PreSolicitation 36C24725R0004_1.docx

SUBJECT*

Columbia VAMC Home Oxygen and Ventilator Services - PreSolicitation

GENERAL INFORMATION

Columbia VA Health Care System

6439 Garners Ferry Rd.

Columbia SC

CONTACT INFORMATION

VISN 7 Network Contracting Office LaVista Business Park - Bldg A 2008 Weems Road Tucker GA 30084

POINT OF CONTACT*

Contract Officer Leonard Robinson leonard.robinson@va.gov

ADDITIONAL INFORMATION

DESCRIPTION

Pre-solicitation Synopsis This is a pre-solicitation announcement only. Solicitation documents will be available on or about January 17, 2025. The solicitation will contain all necessary proposal instructions.

The Department of Veteran Affairs VA Southeast Network Columbia VA Healthcare System intends to award a Firm-Fixed Price (FFP) Indefinite Delivery-Indefinite Quantity (IDIQ) contract for Home Oxygen and Ventilator Services within a defined area of responsibility/jurisdiction to the patient’s residence or other location. The area of responsibility/jurisdiction for the Columbia VA Healthcare System facility will be in accordance with the Performance Work Statement (PWS). The PWS will define the effort required for the setup, installation, and management of Home Oxygen and Ventilator Services in accordance with Joint Commission (The Joint Commission) standards for home care. Services will be provided to veteran beneficiaries serviced by Columbia VA Healthcare System, 6439 Garners Ferry Rd., Columbia, SC 29209. The Columbia VA Healthcare System does not have the capacity to provide these services, so a contract has been sought to provide home oxygen and all associated products and services. This requirement is for commercial items as defined in FAR 2.101. This pre-solicitation notice is published in accordance with Federal Acquisition Regulation (FAR) 15.201.

The requirement will be solicited as a set aside for Service-Disabled Veteran-Owned Small Businesses (SDVOSBs). The applicable NAICS code is 532283 - Home Health Equipment Rental with a size standard of 36 million dollars. The Product Service Code is W065 – Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and Supplies.

The period of performance for this acquisition is anticipated to begin March 01, 2025 to February 28, 2030.

The solicitation, any documents related to this procurement, and all amendments issued will be in electronic form. The solicitation is not yet available. Once available, the solicitation will be posted to Sam.gov.

The solicitation is expected to be available January 17, 2025.

Solicitation 36C24725R0004 and subsequent amendments will be posted to Sam.gov. Prospective offerors are responsible for downloading their copy of the solicitation and for frequently monitoring the Beta SAM website for solicitation amendments. The Government is not responsible for the inability of the Offeror to access the solicitation documents posted. Prospective offerors should also register at SAM.gov on the interested vendor list under 36C24725R0004. No telephone or FAX requests will be accepted, and no hardcopy solicitation/amendment will be mailed or faxed. Offerors must also be registered in the System for Award Management in order to participate in this procurement at https://Sam.gov.

All responsible sources may submit a proposal which shall be considered by the Government. By submitting a proposal, the offeror will be self-certifying that neither the principal corporate officials nor owners are currently suspended, debarred, or otherwise ineligible to receive contracts from any federal agency. Failure to do so may represent grounds for refusing to accept the proposal. By submission of a proposal, the offeror acknowledges that a prospective awardee must be registered in the System for Award Management (SAM) database prior to award, during performance, and through final payment of any contract resulting from the solicitation, except for awards to foreign vendors for work to be performed outside the United States. A lack of registration in the SAM database will make an offeror ineligible for an award. Offerors may obtain information on registration and annual confirmation requirements by calling 1(866) 606-8220, or via the Internet at https://Sam.gov.

All questions shall be submitted in accordance with the solicitation, dates, and procedures. Please direct all questions regarding this requirement to Leonard Robinson, Contract Officer, at leonard.robinson@va.gov.

Presolicitation Notice Presolicitation Notice

Presolicitation Notice

STATEMENT OF WORK

HOME OXYGEN AND VENTILATOR SERVICES

COLUMBIA VA HEALTH CARE SYSTEM

1. SCOPE: This Performance Work Statement (PWS) defines the effort required for the setup, installation, and management of Home Oxygen services and Ventilation, in accordance with Joint Commission (JC) standards for Homecare, to Veteran beneficiaries serviced by Columbia VAMC/VISN 7. This PWS includes the associated program management, human engineering, and logistic support planning requirements. The use of the term’s “beneficiary”, “Veterans”, “Patients”, and “Patient” are used interchangeably and refer to the recipient of required services, equipment, and supplies required under the contract.

1.1 BACKGROUND: The acquisition of Home Oxygen services is being initiated to provide Home Oxygen services to Veteran beneficiaries serviced by Columbia VAMC/VISN 7. VISN 7 does not have the capacity to provide these services, so a contract has been sought for the provision of home oxygen and all associated products and services.

1.2 VETERANS SERVED: The Department of Veteran Affairs VA Southeast Network Columbia VAMC/VISN 7 currently serves an estimated 1,500 oxygen-using patients. The volumes or amounts shown in the Solicitation are estimates only and impose no obligation on the VA, either minimum or maximum. The contract shall be for the actual requirements of the VA as ordered by the VA during the life of the contract.

1.3 LOCATIONS: The Contractor shall provide Home Oxygen within a defined area of responsibility/jurisdiction to the patients’ residence, or other location as indicated on the order for Home Oxygen. Area of responsibility/jurisdiction for each VA facility includes the counties identified as applicable to the area of responsibility/jurisdiction.

Counties: Abbeville, Aiken, Anderson, Allendale, McCormick, Bamberg, Barnwell, Beaufort, Calhoun, Cherokee, Chester, Chesterfield, Clarendon, Darlington, Dillon, Edgefield, Fairfield, Florence, Greenville, Greenwood, Hampton, Kershaw, Lancaster, Laurens, Lee, Lexington, Marion, Marlboro, Newberry, Oconee, Orangeburg, Pickens, Richland, Saluda, Spartanburg, Sumter, Union, York NOTICE: CONTRACTOR MUST HAVE A BUSINESS LOCATION PRIMARILY ENGAGED IN PERFORMANCE OF THE SCOPE OF WORK FOR THE CATCHMENT AREA WITHIN A 50 MILE RADIUS FROM THE SUPPORTED MEDICAL CENTER. THIS BUSINESS LOCATION MUST BE MAINTAINED FOR THE DURATION OF THE CONTRACT PERIOD OF PERFORMANCE.

NOTE: The location of the patient’s place of residence, and not which VA facility will order the home oxygen services, will determine which contract the Government will utilize to obtain home oxygen services. The Government reserves the right to purchase the services from the Contractor awarded a contract whose area of responsibility/jurisdiction includes the location of the patient’s place of residence.

1.4 PORTABLE EQUIPMENT AT VA MEDICAL CENTERS: A stock of ten (10) portable cylinders, regulators and 02 carriers shall be continuously maintained by the contractor at the VA Medical Center. These cylinders shall be used only to accommodate Home Oxygen beneficiaries who are visiting VA or being discharged and require a tank of oxygen to go home. This service shall be provided at no additional cost to the Government. VA shall furnish storage space and maintain all security for this equipment. Contractor shall be permitted access to the space and equipment when requested, by telephone, with 24 hours’ notice to the VA Medical Center’s Prosthetics Service. Contractor shall maintain an updated inventory of all equipment on a quarterly basis.

2.0 NOTIFICATION AND DELIVERY:

2.1 NOTIFICATION: The Contracting Officer’s representative (COR) or designee shall provide the Contractor with notification via facsimile to initiate individual patient service requirements. This shall include patient’s oxygen prescription, oxygen prescription expiration date, equipment, supplies, and services to be provided including the date and place of delivery. The Contractor shall confirm receipt of the request within two (2) working hours of notification. Contractor shall confirm by secure email to COR or alternate COR for all Home Oxygen initiations, plan of care changes, and discharges. The COR or alternate COR shall also provide notification of VA initiated discontinuance of service via secure email. All changes to patient care shall be confirmed in writing. The written documents shall include the authorizing official’s signature. The prescription is terminated the day the patient expires.

2.2 NOTIFICATION TO VA REGARDING STATUS OF DELIVERY OF HOME OXYGEN SERVICES:

a. The contractor shall notify the appropriate VA of initial delivery of home oxygen equipment by emailing a copy of delivery ticket. The delivery ticket shall be signed and dated by the patient. This notification shall be made within two (2) working days. This notification shall be made when patient requires changes in medical equipment or equipment switch-outs.

The Contractor shall notify the appropriate VA by PKI encrypted email within one (1) working day if expected delivery of medical equipment is not completed. This notification shall include reason why delivery was unable to be completed within the 24-hour timeframe.

The Contractor shall notify the appropriate VA by PKI encrypted email within one (1) working day if the patient refuses delivery of medical equipment and/or signs the Contractor’s AMA form. Copy of the AMA form signed by patient shall be included in this notification.

2.3 DELIVERY OF MEDICAL EQUIPMENT:

a. The Contractor shall deliver and set up in the patient’s residence, all equipment and supplies ordered by an authorized VA Physician, COR, or Designee. Contract prices are all-inclusive. The Contractor shall not be reimbursed for costs incurred in excess of the contract prices in the Schedule of Supplies/Services for services provided in accordance with the Schedule of Supplies/Services.

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b. Patients shall be notified of expected delivery times by the Contractor. Veterans shall be provided with four (4) hour delivery time window for expected time delivery.

c. Deliveries of medical equipment and supplies shall be made in full, without exception. If the contractor is unable to fulfill the full prescribed medical equipment and supplies list, they may choose to partial delivery. The cost for such delivery shall be considered at no cost to VA and is for the convenience of the Contractor. Payment shall only be issued for full deliveries. In such cases where a partial delivery is made, the remainder of the delivery shall be made within one (1) calendar day. Contractor shall maintain sufficient stock (or have available) to ensure all deliveries can be made within the contractual timeframes.

d. The Contractor shall deliver portable oxygen equipment to previously established and new patients being discharged to their home from non-VA Facilities and other facilities as requested by VA Staff per the needs of the Veteran. Equipment shall be delivered within 4 hours of the request.

2.4 EXCESS DELIVERY: The Contractor shall not deliver supplies and/or equipment in excess of those prescribed, and the Contractor shall not be paid for any excess deliveries.

2.5 NON-SCHEDULED DELIVERIES: Contractor shall provide non-scheduled deliveries in the event the patient requires “an additional” delivery to the routine delivery.

3.0 SERVICE SPECIFICATIONS:

3.1 PRESCRIPTION CHANGES: 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, COR, or designee.

3.2 HOME VISITS:

a. The Contractor shall visit patients’ residences for regularly scheduled maintenance visits in performance of this contract by appointment only; between the hours of 7:00 a.m. and 7:00 p.m. Exceptions shall be made in the cases of emergencies.

b. The Contractor is responsible for scheduling the appointments to the patient’s home 24-48 hours prior to the appointment.

c. On each scheduled set-up/delivery the Contractor shall reassess the need to instruct the patient on the use and care of the equipment and supplies as necessary.

d. Contractor shall re-instruct patient, family, or care givers as necessary without formal order from the VA.

3.3 CDC COVID 19 PROCEDURES:

Contractor shall abide by all CDC guidelines regarding social distancing, cleaning of equipment and materials, and personal protection equipment. Updated guidelines can be found on the CDC website: https://www.cdc.gov/coronavirus/2019-ncov/community/index.html.”

3.4 INITIAL SET-UPS:

a. Initial set-ups are services provided to those patients who have not been provided a VA authorized oxygen therapy delivery system in the residence or nursing home on a previous occasion or have not used such a system continuously for the past 60 days.

b. Set up will be performed 7 days a week within 24-48 hours of receipt of signed VA physician order, COR, or designee. Orders received before 12:00 noon will be set up same day whenever possible. Emergent requests received will be set up within 4 hours of receipt of signed VA physician order to allow discharge from emergency room or inpatient facility. Once initial set-up has been completed, the Contractor shall develop a regular delivery schedule for home oxygen and supplies to patients. All Initial 50 PSI setups shall include all disposables large bore tubing, large volume nebulizers, drain bags and masks.

c. Switch-outs are services provided to those patients who are presently using an oxygen delivery system or have used such a system continuously within the past 60 days. The Contractor shall provide equipment switch-outs by staff with documented competency training on the manufacturer’s recommended assembly, use, and maintenance of the equipment used under this contract. Failure to perform the switch-outs as ordered by VA staff shall result in no cost to the government. Payment shall be made once switch-outs are completed as prescribed by VA staff. Payments shall be assessed based on the provider’s established rate and prorated from set-up date. Medical equipment switch-out requested to increase the patient’s quality of life or due to changes in the patient’s oxygen requirement shall be made at no extra charge to the government.

d. Set-up of Home Oxygen includes setting up and ensuring the appropriate oxygen system is operational, instruction and training of Patient, and/or caregiver and home environment safety check. Failure to deliver within the required time shall result in the VA obtaining oxygen from another source. Any costs in excess of contract pricing for services provided shall be billed to contractor or credited to next invoice at the discretion of the ordering facility.

e. The Contractor is responsible for establishing appointments with patients when initiating set- ups, deliveries, and switch-outs within 24 hours of receipt of signed VA physician order, COR, or designee.

3.5 ASSESSMENT REQUIREMENTS:

a. The Contractor shall perform an assessment of the patient’s home and environment in accordance with JC accreditation standards for Homecare and maintain documentation of assessments in the individual patient file or folder.

b. The Contractor shall notify the COR/designee during the home visit if the Contractor’s staff determines that the presence of oxygen in the home presents such a danger that the oxygen must be removed, or in the case of an initial set-up, not placed in the home.

c. The Contractor shall notify the COR or designee by telephone or email within two (2) hours if any unsafe conditions are observed in the patient’s home that preclude the installation of continuance of oxygen service. Unsafe conditions may include, but are not limited to, fire safety hazards, oxygen safety hazards, patient abuse by family or caregivers, or any instance that places the patient or Contractor’s staff in immediate danger. The Contractor shall provide written documentation of the safety hazard to the COR or designee within one (1) business day of incident.

d. The Contractor shall check the adequacy of the electrical outlets in the patient’s home and immediately report unsafe conditions to the COR or designee. VA shall not be responsible or liable for any unsafe electrical conditions caused by the Contractor. Any alterations to the patient’s residence shall be the responsibility of the patient. If ordered equipment cannot be safely installed, the COR or designee shall provide an alternative oxygen delivery system after approval until new prescription can be obtained. If no alternative is available, the prescribing VA physician shall be notified by the COR or designee.

3.6 PATIENT EDUCATION REQUIREMENTS:

a. The Contractor shall provide initial education to each patient at the time of set-up. The initial set up visit, stated above, will account for said annual check. This information shall be presented verbally, in demonstration and material covered shall be in written form to be left with the patient/care giver. The written material shall be in English as well as the foreign language of the patient, should the patient not speak English. In the case of such an occurrence the Contractor is to advise the VA facility to facilitate adequate instructions. All patient education material must be presented in written form to the COR or designee for approval prior to distribution to patients. The Contractor shall implement any new or revised education material as directed by the COR or designee. The VA shall determine whether the Contractor shall use his/her forms or forms supplied by the VA for documentation of services provided to patients. Regardless of whether the VA provides a VA Patient Rights & Responsibilities document and/or forms to the Contractor, and/or the Contractor uses his/her VA Patient Rights & Responsibilities and/or forms, the Contractor is responsible for duplication of the documents/forms when copies are needed to give to patients.

b. Patients shall be provided a copy of VA Patient Rights & Responsibilities, Suicide Prevention information, and Advance Directives as appropriate. The Contractor shall document that the patient/care giver has been instructed in accordance with JC Standards for Homecare.

3.7 DISCONTINUATION OF SERVICE:

a. The Government shall notify the Contractor in the event of an order to discontinue oxygen service to any patient covered under this contract as soon as identified (but not earlier than two (2) weeks prior to expiration). Notification shall be by PKI encrypted email or telephone. At least two (2) weeks prior to the scheduled termination of prescription the Contractor shall notify the COR or designee via telephone or PKI e-mail, if removal of home oxygen may be detrimental to the patient. Payment shall be pro-rated based upon the notification date of discontinuance of service. The Contractor shall notify the Government within next business day of a patient death, or upon finding a patient has moved out of the service area.

b. The Contractor shall remove equipment from the patient’s residence at the earliest possible time but no later than five (5) business days after notification unless approved by the COR or designee. The date and time of equipment pickup shall be coordinated with the patient and/or next of kin and/or significant other. The Contractor shall make every effort to meet the patient’s or patient’s families’ requests for pickup times. The Contractor shall honor family’s requests to pick up equipment before or after funerals or family gatherings relative to patient funerals. The Contractor shall treat such requests with the utmost courtesy and give such requests the highest priority. In the event the patient refuses to release the equipment the Contractor shall immediately notify the COR or designee. Billing of services ends at time of VA-issued notification to discontinue order or prescribed duration of therapy.

3.8 EMERGENCY SERVICES:

a. The Contractor shall provide emergency services on a 24-hour basis, and the contractor shall provide services at the patient’s home no more than four (4) hours of receiving a call. If the Contractor is unable to respond to an emergency service call within four (4) hours, the Contractor shall be responsible for making arrangements with another supplier to provide oxygen, and the Contractor shall be responsible for any excess cost above the contract reimbursed price. A written explanation of why the Contractor was unable to respond to the emergency must be provided to the COR or designee within one (1) business day.

b. An emergency exists if the COR or designee informs the Contractor that he/she considers the situation an emergency, or if the patient states in a telephone call to the Contractor that an emergency exists in regard to the function of the home oxygen equipment or use of the equipment. The Contractor shall provide written details of the patient emergency to the COR or designee within one (1) business day of notification by the patient. This written report shall contain time of initial call and time contractor arrived at the patient’s house, and details of the emergency.

c. The Contractor shall maintain a telephone number for emergency purposes so that the VA and patients who have been authorized to receive home oxygen may contact the Contractor outside of normal business hours. The Contractor shall provide the telephone numbers to the patients and to the COR. This emergency telephone number will be operated and answered 24 hours a day, 7 days a week, 365 days a year.

d. 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.

3.9 SIGNAGE: The Contractor shall provide the patient signs for all entrances into the patient’s residence, 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. The Contractor shall attach patient education and expectations placard to all concentrators and liquid oxygen stationary systems.

3.10 TRAVELING PATIENTS:

a. The Contractor shall be responsible for coordinating all home oxygen for patients who travel both within and outside their respective contracted area of responsibility/jurisdiction, unless otherwise indicated. The COR or designee, or patient, shall be responsible for notifying the Contractor where/when the patient is traveling to and the mode of transportation. The Contractor is responsible for coordinating with the patient when travel has been completed.

b. Traveling patients shall be provided with a Federal Aviation Administration (FAA) approved portable concentrator for travel purposes at the request of the COR or designee. The VA estimates 30% of patients will travel at some point within each year. These units shall not be standard for long term use.

c. Invoices for travel patients are to be provided to the VA within seven (7) days of patient return from travel destination.

d. Patients traveling within the Contractor’s area of responsibility/jurisdiction shall be provided all home oxygen under the contract at the contract rate. Patients traveling within contracted areas of responsibility/jurisdiction covered under other VISN 7 contracts for home oxygen, but not within the Contractor’s area of responsibility/jurisdiction, shall be provided all required oxygen services at whatever contract rate that applies to the area the patient is traveling to. The Contractor currently providing home oxygen shall notify and arrange for home oxygen with the contractor whose area the patient is traveling to.

e. For patients traveling outside the areas of responsibility/jurisdiction covered by Columbia VA Health Care System contract for home oxygen, and/or temporarily relocating, the Contractor shall arrange for home oxygen. The Contractor shall obtain pre-approval from the COR or designee on pricing if it is above the contract price on the Contractor’s contract. If approved, the Contractor shall be reimbursed the contract rate plus the additional costs incurred for providing appropriate home oxygen. The Contractor shall provide the COR or designee evidence of any additional costs involved in providing the services. Travel outside of the areas of responsibility/jurisdiction covered by VISN 7’s contracts for home oxygen includes the remaining United States.

f. Home oxygen for overseas travel is the responsibility of the patient.

4.0 EQUIPMENT SPECIFICATIONS AND ASSOCIATED REQUIREMENTS:

4.1 EQUIPMENT MAINTENANCE:

a. At least once every 30 days the Contractor shall visit the patient to reassess equipment compliance, educational needs, and to perform an environmental survey. A written report shall include at a minimum the following data:

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

2. Monitor compliance on prescription (Liters Per Minute (LPM), hours per day).

3. Type of equipment, hours on concentrator (Serial numbers for the rented equipment shall be the Contractor’s responsibility and kept on file in the Contractor’s main office).

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

5. Inspection compliance of intake filters (exchange or clean by patient); follow-up education and/or reinforcement of compliance documented.

6. Revised plan of service as needed.

7. A delivery report shall be developed by the Contractor, signed and dated by the contract staff and the patient/care giver and a copy shall be left with the patient. 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 invoices by the 10th business day of the month following service. The report must include a patient list and associated scanned delivery/maintenance receipts with patient’s signatures, patient signed patient education notes and clinical notes associated with plan of care changes. The report shall be submitted by the Contractor in both hard copy and on electronic media (DVD or CD). Format to be approved by VA. Changes to the format shall not constitute a need for a contract modification.

4.2 NECESSARY EQUIPMENT AND SERVICES:

a. In accordance with the prescription received from the VA facility, the Contractor shall provide the patient with the following items:

1) Humidifiers and water traps, when the liter flow is equal to or greater than four (4) liters per minute, or if prescribed. The number of humidifiers must be sufficient to ensure that they are not depleted between re-supply visits. The number of traps shall be based on the patient’s flow rate. Humidifiers and water traps are changed every two-weeks with a supply in reserve at all times sufficient to last until the contractor’s next visit.

2) Six (6) disposable oxygen cannulas on hand for a change every two (2) weeks with a supply in reserve at all times until the Contractor’s next scheduled visit.

3) Six (6) disposable masks for change/wash every two (2) weeks with a supply in reserve at all times (when masks are prescribed in lieu of nasal cannulas).

4) 25-50 feet of oxygen connecting tubing shall be replaced every 30 days with an equivalent section of tubing in reserve at all times (to be included in initial setup) until the Contractor’s next scheduled visit.

5) Tracheotomy collar and accessories (e.g. tubing and large volume nebulizer) with a supply on hand allowing for change every three (3) days and a supply of five (5) each in reserve at all times until the Contractor’s next scheduled visit.

6) Safety holders shall be provided at no charge for all patients with a prescription for four (4) or more cylinders.

7) 2 Oxygen Thermal Fuses per source per patient IAW AL18-01 (see attached)

b. Contractor shall schedule and perform home visits every 30 days for traditional concentrators and every home fill system to educate patients and perform equipment inspection and maintenance in accordance with manufacturer’s recommendations.

c. Contractor shall maintain, deliver, and pick-up VA owned equipment.

d. One Oxygen-conserving nasal cannula with pendent reservoir (if prescribed).

e. Airway clearance device (if prescribed)

f. Cough assist device (if prescribed)

4.3 CONTRACTOR OWNED CONCENTRATORS:

a. The Contractor shall furnish, install and service all oxygen equipment to dispense oxygen and supplies ordered under this contract. All equipment shall be current, state-of-the-art model and all supplies are to be new. 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.

b. The concentrators must meet the following standards and guidelines:

1. The American Association for Respiratory Care for Respiratory Equipment Used in the Home.

2. American Society for Testing Materials (ASTM) minimum standards specification for electrically

3. powered home care portable ventilators.

4. Association for the Advancement of Medical Instrumentation (AAMI).

5. Joint Commission (JC) Standard for Home Care.

Please note: Ventilators, 50 PSI Compressors and POC’s are included in this PWS, as needed.

4.4 CYLINDERS:

a. The Contractor shall furnish cylinders required under this contract that are in accordance with the Interstate Commerce Commission Regulations, and transport cylinders in accordance with Code of Federal Regulations (CFR) Part 49, U.S. Department of Transportation. ‘H’ or “M” cylinders furnished by the Contractor shall have ‘H’ or “M” safety stand at no additional charge to the Government. This stand shall remain Contractor-owned.

b. Oxygen Cylinders provided must be United States Pharmacopoeia (U.S.P.) oxygen.

4.5 OXYGEN SAFETY VALVES:

a. The Contractor shall furnish oxygen safety valves to each Veteran on home oxygen. These valves shall remain Contractor-owned and will be replaced every one (1) year. Two (2) each oxygen safety valves will be issued for each Veteran on home oxygen (one (1) each to be placed between the nasal cannula and oxygen tubing, with another one (1) each being placed between the oxygen concentrator (at the flow meter) and oxygen tubing).

b. Oxygen safety valves act like a fuse to automatically isolate the oxygen supply in case of accidental fire, and potentially:

i. Provides an additional level of protection, buying the patient, caregivers, emergency personnel and others valuable time to evacuate.

ii. Prevents the progression to upstream equipment oxygen concentrator, high pressure cylinder or liquid vessel.

iii. Lessens the probability that the fire will spread further, minimizing the overall cost of restoration.

c. Veterans with heated humidity will not be provided with a valve, as this is a contraindication indicated by the manufacturer.

d. Veterans shall be instructed to clean exterior surfaces of the valves every two (2) weeks with an alcohol or disinfectant wipe.

e. Oxygen safety valves should be provided during a regularly scheduled cylinder delivery or every 30-day equipment maintenance visit. Special visits to deliver oxygen safety valves should not be made.

f. If patient refuses oxygen safety valve, documentation of refusal, signed by the patient, must be provided to the VA.

g. If contractor is unable to contact patient, notification should be made to the VA requesting updated contact information. If patient is still unable to be contacted, written documentation of 3 attempts to contact patient should be provided to the VA.

h. If the delivery of safety valve coincides with a patient’s extended winter vacation, notification of this should be made to the VA in writing. Valves should be delivered to patient during first equipment delivery when patient returns. Follow up documentation should be provided to the VA after valves are delivered.

i. Valves to be used must meet or exceed the below device specifications:

Resistance to flow n/a

0.1 kpa (0.15 psi) at 2 lpm, 0.7kPa (0.10psi) at 5 lpm, 3.8 kPa (0.55 pse) at 15 1pm

(1) Likely upstream system pressure following activation of the valve; (2) Leak through the valve after activation; (3) Leak from the valve body after activation. Subject to correct installation as per instruction.

4.6 MALE-FEMALE OXYGEN SWIVEL CONNECTOR:

a. The Contractor shall furnish a male-female oxygen swivel connector to each Veteran to be used in conjunction with the oxygen safety valve, as requested by the Veteran or VA staff.

i. Oxygen swivel adapters shall not be routinely issued like oxygen tubing or filters, but only as requested by the Veteran or VA staff.

ii. All requests for oxygen swivel connectors, made by either the Veteran or VA staff must be documented on the patient signed equipment maintenance sheet or patient signed delivery sheet.

iii. Delivery of swivel connectors shall be completed during a regularly scheduled delivery / equipment maintenance appointment. Any deliveries made outside this defined time must have prior approval from VA Prosthetics / COR or designee.

b. The swivel connector is designed to help prevent oxygen tubing from twisting, kinking or becoming tangled.

c. Two (2) each swivel connectors will be issued for each Veteran who is receiving VA home oxygen and has an oxygen safety valve, as requested. These swivel connectors shall remain Contractor-owned and will be replaced every one (1) year and as needed with prior approval from VA Prosthetics / COR or designee.

d. Male-female oxygen swivel connectors must meet or exceed the following specifications:

4.7 HOME OXYGEN EQUIPMENT:

a. Installation - The installation of all machines and equipment by the Contractor shall be performed by a competent professional familiar with the 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 the most current National Fire Protection Association (NFPA) Life Safety Codes and NFPA Oxygen Cylinder Requirements. The Contractor shall provide a safety/emergency checklist to be completed, then signed by the patient or his/her caregiver and retained in the beneficiary account folder.

b. Maintenance - The Contractor shall ensure that all equipment is inspected at manufacturer’s recommended intervals. A Contractor’s staff member shall conduct a check of the concentrator using a certified oxygen analyzer that is calibrated according to the manufacturer’s standards. Equipment shall be maintained per manufacturer’s specifications, and the maintenance shall be completed using the manufacturer’s checklist. It shall include compressor inlet pre-filter changes and compressor inlet bacteria filter changes according to the manufacturer recommendations. The alarm battery shall be tested at each maintenance check, changed as indicated but at least annually. The Contractor is responsible for tracking and documenting maintenance of equipment in accordance with manufacturer specifications and providing these records for review upon request. Contractor shall furnish parts and labor for routine maintenance at no cost to the VA. The Contractor shall have recall procedures for equipment and supplies.

4.8 EQUIPMENT SPECIFICATIONS FOR OXYGEN CONCENTRATORS:

a. The oxygen concentrators shall be Underwriter Laboratory (UL) approved and must at a minimum meet the following specifications:

1) Electrically powered (115 volts).

2) There shall be a battery-operated audible alarm to indicate a power failure.

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

4) Hour meter and OCI indicator.

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

b. All electrically powered equipment used in performance of this contract shall be UL approved and shall be the most recently developed in the field at the time of use and not more than three (3) years old.

c. Contractor-owned equipment shall be repaired or replaced at no cost to the Government when breakdown or malfunction is due to normal usage or due to the fault of the Contractor.

4.9 FIVE (5) LPM CONCENTRATOR:

1. Concentrators must meet the following specifications:

a. Deliver 92 - 95% oxygen (+ / - 3%) at flow rates up to 5LPM.

b. Operate on 120 VAC, 60 Hz.

c. Irregular pressure alarm

d. Have power failure alarm.

e. Weigh 60 pounds or less.

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

g. Must meet Food and Drug Administration (FDA) Quality Systems Regulation (QSR) standards.

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

i. Sound level of 60db or less.

Concentrators that have oxygen sensing devices are preferred, but not required.

4.10 TEN (10) LPM CONCENTRATOR:

1. Concentrators must meet the following specifications:

a. Deliver 92 - 95% oxygen at flow rates from 0.5 to 7 LPM.

b. Deliver 90 - 95% oxygen at flow rates from to 7 to 10LPM.

c. Alarms for the following failures required: Power Failure, O2 Concentration (Optional), and Irregular Pressure.

d. No larger than 26.0 H x 14.7 W x 19.1 Deep (in) 28.4 H x 39.4 W x 47.0 deep (cm).

e. No heavier than 60 lbs (10 LPM unit) 110 volt; 60 cycle.

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

g. Must meet FDA QSR standards.

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

i. Sound level of 60 db or less.

Concentrators that have oxygen sensing devices are preferred, but not required.

4.11 CONCENTRATOR WITH PORTABLE GASEOUS OXYGEN SYSTEM:

1. Oxygen concentrator with home compressor used to fill portable oxygen cylinders. Home compressor feature may be integrated into the stationary concentrator or may be a separate component. Oxygen concentrator to deliver flow rates of either up to 5 LPM or up to 10 LPM (low flow or high flow concentrator). System shall include the following accessories:

a. Portable containers.

b. Regulator.

c. Flow meter.

d. Integrated oxygen conserving device.

e. Humidifier.

f. Nasal cannula or mask.

g. Tubing.

h. Cylinder carrier.

i. Oxygen Thermal Fuse.

j. 5 self-filling type oxygen cylinders (includes E, B, C and/or D cylinders) Contractor shall provide at no cost to the VAMC and Outpatient Clinics a home-fill system so patients can be titrated on actual unit before he/she goes home at no cost to the VA. Devices shall then be billed at monthly rental charge.

4.12 RENTAL DEMAND PULSE CONSERVER DEVICE: Contractor shall provide an oxygen- conserving device when ordered. Devices shall be approved by the VA and furnished to the VA Medical Center and Outpatient Clinics at no charge, so patients can be titrated accordingly. Contractor shall provide at no cost to the VA an oxygen-conserving device so patients can be titrated on actual unit before he/she goes home. Devices shall then be billed at monthly rental charge upon delivery of prescribed equipment.

4.13 PNEUMATIC POWERED OXYGEN CONSERVING DEVICES:

Pneumatic units shall meet the following specifications:

a. Flow settings from .5 to 6.

b. Have easy to read content gauge.

c. Have continuous flow setting.

d. Have at least 2-year warranty.

e. Weight less than 30 oz.

4.14 ELECTRIC POWERED OXYGEN CONSERVING DEVICES:

Electric units must meet the following specifications:

a. Flow settings from .5 to 6.

b. Have easy to read content gauge.

c. Have alarm for low oxygen pressure level.

d. Have alarm for “no inspiration taken”.

e. Have continuous flow setting.

f. Have at least 2-year warranty.

g. Weight less than 30 oz.

4.15 LIQUID OXYGEN SYSTEM:

Liquid oxygen system consists of a 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 standard reservoir weighs 165 pounds full and the portable unit weighs 6-8 pounds full. System shall 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 0.5 to 6 LPM.

d. Portable must come with shoulder strap.

e. May have electrical or mechanical content indicators.

f. Safety pressure relief valves, primary and secondary.

4.16 LIQUID SYSTEM WITH CONSERVING DEVICE:

This system consists of a 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 four (4) pounds full. System shall 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 one (1) to six (6).

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

e. May have electrical or mechanical content indicators.

The Plan of Service must be developed by VA or the Contractor’s clinical representative, in accordance with the Plan of Care and the appropriate clinical staff at each VA facility. No alteration to the prescription shall be permitted without written prior approval of the COR or designee.

4.18 BACKUP SYSTEM:

a. Patients with a prescription for an oxygen concentrator shall be provided with an appropriate backup system. This system shall consist of a compressed gas source and regulator with stand, humidifiers, cannulas/mask for use during the event of a power failure or mechanical problem and necessitating the use of the backup cylinder. The cost for the above mentioned backup system would be borne by the Contractor. Any patient refusing to accept oxygen equipment or supplies prescribed by the VA is considered Against Medical Advice (AMA) and must sign the Contractor’s visit documentation or AMA form. The Contractor shall send the signed form and report within one (1) business day to the COR or designee by facsimile or secured email. In the event that a patient refuses to sign the Contractor's visit documentation or AMA form, the Contractor shall notify VA via facsimile or secured email within one (1) business day.

b. The Contractor shall ensure all patients have at minimum a non-electrical oxygen supply to last three (3) times the Contractor’s response time to a call. The minimum supply shall take into account each patient’s prescription flow-rate and distance from the Contractor’s location, and so actual supply levels may differ from patient to patient. The cost of backup systems, backup oxygen, and backup equipment shall be borne by the Contractor. If H tanks are used for backup, the Contractor shall furnish an H tank stand for each H tank at no cost to the Government. Liquid oxygen supply may be considered backup oxygen; however, the oxygen supply must be maintained at the minimum three (3) times the Contractor’s response time, and the cost of any additional equipment such as extra stationary units used solely to maintain the minimum level of backup oxygen shall be borne by the Contractor. The cost of liquid oxygen used solely for backup purposes shall be borne by the Contractor.

4.19 STOCK STORAGE PORTABLE EQUIPMENT AT VAMC:

a. Ten (10) portable cylinders, regulators and 02 carriers shall be continuously maintained by the Contractor at the VA Medical Center. These cylinders shall be used only to accommodate home oxygen beneficiaries who are visiting VA or being discharged and require a tank of oxygen to go home. This shall be provided at no additional cost to the Government for this service.

b. Portable cylinders, regulators and 02 carriers shall be delivered to the VAMCs within One (1) business day of request to accommodate home oxygen beneficiaries who are visiting the VA or being discharged and require a tank of oxygen to go home, at no additional cost to the Government.

c. The VA shall furnish storage space and maintain all security for the above equipment. The Contractor shall be permitted access to the space and equipment when requested, by telephone, with 24 hours’ notice to the Respiratory Therapy Department. The Contractor shall maintain an updated inventory of all equipment on a quarterly basis.

4.20 DEMURRAGE CHARGES: The Contractor agrees to provide cylinders without assessing demurrage charges on the Government. The Contractor further agrees that the free loan period of cylinders is indefinite but shall not exceed the term of the contract.

4.21 LOSS OR DAMAGED EQUIPMENT: The VA will not pay for the Contractor’s lost or damaged equipment provided under this contract. Accordingly, this is considered to be the cost of doing business and is the requirement of the Contractor to pay for this type of equipment.

5.0 REQUIREMENTS AND STANDARDS:

5.1 SITE VISITS: Periodic, unscheduled on-site Contractor and home oxygen patient visits shall 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.

Site visits are conducted to ensure the Contractor’s compliance with coordinating, supervising and evaluating the services provided under the requirements of this contract.

5.2 CONTRACTOR STAFF COMPETENCIES: Contractor must provide their staff with documented competency training to deliver prescribed supplies/cylinders/liquid oxygen (LOX) as required to each beneficiary as needed.

5.3 STAFFING AND EMPLOYEE REQUIREMENTS:

a. The Contractor shall be staffed to render satisfactory, timely, and courteous service to the patient at all times. The number of employees shall be equal to the workload and service response times specified in this contract. Workload fluctuations and personnel absences are the sole responsibility of the Contractor. The Contractor shall be responsible for the acts and omissions of his/her employees.

b. All home oxygen services shall be performed in strict accordance with JC standards for Homecare by a competent professional familiar with the nature of the home oxygen equipment involved, and who has demonstrated competency. Employees providing services must have current education, training, and experience commensurate with the home oxygen equipment and scope of services provided. Only employees that have been properly trained and who have demonstrated competency shall perform equipment deliveries, recoveries, and patient education on the equipment.

c. The Contractor shall educate, evaluate, and document employee education and training, in strict accordance with the current JC standards for Homecare. The Contractor shall maintain personnel folders on all employees performing under this contract. The Contractor shall provide and document both initial employee orientation and on-going education and training, which demonstrates the employee’s knowledge, experience, and competence, are appropriate for his/her assigned responsibilities. The Contractor shall perform initial assessment and ongoing assessment of employee competency for all employees involved with the delivery/recovery of equipment covered under this contract in strict accordance with the current JC standards for Homecare and document the employee competency. Employee’s records shall include evaluations of performance. The Contractor shall make all employee records available for review by VA personnel during their visit to the Contractor’s facility, and as requested in response to JC surveyors.

d. As a part of the employee’s initial orientation, the Contractor shall provide an orientation on the VA and on the requirements of this contract. Training topics shall cover all aspects of the services provided under this contract, including patient confidentiality and infection control procedures.

e. The Contractor shall provide COR or designee with a list of key employees and all employees currently competent to perform delivery/recovery and patient education services within ten (10) days after contract award and submit a revised listing within twenty (20) days after any changes are made. The Contractor shall also identify in writing subcontractor personnel in similar employee positions. Key personnel must be given the authority to represent the Contractor in all day-to-day matters. The Contractor shall identify at least one individual who has the authority to fully represent the Contractor in all contract matters.

f. Each employee visiting patient’s homes shall have five (5) unannounced follow-up visits by a supervisor each quarter to assure employee’s accuracy of data entry, patient…