Sole Source Justification Ambulance Services NorCal.pdf

Effective Date: 02/01/2022 Page 1 of 4

DEPARTMENT OF VETERANS AFFAIRS

SOLE SOURCE JUSTIFICATION UNDER SIMPLIFIED PROCEDURES FOR CERTAIN

COMMERCIAL ITEMS IN ACCORDANCE WITH FAR 13.5

Acquisition Plan Action ID: 36C261-24-AP-2478 JOFOC Tracker ID: FY24 - NCO 21 - 1174

1. Contracting Activity: Department of Veterans Affairs (VA), Regional Procurement Office West

(RPOW), Network Contracting Office (NCO) 21 on behalf of the Veterans Integrated Service Networks (VISN) 21, VA Northern California Health Care System (VANCHCS). Purchase Request # 612-24-2-921-0051.

2. Nature and/or Description of the Action Being Processed: This procurement is for acute and basic life support (ALS/BLS) ambulance ground transportation services for the VANCHCS 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 will be a bridge contract for a period of six months, with the period of performance starting April 1, 2024, and ending September 30, 2024. FAR Clause 52.217‐8 Option to Extend Services will be added to the contract in case extra time is required to avoid another bridge contract. This action will be for a new firm fixed‐price bridge contract to the successfully performing incumbent vendor: Bay Medic Transportation.

3. Description of Supplies/Services Required to Meet the Agency’s Needs: The acquisition is for twenty-four-hour ambulance services as needed for beneficiaries of the Department of Veterans Affairs. These services are to assure appropriate transportation for authorized beneficiaries between designated sites. The services will be classified as Standard or Urgent and encompass the VA medical centers and community‐based outpatient clinics which make up the catchment area for all VANCHCS. BLS transport services will be provided by licensed/certified Emergency Medical Technicians (EMTs) and all of the attendants on a BLS transport, including the driver, will be a fully certified EMT as defined by California State laws/regulations, county regulations, and local ordinances. ALS transport is at the BLS level but one of the attendants will be a licensed/certified paramedic. The catchment areas for the VANCHCS are the urban and rural counties of Sacramento, Butte, Colusa, Glenn, Siskiyou, Tehama, Tuolumne, Stanislaus, San Joaquin, Trinity, Solano, Amador, El Dorado, Sutter, Yolo, Yuba, Shasta and Contra Costa.

The estimated contract value for Bay Medic Transportation’s Services is $732,794.88.

4. Statutory Authority Permitting Restricted Competition:

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 restricting competition on this procurement. Competition is restricted on this procurement for the reason below:

( ) Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements

(X) Unusual and Compelling Urgency ( ) Industrial Mobilization, Engineering, Developmental or Research Capability or Expert

Services ( ) International Agreement ( ) Authorized or Required by Statute ( ) National Security ( ) Public Interest

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

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

VANCHCS has an urgent and compelling need for acute and basic life support ground ambulance transportation services for authorized Veteran beneficiaries.

Previously, NCO 21 awarded a sole source multiple-award Indefinite Delivery Indefinite Quantity (IDIQ) contract to two vendors, American Medical Response West (Large Business) and Bay Medic Transportation (Small Business). A justification for other than full and open competition (JOFOC) for the sole source multiple-award IDIQ contracts was reviewed and approved by Curtis Jordan, Executive Director, RPOW Head of Contracting. The multiple-award IDIQ contracts are expiring on March 31, 2024 and currently, there is insufficient time to compete the long-term procurement because there is less than 30 days before contract expiration. This is a new JOFOC request for a sole source procurement of a 6-month bridge contract with Bay Medic Transportation to allow time to procure a long-term contract for ground ambulance transportation services. A new sole source is sought for this action per the guidelines of FAR 6.302-2 (2)(i).

The unusual and compelling urgency arose due to several reasons, including shortage in staff for the Ambulatory Care Service, major changes in the performance work statement for the long-term procurement, and also challenges with finding fully licensed ambulance companies that can cover rural areas within VANCHCS. The Ambulatory Care Service experienced turnover in the past several months, which resulted in delays in submitting a long-term procurement package for ground ambulance transportation services. Due to staff turnover, new employees and new Contracting Officer’s Representatives encountered large learning curves on how to prepare a complete procurement package. Additionally, there were major changes to the performance work statement that still require the Service to review, revise, and ensure the changes meet VANCHCS’ specific requirements for ground ambulance transportation services. Lastly, competition for ambulance transportation services has been historically challenging for VANCHCS. The nature of the industry requires ambulance vehicles that meet regulatory standards and sufficient staffing of skilled paramedics and emergency medical technicians (EMT). Medicare reimbursement rates are traditionally used to pay for ambulance transportation services, but these rates are low so the recruitment for these professionals have been difficult. In October 2021, a congressional letter addressed the workforce shortage of paramedics and emergency medical technicians (https://ambulance.org/2021/10/04/workforceshortage/). Furthermore, ambulance companies must also have the ability to provide twenty-four hour ambulance services on an as needed basis and can meet response times for standard and urgent care.

This sole source vehicle is needed to provide essential services and prevent further delays and a potential lapse in services that may cause life-threatening circumstances to arise. Failure to award a contract would jeopardize patent safety, as the contract provides a means of transportation for Veterans through basic life support (BLS), Advanced Life Support (ALS), and Critical Care Transport (CCT) ambulatory services. A short-term solution is needed to compete the long-term procurement in accordance with national policy and standards.

6. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable:

A Notice of Intent to Sole Source will be posted to SAM.gov noting the Government intends to issue a new firm fixed-price contract to the incumbent vendor. The Government intends to issue a new solicitation for a long-term firm fixed-price IDIQ using competitive procedures to solicit from as many potential sources available.

https://ambulance.org/2021/10/04/workforceshortage/

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7. Determination by the CO that the Anticipated Cost to the Government will be Fair and Reasonable: All efforts will be made to negotiate with vendors to obtain these services at the best possible pricing in accordance with the current marketplace/industry costs. The anticipated cost will be determined fair and reasonable through comparison with recent and current Government contracts in similar size and scope, Medicare reimbursement rates, and private sector and municipality ambulance transportation costs. Pricing is determined fair and reasonable based on a comparison to pricing of the current contract, 36C26123D0011 awarded 09/30/2022, in accordance with FAR 13.106-3(a)(2)(ii).

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

Market Research Was Not Conducted:

Conducted an acquisition history review and found there are no other vendors that have provided similar services in the catchment area other than the two incumbent vendors. SAM entity records were reviewed, and although multiple vendors were found under the related NAICS 621910 Ambulance Services, most vendors were vendors that provide supplemental supplies and services for ambulances, such as gurneys, oxygen, and other life-support-related supplies and services. The Dynamic Small Business Search resulted in similar findings as SAM, where multiple small vendors provide supplemental ambulance supplies or services. FPDS review resulted in many vendors identified within California, but a majority of the vendors are located outside the catchment area – in areas such as Los Angeles and San Diego. VetCert was checked for NAICS 621910 where most vendors were for supplemental supplies and services for ambulances and/or outside the catchment area. Lastly, a search for ambulance in GSA eLibrary found 621-032 for EMT Paramedic (Includes Certified Emergency Medical Technician and Certified Paramedic) Scheduler (Drug & Alcohol Testing) Blood & Alcohol Technician Ambulance Driver and MAS for Children’s Air Ambulance which do not meet the Government’s requirement.

9. Any Other Facts Supporting the Use of Other than Full and Open Competition:

Per the previous acquisition, competition within the ambulance services marketplace in the VANCHCS catchment has been historically difficult. Various factors have led to the difficulty including geographic location limitations, low Medicare reimbursement rates, labor shortages, and many barriers to entry, resulting in a restrictive marketplace.

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

Bay Medic Transportation.

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:

Ambulance transport and emergency medical services are in short and restricted supply on a nationwide level. It is hoped this short‐term bridge contract will allow enough time for a long-term solution to compete a long‐term contract.

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.

Merico A. Zanotti Date Assistant Chief of Benefits and Data Management

VANCHCS

Effective Date: 02/01/2022 Page 4 of 4

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.

Emily Trinh Date Contracting Officer Network Contracting Office 21

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.

Joleo Dianala Date Branch Chief, Healthcare Resources II

Network Contracting Office 21 https://dvagov.sharepoint.com/sites/VHAProcurement/VHAPM/VHAPM_Part_806.3.aspx

VHAMACDIANAJ

Typewritten Text 03/22/2024