S02 RFP 36C26021R0050 6-9-2022.docx

36C26021R0050

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.

DUNS:

DUNS+4:

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. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

06/09/2022 Jacob Jackson 3608162781 07/15/2022 17:00

PST

36C260

Department of Veterans Affairs Network Contracting Office 20 5115 NE 82nd Ave, Suite 102 Vancouver WA 98662

X

621610 $16.5 Million

N/A

Department of Veterans Affairs VISN 20 Catchment Area, dictated by order.

Y

Network Contracting Office 20

5115 NE 82nd Ave, Suite 102 Vancouver WA 98662

FMS-VA-2(101)

Financial Services Center

PO BOX 149971

Austin TX 78714-9971

See CONTINUATION Page The Department of Veterans Affairs seeks to establish one (1) to seven (7) Indefinite Delivery Indefinite Quantity (IDIQ) Contracts for Home Oxygen Delivery and Services for use within Veterans Integrated Service Network 20 (VISN20).

See Statement of Work and Schedule for requirement.

See addendum to 52.212-1 for specific instructions.

Contracting POC: Jacob Jackson, jacob.jackson2@va.gov

The minimum guarantee of the contract(s) is $500.00.

See CONTINUATION Page

Peggy L. Corcoran Contract Officer

Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C260, Peggy L. Corcoran

Network Contracting Office 20 5115 NE 82nd Ave, Suite 102 Vancouver WA 98662

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

3. INVOICES: Invoices shall be submitted in arrears:

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

Department of Veterans Affairs

FMS-VA-2(101)

Financial Services Center

PO BOX 149971

Austin TX 78714-9971 ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

Page 1 of Page 1 of

B.2 STATEMENT OF WORK (SOW)

Veterans Integrated Service Network (VISN) 20 provides services to beneficiaries in Idaho, Oregon, Washington, Northern California and Western Montana. The Contractor shall be responsible for providing Home Oxygen Durable Medical Equipment and supplies to all beneficiaries serviced by VISN 20. The contractor shall provide all supplies, materials, equipment, transportation of equipment, equipment services, labor, supervision, training on equipment, safety management, infection control, as necessary for patients on home oxygen therapy, as specified under this Statement of Work (SOW). These services shall be required twenty-four (24) hours a day, seven (7) days a week, including holidays. The contractor shall be staffed and stocked to render services provided in accordance with all terms and conditions of this SOW for the duration of the performance period. The contractor shall establish a dedicated customer service team and centralized phone line to service the requirements of this contract. Offerors should thoroughly review the specifications and be familiar with the area of coverage before submitting their proposal to be fully aware of the supplies and services required. 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.

All issuing of equipment, and follow-up care provided under this contract shall be provided in accordance with all current Joint Commission or equivalent accreditation standards. Contractors must be accredited by The Joint Commission or an equivalent accrediting agency and must maintain that certification for the duration of the contract. If the contractor is re-surveyed by Joint Commission or an equivalent accreditation body during the contract term, the contractor shall notify the Contracting Officer of survey dates, the outcome of the survey, and provide copies of new certificates as issued. Contractor’s facilities may be inspected by the respective Medical Center prior to the contract award. Subcontractors must follow Joint Commission or equivalent accreditation standards and shall be monitored by the contractor for compliance. The Contracting Officer (CO), Contracting Officer’s Representative (COR) or designee shall be notified if a subcontractor is utilized. The Contractor’s comprehensive procedure manual shall become part of this contract. The manual shall include, but not be limited to, delivery/set-up, infection control, safety, rights and responsibilities of the Veteran/patient, inventory, employee training (to include patient age specific), employee competency records, and performance improvement. The contractor shall be required to have a DO NOT RESUSCITATE (DNR) policy in accordance with applicable state regulations. A copy of the DNR policy shall also become part of this contract.

IMPLEMENTATION

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 no disruption of supplies/services to Veteran beneficiaries. Transition of services to the new Contractor shall be completed as soon as possible, but no later than 90 calendar days from the date of award of a new contract. If the Contractor fails to accomplish the phase-in, the Contractor shall be responsible for any costs the Department of Veterans Affairs (VA) may have to pay the incumbent Contractor beyond 90 days.

The successor Contractor shall provide the facility COR or designee, 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.

Payment to the incumbent Contractor shall be made up to the day services 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.

DESCRIPTION/REQUIREMENTS

The number of Veterans being served by this agreement will change. VISN 20 currently serves an estimated 6100 Home Oxygen-using patients and 60 Ventilator-using patients.

The volumes or amounts shown in the SOW are estimates only and impose no obligation on the VA as either minimum or maximum. The contract shall be for the actual requirements of the VA as ordered by the VA during the life of the contract. The HOC (Home O2 Coordinator) or designee will provide the contractor with notification to initiate individual beneficiary service requirements via fax or encrypted electronic means (telephone for emergencies), including the beneficiary’s oxygen prescription, equipment, supplies and services to be provided to include date and place of delivery, and the contractor will confirm receipt of the request within two working hours of notification via fax or encrypted electronic means (telephone for emergencies); the HOC or designee will also provide notification of VA initiated discontinuance of service. The notification may be made orally but will be confirmed in writing within three (3) working days. The written documents will include the authorizing official’s signature.

Veterans with a prescription for an oxygen concentrator shall be provided with an appropriate backup system consisting of a compressed gas source, humidifiers, cannulas/mask for use during the event of a power failure or mechanical problem and necessitating the use of the backup cylinder. The cost for the above-mentioned backup system would be borne by the Contractor. The cost of replacement of equipment damaged, lost or misplaced not through beneficiary’s negligence shall be borne by the Contractor. Documentation is required if the patient declines the oxygen back-up system and shall be submitted to the HOC or designee within 24 hours. The documentation must include a statement signed by the beneficiary indicating discontinuing the equipment is “against medical advice”.

In accordance with the prescription received from the Veterans Affairs Medical Center (VAMC), the contractor shall provide the beneficiary with the following items:

Ventilators and respiratory care supplies when deemed necessary. The number of supplies must be sufficient to ensure that they are not depleted between re-supply or maintenance visits.

Humidifiers and water traps when deemed necessary. The number of humidifiers must be sufficient to ensure that they are not depleted between re-supply visits. The number of traps will be based on the patient’s flow rate.

Disposable oxygen cannulas on hand for a change every two weeks with a supply in reserve always until the Contractor’s next scheduled visit.

Disposable masks for change/wash every two weeks with a supply in reserve always (when masks are prescribed in lieu of nasal cannulas).

The contractor must provide two bidirectional inline Fire-safe cannulas/Thermal Fuses (or equivalent) for each system provided (stationary/portable) sufficient to be changed out according to manufacturer’s guidelines. Mandatory requirements for use of thermal fuses are as follows:

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 Liters per minute, 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.

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.

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. 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).

5. 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.

6. Thermal fuses must be replaced at the end of their expected life per manufacturer’s guidelines. Thermal fuses must be replaced if actuated or involved in a fire.

25-50 ft. of oxygen connecting tubing shall be replaced every 6 months with an equivalent section of tubing in reserve always (to be included in initial setup) until the Contractors next scheduled visit.

Cylinder Safety holders shall be provided to all Veterans with a prescription for compressed gas systems. This shall be provided at no additional charge to the VA. These holders shall hold the tanks in such a way as to prevent tipping/rolling and be capable of holding all the tanks the patient has.

Initial set-ups are considered as those beneficiaries who have not been provided home oxygen therapy delivery system by a VISN 20 VA facility on a previous occasion or have not used such a system continuously for the past 60 days.

The Contractor shall provide the initial set-up within 24-hours of request from the HOC or designee, to include weekends and holidays; this shall also apply to service calls. The VAMC reserves the right to obtain the service from another source and to charge the contractor with any excess cost, which may result, if the contractor is unable to meet the 24-hour response time. Exception: patients being discharged from the hospital; set-ups will be coordinated with the HOC or designee to ensure set-ups are completed within 6 hours after the patient has been discharged.

Each beneficiary will have an appropriate plan of service documented and kept in the contractor-maintained record.

The Contractor shall be responsible for notifying the HOC or designee by telephone at time of setup if any alteration to the beneficiary's home is necessary to accommodate the oxygen equipment, including electrical work.

The Contractor is responsible for making every effort to establish appointments with VA beneficiaries when initiating setups and deliveries. Deliveries will not be left unattended at the beneficiary’s home. If the VA beneficiary chronically fails to meet appointments, the Contractor shall notify the HOC or designee. The HOC or designee will contact the VA beneficiary and a corrective action plan will be implemented. HOC or designee will notify the Contractor of any changes. If the Contractor has not made valid and documented attempts (3 calls at different times and days) to contact the VA beneficiaries for setups and/or deliveries, the Government reserves the right to call in a third party and bill the Contractor if the Contractor fails to perform.

The government shall notify the Contractor in the event of an order to discontinue oxygen service to any beneficiary covered under this contract. Notification shall be by encrypted or de-identified by electronic means and/or facsimile (telephone if an emergency). Payment will be pro-rated based upon the notification date of discontinuance of service. The Contractor shall notify the government within one business day of a patient death, or upon finding a patient has moved out of the service area.

The Contractor shall remove equipment from the beneficiary’s residence at the earliest possible time but no later than five (5) business days after notification unless a different timeframe is approved by the HOC/designee. The date and time of equipment pickup shall be coordinated with the patient/caregiver or next of kin. The Contractor shall make every effort to meet the beneficiary’s or beneficiary’s families’ requests for pickup times. The Contractor shall treat such requests with the utmost courtesy and give such requests the highest priority.

Site Visits: Periodic, scheduled and unscheduled on-site contractor and home oxygen patient visits will be made by HOC, designee or other VA employees to monitor the contractor’s performance under this contract. The contractor agrees to make available all records and documentation necessary during these visits. In addition, the Contractor agrees to visits by an accrediting body or other Government representative accompanied by the Contracting Officer, COR or designee as necessary to review contract services. These visits shall be allowed at no additional cost to the Government.

The Contractor will be responsible for coordinating, supervising, and evaluating the services provided by any subcontractor.

At least once every ninety (90) calendar days the Contractor shall visit VA beneficiaries to reassess equipment compliance, equipment educational needs, etc. A written report will include at a minimum, the following data:

· Name and social security number (SSN) last four, Date of Birth (DOB) of beneficiary using the equipment.

· Type of concentrator, hours on concentrator, and serial numbers for the rented equipment shall be the vendor’s responsibility and kept on file in vendor’s main office.

· Ventilators (invasive/non-invasive): Contractor will provide recommended maintenance schedule (RMS) per manufacturer’s guidelines. Home assessment, patient training and education, registered respiratory therapist (RRT) monthly visits, evaluation of patient/equipment, periodic maintenance and or Ventilator check out completed in the home environment will be done on a monthly basis.

· Inspection results of liter flow rate in monitoring patient compliance (as compared to prescription). Results of non-compliance will be sent to HOC or designee.

· Inspection compliance of intake filters (exchange or clean by patient).

· Revised plan of service as needed.

A report shall be developed by the contractor, signed and dated by the contractor staff and the VA beneficiary and/or care giver. A copy of this report shall be offered to be left with the beneficiary. The reports shall be legible and attached to the invoice. All reports shall be submitted to the VISN 20 office or designee in alphabetical order, with the monthly bills by the 10th business day of the month following service.

The Contractor shall maintain a VA beneficiary account folder in compliance with the Privacy Act and Health Insurance Portability and Accountability Act (HIPAA). All beneficiary files are subject to review by designated VAMC officials and accreditation surveyors on behalf of the VAMC during accreditation surveys or consultation. As a minimum the VA beneficiary folder will adhere to current Joint Commission or equivalent accreditation Standards for patient record keeping. These folders may be paper or electronic.

Contaminated equipment shall be separated from clean equipment. The Contractor’s warehouse shall have clear demarcation between contaminated and clean storage areas.

Delivery vehicles, if dirty and clean equipment is transported in the same vehicle, will have a clearly demarcated area for clean and dirty items. Contractor’s procedure for handling the pickup of dirty equipment will meet Joint Commission or equivalent accreditation Standards.

Standard precautions shall be used to prevent exposure to blood borne pathogens (diseases). Face Masks and disposable gloves shall be worn when handling used equipment/items that are visibly soiled with blood or body fluids. Center for Disease Control (CDC) hand hygiene guidelines shall be strictly followed. Hands shall be decontaminated before and after visiting each patient, and after removing gloves. Hands that are not visibly soiled may be decontaminated by using an alcohol hand rub. Hands that are visibly soiled must be decontaminated by washing with antimicrobial soap and water for no less than 15 seconds. Gloves should be disposed of according to CDC guidelines.

The Contractor shall comply with all federal guidance on workplace safeguards pertaining to employees of federal contractors, including, but not limited to, vaccination and use of personal protective equipment.

EMERGENCY SERVICES

The contractor shall have a well-established communication system, providing a toll-free phone number for 24-hour emergency services and the ability to provide services at the beneficiary’s home within 6 hours of a call. All emergency services shall be provided within six (6) hours of a call. Contractor is responsible for maintaining records of all emergency calls. Records shall be made available upon request to the HOC.

Contractor must provide a written emergency management plan in compliance with Joint Commission or equivalent accreditation standards. The contractor must notify the HOC or designee as soon as possible in the event the Contractor activates their disaster plan. At the time of set up, Contractor shall provide beneficiaries with a telephone number to call (a sticker must be affixed to the concentrator with the Contractors name and toll-free contact number) if there are any questions or additional information is required, and instructions for what to do in a natural disaster or other emergency. The Contractor shall “test” their emergency plan at least once per year and provide a copy of the test along with a critique of the emergency plan to the HOC or designee. The Contractor’s plan to correct any deficiencies shall also be provided to the COR or designee.

If the Contractor is unable to respond to an emergency service call within six (6) hours, the Contractor is responsible for making arrangements with another supplier to provide oxygen at the Contractor’s expense. A written explanation of why the Contractor was unable to respond to the emergency must be provided to the HOC or designee within two (2) business days of the date the emergency call was placed.

The Contractor shall ensure all patients have at minimum a non-electrical oxygen supply to last three (3) times the contractors’ response time to a call (18 hours of non-electrical back up {6 hours response time x 3 = 18 hours}). The minimum supply will take into account each patient’s prescription flow-rate. Actual supply levels may differ from patient to patient. This calculation should be provided to the Veteran by the Contractor on the initial delivery/set up. The cost of backup systems, backup oxygen, and backup equipment shall be borne by the Contractor and provided as a separate system from the portability. If H tanks are used for backup, the Contractor shall furnish an H tank stand for each H tank at no cost to the government. Liquid oxygen supply may be considered backup oxygen; however, the oxygen supply must be maintained at the minimum three (3) times the Contractor’s response time, and the cost of any additional equipment such as extra stationary units used solely to maintain the minimum level of backup oxygen shall be borne by the Contractor. The cost of liquid oxygen used solely for backup purposes shall be borne by the Contractor.

The Contractor shall provide and encourage patients to allow signs to be posted on all entrances into the residence, stating "Warning Oxygen in Use, No Smoking" or other verbiage that NO Smoking is allowed due to oxygen being present and document that the beneficiary/care giver is instructed in the safe use of oxygen and equipment per OSHA.

PATIENTS WHO TRAVEL

The contractor shall be responsible for arranging and coordinating all oxygen services for Veterans who travel within the United States both within and outside their respective contracted jurisdiction. The Veteran will be responsible for notifying the contractor where the Veteran is traveling to and the mode of transportation. Arranging, coordinating, and providing travel oxygen services shall be provided at no additional cost to the VA. Requests for prescription for portable concentrators, if needed, should be referred to the HOC or designee and the facility POC.

PAYMENT AND INVOICING

Payment shall be made monthly in arrears based upon the Government’s certification of a properly submitted invoice.

Invoices shall be sent electronically to the address listed in Block 18a of the Standard Form (SF) 1449, with a copy provided to the HOC by secured email using an Excel Spreadsheet format, no later than the 10th business day of each month following service. Email address(es) to be provided at time of award. VA will review the invoice against its record. VA will notify the contractor of invoice discrepancies. Upon the resolution of the discrepancies, VA will approve the invoice and make payment to the contractor.

The Vendor home oxygen bill must be provided in Microsoft Excel format with the following named columns in order:

Patient’s Full Name – The patient’s full name can be in a single “Patient Name” column (“First, Last Middle” format), or broken down into first and last name columns. Either the patient name or first name column may include the patient’s full middle name or middle initial, but it is not required.

Patient’s Social Security Number – The bill must include the patient’s last four digits of their SSN and their DOB. The patient’s full SSN shall not be used for privacy reasons. It is permissible to have additional information in the in this column as long as the patient’s last four digits of their SSN and DOB is contained somewhere within the column in a structured format.

Item Description – A structured and uniform description of each billable item from the vendor. This can be brief or detailed.

Quantity (Qty) – the quantity of the billable item or service that was provided.

Unit Cost – The cost-per-unit of each billable item. The bill must include the total cost.

Billable Item’s Date of Service

Total Cost– The total cost of the billable item or service (Qty x Unit Cost).

HCPCS – Includes the Healthcare Common Procedure Code (HCPC).

The Contractor shall not charge patients or 3rd party payers any fees or surcharges for services rendered under this contract. If the Contractor or VISN 20 facility Prosthetics Service receives notice of any additional charges, the Contractor shall fully cooperate with the COR and Contracting Officer investigating such allegations shall promptly refund any payment deemed improper by the Contracting Officer to the party who made the payment.

Invoices are paid in accordance with the Prompt Payment Act upon receipt and approval of a proper invoice. Each invoice must include the following information: contract number, patient name, DOB, last four of the SSN, period of service, itemized list of equipment in place, itemized list of supplies used, to include quantities, etc. as shown on the pricing schedule.

REPORTS

Contractor must submit a copy of all proposed reports as part of the offeror’s technical proposal.

The Contractor will provide a written, semi-annual report meeting all Joint Commission or equivalent accreditation Standards for improving organizational performance (The Joint Commission or equivalent accreditation Standards may be accessed at www.jointcommission.org). Report shall be due by the 8th calendar day of November and May each year.

Incident Report – Reporting special incidents found or occurring during a home visit, to include finding patients in need of emergency medical assistance, safety hazards that do not fall into the category of presenting immediate life-threatening danger to the patient or Contractors staff, inability to contact a patient within a reasonable period of time, and any other incident meeting the Contractors written policy for incident reporting according to accreditation standards. Incidents shall be reported to the HOC in writing within two (2) business days.

Customer Satisfaction - In accordance with Joint Commission or equivalent accreditation the Contractor will collect data on service satisfaction from contracted patients and their families or caregivers from each facility on a quarterly basis. A copy of survey results will be submitted to the HOC(s) or designee in Quarterly reports. The report shall be due by the 8th calendar day of August, November, February and May each year.

Infection Control/Communicable Diseases – Report will include data related to the Contractor’s ongoing Infection Control Program. Infection control reports will be sent to the HOC on a semi-annual basis. Report shall be due by the 8th calendar day of November and May each year.

Periodic Maintenance Report: The contractor will create and provide a report on data related to manufacturer’s Maintenance / Test Schedules on all equipment. Report shall be due by the 8th calendar day of November and May each year.

The Contractor shall provide the following written emergent patient safety reports in addition to verbal reporting requirements listed in each item below, throughout the contract period. The Contractor will provide a copy of their patient incident report to the HOC for approval. If the report is disapproved the Contractor shall be required to make changes to their report or utilize the VA’s incident reporting form.

Sentinel Events - The contractor is required to inform the COR within one (1) business day of a sentinel event that occurs during the performance of this contract involving VA beneficiaries.

Refusal of service - All beneficiaries have the right of refusal of 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 however, in addition a written report will be provided by the Contractor with the specifics of the refusal to the HOC or designee by fax or encrypted electronic means (telephone in case of emergency) within one (1) hour of being notified of the refusal of service. If the refusal occurs during a home visit, the Contractor’s staff shall make an attempt to notify the HOC or designee prior to leaving the home of the refusal during the home visit. The Contractor will obtain a statement signed by the beneficiary indicating discontinuing the equipment is “against medical advice” and include a copy with the written report.

The contractor shall report suspected incidents of abuse or neglect to the patient by family members or caregivers. Suspected incidents shall be reported immediately (within 24 hours during business hours) to the HOC or designee, as well as to the adult protective agency. The contractor will follow all state and local laws in reporting suspected incidents of abuse or neglect.

INFECTION CONTROL AND COMMUNICABLE DISEASES REQUIREMENT

Contractor must submit a copy of the plan for surveillance, prevention and control of infection as part of the offeror’s technical proposal. This plan must be kept current through the duration of the contract. The plan must meet current Joint Commission or equivalent accreditation Standards in order to be considered.

Contractor shall provide a list of names to the HOC or designee of all Veteran patients exposed to communicable diseases by contracted staff during an identified incubation period. The type of exposure will also be identified.

The HOC or designee will consult with VA infection control staff regarding the need to contact exposed patients and/or complete any needed medical follow-up.

Infection control reports will be sent to the HOC on a semi-annual basis. Reports shall be provided as outlined in Reports paragraph above.

SAFETY REQUIREMENTS

At time of set-up and again during home visits, the Contractor shall perform an assessment of the beneficiary’s home and environment, (to include a falls assessment) in accordance with The Joint Commission or equivalent accreditation standards and maintain documentation of assessments in the individual patient file or folder. At time of set up and again during home visits, and other identified times the contractor will perform a safety assessment of the home and equipment. The Contractor shall verify the presence of smoke alarm(s) and fire extinguishers and instruct the patient to test all smoke alarms monthly and check that extinguishers are fully charged. In the event the contractor finds no smoke alarms present in the home, the contractor shall instruct the patient in the importance of smoke alarms, and document on the check list submitted to the HOC/designee.

The Contractor shall verbally notify the HOC or designee by the next business day of any unsafe conditions observed in the VA beneficiary’s home that preclude 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 HOC or designee within two (2) business days of the incident.

The Contractor will document and report to the VA Home Oxygen Coordinator, COR or designee any patient who is non- compliant 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. The Contractor shall furnish written documentation of the safety hazard to the HOC or designee within two (2) business days of the incident.

The Contractor will check the adequacy of the electrical outlets where any electrically powered oxygen equipment is plugged into in the patient’s home and immediately report unsafe conditions to the HOC or designee. It is the Veterans’ responsibility to have the appropriate electrical system in their residence. 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 HOC or designee may approve an alternative oxygen delivery system until a new prescription can be obtained. If no alternative is available, the prescribing VA physician will be notified.

The Contractor shall conduct a fire risk assessment of all new patients, and a reassessment is to be conducted when renewing an oxygen prescription, or at any time there is a change in the patient’s oxygen therapy (e.g. equipment). The Government shall alert the contractor to those patients who are at high-risk for smoking while oxygen is in use. Contractor educational materials must be provided upon initial delivery and every 6 months thereafter. Checklists used by vendors for medical gas follow-up services must, at minimum, cover the following items:

· “No Smoking, Oxygen in Use” signs are provided and/or posted.

· Contractor’s name and toll-free emergency telephone number where they can be reached 24 hours/day is affixed to all equipment.

· Smoke alarm is present, and alarm sounds when tested.

· Veteran has been instructed to remove the cannula, shut-off the oxygen supply, and wait for oxygen to dissipate prior to smoking or being in close proximity to spark or flames (i.e. candles, gas stove).

· Verification that the Veteran has been instructed to test all smoke alarms monthly.

· Veteran and family, caregiver or cohabitants are provided education and given educational materials regarding the hazards of smoking and using an open flame near oxygen.

· Reminder card: Contractor will provide to all patients a reminder card at time of change over, or new set-up, listing the following information:

· Check air filters daily. Wash with clear tap water on Monday, Wednesday, Friday and Sunday. More often when dirty.

· Change nasal cannulas on the 1st and 15th of each month-more often if you are sick.

· Change 25’ or 50’ tubing at least every 6 months.

· Change humidifier bottle on the 1st of every month. Clean humidifier and change water if it is cloudy.

· No free-standing tanks.

· No smoking and or open flame while utilizing oxygen.

EMPLOYEE CERTIFICATON

Contractor shall develop, maintain, and make available for review, personnel folders on all employees performing under this contract. The personnel folder will include background check, tuberculosis (TB) test results, compliance with VHA Supplemental Contract Requirements for ensuring adequate COVID-19 Safety Protocols for Federal Contractors.

Contractor must provide and document employee orientation, ongoing employee education, and ongoing assessment of employee competency for all employees involved with the delivery/recovery of equipment covered under this contract according to Joint Commission or equivalent accreditation standards.

Contractor will provide HOC or designee with a list of all employees currently competent to perform delivery/recovery and patient education services at the time the contract is awarded. HOC or designee will inspect employee files at the time of the inspection of Contractor premises and vehicles.

Contractor will educate, evaluate and document employee education in strict accordance with current Joint Commission or equivalent accreditation standards.

Only employees that have been properly trained and who have demonstrated competency may perform equipment deliveries, recoveries, and patient education on the equipment. The Contractor shall be staffed and have sufficient supplies to render satisfactory and courteous service at all times to the beneficiary. The contractor shall be responsible for the acts and omissions of his/her employees, his/her sub-contractors or satellite offices and their employees. Sub-contractors are required to adhere to the requirements of this contract.

Contractor must maintain their staff’s competency training and make copies available for proof of training to the Government when requested.

EQUIPMENT

The Contractor shall furnish, install and service all oxygen equipment to dispense oxygen and supplies ordered under this contract. All electrically powered equipment used in performance of this contract shall be UL approved and shall be current state of the art at the time of issue and all supplies are to be new. A label with the contractor’s name and toll-free emergency telephone number where they can be reached 24 hours/day will be affixed to all equipment. Standards follow-

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

American Society for Testing Materials (ASTM) minimum standards specification for electrically powered home care portable ventilators.

Association for the Advancement of Medical Instrumentation (AAMI).

Joint Commission or equivalent accreditation Standard for Home Care, current year standard.

The installation of all machines and equipment by the Contractor shall be performed by a competent professional familiar with nature of the equipment involved and fully qualified under the laws of the state in which the services are being rendered. Installation shall be consistent with local fire and safety codes in the respective area of the applicable state and shall conform to National Fire Protection Association NFPA (Life Safety Codes) and NFPA (Oxygen Cylinder Requirements). The Contractor shall provide a safety/emergency checklist to be completed, then signed by the Veteran or his/her caregiver and retained in the beneficiary account folder.

The Contractor shall ensure that all equipment is in accordance with all manufacturer Recommended Maintenance Schedules. Preventative maintenance (PM) performed at least once a year or more often in accordance with manufacturer recommendations.

Contractor-furnished equipment shall be maintained per manufacturer’s specifications. Contractor-owned equipment shall be repaired or replaced at no cost to the Government when breakdown or malfunction is due to normal usage or due to the fault of the Contractor.

In the event missed PM’s are due to the patient failing to be available and the contractor has made three attempts to reschedule the PM, those PMs will not count against the contractor’s performance. Any missed PM except those due to the patient being unavailable shall be completed within two (2) business days. In the event the patient cannot be reached or is not available, contact the HOC or designee.

A Contractor’s staff member will conduct a check of the concentrator according to the manufacturer standards. Maintenance on equipment shall be done by a manufacturer’s checklist. It shall include compressor inlet pre-filter changes and compressor inlet bacteria filter changes according to the manufacturer recommendations. If present the alarm battery shall be tested at each maintenance check, changed as indicated but, at least annually. The Contractor is responsible for tracking and documenting maintenance of equipment in accordance with manufacturer specifications and providing these records for review, upon request. Contractor shall furnish parts and labor for routine maintenance. The Contractor shall have recall procedures for equipment and supplies.

The Contractor shall not change or alter a VA beneficiary’s oxygen prescription or equipment requirements without a new prescription from the beneficiary’s VA physician.

Transition Period: At the end of the contract period, a transition period will be required during which incumbent Contractor will continue to provide services at the contract prices while the incoming Contractor is taking over. The transition period shall be completed within 90 days from new contract award date. Incumbent Contractor shall provide a complete list of patients and equipment to the VA in order to assist in the transition.

EQUIPMENT SPECIFICATIONS

Oxygen Concentrators shall be Underwriter Laboratory (UL) approved and must, at a minimum meet the following specifications:

· Electrically powered (115 volts).

· There shall be an audible alarm to indicate a power failure.

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

· The oxygen concentrator shall have an hour meter and OCI indicator.

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

· Concentrators shall be capable of delivering a standard flow rate up to 5 liters per minute and hi-flow up to 10 liters per minute.

Liquid System: Standard setup includes stationary reservoir, two (2) portable devices, transfilling equipment, regulator, and all expendable supplies as required. Each liquid oxygen setup shall also include an emergency back-up system with the capacity to provide delivery of oxygen, at the prescribed rate of flow for twenty-four (24) hours. The back-up system will consist of compressed gas cylinders ("H" or "M" type), stand(s), regulator-flowmeter, tubing, connectors, nasal cannulas/mask, as ordered, storage rack, and expendable supplies as required for use during the event of a power failure or mechanical problem necessitating the use of the back-up system/cylinder. The cost of necessary expendable supplies, as required for use, shall be included in the monthly rental/service cost.

Home oxygen fill systems capable of refilling gas cylinders. The system must meet all industry and Joint Commission or equivalent accreditation standards.

Portable Oxygen Concentrators shall be Underwriter Laboratory (UL) approved. Portable oxygen concentrators (POCs) must, at a minimum be capable of providing either pulse dose or continues flow to meet the beneficiary prescription needs. POC shall include backup batteries and supplies to meet travel needs. Requests for prescription for portable concentrators, if needed, should be referred to the Clinical Coordinator.

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

Ventilators (invasive/non-invasive): Rental equipment will meet the prescribed needs of the Veteran. The standard procedure will be to have contractor deliver ventilator and supplies to include an emergency back-up ventilator, with equivalent capabilities to the primary ventilator, placed in the home. Emergency back-up power will be provided as a mix between internal and external batteries. Contractor will provide recommended maintenance schedule (RMS) per manufacturer’s guidelines. Home assessment, patient training and education, RRT monthly visits, evaluation of patient/equipment, periodic maintenance (PM’s) and or Ventilator check out completed in the home environment will be done on a monthly basis. PM’s identified by the manufacturer’s guidelines will be met and documentation of those PM’s will be documented and kept on file with Contractor. Contractor will be responsible for retaining the documentation of the home visits and will be responsible for retaining and or providing these documents to the VA upon request by VA physician (s) and or staff RT (s).

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

PATIENT EDUCATION REQUIREMENTS

The Contractor shall provide education on the equipment to each Veteran/caregiver at the time of set-up and assess the need for reinforcement during visits. This information is to be presented verbally, in demonstration and material covered shall be in written form to be left with the beneficiary/care giver.

All patient education material must be presented in written form to the CO for approval prior to the award. The contractor, as directed by CO or designee, will implement any new or revised education material. The VA will determine whether the contractor shall use their forms or forms supplied by the VA for documentation of services provided to VA beneficiaries. Completed patient education information and initial set-up documentation shall be via fax or encrypted electronic means to the HOC or designee on the next business day.

Veterans will be provided a copy of Patient Rights & Responsibilities, and any advance information concerning directives. The Contractor shall document that the beneficiary/care giver is instructed in accordance with Joint Commission or equivalent accreditation Standards.

The Contractor shall visit beneficiaries' residences in performance of this contract by appointment only, at a time mutually agreed upon by the patient and/or care giver and contractor. Exceptions will be made in the cases of emergencies.