2021-0050 JOFOC CNH 36C26119D0067 P00002_Redacted.pdf

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID: 36C26119D0067 P00002

1. Contracting Activity:

Department of Veterans Affairs, VISN 21, Network Contract Office (NCO) 21 for the Veterans Affairs Pacific Islands Healthcare System (VAPIHCS)

2. Nature and/or Description of the Action Being Processed:

The current contractor, Island Health Care Limited Partnership, dba Aloha Nursing and Rehab, is providing Community Nursing Home (CNH) services in Honolulu, Hawaii through the Indefinite Delivery Indefinite Quantity (IDIQ) contract 36C26119D0067 with two one-year ordering periods which expires April 30, 2021. This JOFOC seeks to increase the IDIQ ceiling in the amount of $1,000,000 from $6,000,000 to $7,000,000. The ceiling increase is needed to provide continuity of services under the established IDIQ ordering period. The period of performance will remain the same. The requirement for a ceiling increase is due to increased demand for nursing home services and the additional number of eligible veterans being placed at this facility; however, the time on the contract is not being extended.

3.

The proposed modification is to increase the ceiling of IDIQ contract 36C26119D0067, therefore providing uninterrupted community nursing home services that meet total medical, nursing, and psychosocial needs of VA beneficiaries:

All nursing home facilities must have current Center for Medicare and Medicaid Services (CMS) certification (Medicare and/or Medicaid) and a State nursing home license.

The VA requires CNHs to have bed capacity to ensure their ability to take referrals when requested. The CNH can accept VA referrals in a timely fashion (ideally within 24 hours of request).

Provider visits must be provided at the rate of one (1) visit per month. Laboratory, x-ray, and other special services will be available to VA patients as needed. In addition, the care

VHAPM Part 806.3 Other Than Full and Open Competition (OFOC) SOP Attachment 2: Request for Sole Source Justification Format >SAT

OFOC SOP Revision 10 Page 2 of 5 Original Date: 03/22/11 Revision 10 Date: 09/10/2020 provided will include room, meals, nursing care, and other services or supplies commensurate with the VA-authorized level of care, without extra charge.

The per diem rate(s) established in this IDC include the cost of primary medical care, one

(1) provider visit per month and needed consultation, drugs and routine supplies, laboratory, x-ray, and other special services authorized by VA, unless otherwise specifically excepted.

Full attention shall be given to motivating and educating patients to achieve and maintain independence in the activities of daily living. Every effort shall be made to keep patients ambulatory and to achieve an optimal level of self-care.

4. Statutory Authority Permitting Other than Full and Open Competition:

(X) (1) Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements per 41 USC §3304(a)(1) as implemented by FAR 6.302-1;

( ) (2) Unusual and Compelling Urgency per 41 USC §3304(a)(2) as implemented by FAR 6.302-2;

( ) (3) Industrial Mobilization, Engineering, Developmental or Research Capability or Expert Services per 41 USC §3304(a)(3) as implemented by FAR 6.302-3;

( ) (4) International Agreement per 41 USC §3304(a)(4) as implemented by FAR 6.302-4 ( ) (5) Authorized or Required by Statute per 41 USC §3304(a)(5) as implemented by FAR 6.302-5;

( ) (6) National Security per 41 USC §3304(a)(6) as implemented by FAR 6.302-6;

( ) (7) Public Interest per 41 USC §3304(a)(7) as implemented by FAR 6.302-7;

5.

the Use of the Authority Cited Above (applicability of authority):

As prescribed in VHA Handbook 1143.2, for more than 35 years the CNH Program has maintained two cornerstones: some level of patient choice in choosing a nursing home close to e approach to local oversight of CNHs.

The quality of care for the veteran is accomplished through placement in a nursing home that is in close proximity to where the veteran and acement decision is made by VA, the veteran, ll be based on established VA contracts in the area. The geographic factor in these circumstances makes this requirement unique and, therefore, not subject to competition.

Aloha Nursing & Rehab currently has 23 veterans being treated at their facility. The nursing home meets VA exclusion review quality of care standards. The nursing home has had a contract vehicle in place with the VA since 2014 and has consistently provided excellent care to our Veterans. It would cause medical hardship on the 23 patients to move them, may disrupt treatment plans, and may be disruptive to family members if relocated to a different facility.

OFOC SOP Revision 10 Page 3 of 5 Original Date: 03/22/11 Revision 10 Date: 09/10/2020

6. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable:

A notice of the proposed contracting action as represented within this justification document will be made in accordance with FAR Subpart 5.2.

7. Determination by the CO that the Anticipated Cost to the Government will be Fair and Reasonable:

Rates and established performance periods remain unchanged as previously awarded under the established IDIQ ordering periods. Fair and reasonable pricing was determined in accordance with FAR 13.106-3(a)(2). Pricing was evaluated to be fair and reasonable based on a comparison to the Independent Government Cost Estimate (IGCE) and established Medicare Resource Utilization Group (RUG) rates and or Medicaid rates. The Government estimate was prepared based on established Medicare RUG rates for various levels of care and established VA nursing home rates based on VA national guidelines for determining cost for VA nursing home contracts.

8. Description of the Market Research Conducted and the Results, or a Statement of the Reasons Market Research Was Not Conducted:

9. Any Other Facts Supporting the Use of Other than Full and Open Competition:

VHA Handbook 1143.2 allows for a level of veteran choice in choosing a nursing home close to the Since there are Veterans are curren facility, the VA does not intend on disrupting their care in order to place them at a different facility

10. Listing of Sources that Expressed, in Writing, an Interest in the Acquisition:

The current contractor, Aloha Nursing & Rehab, will continue to provide services for the veterans residing there.

11. A Statement of the Actions, if any, the Agency May Take to Remove or Overcome any Barriers to Competition before Making subsequent acquisitions for the supplies or services required:

The ceiling increase is only a short-term solution until April 30, 2021, at which time a new long-term contract will be established. Based on the inherent nature of the service and in line with VA policy where the veteran and his/her family play a role in determining which nursing home facility will provide treatment for the veteran, the opportunity to increase competition is limited.

Notwithstanding the foregoing limitations, the Government intends to post an open and continuous

OFOC SOP Revision 10 Page 5 of 5 Original Date: 03/22/11 Revision 10 Date: 09/10/2020

c. VHA RPO HCA Review and Approval: I have reviewed the foregoing justification and find it to be complete and accurate to the best of my knowledge and belief and recommend approval (if over $68 million) or approve ($700K to $68 million) for other than full and open competition.

Curtis M. Jordan Date Executive Director, Regional Procurement Office West Head of Contracting Activity (HCA)