Draft_JA_FBCH_FHCs_070319_Redacted.pdf

JUSTIFICATION AND APPROVAL

Justification and Approval for Other than Full and Open Competition Sole Source Acquisition

FAR Subpart 6.3 Other Than Full and Open Competition

1. Identification of the agency and contracting activity: Defense Health Agency (DHA), Deputy Assistant Director Acquisition (DAD-A), J-4, National Capital Region-Contracting Division (NCR-CD), HT0014, .

2. Nature and/or Description of Action being approved: Approval is requested for a second, 12-month interim contract for the Family Health Centers (FHCs) operating as extensions of Fort Belvoir Community Hospital (FBCH), and located in Dumfries and Fairfax, Virginia. The estimated dates of this requirement are from 01 July 2019 to 30 June 2020. The estimated cost of this requirement is . This requirement will be a sole source contract utilizing the incumbent contractor, Spectrum Healthcare Resources, Inc. (Spectrum), to operate the FHCs, which are providing various types of medical services as described below.

Although a new IDIQ vehicle was issued in September 2018 for this requirement, a Task Order against that IDIQ cannot be issued at this time because the contractor is still preparing the new location at Fairfax, and the larger footprint at Dumfries. Services will not be ready to start using erefore, since medical services must be provided, the requirement must continue under the existing terms and conditions, and an interim contract must be issued from July 1 until the new facilities are ready and it is no longer needed.

3. Description of Supplies/Services: This requirement provides for all facilities, staffing, equipment, maintenance, security and supplies to provide primary healthcare and selected specialty healthcare for an enrolled population of approximately 51,000 Tricare beneficiaries.

The facilities each have full service primary care capabilities and supporting ancillary services, including but not limited to: Family Practice, Pediatrics, Internal Medicine, Pharmacy, Laboratory, and Radiology. Family Health Center South (Dumfries) supports limited specialty care, including Physical Therapy, Optometry, OB/Gyn, and Orthopedics. Family Health Center North (Fairfax) supports limited specialty care, including Physical Therapy and Optometry.

Both facilities run Behavioral Health programs. The Base Period will consist of 2 months, from 01 July 2019 until 31 August 2019, . The contract type will be Firm Fixed Price; the type of funds to be used will be Operations & Maintenance (O&M).

4. Statutory Authority Cited permitting other than full: The statutory authority permitting other than full and open competition is 10 U.S.C. 2304(c)(1), as implemented by FAR 6.302- 1(a)(2)(iii)(B). This is applicable when services required by the agency are available from only one responsible source, and no other type of services will satisfy agency requirements. Then full and open competition need not be provided for, and services may be deemed to be available from only the original source in the case of follow-on contracts for the continued provision of highly specialized services. This is applicable when it is likely that award to any other source would

5. Reason for Authority Cited: Spectrum is the proposed source for this requirement because, as the current contractor, they are currently providing the services and are the only readily available, responsible source capable of providing all the services by the required start date of 01 July 2019. The first (current) interim contract was awarded to Spectrum as a sole source contract, number HT0014-18-C-0004; current contract cost is $80,630,569.99 for 18-months, ending on 30 June 2019. The long-term re-competing effort was also awarded to Spectrum, on 01 September 2018; the Indefinite-Delivery, Indefinite-Quantity (IDIQ) contract number is HT0014-18-D-0030. A first Task Order (TO), number HT0014-18-F-0376, was issued under the IDIQ, for phase-in and facilities preparation prior to the start of medical operations. The initial period of performance for the first TO is 01 September 2018-31 August 2019; it is likely that a second, 2-month interim contract would have been needed, regardless of construction constraints or delays, to provide medical services from 01 July 2019 to 31 August 2019. Construction-related delays, however, and specifically the amount of time it will take to obtain construction permits for the outside portion of construction at both facilities, are the reason why a second interim contract is required, as it is now estimated that construction will be completed sometimes during the second quarter of FY20. Contract requirements, including facility physical security requirements, are very unique; there are few qualified and responsible companies able to provide these types of services; Fairfax and Prince William counties have both notified the contractor that they require additional time to review and approve their construction permit applications for the outside portion of the facilities, including a 25-meter standoff, extensive parking lot renovations, traffic flow changes and other physical security measures, which involve the preservation or planting of many existing trees, and other property layout updates. The current interim contract expires 30 June 2019 with no options or extensions remaining. Another interim contract is required to continue services for the current beneficiaries until phase-in and facilities preparations are completed under the re-competed effort, and until medical operations can start under the re-competed effort.

Based on contract history, potential contractors cannot meet the lead-time requirements necessary to stand up new healthcare facilities for a 01 July 2019 start date, because building arrangements, outfitting the building to support clinic operations, and staffing all require a lead-time of approximately 12- to 18-months after contract award. Furthermore, a long-term contract has already been awarded; a few more months are needed until medical operations can start under the new long-term contract.

Displacing the beneficiary population to the Northern Virginia healthcare network until medical operations can start under the new long-term contract is not a feasible or cost-effective solution.

The beneficiary population is too large for the local primary care network to absorb. FBCH cannot accommodate the displaced beneficiaries as it is already operating at capacity.

Furthermore, the new FHCs are being readied and will be able to start medical operations during the second quarter of FY20. Transferring the 51,000 beneficiaries to the Northern Virginia healthcare network or to another Military Treatment Facility would cause high rates of patient dissatisfaction, and is likely to affect patient care and quality of care.

Department of Defense Health Affairs Policy 06-007 specifies access to healthcare standards for the beneficiary population. Beneficiaries access to healthcare and quality of healthcare are likely to be significantly affected if operations do not continue under the current Family Health Centers contract.

6. Efforts to Obtain Competition: A competitive, full and open contract for the acquisition of Family Health Centers was awarded on 01 September 2018. The current interim contract provides medical operations until 30 June 2019, which is not enough time until they can start under the new long-term contract. A second, interim contract is required to cover the requirement between the expiration of the current contract and the start of medical operations under the new contract, depending on the actual length of construction delays.

7. Actions to Increase Competition: A competitive, full and open acquisition was conducted, and a long-term contract was awarded on 01 September 2018 for a base plus four option years.

The second interim contract is necessary to continue providing services to the beneficiary population until phase-in and facilities preparations are completed, and until medical operations can start under the re-competed effort.

8. Market Research: IAW FAR Part 10, market research was conducted in April 2019, specifically for the second interim contract. It consisted of an FBO announcement, notifying all interested parties that the Government intended to issue a sole source contract to Spectrum, and that all vendors capable of performing the requirement could respond and contact the Contracting Officer. No answers or queries were received from any vendor other than the incumbent contractor. Only the incumbent contractor was determined capable of providing all services and facilities for a 01 July 2019 start in order to avoid patient care interruptions. The incumbent contractor is the only responsible source that can satisfy the agency requirements of providing both facilities and services by 01 July 2019 without a lengthy transition period.

9. Other Facts:

a. Explanation of why technical data packages, specifications, engineering descriptions, statements of work, or purchase descriptions suitable for full and open competition have not been developed or are not available: Not applicable. The requirement was re-competed, however medical operations under the new contract will not start until 01 January 2020 at the earliest.

b. Historical data.

(1) Previous Awards:

HT0014-18-F-0376 Spectrum Healthcare Resources, Inc.

Period of Performance: 1 Sep 18-31 Aug 19 Total Contract Cost: $19,354,246.73

HT0014-18-D-0030 Spectrum Healthcare Resources, Inc.

Period of Performance: 1 Sep 18-31 Aug 23 Total Contract Cost: $242,813,561.21

HT0014-18-C-0004 Spectrum Healthcare Resources, Inc.

Period of Performance: 1 Jan 18-30 Jun 19 Total Contract Cost: $80,630,569.99

W81K04-11-C-0012 Spectrum Healthcare Resources, Inc.

Period of Performance: 1 Jul 11-31 Dec 17 Total Contract Cost: $262,791,413.91

(2) Competitive status of actions:

Contract HT0014-18-F-0376 was the first task order issued under HT0014-18-D-0030.

Contract HT0014-18-D-0030 was full and open competition.

Contract HT0014-18-C-0004 was a sole source interim contract.

Contract W81K04-11-C-0012 was full and open competition.

(3) Authority previously used for other than full and open competition:

HT0014-18-C-0004 under FAR 6.302-1(a)(2)(iii)(B)

c. Previous procurement justification was necessary for continuity of services due to delays caused by the construction-permitting process. As previously stated, contract requirements, including facility physical security requirements, are very unique; there are few qualified and responsible companies able to provide these types of services; Fairfax and Prince William counties have both notified the contractor that they require additional time to review and approve their construction permit applications for the outside portion of the facilities, including the 25-meter standoff and other physical security measures, which involve the relocation and planting of many existing trees and other property features. It is not possible to compete the requirement in a timely manner without displacing the enrollment population to the civilian network.

10. Interested Sources: The requirement is for the continuation of medical operations starting on 01 July 2019, with fully equipped buildings and a complete staff, and without time for a transition period. Only the incumbent contractor is capable of providing the required services by the required start date.

11. Methods to overcome barriers: Not applicable. Barriers to competition have already been removed because the new contract currently undergoing source selection was advertised as a competitive, full and open requirement.

Coordination:

12. Technical/Functional Representative:

I certify that the supporting data under my cognizance which are included in the justification is accurate and complete to the best of my knowledge and belief.

13. Requirements Certification:

I certify that the supporting data under my cognizance which are included in the justification is accurate and complete to the best of my knowledge and belief.

14. Fair and Reasonable Cost Determination:

I hereby determine that the anticipated cost to the Government for this contract action will be fair and reasonable.

15. Legal Review:

I have reviewed this J&A and it is deemed to be legally sufficient.

Approval:

16. Contracting Officer: This certification shall be made by the contracting officer who will sign the contract resulting from this justification and approval (J&A).

I certify that this justification is accurate and complete to the best of my knowledge and belief.

17. Competition Advocate (CA):

Based on the foregoing justification, I hereby approve the procurement of Fort Belvoir Community Hospital Family Health Centers of Fairfax and Dumfries on an other than full and open competition basis pursuant to the authority of 10 U.S.C. 2304(c)(1) FAR 6.302- 1(a)(2)(iii)(B), subject to availability of funds, and provided that the supplies and/or services herein described have otherwise been authorized for acquisition.

18. Head of Contracting Activity (HCA) (or designee):

Based on the foregoing justification, I hereby approve the procurement of Fort Belvoir Community Hospital Family Health Centers of Fairfax and Dumfries on an other than full and open competition basis pursuant to the authority of 10 U.S.C. 2304(c)(1) FAR 6.302- 1(a)(2)(iii)(B), subject to availability of funds, and provided that the supplies and/or services herein described have otherwise been authorized for acquisition.