PWS Sources Sought Draft.pdf

PERFORMANCE WORK STATEMENT

VISN 04 WESTERN PENNSYLVANIA HOME OXYGEN

SECTION 1. ACRONYMS and DEFINITIONS

1.1 ACRONYMS

The following are acronyms which may be used in place of full text throughout this Performance

Work Statement.

AC Alternating Current

ACOR Alternate Contracting Officer Representative

AQL Acceptable Quality Level

BiPAP Bilevel Positive Airway Pressure

CAP Corrective Action Plan

CLIN Contract Line Item Number

CO Contracting Officer

COR Contracting Officer Representative

CPAP Continuous Positive Airway Pressure

CPARS Contractor Performance Assessment Reporting System

CPR Contract Performance Report

DC Direct Current

DNR Do Not Resuscitate

FAR Federal Acquisition Regulation

FCOR Facility Contracting Officer Representative

GFP Government Furnished Property

HCP Healthcare Personnel

HIPAA Health Insurance Portability and Accountability Act of 1996

HME Home Medical Equipment

IDIQ Indefinite Delivery Indefinite Quantity

JC Joint Commission

LPM Liters Per Minute

PMI Preventative Maintenance Inspection

PRS Performance Requirements Summary

P&SAS Prosthetics and Sensory Aid Service

PSI Pounds Per Square Inch

PWS Performance Work Statement

QA Quality Assurance

QC Quality Control

QCP Quality Control Plan

QASP Quality Assurance Surveillance Plan

RCP Respiratory Care Practitioner

SER Service Evaluation Report

SSN Social Security Number

TO Task Order

UL Underwriters Laboratories

VA Department of Veterans Affairs

VAMC Veterans Administration Medical Center

VCOR VISN Contracting Officer Representative

VHA Veterans Health Administration

VISN Veterans Integrated Service Network

1.2 DEFINITIONS

The following are definitions for words or phrases used throughout this PWS.

1.2.1 Alternate Contracting Officer Representative (ACOR) - Individual who may be appointed to perform the same functions as the FCOR or but only in the absence of the FCOR

1.2.2 Business Days - Monday through Friday weekly excluding holidays and weekends

1.2.3 Calendar Days - Every consecutive day on the calendar including holidays and weekends

1.2.4 Contracting Officer (CO)- A person with authority to enter into, administer, and terminate contracts and make related determinations and findings on behalf of the

Government. The only individual legally authorized to bind the Government.

1.2.5 Contracting Officer Representative (COR) - An individual, including a contracting officer’s technical representative (COTR), designated and authorized in writing by the contracting officer to perform specific technical or administrative functions

1.2.6 Contractor - A supplier or vendor having a contract to provide specific supplies or service to the Government. The term used in this PWS refers to the Prime

Contractor.

1.2.7 Facility Contracting Officer Representative (FCOR) - An employee of the U. S.

Government appointed by the CO to assist with contract administration at the facility level and to liaison between the Contractor, CO and VCOR. Each facility will have an appointed FCOR. Such appointment must be in writing and must state the

FCOR’s scope of authority and limitations. This individual has authority to provide direction to the Contractor if within scope of the contract, does not constitute and change to the contract, and has no funding implications. This individual does not have authority to change the terms and conditions of the contract.

1.2.8 Healthcare Personnel - All VA licensed and unlicensed, clinical, and administrative, paid, and unpaid, full, and part-time employees, intermittent employees, fee basis employees, VA contractors, students, researchers, volunteers, and trainees who work in VHA locations.

1.2.9 Joint Commission (JC) - A private non-governmental agency that establishes guidelines for the operation of hospitals and other health care facilities, conducts accreditation programs and surveys, and encourages the attainment of high standards of institutional medical care in the United States.

1.2.10 Quality Assurance (QA) - The Government procedures to verify provided

Contractor services are performed according to acceptable standards

1.2.11 Quality Assurance Surveillance Plan (QASP) - A written document specifying the methodology to be used to surveil Contractor performance

1.2.12 Quality Control (QC) - All measures taken by the Contractor to assure the quality of services provided meets contract requirements

1.2.13 Respiratory Care Practitioner (RCP) - A Certified Respiratory Therapist who has passed the advanced level written and clinical simulation examinations of the

National Board for Respiratory Care. Has advanced clinical skills, advanced decision-making skills, and further training to act in a consulting role in matters concerning patient care planning and treatment.

1.2.14 Task Order (TO) - An order for services placed against this established IDIQ

Custodial Supplemental Services contract

1.2.15 Underwriters Laboratories (UL) - A not-for-profit product safety testing, consulting and certification organization with a global reach and acceptance

1.2.16 VA Beneficiary - Patient who is recipient of prescribed VA treatment

1.2.17 VISN Contracting Officer Representative (VCOR) - An employee of the U. S.

Government appointed by the CO to assist the FCORs with contract administration.

The VCOR also liaisons between the FCORs and CO. Such appointment must be in writing and must state the VCOR’s scope of authority and limitations. This individual has authority to provide direction to the Contractor if within scope of the contract, does not constitute and change to the contract, and has no funding implications. This individual does not have authority to change the terms and conditions of the contract.

SECTION 2. GENERAL INFORMATION

2.1 BACKGROUND

Veterans Integrated Service Network (VISN) 4 provides Home Oxygen delivery and set-up to

Veteran beneficiaries in Pennsylvania. A list of all VISN 4 geographical areas covered under this requirement is provided in ATTACHMENT A, also labeled “Western PA Home Oxygen

Catchment Areas”.

2.1.1 The Contractor shall be responsible for providing Home Oxygen supply to Veteran beneficiaries serviced by VISN 4 VA Medical Centers’ Prosthetics and Sensory Aid

Service (P&SAS).

2.1.2 The Contractor shall arrange for Home Oxygen for veterans traveling, temporarily relocating, and for infrequent instances of Home Oxygen delivery and set-up which may be required in other states located outside the normal geographical areas listed in

ATTACHMENT A.

2.1.3 The Contractor shall provide all supplies, materials, equipment, transportation of equipment, set-up, labor, supervision, patient education, safety management, and infection control, as necessary, for patients on home respiratory care therapy, as specified herein and authorized by the Facility Contracting Officer Representative

(FCOR) or Alternate Contracting Officer Representative (ACOR).

2.1.4 Due to the regular fluctuation of patients, multiple task orders (TOs) may be issued daily.

2.1.5 These services shall be required twenty-four (24) hours a day, seven (7) days a week, including Federal Holidays as listed in Section 2.9 of this PWS.

2.1.6 The Contractor shall be staffed and stocked to render Home Oxygen delivery and set-up provided in accordance with all contract terms and conditions for the duration of the performance period.

2.1.7 It is the Offerors/Contractors responsibility to thoroughly review the specifications and become familiar with the area of coverage to be fully aware of the Home Oxygen delivery and set-up requirements.

2.1.8 Lack of understanding will not relieve the offeror from performing in accordance with the strict intent and meaning of the specifications and will not authorize additional cost to the Government.

2.2 PERFORMANCE PERIOD – Ten years from Date of Award.

Each Base year will be 12 months. Contract Length; 10 Base Years.

2.3 TYPE OF CONTRACT

Firm-Fixed-Price Indefinite Delivery Indefinite Quantity

2.4 ORDER FORMAT

2.4.1 Ordering Facility

Task orders will be placed by Veteran’s Affairs Prosthetic or Respiratory personnel via email, facsimile, or another electronic format. Each individual task order will describe the deliverables required as well as the inclusive tasks and services.

2.4.2 Contractor Provided Delivery, Set Up, and Equipment Pickup Verification

Unless otherwise agreed to, all deliveries made by the Contractor under this contract must be accompanied by delivery tickets or sales slips, provided by the Contractor, and must contain the following information at a minimum:

(a) Name of Contractor

(b) Contract Number

(c) Order Number

(d) Item Name(s)/Number(s)

(e) Task/Delivery Order Number

(f) Date of Purchase

(g) Quantity and Unit Price of Each Item

(h) Date of Delivery and Setup

2.4.3 Invoices will be submitted to the Prosthetic Department of the respective VA

Medical Center that places the task order.

2.5 AUTHORIZED USERS

Authorized Users refers to the clinical staff such as the Respiratory Care Practitioner or any other authorized medical professionals who are responsible for identifying the need of the patient and making the necessary recommendation in the form of a consult to the

Prosthetics Department. The respective Prosthetic or Respiratory personnel will then be responsible for creating the TO (Task Order) which is then submitted to the vendor as outlined in Section 2.4, “Order Format” of this PWS.

2.6 VISN-04 AUTHORIZED VA MEDICAL CENTERS

The below table provides the five (5) VISN-04 VA Medical Centers who may place orders.

VISN-04 Medical Centers

Facility Address City State ZIP

Altoona (503) 2907 Pleasant Valley Boulevard Altoona PA 16602

Butler (529) 353 North Duffy Road Butler PA 16001

Erie (562) 135 E. 38th Street Erie PA 16504

Pittsburgh Heinz

Campus (646)

1010 Delafield Road Pittsburgh PA 15240

Pittsburgh University

Drive (646)

University Drive C Pittsburgh PA 15240

2.7 PAYMENTS

Payments to the Contractor will be issued monthly following receipt of invoice and acceptance of materials and services.

2.8 ADMINISTRATION

On behalf of the Contracting Officer, the FCOR is responsible for the general administration of individual orders, review and acceptance/denial of all deliverables, and technical direction required under said orders. The FCOR will serve as the Government point of contact concerning information exchange, submission review, and payment.

Nothing stated by the FCOR or VCOR shall be construed to change contract requirements unless supported in writing in advance by the CO.

2.9 FEDERAL HOLIDAYS

New Year’s Day Labor Day

Martin Luther King Day Columbus Day

President’s Day Veteran’s Day

Memorial Day Thanksgiving Day

Independence Day Christmas Day

SECTION 3. SCOPE OF WORK

3.1 CONTRACTOR CERTIFICATIONS/STANDARDS, INSPECTIONS, AND MANUALS

3.1.1 Contractor must be Joint Commission (JC) accredited for Home Care and must maintain the accredited standard for the duration of the contract.

3.1.2 All initial and follow-up care provided under this contract shall be provided in accordance with all current Joint Commission (JC) standards for Home Care related to home oxygen therapy.

3.1.3 If the Contractor is re-surveyed by the JC during the contract term, the Contractor shall notify the Contracting Officer (CO) of survey dates, the outcome of the survey, and provide copies of new certificates as issued.

3.1.4 The Facility Contracting Officer’s Representative (FCOR) or Alternate Contracting

Officer’s Representative (ACOR) shall be notified if a subcontractor is utilized.

3.1.5 Any and all subcontractors must follow JC standards and shall be monitored by the

Contractor for compliance.

3.1.6 Contractor facilities may be inspected by the respective Medical Center prior to the contract award.

3.1.7 The Contractor’s comprehensive procedure manual shall become part of this contract.

The manual shall include, but not be limited to:

• delivery and set-up

• infection control

• safety

• rights and responsibilities

• inventory

• employee training (to include age specific)

• competency records and performance improvement

• Contractor shall be required to have a DO NOT RESUSITATE (DNR) policy in accordance with State Regulations. A copy of the DNR policy shall also become part of this contract.

3.2 ADDITIONAL TERMS AND CONDITIONS

3.2.1 Copies of all relevant permits/licenses and certification inclusive of any sanctions current or pending throughout the United States of America must be supplied to each

VA Medical Center identified in this solicitation. These documents must be updated immediately by providing current certificates as they become available throughout the life of the contract.

3.2.2 At the Government’s request, the Contractor shall participate in the kickoff meeting via teleconference within 10 days of issuance of a delivery order under this established contract.

3.3 CAPABILITY

The Contractor must be capable of performing contract compliant Home Oxygen Services, as stated in this PWS, to all Veteran beneficiaries located in, but not limited to, the Catchment Area

Counties as outlined in this PWS and Attachment A “Western PA Home Oxygen Catchment

Areas”.

3.4 CONFORMANCE STANDARDS

Contractor shall provide services and material to ensure that the equipment functions in conformance with the latest requirements of Federal and VA specifications and requirements as applicable. The equipment shall be maintained such that it meets or exceeds the performance specifications as established in the OEM’s technical specifications. Additional performance specifications that exceed the OEM’s specifications shall be specified in writing by the VA.

3.5 CONTRACTOR PERSONNEL

The Contractor must not employ persons for work on this contract if such employee is considered by the CO or FCOR to be a potential threat to the facility’s operational mission or the health, safety, security, general well-being of the VISN 4 VAMC’s employees, facility population, and all Veteran beneficiaries both in the facilities as well as in their respective home or place of residence.

3.5.1 Attire: All employees must wear Contractor provided uniforms or comply with

Contractor’s dress code which must include pants, shirts or blouses, and protective clothing when applicable. The dress code must be the same color or color combinations for all Contractor employees and distinguishable from VAMC staff and facility population. All apparel, whether uniform or dress code requirements, will be worn as designed by the manufacturer. Open toe shoes or sandals will not be worn. A leather shoe covering the entire foot is recommended. All personnel will display a

Contractor provided identification badge while on station. The badge must indicate the employee name and the name of the Contractor and must be attached to employee clothing at chest level.

3.5.2 Appearance: Contractor personnel must be clean and present a neat appearance.

Hair must be neatly trimmed and combed.

3.5.3 Employee Training: The Contractor is responsible for providing personnel of an adequate skill and educational level. Personnel must maintain their skill and education levels throughout contract life. Personnel selected by the Contractor must have the necessary education and training to perform the requirements of the contract prior to reporting to work under the contract.

3.6 ACCESSABILITY

Pass and badge requirements may vary amongst the VISN 04 facilities. To ensure compliance, the

Contractor must obtain facility requirements from the FCOR prior to work commencement. The

Contractor must comply with all registering, credentialing, and identification procedures when entering any VA owned or controlled property, to include but not limited to, pre-registering and submitting a fee for credentialing to any third party vendor(s) used to register, schedule, and identify contracted service providers.

3.7 INFECTION CONTROL POLICY, FLU IMMUNIZATION, AND HEALTH

EMERGENCIES/PANDEMICS

3.7.1 Contractor must comply with the applicable facility’s Infection Control Policy, Tuberculosis Surveillance Policy, and Infectious Disease Policy. Guidance and policy requirements will be provided by the FCOR and the facility’s Infection

Prevention and Control Office. Costs incurred to establish and maintain Contractor compliance will be borne by the Contractor.

3.7.2 Flu Immunization

3.7.2.1 VHA Directive 1192 requires all healthcare personnel (HCP) to participate in seasonal influenza prevention programs and outlines the key implementation steps. HCP are defined as all VA licensed and unlicensed, clinical, and administrative, paid, and unpaid, full, and part-time employees, intermittent employees, fee basis employees, VA Contractors, students, researchers, volunteers, and trainees who work in VHA locations.

HCP covered by the policy are expected to receive annual influenza vaccination. Those HCP unable or unwilling to be vaccinated are required to wear a face mask throughout the influenza season. Masks are available at entrances throughout the medical center.

3.7.2.2 It is the responsibility of the Contractor to ensure that all contract staff is compliant with the requirements outlined in VHA Directive 1192. The

Contractor shall maintain the following documentation:

• Documentation of vaccination, e.g., signed record of immunization from a health care provider or pharmacy, or a copy of medical records documenting the vaccination.

• Completed Health Care Personnel Influenza Vaccination Form

(Attachment B of VHA Directive 1192) if unwilling or unable to receive the vaccine.

3.7.2.3 The Contractor is required to submit annual certification to the Facility

Contracting Officer’s Representative (FCOR) confirming that all contract staff performing services at VA facilities are in compliance with VHA

Directive 1192.

3.7.3 Health Emergencies/Pandemic

3.7.3.1 During a local, state, or federal declared emergency for the events of a natural disaster, severe weather and pandemic health emergencies that pose a serious public health risk, the six month routine assessment may be completed by a telephone or virtual visit by the vendor until such time that declared emergency is lifted. The VAMC will notify the vendor when these circumstances exist to invoke this contingency. The VAMC reserves the right to require an in-home visit during said emergency when the VAMC deems it necessary for Patient safety.

3.7.3.2 A telephone or virtual visit will review at minimum:

• The entire Plan of Care

• Safety review from the Plan of Care

• Fall assessment

• Fire safety and education

• Recent hospitalizations, infections, or any related health concerns

• Review tank availability, storage, supplies, display of “Oxygen In Use” sign is posted

• 6 month concentrator and necessary equipment checks can be completed by phone to include current hours and supply needs.

• When tanks and equipment need replaced, the Contractor will contact the patient and agree on a secure location to deliver the equipment and document where the Contractor is to leave the tanks and supplies.

3.7.3.3 In times of pandemic health emergencies, deliveries will be made in a no-contact method when possible and a pre-arranged location will be determined with Veteran.

3.7.3.4 Upon delivery of equipment and supplies to the patient, the Contractor is required to take a photograph of the delivered items in place as documentation of the delivery.

3.7.3.5 Contractor is to confirm pick up of delivered equipment and supplies with the patient and document on the delivery ticket as specified in Section

2.4.2, “Contractor Provided Delivery, Set Up, and Equipment Pickup

Verification”.

3.8 DATA SECURITY

3.8.1 The contractor shall comply with applicable VA Information Security requirements, shall abide by all applicable security/confidentiality requirements as set forth by

HIPAA.

3.8.2 All VA Contractors shall complete and return the signed Rules of Behavior (ROB) prior to handling any patient’s sensitive information. All VA Contractors will comply with Privacy and HIPPA training, as well as any other additional required training (as needed).

3.8.3 The Contractor shall be responsible for properly protecting all information used, gathered, or developed as a result of work under a resulting contract. In addition, the

Contractor shall protect all Government data by treating the information as sensitive.

3.8.4 Sensitive but unclassified information, data, and/or equipment will only be disclosed to authorized personnel as described in the Task Order. The Contractor shall ensure that appropriate administrative, technical, and physical safeguards are established to ensure the security and confidentiality of this information, data, and/or equipment is properly protected. When no longer required, this information, data, and/or equipment shall be returned to Government control; destroyed; or held until otherwise directed by the Contracting Officer.

SECTION 4. PERFORMANCE REQUIREMENTS – SPECIFIC TASKS

Task 4.1 Performance Requirement: New Patient Set-ups-Oxygen Systems

Upon receipt of a Department of Veterans Affairs (VA) prescription, the Contractor shall deliver and set-up, in the veteran’s residence, all equipment and all supplies ordered. New set-ups shall be performed as described:

4.1.1 All orders for new patient set-ups, placed by the VA and received by the Contractor shall be delivered within the same business day.

4.1.2 In the event the Contractor is unable to meet those delivery times, the Contractor must notify the VA immediately. The VA reserves the right to obtain the service from another source and to charge the Contractor with any excess cost which may result.

4.1.3 Contractor shall notify the ordering facility’s FCOR or P&SAS if the Contractor is unable to contact the patient or caregiver no later than four (4) hours after receipt of the delivery order.

4.1.4 Patients being discharged from a hospital stay or clinical setting who require oxygen for travel home require the Contractor deliver a tank for said travel. The Contractor will establish a process for this delivery system for patients at the VAMC hospital and any non-VA hospitals within the catchment area.

Task 4.2 Mandatory Requirements for Use of Thermal Fuses

Mandatory requirements for use of thermal fuses are as follows:

4.2.1 Thermal fuses must be provided for all patients on home oxygen therapy unless there is a documented clinical contraindication (e.g., patients using heated humidity, patients with flow rates in excess of 25 LPM, patients with behavioral conditions that make use of thermal fuses impractical). If thermal fuses are not provided due to clinical contraindication, this must be documented in the patient’s medical record.

4.2.2 Two thermal fuses 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.

4.2.3 Thermal fuses are not required for portable pulse dose/intermittent oxygen therapy equipment when the equipment does not have a continuous flow setting.

4.2.4 Thermal fuses provided must work regardless of their orientation in the oxygen tubing (bidirectional) or have a design that prevents them from being installed in the wrong orientation (e.g., source end of thermal fuse has threads or bayonets that make backwards installation impossible).

4.2.5 Existing unidirectional thermal fuses that are capable of being installed in the wrong orientation must be replaced at the next scheduled home oxygen visit or sooner if possible.

4.2.6 At the time of installation, education must be provided to the patient describing the proper use and placement of thermal fuses, including that a thermal fuse does not make it safe to smoke, be near people who are smoking, or be near any source of sparks or flame while using oxygen.

4.2.7 Thermal fuses must be replaced at the end of their expected life per manufacturer’s guidelines.

4.2.8 Thermal fuses must be replaced if actuated or involved in a fire.

Task 4.3 Performance Requirement: Initial Set-ups - Oxygen Systems

4.3.1 Set-ups shall be performed by a Contractor trained and qualified technician or

Respiratory Care Practitioner (RCP).

4.3.2 Contractor shall provide up to fifteen (15) tanks with initial set-up when portable is ordered. For safety reasons, only fifteen (15) tanks can be in the home at any one time. If a patient requires more than fifteen (15) tanks after the initial set-up, the

FCOR or ACOR will issue an order for any additional tanks. The government will determine the size of tanks upon set-up based on the written prescription by the provider.

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

4.3.4 The Contractor shall notify the FCOR, ACOR, or prescribing physician 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.

4.3.5 The Contractor shall verbally notify the FCOR or ACOR immediately by phone of any unsafe conditions observed in the VA beneficiary’s home and precludes the installation or 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 furnish written documentation of the safety hazard to the FCOR or ACOR within one (1) business day of the incident.

4.3.6 The Contractor shall document and report to the VA Home Oxygen Coordinator or

FCOR any patient who is noncompliant with safety guidelines set forth in the education and orientation material and/or whose behavior poses a risk of self-harm or harm to others (e.g. smoking while on oxygen), despite warnings and ongoing educational interventions.

4.3.7 The Contractor shall check the adequacy of the electrical outlets in the patient’s home and immediately report unsafe conditions to the FCOR or ACOR. VA shall not be responsible or liable for any unsafe electrical conditions caused by the Contractor.

Any alterations to the veteran’s residence will be the responsibility of the veteran. If ordered equipment cannot be safely installed, the Contractor may provide an alternative oxygen delivery system after approval by the FCOR and Respiratory Care

Practitioner (RCP) until a new prescription can be obtained. If no alternative is available, the prescribing VA physician will be notified.

4.3.8 The Contractor shall verify the presence of the smoke alarms and instruct the patient to test all smoke alarms monthly. In any home where smoke alarms are not present, the Contractor will notify the FCOR for further review and potential action.

4.3.9 If the oxygen set-up is performed by a technician only, the visit shall be limited to set-up and instruction, solely focusing on the equipment use and safety and not providing instruction for the purpose of deriving the intended medical benefit. If the set-up visit is performed by a Respiratory Care Practitioner (RCP), in addition to set-up and instruction in the use and safety of equipment, the patient shall receive patient education relevant to his/her medical condition, the prescription, and the intended medical benefit of the applicable home oxygen treatment.

4.3.10 Contractor shall provide documentation to the FCOR containing:

• Name of the Contractor’s branch/division servicing the patient

• Date of visit

• Recommendations and/or problems relating to the beneficiaries use of the oxygen equipment

• Proper name, social security number (SSN), and phone number

• Review of prescription and verification of percent of oxygen concentration

• Manufacturer’s model and serial number for Government Owned Equipment

4.3.11 In addition to the above list, the Contractor shall also provide review of on-site environmental conditions that includes a check of electrical sockets if powered equipment is provided and make all appropriate site preparations (e.g., uncluttered area for storage of standing tanks, fire safety notation of observable safety hazards, etc.) before placing oxygen equipment in the home.

4.3.12 Two bi-flow (or bi-directional) thermal fuses 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.

4.3.13 The Contractor and the employees shall NOT directly or indirectly make recommendations/comments to patients with respect to the services being provided to the VAMCs under this contract. The Contractor shall refrain from discussing repair/replace items of equipment or any services not specifically delineated in this contract to patients. Any concerns raised by the patient/caregiver outside the scope of this contract regarding services provided shall be addressed to the FCOR, as appropriate, for solution. The Contractor shall not solicit or deal directly with the veteran except as stated in this Scope of Work.

Task 4.4 Performance Requirement: Initial Oxygen Follow Up Visit - Required when initial set-up is performed by a Contractor qualified technician

4.4.1 Follow-up visits shall be performed by a Respiratory Care Practitioner only, within seventy-two (72) hours after initial set-up by a qualified technician.

4.4.2 Contractor shall provide proof of initial set-up, patient Plan of Care and Education.

4.4.3 Contractor shall submit the required documentation to the FCOR with the following monthly invoice.

4.4.4 A Respiratory Care Practitioner shall follow up within seventy-two (72) hours to perform the required patient education and develop a Plan of Care. Documentation of patient education, Plan of Care, and all visits shall be in compliance with the current JC Home Medical Equipment (HME) standards and shall be provided to the respective FCOR or ACOR with the next monthly invoice.

Task 4.5 Performance Requirement: Initial Set-Up-CPAP/BiPAP

4.5.1 Initial set-up for Continuous Positive Airway Pressure (CPAP)/Bilevel Positive

Airway Pressure (BiPAP) shall be performed by a Respiratory Care Practitioner only.

The Contractor shall submit proof of initial set-up and patient Plan of Care and

Education.

4.5.2 Contractor shall submit the required documentation to FCOR or ACOR with the following monthly invoice.

4.5.3 All VA issued CPAP/BiPAP shall be delivered and set-up by a Respiratory Care

Practitioner within three (3) business days of the VA prescription, unless otherwise notified by the ordering facility. Set-up shall include the pressure setting(s), instructions, mask fitting, safety, and any other necessary instruction. VA will provide sufficient supplies to last between maintenance visits.

4.5.4 Oxygen orders with CPAP and BiPAP units shall be delivered within twenty-four

(24) hours in accordance with Task 2.1.

Task 4.6 Performance Requirement: Setup –Air Compressors, and Suction

Machine/Maintenance Visit Requirements and Time Frames

4.6.1 All air compressors, and/or suction pumps will be delivered and setup within twenty-four (24) hours of contact by the VAMCs Prosthetic Service.

4.6.2 All deliveries will be completed by a Respiratory Care Practitioner or other qualified personnel.

4.6.3 The air compressors, and/or suction pump request will be in the form of the

Prosthetics Request/Consult. This initial request/consult will be generated from the

VAMCs Physician including all equipment requirements and settings and sent electronically to the VAMC Prosthetic Service who will then fax request to the

Contractor. A purchase order will then be faxed to the Contractor with the purchase order number and credit card number to confirm the order.

4.6.4 The Plan of Service will then be created at the time of delivery by the Contractor’s

RT and will include any problems in the patient’s health status and/or compliance with the Plan of Care, and will ensure equipment and treatment is appropriate for the patient’s use in the home environment.

4.6.5 Copies of the Plan of Care and Plan of Service shall be furnished to the Prosthetics

Service via encrypted email within five (5) working days of the Contractor delivery and set up. These records shall also be maintained by the Contractor in the Veteran

Patient Account Folder

Task 4.7 Performance Requirement: Equipment Monitoring/Maintenance Visit Requirements and Time Frames

4.7.1 As part of the equipment monitoring visit, the Contractor shall ensure the patient has adequate supplies (mask supplies, colored tubing, filters, pre-filled humidifiers, etc.)

to last between visits.

4.7.2 The Contractor shall provide delivery of prescribed equipment and supplies to each beneficiary on an as prescribed or as needed basis. The cost of this visit shall be borne by the Contractor. The Contractor shall visit beneficiaries' residences in performance of this contract by appointment only, between the hours of 8 a.m. and 8 p.m., Monday through Saturday, exceptions will be made in the cases of emergencies.

4.7.3 At a minimum of once every six (6) months +/- seven (7) calendar days from the previous six (6) month visit, the Contractor’s Respiratory Care Practitioner (RCP) will visit the VA beneficiary to reassess equipment compliance, educational needs, etc. A written report will be required to include, at a minimum, the following data:

• Name and Social Security Number (SSN) of beneficiary using the equipment

• Monitor compliance on prescription (Liters Per Minute [LPM], Hours Per Day)

• Type, hours on concentrator *Serial numbers kept on file should be for VA owned equipment only. Serial numbers for the rented equipment shall be the vendor’s responsibility and kept on file.

• Inspection results of liter flow rate in monitoring patient compliance as compared to prescription

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

• Revised plan of service as needed

• Identify any safety concerns and /or non-compliance issues

• A report shall be developed by Contractor, signed, and dated by the contract staff and the VA beneficiary/care giver, and a copy shall be left with the beneficiary.

• The reports shall include any issues with action plans for compliance.

• All reports will be legible and attached to the invoice.

• All reports shall be submitted to the FCOR, ACOR, or designee in alphabetical order with the monthly bills by the tenth (10th) business day of the following month.

• At minimum, once every six (6) months and +/- seven (7) calendar days from the previous six (6) month inspection, a Preventative Maintenance Inspection (PMI) will occur on all equipment, both Contractor owned and VAMC owned.

• The Contractor’s staff member will conduct a check of the concentrator using a certified oxygen analyzer calibrated according to manufacturer’s standards.

• Filters will be replaced as indicated by the manufacturer.

• The alarm battery shall be tested at each maintenance check and changed at least annually as indicated.

• The Contractor is responsible for tracking and documenting maintenance of equipment and providing these records upon request.

4.7.4 During the scheduled visit, the Contractor shall be responsible for carrying out the plan of care by monitoring issues of patient compliance, completion of a home safety assessment, verification of the patients’ ability to operate equipment, cleaning and maintenance and patient re-education as indicated. Documentation of each visit will be provided to the FCOR or ACOR with the monthly billing.

4.7.5 All beneficiaries have the right to refuse service. In the event a beneficiary refuses service or orders the equipment to be removed from the home, the Contractor shall comply with the beneficiary’s wishes. At the time of the refusal, the Contractor shall have the veteran sign a letter of refusal. If the refusal occurs during a home visit, the

Contractor’s staff shall notify the FCOR or ACOR of the refusal during the home visit. In any case, the Contractor shall report the specifics of the refusal to the FCOR or ACOR by telephone within one (1) hour and shall follow-up with a written report in the Daily Incident Report. Visit refusals or failure to keep a scheduled appointment shall be faxed or emailed daily to each FCOR or ACOR for action. No less than three (3) attempts shall be made to visit the beneficiary. Payment for monthly rental, service, or supplies will not be rendered without this required documentation.

4.7.6 In the event that a scheduled visit will not occur, the FCOR or ACOR will be notified and provided with details regarding attempts to make contact with the veteran for service.

4.7.7 Contractor shall document all prescription renewals in the patient’s file.

4.7.9 The Contractor shall not change or alter a VA beneficiary’s equipment settings to deviate from the current prescription without obtaining a new oxygen prescription from the beneficiary’s VA physician.

Task 4.8 Performance Requirement: Emergency Protocol

4.8.1 The Contractor shall have a well-established communication system providing

Twenty-four (24) hour emergency Home Oxygen delivery and set-up and the ability to provide those services at the beneficiary’s home within a maximum of four (4) hours of notification to Contractor. An emergency exists if the appropriate P&SAS staff or FCOR informs the Contractor that he/she considers the situation an emergency, or if the VA beneficiary states in a telephone call to the Contractor that an emergency exists in regard to the function or use of the respiratory related equipment or use of the equipment.

4.8.2 In emergent situations, the Contractor shall provide service to the beneficiary within four (4) hours; in the event the Contractor is unable to meet the appropriate response times, the Contractor is responsible for making arrangements with another supplier to provide oxygen at the Contractor’s expense. A mandatory written justification detailing why emergency service was not available shall be provided by the

Contractor to the FCOR and the Contracting Officer within twelve (12) hours from the original time the Contractor was called to provide the service.

4.8.3 The Contractor shall provide a written Emergency Contingency Plan for natural disasters which provides for continued uninterrupted care and support in the event of an emergency resulting in an interruption of service. At a minimum, the plan shall address such items as severe weather, power outages, loss of personnel, damage to the Contractor’s site, and communications. A copy of this plan shall be provided in the proposal. If the emergency contingency plan is activated the FCOR or ACOR will be contacted immediately and notified of reason for activation and subsequent implementation of Emergency Contingency Plan.

4.8.4 The Contractor shall ensure all patients have, at a minimum, a non-electrical oxygen supply to last at least twenty-four (24) hours. The minimum supply shall take into account each patient’s prescription flow-rate and distance from the Contractor’s location, so actual supply levels may differ from patient to patient.

4.8.5 The cost of backup systems, backup oxygen, and backup equipment shall be borne by the Contractor. If M60 tanks are used for backup, the Contractor shall furnish an

M60 tank stand for each M60 tank at no cost to the government. Liquid oxygen supply may be considered backup oxygen; however, the oxygen supply must be at a prescribed rate of flow for twenty-four (24) hours 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.

Task 4.9 Performance Requirement: Discontinuation of Home Oxygen Delivery and Set-Up

4.9.1 Upon termination of Home Oxygen delivery to the beneficiary, either by physician’s prescription or the death of a beneficiary, the Contractor shall pick up all oxygen equipment and supplies at the earliest possible time, but no later than five (5) business days after receipt of notification from the appropriate P&SAS staff or

FCOR. Payment for Home Oxygen shall cease upon this notification. The final invoice shall be prorated from the date of notification. Final services shall be billed with the next scheduled invoice.

4.9.2 In the event the Contractor gains knowledge of the patient’s death prior to the servicing VA, the Contractor shall immediately notify the FCOR of the patient’s death and the date the Contractor was made aware of the death. Billing shall cease on the day the Contractor becomes aware of the patient’s death. The final invoice shall be prorated from the date of notification.

Task 4.10 Performance Requirement: Service Transition

4.10.1 In the event award is made to other than the incumbent Contractor, the new

Contractor shall arrange with the incumbent Contractor for exchange of equipment, ensuring that there is a continuity of services and no disruption of supplies/services to veteran beneficiaries. Transition to the new Contractor shall be complete as soon as possible, but no later than ninety (90) calendar days from the date of award of a new contract. Additionally, if the Contractor fails to accomplish the phase-in, the

Contractor shall be responsible for any duplicate costs the VA may have to pay the incumbent Contractor beyond thirty (30) calendar days. In the event the delay is due to the ex-incumbent Contractor’s lack of cooperation during the phase-in process, the incumbent Contractor will not be held liable for this delay.

4.10.2 This period will be designated as the period for the transfer of VA veteran beneficiaries from the incumbent to the successor Contractor. The change shall, at a minimum, include oxygen care and instructions, usage, set-up, and emergency service. Contractor shall coordinate, through the Contracting Officer, the schedule of initial patient visits with the Prosthetics FCOR or ACOR for each facility. The transition shall be coordinated through the Contracting Officer and FCOR. The appropriate VA facility shall provide the successor Contractor with an up-to-date prescription.

4.10.3 The successor Contractor shall provide the FCOR, by 12:00 p.m. each Friday during the transition period, a detailed listing of the VA beneficiaries whose oxygen service has been changed over from the incumbent to the successor Contractor. The list shall include the exact date of the change for each beneficiary. Along with this list, the successor Contractor shall also provide documentation showing that the incumbent

Contractor has been notified to pick up their equipment.

4.10.4 Payment to the incumbent Contractor shall be made up to the day supplies/equipment were transferred to the successor Contractor. Payment shall be pro-rated based upon the unit prices in affect during the most recent contract year. Coordination during the transition period shall be accomplished at no additional expense to the Government.

4.10.5 Transition Period: At the end of the contract period, up to a ninety (90) day transition period may be required during which the incumbent Contractor will continue to provide Home Oxygen delivery and set-up at the contract prices, while the incoming Contractor is transitioning in by replacing all incumbent equipment with their equipment.

4.10.6 After award of the contract, the Contractor, at no additional cost to the VA, shall be responsible for picking up existing inventory from the incumbent Contractor’s storage facility within fifteen (15) calendar days after the effective date of the Notice to Proceed.

Task 4.11 Performance Requirement: Equipment Maintenance/Repair

4.11.1 Contractor shall have written equipment preventive maintenance policies and procedures and shall maintain a system for tracking all equipment preventative maintenance by model and serial number. The safety and working condition of the equipment shall be monitored on an ongoing basis, including maintaining preventative maintenance logs, calibration logs, recalls, logs of oxygen cylinder lot, batch numbers, and the results documented by serial number. This documentation shall be maintained for the term of the contract.

4.11.2 All current documentation shall be forwarded to the appropriate FCOR or ACOR monthly. Only qualified technicians with documented training will provide maintenance and repair to this equipment. The Contractor shall perform a formal

Preventive Maintenance Inspection (PMI) immediately before stored equipment is issued.

4.11.3 The Contractor shall have a written recall plan or system in place for identification of equipment recalls, hazardous or defective equipment, and action taken.

4.11.4 The Contractor is responsible for repairing VA owned equipment under this contract when specified by the FCOR or ACOR. If the FCOR or ACOR requires the

Contractor to repair VA owned equipment, the VA reserves the right to furnish replacement parts or obtain maintenance and repair to any item if, in the opinion of the FCOR or ACOR, the Contractor’s cost for such maintenance and repair is deemed to be excessive and the matter cannot be mutually resolved. The Contractor shall provide loaner equipment equal to or exceeding existing equipment while repairs are being made to patient’s equipment. VA owned equipment repairs estimated to cost more than $75.00 must be pre-approved by the FCOR or ACOR prior to the Contractor commencing the work.

Task 4.12 Performance Requirement: Reserve Supply

4.12.1 An adequate supply of liquid tanks, aluminum/composite compressed O2 tanks, with regulator, and E-tank stands shall be provided and stored at each VA facility as directed by the FCOR. Quantities and sizes of tanks will vary and shall be agreed upon by the Contractor and FCOR.

4.12.2 The reserve supply shall accommodate home oxygen patients who are either being discharged from the hospital or visiting (appointments) and require a supply of oxygen to enable the VA beneficiary to reach home. These tanks may travel with the patients to surrounding VISN 4 facilities. Adequate inventory shall be maintained by the Contractor.

Task 4.13 Performance Requirement: VA Beneficiary Records

4.13.1 An individual beneficiary account record shall be maintained by the Contractor in compliance with the Privacy Act and maintain the Health Insurance Portability and

Accountability Act of 1996 (HIPPA) compliance. Copies of these beneficiary records may be maintained on a computer or via paper files and shall be provided to the FCOR upon request or when a patient is discharged from the Home Oxygen

Healthcare program or upon death. The individual patient medical records shall be maintained and housed at the Contractor’s individual branch providing the oxygen service. At a minimum, the record shall include the following:

• Beneficiary identifying information (full name, complete SSN, home address, phone number of beneficiary caregiver, serial number, and type of VA owned equipment)

• Emergency contact phone number at a separate residence other than the beneficiary

• Copy of physician’s prescription (original or renewal)

• Plan of Care as developed by Contractor

• Documentation of the initial and monthly visits, assessments, and Home Oxygen supplied

• Initial and continuing verbal and written instructions to the beneficiary and/or care giver (to include, but not limited to basic home safety, safe and appropriate use of equipment, handling, cleaning, precautions on smoking, and storage-universal precautions)

• Patient complaints, accidents, injuries, and safety hazards identified, and corrective actions taken

• Documentation of all beneficiary education to include course of action in emergency situations

• Infection control- Contractor will comply with standard precautions in the handling, storing, cleaning, delivery of home oxygen equipment, and shall maintain a system for reporting, documenting, and evaluating records of infection among beneficiaries and Contractor staff

Task 4.14 Performance Requirement: Plan of Care

4.14.1 An initial Plan of Care shall be developed and implemented by a Respiratory Care

Practitioner during the initial setup by the Contractor for each VA beneficiary and a copy shall be forwarded to the respective FCOR with the monthly invoice. At a minimum, the plan shall include the following:

• A statement of the patient’s needs and problems

• Measurable beneficiary goals

• Notation of the Home Oxygen delivery recorded, and any additional actions taken

4.14.2 The Plan of Care shall be signed by the visiting Respiratory Care Practitioner and VA beneficiary or care giver. The beneficiary shall retain the original. The Contractor shall retain one (1) copy and forward one (1) copy to the FCOR.

4.14.3 The Contractor shall maintain records of all visits for the term of the contract.

4.14.4 The Plan of Care for CPAPs and BiPAPs shall be completed on initial set up, and every six (6) months thereafter. At a minimum, the assessment shall include the beneficiaries’ tolerance and compliance to equipment and mask fitting.

Task 4.15 Performance Requirement: Education/Instruction

4.15.1 Education regarding all equipment, supplies, and smoking shall be provided to the beneficiary/caregiver by the Contractor in accordance with JC standards. VA supplied video on home oxygen safety will be shown to all oxygen patients prior to set up. At a minimum, the Contractor shall document and provide instruction to the patient/caregiver on the safe and appropriate use of the medical equipment, including basic home safety, storage, handling, required maintenance, electrical safety, equipment hazards and malfunctions, infection control, emergency preparedness, and the beneficiary’s responsibilities in the care and use of all equipment.

4.15.2 The Contractor shall provide, as a part of the technical proposal, all patient education materials to be used throughout the life of the contract.