J A__HAMS_Redacted.pdf

COORDINATION AND APPROVAL DOCUMENT

Justification Review Document

Contracting Activity: 773 Enterprise Sourcing Squadron

Purchase Request/Local Identification Number: TBD

Project/Program Name (and Program Element, if applicable):

Hospital Aseptic Management Services

Estimated Contract Cost (including options):

$ 44M for all six contractors 3-month base period w/3 3-month options for a total potential of 12 months

Type Program: Other Contracting

Authority: 10 U.S.C. 2304(c)(2), as implemented by FAR 6.302-2

Type J&A: Class Unusual and Compelling

Contracting Officer: Sharon D. Bickford, 773 rd

ESS

(Name) (Office Symbol) Date Signed

DSN: 969-0528 COM: 210-395-0528

Program Manager: John L. Wrockloff, Lt Col AFMSA/SG8F

DSN: 945-5331 COM: 210-925-5331

Local Legal Reviewer: John G. Terra AFLOA/JAQ

DSN: 969-9371 COM: 210-935-9371

Chief of the Contracting Office: Larry D. Mercier, Lt Col 773 rd

ESS/CC

DSN:969-9722 COM: 210-395-9722

Head of Procuring Steven J. Zamparreli ESG/CL Date Signed Activity and (Name) (Office Symbol) Competition Advocate DSN: 787-3259 COM: 937-257-3259

CLASS

JUSTIFICATION FOR OTHER THAN

FULL AND OPEN COMPETITION

I. CONTRACTING ACTIVITY

The Air Force contracting activity responsible for the proposed action is the 773 rd

Enterprise

Sourcing Squadron (773 ESS), 3515 S. General McMullen, San Antonio, Texas, 78266. Due to the circumstances described below, Hospital Aseptic Management Services (HAMS) will be acquired in accordance with FAR 6-302-2, Unusual and Compelling Urgency, (10 U.S.C.

2304(c)(2), in support of the Air Force Medical Support Agency, Health Facilities Division, AFMSA/SG8F.

II. NATURE AND/OR DESCRIPTION OF THE ACTION BEING PROCESSED

HAMS is a recurring, non-personal, commercial services requirement for aseptic cleaning, protection and beautification (disinfection) of areas at 51 Air Force Medical Treatment Facilities

(MTFs) across the continental United States. Identified below are the current HAMS contractors:

MBM Inc./JXM Inc. Joint Venture – Contract number FA7014-06-D-0024;

Teltara – Contract number FA7014-06-D-0025;

Hospital Klean of Texas – Contract number FA7014-06-D-0026;

ISS TMC Services Inc. – Contract number FA7014-06-D-0027;

Kentucky Building Maintenance Inc. – Contract number FA7014-06-D-0028;

National Maintenance Inc. – Contract number FA7014-06-D-0029.

Under the current six Indefinite Delivery, Indefinite Quantity (IDIQ) HAMS contracts, a total of fifty-one (51) firm fixed price task orders with multiple year options – one order for each of the aforementioned Air Force MTFs - were competitively awarded. All 51 of these task orders expire on 30 September 2012.

The Class Justification is for award of six firm fixed price (FFP) contracts to the current HAMS contractors as an unusual and compelling urgent need exist. The need to continue the existing service contracts is necessary as the award of the follow-on contracts have been delayed by unforeseen required discussion and evaluation of the responsibility of the small business offferors. The current contracts expire on 30 September 2012. The period of performance for the instant action will be 1 October 2012 through 31 December 2012, with three (3) 3-month option periods allowing coverage through 30 September 2013 if necessary. The contracts will be negotiated and awarded no later than 30 September 2012. The performance schedule will allow continuation of services for three months while providing time to issue the follow-on contracts.

Award of the follow on contract is anticipated within the first three months however, recognizing the risk that award may not be feasible within 3 months; the option periods are included to remove the risk of non-availability of services. The total estimated price for all 51 MTFs is

$44M for 12 months of performance.

III. DESCRIPTION OF THE SUPPLIES/SERVICES REQUIRED TO MEET THE

AGENCY’S NEEDS

Medical aseptic housekeeping, medical waste management, and linen services constitute the

HAMS requirement. These services directly support the United States Air Force (USAF)

Hospital Aseptic Management System at multiple United States Air Force Medical Treatment

Facilities throughout the continental United States. The total estimated value of the follow-on contracts is $44M. Fiscal year 2013 Defense Health Program, Operation and Maintenance funds will be used to support the acquisition. The contractor will operate and manage total asepsis in the MTFs for both general and critical care areas. The desired outcome of the overall program is for the aseptic cleaning, protection, and beautification of all rooms/areas identified for coverage at 51 MTFs. The three general areas identified in the PWS are: 1) aseptic cleaning, which is the removal of soil, and/or grime from a surface that includes total disinfection standards, policies, and procedures to create and maintain areas free of pathogenic organisms; 2) protection, which is preventing damage to surfaces and equipment caused by normal use or improper cleaning procedures; and 3) beautification which is thorough cleaning, protection and continuous policing to provide a pleasant, safe environment conducive to quality care for patients, visitors and staff.

Aseptic management involves all areas at the MTF locations including: surgery (pre-schedule, post care, and end of the day), delivery rooms, newborn nursery, recovery rooms, Intensive Care

Units, diagnostic rooms, treatment rooms, clinics, waiting rooms, and common areas. It includes ensuring areas are clean prior to use for medical procedures, to maintaining the cleanliness of the areas while in use, as well as cleaning up blood and other bodily fluids resulting from medical care. Aseptic management is employed to maximize and maintain asepsis, the absence of pathogenic (disease causing) organisms in the clinical setting. The goal of aseptic management is to protect patients, staff, and visitors from infection. Aseptic management is essential to the operation of any medical treatment facility. Continued use of MTFs without aseptic management would be a breach of the standard of care endangering patients, staff, and visitors.

MTFs without aseptic management could not be used and would have to shut down. Aseptic management is an essential prerequisite for medical care. The United States Centers for Disease

Control estimates that within the United States there are approximately 1.7 million hospital-associated infections that cause or contribute to 99,000 deaths annually.

IV. STATUTORY AUTHORITY PERMITTING OTHER THAN FULL AND OPEN

COMPETITION

10 USC 2304(c), as implemented by FAR 6.302-2 (FAR 6.303-2(a)(4)) and Unusual and

Compelling Urgency.

http://www.healthline.com/goldcontent/benzocaine-1 http://www.healthline.com/galecontent/pathogenic-organisms http://www.healthline.com/adamcontent/travelers-guide-to-avoiding-infectious-diseases http://www4.law.cornell.edu/uscode/html/uscode10/usc_sec_10_00002304----000-.html http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/06.htm http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/06.htm

V. DEMONSTRATION THAT THE CONTRACTOR’S UNIQUE

QUALIFICATIONS OR NATURE OF THE ACQUISITION REQUIRES THE USE OF

THE AUTHORITY CITED ABOVE (APPLICABILITY OF AUTHORITY)

The award of the HAMS follow-on requirement is in the final stage of the competitive acquisition process. The solicitation (FA8052-12-R-0004) was released on 21 February 2012 and proposals were received on 17 April 2012. The estimated award date was scheduled for 22

August 2012. However, the HAMS acquisition was delayed on 23 July 2012 due to unforeseeable issues to be resolved with the offerors. A delay of approximately four weeks has occurred. The basic contract award date has been revised to 21 September 2012. The revised award date of the follow-on contracts does not provide sufficient time to evaluate the individual

MTF proposals for task order awards so services can be accomplished and effectively transitioned from the incumbent contractor’s to the new contractors or awardees. Award of the task orders was to occur on 5 September 2012 to allow a necessary 22-day transition time.

Delay in issuance of the contract has also delayed issuance of task orders to perform the critical services.

These delays will result in a mission stoppage of medical services if contracts are not awarded by

1 October 2012. Injured and ill patients in the military community would need to be referred out to other civilian medical facilities that were still operating. It is unclear whether sufficient non-military assets are available to support the thousands of patients that need care on a daily basis.

Additionally, there are a substantial number of patients whose relocation to another medical facility, even if available, would be detrimental to their care, potentially resulting in death.

These include individuals in ICU units.

The government does not have in-house resources to accomplish this work. On an emergency basis, the government could reassign current medical professionals not currently qualified for aseptic management to the task of aseptic management. That would require training and qualifying the other medical professionals, such as medical doctors, registered nurses, and other specialists on aseptic cleaning. Using medical professionals to clean rooms would be a substantial misuse of resources plus would result in taking these health care providers from their duties of providing health care. Without a contract in place and performing on 1 October 2012, the AF would be forced to significantly reduce or suspend healthcare services provided at these facilities, disengaging care to the Tricare network. This would impact all active duty, dependents, and retirees’ access to medical care. There are nearly 900,000 enrollees at the AF

MTFs. Accreditation of each MTF as a facility suitable to provide health care services would be jeopardized.

The Government interests require that the current incumbent contractors be given binding commitments to continue performance so no break in services occurs. These six contractors have been effectively providing Hospital Aseptic Management Services to these facilities for almost six years. Using the current incumbents minimizes, if not eliminates, risks of the hospitals closing due to a failure to have aseptic management in place and do not require a transition period to begin services. Seeking competition with the limited amount of time introduces unacceptable risks of loss of aseptic management resulting in closing of healthcare facilities.

The authority of FAR 6.302-2 supports qualified incumbent contractors to continue Hospital

Aseptic Management Services while providing sufficient time within which to complete the award of the follow-on HAMS contract.

VI. DESCRIPTION OF EFFORTS MADE TO ENSURE THAT OFFERS ARE

SOLICITED FROM AS MANY POTENTIAL SOURCES AS DEEMED PRACTICABLE

Under the current six HAMS IDIQ contracts, a total of fifty-one (51) firm fixed price task orders with multiple year options – one order for each of the aforementioned Air Force MTFs - were competitively awarded. All 51 of these task orders expire on 30 September 2012. With the limited amount of time available to obtain services, soliciting additional sources for the short term contracts would not be practicable or provide for a transition period to prevent a stoppage of aseptic services. There is substantial risk that services would not continue with the award of these short term contracts to anyone other than the contractors currently providing services. A notice of this action was not published pursuant to the exception located in FAR 5.202(a)(2).

VII. DETERMINATION BY THE CONTRACTING OFFICER THAT THE

ANTICIPATED COST TO THE GOVERNMENT WILL BE FAIR AND REASONABLE

The commercial services have remained the same since 2006 and sufficient historical pricing for each MTF is available to perform price analysis to determine a fair and reasonable price. The contracting officer has determined that historical pricing is available for each MTF, the services are well defined, and this will be a continuation of services currently being performed; therefore sufficient data is available to determine a fair and reasonable price. Price analysis can be performed.

VIII. DESCRIPTION OF THE MARKET RESEARCH CONDUCTED AND THE

RESULTS, OR A STATEMENT OF THE REASONS MARKET RESEARCH WAS NOT

CONDUCTED

Market research was not conducted for the instant action due to the unusual and compelling nature of the requirement and the unforeseen circumstances resulting from responsibility determination of offerors. However, the services remain commercial services available in the market place available from multiple sources as occurred under the previous contract awarded in

2006. In addition, the follow-on acquisition is restricted as a small business set-aside indicating multiple small businesses can perform the effort. Given the acquisition history and due to the unusual and compelling urgent need to continue services, further market research was not performed.

IX. ANY OTHER FACTS SUPPORTING THE USE OF OTHER THAN FULL AND

OPEN COMPETITION

The follow-on acquisition is limited to small business participation in providing aseptic services to the Air Force causing the unforeseen delay on completing the acquisition. Time does not permit full and open competition. If there is a break in services the health and safety of thousands of patients would be adversely affected resulting in injury and illness.

X. LIST OF SOURCES, IF ANY, THAT EXPRESSED INTEREST IN THE

ACQUISITION

See Section VI above.

XI. 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

The follow-on acquisition is near completion. However due to this unforeseeable circumstance, the acquisition milestones did not account for this delay. For subsequent acquisitions, the procuring activity must commence the approved acquisition plan eighteen months to two years prior to contract expiration to add time for unforeseen contingencies and further mitigate the risk to the schedule.

XII. CONTRACTING OFFICER’S CERTIFICATION

The contracting officer’s signature on the Coordination and Approval Document evidences that she has determined this document to be both accurate and complete to the best of her knowledge and belief.

XIII. TECHNICAL/REQUIREMENTS PERSONNEL’S CERTIFICATION

As evidenced by their signatures on the Coordination and Approval Document, the technical and/or requirements personnel have certified that any supporting data contained herein, which is their responsibility, is both accurate and complete.