PG_Part806.3_Atch9_FAR6_JA_OVER_SAT x1.pdf

Attachment 9: Request for Sole Source Justification Format >SAT

VHAPG Part 806.3 OFOC Page 1 of 4 Revision: 02 Effective Date: 11/15/23 Acquisition ID#: __________________

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID: 36C244-24-AP-2100

1. Contracting Activity: Department of Veterans Affairs, VISN 4, Corporal Michael J.

Crescenz VA Medical Center (CMCVAMC) located at 3900 Woodland Avenue, Philadelphia

PA 19104.

2. Nature and/or Description of the Action Being Processed: This is an urgent request for a neuromonitoring contract for CMCVAMC operative procedures. The intent of this contract is to provide intraoperative monitoring for a multitude of surgical procedures.

This requirement is considered extremely urgent since the some of the procedure being supported through this proposed contract could be considered life or death to the veteran.

Because of the loss to schedule these procedures, CMCVAMC has had to cancel cases when services are not available. Without these services, more cases will have to be canceled.

3. Description of Supplies/Services Required to Meet the Agency’s Needs: Intraoperative neurophysiological monitoring (IONM) helps assess the integrity of neural structures and consciousness during surgical procedures. It includes both continuous monitoring of neural tissue as well as the localization of vital neural structures. The goal of IONM is to identify intraoperative neural insults that allow early intervention to eliminate or to significantly minimize irreversible damage to the neurological structure and prevent a postoperative neurologic deficit.

It is recommended for individuals at increased risk of neurological injury during a surgical procedure. There are different modalities of IONM and each monitors a specific neural pathway. Many subspecialties within Surgical Services utilizes this service when operating.

IONM systems must be equipped with all channels to monitor different modalities of IONM required for the specific type of surgery including Deep Brain Stimulation procedures. The monitoring system displays continuous trends and raw signals as well as triggering the stimulation of specific muscle and nerve to record the signals.

IONM is performed by highly trained and skilled technicians who work under the direction of professionals with training and experience in IONM. Neurophysiologists interpret all reports in real-time.

The discussion between the surgeon, anesthesiologist and IONM technician will determine the appropriate modality of IONM required for the scheduled procedure. IONM technicians will set up all vendor equipment in the operating room and discuss with nursing personnel

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Acquisition ID#: __________________ the most suitable location for monitoring equipment to be placed. The IONM technician will set up and check all equipment before the patient arrives in the operating room. The technique for IONM involves placement of electrodes or other monitoring devices under aseptic skin preparation, acquisition, recording and interpretation after the patient has been placed under anesthesia.

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

( ) (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;

( X ) (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):

The contrctors unique qualifications are familiarity with the surgeons that CMCVAMC. As previously stated, these contractors have been performing these services prior to the contemplation of this contract. The surgeons there have grown to have a unique relationship with the staff and the equipment they use to perform the IOM services. This is a unique characteristic that could effect the outcome of a procedure to a veteran.

Additionally, because this procedure of paying for these services with GPC was only recently discoved, there are multiple procedures that have been cancelled already and future oporations that will have to be cancelled without these services. Again, this requirement is considered extremely urgent since the some of the procedure being supported through this proposed contract could be considered life or death to the veteran

6. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable: The contracting officer has first hand knowledge of this type of requirement and is acutely aware of the available sources in the area that could provide these services. However, do to both the surgeon preference and the time constraints to provide possible life-saving services, no efforts were made to solicit additional offers from other potential sources.

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

Reasonable: These services were being performed previously at the facility not under

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Acquisition ID#: __________________ contract, but via Government Purchase Card (GPC). After discovering that these services were not allowed to be paid for with GPC, the need was brought to contracting. The costs for the services that have been quoted to the Government are in-line with the prices the Government was paying using GPC.

These prices were also compared to prices from previous contracts for similar services at other facilities in the VISN. This analysis shows that the prices submitted, while having some differences in unit of measure and specific services being provided, are similar. It should also be noted that the current contract that was used for comparison is an affiliate contract that was held to unique requirements and negotiated before award.

Further, these prices were compared to contracts listed on the Federal Procurement Data System (FPDS) website. The NAICS code 621999 and key words “intraoperative” & “neuromonitoring” were used. Many similar actions were found with a variety of contract vehicles have been used to acquire these services. Importantly though, the prices for these service provided under all searches were found to be comparable to prices offered under the IGCE and preliminary quote from the proposed vendor. More details of these comparisions will be noted in the S19 – Best Value Decision/Price Reasonableness Determination.

This leads to the overall determination that the anticipated price to the Government will be both fair and reasonable.

IGCE - $691,912.27

8. Description of the Market Research Conducted and the Results, or a Statement of the Reasons Market Research Was Not Conducted: Market research was performed by both the end user and the contracting office and has been added to the contract file. This research reveals that though there are other entities that could perform these services, the best acquisition strategy for this requirement is to sole source the award to Specialty Care.

9. Any Other Facts Supporting the Use of Other than Full and Open Competition: The physicians that will be working with these staff and their equipment have built a level of comfort and predictablility from this repetitive performance. To change something this critical to patient care may cause a slip of focus in a moment of critical importance. Though this may not be a salient characteristic that can be measured and given the weight of the task they are performing, this preference for consistency has been given the highest priority.

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

- Specialty Care

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: Moving forward, the best actions for the Government to take for these services would be to establish a base plus four (4) option years contract for this requirement.

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Acquisition ID#: __________________

Because of time, this contract will not be able to cover a base plus four (4) option years format and because of that, pricing may change with time.

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.

Laurie S. Rentz Program Analyst- Surgical Services Corporal Michael J. Crescenz VA Medical Center

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

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

Jacob C. Silbaugh Contracting Officer Department of Veterans Affairs, Network Contracting Office 4, Medical 1

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.

Kevin M. Balser Branch Chief

Department of Veterans Affairs, Network Contracting Office 4, Medical 1 https://dvagov.sharepoint.com/sites/VHAProcurement/VHAPM/VHAPM_Part_806.3.aspx