P03 - JA Other than Full and Open_Respiratory_V2.pdf

VHAPG Part 806.3 OFOC Page 1 of 4 Revision: 01 Effective Date: 04/01/23

DEPARTMENT OF VETERANS AFFAIRS

Jus fica on and Approval (J&A)

For

Other Than Full and Open Compe on (>SAT)

Acquisi on Plan Ac on ID: 36C248‐24‐AP‐6579

1. Contrac ng Ac vity: Department of Veterans Affairs, VISN 08, Malcom Randall VA Medical Center, Network Contrac ng Office (NCO) 08 Healthcare Resources Team. The purchase request number

(2237) is 573‐25‐1‐130‐0004.

2. Nature and/or Descrip on of the Ac on Being Processed: This procurement is conducted in accordance with FAR Part 13.5 Simplified Procedures for Certain Commercial Products and

Commercial Services and specifically FAR 13.501 Special Documenta on Requirements, where acquisi ons conducted under Simplified Acquisi on Procedures are exempt from the requirements of FAR Part 6, but s ll require a jus fica on using the format of FAR 6.303‐2. Network Contrac ng

Office (NCO) 8 an cipates the award of an Indefinite Delivery Indefinite Quan ty (IDIQ) contract for

Off‐site In‐home Respiratory Therapy Services from R. Keith Enterprises Inc, dba The Respiratory

Agency, located at 10502 Johanna Ave, Riverview FL, 33578‐4305.

These services will be used by the Malcom Randall Pulmonology Sec on of Medical Service to help meet the needs of one (1) Veteran and deliver professional treatment, observa on, and direct medical repor ng to the VA physicians regarding the pa ent's progress, regress, and any acute episodes requiring stat consulta on for those pa ents mee ng the criteria for the Lung Expansion

Protocol (LEP).

3. Descrip on of Supplies/Services Required to Meet the Agency’s Needs: Malcom Randall VA

Medical Center has a requirement for Off‐site In‐home Respiratory Therapy Services. This contract will provide services that follow neuro‐respiratory guidelines for one (1) neurologically compromised pa ent at high risk of developing ven latory failure due to atelectasis, mucus plugging and consolida on. However, due to the Veteran’s diagnosis, he is not eligible for inclusion into the SCI program at James A Haley, and Malcom Randall VAMC does not have the capacity to provide in home services, so a contract has been sought for the provision of Respiratory Therapy for LEAC procedures and all associated products and services.

Given the one (1) Veteran’s dependency on this type of care, and in many cases his reliance on mechanical ven latory support ‐ clinical deteriora on of the Veteran may develop in rapid fashion without this clinical service. This would likely result in the Veteran requiring urgent or even emergent transfer to an acute care se ng for life saving interven ons.

The Government an cipates that the resul ng ac on will be an indefinite delivery, indefinite quan ty (IDIQ) contract for services for the base year with four (4) one (1) year op on periods. The es mated period of performance for the base year contract will be from 10/15/2024, through

10/14/2025, with an ul mate comple on date of 10/14/2029.

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Effective Date: 04/01/23

The independent Government Cost Es mate (IGCE) for the base year contract has an es mated cost of $65,700.00. The total amount if the op ons are exercised will be $363,029.00. The payment method for these services changed na onally and now is required to be paid via contract. Without such cri cal services, the Veteran’s quality and life and health will be severely impacted with nega ve outcomes.

R. Keith Enterprises Inc, dba The Respiratory Agency is a verified Service‐Disabled Veteran Owned

Small Business (SDVOSB) as registered in h ps://veterans.cer fy.sba.gov/ and is currently providing similar services at JAHVA under contract 36C24823D0091.

4. Statutory Authority Permi ng Other than Full and Open Compe on:

FAR 13.5 Simplified Procedures for Certain Commercial Items. The statutory authority for applying the Simplified Procedures for Commercial Items of FAR 13.5 is 41 U.S.C. § 1901 and is implemented by FAR 13.106‐1(b)(2) for restric ng compe on on this procurement.

Compe on is restricted on this procurement for the reason below:

(X) Only One Responsible Source and No Other Supplies or Services Will Sa sfy Agency Requirements

5. Demonstra on that the Contractor’s Unique Qualifica ons or Nature of the Acquisi on Requires the Use of the Authority Cited Above (applicability of authority):

The required services were carefully reviewed by the Chief of Medical Services, Contrac ng Officer

Representa ve (COR), and Contrac ng Officer (CO) prior to determining its feasibility for compe on and the decision to establish a service contract. The Respiratory Agency is the only local company with the appropriate resources and experienced personnel with the unique exper se to conduct an in‐home respiratory service in accordance with AARC and by the best scien fic literature as determined by the NRC program. The Respiratory Agency is the only local agency that can provide this unique service with the experience and exper se required by the Malcom Randall VA Medical

Center to fully execute and meet all the Governments requirements.

The Respiratory Agency has been providing this service through a local contract with the James A.

Haley Veterans Hospital (JAHVH) since 2009 to hundreds of veterans. Malcom Randall VA Medical

Center has one (1) Veteran that requires the same type and quality of care provided to the JAHVH pa ents. The Veteran’s family, a er learning about these services at JAHVH specifically requested

The Respiratory Agency.

Without this unique in‐home service, the one (1) Veteran would require hospitaliza on in a Long‐

Term Acute Care (LTAC) Facility or have the undue burden maintaining respiratory services through mul ple on‐site JAHVH visits on a weekly basis. Because pa ents are treated in their environment and are enjoying an improved quality of life with their families, we see fewer re‐admits to the hospital for treatment or re‐treatment of respiratory illnesses or condi ons.

The Respiratory Therapists' rou ne care enable professional treatment, observa on, and direct medical repor ng to the physicians and offers peace of mind to all, VA Physicians, pa ents, and their families with immediate response, should a respiratory related emergency arise.

6. Descrip on of Efforts Made to ensure that offers are solicited from as many poten al sources as deemed prac cable: Market Research was conducted using the Internet by searching through the

Veterans Small Business Cer fica on, Dynamic Small Business Search, GSA E‐Library, FPDS‐NG ezSearch, and Google Internet Search engines. The market research results showed no companies

VHAPG Part 806.3 OFOC Page 3 of 4

Effective Date: 04/01/23 were found offering the same in‐home services required for this one (1) veteran, Nor were any companies found that publish their price list.

These services are needed to maintain the con nuity of care for the one (1) Veteran with neuromuscular pulmonary dysfunc on. These protocols of care are specific interven ons provided to this uniquely complex Veteran. Without these interven ons, a significant risk for respiratory complica ons may occur that range from infec on/pneumonia to respiratory failure will exist.

7. Determina on by the CO that the An cipated Cost to the Government will be Fair and Reasonable:

The Contrac ng Officer (CO) will determine price reasonableness in accordance with Federal

Acquisi on Regula on (FAR), 13.106‐3, (a), (2), (vi), (vii). As such, the Government expects the reimbursement methodology for the procurement to be Current Procedural Terminology (CPT) code number S5181. As such, a pre‐determined rate for CPT S5181 has already been established as fair and reasonable and the VA is only authorized to compensate the contractor for 100% of the CPT rate in accordance with Centers for Medicare & Medicaid Services (CMS) guidelines. The VA Home

Healthcare Respiratory Therapy includes the following CPT Code: S5181(Home Health Respiratory

Therapy).

8. Descrip on of the Market Research Conducted and the Results, or a Statement of the Reasons

Market Research Was Not Conducted: Market research revealed that there was not a reasonable expecta on of receiving quotes from two (2) or more Service Disable Veteran Owned Small

Businesses or Veteran Owned Small Businesses that could provide the service. The contractor "The

Respiratory Agency" R. Keith Enterprises is represented as a Veteran Owned Small Business on

SBA.GOV.

Market research conducted on the Veterans Small Business Cer fica on, Dynamic Small Business

Search, GSA‐ELibrary, contract directory, FPDS‐NG ezSearch and Google search engine yielded that there are no local businesses that can service needed by the Malcom Randall VA Medical Center. The

Respiratory Agency is the only locally operated vendor capable of providing the service currently.

9. Any Other Facts Suppor ng the Use of Other than Full and Open Compe on: The Malcom

Randall VA Medical Center has never had an emergent need for home health respiratory therapy services. This contract is in direct support of the one (1) Veteran's care. The Veteran is ac ve with the spinal cord injury (SCI) service at Lake City Medical Center. Evalua on is required from the

Pulmonary clinic prior to the Veteran receiving respiratory services.

10. Lis ng of Sources that Expressed, in Wri ng, an Interest in the Acquisi on: NA

11. A Statement of the Ac ons, if any, the Agency May Take to Remove or Overcome any Barriers to

Compe on before Making subsequent acquisi ons for the supplies or services required: There are no other viable op ons for removing exis ng barriers to compe on for this acquisi on. The

Malcom Randall VA Medical Center is not equipped with the staff, equipment, or supplies to provide this service. This award will be sole sourced to R. Keith Enterprises. The requirement will be posted in the Government Point of Entry (GPE), sams.gov, a er award.

12. Requirements Cer fica on: I cer fy that the requirement outlined in this jus fica on is a Bona Fide

Need of the Department of Veterans Affairs and that the suppor ng data under my cognizance, which are included in the jus fica on, are accurate and complete to the best of my knowledge and belief.

VHAPG Part 806.3 OFOC Page 4 of 4

Effective Date: 04/01/23

Name: Craig W. Pasanen

Title: Supervisory Program Specialist

Facility: Malcom Randall VAMC

13. Approvals in accordance with the FAR Part 13.501(a)(2)(i):

a. Contrac ng Officer or Designee’s Cer fica on: I cer fy that the foregoing jus fica on is accurate and complete to the best of my knowledge and belief.

Name: Peter Bedard

Title: Contrac ng Officer

Facility: Network Contrac ng Office (NCO) 08

b. One Level Above the Contrac ng Officer: I cer fy the jus fica on meets requirements for other than full and open compe on.

Name: Yamil Gomez

Title: Branch Chief Healthcare Resources Team

Facility: Network Contrac ng Office (NCO) 08