Q999--Durable Medical Equipment - VISN wide Contract(s) (VA-19-00090167)

STATEMENT OF WORK DELIVERY OF DURABLE MEDICAL EQUIPMENT 1. OVERVIEW OF SERVICES Contractor shall provide storage, delivery, installation, repair (when required) and pick-up of VA owned durable medical equipment for beneficiaries of the Department of Veterans Affairs (VA) Medical Centers in the VISN 20 patient service catchment areas (Anchorage, AK; Boise, ID; Portland, OR; Puget Sound, WA; Roseburg, OR; Spokane, WA; Walla Walla, WA; and White City, OR) in strict accordance with the terms and conditions of this statement of work. 2. GOVERNMENT OWNED ITEMS Contractor shall deliver or pick up recovered government-owned equipment, e.g. wheelchairs, power chairs, scooters, hospital beds, trapezes, patient lifts, etc., in accordance with the terms, conditions and specifications set forth herein. Deliveries and pickups to be made at such times and in such quantities as required and as specified by the VA Contracting Officer or his/her designee. Delivery and pick up charges shall be in

accordance with rates specified. 3. TIME FRAME FOR DELIVERY/PICKUP SERVICES Contractor shall deliver or pick up an item or items within three working days from receipt of notification from the Program Manager, Prosthetics and Sensory Aids Service (PSAS), Contracting Officers Representative (COR) or his/her designee. Contractor shall pick up or deliver an item within 24 hours when an emergency service is specified by the PSAS or COR. If a situation arises where the delivery cannot be scheduled within three working days after notification, the initiator of the VA delivery order shall be contacted immediately. 4. WORK HOURS The services covered by this contract shall be furnished by the Contractor as defined herein. The Contractor shall be available as scheduled. The Contractor shall not be required, except in case of emergency, to furnish such services on a Federal Holiday or during off-duty hours as described below: The following terms have the following meaning: Work Hours: Monday through Friday, 8:00 a.m. to 4:30 p.m. Non-Work Hours: Monday through Friday, 4:31 p.m. 7:59 a.m., and all Saturdays and Sundays. Federal Holidays: The holidays observed by the Federal Government are: New Year s Day January 1 Martin Luther King Jr. Birthday Third Monday in January Presidents Day Third Monday in February Memorial Day Last Monday in May Independence Day July 4 Labor Day First Monday in September Columbus Day Second Monday in October Veterans Day November 11 Thanksgiving Day Fourth Thursday in November Christmas Day December 25 or any other day specifically declared by the President of the United States of America to be a Federal Holiday. When one of the holidays falls on Sunday, the following Monday shall be observed as a Federal Holiday. When a holiday falls on a Saturday, the preceding Friday shall be observed as a Federal Holiday. 5. DELIVERY LOCATIONS The following represents primary delivery locations for each VA Medical Center this list is not all inclusive: 5.1. Geographic Area One: Alaska VA Healthcare System (463) The following municipalities in Alaska Zone 1 but not limited to: Anchorage, Kenai Peninsula, Matanuska-Susitna, Valdez-Cordova, Yakutat, Haines, Skagway-Hoonah-Angoon, Juneau, Sitka, Wrangell-Petersburg, Ketchikan Gateway, Prince of Wales-Outer Ketchikan, Kodiak Island The following municipalities in Alaska Zone 2 but not limited to: Southeast Fairbanks, Denali, Fairbanks North Star, Yukon-Koyukuk The following municipalities in Alaska Zone 3 but not limited to: Lake and Peninsula, Aleutians East, Aleutians West, Bristol Bay, Dillingham, Bethel, Wade Hampton, Nome, Northwest Arctic, North Slope 5.2. Geographic Area Two: Puget Sound Health Care System (Seattle and American Lake Divisions) (663) The following counties in Washington but not limited to: Whatcom, San Juan, Skagit, Clallam, Jefferson, Snohomish, King, Pierce, Kitsap, Grays Harbor, Mason, Thurston, Lewis 5.3. Geographic Area Three: Mann-Grandstaff (Spokane) VA Medical Center (668) The following counties in Washington but not limited to: Okanogan, Chelan, Douglas, Kittitas Grant, Stevens, Spokane, Lincoln, Kootenai, Benewah, Ferry, Adams, Pend Reille, Whitman The following counties in Idaho but not limited to: Boundary, Bonner, Kootenai, Benewah, Latah, Shoshone The following counties in Montana but not limited to: Lincoln, Sanders 5.4. Geographic Area Four: Jonathan M Wainwright Memorial (Walla Walla) VA Medical Center (687) The following counties in Washington but not limited to: Yakima, Benton, Franklin, Walla Walla, Columbia, Garfield, Asotin The following counties in Oregon but not limited to: Umatilla, Union, Wallowa The following counties in Idaho but not limited to: Nez Perce, Clearwater 5.5. Geographic Area Five: Boise VA Medical Center (531) The following counties in Idaho but not limited to: Clearwater, Nez Perce, Lewis, Idaho, Adams, Washington, Valley Boise Lemhi, Custer, Butte, Washington, Payette, Gem, Elmore, Canyon, Ada, Camas, Blaine, Owyhee, Gooding, Lincoln, Minidoka, Twin Falls, Cassia The following counties in Oregon but not limited to: Baker, Grant, Harney, Malheur 5.6. Geographic Area Six: VA Portland Health Care System (648) The following counties in Oregon but not limited to: Washington, Clackamas, Multnomah, Polk, Marion, Linn, Lincoln, Benton, Tillamook, Hood River, Wasco, Sherman, Deschutes, Jefferson, Crook The following counties in Washington but not limited to: Pacific, Wahkiakum, Cowlitz, Clark, Skamania, Klickitat 5.7. Geographic Area Seven: VA Roseburg Health Care System (653) The following counties in Oregon but not limited to: Lane, Douglas, Coos, Curry 5.8. Geographic Area Eight: VA Southern Oregon Rehab Center & Clinics (White City) (692) The following counties in Oregon but not limited to: Josephine, Jackson, Klamath, Lake The following counties in California but not limited to: Del Norte, Siskiyou, Modoc, Shasta 6. NON-SOLICITATION/NON-DISCRIMINATION Contractor shall conduct business hereunder, only with the appropriate VA office and in no case deal directly with or solicit beneficiaries of the VA. The contractor shall provide all services specified in this contract for any person determined to be eligible by the PSAS, COR or his/her designee regardless of the race, color, sex, religion or national origin of the person(s) to whom such services are rendered. The contractor further warrants that he/she shall not resort to sub-contracting as a means of circumventing this provision. 7. QUALIFICATIONS 7.1. Offers shall be considered only from bidders who are regularly established home and healthcare businesses and who are financially responsible and have the necessary equipment, personnel and facilities to furnish service in the volume specified for all requirements under this contract. Successful contractors shall meet all requirements of the State and City codes regarding operations of this type of service. 7.2. Contractor must meet Joint Commission (or an equivalent accreditation body) standards for providing these services, and provide documentation of meeting such standards. The contractor shall be asked to submit a completed Periodic Performance Review (documentation of meeting Joint Commission standards) annually--90 days prior to the end of the contract period. 8. EQUIPMENT, STORAGE AND INVENTORY CONTROLS 8.1. All equipment and supplies initially provided under the terms of this contract shall be jointly inventoried by the contractor and VA designated official. The property shall be immediately placed on the inventory listing by the contractor who must ensure an accurate inventory record is available and maintained at all times. 8.2. The contractor shall maintain a separate, detailed cumulative inventory of all items stored under the terms of this contract. Inventory listing shall contain information as to the location, condition, disposition, manufacturer, model, serial number, and any modification(s) incorporated therein. It shall also include documentation that the items have been serviced, functioned checked, cleaned, and stored in accordance with the terms of the contract and Joint Commission standards. A copy of this inventory shall be provided to the COR (or designee) after close of business on the last workday of each month. 8.3. All items listed on the inventory shall be made immediately available for issue/reissue. The contractor shall maintain a clean environment for storage and delivery of equipment and delivery vehicle(s). Equipment management shall be compliant with established Joint Commission guidelines and standards. 8.4. All government owned property (GOP) shall be individually labeled and easily identified. The VA contracting officer or COR (or designee) may conduct joint inventories at any time. 8.5. The contractor shall request disposition instructions for all items that can t be reissued. The PSA Program Manager/ COR shall inform the contractor in writing of the method to be used for disposing of items. For items that leave the contractor s possession for repairs or other authorized reasons, a receipt shall be obtained by the contractor and kept available for proper record keeping. 8.6. The contractor may be held financially liable for replacement cost for all property turned over to the contractor by the VA, or picked up from Veteran beneficiaries upon request of the VA, when it can t be accounted for as a result of joint inventories. Replacement equipment that is lost due to contractor negligence shall be purchased by the VA and charged to the contractor. 9. DELIVERY/SET UP/ADJUSTMENTS AND INSTRUCTIONS OF GOP When medical equipment that has been recovered from Veteran beneficiaries is to be reissued, the contractor agrees to reissue these items first and to deliver, set up, adjust, and instruct in their care and use at the rate specified on this contract. If reissued equipment or stock is not available, the VA Prosthetics staff shall procure the item then the contractor shall deliver, or set-up, if drop shipped to the patient s home. A receipt or notice of delivery showing contractor s name, telephone number, and address shall be provided to the Veteran/caregiver in the event service or repairs are required. The contractor shall furnish a delivery checklist, copy of the Patient Rights and Responsibilities, and verification of education to be signed and dated by the Veteran/caregiver and the delivery person. A copy of this delivery checklist shall be included with each invoice submitted for payment. 10. HOSPITAL BED MATTRESSES In all cases where a hospital bed is to be issued or re-issued, a new standard mattress shall be furnished. The contractor shall dispose of all standard mattresses recovered from VA beneficiaries. Specialty mattresses shall not be disposed of without the consent of the PSA Manager or COR. 11. PROOF OF DELIVERY The contractor shall be responsible for insuring that the Veteran/caregiver is home when delivery is scheduled. The government assumes no liability for additional trips required if no one is home when delivery is attempted. Contractor shall be required to provide proof of delivery. Proof of delivery shall be receipt of delivery checklist to include equipment serial number, signed and dated by the Veteran/caregiver and delivery person. 12. PATIENT RECORDS Records of deliveries, pick-ups, etc., to Veteran beneficiaries shall be maintained at the contractors local office servicing this contract. Records shall include, but are not limited to, signed and dated delivery checklist, copy of patient education, copy of VA delivery order, and a copy of submitted invoice. Invoice shall contain name and address of Contractor, invoice date, patient name, date when order was received, service provided to patient and at what address and date of service. A copy of the patient record shall be submitted to the COR within 5 business days of the service rendered. Upon termination of this contract, the original records shall be given to the COR or designee within 30 days. 13. ROLES AND RESPONSIBILITIES Role and/or Responsibility VA Medical Center or designee Contractor 1. Delivery Process VA Prosthetics staff shall review order, verify need, initiate delivery order and contact contract vendor. Responsible for furnishing equipment and supplies as ordered to VA beneficiaries in a professional manner. 2. Patient Education Contract vendor shall supply VA Prosthetics staff with copies of the educational materials provided to patients for review and concurrence. VA Prosthetics staff, in conjunction with the appropriate medical center staff, shall work to overcome any identified barriers to learning. Responsible for providing comprehensive, easily understood, well documented patient education specific to the equipment delivered. Any barriers to learning shall be brought to the attention of VA Prosthetics staff immediately upon identification. 3. Home Assessment VA Prosthetics shall respond to any concerns identified by the contractor regarding safety and appropriateness of the equipment to be set-up in the patient s home. If VA Prosthetics is aware of any known potential environmental issues, every attempt shall be made to notify the contract vendor of these concerns. If deemed to be unsafe, shall refer back to the appropriate medical center staff to discuss with patient. Responsible for evaluating the home environment to ensure that the equipment can be safely installed in the patient s home. Any concerns related to safety or appropriateness of the equipment shall be immediately addressed with the PSAS Manager or COR prior to setting up equipment. All hazards associated with trips and falls shall be reported immediately. Any fall information verbalized by the patient shall be included with the report. 4. Discharge Planning VA Prosthetics staff shall contact the contract vendor when an item needs to be picked up from a patient s home. The contract vendor shall pick up the identified item. By the end of the billing period the contract vendor shall send verification of the pick-up, including description of the item and the serial number when applicable. 14. STORAGE OF RECOVERED EQUIPMENT 14.1. Recovered equipment shall be tagged as GOP, numbered for inventory purposes and shall include the name of the beneficiary from whom such equipment was recovered. GOP shall be kept segregated from contractor-owned equipment. A current inventory of equipment shall be kept at all times and shall irregularly be inspected and verified by the program manager, PSAS or his/her designee. Such inspections shall be conducted at the contractor s storage facility and copy of the current inventory shall be furnished to the VA at that time. The contractor shall be notified in advance should a Veteran or caregiver wish to pick up GOP in person. There shall be no charge for such a pick up. 14.2. The contractor shall provide a clean, pest/rodent free, secure contained area, with approximately 1000 square feet of space per medical center facility, for the storage of Government-owned supplies and equipment covered under this contract. Storage area must conform to all applicable State, Local and National Fire Protection Association Codes. In addition, the storage area must meet all State requirements for insurance. The contractor shall provide a warehouse location within 20 miles of each VA Medical Center herein this contract. 15. REPAIR OF EQUIPMENT Contractor shall, when requested, repair GOP (to include e.g. hospital beds, trapezes, patient lifts, etc.). Contractor shall submit a repair quotation for equipment with five workdays of such a request from the COR or designee. The Contractor shall be reimbursed for repairs based on the actual cost of parts and labor both of which shall be listed on the repair quotation. Some parts may be provided to the contractor by the government at the government s discretion. All repair quotations shall include tag or inventory number, serial number if applicable; the name of the beneficiary and an itemized listing of needed repairs to include parts and labor. No repairs shall be done without prior authorization from the PSAS Manager, COR or designee. If deemed economically feasible by the VA to repair such equipment, an authorization shall be forwarded to the contractor. If deemed infeasible to repair, the contractor shall be advised to list the equipment as SCRAP and to process it under the provisions below. 16. SCRAP ITEMS All items determined by the VA to be economically infeasible to repair or not usable for any reason shall be recycled or disposed of whichever is appropriate by the contractor only after approval by PSAS Manager or COR. 17. MILEAGE REIMBURSEMENT The contractor shall be reimbursed for mileage costs associated with pick-up and deliveries outside of a 50-mile radius of the associated VA Medical Center (requesting facility) to the delivery location. The reimbursement shall be based upon mileage estimates provided by MAPQUEST at www.mapquest.com. The reimbursement rate shall be the GSA contract rate for Privately Owned Vehicle Mileage Reimbursement found at www.gsa.gov. Payment for multiple deliveries performed on the same day in series shall be for actual mileage. 18. INFECTION CONTROL PROCEDURES 18.1. For the safety of our beneficiaries and contractor personnel, universal precautions shall be taken with all recovered equipment and during deliveries/pick-ups. Recovered equipment placed in delivery vehicle(s) shall be kept separate from clean equipment and shall be bagged and sealed. Gloves are to be worn when handling recovered equipment. If not worn, the delivery person shall wash his/her hands before handling clean equipment. If hand-on contact with patients is anticipated during the delivery/pick up, gloves should be worn. If not worn, the delivery person shall wash his/her hands after such contact. Repair items shall be cleaned and disinfected within the manufacturer s guidelines, and established Joint Commission standards, and stored separately from un-cleaned items. The tag denoting the items as GOP shall be annotated as cleaned . Staff members with a contagious disease shall have no contact with beneficiaries or clean equipment. Exceptions would be employees with mild cold or similar condition. In such a case, gloves shall be worn and contact shall be limited. 18.2. Contractor shall wash equipment per manufacturer guidelines. If no manufacturer guidelines exist then equipment shall be cleaned in detergent/disinfectant solution, LPH or equivalent. All recovered/reusable equipment shall be bagged accordingly, and labeled with data and placed in a non-contaminated storage area. All equipment and supplies removed from storage for delivery shall be inspected for cleanliness prior to delivery. 19. ADDITIONAL INFORMATION 19.1. The contractor shall immediately report to the PSAS Manager or COR all accidents, malfunctions, injuries, deaths, and equipment recalls related to delivery/ pick up of GOP. 19.2. Contractor shall provide documentation showing all personnel responsible for delivery; set up and recovery of durable medical equipment are trained in this area. This documentation shall include name of individuals, date of training, verified by a manager of the company. Contractor shall provide and document appropriate orientation programs for all employees involved in the delivery, set up and recovery of GOP, e.g., safety and equipment management appropriate to the services provided, electrical equipment set up, infection control procedures, patient confidentiality, handling emergencies, etc. Delivery technicians must have a current driver s license and criminal background check. Contractor must have written procedures to deliver, recover, receive, clean and when appropriate, sterilize reusable items. Such procedures must address separation of clean/unclean equipment in the storage and delivery of GOP. These policies must be maintained at each site where services under this contract are being provided. In addition, a copy of all policies regarding this contract shall be provided to the contracting officer or designee prior to beginning services under this contract. All equipment must be labeled or tagged and dated to document such procedures. 20. END OF CONTRACT RESPONSIBILITY Contractor agrees to provide all assistance necessary to coordinate the removal of government property from storage area at the conclusion of this contract. Removal of VA-owned items from the storage area shall be the responsibility of the succeeding contractor. 21. CONTRACTOR PHASE-IN REQUIREMENTS Within 5 calendar days after the start-work date of the contract, the contractor, at no additional cost to the VA, shall be responsible for picking up existing inventory from the previous/incumbent contractor s storage. 22. WARRANTIES ON REPAIRS The contractor shall warrant his repairs to the GOP for a period of at least ninety days. 23. ELECTRICAL REQUIREMENTS: If equipment being furnished requires electrical power and the Veteran s home does not have three pronged outlets, the contractor shall provide and install the three-pronged adapter with ground wire to complete the installation. In the event electrical outlets appear unsafe to the contractor or his/her representative, the program manager, the PSAS shall be notified immediately prior to equipment being set-up. All accidents, malfunctions, injuries, deaths, and equipment recalls related to the provision, delivery and use of GOP shall be reported to the Contracting Officer or COR. 24. ACCEPTANCE The PSAS Manager or COR shall be responsible for receipt, verification and acceptance of all services and equipment delivered under the terms of this contract. 25. FALLS PREVENTION PROGRAM The contractor shall provide documentation within 5 days from each visit of any obvious hazards that could cause trips or falls. Contractor shall question Veteran to determine if any falls have occurred, duration and frequency. Contactor shall also compile this data and provide it quarterly. Report shall provide the number of VA patients who fall as a result of DME equipment issued (Numerator), and the number of VA patients who receive DME equipment (Denominator). 26. PATIENT SATISFACTION PROGRAM The contractor shall develop and have approved by the PSAS Manager or COR a Satisfaction Survey. The Survey shall be issue specific, include comments area for complaints and other issues pertinent to the Veteran. Areas addressed but not limited to are: Pre-delivery set-up or removal coordination, vendor provided education, patient safety concerns, equipment set-up properly, equipment clean and in good condition, contractor courtesy, falls data, injuries from the equipment and satisfaction with the equipment. Contactor shall provide all original surveys to the VA, and compile satisfaction data and provide it quarterly. 27. SITE VISITS Periodic, scheduled and/or unscheduled, on-site contractor visits may be made by COR or designee to monitor the contractor s performance under this contract. The contractor agrees to make available all records and documentation necessary during the monitoring visits. Contractor shall abide by all HIPAA requirements and requirements pursuant to the Privacy Act (5USC 552a) as it applies to the contract. Contractor shall have PKI (Public Key Infrastructure) accessibility for protected communication with PSAS staff at VAMC facility. Payment: Contractor must accept a government purchase card (VISA) as the form of payment and possess a Level II purchase card capability. 28. QUALITY ASSURANCE PLAN The contractor shall develop and maintain a Quality Assurance Plan outlining processes and procedures in place to ensure strict adherence to this statement of work.