, certifications, staffing rosters, and resumes or curriculum vitae.

Response: Documentation from relevant, local, or state agencies for licensing and certifications are expected for staff. A well-organized and clear system is expected for staff rosters with employee files that contain resumes, education, certifications, etc.

47. Please confirm whether a subcontractor’s Respiratory Therapist staff, branch resources, accreditation support, equipment resources, and on-island coverage may be relied upon to satisfy technical capability and geographic coverage requirements, provided limitations on subcontracting are met.

Response: No. We need to be able to audit the contractor to ensure they’re meeting every aspect of the PWS and QASP. Subcontractors can’t be held to those standards since the contract wasn’t awarded to them.

48. Please clarify whether a certified Respiratory Therapist and a registered Respiratory

Therapist are both acceptable for all required set-up and home-visit tasks or whether any tasks require only a registered Respiratory Therapist.

Response: CRTs and RRTs have similar overlap in scope of practice in the State of

Hawai'i, and while RRTs are frequently standardized, CRTs continue to receive licensing. Both CRTs and RRTs are expected to work within their scope of practice within the State of Hawaii.

49. Please identify the minimum staffing assumptions expected by the Government for after-hours service, ventilator coverage, local branch or resource support, and on-island emergency response.

Response: The Government expected the contractor to have the minimum number of staff to provide RRT and medical education coverage, setup/delivery coverage, support coverage for afterhours and emergency response times.

50. Please confirm whether proof of accreditation by a nationally recognized organization other than The Joint Commission will be accepted as equivalent and identify any specific documentation the Government expects with the quote.

Response: Proof of accreditation may be from any recognized accreditation body for home oxygen services equivalent to the Joint Commission and its standards.

51. Please confirm whether the requirement for a direct local number with an employee on duty for after-hours orders prohibits the use of an after-hours call service that escalates to local on-call personnel, or whether a local live-answer model is sufficient.

Response: Local live-answer model is sufficient.

52. Please clarify what evidence the Government will accept to demonstrate inter-island logistics capability, including warehousing, freight arrangements, air or sea transport, on-island inventory, and subcontracted delivery or clinical support.

Response: The Government will accept any documentation that clearly states the

Contractor's capabilities.

53. The posted Past Performance Questionnaire appears to refer to temporary medical staffing or similar services. Please confirm that the form is intended for this home oxygen and ventilator procurement and that references for home oxygen, ventilator, respiratory therapy, durable medical equipment, or analogous in-home respiratory support services will be considered relevant.

Response: PPQ is correct and reflects “Home Oxygen”.

54. Please clarify how many past performance references are required if the offeror has relevant Federal contracts in Contractor Performance Assessment Reporting System and also intends to submit non-Federal references.

Response: See page 87 of the RFQ. “Past Performance from the past 5 years.”

55. Please confirm whether the Government will consider subcontract past performance or key personnel past performance where the prime offeror can demonstrate direct relevance to home oxygen, ventilator, or island-based home respiratory service delivery.

Response: All performance will be evaluated if in the quote.

56. Please confirm whether the evaluator must use the posted questionnaire verbatim or whether a letter on the evaluator’s letterhead addressing the same topics will be accepted if the evaluator declines to complete the form.

Response: The Past Performance Questionnaire is not required. If the vendor is satisfied with their CPARS record, then that it sufficient.

57. Please clarify whether references received after the date requested by the offeror but before quote closing on May 13, 2026 will be considered, especially where evaluator response timing is outside the offeror’s control.

Response: Questionnaires received after the cutoff date will not be accepted.

58. Please confirm whether the Government will consider past performance for home oxygen and ventilator contracts that include similar service components even if the reference contract used a different North American Industry Classification System code or product/service code.

Response: The evaluation of past performance will be on the performance of the vendor regardless of the NAICS.

59. Please confirm whether adverse Contractor Performance Assessment Reporting System information will be evaluated in context, including evidence of correction, rebuttals, and subsequent performance improvement.

Response: If additional information is required then this will be at the discretion of the Contracting Officer.

60. Please confirm whether past performance demonstrating remote, island, or geographically complex delivery operations and continuity-of-services performance will be considered especially relevant to the Government’s evaluation of geographic coverage and past performance.

Response: All past performance will be evaluated within the past 5 years.

61. Standard Form 1449 states that Federal Acquisition Regulation 52.212-5 is attached, but the contract clause section as posted does not clearly reproduce or itemize the specific

52.212-5 clauses applicable to this acquisition. Please provide the full text or attachment for Federal Acquisition Regulation 52.212-5 and identify all checked subclauses applicable to this procurement.

Response: The Revolutionary FAR Overhaul (RFO) has removed 52.212-5 regardless of what the SF 1449 states in block 27a and 27b. All clauses and provisions by reference can be found in section C & D of the RFQ.

62. The transition section expressly references Federal Acquisition Regulation 52.237-3

Continuity of Services, but that clause does not appear to be expressly listed in the clause section provided. Please confirm whether Federal Acquisition Regulation 52.237-3 is intended to be incorporated into the awarded contract and, if so, amend the solicitation accordingly.

Response: If required, this clause may be utilized through a bilateral modification but the RFQ does include RFO 52.217-8 which can meet this need.

63. Please confirm whether the use of Federal Acquisition Regulation 52.217-8 Option to

Extend Services is intended to operate in addition to the phase-out language in the

Performance Work Statement and how the two provisions should be read together if transition extends beyond expiration.

Response: See response above.

64. Please confirm whether the checked and unchecked commercial item clause structure on

Standard Form 1449 is final and whether any additional addenda to Federal Acquisition

Regulation 52.212-4 or 52.212-1 are anticipated by amendment.

Response: If you are referring to block 27a it states “by reference” which they are not. They are provided in full text.

65. Please confirm whether the product or service code shown in the price schedule is correct and amend if necessary.

Response: This is a repeat question. See response above.

66. Please confirm whether quotes, rather than proposals, are the intended submission format, given that Standard Form 1449 reflects a request for quote. If the Government expects proposal-style narratives, please identify any page limits, formatting requirements, and file naming conventions.

Response: This is solicited under RFO Part 12 utilizing Simplified Procedures so an

RFQ is correct.

67. Please confirm whether there are any page limits, file size limits, or file-format limitations for the technical submission, pricing schedule, certifications, and past performance materials.

Response: There is no page limit but if you send large files, please note that our servers cannot receive large files so, please send multiple emails. It is the

Contractor’s responsibility to ensure all emails and files are received PRIOR to the date and time cutoff.

68. Please confirm whether offerors may submit a subcontractor Letter of Intent or Teaming

Agreement in support of technical capability and geographic coverage.

Response: Offerors may send. This does not change the evaluation factors.

69. Please confirm whether the Government will permit clarifications if a required attachment is inadvertently omitted, given the statement that award may be made without discussions.

Response: If clarifications are needed, this will be made at the discretion of the

Contracting Officer.

70. Please clarify whether the requirement for a facility or resources physically located in the geographic area within fifty miles of each medical center must be satisfied at the time of quote submission or may be established by award with binding evidence of capability, particularly given the multi-island nature of the catchment.

Response: May be established after award but must show binding evidence prior to start of performance.

71. Please confirm whether proof of local resources may include subcontractor resources, leased space, warehousing arrangements, freight arrangements, or service agreements rather than only a wholly owned staffed branch.

Response: Yes, but if working with a different subcontractor after award then this will need to be verified prior to start of performance.

72. Please confirm whether technical capability, location or geographic coverage, past performance, and price are listed in descending order of importance or whether they are of equal importance. The current evaluation language does not expressly state relative weight.

Response: They are not weighted.

73. Please confirm whether the Government will evaluate only compliance with the items listed under Factor 1 Technical Capability or whether broader Performance Work

Statement requirements will be comparatively assessed.

Response: See RFO 52.212-2 on page 90 of the RFQ.

74. Please confirm whether make-and-model information will be required in the quote where the Government requests commercial product debrief information on the make and model of the delivered product.

Response: No. We will request this information once the contract is awarded. We will need this information to request maintenance requirements from the manufacturer.

75. Please clarify whether Factor 2 Location / Geographic Coverage will be evaluated based on proximity to Honolulu only, patient-location coverage across the islands, or both.

Response: Factor 2 Location / Geographic Coverage will be evaluated based on patient-location coverage across the islands to the Contractors established sites.