36C24222D0010 APPROVED JA for OFOC - FLHCS TEMPORARY NURSE AND NURSE SUPPORT STAFF - GHOST RX.pdf

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID: 36C242-21-AP-3262

1. Contracting Activity:

Department of Veterans Affairs, Regional Procurement Office East, Network Contracting Office 2 (NCO 2), Canandaigua VA Medical Center, 400 Fort Hill Avenue, Canandaigua, NY 14424

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

Network Contracting Office (NCO) 2 intends to award a sole source contract to Ghost RX, Inc., a Service-Disabled Veteran Owned Small Business (SDVOSB), registered in the Vendor Information Pages (VIP) for Temporary Nurse and Nurse Support Staff Services in support of the VA Fingerlakes Healthcare System (VAFLHCS) while recruitment continues to fill nursing vacancies at the Bath and Canandaigua VA Medical Centers. This requirement seeks to fill 11 vacancies on a temporary basis, comprising of 3.0 FTE Registered Nurses (RNs), 3.0 FTE Licensed Practical Nurses (LPNs), and 5.0 FTE Certified Nursing Assistants (CNAs).

The proposed sole source contract is for a one-year Firm Fixed Price (FFP) Indefinite Delivery/Indefinite Quantity (IDIQ) contract with two (2) three-month option periods.

The anticipated base period of performance is November 1, 2021 through October 31, 2022, with the option to extend services for up to an additional six-months should there continue to be difficulty recruiting, hiring, and onboarding permanent VA staff at these locations.

3. Description of Supplies/Services Required to Meet the Agency’s Needs:

The VAFLHCS has an immediate need for nurse and nurse support staff services.

Presently, VAFLHCS has experienced staffing levels that are critically low due to extended medical leave/Family Medical Leave Act (FMLA) absence, retirements, transfers, resignations, and terminations. A robust recruitment process has been in progress, but the hiring lag time is a factor in getting qualified staff on board. To continue to provide care to their Veteran inpatient long-term care residents 24 hours/7 days a week during this staffing shortage, Nursing has been detailing staff from other areas, which results in increased workload in those areas and decreased nurse satisfaction, in addition to utilizing voluntary and involuntary overtime. Temporary staffing is needed to fill the gaps between vacancies and on-board nursing staff and to prevent staff fatigue and exhaustion, which is occurring as a result of overtime use to fill the work hours/vacancy gaps needed to provide care.

Specifically, VAFLHCS has requested a total of 6.0 FTE RNs, 6.0 FTE Licensed Practical Nurses and 10.0 FTE Certified Nursing Assistants, which includes overtime and holiday pay. The government estimate for these services is $4,973,887.45 based on the number of hours estimated for one base year plus two (2) three-month option periods.

Request for SDVOSB/VOSB Sole Source Justification Format >SAT – Acquisition Plan 36C242-21-AP-3262, Temporary Nurse and Nurse Support Staff Services

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Given the urgency of the request and the high volume of required positions, a decision was made to split the request into two (2) separate requirements with VIP-verified SDVOSBs, each seeking to fill 3.0 FTE RNs, 3.0 FTE Licensed Practical Nurses and

5.0 FTE Certified Nursing Assistants. This approach provides more opportunity to the SDVOSB community than a single award, and also increases the likelihood of expeditious filling of positions since two businesses are filling the requirement. Each requirement is estimated at approximately $2,486,943.73 for one base year plus two

(2) three-month option periods. A separate JOFOC will be routed for the second portion of the requirement.

Due to the amount of time it takes to on-board and train VA nurses, it is felt that this timeframe will offer VA efficiency and well-trained contract staff as recruitment activities continue. It is expected that staffing needs will likely change throughout the year as permanent VA hires are made. The resulting contract will need to allow variation in the number of hours required, so an IDIQ contract is best suited to meet this need. In accordance with 38 USC § 8127(c), the contract maximum will not exceed $5,000,000.00.

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

41 USC §3304(a)(5), 38 U.S. Code § 8127(c), as implemented by VAAR 819.7007 and FAR 6.302-5 (Authorized or Required by Statute). COs may use the non-competitive (sole source) procedures authorized in VAAR 819.7007 or 819.7008 up to $5,000,000. Check the specific VAAR clause used below:

(x) 819.7007 Sole source awards to a verified service-disabled veteran-owned small business; or ( ) 819.7008 Sole source awards to a verified veteran-owned small business

5. Demonstration that the Contractor’s Unique Qualifications and/or Nature of the Acquisition Requires the Use of the Authority Cited Above (applicability of authority):

Pursuant to 38 U.S.C. § 8127(c) a sole source award to a SDVOSB concern is authorized where the SDVOSB concern is determined to be a responsible source with respect to performance of the contract; the anticipated award will exceed the simplified acquisition threshold but will not exceed $5,000,000; and the contract award can be made at a fair and reasonable price that offers best value to the United States. Ghost RX, Inc. (DUNS No. 879125743) is a verified SDVOSB by the Center for Veteran Enterprise (CVE) on the Vendor Information Pages (VIP), last verified on June 17, 2020 with an expiration date of June 17, 2023. Additionally, Ghost RX, Inc. has performed satisfactorily on contracts for similar services both within VISN 2 and with other VA locations.

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6. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable, including whether a notice was or will be publicized as required by subpart 5.2 and, if not, which exception under

5.202 applies:

A Request for Information (RFI) was sent to all SDVOSB and VOSB FSS Schedule 621i contract holders for SINs 025 (Registered Nurse), 038 (Licensed Practical Nurse), and 040 (Certified Nurse Assistant) via email on September 13, 2021. The RFI provided an opportunity for the identified businesses to respond with their interest and capability to provide the described requirement. A total of 9 responses were received from VIP-verified SDVOSBs, including the response from Ghost RX, Inc. There were no VOSB responses.

Due to the urgent and immediate need for the requested staffing, no other outreach was conducted. In the event services are needed beyond the short-term contract actions, they will be procured on a competitive basis.

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

The Contracting Officer will determine fair and reasonableness of the proposed prices through a comparison of those prices to the Independent Government Cost Estimate (IGCE), market research, and other available price analysis techniques in accordance with FAR 13.106-3(a)(2). The Government has ample recent pricing information available through other contracts for similar services to assist with this determination as temporary staffing services have been utilized extensively.

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

NCO 2 conducts ongoing market research for temporary health care staffing firms to fulfill various staffing needs within VISN 2. Market research to identify sources has historically been conducted through the publishing of Sources Sought Notices on www.beta.sam.gov, review of Federal Supply Schedule (FSS) Professional and Allied Healthcare Staffing Services (Schedule 621i) and informal RFIs, as well as outreach among Health Care Resource (HCR) Contracting Officers both within NCO 2 and other NCOs that have temporary staffing requirements.

Recent market research has shown there are several SDVOSBs that provide nurse staffing services, and there is typically interest from SDVOSBs regarding health care staffing requirements for this region. Of those vendors that express interest, CO knowledge of existing contracts provides insight about how well they have performed on current and prior staffing requirements in order to make an educated determination on the likelihood of success in fulfilling a requirement.

https://www.acquisition.gov/content/part-5-publicizing-contract-actions https://www.acquisition.gov/content/part-5-publicizing-contract-actions http://www.beta.sam.gov/

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The following market research was conducted to identify potential sources to fulfill this requirement:

i. A search was conducted in VIP for both SDVOSBs and VOSBs under NAICS 561320 – Temporary Help Services resulting in the identification of 780 SDVOSBs and 120 VOSBs. It was impossible to determine whether the identified companies were capable of fulfilling the subject requirement as the NAICS code is very broad.

ii. Due to the large number of results from VIP, an RFI was sent to all SDVOSB and VOSB FSS Schedule 621i contract holders for SINs 025 (Registered Nurse), 038 (Licensed Practical Nurse), and 040 (Certified Nurse Assistant) via email on September 13, 2021. A total of 9 responses were received from VIP-verified SDVOSBs. There were no VOSB responses. Of the responses received, Ghost RX, Inc. was one of the businesses that appeared most capable of fulfilling the Government’s urgent high-volume requirement expeditiously and had favorable past performance for similar services in VISN 2 and elsewhere.

As a result, the following tasks were completed:

a. In a query of Center for Veteran Enterprise (CVE) on the Vendor Information

Pages (VIP), Ghost RX, Inc. was listed as a verified Service-Disabled Veteran Owned Small Business.

b. In a review of the System for Award Management (SAM) website, Ghost RX, Inc. (DUNS No. 879125743) is listed as a small business under this requirement’s NAICS Code 561320 (Temporary Help Services) with Size Standard of $30.0M.

c. In discussion with Ghost RX, Inc., it was confirmed that they foresee no difficulties fulfilling the described requirement expeditiously.

iii. A search was conducted in SBA’s Dynamic Small Business Search resulting in the identification of 1,511 SDVOSBs and 386 VOSBs under NAICS 561320 – Temporary Help Services.

iv. No additional outreach was conducted as a result of the information outlined in items i and ii, above, and the urgency of the requirement.

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

None. Pursuant to 38 U.S.C. § 8127(c) a sole source award to a SDVOSB concern is authorized where the SDVOSB concern is determined to be a responsible source with respect to performance of the contract; the anticipated award will exceed the simplified acquisition threshold but will not exceed $5,000,000; and the contract award can be made at a fair and reasonable price that offers best value to the United States. Ghost RX, Inc. is a verified SDVOSB by the Center for Veteran Enterprise (CVE) on the

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Vendor Information Pages (VIP). Ghost RX, Inc. (DUNS No. 879125743) has performed satisfactorily under other temporary staffing services contracts for similar services within VISN 2, as well as for other Veteran Integrated Service Networks.

Given the urgent need for nurse and nurse support staff, it is in the best interest of the Government to fulfill the immediate need by utilizing the statutory authority to negotiate on a sole source basis with a VIP-verified SDVOSB.

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

In addition to Ghost RX, the following sources expressed interest in the requirement:

Ansible Government Solutions, A-Team Solutions, Dilligas Corp dba US Got People, EGA Associates LLC, Millbrook Support Services, Nelson Enterprise Technology Services, One Stop Recruiting LLC, and Vighter LLC. These and other potential sources may be considered for any future competitive procurements.

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:

This procurement will result in a 1-year contract (with optional extensions of up to six-months) to fulfill an urgent and immediate need for temporary nurse and nurse support staff services. In the event the VAFLHCS is unable to hire permanent VA employees at the required levels, NCO 2 will work with VAFLHCS towards award of a competitive contract action for the stated requirement in order to minimize the need for future sole source requirements.

12. Requirements Certification: I certify that the requirement outlined in this justification is a Bona Fide Need of the Department of Veterans Affairs and that the supporting data under my cognizance, which are included in the justification, are accurate and complete to the best of my knowledge and belief.

Lorraine A. Hussain Date Acquisition Utilization Specialist VA Fingerlakes Healthcare System

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13. Approvals in accordance with the VHAPM Part 806.3 OFOC SOP:

a. Contracting Officer or Designee’s Certification (required): I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief.

Lauren M. Helming Date Contracting Officer Network Contracting Office, NCO 2

b. One Level Above the Contracting Officer (Required over the SAT but not exceeding $700K): I certify the justification meets requirements for other than full and open competition.

Allan M. Preston Date Branch Chief, Medical Sharing Network Contracting Office, NCO 2

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.

Joseph P. Maletta Date Executive Director, RPO East Head of Contracting Activity (HCA) https://vaww.pclo.infoshare.va.gov/PMWeb/VHAPM_Part_806.3.aspx

Date8_af_date: 10/7/21