5.1.1 P00012 - LSJ - Medical 2023 - EP edits FV(mlv-jj-tb).pdf

FAR 8.405-6(a)(1)(i)(A) Limited Sources Justification (LSJ)

Medical Services

LSJ # 23-172

This acquisition is conducted under the authority of the Multiple-Award Schedule Program, 41 U.S.C. 152(3), Competitive Procedures, and 40 U.S.C. 501, Services for Executive Agencies.

1. Agency and Contracting Activity. Identification of the agency, contracting activity, and specific identification of the document as a “Limited-Sources Justification.”

The Department of Homeland Security (DHS), Federal Emergency Management Agency (FEMA), Office of the Chief Component Procurement Officer (OCCPO), proposes to extend an interim Blanket Purchase Agreement (BPA) pursuant to FAR 8.405-6(a)(1)(i)(A), Limiting Sources, for Medical Services because an urgent and compelling need still exists.

2. Nature and/or description of the action being approved. Describe the action being approved and include the name and address of the proposed contractor(s).

DHS/FEMA/OCCPO intends to limit the number of sources solicited pursuant to FAR 8.405- 6(a)(1)(i)(A) for the procurement of Medical Services in support of FEMA personnel at FEMA fixed (non-disaster) locations and disaster locations to current Contractor: Spectrum Healthcare Resources, Inc. 12647 Olive Boulevard, Suite 600, St. Louis, Missouri 63141.

3. Description of Supplies/Services. Describe the supplies or services to be acquired.

Provide the estimated total value (including options, if any).

FEMA, Office of the Chief Administrative Office (OCAO), Environmental Safety and Health Office (ESH) requires contractor support to help develop and maintain the broadest health services possible for federal managers and their employees. The Contractor shall work in a partnership with FEMA Headquarters to support managers and workers alike to design and deliver comprehensive solutions to meet FEMA’s occupational health needs by customizing programs to help build a healthier and more productive federal workforce as well as a safer workplace for employees. To meet this need, FEMA requires medical oversight, occupational health center services and clinical staffing support, special testing for COVID-19 and vaccinations, extended nursing hours to support the National Recovery Communication Center (NRCC) and/or Regional Recovery Communication Centers (RRCC), medical employability, fitness for duty, consultation immunizations and travel medication, respiratory clearances, and Commercial Driver License (CDL) clearances be established FEMA wide at various locations to include fixed site and disaster sites (including remote areas) within the United States and all Territories.

The extended interim BPA will be a hybrid structure consisting of labor hour and Time and Materials (T&M) contract line-item numbers.

Medical Services

The total estimated amount for the interim BPA extension is $898,827.15. The total BPA value including the interim BPA extension is $12,964,987.20. Call orders for fixed locations will use Fiscal Year (FY) 23 Operation & Support (O&S) funding. Call orders for disaster locations will use Disaster Relief Fund (DRF) no-year funds.

Estimated Total Value:

July 1, 2023, to September 30, 2023

Medical – Fixed and Disaster Sites $898,827.15

Total: $898,827.15

4. Authority and supporting rationale.

This acquisition is being conducted under the authority of the Multiple-Award Schedule Program, 41 U.S.C. 152(3), Competitive Procedures, and 40 U.S.C. 501, Services for Executive Agencies, in accordance with FAR 8.405-6(a), Limiting Sources. The extension of the BPA will be made pursuant to FAR 8.405-6(a)(1)(i)(A), because a continuation of the urgent and compelling need exists.

Medical services were previously provided through an Inter-Agency Agreement (IAA) with the Department of Health and Human Services, Program Support Center, Federal Occupational Health (FOH). After the IAA ended, FEMA awarded an Urgent and Compelling BPA to Spectrum Healthcare Resources, Inc. under FAR Part 8. This BPA was issued under GSA Contract #GS-V797P-2290D. The award was issued with a 3-month base and one 3-month option. While FEMA worked to compete the services, it extended the contract several times as described in the chart below. FEMA competed and awarded a health and behavioral services contract in December 2023. The award was protested, and GAO sustained the protest in March 2023. The Agency is re-evaluating the proposals pursuant to the GAO decision.

Date Modification

Number Period of Performance Base or Option Period

12/10/2020 12/16/2020 – 03/15/2021 Base w/3-mo. Option 06/17/2021 P0001 03/16/2021 – 06/15/2021 Option 1 (3 mos.)

06/15/2021 P0002 06/16/2021 – 09/15/2021 Extension 52.217-8 09/15/2021 P0003 09/16/2021 – 12/15/2021 Extension 52.217-8 10/05/2021 P0004 10/05/2021 – 12/15/2021 Add alternate COR 10/08/2021 P0005 10/08/2021 – 12/15/2021 Add FAR Clause

52.223-99 12/13/2021 P0006 12/16/2021 – 06/30/2022 Extend via LSJ 04/20/2022 P0007 09/19/2021 – 06/30/2022 Reinstate COR 06/10/2022 P0008 06/10/2022 – 06/30/2022 Revised PWS 06/30/2022 P0009 07/01/2022 – 12/31/2022 Extend via LSJ P0010 01/01/2023 – 03/31/2023 Extend via LSJ

03/28/2023 P0011 04/01/2023 – 06/30/2023 Extend via LSJ Current P0012 07/01/2023 – 09/30/2023 Extend via LSJ

Medical Services

FEMA continues to have an urgent and compelling need to continue these Medical Health services in the interim while allowable time is provided to address the sustained GAO Protest.

FEMA needs to continue coverage of the interim contract to protect the workforce allowing the workforce to remain engaged in the mission without the need to vacate their workstations for long periods of time to receive medical treatment. This contract affords FEMA the ability to vaccinate employees who work on the front lines along with staffing nurses and medical personnel.

Section 5(a)(1) of the Occupational Safety and Health Act (OSHA) 29 CFR 1910, requires an employer to furnish to its employees: “employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm.” Providing a Medical Health program is a necessary step in ensuring that the FEMA workforce and those places where FEMA sends its employees are free from such recognized hazards. If the Medical Services interim contract is not extended, there will be a lapse in service and FEMA would not be in compliance with the requirements of OSHA as no coverage of medical services could lead to risking the health and safety of FEMA personnel at both fixed and disaster locations. FEMA’s mission generates a significant amount of stress and physical exertion upon its work force when dealing with various disasters to include natural disasters (i.e., hurricanes, wildfires, etc.), acts of terrorism, and other manmade disasters. FEMA’s mission requires long hours, often up to 16 hours in a workday, travel to unfamiliar locations, and little opportunity to seek care for medical treatment. Without these services, the employee will be required to demobilize or go on rotation in order to seek medical attention. Removing FEMA personnel from a disaster to seek medical treatment will impact disaster operations and the FEMA mission by reducing personnel with potentially no immediate replacement personnel.

As a result, FEMA intends to extend the Medical Service interim contract with Spectrum Healthcare Resources, DUNS 048441815/UEI SAM Z3JZT1J9TSG1, based on the urgent and compelling need for these services. Spectrum Healthcare can provide continuity of operations with the least impact on operations. In addition, Spectrum Healthcare already has an established infrastructure to perform, vaccinations, medical care, etc. It has the capacity to support FEMA’s disaster operations without a lapse in coverage. By extending this contract, it will prevent, to the highest degree possible, a lapse in coverage. Any such lapse in services could impact the Medical Services that are critical to the safety of FEMA’s federal employees.

5. Determination by the ordering activity contracting officer that the anticipated order represents the best value consistent with FAR 8.404(d).

The Contracting Officer has determined that extending the interim Medical Services contract with Spectrum Healthcare Resources, Inc. for the provision medical health services represents the best value to meet the Government’s immediate need. Current price research

Medical Services has confirmed that Spectrum’s current pricing is consistent with what FEMA has paid for these services historically. Orders will be placed in accordance with FAR 8.404, “Use of Federal Supply Schedules.” The General Services Administration (GSA) has already negotiated fair and reasonable rates. Discounts to these GSA schedule rates will be requested. Additionally, prior to issuance of orders, the ordering activity will consider the level of effort and the mix of labor proposed to perform the specific task being ordered to determine that the total price is reasonable. The contractor’s labor mix and level of effort will also be compared to the Independent Government Cost Estimate (IGCE) for each order.

The Contracting Officer will further ensure that the anticipated orders issued from this BPA represents the best value by determining the price as fair and reasonable based on historical prices, an independent government estimate and previously negotiated/competed prices under the BPA. Additionally, wage determination rates will be used to establish the minimum basis for personnel pay. This extended contract will continue to be structured with T&M contract line items for services conducted at the disaster sites. Labor costs will be reimbursed for actual hours worked and travel costs will be reimbursed for only reasonable, allowable, and allocable costs. These measures will provide FEMA confidence that cost will not substantially increase for this action and will be used to ensure fair and reasonable pricing.

6. A description of the market research conducted among schedule holders and the results, or a statement of the reason market research was not conducted.

Extensive market research for this effort was conducted in April 2022. It is expected that the there is no drastic change with regards to interested vendors as well as pricing for supplies and services. An analysis of the previous market research revealed that there are several vendors capable of providing Medical Health Services. FEMA competitively awarded a contract in December 2022, which as described above was protested at GAO and ultimately sustained.

7. Any other facts supporting the limited-sources justification. Additional facts may be stated in this section. If there are no additional facts, you must state that here.

8. A statement of actions, if any, the agency may take to remove or overcome any barriers that led to restricted consideration (i.e., limited sources) before any subsequent acquisition for the supplies or services is made. Include a statement of actions taken or that will be taken to increase competition for future acquisitions of the same item/service (e.g., the government intends to revise overly restrictive technical specifications, acquire data rights, or pursue some other means to increase future competition).

Barriers that prevent this urgent and compelling contract from being competed in normal fashion include the transition period for an outside vendor to establish the infrastructure, as mentioned previously, to handle a contract of this magnitude on a national scale.

Spectrum Healthcare Resources, Inc. services have pre-established relationships with Medical Personnel throughout the location where FEMA operates. They have been providing these services previously through FOH for nearly 20 years. Any other vendor would require a time frame that would not permit them to begin services on July 1, 2023. As stated above, Medical Services

FEMA competitively awarded the medical health services requirement in December 2023.

The solicitation for the re- compete was publicized on the Government-wide Point of Entry (www.sam.gov) and was based upon full and open competition which ensured solicitation to as many potential sources as possible.

9. DHS/FEMA intends to post this requirement on SAM.gov pursuant to FAR 8.405- 6(a)(2)(i).

10. Technical/Requirements Personnel Certification.

Pursuant to FAR 8.405-6(c)(2)(x), I certify that this requirement meets the Government’s minimum need and that the supporting data, which form a basis for the Limited-Sources Justification, are accurate and complete.

Mayra Lopez-de-Victoria Contract Technical Representative/COR

11. Contracting Officer Certification and/or Approval *

Pursuant to FAR 8.405-6(c)(2)(ix), I certify that the Limited-Sources Justification is accurate and complete to the best of my knowledge and belief:

Janice Joseph Contracting Officer Date

12. Approval

Tyuana Bailey Date Component Competition Advocate