Q and A for RFQ 36C26224Q0350 v2.pdf

Questions and Answers for RFQ 36C26224Q0350 – VA Long Beach Medical Gases Requirement

1. For the 3 locations Dermatology Clinic Bldg OP126 Room W156, Primary Care Clinic 2nd Floor Bldg 164, and Primary Care Clinic 1st Floor Building 164; will the contractor be required to travel to the service’s location (listed below) to pick up and refill the dewar or will the service bring the dewar to the main dock to be refilled?

Answer: Yes – The Vendor is required to travel to the listed location. The service will NOT bring the dewar to the main dock to be refilled.

2. What is the expected turnaround time from order?

Answer: Within 1 day or the next for Emergency

3. Are Tuesdays and Thursdays both days of delivery?

Answer: Yes

4. How will the orders be placed?

Answer: Through email to Vendor

5. How many rental cylinders are expecting to be needed per month?

Answer: It varies by usage of the facility.

6. How many onsite at once?

Answer: There are:98 full tanks H, 16 for empty, E-tote 150 full and 50 empty spaces for empty cylinder.

7. Several items take a 3 to 4-week lead time. Would the customer be willing to hold more assets on-site than normal to accommodate?

8. Delivery days of Tuesday and Thursday - 7am -11am. What is the reasoning for the 4-hour window and can this be adjusted? 7 am is technically prior to being open for regular business?

Answer: Dock is utilized by multiple services like Kitchen, Eng for Construction trucks, Mailroom, etc. Distribution area is 24 hours operation and delivering at the time window is crucial for the operation of the Medical Distribution to prevent delays due to multiple offices utilizing the docks during the daytime operation.

9. The VA is using both customer-owned and contractor-owned cylinders. 1) What is the plan for determining/identifying which cylinders are government owned and which are contractor owned, as we prefer to separate Ship-To Accounts. 2) Will the VA accept only contractor owned?

Answer: None of the Cylinders are owned by the VA.

10. Contract shall furnish all materials needed to complete the job. We would like to clarify that the VA may need to purchase carts/racks and any other equipment for the cylinders. We supply only the gas/cylinders.

Answer: The VA understands that this requirement is only for the supply of gas.

11. 2-hour response time - we cannot commit to this small of a window, we may be able to respond with a live person on the phone in 2 hours but not an actual delivery in 2 hours.

Answer: 2-Hour response time refers to confirmation of notification for emergent delivery.

Delivery window is 4 hours from time of confirmation.

12. Item 4: Is electronic invoicing allowed?

13. Item 8: Please clarify that supplier is not responsible for managing the VA's par levels at their hospital.

Answer: Inventory Manager in the facility is responsible for managing the par levels.

14. What is the Current Contract # for this same service and who is the current Prime Contractor?

Answer: The current contract # is 36C26222P2347 and was awarded to Global Stripes.

15. What is the GOV’s rationale for having this procurement only be for a single year? This provides a decided advantage to the current Contractor as they have assets in place and a business case is difficult to make for a one year ROI?

Answer: The customers current need is for a year. Future planning may result in an award with a Period of Performance longer than one year.

16. Please confirm the Period of Performance Start Date as the CLINs (starting PG 6 of 62) list the Base Year of 10/1/2023 – 9/30/2024 yet the current RFQ Submission date (1/9/2024) is 3-months after the listed start date.

Answer: SOW has been updated to state Period of Performance is 1 year.

17. Page 4 of 62 under paragraph 2 “SCOPE” requires “the Prime or Subcontractor:” The contractor (prime) will appear in person for a site visit upon awarding of the contract as well as approximately six months after the start of the contract to inspect all delivery points.”

Shouldn’t this be the Prime Contractor’s responsibility (not delegated to the SUB) to personally inspect the locations they are awarded? Since the SDVOB Awardee, AND the accountable entity to the GOV, what is the GOV’s rationale to allow this task to be delegated to the SUB?

The way the language reads (our words and interpretation), this seems to abrogate the Prime’s responsibility to the GOV, specifically NOT requiring them to attend the Post Award Site Visit and then again 6 Month later (which is too late, they should do this on the initial visit to fully understand the conditions at each site and NOT wait 6 months). Respectfully, this is a critical Hospital/CBOC Function, Medical Oxygen and Specialty Gas Cylinders. As well as this appears in conflict with PL 116-183 (see attached).

Answer: SOW updated to state Prime will appear in person for a site visit. A 6-month inspection is referring to an additional inspection mid-way through contract period of performance.

18. What are the hours of operations that an Emergency Delivery can be made for a

VAMC/CLC/CBOC?

Answer: Main facility is 24 hours operation and no Emergency orders have occurred in CBOCS.

19. Is the current supplier making all deliveries between 7 AM – 11 AM or is this a new requirement? Is the 7 AM – 11 AM window also apply to the CBOC? This is nonstandard and requiring this tight delivery window in a major metropolitan area and will cause offeror costs to rise exponentially. What is the rationale for a (4) hour delivery window rather than industry standard of 7 AM – 3 PM or similar 8-hour delivery window?

Answer: Yes, the current supplier is making all deliveries between the hours of 7:00 AM – 11:00 AM. The first 4-hour window is crucial to Medical Distribution operation where Technicians delivers medical supplies to other clinic throughout the day. The CBOC operation time starts at 8:00 am and they, too, will be seeing patient throughout the day.

20. Is the VAMC requiring “point of use” deliveries internal to the VAMC? Standard protocol is to deliver cylinders to a centralized delivery point (e.g., loading dock or cylinder storage room near the loading dock) and not internally to the VAMC due to liability reasons (potential interaction with patients). Is the GOV going to sign off on releasing the Contractor from liability (e.g., if a delivery driver runs into a patient and injures them) in order to fulfill this request? All orders can be ordered for a specific department (e.g., Primary Care 2nd Floor) however the best practice is to deliver to a centralized delivery point. If there are multiple delivery points on site (e.g., CLC) this is not an issue if there is still a centralized delivery point at each on-site location and drivers are not entering into the facility with the potential to interact with patients. NOTE:

The RFQ requires delivery to the Anaheim CBOC, which is 97 Miles away from San Diego, see below for emergency delivery where the GOV requires 2 hour delivery? This is not reasonable, nor is 4 hours, emergency delivery is usually 24 hours, which is reasonable given a valid Emergency Order.

Answer: The current vendor is delivering to multiple locations. Technicians are not qualified to handle gases to deliver to CBOCs; therefore, delivery to CBOCs is required. There has not been an emergency for CBOC locations within the past 5 years; however, the emergency timeframe is for when the vendor must respond to the emergency order – delivery must occur by the next day. The Government will not sign off on releasing the Contractor from liability regarding delivery of gas supply to an internal location within the VA.

21. What is the current delivery process at the VAMC? Are VA Personnel unlocking cylinder storage areas for the delivery driver and signing a Proof of Delivery slip verifying what cylinders, by CLIN, have been delivered/returned?

Answer: The vendor calls the Medical Distribution office to notify the VA of their arrival. Vendor delivery personnel is met so that cage can be opened by VA personnel. Delivered items are inventoried to record what is being delivered and picked up in coordination with Distribution Supervisor. Order and invoice will be presented to Distribution Supervisor. Once delivery and or refill for Dewars is completed, the invoice will be handed to the Technician to affirm what was received.

22. Is the Prime Contractor (SDVOB) required to have a Medical Gas Distribution license in the State of CA? *There is no mention of a requirement of the Prime Contractor to be licensed in the State of California to resell/distribute Medical Grade Oxygen (a prescription drug). Please confirm that offerors (if out of state) an OUT OF STATE WHOLESALE DISTRIBUTION LICENSES for the

State of CA (if in state, a CA Distribution License) – in sum, the prime contractor licensed in the State of California to resell/distribute Medical Grade Gas at the time of the Proposal Submission?

Based on the Supremacy Clause, federal laws constitute supreme Law of the Land in regard to any state and federal conflicts of law. The VA, in this case, is a consumer of the medical gas (prescription drug) supply as medical gases are dispensed to patients by the VA. The portion of the SOW has been updated to remove the requirement of a license to distribute prescription drugs.

23. The State of California Board of Pharmacy requires for SDVOSB firms to be licensed in the State of California to resell Medical Grade Oxygen for human consumption (an FDA classified prescription drug). The SDVOSB firm cannot rely on the Subcontractor License as the Prime Contractor is the contract holder. In the event anything happens (e.g., Gas Contamination), the direct responsibility lies on the Prime Contractor and not the sub. This is even more pertinent when taking into consideration VAAR 852.219-76 Certificate of Compliance for Supplies & Products (PG 24 - 62 in the RFQ), which requires the offeror to affirm in writing that they take ownership/possession of the product and will perform 50% of the contract costs billed.

Would the VA want the only unlicensed entity in the Pharmaceutical Supply Chain to be the Prime Contractor?

Answer: VAAR clause 852.219-76 applies to this solicitation and vendors are required to attest and certify in accordance with the clause as written.

24. How does the GOV intend to enforce Limitations of Subcontracting in accordance with VAAR 852.219-76 (Certificate of Compliance - per PG 24-62 in the RFQ)? Additionally, the Certificate of Compliance requires the offeror to affirm that they take “possession or responsibility of the item,” which requires licensing in the state of CA (Prime Contractor taking responsibility for delivery of the prescription drug, regardless of what entity is physically delivering it to the Hospital). Furthermore, VISN 21 has a documented record of requiring the prime Contractor to be licensed in the State of CA (we can provide documentation if needed).

Answer: VAAR 852.219-76 applies to this RFQ. Vendors are responsible for ensuring adherence.

The Federal Government is not subjected to follow regulations established by any state which conflicts with federal regulation. Also see the answer to question 22 above.

25. Please verify the HCS CBOCs that require direct delivery as there are contradictions. PG 4 of 62 states “deliveries to VALB as well as OPC(s) in Laguna Niguel, Villages at Cabrillo, Santa Ana, Santa Fe Springs”, Placentia, Gardena yet PG 6 of 62 only lists Anaheim as an OPC Delivery Location.

Answer: SOW has been updated to reflect accurate delivery locations.

26. Is the Anaheim CBOC still in the process of relocating to Placentia as stated in the below article on VA.gov (dated 6/8/2022 – article also states that Placentia CBOC was to open in July 2022)? If so, what is the timeline and expected date of transfer from Anaheim to Placentia? NOTE: The Anaheim CBOC is not listed on the VA.gov list of locations for Long Beach VA HCS but Placentia CBOC is (https://www.va.gov/long-beach-health-care/locations/ https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.va.gov%2Flong-beach-health-care%2Flocations%2F&data=05%7C02%7C%7Cf4483f7c270449eb801a08dc02448ea3%7Ce95f1 b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C638387741041844126%7CUnknown%7CTWFpb GZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C4100 0%7C%7C%7C&sdata=cXgIjWLn%2B2jt5X3IA%2Bd3Ubi8eK2MUGMBeqh7hVmmlgY%3D&reserv ed=0

Answer: SOW has been updated to reflect accurate delivery locations.

27. https://www.va.gov/long-beach-health-care/stories/anaheim-clinic-relocating-to-placentia/ https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.va.gov%2Flong-beach-health-care%2Fstories%2Fanaheim-clinic-relocating-to-placentia%2F&data=05%7C02%7C%7Cf4483f7c270449eb801a08dc02448ea3%7Ce95f1b23abaf4 5ee821db7ab251ab3bf%7C0%7C0%7C638387741041844126%7CUnknown%7CTWFpbGZsb3d8e yJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C41000%7C%7C %7C&sdata=lmSU5indvJN4szPmLJBG6VC7jlJAupIViCzyrH1BBsA%3D&reserved=0 Please confirm that the Anaheim CBOC (or Placentia CBOC) does not require any Oxygen Cylinders? CBOCs commonly require Integrated Valve Oxygen E Cylinders and per the VA.gov article, the new CBOC is expansive with their possibilities which leads to believe additional gases may be required.

Answer: That is correct only E-Tote.

28. What are the hours of operations for deliveries for the Anaheim CBOC (or Placentia CBOC)?

Answer: Hours of operation is from 7:00 AM - 3:30 PM. SOW has been updated to reflect accurate delivery locations.

29. What is the size of the Liquid Nitrogen Dewar utilized at Anaheim CBOC (or Placentia CBOC)?

Answer: NI LT25N

30. Is 2-hour delivery being provided by the current supplier or is this a new requirement?

*This is nonstandard, and no supplier can make Emergency Delivery within (2) hours after notification in a major metropolitan area. Drivers are on pre-established routes for healthcare customers and may have to return to the fill plant before delivering to the VA facility. Another factor is drivers having the hours available to make this additional delivery. Standard Language for Emergency Delivery is within (24) hours which often includes after-hours deliveries in which the VA will have to provide a representative to receive the delivery. Will the GOV please amend this language to “within (24) hours” with the contractor must respond within (2) hours? If an Emergency Delivery is placed towards the end of the day (e.g., 3 PM - 4 PM) then there’s no guarantee that there will be a driver available to deliver that same day, even less likely within (2) hours. The is especially relevant if a CBOC requires an emergency delivery and it is placed towards the end of the workday. NOTE: The RFQ requires delivery to the Anaheim CBOC, which is 97 Miles away from San Diego, see below for emergency delivery where the GOV requires 2-hour delivery? This is not reasonable, nor is 4 hours, emergency delivery is usually 24 hours, which is reasonable given a valid Emergency Order.

Answer: SOW is updated to reflect that Anaheim does not exist and location moved to Placentia.

31. Is delivery hours of between 7AM – 11AM Tuesday and Thursday being provided by the current supplier or is this a new requirement?

Answer: Yes

32. How many GFEs does the VA own by CLIN on the property books and how much (estimated) does the VA keep on hand at any given time?

1. CLIN 0022 – OXYTOTE -; Qty of 150 NOT VA Owned; Keep 150 On-Hand

2. CLIN 0023 – NITROGEN HIGH PURITY, SIZE H OR K; Qty of 14 NOT VA Owned;

Keep 14 On-Hand

3. CLIN 0024 – NITROUS OXIDE, SIZE E- None

4. CLIN 0025 – NITROUS OXIDE, MEDICAL, ALUMINUM E TANKS - None

5. CLIN 0026 – NITROUS OXIDE, MEDICAL, 20#; Qty of 2 NOT VA Owned; Keep 2 On-Hand

6. CLIN 0027 – NITROUS OXIDE, MEDICAL, 50#LBS, SIZE H OR K; Qty of 14 NOT VA Owned; Keep 14 On-Hand.

33. Please clarify “provide service” for Liquid Nitrogen Dewars (Dermatology).

Answer: SOW Language has been updated to reflect “provide supply”.

34. What are the Liquid Nitrogen Dewar Sizes utilized by Location (outline in PGs 5-6 of 62). Are these all VA Owned?

1. Dermatology – (2) Dewars 25 liter NOT VA Owned

2. Primary Care 2nd Floor – (1) Dewar 25 liter NOT VA Owned

3. Primary Care 1st Floor – (1) Dewar 25 liter NOT VA Owned

4. Placentia CBOC – (1) Dewar 25 liter NOT VA Owned

Answer: All of the listed are NOT VA Owned.

35. What is the projected Award Date and does the Period of Performance include phase-in/phase-out transition between contracts?

Answer: The projected award date is in February 2024. Current contract runs through March 2024.

36. What is the rationale for making Price the only Evaluation Factor, for awarding something as critical as Medical Grade Oxygen, a Prescription Drug? Why are bidding vendors not required to submit a statement of technical capability (to include Past Performance & Licensing/proper Insurance - which is a requirement by the CA Board Pharmacy)? PG 42 of 62 states “Technical and past performance, when combined, are equal to price” yet there are no technical submission requirements and award is based solely on price. Please consider: Making Technical Capability an Evaluation requirement, if not – is there any requirement to discern/evaluation that all offerors (other than the incumbent) are Technically qualified to perform this work/support VETERAN CARE? How would the GOV discern that a “lowest price” offer (other than the incumbent) is technically acceptable sufficient to award to that “lowest priced” offeror?; Making Recent and Relevant Past Performance an Evaluated factor – as a predictive analysis for an offerors ability to perform/support this critical Hospital function? How would the GOV discern that a “lowest price” offer (other than the incumbent) has a history of successfully performing similar work?; There are many specific, nonstandard technical delivery requirements for this service contract (e.g., tight delivery window on specific days, short emergency delivery allowance) which will cause overall costs to rise significantly however Price is the only Evaluation factor?

Answer: This action is a supply procurement. The evaluation will be price only. There are insurance requirements for action.

37. CLIN 0002: Is there a reason why the UNIT is MO and not CY?

Answer: Item measurement updated to reflect CY.

38. CLIN 0021: Confirm that Liquid Nitrogen Dewar Fills are for the “Full” Dewar Fill or is it meant to be “Per Liter?”

Answer: It is per liter. 5 Liter per week is total of 240 liter per year.

39. Is there a reason for why some Cylinder Gas CLINs are CY (0001-0017) while others are “EA” (0018-0032 & 0040)? It should read CY vice ea.

Answer: “CY” is the correct Unit for both Cylinder Fill & Rental CLINs.

40. PG 4 of 62 states that the contractor or subcontractor is responsible for “…securing tanks with chains and ensuring the collection areas are locked or secured when they leave.” This infers that the drivers are letting themselves into the cylinder storage rooms which, per NFPA regulations, this is the responsibility of the facility personnel, not a delivery driver.

RECOMMEND REMOVING THIS LANGUAGE AS IT IS INCORRECT.

Answer: This language was removed from SOW.