Sources Sought CLIN LISTING.pdf

HOME OXYGEN WEST

VISN 4

ALTOONA, BUTLER, ERIE, PITTSBURGH

APRIL 20,2021

QTY QTY QTY QTY QTY QTY QTY QTY QTY QTY

Delivery and Monthly Rental of concentrator with backup system and portability items. Backup system consists of compressed gas source (M60 Cylinders Only), appropriate continuous flow regulator, stand, nasal cannula (with tubing), two (2) 25-foot tubing or one (1) 50-foot tubing, two (2) Oxysafe (or equivalent) fire safe devices (with appropriate fire safe tubing), and the following when specified by the VA: cannula (with tubing) and pre-filled humidifier, if indicated on the prescription. Portability items consist of appropriate cylinders (Cylinder sizes B [M6], D, & E), appropriate conserving device, (2) Oxysafe (or equivalent) fire safe devices handcart and cylinder pouch/bag. Concentrator will have flow rate capacity up to 5LPM. This set up is intended for the patient who is prescribed for use during the day and at night. NOTE: Pre-filled humidifiers are required for Altoona VA patients only.

0001A ALTOONA - see CLIN 0001 7200 7200 7200 7200 7200 7200 7200 7200 7200 7200 0001B BUTLER - see CLIN 0001 2400 2400 2400 2400 2400 2400 2400 2400 2400 2400 0001C ERIE - see CLIN 0001 8640 8640 8640 8640 8640 8640 8640 8640 8640 8640 0001D PITTSBURGH - see CLIN 0001 11700 11700 11700 11700 11700 11700 11700 11700 11700 11700

Delivery and Monthly Rental of concentrator with backup system and portability items. Backup system consists of compressed gas source (M60 Cylinders Only), appropriate continuous flow regulator, stand, nasal cannula (with tubing), two (2) 25-foot tubing or one (1) 50-foot tubing, two (2) Oxysafe (or equivalent) fire safe devices (with appropriate fire safe tubing), and the following when specified by the VA: cannula (with tubing) and pre filled humidifier, if indicated on the prescription. Portability items consist of appropriate cylinders (Cylinder sizes B [M6], D, & E), appropriate conserving device, (2) Oxysafe (or equivalent) fire safe devices, handcart and cylinder pouch/bag. Concentrator will have flow rate capacity up to 10LPM. This set up is intended for the patient who is prescribed for use during the day and at night. NOTE: Pre-filled humidifiers are required for Altoona VA patients only.

0002A ALTOONA - see CLIN 0002 320 320 320 320 320 320 320 320 320 320 0002B BUTLER - see CLIN 0002 420 420 420 420 420 420 420 420 420 420 0002C ERIE - see CLIN 0002 468 468 468 468 468 468 468 468 468 468 0002D PITTSBURGH - see CLIN 0002 1800 1800 1800 1800 1800 1800 1800 1800 1800 1800

0003 Cylinder Refill and Delivery, size "E" for CLINS 0001 and 0002. Aluminum (or metal of equivalent weight) tanks required.

0003A ALTOONA - see CLIN 0003 6000 6000 6000 6000 6000 6000 6000 6000 6000 6000 0003B BUTLER - see CLIN 0003 2100 2100 2100 2100 2100 2100 2100 2100 2100 2100 0003C ERIE - see CLIN 0003 9108 9108 9108 9108 9108 9108 9108 9108 9108 9108 0003D PITTSBURGH - see CLIN 0003 1800 1800 1800 1800 1800 1800 1800 1800 1800 1800

0004 Cylinder Refill and Delivery, size "D" for CLINS 0001 and 0002. Aluminum (or metal of equivalent weight) tanks required.

0004A ALTOONA - see CLIN 0004 5400 5400 5400 5400 5400 5400 5400 5400 5400 5400 0004B BUTLER - see CLIN 0004 3000 3000 3000 3000 3000 3000 3000 3000 3000 3000 0004C ERIE - see CLIN 0004 4176 4176 4176 4176 4176 4176 4176 4176 4176 4176 0004D PITTSBURGH - see CLIN 0004 10000 10000 10000 10000 10000 10000 10000 10000 10000 10000

0005 Cylinder Refill and Delivery, size "B" (M6) for CLINS 0001 and 0002. Aluminum (or metal or equivalent weight) tanks required.

0005A ALTOONA - see CLIN 0005 11280 11280 11280 11280 11280 11280 11280 11280 11280 11280 0005B BUTLER - see CLIN 0005 3000 3000 3000 3000 3000 3000 3000 3000 3000 3000 0005C ERIE - see CLIN 0005 27600 27600 27600 27600 27600 27600 27600 27600 27600 27600 0005D PITTSBURGH - see CLIN 0005 25000 25000 25000 25000 25000 25000 25000 25000 25000 25000

0006 Cylinder Refill and Delivery, size "M60" for CLINS 0001 and 0002. Aluminum (or metal or equivalent weight) tanks required as backup system.

0006A ALTOONA - see CLIN 0006 636 636 636 636 636 636 636 636 636 636 0006B BUTLER - see CLIN 0006 600 600 600 600 600 600 600 600 600 600 0006C ERIE - see CLIN 0006 600 600 600 600 600 600 600 600 600 600 0006D PITTSBURGH - see CLIN 0006 60 60 60 60 60 60 60 60 60 60

Delivery and Monthly Rental of Liquid Oxygen System (90-150 lbs.) with stationary unit, portable unit, nasal cannula (with tubing), two (2) 25-foot tubing or one (1) 50-foot tubing, two (2) Oxysafe (or equivalent) fire safe devices (with appropriate fire safe tubing) on both stationary and portable, backup system consisting of tank set up (M60 Cylinders Only), appropriate continuous flow regulator, stand, and the following when specified by the VA: mask (with tubing) and disposable pre-filled humidifier, if indicated on the prescription.

0007A ALTOONA - see CLIN 0007 120 120 120 120 120 120 120 120 120 120 0007B BUTLER - see CLIN 0007 840 840 840 840 840 840 840 840 840 840 0007C ERIE - see CLIN 0007 54 54 54 54 54 54 54 54 54 54 0007D PITTSBURGH - see CLIN 0007 9180 9180 9180 9180 9180 9180 9180 9180 9180 9180

0008 0010 Liquid Oxygen Per Pound For CLIN 0007

0008A ALTOONA - see CLIN 0008 43200 43200 43200 43200 43200 43200 43200 43200 43200 43200 0008B BUTLER - see CLIN 0008 72000 72000 72000 72000 72000 72000 72000 72000 72000 72000 0008C ERIE - see CLIN 0008 11040 11040 11040 11040 11040 11040 11040 11040 11040 11040 0008D PITTSBURGH - see CLIN 0008 840000 840000 840000 840000 840000 840000 840000 840000 840000 840000

CLIN

Y6 6001-6014

Y7 7001-7014

Y8 8001-8014

Y9 9001-9014

DESCRIPTIONSUBCLIN

BASE

0001-0014

Y1 1001-1014

Y2 2001-2014

Y3 3001- 3014

Y4 4001-4014

Y5 5001-5014

HOME OXYGEN WEST

VISN 4

ALTOONA, BUTLER, ERIE, PITTSBURGH

APRIL 20,2021

Delivery and Weekly or Monthly Rental of portable oxygen concentrator (Inogen G2, Eclipse, Simply Go, Simply Go mini or equivalent of either as designated by the VA, to include new and emerging technology) and all accessories including but not limited to nasal cannula (with tubing), two (2) Oxysafe (or equivalent) fire safe devices (with appropriate fire safe tubing), 2 sets of back-up batteries, handcart, and concentrator pouch/bag. This set up is intended for the patient who is traveling, or has other situations which require a portable concentrator. All Patients would need evaluated by RT on rental system at the time of set up for proper saturation at the prescribed liter flow.

0009A ALTOONA - see CLIN 0009 180 180 180 180 180 180 180 180 180 180 0009B BUTLER - see CLIN 0009 480 480 480 480 480 480 480 480 480 480 0009C ERIE - see CLIN 0009 162 162 162 162 162 162 162 162 162 162 0009D PITTSBURGH - see CLIN 0009 0 0 0 0 0 0 0 0 0 0

0010 Electric Air Compressor capable of continuous use of up to 10 liters per minute to include a large volume nebulizer, a large volume aerosol tubing and disposable trach mask.

0010A ALTOONA - see CLIN 0010 36 36 36 36 36 36 36 36 36 36 0010B BUTLER - see CLIN 0010 12 12 12 12 12 12 12 12 12 12 0010C ERIE - see CLIN 0010 24 24 24 24 24 24 24 24 24 24 0010D PITTSBURGH - see CLIN 0010 250 250 250 250 250 250 250 250 250 250

Respiratory Therapy Visit for the delivery or recovery of VA owned equipment including but not limited to the set up and troubleshooting for CPAP/Bi- Level Positive Airway Pressure (PAP)/Portable Oxygen Concentrator (POC), suction machines, air compressors, VA owned ventilators, prescription change and/or additional components such as but not limited to Mask sizing/fitting, Heated Humidifiers, CPAP-A/BiPAP settings. Respiratory Therapy Visit for education to be completed upon initial set up and every 6 months to include card download and compliance reports for all active Home Oxygen and PAP patients. PLEASE NOTE: If patient is ordered more than one item (i.e. oxygen and PAP), this will be covered by ONE (1) Respiratory Therapy visit only.

0011A ALTOONA - see CLIN 0011 2880 2880 2880 2880 2880 2880 2880 2880 2880 2880 0011B BUTLER - see CLIN 0011 1080 1080 1080 1080 1080 1080 1080 1080 1080 1080 0011C ERIE - see CLIN 0011 396 396 396 396 396 396 396 396 396 396 0011D PITTSBURGH - see CLIN 0011 1020 1020 1020 1020 1020 1020 1020 1020 1020 1020

0012 Nocturnal pulse oximetry study as ordered by the VA including all reports. Est. Quantity 0 Unit Price $________ Amount price for 12mo

0012A ALTOONA - see CLIN 0012 180 180 180 180 180 180 180 180 180 180 0012B BUTLER - see CLIN 0012 24 24 24 24 24 24 24 24 24 24 0012C ERIE - see CLIN 0012 48 48 48 48 48 48 48 48 48 48 0012D PITTSBURGH - see CLIN 0012 150 150 150 150 150 150 150 150 150 150

Rental Ventilator: Service includes maintenance and replacement supplies (as specified) and all of the following will be performed on a monthly Basis:

(a) Routine inspection per manufactures specifications. (b) Ventilator settings flow sheet must include:

1. Check respiratory rate (set and actual;)(peep if applicable). 2. Check tidal volume (delivered and exhaled)

3. FI02 4. Pressure limit/peak pressure. 5. Alarm settings (high/low). 6. Mode. (c) Check ventilator filters.(d) Check humidification system.

(e) Check internal and external batteries & emergency backups.(f) Check circuit (g) Check hour meter (report when due for preventive maintenance).(h) Comments/observations.(i) Replacements items: 1. Filters (disposables).2. Circuit.3. Peep Valve.4. Humidifier.5. Resuscitation bag (as needed).

0013A ALTOONA - see CLIN 0013 60 60 60 60 60 60 60 60 60 60 0013B BUTLER - see CLIN 0013 60 60 60 60 60 60 60 60 60 60 0013C ERIE - see CLIN 0013 0 0 0 0 0 0 0 0 0 0 0013D PITTSBURGH - see CLIN 0013 144 144 144 144 144 144 144 144 144 144

Delivery and monthly rental of home fill concentrator with 2 portable self-fill tanks appropriate conserving device, (2) Oxysafe (or equivalent) fire safe devices , and cylinder pouch/bag and Backup system consists of compressed gas source (M60 Cylinders Only), appropriate continuous flow regulator, stand, nasal cannula (with tubing), two (2) 25-foot tubing or one (1) 50-foot tubing, two (2) Oxysafe (or equivalent) fire safe devices (with appropriate fire safe tubing), and the following when specified by the VA: cannula (with tubing) and humidifier. Home fill tanks to include appropriate conserving device, (2) Oxysafe (or equivalent) fire safe devices and cylinder pouch/bag

0014A ALTOONA - see CLIN 0014 0 0 0 0 0 0 0 0 0 0 0014B BUTLER - see CLIN 0014 32 32 32 32 32 32 32 32 32 32 0014C ERIE - see CLIN 0014 0 0 0 0 0 0 0 0 0 0 0014D PITTSBURGH - see CLIN 0014 96 96 96 96 96 96 96 96 96 96

Y8 8001-8014

Y9 9001-9014

BASE

0001-0014

Y1 1001-1014

Y2 2001-2014

Y3 3001- 3014

Y4 4001-4014

Y5 5001-5014

Y6 6001-6014

Y7

7001-7014CLIN SUBCLIN DESCRIPTION