36C24420D0032-001.pdf

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>$150K)

1. Contracting Activity: Department of Veterans Affairs, Wilkes-Barre VA Medical Center, 1111 East End Boulevard Wilkes-Barre PA, under purchase request 693-20-2-218-0006.

2. Nature and/or Description of the Action Being Processed: Justification for Other Than Full and Open Competition (OTFOC) applies to a one (6) month base contract that will provide for continuation of critical Community Based Outpatient Clinic (CBOC) Services to meet the needs of Veteran beneficiaries of the WBVAMC in Columbia County, Pennsylvania while a long-term contract is being procured. The long-term contract is anticipated to be awarded within one month and anticipated to open by 1 August, 2020. The Government anticipates award of a new fixed price Indefinite Delivery/Indefinite Quantity (IDIQ) interim contract. This interim contract must be awarded no later than January 28, 2019 to ensure there is no break in services.

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

This solicitation is for a CBOC for providing primary care services in a private hospital, office or clinic environment to Veterans primarily residing in Columbia County, PA. The Parent Facility for this CBOC is the WBVAMC. The Contractor shall provide a community-based outpatient clinic solely dedicated to Veterans. Primary care services will provide a continuum of care from prevention to diagnosis and treatment, to appropriate referral and follow-up. Those patients needing specialty or follow-up care shall be referred to WBVAMC. The CBOC must have the necessary professional medical staff, diagnostic testing and treatment capability, and referral arrangements needed to ensure continuity of health care. Primary services include longitudinal outpatient medical care for the purposes of prevention and detection of disease and subsequent management of medical conditions, for Veterans deemed eligible. The care will be provided by primary care providers who may be general practitioners or general internists of their authorized designees. The CBOC, at a minimum, shall provide one standard of care that must be consistent, safe and of high quality. Additionally, the CBOC is expected to comply with all relevant VA policies and procedures, including those related to quality, patient safety and performance. The CBOC must be poised to respond quickly to VA policy and procedure changes. If requested or required by either the government or Contractor, Contractor work will work closely with the Contracting Officer and COR to modify the contract expeditiously, to limit the impact on the clinic’s Veterans and ensure consistency with the care provided by the Vas other primary care clinics. The care provided by the CBOC should be patient centered, continuous, accessible, coordinated, and consistent with WBVAMC standards, including the thirteen (13) service standards detailed in VHA Directive 2006-041, “Veterans Health Care Service Standards,” dated 6/27/2006 (or subsequent revisions thereto). The estimated value for the one (6) month contract period is $425,250.00

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 FAR 6.302-1;

( ) (2) Unusual and Compelling Urgency per FAR 6.302-2;

( ) (3) Industrial Mobilization, Engineering, Developmental or Research Capability or Expert Services per FAR 6.302-3;

( ) (4) International Agreement per FAR 6.302-4 ( ) (5) Authorized or Required by Statute FAR 6.302-5;

( ) (6) National Security per FAR 6.302-6;

( ) (7) Public Interest per 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): The new clinic in Columbia County, PA will open on 1 August 2020. The Contractor has 120 days from the notice to proceed, to establish the necessary clinical facility and open the service. In the meantime, a short-term solution is required to be implemented so that these critical services for the Veteran beneficiaries can continue without interruption. WBVAMC Quality and Patient Safety staff has determined that a contract must be in place at all times to ensure that necessary safeguards required for proper patient care are provided. This short-term solution represents the best viable option to maintain continuity of services at the CBOC location; it is for these reasons that there is only one responsible source. Award of this interim contract will be made to the incumbent Contractor who currently provides CBOC services in accordance with The Joint Commission. The incumbent Contractor is in a unique position in that they are the only one capable of preventing unacceptable delays. In fact, any break in service by a CBOC could be life threatening to a Veteran. The incumbent is also the only Contractor with the specialized knowledge capable of providing this continuation of services, as new Contractors will require 120 days for start-up due to the complexity of the work performed.

6. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable: It was determined that conducting a competitive procurement for this short-term interim period would result in an interruption of these critical services for Veteran beneficiaries due to the time and resources required to implement services with a new provider.

The current Contractor, Alley Medical, already has the physical clinical facilities established and in operation providing medical care to Veteran beneficiaries. To change Contractors during this interim time period would require the existing facility and service to shut down while a different Contractor establishes a new location and service, and then possibly change again when the long-term contract is awarded. This would be extremely disruptive to the continuity of care currently provided and frustrating to Veteran beneficiaries to change doctors, and have to figure out where the continuously changing clinic is located. Therefore, it is not practicable to solicit offers from any sources other than the incumbent.

7. Determination by the Contracting Officer that the Anticipated Cost to the Government will be Fair and Reasonable: The Contracting Officer will determine that the anticipated cost to be fair and reasonable based on current contract pricing which is expected to remain consistent during the six

(6) month contract period. The estimated price for the six month period is $425,250.00 for the Columbia County CBOC.

8. Description of the Market Research Conducted and the Results, or a Statement of the Reasons Market Research Was Not Conducted: Market Research was not conducted. Market research for the upcoming long-term contract has been conducted.

9. Any Other Facts Supporting the Use of Other than Full and Open Competition: There are approximately 1575 Veteran beneficiaries in Columbia County who rely on the county CBOC for their medical care. The current Contractor has been providing the service at these locations for approximately the last ten (10) years, and has the systems and processes established for Veteran eligibility, electronic patient records, diagnostic requests, invoicing telemedicine, and other requirements to meet VA standards of care. Changing Contractors at this short notice will take months for a new Contractor to establish these processes after they are able to identify a physical location and modify it to meet Joint Commission, OIG, and VA standards of care for Veterans. It would be a disservice to the Veteran beneficiaries whose medical care would be disrupted forcing them to travel long distances to other VA facilities (some of whom cannot drive themselves), change doctors, and/or delay their healthcare altogether while waiting for a new Contractor to establish its facility and processes necessary to provide care.

10. Listing of Sources that Expressed, in Writing, an Interest in the Acquisition: This procurement is a sole source with the incumbent.

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: A competitive solicitation was completed for CBOC services in Columbia County and was open to all vendors capable of providing the service. There have been no barriers to competition.

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.

Karen Leshko

1/21/2020 Date

Health System Specialist Wilkes-Barre VA Medical Center

13. Approvals in accordance with the VHAPM, Volume 6, Chapter VI: 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.

1/23/2020 Date

Brandi Shellhammer Contracting Officer

Karen Leshko 142344

Digitally signed by Karen Leshko 142344 Date: 2020.01.21 16:12:08 -05'00'

b. Director of Contracting /Designee (Required $150K and above): I certify the justification meets requirements for other than full and open competition.

Date

Mark Knorr Branch Chief, Medical Services East Network Contracting Office 4 // Designee