36C24223D0074- APPROVED JA FOR OFOC- SYRACUSE VAMC- PRESBYTERIAN HOME SOCIAL ADHC SERVICES.pdf

Justification and Approval for Other Than Full and Open Competition 36C242-23-AP-1345

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID: 36C242-23-AP-1345

1. Contracting Activity: Department of Veterans Affairs, Regional Procurement Office (RPO) East, Network Contracting Office (NCO) 2, Bath VA Medical Center, 76 Veterans Avenue, Bath, NY 14810 procuring the request on behalf of the Syracuse VA Medical Center, in Veterans Integrated Service Network (VISN) 2 located at 800 Irving Avenue, Syracuse, NY 13210.

2. Nature and/or Description of the Action Being Processed: This contract is for social model adult day health care (ADHC) services for eligible beneficiaries of the Syracuse VA Medical Center. The Contractor provides adult day health care services to meet the social needs of VA beneficiaries and any specialty care services as identified (i.e. caregiver respite, toileting, ambulation and transferring, socialization, etc) as a particular need in the ADHC program. In accordance with FAR 13.5 Simplified Procedures for Certain Commercial Items and specifically FAR 13.501, Special Documentation Requirements, this acquisition is conducted under Simplified Acquisition Procedures and is exempt from the requirements of FAR Part 6, but requires a justification using the format of FAR 6.303-2.

A new, fixed price (FP) Indefinite Delivery, Indefinite Quantity (IDIQ) will be awarded to replace the subject Contractor’s current Basic Ordering Agreement (BOA), VA528-16-G-0003. In accordance with a Directive issued by VHA Procurement Executive Director on June 9, 2022, VA will discontinue use of Basic Ordering Agreements for adult day health care and nursing home services to comply with Procurement Policy Memorandum 2016-02.

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

Social model adult day care health services have proven as to be an effective tool for Syracuse VAMC to prevent or prolong Veterans from needing full-time nursing home care, especially Veterans with dementia who do not otherwise meet requirements for medical model services.

A review of potential acquisition alternatives was performed and determined that no acceptable options were available. Veteran Care Agreements (VCAs) are not a feasible alternative, as the Office of Community Care Fee Schedule reimburses at significantly higher rates than negotiated contract rates in the Syracuse, NY region.

Negotiated-rate VCAs are not available through the Office of Community Care at this time. VCA reimbursement would impact the Syracuse VAMC budget and would limit the availability of services for Veterans. Social model adult day health care services are not provided on-site at the Syracuse VA Medical Center. Social model services

Subj: Justification and Approval for Other Than Full and Open Competition 36C242-23-AP-1345 are used when Veterans do not meet qualifications for medical model adult day health care services provided though the Community Care Network (CCN) contracts with VA Optum. VA Optum does not credential/accept social model adult day health care providers in the VISN 2 region (CCN Region 1).

The total estimated value of this requirement is $738,400.00. A 1358 will be used to cover the cost of the requirement, obligation number 528-Y34069. The planned performance period award will be for five (5) continuous years, without options. The anticipated start date is 08/01/2023.

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. Demonstration that the Contractor’s Unique Qualifications or Nature of the Acquisition Requires the Use of the Authority Cited Above (applicability of authority): FAR 6.302-1 is applicable, since a Veteran placement in an ADHC requires a geographic closeness to the family of the patient to maintain necessary quality of care for the Veteran. Placing a Veteran in an ADHC in the vicinity of his/her family and friends meets the “only one responsible source” under the FAR and is authorized by VHA Handbook 1141.03. It was determined that competition would not be appropriate. Two Veterans currently receive ADHC services from the subject Contractor and are satisfied with the services.

6. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable: It is not feasible to obtain competition based on market research, since the “only one responsible source” under the FAR is met as outlined in section 5, above. The necessary quality of care for the Veteran is only accomplished through placement in an ADHC in a particular locale in close proximity to the Veteran’s family and friends. Competition could lead to a placement in a distant location. Then the Veteran’s family and friends could be either in an inconvenient location or great distance away which would interfere with quality of care for the Veteran. Notably, instead of competition, VA’s community ADHC program placement decision is made by VA, the Veteran, and the Veteran’s family when they choose from available VA contracts and factor in where the Veteran and the Veteran’s family reside. If other potential sources are identified and there is a bona fide need for services, the Geriatric & Extended Care Coordinator would conduct an assessment and refer a new request to the Network Contracting Office.

7. Determination by the CO that the Anticipated Cost to the Government will be Fair and Reasonable: Reimbursement for these services is a per diem rate based on half day or full day services plus additional charges for one-way or round-trip transportation when clinically indicated. Private per diem rates are provided as the basis of the rates, Medicaid or Medicare rates are not applicable social model services. The Contract Specialist will evaluate the proposed rates against historical awards for social model services, in accordance with FAR 13.106-3(2)(ii). Rates will also be compared to the Office of Community Care 2023 Fee Schedule used for reimbursement for Veteran Care Agreements and CCN/Optum. If rates cannot be determined fair and reasonable, a contract will not be awarded.

8. Description of the Market Research Conducted and the Results, or a Statement of the Reasons Market Research Was Not Conducted: The Contract Specialist conducted searches on the Veteran Information Pages (VIP), the Small Business Administration (SBA) Dynamic Small Business Search Tool and the Federal Procurement Data System (FPDS-NG). A limited number of potentially capable vendors were identified, many of which currently have BOAs with the Syracuse VA Medical Center and will require IDIQ contracts in the future.

It was determined that competition would not be appropriate because the “only one responsible source” is met when the Veteran and the Veteran’s family select (on a sole source basis) an ADHC in a particular geographic location near family, so no competition is required for quality of care reasons.

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

In 2022, VA Central Office (VACO) combined Homemaker and Home Health Aide (HHA), ADHC and in-home respite into “personal care services” and increased the number of hours available to Veterans for these services. There is an anticipation that demand for services will increase due to the expansion in the number of hours available, coupled with the shortage of HHA service providers in the community.

Veterans waiting on a waitlist for VA HHA services are switching to social model adult day health care services as an alternative to home HHA care.

Presbyterian Home for Central New York provides a valuable ADHC program for the use of eligible beneficiaries of the Syracuse VAMC. Any disruption to services would create a burden to Veterans and their caregivers. The VA MISSION Act of 2018 Public Law No: 115-182 (Sec. 101) (06/06/2018) requires that the VA must coordinate health care to eligible Veterans by ensuring the continuity of services and ensuring that eligible Veterans do not experience a lapse in care or an unusual or excessive burden in accessing care due to errors or delays by the VA or its contractors.

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

Presbyterian Home for Central New York, a large non-profit organization.

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: Further market research is not necessary for the reasons stated in sections 5 and 6, above.

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.

Steve Pereira Date Geriatric & Extended Care Coordinator, COR Syracuse VA Medical Center

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.

Heather Schrader Date Contracting Officer, Medical Sharing Network Contracting Officer (NCO 2)

b. One Level Above the Contracting Officer (Required over SAT but not exceeding $750K): I certify the justification meets requirements for other than full and open competition.

Jadwiga Kustra Date Division Chief Network Contracting Officer (NCO 2) https://dvagov.sharepoint.com/sites/VHAProcurement/VHAPM/VHAPM_Part_806.3.aspx