S06 - 36C25225R0072 0001.docx

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.

is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer) None

12-18-2025

None

Department of Veterans Affairs 36C252 115 South 84th Street, Suite 101

Milwaukee WI 53214-1476

Department of Veterans Affairs 36C252 Great Lakes Acquisition Center - HC 115 South 84th Street, Suite 101 Milwaukee WI 53214-1476 To all Offerors/Bidders

36C25225R0072

X

X

** HOUR & DATE for Receipt of Offers is EXTENDED to: 01-15-2026 10:00 CST one (1) The purpose of this amendment is to provide responses to the questions submitted on 12/01/2025. Please see continuation page for responses along with a revised Attachment K document.

Additionally, proposal package due date has been extended from 01/05/2026 at 10:00 am Local (Central) Time to 01/15/2026 at 10:00 am Local (Central) Time.

Please ensure the signed amendment document is included with your proposal package

Joni Dorr Contracting Officer

COMPILATION OF VENDOR QUESTIONS

Responses are denoted in Red

Due Date

· Q: May the Government please consider extending the due date pending release of the responses to the questions submitted during the solicitation process?

A, The Government will extend from 01/05/2026 to 01/15/2026.

Award

· Q: May the Government confirm if it intends to award the contract to one or multiple contractors?

A. The Government confirms that the award will be to a single Contractor

Price/Cost Schedule

· Q: May the Government please confirm if this is the only file the offeror is to submit for their price proposal (i.e. no excel price sheet)?

A. The Offeror may provide an excel price sheet, but must also provide pricing in the Price/Cost Schedule of the contract. The excel price sheet will be considered for evaluation, but eliminating the Price/Cost Schedule will allow for the determination of not meeting the minimum document requirements.

· For the period of 07/01/2026 to 6/30/2026:

· “VA-Owned Concentrator with Backup System” and “VA-Owned Concentrator without Backup System”

· Q: May the Government please confirm if the Rx/consult submitted by the VA will delineate the backup system requirement?

A. No-All VISN 12 oxygen patients are to receive a back-up system. In the vast majority of cases, back-up O2 systems will be included on the VA consults/orders. There may be periodic cases when back-up systems are not listed on orders but the expectation is that ALL oxygen patients will have a back-up system. IF the veteran refuses the back-up system for any reason, the VA will not be charged for a VA concentrator with back-up system and only for the VA concentrator service charge per patient per month.

These will be two separate line item rates as veterans have refused this in the past or were not provided routinely on the first delivery date prompting to veteran to refuse another visit to place into the home.

· “Contractor-Owned Liquid Oxygen System Rental Management, Services, Supplies” and “Contractor-Owned Liquid Oxygen Portable Device Rental Management, Services, Supplies”

· Q: May the Government add a line item for the Liquid Oxygen refills per pound?

A. Because of the rate of evaporation and our inability to ensure that each of the units are filled to the maximum each refill, and pre and post amounts not being able to be verified, we cannot utilize the per pound route and have chosen a set price for rental that would include the contents – We have very few liquid oxygen patients so this will inevitably make it easier for all concerned.

Invoices

· “The VA has mandated electronic invoice submission to the Veterans Affairs Financial Services Center (VAFSC).”

· Q: May the Government please confirm the contractor will not be required to mail hard copies of the invoice and/or documentation to the VA?

A. This question may be mixing two different things—monthly invoices and vendor documentation. All invoices must be submitted through Tungsten for this requirement. No hard copy invoices will be allowed. See pages 2-3 in PWS.

Documentation is an entirely different topic. The vendor will be required to submit all patient education documentation (see Attachment K) within 24 hours of completion via encryption to the applicable site’s ORPC (Outpatient Respiratory Program Coordinator). The ORPCs will use these documents to perform quality assurance and contract oversight functions. (See page 30 of the PWS.)

Monthly, the Contractor will also submit hardcopies of the Attachment K patient education documentation to the VISN 12 Program Analyst (PA). The VISN 12 PA will use the hardcopies to perform second-tier reviews of the vendor’s documentation as well as quality assurance and contract oversight functions. These documents will be separated by VISN 12 Hospital and shall be sorted and alphabetized. (See page 30 of the PWS.)

Monthly, the Contractor will create a detailed Excel spreadsheet listing all equipment rentals and/or services provided per veteran for each site. The spreadsheets shall be sorted alphabetically by veteran’s last name and all applicable charges for the billing period and shall contain the following information:

i Patient’s name, date of birth (DOB), and last four of SSN, Date of service ii Description of equipment, supplies, and/or services including corresponding Healthcare Common Procedure Codes (HCPC if applicable) iii Quantities iv Unit Prices v Invoices (Excel spreadsheets) will break out cost per patient vi Total balance owed

This will be sent to each of the VA sites monthly electronically.

Security & Privacy Control

· “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).”

· Q: May the Government please confirm if they will accept the contractors background screening if it meets or exceeds the SAC & NACI requirements?

A. YES – Copies of this background check should be available in the personnel folders for verification purposes.

Portable Oxygen Systems (Monthly Rental from Contractor)

· Compressor tank filling system rental

· Q: May the Government please clarify how many self-fill cylinders are to be provided with the rental of the home-fill/self-fill system?

A. As requested to meet ADLs for veteran – This could all be the same size or vary depending on how your company assesses this when provided – We could place the amount at 6 total expected for any delivery that are 3 small and 3 larger to accommodate everyone’s needs but are not limited on the amount of tanks provided for the home fill rental.

Monthly Air Compressor Rental (E0565)

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

· Q: May the Government please confirm if the set-up is to completed by a Patient Service Technician or Respiratory Therapist?

A. PST – We cannot mandate an RRT perform d/t guidelines communicated from VACO. All of the PSTs MUST be trained and competent to provide the necessary training and education for HHTC veterans to include set-up, education, infection control education, cleaning and disinfecting, sterile or yankauers suctioning, operation/cleaning (if ordered) etc. The preliminary clinical RT education and instruction will be provided by our VISN 12 site RT departments prior to discharge and reinforced by your PSTs.

Preventative Maintenance (PM) & Upkeep of VAMC 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.”

· Replacement of casters, power cords and oxygen outlet ports are considered major repairs, as the units must be opened to complete the repair.

· Q: May the Government please consider updating the minor repair requirement to only include the replacement of knobs?

A. Taking off a shell of a unit requires removing some screws and you have access to perform minor replacement of cords, casters, knobs and oxygen outlet ports. Many of these damages are the result of transport and not occurring in the home (rare) which is the responsibility of the vendor to ensure their personnel take care of government equipment properly in all aspects, treating it like it’s your own. The training required to perform these repairs is minimal and we would still consider these minor.

· “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.”

· Major repairs are not completed at the local level, as they are far more complex and may require specialized training.

A. Every homecare company in the US either has these services performed internally or have established agreements with other companies to provide these repairs, we are asking for your best pricing to perform this work to get these concentrators functioning again and back in inventory to support orders from our sites for our veteran’s oxygen needs. Once the pricing for repairs is sent to the COR, we will make the determination of whether to sell these to the vendor providing services in this contract or repair. The same unit would go back to said veteran when repaired as then we can associate the cost with that specific veteran when down if costs are reasonable and paid via the monthly bill as service cost that is reasonable or comparable with industry standard vendor cost to repair.

· Q.: May the Government please clarify how pricing will be determined when asked to provide major repairs?

A. The contractor will determine pricing based on their agreements with other biomed companies performing repair or from their internal repair facility and this would be cost of component and labor.

· Q: May the Government please confirm the contractor will have the right of first refusal when asked to provide major repairs?

A. Refusing to provide services as specified in the contract is not acceptable as we will utilize this to make a determination whether to go forward with the repair (if out of the warranty period) or sell the equipment to the contractor.

High Fire Risk Oxygen Patients

· “iv. Contractor shall test smoke alarms and ensure fire extinguishers shall be current and full.”

· It is not customary for contractors to test smoke alarms or inspect fire extinguishers. They may request the patients/caregivers to show them where the items are located, but they are not allowed to physically touch the items.

· Q: May the Government consider updating the verbiage to read “Contractor shall encourage patients and/or caregivers to test smoke alarms and inspect their fire extinguishers to ensure they are current and full”?

A. No – Per page 18-19 of the SOW (18 iv)

· “v. Contractor shall place No Smoking signs at entrances to the residence prior to leaving residence and ensure they shall be present when visiting for all future visits.”

· Q: May the Government consider updating the verbiage to read “Contractor shall encourage patients/caregivers to post the provided No Smoking signs at entrances and ensure they are present when visiting for all future visits.”?

A. No – Per page 18-19 of SOW (18 v) and Pages 28-29 (42 i.b)

Contractor Employees

· “x. Contractor personnel shall have the experience and capability to perform minor repairs on VA Medical Center owned concentrators to remain in service or inventory to include, at a minimum, casters, filters, oxygen outlet, power cords and control knobs.”

· Replacement of casters, power cords and oxygen outlet ports are considered major repairs, as the units must be opened to complete the repair and may require specialized training at an outside facility.

· Q: May the Government please consider updating the minor repair requirement to only include the replacement of control knobs and/or filters?

A. Taking off a shell of a unit requires removing some screws and you have access to perform minor replacement of cords, casters, knobs and oxygen outlet ports etc. Many of these damages are the result of transport and not occurring in the home (rare) which is the responsibility of the vendor to ensure they can perform these minor repairs seamlessly.

· “Contractor shall have a single, continuous (24/7/365) toll free number to permit VA Medical Center and/or patients with the ability to speak to a “live” customer service representative within three (3) minutes and have their needs addressed. Customer service representatives shall be able to resolve patient or VA Medical Center issues conveyed without transferring calls. All calls shall be recorded for customer satisfaction purposes.”

· While contractor personnel do everything possible to assist patients/caregivers and/or VA personnel without transferring, there are times when calls will need to be returned or transferred to obtain a resolution.

· Q: May the Government please clarify if its intent is for the contractor to have a call center exclusively available for VISN 12 to assist patients/caregivers and/or VA personnel continuously?

A. The service provided is 24/7/365 and veterans contacting the contractor should not have long wait times resulting in customer complaints. Also, all contractor phone lines will reference the contracted awardee’s name (not sister companies or other companies DBA) when dialed. Many veterans have expressed concern that they do not recognize the name of the company providing the service and do not answer the phone thinking it is a spam call delaying service or support for that veteran.

HIPAA Compliance

· “iv. It shall be required that the Contractor coordinate with the COR to obtain VA Public Key Infrastructure (PKI) encryption within 30 days of award to communicate patient identifiable information with the VA Medical Center while protecting patient confidentiality

· Q: May the Government please consider removing this section, as PKI is no longer a viable encryption method?

A. Vendor shall have encryption capabilities to send and receive PII via email AZURE

Documentation Requirements

· “iii. “The VISN utilizes a Required Forms Matrix (Attachment K)…”

· “iv. Should the Contractor choose to use the VISN forms…”

· It appears the forms listed in section iii. (Attachment K) and the forms listed in section iv. do not correlate.

· Q: May the Government please clarify the required forms to be utilized in the contract?

A. We can use the offeror’s forms or the examples provided in the attachments – We will assess the offeror’s forms and make a decision on which ones to utilize in the performance of the contract.

Contractor Documentation Submission Requirements

· “i. ALL equipment set-up documentation includes those documents listed on the VISN 12 Required Forms Matrix (Attachment K) and applicable delivery tickets. These documents shall be sent via encrypted e-mail to the applicable ORPC no later than the next business day (within 24 hours) after completion.”

· Q: May the Government consider updating the verbiage to state “All equipment set-up documentation includes those documents listed on the VISN 12 Required Forms Matrix (Attachment K) and applicable delivery tickets. These documents shall be sent via encrypted e-mail to the applicable ORPC or uploaded into the contractor’s proprietary Electronic Medical Record system no later than the next business day (within 24 hours) after completion.”

A. No

· “ii. Monthly vent and compressor visit documentation includes those documents listed on the VISN 12 Required Forms Matrix (Attachment K) under the Monthly Visits columns. These documents shall be sent via encrypted e-mail to the applicable ORPC no later than the next business day (within 24 hours) after completion.”

· Q: May the Government consider updating the verbiage to state “All equipment set-up documentation includes those documents listed on the VISN 12 Required Forms Matrix (Attachment K) and applicable delivery tickets. These documents shall be sent via encrypted e-mail to the applicable ORPC or uploaded into the contractor’s proprietary Electronic Medical Record system no later than the next business day (within 24 hours) after completion.”

A. No

· “iii. Annual and semiannual PMIs shall be sent via encrypted e-mail to the applicable ORPC no later than the next business day (within 24 hours) after completion.”

· Q: May the Government consider updating the verbiage to state “Annual and semiannual PMIs shall be sent via encrypted e-mail to the applicable ORPC or uploaded into the contractor’s proprietary Electronic Medical Record system no later than the next business day (within 24 hours) after completion.”

A. No

· “iv. Transition documents (PMIs) shall be sent via encrypted e-mail to the applicable ORPC no later than the next business day (within 24 hours) after completion.”

· Q: May the Government consider updating the verbiage to state “Transition documents (PMIs) shall be sent via encrypted e-mail to the applicable ORPC or uploaded into the contractor’s proprietary Electronic Medical Record system no later than the next business day (within 24 hours) after completion.”

A. No

1. PWS Section 8, PORTABLE OXYGEN SYSTEMS (Monthly Rental from Contractor):

v. Unlimited resupplies shall be provided per monthly price.

Question: Can you change unlimited resupplies to a not to exceed number? Any time unlimited resupplies are an option, the VA ends up paying for refills/resupplies that patients aren’t using.

Supplies provided are per PWS

Or in the alternative, add a contract line item for refills for the portable oxygen system. By adding a line item for the refills, the VA will only be paying for the exact amount of refills used.

I do agree if ANY veteran does not use their portable tanks- ever- this should be conveyed to the VA via documentation/email or phone so we can support your re-education and instructions to use as prescribed. If we have non-compliant patients we usually address initially then if continued non-use, we have them sign the AMA. When they are ready to use as prescribed, we will then reassess the situation and provision of oxygen equipment at that time internal to the VA but vendors documentation and communication is critical for us to achieve this oversight.

1. The PWS states that Respiratory Therapists are only required for Ventilator Patients.

Question: Please clarify – Are Respiratory Therapists only required for Ventilator Patients? If not, please describe in detail the other responsibilities for Respiratory Therapists.

Yes See page 12-14 and page 70

1. Regarding VA-owned Ventilators Question: When VA-owned Ventilators are used, is the backup ventilator also VA-owned or is the backup ventilator contractor owned?

It will be per order received

1. PWS Section 35. INFECTION CONTROL/COMMUNICABLE REQUIREMENTS:

i. Contractor shall provide a current plan for surveillance, prevention, and control of infection at time of proposal submission. The plan shall meet or exceed The Joint Commission (TJC) standards.

Question: Are contractors required to provide a current plan for surveillance, prevention, and control of infection at time of proposal submission? If so, what proposal volume should it be submitted under? I ask because this is not mentioned in the proposal instructions or the evaluation factors for award.

At time of award we will review but all offerors should understand that the minimum is to meet Joint Commission requirements and National Patient Safety Goals and have a surveillance system to ensure compliance with said standards.

1. Regarding Portable Oxygen Concentrators Question: Are patients prescribed Portable Oxygen Concentrators as their only source of oxygen equipment (i.e. no stationary concentrator)? If so, will contractors need to calculate providing a backup system to the POC?

Yes, however, this is a rare occurrence. Again, all VISN 12 home oxygen patients are required to have emergency back-up O2 systems (with the exception of tank-only cluster headache patients).

1. Can you please provide the historical average number of E, D, C, or B (M6) size cylinders deliveries/refills that have occurred on a monthly basis?

Tanks per year and per month below:

1. The solicitation does not explicitly state how long offers must remain valid. Can the VA confirm the required offer acceptance period?

Offers shall remail valid for 180 days from the proposal due date.

1. With regard to the Price Proposal, Page 71 states “This proposal shall include the following: Current and active SAM registration (Please note that an inactive SAM will result in a non-responsive/technically unacceptable finding)” – do we need to provide an actual copy of our SAM registration in the Price Proposal volume?

Yes, an active SAM registration will be required as part of the proposal package or the Offeror may be excluded from consideration due to not providing all mandatory documentation.

1. Volume 2 Experience states “Service area at least as large as the VISN 12 catchment area per PWS.” Please explicitly define “as large as the VISN 12 catchment area” – Does this mean # of states, cities or counties, or does this mean number of square miles?

Same or similar to tri-state area provided in map attachment and population of veterans on oxygen (~3800)

1. Page 70 states “Offeror shall provide all Respiratory Therapists’ license and credentials demonstrating Home Respiratory services at time of submittal.” How may RT licenses and credentials must be provided?

Electronic (scanned) copies of NBRC & state licensure. (See page 22 of the PWS.)

1. Page 79 – Evaluation, states:

(3) Veterans Involvement: The Government will give preference to offers (i.e. Prime Contractor) received from VOSBs and additional preference to offers (i.e. Prime Contractor) received from SDVOSBs. Preference shall be applied when all other factors (price, experience capability) are equal. To receive credit, at the time of submission and at the time of award an Offeror must be registered and verified in SBA Veteran Small Business Certification Program portal at https://veterans.certify.sba.gov and must meet federal small business size standards for the North American Industry Classification System (NAICS) code assigned to this solicitation. Non-SDVOSB/VOSB proposals that use SDVOSBs or VOSBs as subcontractors will receive some consideration under this evaluation Factor. Offerors must state in their proposal the names of the SDVOSBs and VOSBs with whom they intend to subcontract and provide a brief description of the proposed subcontracts and the approximate dollar values of the proposed subcontracts. In addition, the proposed subcontractors must be registered and verified at the time of submission and at the time of award in SBA Veteran Small Business Certification Program portal at https://veterans.certify.sba.gov and must meet federal small business size standards for the NAICS code assigned to this solicitation at time of both proposal submission and at time of award.

Question 1: When you say “Preference shall be applied when all other factors (price, experience capability) are equal”, are you saying you will only apply the preference if the experience capability is equal and our price is equal to another bidder? If so, please define equal. Are you saying our price will have to be exactly the same as another bidder in order for the preference to be applied?

Yes. All factors (experience and price) must be equal to another Offeror for the Veterans preference to be applied.

Question 2: When you say “The Government will give preference to offers (i.e. Prime Contractor) received from VOSBs and additional preference to offers (i.e. Prime Contractor) received from SDVOSBs.” What type of preference are you referring to? Are you referring to a certain percentage being subtracted from our total evaluated price? If not, please define what you are referring to when you say “preference and additional preference”. If yes, please provide the percentage that will be subtracted from VOSB and SDVOSB offerors.

VOSBs will have preference considered above other small businesses and large businesses when all factors (experience and price) are equal. An SDVOSB will have preference over VOSBs, small businesses, and large businesses when all factors (experience and price) are equal.

Question 3: When you say “Non-SDVOSB/VOSB proposals that use SDVOSBs or VOSBs as subcontractors will receive some consideration under this evaluation Factor.” Again, is this “some consideration” considered a certain percentage being subtracted from our total evaluated price? If not, please define what you are referring to when you say “some consideration”. If yes, please provide the percentage that will be subtracted from proposals that use SDVOSBs or VOSBs as subcontractors.

If all factors (experience and price) are considered equal except Contractor status, and there is sufficient evidence that the Subcontractor will be utilized for the duration of the requirement, then a preference would first apply with a Prime Contractor with SDVOSB concerns, then a Prime Contractor with VOSB concerns.

Discrepancy of SOW vs PWS

It should be noted that all references to a Performance Work Statement (PWS) is the Statement of Work (SOW)

1. Any reason this didn’t come out as an SDVOSB set aside?/ A summary of the market research conducted to support issuing the requirement on an unrestricted basis, consistent with FAR 10.001 and VAAR 810.001; and Whether an SDVOSB set-aside was evaluated pursuant to VAAR 819.502-2-70 (the “Rule of Two”), and the factors that informed the resulting acquisition strategy.

Market research was conducted in accordance with FAR Part 10, VAAR Part 810. Consideration was given to FAR 19 and VAAR 819, in relevant part, as is required for all VA Acquisitions. Specifically, I queried several databases and sources, including SBA DSBS, GSA eLibrary, VetCert, and published a sources sought and considered responses, and reviewed like acquisition strategies in other VISNs. After thorough consideration of those results, and with the concurrence of the Small Business Liaison and Office of Small & Disadvantaged Business Utilization representative, the CO determined that the VA Rule of Two was not met and that there are not two or more small business concerns that will submit offers and that award can made at a fair and reasonable price that offers the best value to the Government. While there may certainly be interested veteran-owned small businesses, the CO determined that there are not two or more capable small business concerns that will submit offers in response to this Solicitation. Additionally, during market research, it was discovered that other VISNs did not provide a set-aside for their Home Oxygen Delivery solicitation. Please note that although this is solicited as unrestricted, Veterans Preference is considered for this requirement.

To increase competition a bit amongst SDVOSBs, may want to use the 532283 NAICS.

The Integrated Product Team, with facility subject matter experts and our Office of General Counsel attorney, determined 621610 was the appropriate NAICS for this action, a decision that lies with the Contracting Officer and facility partners.

A. AREA OF RESPONSIBILITY & SERVICE ZONES

1. Please provide GIS boundary files for each VAMC catchment area to accurately calculate the “catchment + 100 miles” perimeter for pricing and logistics.

See map provided in attachments

2. What is the historical annual volume of Non-Territory service requests requiring coverage outside VISN 12 + 100 miles?

Maybe 1 or 2 per year

3. For Non-Territory cases, will VA reimburse actual subcontractor cost plus an administrative fee?

Yes, the contractor will notify the site’s Outpatient Respiratory Program Coordinator, COR/designee with pricing information and once reviewed, we will make a determination of whether to utilize that specific vendor or an alternative for the best possible pricing.

4. When a patient travels within CONUS, must the contractor support them at VISN 12 CLIN pricing regardless of cost?

If the vendor has a national footprint and locations which provide equipment and/or services, yes, the pricing will be the same as if in VISN 12 catchment area. If it does not have this capability this is negotiated and approved by VA sites/COR on a case by case basis.

B. RESPONSE TIMES & WORKLOAD

5. Please provide 3 years of historical emergency call volume by VAMC AND by modality.

Annual volume over the last year regarding after hour calls from veterans – 16,587 Annual volume of after hour calls from VA sites - 1138

6. Will VA allow a tiered rural/urban emergency response standard for remote areas?

No

7. Does the 3-hour emergency response clock begin upon order entry, email transmission, or verbal notice?

All of them – Usually emergent needs are after hours in which a concentrator fails or a vent issue (rare) etc and usually is from the time the veteran contacts the vendor’s 800 #/Phone #

8. For STAT orders received after hours, can the contractor complete them the next business day unless clinically unsafe?

Usually when STAT orders are generated by the site it is per order received and timeframe communicated. This is not up to the vendor to determine whether or not to provide this if the order was received – This would be a rare circumstance for these orders to be sent after hours to the vendor and normally a heads up is provided to the vendor during working hours.

C. DELIVERY FREQUENCY & LOGISTICS

9. For tank patients, does the CLIN include unlimited deliveries, or will VA define a maximum number per month?

This is unlimited but for the most part, these all can get on a delivery schedule based on their needs and tweaked from that standpoint – We do not have an excessive amount of veterans requiring a substantial amount tanks per week or two weeks etc

10. For LOX patients, how many refill visits per month are expected within the CLIN rate?

Depends on ADLs, evaporation rate etc – We currently have 0 LOX patients in VISN 12.

11. Are all equipment change-outs required within 24 hours regardless of distance?

See page 20, 21. of PWS

12. Are monthly in-home visits required for ALL oxygen patients, or only high-risk classifications?

Monthly visits for ALL oxygen patients is not in the PWS. The visit requirement for vent patients, air compressors are per order received. There is an annual visit requirement for standard risk veterans on oxygen and a semi-annual visit for high risk veterans.

13. For failed delivery attempts (no answer, wrong address), is the visit billable?

No – When service is performed

14. If VA requests a “drive-by + door tag,” is this billable under any CLIN?

No – When service is performed

D. RESPIRATORY THERAPIST (RT) LABOR

15. Must monthly RT visits be provided for ALL ventilator patients (VA-owned and contractor-owned)?

Per order received

16. Must RTs perform ALL ventilator setups and ALL travel setups, or can technicians perform non-clinical tasks?

Vent = RT Technicians can perform all other non-clinical tasks

17. Please provide historical RT visit volume and emergency RT dispatch counts for accurate RT staffing projections.

Approximately 500-600 vent set-ups/RT visit/year VISN wide with most vents/orders coming from Milwaukee and Hines areas of service

Vent related visit quantities – One year snapshot:

18. Does VA require a minimum number of RT FTE per VAMC?

No – Mostly depends on frequency of vent set-ups and follow-ups monthly or quarterly visits as ordered and the ability to perform per contract timelines

E. CONSUMABLES INCLUDED IN MONTHLY PRICING

19. Does VA require unlimited consumable replenishment (tubing, cannulas, humidifiers, HMEs, suction supplies)?

As specified in the PWS – Oxygen patients - 4 cannulas/mo for change out weekly, prefilled humidifier bottles as needed, 2 extension tubing/mo, connectors, ear protectors, FSV as needed

20. Please provide historical monthly consumption per patient for each consumable type.

We have approximately 3800 oxygen patients – See 18 for estimate

21. Must contractors include ALL ventilator disposables under VA120 (filters, circuits, trach supplies, HMEs, suction kits, water chambers)?

Yes

22. Must POC CLINs include all battery replacements?

Yes

23. What is the expected POC battery replacement frequency?

Depends on user and quality of batteries provided - There is no way to specifically answer this question

F. EQUIPMENT-SPECIFIC CLIN REQUIREMENTS

For POC CLINs, must contractors provide both pulse-dose and continuous-flow units within the same CLIN rate?

Yes – The majority are pulse dose

24. Must concentrator CLINs include all thermal fuses and monthly safety devices?

Yes

25. Must contractors include OEM-specific filters and consumables for VA-owned ventilators?

Per manufacturer

26. Must contractors supply transfill-compatible cylinders and regulators within the transfill CLIN?

Yes

G. BACKUP OXYGEN REQUIREMENTS

27. Please define the exact backup oxygen quantities required to meet “three times response time” for each modality.

This depends on your servicing site location and the veteran’s location and flow rate

28. If backup oxygen is depleted during extended power outages or emergency events, is replenishment reimbursable?

No

H. WAREHOUSING & INVENTORY REQUIREMENTS

29. Is the requirement for 1,500 sq ft per VAMC mandatory at separate physical locations, or can inventory be consolidated?

It can be consolidated but your servicing sites must be able to accommodate separation of all equipment stored for multiple sites and ensure that ALL services (emergent, same day, within 24 hours etc) and response times are per PWS timeframes

30. Please provide estimated VA-owned inventory quantities expected to be stored at contractor warehouses.

Approximately 50-100 concentrators per VA site as well as vents, suction machines etc – This does not account for those ”repair under warranty” concentrators being stored and ready for RMA process with manufacturer/vendor).

31. Will VA reimburse the cost of warehouse upgrades (racking, ventilation, electrical, LOX storage compliance, ventilator charging)?

No

32. What inventory cycle count frequency does VA require for GFE?

As needed with PAR levels established with each site’s Prosthetics Dept for reorders when necessary, communicated by vendor when reorder point is reached.

33. What shrinkage rate (loss/damage) for GFE is allowable before contractor liability applies?

This is handled on a case by case basis with COR with details of the event communicated by vendor (pictures of damage, description of event that resulted in loss or damage etc)

I. GOVERNMENT-FURNISHED EQUIPMENT (GFE) LIABILITY

34. Who is financially responsible for VA-owned equipment unrecoverable due to patient relocation, death, eviction, or refusal?

Refusals will have VA police involved with communication of that from contractor to VA ORPC/COR

We utilize next of kin information provided to assist and communicate these instances as you are aware of them to work together to retrieve. If all efforts are exhausted, the VA will be responsible, not the vendor.

35. Can the contractor decline acceptance of GFE that arrives damaged, contaminated, or unsafe?

Yes, ALL equipment must be verified during the acceptance process (quantity, damage etc-take photos if necessary to support) and VA notified if damaged to ensure we get a replacement from the vendor utilized to provide.

36. Will VA create a separate reimbursable CLIN for major repairs to GFE (compressor, LOX, vent repairs)?

No

37. Will VA reimburse disposal costs of VA-owned equipment deemed unserviceable?

No

J. FUEL, VEHICLE & RURAL LOGISTICS COSTS

38. Will VA allow a fuel surcharge CLIN due to multi-state rural coverage?

No

39. Does VA require a minimum number of dedicated vehicles per VAMC?

No but all timelines still need to be met regardless

40. Must contractor vehicles meet any specific hazmat/oxygen transport ventilation standards?

Whatever state or federal guidelines apply in the performance and delivery aspects for home oxygen transport

K. SUBCONTRACTOR & THIRD-PARTY SUPPORT

41. Will VA reimburse actual third-party vendor cost + administrative fees for service outside the contractor’s service footprint?

Yes, this will be negotiated and pending acceptance from VA

42. Will VA allow use of existing VHA contractors in other VISNs for patient travel support and reimburse their billed rate?

Yes if negotiated and accepted as fair and reasonable pricing

L. BILLING, PRORATION & INVOICE RULES

43. Does proration apply uniformly to all CLINs (concentrator, LOX, tanks, POC, vent, compressor)?

Yes

44. If the contractor responds but the patient is deceased, hospitalized, or unavailable, is the attempted visit billable?

No – Only when the service/support is provided

45. Please provide historical invoice denial reasons to ensure documentation alignment.

“Denials” or requests to correctly bill include proration for any given monthly charges d/t DC’d order date, date of death (back-dating), AMAs when equipment is billed for when AMA completed and billing should cease at that point and corresponding proration to the date AMA obtained. Travel billing should be done per dates of travel only which are communicated on the travel order. Also, contractors must ensure that VA concentrators and VA vents are provided per order received and not provide contractor equipment in lieu of VA equipment when available

46. Can the contractor submit consolidated batch invoices across VISN 12 instead of per-VAMC submission?

No – Each of the sites are responsible for their own payment and invoices should reflect what was provided for each of the sites in any given monthly period.

M. TRAINING, ONBOARDING & COMPLIANCE COSTS

47. Are NACI and SAC fingerprinting costs contractor-paid without reimbursement?

Yes. This is the responsibility of the Contractor.

48. Will VA reimburse for cybersecurity, HIPAA, and privacy training?

No. This is the responsibility of the Contractor.

49. Must contractor personnel be trained on each new VA-owned equipment model before deployment, and at contractor expense?

Yes, the contractor personnel performing services for VISN 12 veterans shall be well versed in providing equipment and education for our products utilized. The representatives of the equipment/products that the VA will be utilizing offer this training/in-service at zero cost to the contractor. If the product representative refuses to perform this training for your staff/company, reach out to the COR immediately as we have never experienced anyone charging for this type of training.

50. Must contractors provide encrypted tablets or digital devices for documentation to meet security requirements?

No, this can be either paper or electronic documentation of education, assessments or service provided per order received. The only caveat is that when communicating with the VA via email, the contractors must have encryption capabilities per VA requirements to send and receive PII.

N. EQUIPMENT DAMAGE, MISUSE & ATTRITION

51. Is the contractor financially responsible for contractor-owned equipment damaged or destroyed due to patient misuse?

Yes. However, if somehow contractors are able to prove this was done to your equipment on purpose or it is obvious the veteran purposely destroyed your equipment, then with specific documentation, pictures and statements by the veteran/caregiver, we would review and reimburse you for the equipment damaged on purpose by the veteran.

52. Will VA reimburse or share costs for contractor-owned equipment lost in nursing homes, shelters, and unstable housing?

No

O. SURGE & SEASONAL DEMAND

53. Will VA permit temporary surge pricing or establish a surge CLIN during seasonal peaks or emergency declarations?

No, the pricing will be per contract agreement.

54. Will VA reimburse pre-staging of inventory (tanks, LOX, vents, concentrators) before storms or predicted emergencies?

No, this is the responsibility of the vendor

P. TRAVEL OXYGEN

55. Please provide historical annual volume of patient travel oxygen requests by VAMC and modality.

56. Will VA establish a separate reimbursable CLIN for travel oxygen support?

No, the travel oxygen will be on a case by case basis and negotiated if the vendor does not have a national footprint to provide in that area of travel

Q. PRICING FORMAT

57. Will VA allow contractors to submit pricing in an Excel spreadsheet to clearly document assumptions, labor allocations, travel zones, warehouse costs, and CLIN methodology?

The Offeror may provide an excel price sheet, but must also provide pricing in the Price/Cost Schedule of the contract. The excel price sheet will be considered for evaluation, but eliminating the Price/Cost Schedule will allow for the determination of not meeting the minimum document requirements.

R. SET-ASIDE STATUS (SDVOSB PRIORITY)

58. Can the Government confirm whether a formal Rule-of-Two analysis was performed for this procurement?

Market research was conducted in accordance with FAR Part 10, VAAR Part 810. Consideration was given to FAR 19 and VAAR 819, in relevant part, as is required for all VA Acquisitions. Specifically, I queried several databases and sources, including SBA DSBS, GSA eLibrary, VetCert, and published a sources sought and considered responses, and reviewed like acquisition strategies in other VISNs. After thorough consideration of those results, and with the concurrence of the Small Business Liaison and Office of Small & Disadvantaged Business Utilization representative, the CO determined that the VA Rule of Two was not met and that there are not two or more small business concerns that will submit offers and that award can made at a fair and reasonable price that offers the best value to the Government. While there may certainly be interested veteran-owned small businesses, the CO determined that there are not two or more capable small business concerns that will submit offers in response to this Solicitation. Additionally, during market research, it was discovered that other VISNs did not provide a set-aside for their Home Oxygen Delivery solicitation. Please note that although this is solicited as unrestricted, Veterans Preference is considered for this requirement

59. Will the Government reconsider the set-aside determination if two or more capable SDVOSBs demonstrate ability to fully perform under the solicitation?

A set-aside determination will not be considered.

1. What is the current warranty status of all VA-owned concentrators and ventilators deployed in the field?

This cannot be determined specifically at this time but our warranties are per manufacturer and based on serial number

1. Percentage of concentrators and ventilators under warranty.

This cannot be determined specifically at this time but our warranties are per manufacturer and based on serial number

1. Does the VA own any of portable oxygen concentrators (POCs) deployed in the field?

Yes, but this is a very rare occurrence. The government will provide a listing of VA-purchased POCs prescribed to specific patients. We also have approximately 70 SeQual POCs in inventory that need to be stored until further guidance is provided.

1. If the VA requests a backup ventilator, is the contractor permitted to bill for that device?

Yes if we request a contractor ventilator on the order.

1. Do Portable Oxygen Concentrator (POC) users also receive a stationary concentrator in the home?

About 95% or more of the time- It is per order received

1. What is the average monthly volume of liquid oxygen (LOX) delivered, in pounds?

Currently we have 0 LOX patients in the whole VISN.

1. How many oxygen cylinders are delivered each month, and what is the breakdown between POC users and cylinder/tank users?

Current # of POCs:

Danville: 165 Hines: 295 Iron Mountain: 157 Jesse Brown: 143 Madison: 113 Milwaukee: 154 North Chicago: 83 Tomah: 116

Tanks per year and per month below:

1. Will…