Attachment_1_Statement_of_Work_DME.pdf

DEPARTMENT OF HOMELAND SECURITY (DHS)

Statement of Work (SOW) For

Durable Medical Equipment (Steady State/Emergency Declaration)

Department of Homeland Security (DHS) Federal Emergency Management Agency (FEMA)

STATEMENT OF WORK

1.0 Project Title

Durable Medical Equipment Kit/PUSH Kit

2.0 Background

Historically, there has been an absence of adequate and appropriate shelter support and care for persons who require Durable Medical Equipment resources to support functional needs during disasters. The provision of Durable Medical Equipment (e.g., walkers, commode, crutches and bariatric mattress etc.) are medical supplies which may be applied and/or are one time usage. The DME list herein has been developed by the Federal Emergency Management Agency (FEMA) Mass Care Functional Needs Support Services (FNSS) review group. Frequently, people with non-life-threatening or compromising functional needs who have arrived at general population shelters without their Durable Medical Equipment and/or caregiver have been turned away. When they have been subsequently directed or transferred to hospitals, those facilities have sometimes refused admission, reserving bed space for individuals with critical medical needs.

Traditionally, the overwhelming majority of shelter providers have offered limited to no assistance to individuals who require functional needs support in order to maintain their independence in general population or functional needs shelters. Currently, there is no contracting method for the Federal government to provide this type and level of support for individuals with functional disabilities within the shelter community.

To help assist those who have arrived at a FEMA Shelter and in need of DME, the Agency is establishing the means to provide Durable Medical Equipment (DME) Push Kits, or the resources contained therein, 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.

3.0 Scope

Contractors shall provide DME Push Kits for FEMA to purchase as needed, based on requirements set forth by the FEMA Headquarters Distribution Center Supply Chain / Emergency Assistance Unit. FEMA will be warehousing these Push Kits which consist only of 47 Line items for PUSH and 51 for full kit. Each Push Kits is designed to support a shelter with a population of 200 persons. Delivery orders shall either require the procurement of full push kits or commodities that make up the kits on an ala carte basis.

4.0 Specific Tasks

4.1 – Each full DME Kit shall include all of the following:

Durable Medical (DM) Equipment Items

Description

Quantity

DM-PUSH

Note 1: ITEMS #1-47 HIGHLIGHTED IN GREEN BELOW WILL BE PUSHED TO THE

FIELD AS PART OF PRE-STAGING ACTIVITIES

Note 2: Items on this page may be ordered ala carte at the LMC or JFO off the existing IDIQ contract to support only what is needed; Items #48-51 are PULL items

Note 3: This is an update of the ‘Sample’ list in the Functional Needs Support Services (FNSS) guidance dated November 2010 based on additional planning factors on what is

DM-000 Note 4:To order entire kit of items #1-51 use DM-000

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" Wid h b A 19" D h 15 1/4" Fl

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 (up to 800lbs) 1 each

DM-011 Wheelchair, Adult 1ea w/Foot Rest; 1ea w/Elevated Leg Rest 2 each

DM-012 Wheelchair, Adult, XL Adult, XL (overall width (open) 39"; 700lbs 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

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

700lbs; Bath b h

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

DM-022 Transfer Boards Standard for Wheelchair 2 each

DM-023

Assorted Utensil Holders (Non-Latex)

Special Soft Holders, 3" L x 1"H

DM-024 Ramps Bariatric Portable, 10' long 6’ X 48’ capacity

800lb

DM-025 Gait Belt-Wipe

70" Gait Belt 2 each

DM-026

Gait Belt-Wipe able/antimicrobial 96" Bariatric 1 each DM-027 Gravity Feeding Set Gravity feeding Set 2 each DM-028 I.V. Pole 2 Hook 4 leg; 2 hook 2 each

DM-029 Assistive listening devices Pocket talker Ultra: PKT D1 EH 2 each DM-030 Headset (listening devices)

Sanitary Headphone Covers 500 each

DM-031 Magnifying glass Coil AT 7x LED Illuminated Magnifier-Round 1 each DM-032 Communication Cards

Prefers large size picture boards 2 each

Adapted eating devices DM-033 Utensils Food Bumper Translucent plastic (clip on) 2 each DM-034 Utensils Comfort grip Angled Fork - Right hand 2 each DM-035 Utensils Comfort Grip Angled Fork - Left Hand 2 each DM-036 Utensils Comfort grip Angled Spoon-Left hand 2 each DM-037 Utensils Comfort grip Angled Spoon-Right hand 2 each DM-038 Utensils Pediatric: Comfort grip spoon-left 1 each DM-039 Utensils Pediatric: Comfort grip spoon-right 1 each DM-040 Utensils Pediatric: Comfort grip fork-right 1 each DM-041 Utensils Pediatric: Comfort grip fork-left 1 each DM-042 Bedside Commode Steel Bariatric Commode. 650lbs (prefer largest

DM-043 Elevated locking toilet seat Capacity up to 350lbs 1 each DM-044 3-in-1 Commode Capacity up to 650lbs 1 each DM-045 Shower Matt Non-Slip 16”x34” Non-Slip Vinyl 4 each DM-046 Digital Infrared

Digital Infrared ½ dozen

DM-047 Seated Bariatric Walker Dual release; heavy duty w/wheels up to 800lb 1each DM-048 Comfort Box 1ea Knit Pant, T-shirt, Pair Socks for Bariatric

10 each

DM-049 Transfer Lift w/2 Mesh Slings

450 lb. Capacity (Hoyer Lift)

DM-050 Wheelchair, Pediatric 1ea w/Foot Rest; 1ea w/Elev. Leg Rest 2 each

DM-051 Refrigerator(No Freezer) Counter Height; Used for Medications 2 each

4.2 – FEMA reserves the right to modify the contents of each DME Kits order, based on the list in section 4.1, depending on the emergency response-specific needs of the affected population.

5.0 Deliverables and Delivery Schedule

5.1 – The contractor(s) shall deliver designated quantities of DME Kits to anywhere in (Continental United States) CONUS, OCONUS (Outside Continental United States), and designated staging areas assigned as part of the federal logistics effort.

Locations as designated by the FEMA Project Officer, or origin specified in the Delivery Order.

5.2 – Contractor shall be able to deliver full DME PUSH Kits, during an Emergency Response with drop trailer if necessary when needed to (ISB) Incident Support Base locations.

5.3 – Contractor shall have a delivery capability of delivering up to 702 complete kits within 72 hours from the time of delivery order.

During steady state, the Contractor shall be capable to deliver to any of the Distribution Center located Conus, a minimum of 2 kits within 10 days. If delivering OCONUS with 3 weeks of notification of Tasks order.

5-4 – Contractor shall maintain accurate records of all shipments and deliveries and ensure that proper signatures are obtained for tracking and accountability purposes, in accordance with government regulations.

6.0- Packing/Labeling

Durable Medical Equipment Push Kit shall be packaged in the vendor’s standard commercial conex and shipped on industry standard size pallets (48 inches L by 40 inches W, 4 way wooden pallets) not to exceed 55 inches in height. Stretch wrap shall cover all sides (excluding the top and bottom) with a minimum of (10) layer of stretch-wrap. The contractor shall label each sealed pallet container in accordance with the following minimum requirements:

(1) A packing slip identifying the commodity

Distribution Center Building Name City State Zip Code DC Atlanta Atlanta GA 30354 DC Frederick Frederick MD 21704 DC Ft Worth Fort Worth Federal Center Ft. Worth TX 76115 DC Moffett Field NASA Ames Research Center Moffett Field CA 94035 DC Pacific Guam Barriagada Guam 96921 DC Pacific Hawaii Aiea HI 96701 DC Caribbean San Juan Industrial Park Caguas PR 00726-8578

99-1269Iwaena Street Carr #1, KM 25.30

Street Address 3780 South Side Industrial Court 4420 Buckeystown Pike 501 W. Felix Street Warehouse #12 Building 144, Door #7 PO Box 24814

(2) The name and place of business of the manufacturer, packer, or distributor

(3) Net quantity of contents in terms of weight, measure, or numerical count (measurement must be in both metric and inch/pound units)

(4) DM-24 Wheel Ramp 10” long must be wrap with stretch wrap as stated in para 6.0.

Contractor (s) may suggest or recommend other techniques to preserve the integrity of the material as well as the finished pallet. This recommendation should be provided to the Contract Officer.