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ATTACHMENT 2
Department of Homeland Security (DHS) Federal Emergency Management Agency (FEMA)
ATTACHMENT 2: STATEMENT OF WORK, 8/20/2012
Durable Medical Equipment (DME)
General Information
Durable Medical Equipment Push Kit
1.0 Background
Historically, there has been an absence of adequate and appropriate support and care for disaster survivors who require Durable Medical Equipment (DME) within shelters. The DME Push Kit herein has been developed by the FEMA Office of Disability Integration and Coordination with guidance from subject matter experts in emergency management and medical care. This document identifies basic durable medical equipment necessary to sustain and support a 100 person shelter for a 72 hour period, which FEMA may provide supplemental assistance to shelter providers when requested by a State pursuant to Section 403 (b) of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (Public Law 93-288) as amended.
2.0 Scope
FEMA is a pursuing a contract vehicle for procuring a completely kitted and packaged DME PUSH Kit, herein defined as “DM-PUSH”. DM-PUSH consists of line items DM-001 through DM-024 (described in paragraphs 4.1). Contractor(s) shall provide DM-PUSH, and/or individual DME listed in paragraph 4.1 on an ala carte basis, as requested by FEMA in both steady state to maintain stock levels, and for rapid deployment under emergency conditions.
3.0 Record Keeping and Acceptance:
A FEMA representative will sign for receipt of kits at each location. This signature does not imply inspection & acceptance. The signature only acknowledges the delivery was made.
Inspection will be made at the point of final destination; any hidden or latent discrepancies will be reported to the CO or COR.
Contractor (s) shall maintain accurate records of all shipments and deliveries and ensure that proper signatures by FEMA representative are obtained for tracking and accountability purposes, in accordance with government regulations.
4.0 DME line items
4.1 Each DM-Push Kit shall include line items DM-001 through DM-024 in the Quantities described below. All DME items should be brand name or equivalent.
| Durable Medical (DM) Equipment Items |
| Description |
| Quantity |
| DM-001 |
| Bed Wedge for Bariatric Cot |
| 24” x 24’ x 12” |
| 3 each |
| DM-002 |
| Westcott 700 Cot, Bariatric w/mattress |
| 600 lb Capacity |
| 3 each |
| DM-003 |
| Westcott 400 Cot w/ Mattress |
| with Half Side Rails |
| 5 each |
| DM-004 |
| Bedside Commode |
| 300 lb capacity |
| 2 each |
| DM-005 |
| 3 in 1 Commode for Over Toilet Use |
| 300 lb Capacity |
| 2 each |
| DM-006 |
| Independent Toilet Seat with Safety Bars |
| Contoured, Soft Foam Armrests; Legs Height Adjustable; Weight Capacity 350 lbs; Adds 4" to Height. Width: 22 1/2"; Width bet Arms: 19"; Depth: 15 1/4"; Floor to Seat 20" |
| 2 each |
| DM-007 |
| Egg Crate Padding |
| 32”W x 72”L, 1.2 density foam, roller compressed pkg |
| 1 each |
| DM-008 |
| Walker, Dual Release |
| Standard w/out Wheels |
| 1 each |
| DM-009 |
| Walker, Dual Release |
| Standard w/wheels |
| 1 each |
| DM-010 |
| Walker, Dual Release |
| Heavy duty w/wheels |
| 1 each |
| DM-011 |
| Wheelchair, Adult |
| 1ea w/Foot Rest; 1ea w/Elevated Leg Rest |
| 2 each |
| DM-012 |
| Wheelchair, Adult, XL |
| To 450 lb Capacity w/Elevated Leg Rest |
| 1 each |
| DM-013 |
| IV-Pole, 5 Castor |
| Heavy Gauge Steel, Slow-descending Pole, 3" Castors w/Dust Covers and Thread Guards; Base has Durable Black Powder Finish |
| 2 each |
| DM-014 |
| Canes, White |
| Standard Cane for the Blind |
| 2 each |
| DM-015 |
| Canes, Quad |
| Large Base |
| 2 each |
| DM-016 |
| Crutches, Adult |
| Hardwood Armpit Crutch w/20" Length of 1" x 1": Padded Top (Adjustable) |
| 2 pair |
| DM-017 |
| Crutches, Youth |
| Same Description as Adult Crutch but Size Adjusted for Children (Adjustable) |
| 1 pair |
| DM-018 |
| Handheld Shower |
| With 84" Hose |
| 2 each |
| DM-019 |
| Shower Chair w/Back Rest |
| 400 lb Capacity |
| 2 each |
| DM-020 |
| Privacy Screen |
| 3 Panel with Castors |
| 10 each |
| DM-021 |
| Dressing Aid Stick |
| 2 hooks: One "C" Hook; One Push-pull Hook; Both Hooks Plastic Coated |
| 2 each |
| DM-022 |
| Transfer Boards |
| Standard for Wheelchair |
| 2 each |
| DM-023 |
| Assorted Utensil Holders (Non-Latex) |
| Special Soft Holders, 3" L x 1"H |
| 2 each |
| DM-024 |
| Wheelchair Ramps |
| Portable, 10' long |
| 1 each |
4.2 FEMA reserves the right to modify the contents of each DME Push Kit dependent on the disaster-specific needs of the affected population.