VISN 23-Wide Home Oxygen Prosthetic Contract

Questions



Page 7, 4. RT and PST visits

* North Dakota state law requires initial setup(s) to be established by a licensed respiratory therapist. Contractors awarded to North Dakota and adjacent areas may be required, on occasion, to complete initial setups in North Dakota and must meet this requirement.

Question: Can a Patient Service Technician complete an initial set up for all other states? YES

If yes, does an RT have to follow up after the initial set-up? No

If yes, what will be the RT follow up schedule? (i.e. 72 hours) N/A. VISN 23 does not require RT assessments.



Page 17, G Portable Concentrator

a. Portable Concentrator - minimum 5 LPM, weight 10 pounds or less, AC/DC capability, 6 hours battery life (1-2 batteries), continuous and pulse does (40 ml or greater) flow option. At least two types of portable concentrators will be offered, one light weight option that weighs 10 pounds or less with a pulse mode from 1 to 5, and one larger continuous flow option which weighs 20 pounds or less. Both options will include AC/DC capability and 6 hour batter life (102 batteries).

Question: Is the expectation for the patient to receive 1-2 batteries for each portable concentrator? The industry standard would be applicable here.

Page 18, 28. D, Smoke Alarms

d. If a smoke alarm is present, test the smoke alarm and document whether or not the smoke alarm is working.

Question: The above statement contradicts the information on Page 12, D. Please confirm the statement below is your expectation on this contract.

d. The Contractor will verify the presence of the smoke alarms and encourage the Veteran to test all smoke alarms on a monthly basis. In any home where smoke alarms are not present, the contractor will encourage the Veteran to obtain a smoke alarm and notify the appropriate VA clinical staff (e.g. VA Home Oxygen Coordinator) for further review and potential action. VISN 23 does not require the contractor to physically check the smoke detector. We do require that they document the presence of smoke detectors and also annotate that education has been provided to the beneficiary.



Page 7, g. Fire Safe Valve and Cannula Tubing

g. Two (2) fire safety valves and cannula tubing will be provided with each concentrator set up and replaced annually

Question: How will you determine if a fire safe valve and cannula is needed for a patient?

(i.e written on order/prescription) Request for fire safety valves is included on the prescription. All initial set-ups will include fire safety valves. Every beneficiary that has a oxygen concentrator will be provided 2 fire safety valves and tubing.



How many of the patients use portable oxygen? VISN 23 currently serves an estimated 4738 oxygen-using VA beneficiaries (Veterans).



How many of the patients use oxygen tanks for portability? Estimated quantities are in the Bid Schedule.



How many of the patients use portable concentrators for portability? Estimated quantities are in the Bid Schedule.



Can the contractor decide what kind of portable oxygen the patient gets? We don't specify the "brand" of concentrator to use, but the equipment has to meet the specs



What is the average amount of tanks used per year? Estimated quantities are in the Bid Schedule.

Answers to contractor's questions



PWS reference Page 11, section 13 c: "The Contractor will check the adequacy of the electrical outlets in the Veteran's home and immediately report unsafe conditions to the COR or designee."



Question 1 - What does "adequacy" actually refer to, and does this mean all outlets in veteran's home have to be checked?



Answer 1 - No, just the outlet that the concentrator is plugged into. Historically we required the three prong outlet, but the newer concentrators have the grounding built into the unit. The language has been left in because occasionally, we have a vendor that has older equipment.



PWS reference Pg. 20, section 33. "Veterans will be provided a copy of VA 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 standards."



Question 2 - Who would hand out the VA document, the VA or us?



Answer 2 - The VA provides the contract vendor a copy of the VA Patient Rights and Responsibilities once the contract is awarded. The vendor incorporates this document in their package that is given to the veteran.



Question 3 - Advance Directives are only addressed with Clinical Respiratory Services per TJC for our industry.



Answer 3 - Advance Directives are only provided when clinical services are required. VA does not use the contract vendor for clinical services.



Question 4 - "The North American Industry Classification System (NAICS) code for this project is 532291 Home Health Equipment Rental with an associated small business size standard of $32.5 million dollars." Would it be possible for this be raised to $60 million dollars?



Answer 4 - The (NAICS) code cannot be raised for this requirement. This is also not set-aside for small business; but an unrestricted solicitation.



Question 5- It states that there is Veteran owned concentrators. How many concentrators are owned?



Answer 5 - All Concentrators are contractor owned, no Veteran owned Concentrators.



Question 6 - Would these concentrators need to be serviced every three months as well?



Answer 6 - The concentrators are the property of the vendor and should be maintained in accordance with manufactures specifications.



Question 7 - About how many patients are on liquid oxygen?



Answer 7 - In 2014 VISN 23 had 617 instances of liquid oxygen use, each month a veteran was on liquid oxygen counts as an instance.

This notice is to correct the response date from July 30, 2015 to September 8, 2015.

Pre-solicitation Notice: The solicitation will be posted on or about 8/06/2015



NCO-23 will be soliciting for:

HOME OXYGEN DELIVERY & SERVICE

Veteran Integrated Service Network 23 (V23) currently serves an estimated 4,861 home oxygen patients in a 10-state area with the bulk of the catchment area residing in the states of Minnesota, North and South Dakota, Iowa, and Nebraska. The Contractor awarded this program requirement will service that entire multi-state area and its home oxygen patients. The contract period will be a base year plus four option years.

The Home Oxygen Program is a 24 hour/day service, seven days a week and encompasses (i) the delivery and set up of prescribed Home Medical Equipment (HME); (ii) Veteran/caregiver education on services, equipment, basic home safety review, and establishing the schedule for ongoing deliveries (iii) preventive maintenance / inspection's (PMI) for equipment (iv) pick-up and cleaning of equipment when services discontinued (v) providing 24-hour emergency services with the ability to provide services at the VA beneficiary's (Veteran) home with a maximum of 6 hours of a call (most emergency services to be provided within 2 hours of a call) (vi) compliance with standards and regulatory bodies governing home care and oxygen usage such as:



" American Respiratory Care Foundations 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 Standard for Home Care, current year standard



(vii) Quarterly reports to VA per contract (e.g. incidents reports, infection control, customer service, etc.)

The term "home respiratory care" or "home oxygen therapy" pertains to the provision of home oxygen therapeutic services necessary to assist the eligible Veteran with oxygen in the home setting. Oxygen is a drug and must have a current prescription (minimally renewal is annually) to include necessary equipment and supplies. The program uses a multidisciplinary approach, involving members of Medical Service and Respiratory Therapy, Prosthetic and Sensory Aids Service (PSAS), Contracting, Accounting, and or performance improvement staff for compliance with the Joint Commission (TJC) standards. There are three primary methods for providing oxygen therapy in the home: (1) Compressed gas, (2) Oxygen concentrators, and (3) Liquid oxygen. The contract prices together with the Veteran's physical condition, daily activities, and projected liter flow rate will be the determining factors in choosing the most economical delivery system in each case and will be determined by the prescribing VA practitioner.

The state of North Dakota requires a Respiratory Therapist for the initial set up of home oxygen service; otherwise the program itself does not require Contract staff to have a clinical license as the clinical oversight for Veterans in the home oxygen program is the responsibility of the VA clinical staff. The Contract staff is expected to have competencies in equipment delivery and set up, PMI, universal precautions (e.g. infection control), etc. as outlined by the contract's scope of work and most current Joint Commission Standards including National Patient Safety Goals. In addition, the Contractor is expected to adhere to the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the National Standards to Protect the Privacy and Security of Protected Health Information (PHI). The contractor is required to be in compliance with all the Joint Commission Standards pertaining to home care for the duration of the contract.

The North American Industry Classification System (NAICS) code for this project is 532291 Home Health Equipment Rental with an associated small business size standard of $32.5 million dollars.