36C24419Q0461-002.pdf

VHAPM Part 808.405-6 Limiting Sources Attachment 2: Request for Limited Sources Justification Format >SAT

VHAPM Part 808.405-6 Limiting Sources Page 1 of 7 Original Date: 08/30/2017 Revision 01 Eff Date: 04/23/2018

LIMITED SOURCES JUSTIFICATION

ORDER >SAT

FAR PART 8.405-6

Acquisition Plan Action ID: VA-244-18-AP-4502

1. Contracting Activity: Department of Veterans Affairs, VISN 04, Lebanon VA Medical Center 1700 South Lincoln Ave, Lebanon, PA 17042

2. Description of Action: This acquisition is conducted under the authority of the Multiple- Award Schedule Program (41 U.S.C. 251 and 40 U.S.C. 501). This procurement is for a multiple year Blanket Purchase Agreement (BPA) for exam chairs off schedule 66 II A category A/A-79 in accordance with FAR Part 8.4 with a twelve month base period of performance and four twelve month option periods.

Order against: FSS Contract Number: V797P-4435B

Name of Proposed Contractor: Midmark Corporation

Street Address: 60 Vista Drive

City, State, Zip: Versailles, OH 45380

Phone: 937-526-8224

3. Description of Supplies or Services:

The estimated value of the proposed action is $ 1,023.523.50

Description/Part Number* Qty MI-626-003; Midmark 626 Barrier-Free® Examination Chair w/ Clean

126 Assist™ Roller System, } IQscale, receptacles, drawer heater, pelvic tilt, wireless controls, w/o top

MI-002-2000-XXX; 626 Premium Upholstery Top - 28" wide premium

XXX = Color of Upholstery; Dark Linen Code 856

MI-002-2002-XXX; 626 Premium Upholstery Top - 32" wide premium XXX = Color of Upholstery; Dark Linen Code 856 30 MI-9A600002; Patient Support Rails, rails only, pair, field installed 126 MI-9A582001; Patient Support Rail Receiver Extensions - pair, field

30 installed, for 32" wide upholstery

This includes Lift gate service to get the chairs to the ground only.

This fee applies to facilities that are not able to take a shipment dock

VHAPM Part 808.405-6 Limiting Sources Page 2 of 7 Original Date: 08/30/2017 Revision 01 Eff Date: 04/23/2018 to dock.

WHITE GLOVE INSTALLATION

(4) IDENTIFY THE AUTHORITY AND SUPPORTING RATIONALE (see 8.405-6(a)(1)(i)(A), (B), and

(C) or 8.405-6(b)), AND IF APPLICABLE, A DEMONSTRATION OF THE PROPOSED

CONTRACTOR’S UNIQUE QUALIFICATIONS TO PROVIDE THE REQUIRED SUPPLY OR SERVICE.

An urgent and compelling need exists, and following the ordering procedures would result in unacceptable delays.

Only one source is capable of providing the supplies or services required at the level of quality required because the supplies or services are unique or highly specialized; the Midmark 626-003 Exam Chairs are the only exam chairs that can be to be lowered 15.5 inches and have an internal roller system. Midmark 626-003 Exam Chairs also have a twenty-eight-inch-wide seat, two electrical receptacles built in (one on each side), removable barrier free arms, the ability to lay completely flat, a built in weight scale, and a paper holder.

The unique attribute of the Midmark exam chair is its ability to lower to 15.5 inches and maintain its mobility via an internal rolling system. The ADA standard for exam chairs is to lower to 17 inches. The Lebanon VA Medical Center plans to capture Veteran’s blood pressure while the Veteran is seated in the exam chair.

According to Harvard Health, new hypertension guidelines published by the American College of Cardiology and American Heart Association (2017), and other medical research, a proper blood pressure reading is conducted by having the patient sit with the back against a chair, feet flat on the floor and the arm supported so the elbow is heart level. The Midmark 626-003 Exam Chair allows the provider or nurse to get an accurate reading for all patients because the lower seat height helps by having the feet flat on the floor while using patient support rails that support arm at heart height.

The current 17-inch ADA height (standard on chairs) is too high for many patients and a proper blood pressure cannot be obtained. Proper blood pressure measurements and treatment are part of the VA’s quality indicators. In addition, not managing blood pressure properly has a negative impact on health as it is a major contributor to strokes and heart attacks. This is also supported in the ACC/AHA guidelines. A more accurate blood pressure is achieved by having both feet flat on the floor and by using the patient support rails that support the arm at the heart height.

The lower height requirement is especially critical in allowing female Veterans with heights in the 3rd percentile to place their feet on the floor. According to the Business and Institutional

VHAPM Part 808.405-6 Limiting Sources Page 3 of 7 Original Date: 08/30/2017 Revision 01 Eff Date: 04/23/2018

Furniture Manufacturers Association (BIFMA) standards, the 3rd percentile female popliteal (knee) height is 13.4” plus 1.2” shoe height.

The exam rooms, which follow the PACT Space Module design guide, do not have enough space for an exam chair and a separate chair for the express purpose of capturing blood pressure. The Midmark 626-003 Exam Chairs will ensure the diverse Veteran population, including: elderly, disabled, amputees, and Veterans of a smaller stature, will all be able to have an accurate blood pressure captured because of its ability to lower to fifteen and a half inches.

In the interest of economy and efficiency, the new work is a logical follow-on to an original Federal Supply Schedule order provided that the original order was placed in accordance with the applicable Federal Supply Schedule ordering procedures. The original order must not have been previously issued under sole source or limited source procedures.

Items peculiar to one manufacturer:

A patent, copyright or proprietary data limits competition. The proprietary data is: (If FAR 8.405-6(a)(2)iii before posting. Do not include specific proprietary data.

Only mention the type of equipment, procedure, etc. to show that proprietary supplies or services are being procured.)

These are “direct replacements” parts/components for existing equipment.

The material/service must be compatible in all aspects (form, fit and function) with existing systems presently installed/performing. Describe the equipment/function you have now and how the new item/service must coordinate, connect, or interface with the existing system.

(5) DESCRIBE WHY YOU BELIEVE THE ORDER REPRESENTS THE BEST VALUE CONSISTENT WITH

FAR 8.404(d) TO AID THE CONTRACTING OFFICER IN MAKING THIS BEST VALUE

DETERMINATION:

The prices for the Midmark 626-0003 Exam Chair and their competitors are readily available on the internet in the form of published pricing lists, as a result the contracting officer can readily determine the VA is paying the same price as other parties. In addition, the VA can compare the prices on this procurement to the prices paid for previous procurements for both the Midmark 626-0003 Exam Chair and their competitors.

(6) DESCRIBE THE MARKET RESEARCH CONDUCTED AMONG SCHEDULE HOLDERS AND THE

RESULTS OR A STATEMENT OF THE REASON MARKET RESEARCH WAS NOT CONDUCTED:

VHAPM Part 808.405-6 Limiting Sources Page 4 of 7 Original Date: 08/30/2017 Revision 01 Eff Date: 04/23/2018

Market research, in accordance with FAR Part 10, was conducted by posting a Request For Information (RFI)/sources sought notice on both the Government Point of Entry (GPE) at www.fbo.gov (36C24419Q0281) and on GSA’s E-Buy site www.ebuy.gsa.gov (RFQ1347044).

Both RFIs were posted on January 24, 2019, and they both closed on February 7, 2019. The RFIs provided a description of the Lebanon VA Medical Center’s need as well as a draft copy of a brand name J&A outlining the VA’s rationale for a brand name justification. Through the RFI, the VA sought to determine if there were other manufactures who produced chairs capable of being lowered to fifteen and a half inches.

The VA received fourteen responses to the RFI. Most of the responses were from Midmark SDVOSB resellers. Midmark also responded to the GSA RFI themselves. Other parties responded by proposing exam chairs manufactured by HNT Medical, DRE Meridian, and UMF Medical.

The only other manufacture capable of meeting the fifteen and half inch height requirement is HNT Medical. However, the only way for HNT Medical to lower to fifteen and a half inches is to remove the retracting wheel base and replace it with a flat base. As a result, the exam chair can no longer be easily moved without logistics or maintenance support in order clean and sanitize the exam rooms. The HNT Medical exam chair’s minimum height with the rolling base is nineteen inches, which is not sufficient for obtaining accurate blood pressure as outlined above in section four of this document.

DRE Meridian proposed a power exam table with a minimum height of sixteen inches. In addition to not meeting the height requirement, this exam table does not have a roller system allowing it to be easily moved without logistics or maintenance support in order clean and sanitize the exam rooms. The DRE Meridian exam table does not meet the VA’s need.

Altamira proposed providing a UMF Medical exam table. The UMF Medical exam table’s lowest height is eighteen and a half inches, which is three inches above the VA’s requirement. In addition to proposing a UMF Medical exam table, Altamira pointed out three reasons they disagree with the VA’s rationale to limit this procurement to the Midmark 626-003 exam chair.

The first area of disagreement was that the Midmark 626-0003 exam chair meets the criteria laid out in the American College of Cardiology and American Heart Association (2017). Altamira points out the Table 8 on page fourteen of the American College of Cardiology and American Heart Association (2017) guidelines states that “measurements made while the patient is sitting or lying on an examining table do not fulfill these criteria.” However, the Midmark 626-003 exam chair is not an exam table. As a result, measurements taken while a patient sits in the Midmark 626-003 exam chair with their feet flat against the floor and their back supported would comply with the American College of Cardiology and American Heart Association (2017) guide. Altamira also alleged that the built-in scale did not comply with the National Institute of Standards and Technology (NIST) standards. The biomedical department at the Lebanon VA Medical center stated that the NIST standards apply to the weights used to test a scale not the scale itself. They further stated that they would follow the manufacture’s recommendation

VHAPM Part 808.405-6 Limiting Sources Page 5 of 7 Original Date: 08/30/2017 Revision 01 Eff Date: 04/23/2018 regarding performing calibration of the weight scale, which in this case does not require calibration for the life of the exam chair. Altamira also stated the VA did not need a built-in scale because the PACT Space Module design guide provides for a scale and height alcove. It is true that the PACT Space Module design guide calls for a scale and height alcove. However, the PACT Space Module design guide is only a guide and not mandatory. In addition, the Lebanon VA Medical Center plans to use the built-in scale for most of their Veterans while weighing wheelchair bound Veterans in the scale and height in order to create a more efficient workflow.

(7) ANY OTHER FACTS SUPPORTING THE JUSTIFICATION:

In addition to ensuring accurate blood pressure measurements, the Midmark 626-003 Exam Chair’s lower height of fifteen and a half inches helps ensure all Veterans will be able to transfer in and out of the exam chairs more easily. Such Veterans include female Veterans, disabled Veterans, amputees, and other Veterans of a smaller stature. The lower seat height and wide flat transfer surface enable patients to transfer onto and off the exam chair with minimal assistance, which is especially useful to the Veteran who is wheelchair bound.

The Midmark 626-003 Exam Chairs are the only exam chairs on the market than can both lower to fifteen and a half inches and still have an internal rolling system. The internal rolling system is critical because it allows the VA staff to move the exam chairs with ease to clean biohazard spills, medical waste spills, and ensure the sanitation of the exam rooms without requiring logistics or maintenance traveling to move the exam chairs to clean.

In addition to the fifteen and a half height with the rolling system, the Midmark 626-003 Exam Chair a twenty-eight-inch-wide seat, removable arms, two built in electrical receptacles, a paper holder, a built-in scale, and the ability to lay flat. No other manufacture’s exam chair has all these features.

The combination of these features further justifies the VA’s need to purchase Midmark 626- 0003 Exam Chairs. The Midmark 626-0003 Exam Chair’s twenty-eight-inch-wide seat accommodates Veterans ranging in size from petite to bariatric and accommodates female pelvic exams. The removable arms allow the Veteran to be transferred from the exam chair to a stretcher if need, as well as aid in obtaining accurate blood pressure measurements and drawing of blood. The built-in electrical receptacles and the ability to lay flat allow the Midmark 626-003 Exam Chair to be used for outpatient surgical procedures such as wound care, vasectomies, ortho procedures, and dermatology procedures by providing a safe flat surface to work on and allowing the VA staff to plug in additional tools need to perform the procedures while minimizing tripping hazards. The built-in weight scale helps the VA manage workflow by weighing most Veterans while in the exam room and reserving trips to the weighing alcove to wheelchair bound Veterans.

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(8) A STATEMENT OF THE ACTIONS, IF ANY, THE AGENCY MAY TAKE TO REMOVE OR

OVERCOME ANY BARRIERS THAT LED TO THE RESTRICTED CONSIDERATION BEFORE ANY

SUBSEQUENT ACQUISITION FOR THE SUPPLIES OR SERVICES IS MADE:

Market research will be conducted to ensure that there are no other manufacturers that can supply an exam chair that meets the need.

(9) 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. I understand that processing of this limited sources justification restricts consideration of Federal Supply Schedule contractors to fewer than the number required by FAR Subpart 8.4.

Paddy Kindt, CBOC Business Manager Lebanon VA Medical Center

(10) APPROVALS IN ACCORDANCE WITH THE VHAPM Part 806.3 OFOC SOP:

a. CONTRACTING OFFICER’S CERTIFICATION (required): I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief.

Andrea Aultman-Smith, Contracting Officer

NCO 04

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.

L. Adam Bryson NCO 04 Branch Chief, Commodities 1

HIGHER LEVEL APPROVAL (Required for orders over $700,000):

c. VHA SAO HCA REVIEW AND APPROVAL (over $700,000 to $68 million): I have reviewed the foregoing justification and find it to be complete and accurate to the best of my knowledge and

PADDY L KINDT 362669

Digitally signed by PADDY L KINDT 362669 Date: 2019.03.20 11:40:56 -04'00'

Leslie A.

Bryson 927341

Digitally signed by Leslie A.

Bryson 927341 Date: 2019.03.20 12:03:02 -04'00'

Andrea Aultman- Smith 155562

Digitally signed by Andrea Aultman-Smith 155562 Date: 2019.03.20 12:07:09 -04'00'

VHAPM Part 808.405-6 Limiting Sources Page 7 of 7 Original Date: 08/30/2017 Revision 01 Eff Date: 04/23/2018 belief and approve for restricting consideration of the Federal Supply Schedule contractors to fewer than the number required by FAR Subpart 8.4.

Joseph Maletta VHA Head of Contracting Activity (HCA)

JOSEPH MALETTA

1347841

Digitally signed by JOSEPH

MALETTA 1347841

Date: 2019.03.20 13:14:14 -04'00'