S02 - 36C25225R0072.pdf

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. UEI: EFT:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

None

Effective 07/01/2026 Date:

36C25225R0072 11-14-2025

Dorr, Joni 414-844-4858 01-05-2026

10:00 am Local

Department of Veterans Affairs

36C252

115 South 84th Street, Suite 101

Milwaukee WI 53214-1476

X

621610

$19 Million

N/A

See PWS for VISN 12 VAMC individual addresses

36C252

Great Lakes Acquisition Center - HC

115 South 84th Street, Suite 101

Milwaukee WI 53214-1476

Financial Services Center

PO Box 149971

Austin TX 78714-9971

See CONTINUATION Page

Home Oxygen delivery services for patients of VISN 12 VA

Medical Centers and associated Outpatient Clinics (CBOCs).

The contract resulting from this solicitation will be awarded as a 5-year ordering period IDIQ with five (5) individually priced periods.

Ensure Addendum to 52.212-1 Instructions to Offerors on pages

70-73 is strictly adhered to and all required documents are included in proposal package in order to be eligible for evaluation.

See continuation page

See CONTINUATION Page

X one

Erika Cannaday

Contracting Officer

36C25225R0072

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA (continuation from Standard Form 1449)

ACKNOWLEDGMENT OF AMENDMENTS

The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO DATE

CONTRACT ADMINISTRATION

All contract administration matters will be handled by the following individuals:

CONTRACTOR:

Contractor Name: _________________________________________

Address: _________________________________________

City-State-Zip: _________________________________________

Point of Contact/Title: _________________________________________

Phone Number: _________________________________________

Fax Number: _________________________________________

E-Mail Address: _________________________________________

UEI Number: _________________________________________

DUNS Number: _________________________________________

Contractor’s past performance point of contact (if different than above):

Name: _________________________________________

Email Address: _________________________________________

GOVERNMENT: Contracting Office Code: 36C252

Great Lakes Acquisition Contracting

115 S. 84th St., Ste 100

Milwaukee, Wi 53214

CONTRACTOR REMITTANCE ADDRESS:

All payments by the Government to the Contractor will be made in accordance with: FAR 52.232-33

PAYMENT BY ELECTRONIC FUNDS TRANSFER – SYSTEM FOR AWARD MANAGEMENT

(OCT 2018)

INVOICES:

a. Invoices shall be submitted monthly in arrears in accordance with: 852.232-72 ELECTRONIC

SUBMISSION OF PAYMENT REQUESTS (NOV 2018).

b. Contractor invoices for equipment rentals or services provided shall be sorted alphabetically and accompanied by an alphabetically arranged consolidated listing of all patients receiving services during the billing period and shall contain the following information:

i. Patient’s name, date of birth (DOB), and last four of SSN

ii. Date of service

iii. Description of equipment, supplies, and/or services including corresponding Healthcare

Common Procedure Codes (HCPC if applicable)

iv. Quantities

v. Unit Prices

vi. Invoice will break out cost per patient

vii. Total balance owed

c. The VA has mandated electronic invoice submission to the Veterans Affairs Financial Services

Center (VAFSC). VAFSC has partnered with Tungsten Network e-Invoicing network, for submissions of all electronic invoices to VA. Tungsten Network electronic invoicing is free to all

VA vendors. In order to submit electronic invoices, all VA vendors must register with Tungsten

Network by submitting an email to VA.Registration@Tungsten-Network.com or calling 1-877-

489-6135 for Enrollment.

d. Contractor shall submit an electronic invoice by the tenth (10th) of the following month services were performed to the Veterans Affairs Financial Services Center (VAFSC) e-Invoice through the website at https://portal.Tungsten-Network.com/Login.aspx. For questions regarding the submission of VA electronic invoices, Tungsten Network customer service may be contacted at

1-877-489-6135.

e. Third-Party Billing: This contract represents an “all inclusive” reimbursement rate for all services provided by the medical facility to the patient. Contractor is not allowed third-party or direct patient billing for any services provided under this contract. Contractor shall not submit bills to any other State, Federal, or third-party agency for reimbursement during the period the beneficiary is covered under this contract.

f. Contractor shall pro-rate all rentals and service charges during the first month from the date of setup to the end of the month. The Contractor shall also prorate the monthly charges in accordance with the date of discontinuance of equipment/service or upon notification of death of patient.

GOVERNMENT INVOICE ADDRESS (See SF1449 Block 18):

a. All invoices from the contractor shall be submitted electronically in accordance with 852.232-72

ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV 2018)

b. Facsimile, e-mail, and scanned documents are not acceptable forms of submission for payment requests.

c. VA’s Electronic Invoice Presentment and Payment System – The Veterans Affairs Financial

Services Center (VAFSC) uses a third-party contractor, Tungsten Network e-Invoice, to transition vendors from paper to electronic invoice submission. Please go to this website:

http://www.tungsten-network.com/customer-campaigns/veterans-affairs-us/ to begin submitting electronic invoices, free of charge.

d. As of July 1, 2020, the VA10091 form has been eliminated and the VAFSC is requiring our vendors to update and add their information in the Customer Engagement Portal (CEP) at https://www.cep.fsc.va.gov/. This is for new vendors being added to FMS only.

e. For assistance setting up e-Invoice, the below information is provided:

* Tungsten Network e-Invoice Setup Information: 1-877-489-6135

* Tungsten Network e-Invoice email: VA.Registration@Tungsten-Network.com

* FSC e-Invoice Contact Information: 1-877-353-9791

* FSC e-invoice email: vafsccshd@va.gov

ACQUISITION OF COMMERCIAL ITEMS:

This Request for Proposal (RFP) solicitation is issued under the authority of FAR Part 15.101-1 Tradeoff

Process. FAR Part 13 and 14 will not be used. From this RFP, the Government intends to award a firm fixed price five (5) year ordering period IDIQ contract with five (5) one-year individual priced periods where the Contractor provides a price that is not subject to any adjustment on the basis of the Contractor’s cost experience in performing the contract.

http://www.tungsten-network.com/customer-campaigns/veterans-affairs-us/ https://www.cep.fsc.va.gov/ mailto:VA.Registration@Tungsten-Network.com mailto:vafsccshd@va.gov

RFP QUESTIONS:

In order to maintain integrity of this solicitation and subsequent award date, all offerors are advised that any question and answer requests must be submitted in a written form via e-mail to the Contract

Specialist joni.dorr@va.gov no later than Monday, December 1, 2025 at 10:00 am Local Time (Central).

Contracting will issue a consolidated response via solicitation amendment to https://sam.gov Contract

Opportunities within five (5) business days to all parties.

CONTRACTING OFFICER AUTHORITY:

The Contracting Officer is the only person authorized to approve changes or modify any of the requirements under this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitment or issue changes that will affect price, quantity or quality of performance of this contract. In the event the Contractor effects any such change at the direction of any person other than the Contracting

Officer, the change shall be considered to have been made without authority and no adjustment will be made in the contract price to cover any increase in cost incurred thereof.

ORDERING OFFICER AUTHORITY

Ordering officers shall be authorized to place orders against this contract. Orders can be placed via email, phone, or fax and issued an order by the applicable VAMC site’s Pulmonary and Prosthetics Departments or the Officer of the Day. The Contracting Officer shall furnish the Contractor with the names of individuals authorized as Ordering Officers, by separate memorandum upon issuance of the contract. The

Contracting Officer shall update this list throughout the life of the contract as Ordering Officers change.

Ordering Officers are responsible for issuing and administering orders placed under this contract. Orders shall include the item(s) to be delivered/provided, patient information, prescription (if applicable) and a location anywhere within the VISN 12 catchment area plus 100 miles in which the item(s) must be delivered. Ordering Officers have no authority to modify any term of this basic contract. Any deviation from the terms of the basic contract must be approved in writing by the Contracting Officer responsible for this contract. Contractor shall accept orders against this contract only from the Contracting Officer and/or authorized Ordering Officers. Fulfilling orders from persons other than the Contracting Officer or

Ordering Officer may result in loss or delay in payment for supplies/services provided under such orders.

IDENTIFICATION, PARKING, SMOKING AND VA REGULATIONS:

i. All VA property is considered Federal Property and all Federal laws are applicable.

ii. It is the responsibility of the Contractor to park in the appropriate designated parking areas.

Information on parking is available from the VA Police Section. The VA will not invalidate or make reimbursement for parking violations of the Contractor under any conditions.

iii. All VA facilities are drug free. Possession of drugs, to include Marijuana and all Marijuana bi-products are prohibited. Enclosed containers, including tool kits, shall be subject to search.

Violations of VA regulations may result in citation answerable in the United States (Federal)

District Court, not a local district, state, or municipal court.

iv. All contractor personnel are required to adhere to all VA rules and regulations.

v. Smoking is prohibited on the entire campus, both inside and outside the VA Facility

vi. Possession of weapons is prohibited. Enclosed containers, including tool kits, shall be subject to search. Violations of VA regulations may result in citation answerable in the United States

(Federal) District Court, not a local district, state, or municipal court.

vii. VHA DIRECTIVE 1192: This Veterans Health Administration (VHA) directive establishes policy and provides guidance for the prevention of seasonal influenza in VHA facilities through the vaccination or masking of health care personnel (HCP). AUTHORITY: Title 38 United States

Code (U.S.C.) 7301(b), 7318(b). Contractor is responsible in ensuring that all aspects of this directive are implemented, including providing face masks and influenza vaccines for all employees working at a VA facility.

viii. While on campus, all persons may be required to wear masks inside any VA Medical Center building, walking on the grounds, and while traveling in vehicles. Contractor shall confirm with

COR before arrival of current mask mandate.

https://sam.gov/

SECURITY & PRIVACY CONTROL:

The Authorization & Accreditation (A&A) requirements of VHA Handbook 6500.6 do not apply to this requirement, therefore, a Security Accreditation Package is not required. No A&A or MOU/ISA is required. Sensitive information exposure as part of this contract involves applicable security controls within the facility as part of the VA Information Security

If there are any questions related to privacy, please have a member of your staff contact the VA Privacy

Service at (202) 461-6309. If there are any questions related to the information security, please have a member of your staff contact the Office of Cyber Security at (304) 262-7733.

Flash Badge:

Applies to common access to VA physical facilities only for a period of 180 consecutive or aggregate days or less in a 365-day period.

All Contractor employees are subject to the same level of investigation as VA employees who have access to VA Sensitive Information. The level of background investigation commensurate with the level of access needed to perform in accordance with the performance work statement is: Special Agreement

Check (SAC) & National Agency Check with Inquiries (NACI). This requirement is applicable to all subcontractor personnel requiring the same access.

• A NACI Tier 1 Background is required. FY26 NACI Tier 1 fees shall apply.

• SAC Fingerprints are required. FY26 SAC Fingerprints fees shall apply.

• Fees are the responsibility of the Contractor and shall be billed accordingly.

Flash Badges allow access to common VA physical facilities. Flash Badges do not allow access to VA information systems or restricted areas. Flash Badges may be issued to Contractors who have a verified need to access common areas only. Flash Badges are issued following, at a minimum, the completion of an identity verification using one Form I-9 approved identity document with a photo. Flash Badges are valid for a period not to exceed one (1) year from the issuance date. Flash Badge must be visible at all times while on site.

If Contractor needs to work in sensitive/restricted areas (e.g. computer room/communications closets) appropriate VA staff must escort Contractors while onsite.

B.1 PERFORMANCE WORK STATEMENT

VISN 12 Outpatient Home Oxygen Delivery Services

1. OBJECTIVE

Contractor shall provide travel, setup, installation, provision of supplies, services, and management of

VISN 12 Home Oxygen Delivery Services. The Performance Work Statement (PWS) shall include the associated program management, human engineering, equipment, and logistic support planning requirements to provide for an effective Home Oxygen Program. Contractor shall also provide administrative, clinical, and logistics support throughout the contract as well as rental equipment with corresponding assessments, follow-up, and/or educational training provided to patients. The Government shall have the option to provide respiratory equipment for issuance to patients in accordance with orders and/or prescriptions.

2. AREA OF RESPONSIBILITY/JURISDICTION UNDER VISN 12

The area (territory) of service shall be inclusive of the following Veteran Integrated Service Network

(VISN) 12 Medical Centers and their catchment areas (Attachment A) plus 100 miles (100 miles shall be defined as 100 miles from the border of the catchment area to the destination utilizing Google Maps):

1. Clement J. Zablocki VA Medical Center (Milwaukee VAMC) located at 5000 W. National Ave, Milwaukee, WI 53295

2. William S. Middleton Memorial Veterans Hospital (Madison VA Hospital) located at 2500

Overlook Terrace, Madison, WI 53705

3. Tomah VA Medical Center (Tomah VAMC) located at 500 E. Veterans St, Tomah, WI 54660

4. Oscar G. Johnson VA Medical Center (Iron Mt. VAMC) located at 325 E. H St, Iron Mountain, MI 49801

5. Captain James A. Lovell Federal Health Care Center (FHCC) located at 3001 Green Bay Rd, North Chicago, IL 60064

6. Edward Hines Jr. VA Hospital (Hines VA Hospital) located at 5000 S. 5th Ave, Hines, IL 60141

7. Jesse Brown VA Medical Center (Jesse Brown VAMC) located at 820 S. Damen Ave, Chicago, IL 60612

8. VA Illiana Health Care System (Danville VA Hospital) located at 1900 E. Main St, Danville, IL

61832

“Non-territory" shall be defined where the patient shall not be in the designated area of responsibility and jurisdiction of VISN 12 or shall be outside of the responsibility/jurisdiction awarded to the Contractor.

These requests shall be required from time to time for patients outside the catchment area plus 100 miles.

If the Contractor provides services outside of the VISN 12 catchment area plus 100 miles, services shall include all rentals, corresponding paperwork package requirements, and follow timelines for deliveries in accordance with the PWS and Section B.3 – Price Schedule. For locations outside of the service area, the

Contractor may arrange for equipment, supplies, and services to be provided by a third-party vendor if unable to provide by existing service locations. Contractor shall make all efforts to communicate with an existing Department of Veterans Affairs – Veterans Health Administration (VHA) Contractor in those areas outside of the catchment area referenced above to provide care, equipment, and services for patients.

Contractor shall obtain pricing to accommodate services or equipment ordered and obtain authorization from the VA Medical Center prior to utilizing third party vendor(s). If approved, the VA Medical Center shall issue an order. Geographical boundaries (Attachment A) plus 100 miles shall be the areas of responsibility for each local VA Medical Center in VISN 12.

3. INVENTORY MANAGEMENT - GOVERNMENT FURNISHED EQUIPMENT AND SUPPLIES

The following Government-furnished inventory shall be provided by the VA Medical Center, all of which shall remain the property of the VA Medical Center. Contractor shall manage in accordance with PWS.

This shall be a near-all-inclusive list of commonly issued respiratory equipment; however, the

Government reserves the right to modify this listing. The Government shall make all efforts to communicate changes to equipment provided to allow the Contractor personnel to obtain education for equipment and accessories that requires specific training for assembly/set-up and corresponding education for delivery to patients.

• Oxygen Concentrators

• Invasive/Non-Invasive Ventilators (to be plugged in when stored at all times. Contractor to have capabilities for downloading data if/when requested)

• Mouthpiece Ventilation System (MPV)

• Heated Humidifiers/Humidification systems

• Suction Devices

**Unless otherwise specified on the order, Contractor shall utilize VA Medical Center owned equipment**

Contractor shall utilize First in-First Out (FIFO) process, as described in VHA Directive 1761, Appendix

I for all inventory stored at the Contractor’s site. Contractor shall manage and report inventory levels monthly of Government-furnished/owned inventory at each of their servicing locations to support orders from all VA Medical Center sites. If utilizing equipment from another VA Medical Center’s site inventory, prior notification shall be made to the Outpatient Respiratory Program Coordinator (ORPC) or

Prosthetics points of contact prior to issuance.

4. ESTIMATED MONTHLY QUANTITIES

Specific quantities shall be based upon VA Medical Center requirements submitted with each order.

(per Section 6). Values reflect estimated monthly quantities for each VA Medical Center and their catchment area.

Concentrators

VA-Owned with Backup /

VA-Owned without

Backup

Contractor-

Owned

Ventilators

VA-Owned

Ventilators

Rental

Portable

Oxygen

Concentrator

Rental

Air

Compressor

Rental

Milwaukee

VAMC

320/320 1 5 1 160 7

Madison VA

Hospital

240/240 1 3 1 120 5

Tomah

VAMC

210/210 1 1 1 130 6

Iron Mt.

VAMC

235/235 1 8 1 175 3

Lovell

FHCC

115/115 1 0 1 80 2

Hines VA

Hospital

330/330 1 20 1 304 7

Jesse Brown

VAMC

195/195 1 4 8 140 9

Danville VA

Hospital

240/240 1 1 1 160 4

H/M Tank

System

Rental

Compressor Tank

Filling System

Owned Rental

Portable Tank

Liquid Oxygen

Liquid Oxygen

Portable Device

Milwaukee

VAMC

7 2 220 2 2

Madison VA

Hospital

4 1 200 0 0

Tomah

VAMC

6 1 160 0 0

Iron Mt.

VAMC

3 2 145 0 0

Lovell

FHCC

0 0 120 0 0

Hines VA

Hospital

0 0 220 1 1

Jesse Brown

VAMC

10 0 210 0 0

Danville VA

Hospital

3 25 200 0 0

5. EQUIPMENT SPECIFICATIONS

All Contractor’s electrically powered equipment used in performance of this contract shall be Underwriter

Laboratory (UL) approved and shall be the most recently developed in the field at the time of use.

Equipment shall be subject to change throughout contract. VA Medical Center shall notify Contractor so education and training can be provided to personnel.

The oxygen concentrators shall be UL approved and shall, at a minimum, meet the following specifications:

i. Deliver oxygen at flow rates up to 10 liters per minute (LPM) that shall be within manufacturer’s recommended purity level.

ii. Operate on 120 volts alternating current (VAC), 60 Hz.

iii. Have thermal protector for compressor.

iv. Must be double insulated and have two prong plugs.

v. Have pressure compensated flow meter.

vi. Alarms for the following failures required: Power Failure, O2 Concentration, and Irregular

Pressure.

vii. Have power failure alarm.

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

ix. Must meet Food and Drug Administration (FDA) Quality System Regulation (QSR) standards.

x. Sound level of 60db or less.

xi. Must have oxygen sensing devices.

Oxygen Conserving Device

Contractor-provided electric or pneumatic powered devices shall limit oxygen flow to inspiration only and thereby increase the duration of the supply. The conserving devise shall be able to function properly in variable temps and freezing condition and shall be able to cycle when triggered.

Pneumatic units shall meet the following specifications:

i. Pulse dose from 1 to 6 or higher.

ii. Have easy to read content gauge.

iii. Conservation ratio of 5:1 or higher.

iv. Have back up continuous flow setting option 2-4 LPM.

v. Less than 13 ounces.

Electric units shall meet the following specifications:

i. Pulse dose from 1 to 6 or higher.

ii. Have easy to read content gauge.

iii. Conservation ratio of 5:1 or higher from 14-40 breaths per minute.

iv. Have back up continuous flow setting option.

v. Lightweight, weighing only <15 ounces with batteries.

vi. Delivers oxygen in the first half of the inspiratory cycle.

vii. Single push button selects the equivalent LPM dosage settings.

viii. Auto shut-off feature conserves battery life.

ix. Fits easily in virtually any carry bag.

Liquid Oxygen System (LOX)

Contractor’s liquid oxygen reservoirs shall be capable of holding approximately 100 Lbs. of liquid for stationary use and to fill portable lox with conserving device capabilities and continuous flow options.

Liquid Oxygen System shall meet the following specifications:

i. Reservoir must have condensation collection tray.

ii. Must have quick release valve for easy refilling.

iii. Must have flow settings capable of 1- 15 LPM.

iv. Number of lox reservoirs provided in the residence should be limited but must provide for continuous liquid oxygen (LOX) over weekends or extended days until replenishment per delivery schedule.

Portable Liquid Systems

Portable Liquid Systems shall meet the following specifications:

i. Models that can support liter flows ranging from 1-15 lpm

ii. Models available that have continuous flow, continuous flow + pulse flow or pulse only

iii. Maximum weight of 9 lbs. when full

iv. Maximum evaporation rate of 1.5 lbs./day

v. Maximum height of 15 inches

vi. Carrying strap and/or stroller

vii. Must have quick release valve for easy refilling

viii. Shall have light emitting diode (LED) or mechanical content indicators.

Portable Oxygen Concentrator – Pulse Dose or Continuous Flow to meet prescriptive needs/order

Portable Concentrators shall meet the following specifications:

i. Shall have extended life battery options.

ii. Shall last minimum of 2.5 hours on highest pulse dose setting.

iii. Shall provide over eight (8) hours on the lowest setting.

iv. Shall be a minimum of four (4) pulse dose setting options.

v. Shall have easy to read liquid crystal display (LCD).

vi. Shall have alternating current/direct current (AC/DC) power supply charging options.

vii. Shall be less than 50 dBA at highest setting.

viii. Shall provide oxygen that shall be 90% +4%/-3% on any setting.

ix. Shall be Federal Aviation Administration (FAA) approved.

x. Shall have alarms indicating Low Oxygen Concentration, Low Battery, No Flow, Depleted

Battery, External Power Failure.

xi. Shall have carrying strap, belt, carrying case or stroller option.

Cylinders

Contractor shall furnish full (capacity per manufacturer), lightweight, aluminum B, C, D, E and M/H cylinders and shall be 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.

Air Compressor (50 PSI)

Contractor shall furnish air compressors that provide up to 50 pounds per square inch (PSI) for high humidity aerosol therapy and shall be lightweight, durable, quiet, easy to operate and clean. Air compressor shall be adjustable from 0-50 PSI. 50 PSI compressors shall meet the following specifications:

i. Electrical Requirements: 115VAC and 60Hz (Standard U.S. Home Electrical Outlets)

ii. Operating Relative Humidity: 95 Percent

iii. Operating Temperature Range: 50 Degrees Fahrenheit to 104 Degrees Fahrenheit

iv. Weight: < 18 pounds

Home-fill/I fill

Home-fill/I fill shall meet the following specifications:

i. Shall have electrical requirements of 115 volts, 60 Hz, 4.1 Amps

ii. Filling time shall be 75 minutes (M6 Cylinder)

iii. Oxygen purity shall be 93% +/- 3%

iv. Power consumption shall be 400 Watts average

6. HOME RESPIRATORY EQUIPMENT & SUPPLIES PER PATIENT/PER MONTH

Contractor shall provide as part of the patient/month charge for VA Medical Center concentrators or oxygen rentals:

i. Initial and ongoing residence, fall, fire, and safety risk assessments per Joint Commission, equipment delivery, set-up, education and follow-up per orders or PWS.

ii. Cannulas/ oxygen interfaces to accommodate weekly change out schedule with two (2) in reserve at all times. Contractor shall provide interface options for patient comfort and/or latex free options. Contractor shall provide oxygen patients short cannulas to be utilized with Bi-directional thermal fuses (Attachment G).

iii. Oxygen extension tubing in accordance with residence/activities of daily living (ADLs) to accommodate monthly change out schedule with reserve tubing on hand always to be provided to the patient.

iv. Swivel tubing connectors as needed to prevent coiled tubing if requested by patient/VA

Medical Center.

v. Ear cushions as requested by patient/VA Medical Center.

vi. Pre-filled humidifiers as requested by patient/VA Medical Center and replenishment as needed for supply at all times.

vii. Pressure valves and inline oxygen enrichment ports for bleed-in PAP (Positive Airway

Pressure) devices (if applicable) when oxygen shall be ordered in conjunction with PAP therapy, which shall be replaced as needed if requested by patient/VA Medical Center.

viii. Back-up oxygen system, regulator, stand, and interfaces for all oxygen patients. If a back-up system is refused after educating patient of dangers, an Against Medical Advice (AMA)

(Attachment D) shall be signed at the time of visit by the patient and Contractor staff to reflect this system was offered but refused.

ix. Contractor shall provide Monthly Concentrator Management/Services/Supplies monthly rate

(price per patient/mo)

x. Contractor shall provide Monthly Concentrator Management/Services/Supplies monthly rate

(price per patient/mo) for those oxygen recipients who shall NOT be provided a back-up system per PWS.

xi. Annual follow up visits to “standard fire risk” oxygen patients and semi-annual visits to “high fire risk” oxygen patients by delivery personnel to provide fire, residence, fall safety, prescription and equipment and supply re-education to the patient. During this visit, Contractor shall perform preventive maintenance of Contractor-owned or VA Medical Center owned equipment in accordance with manufacturers recommendation. Contractor shall perform Concentrator Preventive Maintenance duties described in Section 12 and shall complete the Preventive Maintenance Inspection (PMI) Respiratory Equipment Delivery &

Education Form (Attachment B).

xii. Bi-directional thermal fuses for ALL oxygen patients to maximize patient safety

(Attachment G). Initial issue dates shall be provided by the VA Medical Center and shall be tracked and valves replaced in accordance with manufacturer’s recommendations or as needed to ensure all oxygen patients have them at all times in-line with their stationary or portable oxygen delivery device. If the patient or caregiver(s) dispose of valve(s) accidentally, replacements shall be provided as soon as possible by the Contractor at no cost to the government. This shall be checked/verified and documented at each preventive maintenance inspection interval and replaced at the interval recommended by the manufacturer.

xiii. Ongoing oversight and management of Contractor owned as well as VA Medical Center owned equipment to maintain in accordance with manufacturer’s recommendations.

xiv. Vendor shall provide pick-up and delivery of VA and vendor equipment if patient relocates within VISN 12 catchment area plus 100 miles. This is an infrequent occurrence.

7. STATIONARY OXYGEN DELIVERY DEVICES (Monthly Rental from Contractor)

Shall meet or exceed patient’s liter flow requirements (5 or 10 LPM) machines) (E1390) (Higher liter flows>10 (LPM) at the discretion of the VA Medical Center in collaboration with Contractor).

Contractor shall provide in accordance with:

i. services, supplies, equipment and education in accordance with Section 6.

Liquid Oxygen Stationary Rental (LOX) (E0439)

Contractor shall provide:

i. Stationary LOX units, liquid oxygen, and refills that meet or exceed the patient’s monthly needs in accordance with prescription and ADLs.

ii. Services, supplies and equipment in accordance with Section 6.

H or M Tank Rental (E0424) for stationary usage only (not back-up tank)

i. Stationary tank(s), stand, regulator, tubing, and cannulas/interfaces in the residence in accordance with patient’s prescription – Primarily for cluster headache patients.

ii. Replacement tank(s) as necessary when notified by patient or VA Medical Center.

iii. Services, supplies and equipment in accordance with Section 6.

8. PORTABLE OXYGEN SYSTEMS (Monthly Rental from Contractor):

Portable Tank System (E0431)

Contractor shall provide E, D, C, or B (M6) size aluminum/fiber wrapped cylinders in accordance with prescription/ADLs delivered monthly or as needed for sufficient supply at all times for portability.

i. Regulator and/or pulse dose conserving device with continuous flow back-up option in accordance with prescription. If patient has current conserving device from the VA Medical

Center, Contractor shall provide a conserving device if/when unit fails at the request of the

VA Medical Center or patient that meets prescriptive requirements.

ii. Handcart, backpack style carrying case, over the shoulder pouch/carrying system appropriate to meet patient’s activities of daily living needs.

iii. Conserving devices with new batteries (if applicable) upon delivery with instructions to patients to replace if required.

iv. All patients with tank holders/racks to accommodate safe storage of the size and quantity of tanks within their residence.

v. Unlimited resupplies shall be provided per monthly price.

vi. Services, supplies and equipment in accordance with Section 6.

Liquid Oxygen Portable Device Rental (E0434)

i. Liquid Oxygen Portable Unit(s) Continuous or Pulse Dose to meet patient’s exertional needs for desired LPM or saturation level in accordance with prescription and ADL’s. (Note: some higher liter flow patient portable LOX units shall be required).

ii. Carrying Case or stroller for ease of use during activities.

iii. Services, supplies and equipment in accordance with Section 6.

Portable Oxygen Concentrator Rental (Pulse Dose or Continuous)

Contractor shall:

i. Deliver portable oxygen concentrator (POC) in accordance with prescription.

ii. Provide two (2) extended life batteries or up to four (4) standard batteries, wall, car, and desktop charger.

iii. Provide replacement POCs and batteries if machine or batteries malfunction.

iv. Provide units that shall be FAA approved.

v. Complete AMA form if POC does not meet prescriptive requirements.

vi. Provide carrying case, stroller, or backpack as requested for POC.

vii. Provide services, supplies and equipment in accordance with Section 6.

Compressor Tank Filling System Rental to include concentrator attachments (K0738)

i. Home compressor tank filling system to include Contractor concentrator rental if applicable.

ii. Portable post valve cylinders as requested.

iii. Regulator compatible with transfill cylinder posts and Contractor owned conserving device to provide longer tank duration for portability.

iv. Handcart, backpack, carrying case, over the shoulder pouch or tank carrying system appropriate to meet patient’s activities of daily living needs.

v. Replacement batteries for VA Medical Center owned or Contractor owned conserving devices as requested by patient or VA Medical Center.

vi. Services, supplies, and equipment in accordance with Section 6.

9. MONTHLY AIR COMPRESSOR RENTAL (E0565):

i. Perform delivery and set-up within 24 hours or as specified on order, education and follow-up per order received.

ii. Replenishment of disposable supplies monthly for infection control purposes.

iii. Distilled water as needed.

iv. VA Medical Center suction machine (if ordered)

v. Suction supplies (yankauers, appropriate suction catheters as ordered, suction tubing, trach care kits).

vi. Monthly visits with corresponding documentation to ensure disposable supplies shall be adequately stocked for daily/weekly change out schedule per homecare guidelines.

vii. Patient’s and caregiver’s education on the use of the device and accessories with a priority on infection control education.

viii. Manual resuscitator bag (if applicable)

10. VENTILATOR MONTHLY RENTAL (E0450) – INVASIVE OR NON-INVASIVE:

i. Ventilator delivery by a respiratory therapist within 24 hours or as specified on order and set up in accordance with prescription.

ii. Assessment of equipment by a Respiratory Therapist. Please note that Respiratory Therapists

CANNOT perform in a clinical capacity (i.e. perform patient assessments, evaluation, etc).

iii. Provide monthly RT visit or as ordered to provide patient and caregiver education, equipment and supply assessment and replenishment of disposable supplies to ensure patient has enough until next visit.

iv. Back up ventilator (if requested) that meets the patient’s prescription.

v. Monthly Patient Ventilator Management and System Checks in accordance with American

Association of Respiratory Care (AARC) guidelines.

vi. Assessment and replenishment of disposable supply inventory to ensure the patient has enough until next visit.

vii. Continuous (24/7/365) emergency service and response to issues conveyed by the patient and/or caregivers or the VA Medical Center.

viii. Contractor may be asked to perform data downloads on VA Medical Center owned ventilators or downloads from Contractor’s ventilators and provide to the VA Medical Center

Coordinator or designee if and when requested.

ix. Contractor shall provide accessories and supplies required for application of vent and accessories for infection control purposes. Supplies include the following, at a minimum:

• Filters (disposable)

• Masks/Interfaces

• Hose/Circuit

• Exhalation valve

• Trach adapter

• Tracheostomy tie

• Tracheostomy tube in accordance with prescription to ensure one patient has emergency replacement at all times and trach cleaning supplies as requested

• Disposable inner cannulas as specified

• Suction machine (VA provided)

• Oxygen inlet ports

• Artificial Noses (HME) for change out daily with ample supply in stock at all times

• Supplies (yankauers, appropriate suction catheters/closed suction catheters, suction tubing, suction kits which shall not be provided on a routine basis by the VA pharmacy)

• Heated Humidifiers/Humidification systems (as specified on equipment order) (VA provided)

• Ventilator Stands

• Mouthpiece Ventilation System (MPV)

• Distilled/sterile water (if applicable)

• Manual resuscitator bag with tubing to facilitate pre-oxygenating prior to suctioning

11. RESPIRATORY THERAPIST VISITS (VA120) - VA Owned Ventilator (Invasive/Non-Invasive)

Please note that Respiratory Therapists shall only provide non-clinical services for Ventilator patients.

Respiratory Therapists (RT) shall perform initial set-up of the ventilator system and provide thorough education to patient and caregiver in proper ventilator usage, ventilator function and operation including control knobs, power sources, adding oxygen, troubleshooting the ventilator and alarms, the remote alarm, checking tidal volume, ventilator tubing change, talking devices, cleaning of tubing and humidifier, back pressure with Jackson trach tube (if applicable), MPVs, bagging with manual resuscitation bag, and supplies consistent with requirements and per manufacturer recommendations. Contractor shall provide the Patient and family/caregiver with ventilator operational information and education, at the VA Medical Center, prior to discharge upon the COR or designee’s request.

Contractor shall provide Respiratory Therapists (RT) who shall:

i. Provide set-up of VA Medical Center ventilator and back-up ventilator (if ordered), accessories and supplies in accordance with prescription and timelines specified on order.

ii. Provide monthly Patient Ventilator Management to include data downloads upon request, verification that setting match VA Medical Center order and System Checks by an RT in accordance with most recent AARC guidelines (Currently VA Medical Centers shall be utilizing Astral and LTV ventilators).

iii. Provide monthly RT visit or as ordered to provide patient and caregiver education, equipment and supply assessment and replenishment of disposable supplies to ensure patient has enough until next visit.

iv. Provide continuous (24/7/365) emergency service and response to issues conveyed by the patient/caregivers or the VA Medical Center and replacement VA Medical Center vent if required during the same visit.

v. Assessment of equipment by a Respiratory Therapist. Please note that Respiratory Therapists

CANNOT perform in a clinical capacity (i.e. perform patient assessments, evaluation, etc).

vi. Provide back-up ventilator (if requested) that meets the patient’s prescription.

Contractor shall provide at a minimum:

• Filters (disposable)

• Hose/Circuit

• Exhalation valve

• Trach adapter

• Tracheostomy tie

• Tracheostomy tube in accordance with prescription to ensure one patient has emergency replacement at all times and trach cleaning supplies as requested

• Disposable inner cannulas as specified

• VA suction machine

• Oxygen inlet ports

• Artificial Noses (HME) for change out daily with ample supply in stock at all times

• Supplies (yankauers, appropriate suction catheters as ordered, suction tubing, suction kits)

• Heated Humidifiers/Humidification systems (as specified on equipment order) (VA provided)

• Ventilator Stands

• Mouthpiece Ventilation System (MPV)

• Distilled or sterile water (if applicable)

• Manual resuscitator bag with tubing to facilitate pre-oxygenating prior to suctioning

12. CONCENTRATOR MAINTENANCE

i. Upon receipt of VA Medical Center concentrators/ventilators drop shipped to Contractor’s location(s), the shipment’s contents shall be verified and compared to packing list. Any damaged equipment shall be annotated on packing list prior to signing. Once packing list shall be signed and contents confirmed, packing list shall be fax/scanned to the ordering site’s

Prosthetics department (same day).

ii. Unpack, test/analyze function of concentrator/ventilator. Malfunctioning units under warranty shall be returned to manufacturer for warranty support via the Return Merchandise

Authorization (RMA) process.

iii. Provide and affix “Property of VA” sticker (Minimum 5.5”x 8.5”see (Attachment H) on

ALL VA Medical Center concentrators. These stickers shall also be used to track concentrator hours of use during Preventative Maintenance Inspection (PMI) visits

(Attachment B).

iv. Create and maintain VA Medical Center concentrator/ventilator inventory and tracking system to be reported to the ORPCs/Contracting Officer Representative (COR) monthly. This shall include a virtual spreadsheet that delineates the location (patient’s residence address, inventory at patient’s site, etc.) and status (deployed, warranty support, lost, purchased and

“patient ready” etc.) of each concentrator/vent and date preventive maintenance (PM) performed and shall be due (ventilators).

v. Concentrator/ventilator tracking spreadsheet shall contain, at a minimum:

a. Patient name (last name, first name, middle initial)

b. Delivery date

c. Patient identifiers to include last four of social security number and date of birth

d. VA Medical Center where order was generated.

e. Concentrator/Ventilator manufacturer, model, and serial number

f. Date received in inventory

g. Date of latest PM performed (i.e. wipe down, change filter(s), assess concentrator purity level, inspect/replace batteries (if applicable) with last hours on machine recorded and updated through the life of the concentrator/ventilator).

h. Disposition and Status (i.e. deployed, idle in inventory at Contractor location, lost, warranty support etc.)

i. Contractor servicing site location

Preventive Maintenance (PM) and Upkeep of VA Medical Center Owned Concentrators

Contractor shall schedule and provide routine cleaning, maintenance, inspection, and replacement of minor parts (casters, power cords, knobs, oxygen outlet port) per manufacturer’s recommendations for concentrator and shall not be an additional charge. PM shall be performed semi-annually or annually during visits and shall be documented with the VA Medical Center concentrator tracking spreadsheet.

Normal routine upkeep and maintenance shall be provided to all VA Medical Center owned concentrators in the residence and at the Contractor’s facility for readiness purposes.

Contractor may be asked to provide major repairs to sieve beds, compressors, and shells. Any major repairs required for “out of warranty equipment” shall be communicated to the COR and/or designee.

If concentrator shall be damaged beyond repair, Contractor shall provide a report of damage, picture of unit, and a determination of disposal of unit to the COR. The disposal of the concentrators or any other type of equipment shall be the responsibility, when notified by the COR, of the Contractor.

Contractor shall be responsible for repair/replacement of any damage caused to VA Medical Center owned inventory by Contractor personnel in the performance of the contract.

Purchase of VA Medical Center Concentrators Out of Warranty

Contractor shall have the ability to purchase VA Medical Center Concentrators not under warranty that shall require repair (condition dependent). Purchase of equipment shall be reflected as a credit.

13. VENTILATOR MAINTENANCE

i. Have capabilities to manage and support all required maintenance of VA Medical Center owned equipment per manufacturers recommendation.

ii. Have the capability to provide routine preventive maintenance. If a third party vendor shall be used for completion of VA Medical Center owned equipment maintenance, Contractor shall request approval of pricing from the COR or designee prior to commencing and arranging for maintenance.

Purchase of VA Medical Center Ventilators Out of Warranty

Contractor shall have the ability to purchase ventilators if the VA Medical Center determines to remove from inventory. Pricing shall be negotiated at time of purchase.

14. RECALLS

VA Medical Center, upon notification of equipment recalls, shall inform Contractor by written notice and how to proceed. Contractor shall work collaboratively with the VA Medical Center to address these recalls timely and effectively to meet any deadlines imposed. Contractor shall take the necessary corrective actions and inform each VA Medical Center in writing of actions taken and demonstrate effective tracking of all affected equipment in collaboration with the VA Medical Center.

15. STORAGE AND MANAGEMENT OF VA MEDICAL CENTER EQUIPMENT AND SUPPLIES

i. Be responsible for and possess capability of accepting drop shipments of equipment and supplies from any VISN 12 VA Medical Center site or Contractor and/or manufacturer regardless of size and weight of equipment.

ii. Store equipment and supplies in a clean area, covered/bagged and separated by VA Medical

Center site in a patient ready condition.

iii. Provide storage for reclaimed respiratory equipment that can be utilized for other future orders. This equipment shall be cleaned/disinfected, inspected, tested for operation, bagged/covered and tagged with nomenclature, model or part number, serial number and stored in a patient ready condition.

iv. Provide no-cost pickup and delivery of VA Medical Center respiratory equipment/supplies stored at Contractor’s location to/from VA Medical Center or location specified per VA

Medical Center’s request verbally or via email request. These requests for inventory delivery or pick-up shall be provided within 24 hours of the request.

v. Manage all Government furnished equipment in accordance with FAR 52.245-1 and 52.245-

2.

vi. Provide bi-monthly (twice per month) individualized VA Medical Center site inventory reports to Prosthetics in a spreadsheet format (e.g., Tomah VAMC’s inventory report shall list all Tomah equipment stored at any/all Contractor’s facilities). The spreadsheet shall include the following items:

a. Nomenclature

b. Model/Part Numbers

c. SN (if applicable)

d. Quantities on-hand

e. Reorder Point for communication to Prosthetics to order to replenish inventory.

vii. Notify the local VA Medical Center Prosthetics Supervisor within 24 hours if inventory levels for any equipment or supplies shall be at or below established Periodic Automatic

Replacement (PAR) level/Reorder points established and/or communicated by VA Medical

Center site Prosthetic Representative and/or VISN 12 COR.

viii. Provide notification to applicable VA Medical Center site’s Prosthetics section and/or COR when reclaimed equipment from patient’s residence shall not be serviceable (provide picture to VA Medical Center Prosthetics and Sensory Aids Service (PSAS) and/or COR) and dispose of equipment if/when directed.

ix. Provide storage of Government equipment and/or accessories, in accordance with the VA

Medical Center site estimates below:

VA Medical Center Est Amt of Storage Space Required (square feet)

Milwaukee VAMC 1500 s.f.

Madison VA Hospital 1500 s.f.

Tomah VAMC 1500 s.f.

Iron Mt. VAMC 1500 s.f.

FHCC 1500 s.f.

Hines VA Hospital 1500 s.f.

Jesse Brown VAMC 1500 s.f.

Danville VA Hospital 1500 s.f.

Storage facilities shall be within 45 miles of the VA Medical Centers.

x. Ensure storage facilities allow adequate space for all VA inventory which includes new, used, and repair-needed equipment for the entire duration of contract, regardless of space estimates provided.

xi. Ensure storage area shall be adequately equipped with shelves, bins, etc., to properly accommodate all items being stored. The storage area shall be well secured, well ventilated, and free of dampness and humidity that contributes to deterioration of cartons or rusting of metal equipment. The storage facility shall have sufficient electrical outlets to accommodate simultaneous charging of all ventilators stored and to test powered equipment before issuance.

xii. Shall be held responsible for the proper placement and security of all Government-owned equipment and supplies to insure against loss or damage while located at the Contractor's facility. Storage shall be provided separate and apart, by VA Medical Center, from all other

Contractor owned equipment and supplies. Contractor shall identify Government Furnished

Property (GFP) by marking or tagging and segregating in such a manner to clearly indicate

Government ownership by site at all locations.

xiii. Shall provide ongoing monitoring and reporting of VA Medical Center ventilator inventory in storage and in patients’ residence (Attachment J).