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36C26221R0120
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
36C26221R0120 08-11-2021 Sandra Fusco 562-766-2226 09-03-2021 12pm
PDT
00262 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 4811 Airport Plaza Drive Suite 600 Long Beach CA 90815 00262 Department of Veterans Affairs Network Contracting Office 22 4811 Airport Plaza Drive Suite 600 Long Beach CA 90815
Department of Veterans Affairs Financial Services Center P.O. Box 149971 Austin TX 78714-9971 In-home Oxygen and In-home Ventilator Services for New Mexico VA Health Care System.
This solicitation is set aside 100% for Service Disabled Veteran Owned Small Businesses.
See subsequent pages for details.
X x Sandra Fusco Table of Contents
| SECTION A | 1 |
| A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS | 1 |
| SECTION B - CONTINUATION OF SF 1449 BLOCKS | 3 |
| B.1 CONTRACT ADMINISTRATION DATA | 3 |
| B.2 SCHEDULE OF SERVICES AND PRICE | 4 |
| B.3 PERFORMANCE WORK STATEMENT | 13 |
| SECTION C - CONTRACT CLAUSES | 35 |
| C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (OCT 2018) | 35 |
| C.2 52.216-18 ORDERING (AUG 2020) | 40 |
| C.3 52.216-19 ORDER LIMITATIONS (OCT 1995) | 41 |
| C.4 52.216-22 INDEFINITE QUANTITY (OCT 1995) | 41 |
| C.5 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999) | 42 |
| C.6 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) | 42 |
| C.7 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA ACQUISITION OF COMMERCIAL ITEMS (APR 2020) | 42 |
| C.8 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING—MONITORING AND COMPLIANCE (JUL 2018) | 44 |
| C.9 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) | 45 |
| C.10 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (JAN 2021) (JUL 2020) (DEVIATION) | 45 |
| C.11 MANDATORY WRITTEN DISCLOSURES | 52 |
| SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS | 53 |
| See attached document: D.1 Reference Contract Worksheet | 53 |
| See attached document: D.2. Listing of DOL Wage Determinations_NMVAHCS | 53 |
| See attached document: D.3 Price Worksheet NMVAHCS | 53 |
| See attached document: D.4 Geographic Coverage Area - NMVAHCS | 53 |
| SECTION E - SOLICITATION PROVISIONS | 54 |
| E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (JUL 2021) | 54 |
| E.2 NOTIFICATION TO OFFERORS & PROPOSAL SUBMISSION INSTRUCTIONS | 58 |
| E.3 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014) | 60 |
| E.4 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (OCT 2020) | 60 |
| E.5 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018) | 63 |
| E.6 52.216-1 TYPE OF CONTRACT (APR 1984) | 64 |
| E.7 52.233-2 SERVICE OF PROTEST (SEP 2006) | 64 |
| E.8 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998) | 65 |
| E.9 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL ITEMS (FEB 2021) (JUL 2020) (DEVIATION) | 65 |
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 Sandra Fusco 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:
| [] |
| 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] Monthly |
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.
5. ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:
36C26221R0120
Page 1 of
B.2 SCHEDULE OF SERVICES AND PRICE
This is an indefinite delivery, indefinite quantity, (IDIQ) fixed-price contract. Prices in this schedule represent an all-inclusive rate including labor, incidental costs, overhead, and insurance premium payments for applicable insurance coverage. Costs not incorporated into the contractor’s price will not be reimbursed by the Government.
The guaranteed minimum amount for this contract is $2,000.00. The maximum aggregate value of the orders that can be placed under this contract is $50,000,000.00. The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum amount.
The previous option period pricing will apply to any extension pursuant to FAR 52.217-8 The contract period of performance for this Indefinite Delivery Indefinite Quantity Contract (IDIQ) is a Base Period of One-Year and seven (7) One-Year option periods to be exercised at the discretion of the Government.
Base Period of Performance: November 1, 2021 – October 31, 2022
| ITEM NUMBER |
| DESCRIPTION |
| UNIT |
| UNIT PRICE |
| 0001 |
| Delivery, initial set-up, and patient education for Stationary Oxygen Concentrator System with backup system |
| JB |
| $ |
| 0002 |
| Delivery, initial set-up, and patient education for Portable Concentrator System with backup system |
| JB |
| $ |
| 0003 |
| Preventive Maintenance Services (PM) for Government owned concentrators |
| JB |
| $ |
| 0004 |
| Monthly Rental of Stationary Oxygen Concentrator System with backup system |
With flow rate of 0-5 liters per minute
| 0005 |
| Monthly Rental of Stationary Oxygen Concentrator System with backup system |
With flow rate of 0-10 liters per minute
| 0006 |
| Monthly Rental of Portable Oxygen Concentrator System with backup system |
| EA |
| $ |
| 0007 |
| Delivery, set-up, and patient education for Self fill Oxygen System |
| JB |
| $ |
| 0008 |
| Rental of Self fill Oxygen System |
| EA |
| $ |
| 0009 |
| Stationary Cylinder set-up, size H or M60 |
| JB |
| $ |
| 0010 |
| Cylinder, size H refill |
| EA |
| $ |
| 0011 |
| Cylinder, size M60 refill |
| EA |
| $ |
| 0012 |
| Cylinder, size “E” refill |
| EA |
| $ |
| 0013 |
| Cylinder, size “C” refill |
| EA |
| $ |
| 0014 |
| Cylinder, size “D” refill |
| EA |
| $ |
| 0015 |
| Cylinder, size “B” refill |
| EA |
| $ |
| 0016 |
| Portable Oxygen Concentrator Rental for Traveling Patients |
| EA |
| $ |
| 0017 |
| Monthly rental liquid oxygen system |
| EA |
| $ |
| 0018 |
| Monthly rental portable liquid oxygen system |
| EA |
| $ |
| 0019 |
| Liquid oxygen per pound for item #0016 |
| LBS |
| $ |
| 0020 |
| Home visit by Patient Services Technician |
| JB |
| $ |
| 0021 |
| Delivery, initial set-up, and patient education for ventilator with backup system. An LRT must perform initial set-up |
| JB |
| $ |
| 0022 |
| Monthly Rental of ventilator with backup system |
| JB |
| $ |
| 0023 |
| Monthly LRT visit for patients on ventilators |
| JB |
| $ |
| 0024 |
| Delivery of ventilator to local VA Facility |
| JB |
| $ |
| 0025 |
| Service Call: Trouble shoot or delivery of replacement ventilator to the patient's home |
| HR |
| $ |
| 0026 |
| Cost to package and ship Government-Owned ventilator to manufacturer |
| JB |
| $ |
| 0027 |
| Delivery for re-supply and/or relocation of equipment due to change in beneficiary’s residence within Region |
| JB |
| $ |
| 0028 |
| Fee for deliveries/pick-ups made for over 100 miles |
| JB |
| $ |
Option Period One (1): November 1, 2022 – October 31, 2023
| ITEM NUMBER |
| DESCRIPTION |
| UNIT |
| UNIT PRICE |
| 1001 |
| Delivery, initial set-up, and patient education for Stationary Oxygen Concentrator System with backup system |
| JB |
| $ |
| 1002 |
| Delivery, initial set-up, and patient education for Portable Concentrator System with backup system |
| JB |
| $ |
| 1003 |
| Preventive Maintenance Services (PM) for Government owned concentrators |
| JB |
| $ |
| 1004 |
| Monthly Rental of Stationary Oxygen Concentrator System with backup system |
With flow rate of 0-5 liters per minute
| 1005 |
| Monthly Rental of Stationary Oxygen Concentrator System with backup system |
With flow rate of 0-10 liters per minute
| 1006 |
| Monthly Rental of Portable Oxygen Concentrator System with backup system |
| EA |
| $ |
| 1007 |
| Delivery, set-up, and patient education for Self fill Oxygen System |
| JB |
| $ |
| 1008 |
| Rental of Self fill Oxygen System |
| EA |
| $ |
| 1009 |
| Stationary Cylinder set-up, size H or M60 |
| JB |
| $ |
| 1010 |
| Cylinder, size H refill |
| EA |
| $ |
| 1011 |
| Cylinder, size M60 refill |
| EA |
| $ |
| 1012 |
| Cylinder, size “E” refill |
| EA |
| $ |
| 1013 |
| Cylinder, size “C” refill |
| EA |
| $ |
| 1014 |
| Cylinder, size “D” refill |
| EA |
| $ |
| 1015 |
| Cylinder, size “B” refill |
| EA |
| $ |
| 1016 |
| Portable Oxygen Concentrator Rental for Traveling Patients |
| EA |
| $ |
| 1017 |
| Monthly rental liquid oxygen system |
| EA |
| $ |
| 1018 |
| Monthly rental portable liquid oxygen system |
| EA |
| $ |
| 1019 |
| Liquid oxygen per pound for item #0016 |
| LBS |
| $ |
| 1020 |
| Home visit by Patient Services Technician |
| JB |
| $ |
| 1021 |
| Delivery, initial set-up, and patient education for ventilator with backup system. An LRT must perform initial set-up |
| JB |
| $ |
| 1022 |
| Monthly Rental of ventilator with backup system |
| JB |
| $ |
| 1023 |
| Monthly LRT visit for patients on ventilators |
| JB |
| $ |
| 1024 |
| Delivery of ventilator to local VA Facility |
| JB |
| $ |
| 1025 |
| Service Call: Trouble shoot or delivery of replacement ventilator to the patient's home |
| HR |
| $ |
| 1026 |
| Cost to package and ship Government-Owned ventilator to manufacturer |
| JB |
| $ |
| 1027 |
| Delivery for re-supply and/or relocation of equipment due to change in beneficiary’s residence within Region |
| JB |
| $ |
| 1028 |
| Fee for deliveries/pick-ups made for over |
100 miles
Option Period Two (2): November 1, 2023 – October 31, 2024
| ITEM NUMBER |
| DESCRIPTION |
| UNIT |
| UNIT PRICE |
| 2001 |
| Delivery, initial set-up, and patient education for Stationary Oxygen Concentrator System with backup system |
| JB |
| $ |
| 2002 |
| Delivery, initial set-up, and patient education for Portable Concentrator System with backup system |
| JB |
| $ |
| 2003 |
| Preventive Maintenance Services (PM) for Government owned concentrators |
| JB |
| $ |
| 2004 |
| Monthly Rental of Stationary Oxygen Concentrator System with backup system |
With flow rate of 0-5 liters per minute
| 2005 |
| Monthly Rental of Stationary Oxygen Concentrator System with backup system |
With flow rate of 0-10 liters per minute
| 2006 |
| Monthly Rental of Portable Oxygen Concentrator System with backup system |
| EA |
| $ |
| 2007 |
| Delivery, set-up, and patient education for Self fill Oxygen System |
| JB |
| $ |
| 2008 |
| Rental of Self fill Oxygen System |
| EA |
| $ |
| 2009 |
| Stationary Cylinder set-up, size H or M60 |
| JB |
| $ |
| 2010 |
| Cylinder, size H refill |
| EA |
| $ |
| 2011 |
| Cylinder, size M60 refill |
| EA |
| $ |
| 2012 |
| Cylinder, size “E” refill |
| EA |
| $ |
| 2013 |
| Cylinder, size “C” refill |
| EA |
| $ |
| 2014 |
| Cylinder, size “D” refill |
| EA |
| $ |
| 2015 |
| Cylinder, size “B” refill |
| EA |
| $ |
| 2016 |
| Portable Oxygen Concentrator Rental for Traveling Patients |
| EA |
| $ |
| 2017 |
| Monthly rental liquid oxygen system |
| EA |
| $ |
| 2018 |
| Monthly rental portable liquid oxygen system |
| EA |
| $ |
| 2019 |
| Liquid oxygen per pound for item #0016 |
| LBS |
| $ |
| 2020 |
| Home visit by Patient Services Technician |
| JB |
| $ |
| 2021 |
| Delivery, initial set-up, and patient education for ventilator with backup system. An LRT must perform initial set-up |
| JB |
| $ |
| 2022 |
| Monthly Rental of ventilator with backup system |
| JB |
| $ |
| 2023 |
| Monthly LRT visit for patients on ventilators |
| JB |
| $ |
| 2024 |
| Delivery of ventilator to local VA Facility |
| JB |
| $ |
| 2025 |
| Service Call: Trouble shoot or delivery of replacement ventilator to the patient's home |
| HR |
| $ |
| 2026 |
| Cost to package and ship Government-Owned ventilator to manufacturer |
| JB |
| $ |
| 2027 |
| Delivery for re-supply and/or relocation of equipment due to change in beneficiary’s residence within Region |
| JB |
| $ |
| 2028 |
| Fee for deliveries/pick-ups made for over |
100 miles
Option Period Three (3): November 1, 2024 – October 31, 2025
| ITEM NUMBER |
| DESCRIPTION |
| UNIT |
| UNIT PRICE |
| 3001 |
| Delivery, initial set-up, and patient education for Stationary Oxygen Concentrator System with backup system |
| JB |
| $ |
| 3002 |
| Delivery, initial set-up, and patient education for Portable Concentrator System with backup system |
| JB |
| $ |
| 3003 |
| Preventive Maintenance Services (PM) for Government owned concentrators |
| JB |
| $ |
| 3004 |
| Monthly Rental of Stationary Oxygen Concentrator System with backup system |
With flow rate of 0-5 liters per minute
| 3005 |
| Monthly Rental of Stationary Oxygen Concentrator System with backup system |
With flow rate of 0-10 liters per minute
| 3006 |
| Monthly Rental of Portable Oxygen Concentrator System with backup system |
| EA |
| $ |
| 3007 |
| Delivery, set-up, and patient education for Self fill Oxygen System |
| JB |
| $ |
| 3008 |
| Rental of Self fill Oxygen System |
| EA |
| $ |
| 3009 |
| Stationary Cylinder set-up, size H or M60 |
| JB |
| $ |
| 3010 |
| Cylinder, size H refill |
| EA |
| $ |
| 3011 |
| Cylinder, size M60 refill |
| EA |
| $ |
| 3012 |
| Cylinder, size “E” refill |
| EA |
| $ |
| 3013 |
| Cylinder, size “C” refill |
| EA |
| $ |
| 3014 |
| Cylinder, size “D” refill |
| EA |
| $ |
| 3015 |
| Cylinder, size “B” refill |
| EA |
| $ |
| 3016 |
| Portable Oxygen Concentrator Rental for Traveling Patients |
| EA |
| $ |
| 3017 |
| Monthly rental liquid oxygen system |
| EA |
| $ |
| 3018 |
| Monthly rental portable liquid oxygen system |
| EA |
| $ |
| 3019 |
| Liquid oxygen per pound for item #0016 |
| LBS |
| $ |
| 3020 |
| Home visit by Patient Services Technician |
| JB |
| $ |
| 3021 |
| Delivery, initial set-up, and patient education for ventilator with backup system. An LRT must perform initial set-up |
| JB |
| $ |
| 3022 |
| Monthly Rental of ventilator with backup system |
| JB |
| $ |
| 3023 |
| Monthly LRT visit for patients on ventilators |
| JB |
| $ |
| 3024 |
| Delivery of ventilator to local VA Facility |
| JB |
| $ |
| 3025 |
| Service Call: Trouble shoot or delivery of replacement ventilator to the patient's home |
| HR |
| $ |
| 3026 |
| Cost to package and ship Government-Owned ventilator to manufacturer |
| JB |
| $ |
| 3027 |
| Delivery for re-supply and/or relocation of equipment due to change in beneficiary’s residence within Region |
| JB |
| $ |
| 3028 |
| Fee for deliveries/pick-ups made for over |
100 miles
Option Period Four (4): November 1, 2025 – October 31, 2026
| ITEM NUMBER |
| DESCRIPTION |
| UNIT |
| UNIT PRICE |
| 4001 |
| Delivery, initial set-up, and patient education for Stationary Oxygen Concentrator System with backup system |
| JB |
| $ |
| 4002 |
| Delivery, initial set-up, and patient education for Portable Concentrator System with backup system |
| JB |
| $ |
| 4003 |
| Preventive Maintenance Services (PM) for Government owned concentrators |
| JB |
| $ |
| 4004 |
| Monthly Rental of Stationary Oxygen Concentrator System with backup system |
With flow rate of 0-5 liters per minute
| 4005 |
| Monthly Rental of Stationary Oxygen Concentrator System with backup system |
With flow rate of 0-10 liters per minute
| 4006 |
| Monthly Rental of Portable Oxygen Concentrator System with backup system |
| EA |
| $ |
| 4007 |
| Delivery, set-up, and patient education for Self fill Oxygen System |
| JB |
| $ |
| 4008 |
| Rental of Self fill Oxygen System |
| EA |
| $ |
| 4009 |
| Stationary Cylinder set-up, size H or M60 |
| JB |
| $ |
| 4010 |
| Cylinder, size H refill |
| EA |
| $ |
| 4011 |
| Cylinder, size M60 refill |
| EA |
| $ |
| 4012 |
| Cylinder, size “E” refill |
| EA |
| $ |
| 4013 |
| Cylinder, size “C” refill |
| EA |
| $ |
| 4014 |
| Cylinder, size “D” refill |
| EA |
| $ |
| 4015 |
| Cylinder, size “B” refill |
| EA |
| $ |
| 4016 |
| Portable Oxygen Concentrator Rental for Traveling Patients |
| EA |
| $ |
| 4017 |
| Monthly rental liquid oxygen system |
| EA |
| $ |
| 4018 |
| Monthly rental portable liquid oxygen system |
| EA |
| $ |
| 4019 |
| Liquid oxygen per pound for item #0016 |
| LBS |
| $ |
| 4020 |
| Home visit by Patient Services Technician |
| JB |
| $ |
| 4021 |
| Delivery, initial set-up, and patient education for ventilator with backup system. An LRT must perform initial set-up |
| JB |
| $ |
| 4022 |
| Monthly Rental of ventilator with backup system |
| JB |
| $ |
| 4023 |
| Monthly LRT visit for patients on ventilators |
| JB |
| $ |
| 4024 |
| Delivery of ventilator to local VA Facility |
| JB |
| $ |
| 4025 |
| Service Call: Trouble shoot or delivery of replacement ventilator to the patient's home |
| HR |
| $ |
| 4026 |
| Cost to package and ship Government-Owned ventilator to manufacturer |
| JB |
| $ |
| 4027 |
| Delivery for re-supply and/or relocation of equipment due to change in beneficiary’s residence within Region |
| JB |
| $ |
| 4028 |
| Fee for deliveries/pick-ups made for over |
100 miles
Option Period Five (5): November 1, 2026 – October 31, 2027
| ITEM NUMBER |
| DESCRIPTION |
| UNIT |
| UNIT PRICE |
| 5001 |
| Delivery, initial set-up, and patient education for Stationary Oxygen Concentrator System with backup system |
| JB |
| $ |
| 5002 |
| Delivery, initial set-up, and patient education for Portable Concentrator System with backup system |
| JB |
| $ |
| 5003 |
| Preventive Maintenance Services (PM) for Government owned concentrators |
| JB |
| $ |
| 5004 |
| Monthly Rental of Stationary Oxygen Concentrator System with backup system |
With flow rate of 0-5 liters per minute
| 5005 |
| Monthly Rental of Stationary Oxygen Concentrator System with backup system |
With flow rate of 0-10 liters per minute
| 5006 |
| Monthly Rental of Portable Oxygen Concentrator System with backup system |
| EA |
| $ |
| 5007 |
| Delivery, set-up, and patient education for Self fill Oxygen System |
| JB |
| $ |
| 5008 |
| Rental of Self fill Oxygen System |
| EA |
| $ |
| 5009 |
| Stationary Cylinder set-up, size H or M60 |
| JB |
| $ |
| 5010 |
| Cylinder, size H refill |
| EA |
| $ |
| 5011 |
| Cylinder, size M60 refill |
| EA |
| $ |
| 5012 |
| Cylinder, size “E” refill |
| EA |
| $ |
| 5013 |
| Cylinder, size “C” refill |
| EA |
| $ |
| 5014 |
| Cylinder, size “D” refill |
| EA |
| $ |
| 5015 |
| Cylinder, size “B” refill |
| EA |
| $ |
| 5016 |
| Portable Oxygen Concentrator Rental for Traveling Patients |
| EA |
| $ |
| 5017 |
| Monthly rental liquid oxygen system |
| EA |
| $ |
| 5018 |
| Monthly rental portable liquid oxygen system |
| EA |
| $ |
| 5019 |
| Liquid oxygen per pound for item #0016 |
| LBS |
| $ |
| 5020 |
| Home visit by Patient Services Technician |
| JB |
| $ |
| 5021 |
| Delivery, initial set-up, and patient education for ventilator with backup system. An LRT must perform initial set-up |
| JB |
| $ |
| 5022 |
| Monthly Rental of ventilator with backup system |
| JB |
| $ |
| 5023 |
| Monthly LRT visit for patients on ventilators |
| JB |
| $ |
| 5024 |
| Delivery of ventilator to local VA Facility |
| JB |
| $ |
| 5025 |
| Service Call: Trouble shoot or delivery of replacement ventilator to the patient's home |
| HR |
| $ |
| 5026 |
| Cost to package and ship Government-Owned ventilator to manufacturer |
| JB |
| $ |
| 5027 |
| Delivery for re-supply and/or relocation of equipment due to change in beneficiary’s residence within Region |
| JB |
| $ |
| 5028 |
| Fee for deliveries/pick-ups made for over |
100 miles
Option Period Six (6): November 1, 2027 – October 31, 2028
| ITEM NUMBER |
| DESCRIPTION |
| UNIT |
| UNIT PRICE |
| 6001 |
| Delivery, initial set-up, and patient education for Stationary Oxygen Concentrator System with backup system |
| JB |
| $ |
| 6002 |
| Delivery, initial set-up, and patient education for Portable Concentrator System with backup system |
| JB |
| $ |
| 6003 |
| Preventive Maintenance Services (PM) for Government owned concentrators |
| JB |
| $ |
| 6004 |
| Monthly Rental of Stationary Oxygen Concentrator System with backup system |
With flow rate of 0-5 liters per minute
| 6005 |
| Monthly Rental of Stationary Oxygen Concentrator System with backup system |
With flow rate of 0-10 liters per minute
| 6006 |
| Monthly Rental of Portable Oxygen Concentrator System with backup system |
| EA |
| $ |
| 6007 |
| Delivery, set-up, and patient education for Self fill Oxygen System |
| JB |
| $ |
| 6008 |
| Rental of Self fill Oxygen System |
| EA |
| $ |
| 6009 |
| Stationary Cylinder set-up, size H or M60 |
| JB |
| $ |
| 6010 |
| Cylinder, size H refill |
| EA |
| $ |
| 6011 |
| Cylinder, size M60 refill |
| EA |
| $ |
| 6012 |
| Cylinder, size “E” refill |
| EA |
| $ |
| 6013 |
| Cylinder, size “C” refill |
| EA |
| $ |
| 6014 |
| Cylinder, size “D” refill |
| EA |
| $ |
| 6015 |
| Cylinder, size “B” refill |
| EA |
| $ |
| 6016 |
| Portable Oxygen Concentrator Rental for Traveling Patients |
| EA |
| $ |
| 6017 |
| Monthly rental liquid oxygen system |
| EA |
| $ |
| 6018 |
| Monthly rental portable liquid oxygen system |
| EA |
| $ |
| 6019 |
| Liquid oxygen per pound for item #0016 |
| LBS |
| $ |
| 6020 |
| Home visit by Patient Services Technician |
| JB |
| $ |
| 6021 |
| Delivery, initial set-up, and patient education for ventilator with backup system. An LRT must perform initial set-up |
| JB |
| $ |
| 6022 |
| Monthly Rental of ventilator with backup system |
| JB |
| $ |
| 6023 |
| Monthly LRT visit for patients on ventilators |
| JB |
| $ |
| 6024 |
| Delivery of ventilator to local VA Facility |
| JB |
| $ |
| 6025 |
| Service Call: Trouble shoot or delivery of replacement ventilator to the patient's home |
| HR |
| $ |
| 6026 |
| Cost to package and ship Government-Owned ventilator to manufacturer |
| 6027 |
| Delivery for re-supply and/or relocation of equipment due to change in beneficiary’s residence within Region |
| JB |
| $ |
| 6028 |
| Fee for deliveries/pick-ups made for over |
100 miles
Option Period Seven (7): November 1, 2028 – October 31, 2029
| ITEM NUMBER |
| DESCRIPTION |
| UNIT |
| UNIT PRICE |
| 7001 |
| Delivery, initial set-up, and patient education for Stationary Oxygen Concentrator System with backup system |
| JB |
| $ |
| 7002 |
| Delivery, initial set-up, and patient education for Portable Concentrator System with backup system |
| JB |
| $ |
| 7003 |
| Preventive Maintenance Services (PM) for Government owned concentrators |
| JB |
| $ |
| 7004 |
| Monthly Rental of Stationary Oxygen Concentrator System with backup system |
With flow rate of 0-5 liters per minute
| 7005 |
| Monthly Rental of Stationary Oxygen Concentrator System with backup system |
With flow rate of 0-10 liters per minute
| 7006 |
| Monthly Rental of Portable Oxygen Concentrator System with backup system |
| EA |
| $ |
| 7007 |
| Delivery, set-up, and patient education for Self fill Oxygen System |
| JB |
| $ |
| 7008 |
| Rental of Self fill Oxygen System |
| EA |
| $ |
| 7009 |
| Stationary Cylinder set-up, size H or M60 |
| JB |
| $ |
| 7010 |
| Cylinder, size H refill |
| EA |
| $ |
| 7011 |
| Cylinder, size M60 refill |
| EA |
| $ |
| 7012 |
| Cylinder, size “E” refill |
| EA |
| $ |
| 7013 |
| Cylinder, size “C” refill |
| EA |
| $ |
| 7014 |
| Cylinder, size “D” refill |
| EA |
| $ |
| 7015 |
| Cylinder, size “B” refill |
| EA |
| $ |
| 7016 |
| Portable Oxygen Concentrator Rental for Traveling Patients |
| EA |
| $ |
| 7017 |
| Monthly rental liquid oxygen system |
| EA |
| $ |
| 7018 |
| Monthly rental portable liquid oxygen system |
| EA |
| $ |
| 7019 |
| Liquid oxygen per pound for item #0016 |
| LBS |
| $ |
| 7020 |
| Home visit by Patient Services Technician |
| JB |
| $ |
| 7021 |
| Delivery, initial set-up, and patient education for ventilator with backup system. An LRT must perform initial set-up |
| JB |
| $ |
| 7022 |
| Monthly Rental of ventilator with backup system |
| JB |
| $ |
| 7023 |
| Monthly LRT visit for patients on ventilators |
| JB |
| $ |
| 7024 |
| Delivery of ventilator to local VA Facility |
| JB |
| $ |
| 7025 |
| Service Call: Trouble shoot or delivery of replacement ventilator to the patient's home |
| HR |
| $ |
| 7026 |
| Cost to package and ship Government-Owned ventilator to manufacturer |
| 7027 |
| Delivery for re-supply and/or relocation of equipment due to change in beneficiary’s residence within Region |
| JB |
| $ |
| 7028 |
| Fee for deliveries/pick-ups made for over |
100 miles
B.3 PERFORMANCE WORK STATEMENT
1. General Requirements. The contractor shall provide all the labor, facilities, transportation, and management necessary to perform in-home oxygen and in-home ventilator services for New Mexico VA Health Care System (NMVAHCS). NMVAHCS currently serves an estimated 3100 patients with in-home oxygen and 2 patients with in-home ventilator services. This includes storage and management of Government-owned oxygen and ventilator equipment, delivery, set-up, instruction and maintenance of equipment for VA beneficiaries. The use of the term’s “beneficiary”, “Veteran” and “Patient” are used interchangeably and refer to the recipient of the services required under this contract.
1.1. Contractor shall provide Licensed Respiratory Therapists (LRT) to perform services required under this contract for patients on ventilators.
1.2. Contractor shall provide all in-home oxygen and in-home ventilator services in the Veteran’s physical place of residence. The equipment needs for each Veteran are determined by the prescribing physician.
1.3. Contractor shall provide all the tasks described within this Performance Work Statement (PWS) in accordance with the Home Care standards promulgated by The Joint Commission and the National Patient Safety Goals effective January 2021 for the Home Care Program. These standards, available at www.jointcommission.org, form a part of this PWS and are incorporated herein by reference.
2. Specific Contract Requirements.
2.1. Orders. The Contracting Officer’s Representative (COR) will provide (via encrypted email or fax) the contractor with orders 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 or 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 COR.
2.2. Response Time. 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. The Contractor shall also provide 24-hour emergency services and shall provide services at the patient’s place of residence within two (2) hours of a call.
2.3. 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 the 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.
2.4. In accordance with the prescription received from the COR, 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:
2.4.1. Home Oxygen Supplies:
2.4.1.1. 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.
2.4.1.2. Disposable oxygen cannulas, including pendant cannulas, on hand for change at a minimum of every two (2) weeks with a 30-day supply in reserve at all times until the contractors next scheduled visit.
2.4.1.3. 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.
2.4.1.4. 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.
2.4.1.5. 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 30-day supply in reserve at all times until the contractors next scheduled visit.
2.4.1.6. 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.
2.4.1.7. Safety holders shall be provided for all patients with a prescription for four (4) or more cylinders.
2.4.1.8. 10 each O-rings for 2200 and 3000 psi regulator for each regulator delivered.
2.4.1.9. Carrying bag specifically designed for carrying oxygen cylinders and replaced as needed.
2.4.2. Ventilator Supplies:
2.4.2.1. Circuit, tubing, adapters, connectors, power pack, humidification and bacterial filter
2.4.2.2. Detachable Battery (as prescribed)
2.4.2.3. Replacement Power Cord
2.4.2.4. External Battery and Charger
2.4.2.5. Single Patient use carrier or backpack
2.4.2.6. SD Card (as prescribed)
2.4.2.7. Exhalation Porting Block Active w/PAP and passive exhalation circuits
2.4.2.8. Nasal or mask interface for non-invasive (to include NIOV)
2.4.2.9. Clinical Manual
2.4.2.10. Quick Start Guide
2.4.2.11. O2 Inlet Quick Connect (low flow)
2.5. Initial Set-Ups: Initial set-ups are for those patients who do not currently have a VA authorized oxygen therapy delivery system. Patients may be on continuous or intermittent mechanical ventilation using the LTV 1150 ventilator, Respironics Trilogy 100 or another ventilator as designated by the VA.
2.5.1. The Contractor shall ensure that 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 Government reserves 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.
2.5.2. The contractor shall deliver sufficient oxygen to a designated discharge location to enable a safe discharge when Veterans are being discharged from a VA hospital.
2.5.3. The Contractor shall provide initial set-up of Home Oxygen and/or Ventilators which includes setting up and ensuring the appropriate oxygen system is operational, instruction and training to the patient and/or caregiver is completed, and performance of a home environment safety check.
2.5.4. The Contractor shall provide patients with a telephone number to contact with any questions or if additional information is required. All equipment shall have affixed to it 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. Patients shall be given a document listing a toll-free phone number for routine resupply of oxygen cylinders and supplies.
2.5.5. 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”.
2.5.6. The Contractor shall send electronic confirmation to the COR within (1) one business day of completing 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).
2.5.7. 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 troubleshooting.
2.6. Home Assessments. 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. The home assessment shall include:
2.6.1. 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 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) shall be furnished to the COR or designee within one (1) business day of the incident.
2.6.2. The Contractor shall ensure the electrical outlets being used for oxygen or ventilator purposes in the patient’s home meet the requirements of the contractor’s equipment standards and immediately report unsafe conditions to the COR or designee.
2.6.3. 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. The Contractor is not responsible for any required alterations to the patient’s residence.
2.6.4. 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 and the Contractor shall provide this notification and document to the COR or designee (via VA approved encrypted email) within five (5) business days of the service.
2.7. Patient Visitations. Every six (6) months, or more often as needed, the Contractor shall visit all patients on oxygen 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 contractor’s 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:
2.7.1. Name and social security number (SSN) of patient using the equipment.
2.7.2. Monitor compliance on prescription (LPM, hours per day).
2.7.3. Type of concentrator and hours on concentrator.
2.7.4. Inspection results of liter flow rate in monitoring patient compliance (as compared to prescription).
2.7.5. Inspection compliance of filters (exchange or clean by patient if applicable) according to manufacturer’s guidelines.
2.7.6. Follow-up education and/or reinforcement of compliance documented.
2.8. Monthly Visits 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 of the home visit. 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 COR or designee as soon as possible and no more than one (1) business day if any of the following conditions are known to exist concerning the patient:
2.10.1. Change of address
2.10.2. Abuse of equipment
2.10.3. Request for additional equipment or accessories without the consent of the COR
2.10.4. Observation of unsafe practices
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 at no additional cost to the Government. The COR 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 educational materials must be provided upon initial delivery and every six (6) months thereafter. Educational 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 COR.
3.4. The Contractor shall provide each patient with 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. The Contractor shall receive notification by the patient at least two (2) weeks before the patient’s intent to travel within the United States. The Contractor shall accommodate short notice requests 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 this contract (see attachment D.4 for geographic coverage area) all in-home oxygen and/or in-home ventilator services hereunder at the contract rate utilizing Contractor furnished equipment only.
4.3. When the patient is temporarily traveling outside of the contracted area, the Contractor shall arrange for in-home oxygen and/or in-home ventilator 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 VA medical center nearest the patient’s destination to arrange for in-home oxygen and/or in-home ventilator services.
4.4. Patients receiving in-home oxygen and/or in-home ventilator 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. Contractor shall not provide in-home oxygen or in-home ventilator services that exceed these limits unless authorized to do so, in writing, by the Contracting Officer. If authorized, in-home oxygen or in-home ventilator services that exceed these limits shall be billed to the Government at the then current contract rates shown in the Price Schedule. The Contractor’s shall monitor usage and notify COR when limits are approached and when they are 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 COR a written emergency management plan that is in compliance with Joint Commission standards. This emergency action plan shall address continuity of services for all patients covered by this contract.
5.2. The contractor shall have a well-established communication system, shall provide 24-hour emergency services and shall provide services at the patient’s place of residence within two (2) 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 the ventilator assigned to the patient. If the Contractor is unable to respond to an emergency service call within two (2) hours, the contractor shall make arrangements with another supplier to provide services 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 within two (2) business days. The Contractor shall bear the cost of backup oxygen cylinders and backup oxygen. 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 services 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 with the contractor’s 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 COR 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 or encrypted email. Payment will be pro-rated for the month in which service is terminated with payments made through the period ending five (5) business days after notification to the Contractor to discontinue service.
6.2. The Contractor shall notify the COR 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.
6.3. 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 the 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 as required 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 only. 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. The COR 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 the COR.
9. REPORTS: Quarterly reports are due to the COR or designee by the 10th working day after the conclusion of the quarter via VA approved encrypted email. The reporting quarters are as follows: 1st Quarter- October 1st through December 31st, 2nd Quarter - January 1st through March 31st, 3rd Quarter - April 1st through June 30th and 4th Quarter - July 1st through September 30th. The Contractor shall submit the following reports:
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. The report shall include the total units per CLIN and total dollars invoiced by CLIN. Additionally, a composite report of 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 and a monthly report for ventilator patients. 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:
9.6.1. Sentinel Events - The contractor is required to inform the Home Oxygen Coordinator and 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.
9.6.2. 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.
9.6.3. 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. The Contractor shall affix a label to all equipment with the contractor’s name and emergency telephone number where they can be reached 24 hours/day. The Contractor shall also affix a label identifying Government owned equipment.
10.2. The Contractor shall ensure that the installation of equipment by…
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