36C25920D0035-001.pdf

OFOC SOP Revision 08 Original Date: 03/22/11 Revision 08 Date: 04/18/2018

$1,700,000

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID: 36C259-19-AP-4897, Track ID: 2020-0046 Southern Teller County Health Services District, dba: Cripple Creek Care Center, Community Nursing Home, VA Eastern Colorado Health Care System (ECHCS), Denver, CO

1. Contracting Activity: VHA Regional Procurement Office West, Network Contracting Office

19 (NCO-19), Rocky Mountain Acquisition Center, Department of Veterans Affairs, 6162 S.

Willow Drive, Suite 300, Greenwood Village, Colorado 80111, in support of the VA Eastern Colorado Health Care System (ECHCS). This action is funded by a 1358, therefore there is no associated 2237.

2. Nature and/or Description of the Action Being Processed: This procurement is to award a follow-on contract to Southern Teller County Health Services District, dba: Cripple Creek Care Center for a Community Nursing Home (CNH) located in Cripple Creek, CO (Teller County). We anticipate awarding a sole source Firm-Fixed Price Indefinite Delivery Contract (IDC). The current contract VA259-15-G-0054 expires on 29 February 2020. The IDC will be written for a period of five (5) years. The period of performance for this IDC will be 01 March 2020 – 28 February 2025.

FAR13.5 Simplified Procedures for Certain Commercial Items: This procurement is for the establishment of an IDC utilizing procedures in accordance with FAR 13.5 Simplified Procedures for Certain Commercial Items and specifically FAR 13.501 Special Documentation Requirements, where acquisitions conducted under Simplified Acquisition Procedures are exempt from the requirements of FAR Part 6, but still require a justification using the format of FAR 6. 303-2. This acquisition does not fall within FAR Part 8 Required Sources of Supplies and Services therefore, the procedures associated with limited sources justification will not be utilized.

3. Description of Supplies/Services Required to Meet the Agency’s Needs: The CNH will provide all facilities and services to support short- and long-term care for VA patients. These services include rehabilitation, nursing, and clinical care in accordance with the performance work statement. The current contract VA259-15-G-0054 expires on 29 February 2020.

Southern Teller County Health Services District, dba: Cripple Creek Care Center has met all requirements under VA Handbook 1143.2. Additionally, they are certified under Centers for Medicare and Medicaid Services (CMS) and licensed by the State of Colorado. The period of performance will be five (5) years. The estimated value of the IDC is not to exceed

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4. Statutory Authority Permitting Other than Full and Open Competition: 41 USC §3304(a)(1), as implemented by FAR 6.302-1 (a)(2).

(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;

FAR13.5 Simplified Procedures for Certain Commercial Items: The authority for applying the Simplified Procedures for Commercial Items of FAR 13.5 is 41 U.S.C. 1901 and is implemented by for restricting competition on this procurement via FAR 13.106-1(b)(2).

5. Demonstration that the Contractor’s Unique Qualifications or Nature of the

Acquisition Requires the Use of the Authority Cited Above (applicability of authority):

Currently, there are 5 Veterans being treated and housed at the Cripple Creek Care Center under an existing BOA. The community nursing home facility meets VA exclusion review quality of care standards to provide treatment to Veterans. The community nursing home has had a contract with the VA since 2015. They have consistently provided quality care to our Veterans. The VA patients at this facility cannot be moved without causing undue medical hardship. An attempt to move the patients would cause a disruption in continuity of care and stress on the patients and family members if relocated to a different facility as well as possible non-compliance with VHA Handbook 1143.2. In accordance with FAR 6.302-1 this requirement for Community Nursing Homes Services will be sole sourced to the Cripple Creek Care Center. In addition, as stated in paragraph 6 below, no responses were received in a source sought notice for this procurement.

6. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable: No new CNH has expressed interested in doing business with the Government. A search of the Medicare Nursing Home Compare website https://www.medicare.gov/nursinghomecompare/search.html resulted in 1 community nursing homes in Cripple Creek, CO where the current CNH is located. The VA’s Vendor Information Page (VetBiz) were used to determine if potential offerors exist to determine additional competition. However, the site failed to produce any results for Cripple Creek, CO.

The CNH program requires that any new CNH's that want to do business with the Government must pass a series of inspections. The CNH must pass a clinical inspection and life safety inspection. The CNH Program Coordinators meet with the CNH to understand the services that an offered. Once the CNH passes these inspections, then they can be considered for a contract. As part of the acquisition process a CNH must provide a current state license, insurance and a copy of the state inspection. These documents are provided to the CNH Program coordinator for review and evaluation. The CNH Coordinator will either provide a recommendation to contract or state that the CNH is did not receive a recommendation to contract. This J&A will be posted on FBO.

https://www.medicare.gov/nursinghomecompare/search.html

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7. Determination by the CO that the Anticipated Cost to the Government will be Fair and Reasonable: The Medicaid rates are used as the basis for pricing the CNH contracts. The Medicaid rates are established by each state based on national average. The VA Geriatrics and Extended Care Office through the VHA PM and VA pulse publishes an annual maximum allowable percentage that are applied to each RUG IV category. The RUG IV category identify the different levels of treatment. The add-on percentages are added to the basic Medicaid rate then applied to each RUG IV category. The Medicaid rate and the VA’s add-on percentage make up the per diem rate paid for each patient. The line item structure will illustrate the different RUG IV category and the add-on percentage and the total per diem rate for each level of care. The prices for per-diem rates are determined to be fair and reasonable when the add-on percentage agreed upon by both parties is at or under the maximum allowable percentage established by VA. The add-on percentages do not change through the life of the contract.

8. Description of the Market Research Conducted and the Results, or a Statement of the

Reasons Market Research Was Not Conducted: As described in Section 6 above, A search of the Medicare Nursing Home Compare website https://www.medicare.gov/nursinghomecompare/search.html resulted in 1 community nursing home in Cripple Creek, CO where the current CNH is located. The VA’s Vendor Information Page (VetBiz) was used to determine if potential offerors exist to determine additional competition. However, the site failed to produce any results for Cripple Creek, CO.

Results of the market research shows there is no CNH that expressed interest. Typically, CNH's are not competed. Based on the CNH program requirements, the Veteran has a say in the selection of the facility based on patient needs and proximity of the CNH to patients’ home and family. The CNH Program attempts to inspect a sample of CNH's in a given area to provide the Veteran with several choices. However, the selection of the CNH is determined by whether the CNH has the resources available to meet the Veteran's needs. It is on the CNH Program Coordinator to conduct market research and required inspections to increase the number of available and qualified CNH's that can pass the Government's inspections.

9. Any Other Facts Supporting the Use of Other than Full and Open Competition: The facility averages 5 Veterans in this facility who cannot be relocated due to continuity of care and medical complexity. This CNH is located near the families of the Veterans. An attempt to move the patients would cause stress on the patient and family members if relocated to a different facility.

10. Listing of Sources that Expressed, in Writing, an Interest in the Acquisition: No other

Community Nursing Home expressed interest in this acquisition. The current contractor, Southern Teller County Health Services District, dba: Cripple Creek Care Center, has expressed an interest to continue providing CNH services to the VA and continue in providing care and services to the Veterans currently placed there.

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: There is currently only one (1) facility capable of providing the specialty care and medical needs of the existing patients. Based on the CNH program requirements, the Veteran has a say on the selection of the facility based on patient needs and proximity of the CNH to patients’ home and family. The CNH Program attempts to inspect a sample of CNH's in a given area to provide the Veteran with several choices.

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However, the selection of the CNH is determined on whether the CNH has the resources available to meet the Veteran's needs. It is the CNH Program Coordinator’s responsibility to conduct market research and required inspections to increase the number of available and qualified CNH's that can pass the Government's inspections. The contracting office and CNH Program office will continue to canvas the market for new CNH entrants capable of meeting program requirements.

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.

Name: Michelle Scoggin Date Facility: Rocky Mountain Regional 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.

Joshua Gallegos Date Contracting Officer, Specialized 1 Branch Network Contracting Office 19 http://vaww.pclo.infoshare.va.gov/PMWeb/VHAPM_Part_806.3.aspx

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b. One Level Above the Contracting Officer (Required over SAT but not exceeding $700K): I certify the justification meets requirements for other than full and open competition.

Albert Williams Date Division 1 Chief

Danny O. Freeman Date Director of Contracting

c. VHA SAO HCA Review and Approval: I have reviewed the foregoing justification and find it to be complete and accurate to the best of my knowledge and belief and recommend approval (if over $68 million) or approve ($700K to $68 million) for other than full and open competition.

Curtis M. Jordan Date Executive Director, Regional Porcurement Office West Head of Contracting Activity (HCA)