36C26221R0002.docx

36C26221R0002

PAGE 1 OF

1. 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.

DUNS:

DUNS+4:

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. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

36C26221R0002 01-19-2021

LEE TANNER

(951) 601 4530 02-18-2021 10:00

PST

36C262 Department of Veterans Affairs Network Contracting Office 22 4811 Airport Plaza Drive Suite 600 Long Beach

CA

90815 X X 621610 $16.5 Million N/A X Department of Veterans Affairs Network Contracting Office 22 4811 Airport Plaza Drive Suite 600 Long Beach 90815

36C262 Department of Veterans Affairs Network Contracting Office 22 4811 Airport Plaza Drive Suite 600 Long Beach

CA

90815

The Contractor shall bill in arrears to:

Tungsten Network http://www.tungsten-network.com/us/

1-877-489-6135 See CONTINUATION Page Home Oxygen and Ventilator Services Set-aside for Service-Disabled Veteran Owned Small Business This is a request for a proposal (RFP), all offers shall be submitted via email to Contract Specialist Lee Tanner at lee.tanner@va.gov, PDF files only.

Geographical Area #1 VA Long Beach Healthcare System VA Loma Linda Healthcare System VA Greater Los Angeles Healthcare System VA San Diego Healthcare System See CONTINUATION Page X x One 1 Sandra Fusco Contracting Officer Table of Contents

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 36C262 Department of Veterans Affairs Network Contracting Office 22 4811 Airport Plaza Drive Suite 600 Long Beach CA 90815

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

3. INVOICES: Invoices shall be submitted in arrears:

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.

The Contractor shall bill in arrears to:

Tungsten Network http://www.tungsten-network.com/us/

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

SCOPE OF CONTRACT AND PERFORMANCE WORK STATEMENT

1. SCOPE OF WORK

1.1 VISN 22 currently serves some estimated 8,500 home respiratory care patients. The intent of this contract is to provide all the necessary labor, facilities, transportation, and management to perform home oxygen and ventilator services, to include storage and management of Government-owned home oxygen and ventilator equipment, delivery, set-up, instruction and maintenance of equipment for VA beneficiaries as directed by the VISN 22 Department of Veteran Affairs Healthcare System (VAHCS) facilities listed herein. Here after, home oxygen and ventilator equipment will be referred to as equipment. The use of the term’s “beneficiary”, “Veteran” and “Patient” are used interchangeably and refer to the recipient of required supplies, equipment, and incidental services required under the contract.

1.2 Licensed Respiratory Therapist (LRT) services are required for patients on ventilators.

1.3 All services will be performed in the Veteran’s physical place of residence. The equipment needs are subject to change as determined by the prescribing physician. The contractor shall have a facility or resources physically located in area of service depicted in Attachment 1, in which they will provide service. The contractor’s office location shall include the service office, warehouse, dispatch of vehicles and other functions related to the performance of services of this contract within a fifty (50) mile radius of the VA facilities listed in Attachment 1 to facilitate periodic inspections by VA and/or other accrediting agencies.

1.4 The geographical boundaries described herein (see Attachment 1) have been determined as the areas of responsibility/jurisdiction for each local VA Healthcare System.

1.5 Certain tasks described within this Performance Work Statement must be performed in accordance with the standards promulgated by The Joint Commission. These standards, available at www.jointcommission.org, form a part of this Performance Work Statement and are incorporated herein by reference.

2. SERVICE SPECIFICATIONS

2.1 ORDERS: The Contracting Officer’s Representative (COR) or designee will provide (via encrypted email or 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 VA approved encrypted email and fax) of the request within two (2) working hours of notification; the COR or designee will also provide notification if VA owned equipment is to be provided. The notification may be made orally but will be confirmed in writing within one (1) working day. The written documents will include the authorizing official’s signature, electronic or written. Should there be no Government owned equipment available for issue or replacement, the Contractor has the authority to provide rental equipment and notify the Prosthetics COR.

2.2 BACKUP SYSTEM: The Contractor shall provide Veterans that have a prescription for an oxygen concentrator with a backup system per the prescription, consisting of a compressed gas source and regulator with stand, humidifiers and cannulas/mask for use during the event of a power failure or mechanical problem with non-electrical oxygen supply to last three (3) times the Contractor’s response time. The Contractor shall provide documentation (via VA approved encrypted email and fax) if the Veteran declines the oxygen back-up system, to include the reason for declining backup system and the Veterans signature. Notification (via VA approved encrypted email and fax) shall be provided to COR or designee within five (5) business days of the Veteran declining any prescribed equipment or contractor’s inability to deliver the prescribed equipment. Veterans on continuous mechanical ventilation require two (2) ventilators on hand.

2.3 In accordance with the prescription received from the VAMC, the contractor shall provide the patient with the following items at the time of set-up and when needed as re-supply. Any cost for shipping of the following items shall be borne by the Contractor:

Home Oxygen Supplies:

a. Humidifiers and water traps. The number of humidifiers provided must be sufficient to ensure that they are not depleted between re-supply visits. The number of traps will be based on the patient’s flow rate.

b. Disposable oxygen cannulas, including pendant cannulas, on hand for change at a minimum of every two (2) weeks with a supply in reserve at all times until the contractors next scheduled visit.

c. Disposable masks for change/wash every two (2) weeks with a 30-day supply in reserve at all times until the contractors next scheduled visit.

d. Twenty-five (25) to fifty (50) feet of green oxygen connection tubing shall be replaced every six (6) months with an equivalent section of tubing in reserve at all times (to be included in initial set-up) until the contractors next scheduled visit. The tubing should be green in order to see it better.

e. Trachea collar and accessories (e.g. tubing and large volume nebulizer) with a supply on hand allowing for change every three (3) days with a supply in reserve at all times until the contractors next scheduled visit.

f. Fire-safe valves (thermal fuses) – (2) two fire safe valves must be provided and installed in each home oxygen delivery system (one at the patient end and one at the oxygen source). This must be done for the patient’s primary oxygen therapy equipment as well as any portable oxygen therapy equipment. Fire safe valves are not required for portable pulse dose/intermittent oxygen therapy equipment when the equipment does not have continuous flow setting. The fire safe valves must be changed upon renewal of prescription or immediately if actuated or involved in a fire.

g. Safety holders shall be provided for all patients with a prescription for four (4) or more cylinders.

h. O-rings for 2200 and 3000 psi regulator.

i. Carrying bag specifically designed for carrying oxygen cylinders and replaced as needed.

Ventilator Supplies:

j. Circuit, tubing, adapters, connectors, power pack, humidification and bacterial filter

k. Detachable Battery(s)

l. Replacement Power Cord

m. External Battery and Charger

n. Single Patient use carrier or backpack

o. SD Card

p. Exhalation Porting Block Active w/PAP and passive exhalation circuits

q. Nasal or mask interface for non-invasive (to include NIOV)

r. Clinical Manual

s. Quick Start Guide

t. O2 Inlet Quick Connect (low flow)

2.4 INITIAL SETUPS: Initial set-ups are for those patients who do not have a VA authorized oxygen therapy delivery system. The contractor shall provide the initial set-up within four (4) hours of request from the COR or designee (dependent on patient’s availability), to include after normal business hours, weekends and holidays; this response time shall also apply to service calls.

a. Initial set-ups for Home Oxygen may be provided by the contractor’s Patient Service Technician; does not have to be a Licensed Respiratory Therapist (LRT). Initial set-ups for ventilators require an LRT. The LRT must meet the Veteran at the home upon initial discharge from the hospital. The VISN 22 facilities reserve the right to obtain the initial set-up service from another source and to charge the contractor with any excess cost which may result there from if the contractor is unable to meet the 4-hour response time.

b. Set-up for patients being discharged will require contractor to deliver sufficient oxygen to designated discharge location to enable a safe discharge.

c. Initial set-up of Home Oxygen/Ventilators includes setting up and ensuring the appropriate oxygen system is operational, instruction and training of patient, and/or caregiver, as well as performing a home environment safety check.

d. Patients may be on continuous or intermittent mechanical ventilation using the LTV 1150 ventilator, Respironics Trilogy 100 or other ventilator as designated by the VA.

e. The Contractor shall provide patients with a telephone number to contact with any questions or if additional information is required. All equipment shall contain an adhesive type label containing the vendor’s name and emergency 24-hour toll-free phone number. This label shall be placed on the equipment in an area that is viewable to patients and caregivers. Patient shall be given a document listing a toll-free phone number for routine resupply of oxygen cylinders and supplies.

f. The Contractor shall provide and post on all entrances into the residence, a sign stating, "Warning Oxygen in Use, No Smoking" or other verbiage that No Smoking is allowed due to oxygen being present and document that the patient/caregiver is instructed in the safe use of oxygen and equipment per OSHA regulations. Specified sign shall be no smaller than 4” X 6”.

g. The Contractor shall send electronic confirmation to the Clinical COR within (1) one business day of ventilator issuance and education. The documentation must include the type of equipment issued/delivered and the serial number, type of circuit and size, any problems encountered in the set-up (i.e. patient not able to do return demo, patient or caregiver unable to understand instructions, environment will not support equipment).

2.5 The Contractor shall provide the Operation manual for all equipment to the patient and/or caregiver upon delivering any equipment. The manual shall contain information on operation, maintenance, and trouble- shooting.

2.6 HOME ASSESSMENT REQUIREMENTS: The Contractor shall perform an assessment of the patient’s home and home environment in accordance with the Joint Commission accreditation standards and maintain documentation of assessments in the individual patient records to include but not limited to the following:

a. The Contractor shall notify the COR/designee or prescribing physician during the home visit if the Contractor’s staff determines that the presence of oxygen and/or ventilator in the home presents such a danger that the oxygen and/or ventilator must be removed, or in the case of an initial set-up, not placed in the home. Unsafe conditions may include, but are not limited to, fire safety hazards, oxygen safety hazards or any instance that places the patient or Contractor’s staff in immediate danger. The Contractor shall contact the COR or designee by phone during the home visit. Written documentation (via VA approved encrypted email) will be furnished to the COR or designee within one (1) business day of the incident.

b. The Contractor shall ensure the electrical outlets in the patient’s home meet the requirements of the contractor’s equipment standards and immediately report unsafe conditions to the COR or designee.

c. The Contractor shall notify the COR or designee by telephone at time of set- up if any alteration to the patient's home is necessary to accommodate the equipment, including electrical work. Any alterations to the patient’s residence will be the responsibility of the patient

d. The Contractor shall verify the presence of working smoke alarms and instruct the patient to test all smoke alarms monthly and include this verification in the documentation of assessment. The Contractor shall document any home where smoke alarms are not present and fully functional, the Contractor shall provide this notification to the COR or designee (via VA approved encrypted email) within five (5) business days of the service.

2.7 Every six (6) months or more often as needed the Contractor shall visit all patients on concentrators to reassess equipment compliance and educational needs. A qualified service technician may perform this service. A report shall be developed, signed and dated by the contract staff and the patient/caregiver and a copy shall be left with the patient/caregiver. The reports shall be legible and attached to the invoice. All reports shall be submitted to the COR or designee in alphabetical order, with the monthly bills by the 10th business day of the month following service. This service will be billed as CLIN 019. The written report shall include at a minimum the following data:

a. Name and social security number (SSN) of patient using the equipment.

b. Monitor compliance on prescription (LPM, hours per day).

c. Type of concentrator and hours on concentrator.

d. Inspection results of liter flow rate in monitoring patient compliance (as compared to prescription).

e. Inspection compliance of filters (exchange or clean by patient if applicable) according to manufacturer’s guidelines.

f. Follow-up education and/or reinforcement of compliance documented.

2.8 MONTHLY VISIT’S FOR VENTILATOR PATIENTS: The Contractor’s Licensed Respiratory Therapist (LRT) will visit all patients on ventilators monthly to inspect equipment and reassess educational needs. Documentation of all home visits shall be signed and dated by the LRT and the patient/caregiver and a copy shall be left with the patient/caregiver. The documentation shall be attached to the monthly invoice. This service will be billed as CLIN 022.

2.9 The Contractor shall report to the COR special incidents found or occurring during a home visit; to include finding Patients in need of emergency medical assistance, safety hazards that do not fall into the category of presenting immediate life-threatening danger to the Patient or Contractor’s staff, inability to contact a Patient within a reasonable period of time, and any other incident meeting the Contractor’s written policy for incident reporting according to Joint Commission accreditation standards. All reports shall be provided to the COR via VA approved encrypted email within 24 hours. Contractor shall report all life-threatening situations to the proper authorities immediately (e.g. 911, police, and any other emergency responders).

2.10 The Contractor shall notify the Clinical COR or designee immediately if any of the following conditions are known to exist concerning the patient:

2.11 Failure of the Contractor to respond to routine deliveries or emergency service calls within 24 hours after notification by the VA may be considered grounds for invoking provisions of FAR 52.212-4(m) “Termination for Cause”. The Government may “off-set” for services not provided.

3. PATIENT EDUCATION

3.1 The Contractor shall provide education to each patient or caregiver at the time of set-up and assess the need for reinforcement during visits. This information is to be presented by demonstration and material covered shall be in written form to be left with the patient /caregiver. The written material shall be in English as well as the foreign language of the patient, should the patient not speak English. The Contractor as directed by COR or designee will implement any new or revised education material. The VA will determine whether the contractor shall use their forms or forms supplied by the VA for documentation of education services provided to patients.

3.2 The Contractor shall provide educational and warning information for patients, their families, and caregivers on the hazard of smoking while oxygen is in use. The education materials must be provided upon initial delivery and every six (6) months thereafter. Education materials shall instruct patients on oxygen that smoke to remove the cannula, shut-off the oxygen supply, stand a minimum of 25 feet away and wait for oxygen to dissipate prior to smoking.

3.3 Incidents where patients are reported as non-compliant with the guidelines set forth in the education and orientation material or whose behavior poses a risk of self-harm or harm to others shall be documented by the contractor and reported to the Home Oxygen Coordinator and the COR.

3.4 The Contractor shall provide patients a copy of VA Patient Rights & Responsibilities, and any information concerning advance directives during initial setup. VA Patient Rights & Responsibilities will be provided to the Contractor by the COR.

4. TRAVELING PATIENTS

4.1 Patients will be instructed by the Contractor and VA staff to notify the Contractor at least two (2) weeks before intent to travel within the United States. Accommodations shall be made for short notice in the event of a family emergency. Travel outside the United States is not covered under this contract.

4.2 The Contractor shall provide patients traveling within the geographical area covered by the contract all oxygen services hereunder at the contract rate utilizing Contractor furnished equipment only. The Contractor shall invoice the appropriate VA facility as established herein.

4.3 When the patient is temporarily traveling outside of the contracted area, the Contractor shall arrange for oxygen services at the same contract rate (billed to the patient’s resident VAMC) if the Contractor has a subsidiary office located at the temporary destination. If not, the Contractor will coordinate with the VAMC nearest the patient’s destination to arrange for oxygen services.

4.4 Patients receiving oxygen services under this contract are authorized a maximum of thirty (30) days travel, with a maximum of two (2) set-up charges within a one (1) year period. Subsequent to this, any other oxygen costs will be the patient’s responsibility. It is the Contractor’s responsibility to monitor usage and notify COR if the limits will be exceeded.

5. EMERGENCY SERVICES

5.1 Emergency services are for medical equipment provided to patients when an equipment malfunction or natural disaster may threaten a patient's health. The Contractor shall provide to the Contracting Officer a written emergency management plan, in compliance with Joint Commission standards. This emergency action plan shall address continuity of services for all patients in the affected region.

5.2 The contractor shall have a well-established communication system, providing 24-hour emergency services and shall provide services at the patient’s place of residence within six (6) hours of a call.

5.3 The Contractor shall ensure all patients have a minimum of non-electrical oxygen supply to last three (3) times the Contractor’s response time to be on-site at a patient’s residence after receiving a call. The minimum supply shall consider each patient’s prescription flow-rate and distance from the Contractor’s location; actual supply levels may differ from patient to patient, if each patient has oxygen supply to last a minimum of three (3) times the Contractor’s response time as well as three (3) times the battery life (for vent). If the Contractor is unable to respond to an emergency service call with six (6) hours, the contractor shall make arrangements with another supplier to provide oxygen at the patient’s residence at the contractor’s expense. Contractor shall provide a written explanation of Contractor’s inability to provide emergency service to the COR or authorized personnel within two (2) business days. The cost of backup oxygen systems, backup oxygen, and backup equipment shall be borne by the contractor. If H or M tanks are used for backup, the contractor shall furnish an H or M tank stand for each tank.

5.4 The contractor shall notify the COR or designee immediately in the event of a disaster, natural or otherwise, that may affect the service covered under this contract. The Contractor shall provide patients with written instructions about what to do in case of a natural disaster or other emergency.

5.5 The Contractor shall provide patients phone numbers to call during emergencies twenty-four (24) hours a day, seven (7) days a week. Any changes to the emergency points of contacts or their contact information shall be communicated to VA within three (3) business days.

6. DISCONTINUANCE OF SERVICE

6.1 The COR or designee will notify the Contractor of VA initiated discontinuance of service to any patient covered under this contract. Notification shall be by telephone, fax and/or encrypted email. Payment will be pro-rated for the month in which service is terminated and will be terminated five (5) business days after notification to the Contractor to discontinue service. The Contractor shall notify the COR or authorized personnel within the next business day if Contractor becomes aware of a patient death, or upon finding a patient has moved out of the service area.

6.2 After notification to discontinue service, the Contractor shall remove all equipment from the patient’s residence at the earliest possible time, but no later than five (5) business days after receiving notice unless approved by COR or designee. The date and time of equipment pickup shall be coordinated with the patient or next of kin. The Contractor shall make every effort to meet the patient’s or patient’s families’ requests for pickup times. The Contractor shall honor patient’s or family’s requests to pick up equipment before or after funerals or family gatherings relative to patients’ funeral. The Contractor shall treat such requests with the utmost courtesy and give such requests the highest priority.

7. CONTRACTOR VISITS

7.1 The Contractor shall visit the patient’s residence in performance of this contract by appointment only, between the hours of 8:00 a.m. and 8:00 p.m., Monday through Friday; exceptions will be made in the cases of emergencies. The Contractor shall schedule the appointments to the patient’s home 24-48 hours prior to the appointment. On each scheduled setup/delivery, the Contractor shall reassess the need to instruct the patient on the use and care of the equipment and supplies.

7.2 The Contractor shall make every effort to establish appointments with patients when initiating set-ups and deliveries. Deliveries shall not be left unattended at the patient’s home; physical acceptance of deliveries must take place between the Contractor and either the patient or caregiver. If the patient repeatedly fails to meet appointments, the Contractor shall notify the COR or designee. The COR or designee will contact the patient and a corrective action plan will be implemented. The COR will notify the Contractor of any changes. If the Contractor has not made valid and documented attempts to contact the patient for set-ups and or deliveries the Government reserves the right to call in a third party to provide those services and bill the Contractor for any additional costs the Government incurs because of such action.

8. EXCESS DELIVERY: The VA will not pay for delivery of supplies or equipment in excess of those prescribed without prior authorization by VA.

9. REPORTS: The list of quarterly reports is included in Attachment 6. All quarterly reports are due to the COR or designee by the 5th working day after the conclusion of the quarter via VA approved encrypted email. The reporting quarters are as follows: October 1st through December 31st, January 1st through March 31st, April 1st through June 30th and July 1st through September 30th

9.1 Performance Review Report - The Contractor shall provide a written, quarterly report addressing all the Joint Commission Standards for improving organizational performance (The Joint Commission standards may be accessed at www.jointcommission.org) to the COR. The Contractor shall assess and score each Joint Commission standard and element of performance that is applicable to the contracted services by entering a self-assessed score. Any noncompliant finding or gaps in service identified on the self-assessment shall require a plan of action to correct the finding.

9.2 Patient Satisfaction Report - The Contractor shall collect satisfaction data from Patients and their families on a quarterly basis in accordance with Joint Commission standards. A copy of survey results shall be submitted to COR or designee in quarterly reports via VA approved encrypted email.

9.3 Infection Control Report - The Contractor shall collect, trend, and report on data related to the Contractor’s Infection Control Program to the COR or designee on a quarterly basis for each contract performance period.

9.4 Contract Usage Report – Contractor shall provide a quarterly report via email detailing contract usage by each Medical Center. The report shall include the total units per CLIN and total dollars invoiced by CLIN. Additionally, a composite report of each facility’s usage, to include the total number of unique Patients, the total number of units used by CLIN, the total dollars invoiced by CLIN is required.

9.5 Home Visit Report – Contractor shall provide a quarterly report on the six (6) month home visit requirement for patients on concentrators. Report shall be inclusive to all veterans serviced under the contract. Data shall include date of last home visit, due date of next home visit, incomplete home visits including documentation and action plan.

9.6 The Contractor shall provide the following emergent patient safety reports, within one (1) business day of the action:

a. Sentinel Events - The contractor is required to inform the Home Oxygen Coordinator and/or COR within one (1) business day of a sentinel event via VA approved encrypted email that occurs during the performance of this contract that involves patients serviced under this contract. The Joint Commission defines a sentinel event as a patient safety event that reaches a patient and results in death, permanent harm or severe temporary harm.

b. Refusal of service - All patients have the right of refusal of service. In the event a patient refuses service or orders the equipment to be removed from the home, the Contractor shall comply with the patient’s wishes. The Contractor shall report the specifics of the refusal to the COR by telephone within one (1) hour. If the refusal occurs during a home visit, the Contractor’s staff shall try to notify the COR or designee of the refusal during the home visit.

c. Non-compliant behavior - The Contractor shall report non-compliant behavior with fire safety guidelines set forth in the Patient education and re-assessment material and/or behaviors which pose a risk of self-harm or harm to others. Such behavior shall be reported to the COR or their designee during the home visit if the Contractor's staff determines the patient's non-compliant behavior, within the home environment, is not improving after education. The Contractor shall document noncompliant behavior and any follow-up actions (i.e. education).

10. EQUIPMENT AND SUPPLY REQUIREMENTS

10.1 The Contractor shall deliver, install and service all equipment and supplies ordered under this contract. All disposable supplies are to be new and unused. A label with the contractor’s name and emergency telephone number where they can be reached 24 hours/day shall be affixed to all equipment. A label identifying Government owned equipment shall be affixed to all Government owned equipment.

10.2 INSTALLATION: The installation of equipment by the Contractor shall be performed by a competent professional familiar with nature of the equipment involved and fully qualified under the laws of the State in which the services are being rendered. Installation shall be consistent with local Fire and Safety Codes in the respective area of the State and shall conform to National Fire Protection Association (NFPA) 99/101 (Life Safety Codes) NFPA (Oxygen Cylinder Requirements) which are incorporated herein by reference. The Contractor shall provide a safety/emergency checklist to be completed, then signed by the patient or caregiver and retained in the patient’s account records.

10.3 The Contractor shall not change or alter a patient’s oxygen prescription or equipment requirements without a new prescription from the patient’s VA physician.

10.4 The VISN 22 facilities will not pay for the Contractor’s lost or damaged equipment provided under this contract unless circumstances as reviewed by the COR are concluded to be the result of willful negligence on behalf of patients or VAHCS employees. Accordingly, this is the cost of doing business, and is the requirement of the Contractor to pay for this type of loss. Contractor may request payment for lost or damaged equipment by submitting a written summary of the circumstances of lost or damaged equipment to the COR within 30 calendar days of the occurrence of the incident in question. The COR will review the summary, and a written determination will be made to the Contractor as to the liability. The VISN 22 facilities will not pay for rental on equipment not being used by an authorized patient during the performance of this contract or for equipment that cannot be found.

10.5 OXYGEN CONCENTRATORS: The Contractor shall provide oxygen concentrators that are Underwriter Laboratory (UL) approved and must at a minimum meet the following specifications:

a. Electrically powered (115 volts)

b. Shall include a battery-operated audible alarm to indicate a power failure

c. The oxygen concentrator shall not perform below the manufacturer’s specification

d. The oxygen concentrator shall contain an hour meter and oxygen concentration indicator (OCI)

e. The oxygen concentrator shall be grounded internally or plug into a three-prong wall outlet appropriate for the patient’s home (outlet adaptors are not acceptable).

10.6 FIVE (5) LPM (LITERS PER MINUTE) CONCENTRATOR: The Contractor shall provide 5 LPM Concentrators that meet the following specifications:

a. Deliver 90% oxygen at flow rates up to 5LPM.

b. Operate on 120 VAC, 60 Hz

c. Have thermal protector for compressor

d. Be double insulated or have three prong plugs

e. Have pressure compensated flow meter

f. Have high-low pressure alarm

g. Have power failure alarm

h. Weight 60 pounds or less

i. Be mounted on wheels for easy movement by patient/caregiver

j. Must meet FDA QSR standards

k. Minimum of three-year warranty on concentrator and compressor

l. Sound level of 60db or less Note: Concentrators shall have oxygen sensing devices.

10.7 TEN (10) LPM CONCENTRATOR: The Contractor shall provide 10 LPM Concentrators that meet the following specifications:

a. Deliver oxygen flow rates: (I) 95% to 92% @ 1/2 - 7 LPM flow (II) 95% to 90% @ 7-10 LPM flow (O2 Pressure: 7 PSIG (48 KPA) normal)

b. Alarms for the following failures are required: Power Failure, 02 Concentration (Optional), and Irregular Pressure

c. Be double insulated or have three prong plugs

d. Have power failure alarm

e. Be mounted on wheels for easy movement by patient/caregiver.

f. Must meet FDA QSR standards

g. Minimum of two-year warranty on concentrator and compressor.

h. Sound level of 60 db or less Note: Concentrators shall have oxygen sensing devices.

10.8 OXYGEN CONSERVING DEVICES: The Contractor shall provide Oxygen Conserving Devices that are battery-powered or pneumatic powered devices that limits oxygen flow to inspiration only and thereby increase the duration of the supply. Pneumatic units must meet the following specifications:

a. Flow settings from 1 to 6 or higher

b. Have easy to read content gauge

c. Conservation ratio of 3:1 or higher

d. Have at least 2-year warranty

e. Weight less than 30 oz.

Notes: 1) Pneumatic conservers may use double lumen cannula.

2) Conserving ratios are based on a breath rate of 20 bpm.

Battery-powered Oxygen Conserving Devices must meet the following specifications:

a. Minimum flow settings from 1 to 5

b. Have easy to read content gauge

c. Conservation ratio of 3:1 or higher

d. Bolus delivered per breath of at least 10cc per setting

e. Have continuous flow setting

f. Have at least 2-year warranty

g. Weight less than 30 oz.

10.9 LIQUID OXYGEN SYSTEM: Liquid oxygen system consists of large reservoir and portable unit that is filled from the reservoir. Standard reservoir holds 110 pounds of liquid oxygen and portable unit holds 3-5 pounds of liquid oxygen. The Contractor shall provide liquid oxygen systems that meet the following specifications:

a. Reservoir must have condensation collection tray

b. Must have quick release valve for easy refilling

c. Flow meter range of 1 to 6 LPM, or 1-15LPM for high flow systems

d. Portable unit must come with shoulder strap

e. Shall have electrical or mechanical content indicators

f. Shall have a portable cart or vented backpack bag for portability

10.10 LIQUID OXYGEN SYSTEM WITH CONSERVING DEVICE: Liquid oxygen system with conserving device consists of large reservoir and portable unit that is filled from the reservoir. Standard reservoir holds 110 pounds of liquid oxygen and portable unit holds 0.9 pounds of liquid oxygen. The standard reservoir weighs 165 pounds full and the portable unit weighs 4 to 8 pounds full. The Contractor shall provide liquid oxygen systems with conserving devices that meet the following specifications:

a. Reservoir must have condensation collection tray

b. Must have quick release valve for easy refilling

c. Must have flow settings of 1-6 or 1-15

d. Portable unit must come with shoulder strap and belt loop holder

e. Shall have electrical or mechanical content indicators

10.11 SELF-FILL OXYGEN SYSTEM: The Contractor shall provide self-fill oxygen systems to include a minimum of 4 self-fill compatible oxygen tanks unless otherwise specified (sizes M6, C, D or E), carrying bag, cart, conserving device, fill station and self-fill compatible concentrator. The carrying bag must be specifically designed for carrying oxygen cylinders and replaced as needed.

10.12 PORTABLE OXYGEN CONCENTRATOR: The Contractor shall provide portable oxygen concentrators that can provide continuous flow (FAA Approved) and shall be able to provide a minimum of 2 LPM and a pulse setting of 5, weigh 20 pounds or less, AC/DC capability, continuous and pulse doses (40 ml or greater) flow option.

10.13 VENTILATOR: The Contractor shall provide ventilator as prescribed by the clinical staff.

10.14 EQUIPMENT RECALL: The Contractor is required to have in place an electronic system of notification of equipment hazards, defects and recalls, and shall maintain an effective plan and record of all recall actions. The Contractor shall notify the VA of any recalls initiated and those VA beneficiaries affected within (5) five working days or receipt of recall notification. The VA will likewise notify the Contractor if notification of recall is received.

10.15 Any H or M size oxygen cylinder furnished by the Contractor shall include an H or M size oxygen cylinder safety stand. This stand shall remain contractor-owned. Cylinders shall be clean (free of dust, insects, rodent residue or other soil) when delivered to patient’s residence.

10.16 The Contractor agrees to provide cylinders without assessing demurrage charges on the Government.

10.17 Oxygen provided meet United States Pharmacopoeia (USP) standards.

10.18 SUPPLIES: The Contractor shall have on stock supplies (excludes gas or liquid oxygen) available for issuing or mailing out. Beneficiaries or the COR may telephonically request supplies to be replenished. Replacement supplies shall be shipped by the end of the following business day after the initial order was placed.

10.19 STOCK STORAGE: The Contractor shall, upon request by the facility, stock cylinders, regulators, and carts for Patients who deplete their portable units during appointments or to send home with new start-up (e.g. discharged from inpatient). The Contractor shall coordinate with the Prosthetics and Sensory Aids Service and Respiratory Therapy Services at each facility, for accountability and payment. As authorized, the Contractor shall deliver a portable set-up or refill for Patient discharge at any local facility.

11. EQUIPMENT MAINTENANCE AND REPAIRS

11.1 CONCENTRATORS: The Contractor shall provide service and preventive maintenance (PM) on oxygen equipment (contractor-furnished equipment and government-owned equipment) as recommended by the manufacturer. The Contractor shall track and document maintenance of equipment in accordance with manufacturer specifications and provide these records to the COR for review upon request. Preventive maintenance shall only be performed by a certified service technician that has received the appropriate training. The Contractor shall conduct a check of the concentrator using a certified oxygen analyzer that is calibrated according to the manufacturer standards. The Contractor shall change compressor inlet pre-filters and compressor inlet bacteria filters according to the manufacturer recommendations. The Contractor shall test the alarm battery at each maintenance check; the Contractor shall change the alarm battery as indicated, but at least annually. The Contractor shall ensure that every concentrator has a label or pouch that indicates the most recent service date, service hours and technician’s name. Contractor shall furnish parts and labor for routine maintenance.

11.2 VENTILATORS: The Contractor shall provide service and preventive maintenance (PM) on contractor-furnished ventilators as recommended by the manufacturer. The Contractor shall track government-owned ventilators for preventive maintenance (PM) in accordance with manufacturers specifications. If a ventilator needs maintenance, either scheduled or unscheduled, the contractor will pick up the ventilator from the patient’s home and replace with another ventilator. VA owned ventilators in need of manufacturer’s recommended PM and/or repairs shall be shipped to the manufacturer by the Contractor. The COR shall be notified of necessary repairs and cost prior to approval of those repairs. VA is responsible for costs of maintenance and repairs to the manufacturer and shall be paid separately from this contract.

11.3 RECONDITIONING/REPAIRS: Contractor will prepare equipment for re-issue that meets manufacturer’s recommendations. The Contractor shall track and perform reconditioning service on equipment, which will be returning to service. Reconditioning is at no charge to the Government.

11.4 When it is determined by the VA that an item is beyond economical reconditioning, the item will be held in storage, tagged as unserviceable, and returned to the VA or disposed as instructed.

11.5 Failed equipment will be evaluated and exchanged if needed, upon request of the COR or beneficiary. Contractor will document cause of failure and serial number of broken equipment and send electronic documentation to COR within (1) one business day of providing the service. If failed equipment is under warranty, the contractor shall arrange to have the equipment exchanged or replaced to VA stock. If the equipment is under warranty the contractor is not responsible for shipping charges.

12. LICENSED CLINICAL RESPIRATORY THERAPIST (LRT)

12.1 Licensed Respiratory Therapist (LRT) refers to both Registered Respiratory Therapist (RRT) and Certified Respiratory Therapist (CRT). Registered Respiratory Therapist (RRT) is the preferred licensure for this contract. However, Certified Respiratory Therapists (CRT) may be considered if the CRT’s competencies specific to home ventilation is documented and maintained current throughout the life of this contract. A Licensed Respiratory Therapist (LRT) must be on staff to make home visits to VA beneficiaries on ventilators. The Certified/Registered RT must be licensed and/or have practicing privileges in the state where services are to be rendered. LRT shall maintain licensure throughout the performance of the contract.

12.2 The Contractor’s therapist shall be competent in the use of the prescribed ventilators, Vest therapy, or other ventilator as designated by the VA, oxygen delivery, aerosol equipment, tracheotomies, airway care, and suction machines and cough assist devices. The Contractor shall inform the VA immediately of any change in LRT staff and have competent back up staff to service the beneficiaries.

12.3 The Contractor’s LRT must perform initial set-up of the ventilator system and provide thorough education to patient and caregiver in proper ventilator usage, ventilator function and operation including control knobs, power sources, adding oxygen, troubleshooting the ventilator and alarms, the remote alarm, checking tidal volume, ventilator tubing change, talking devices, cleaning of tubing and humidifier, back pressure with Jackson trach tube (if applicable), bagging with AMBU bag, and supplies consistent with requirements and per manufacturer recommendations.

12.4 Instructions to the patient and caregiver shall include demonstrating the correct use and observing a return demonstration by the patient/caregiver. Documentation of this demonstration signed by the patient/caregiver shall be sent to the VA within one (1) day of delivery or setup of services.

12.5 The Contractor’s LRT shall provide instructions to the patient and/or caregiver in the safe and appropriate use of equipment to include basic home safety, storage and handling of the involved equipment, required maintenance, electrical safety, whom to call in the event of an emergency, etc. Monthly home visits by the Contractor’s LRT shall be performed to inspect equipment and reassess educational needs.

12.6 Written and or video instructions in layman’s terms on the use of ventilators and related supplies is to be provided to the patient/caregiver for on-going reference.

12.7 LRT should notify the Clinical COR or designee in writing and/or by phone of any clinical changes noted during the visit. Critical changes in the patient’s condition related to ventilation should be reported to the pulmonologist of record or patient may be advised to go to the closest Emergency Department for care.

12.8 LRT’s shall not provide any direct patient care that is not explicitly required by the contract.

13. NON-PERSONAL HEALTHCARE SERVICE CONTRACT: The service portion of this contract is a non-personal health care services contract in which the personnel rendering the services are not subject, either by the contract terms or by the manner of its administration, to the supervision and control usually prevailing in relationship between the Government and its employees. The Government will evaluate the quality of professional and administrative services provided but retains no control over the medical and professional aspects of the services rendered. The Contractor shall be fully responsible for the actions of its employees and shall indemnify the Government for any liability producing act or omission by the contractor, its employees and agents occurring during contract performance.

14. REQUIREMENTS AND STANDARDS

14.1 Periodic, unscheduled on-site contractor and home respiratory care patient visits will be made by the COR or designee to monitor the Contractor’s performance under this contract. The contractor shall make available all records and documentation necessary during the monitoring visits. Other visits shall be made by the Joint Commission surveyors and the Home Oxygen Coordinator for each facility

14.2 The Contractor shall develop and maintain a patient account record no more than five (5) days after the initial oxygen set-up and maintain it in compliance with the Privacy Act and Health Insurance Portability and Accountability Act (HIPPA). All patient records are subject to review by designated officials and accreditation surveyors on the behalf of VISN 22 during accreditation surveys or consultation. These records shall include prescription, plan of care, patient education documentation, reports of infections, safety inspection, initial setup with safety check, invoices/delivery slips, equipment list w/serial numbers, changes in patient care and family support system and any other documentation required by Joint Commission. All signed deliveries and maintenance documentation shall be filed in the patient’s record.

14.3 The Contractor shall provide its staff with…