Industry Day Presentation.pdf

OCIO Official use only

Office of the Chief Financial Officer

Medical Staffing Recompete

07/28/2021

ICE Health Service Corps (IHSC) Office of Acquisition Management

Dr. Stewart Smith Assistant Director - IHSC

Captain Terry Smith:

Deputy Assistant Director Health Systems Support - IHSC

Ian Somppi:

OAQ – Section Chief

Presenter Information

Introduction Introduction to IHSC Overall Solicitation/Program Strategy IDIQ vs Task Orders Break

Measuring Performance Solicitation Specific Elements Questions

Agenda

Introduction to IHSC and

Medical Staffing

Background

IHSC and OAQ conducted a comprehensive program assessment and review over the last 2.5 years.

Past Challenges Staffing Shortages – Main factors impacting contractor staffing levels

1. Geographic location of detention centers

2. Compensation levels

3. Numerous stakeholders

4. Political circumstances

IHSC and Contract Requirements Award and Evaluation Burden

Overall Solicitation and

Program Strategy

ICE plans on soliciting a multiple-award Indefinite Delivery Indefinite Quantity (IDIQ) for a period of five years with two, two-year option periods.

Task orders will be a single facility or group of facilities depending on IHSC mission needs and logical grouping.

IHSC Program Management support contract

(outside the scope of this IDIQ) All HQ and IHSC support positions currently on the contract

(~25 FTE) shall be removed and awarded outside this solicitation to prevent conflicts of interest.

Path Forward

Expected efficiencies were not found with a single contractor.

Leveraging TDY, state compact agreements, Collaborative Practice Agreements, etc.

Gain competition efficiencies by having an established pool of experienced medical staffing contractors at the ready Reliance on a single contractor puts program risk is put on the Government Align with IHSC’s existing structure

WHY?

Scope: Provide medical staffing services in accordance with the PWS (specially look to Section 5) IDIQ – Overall scope of work and performance requirements Expecting to award 5-6 IDIQs but heavily driven by proposals

TO – Site specific staffing requirements Everything applicable in the IDIQ flows down to the associated TOs

IDIQ

FAR 16.504 requires an Indefinite-quantity contract to establish a maximum and a minimum Maximum: Gov. provided amount for total program estimated costs over 9-year period Minimum: Annual Industry Day (Section 19.5 of the

PWS)

Part I – Annual Industry Day presentation from the

Government on status of program Part II – Meeting between IHSC/OAQ and IDIQ holder management team Part III – Updates of annual deliverables

Minimum and Maximum

The resultant IDIQs will likely be strategic sourcing vehicles available for other DHS components to use.

This will likely not be mandatory for use for other components

DHS TOs shall use the terms of the IDIQ as a basis, however, may have their own requirements document, QASP, invoicing instructions, deliverables, etc. which will be established within the TO solicitation

DHS Strategic Sourcing Vehicle

Government currently expects 4 task orders. Task orders will only be available to IDIQ awardees

Period of Performance for full task orders will be 12-month base period and four 1-year option periods (5 year maximum)

For initial awards Government will stagger task order award start dates to facilitate transitions.

Task Orders

Why? – size, geography, and standards

Government would like input on proposed regionalization plan. Email CO with suggestions and justifications and ICE will review

Regionalization

Region 1 Region 2 Region 3 Region 4 Berks – PA York – PA

Batavia – NY Varick – NY

Elizabeth – NJ Caroline – VA Folkston – GA

Krome – FL

Eloy – AZ Florence – AZ

Alexandria – LA Jena – LA

Tacoma – WA

Dilley – TX Pearsall – TX

El Paso – TX Houston – TX

Montgomery – TX Port Isabel – TX

Taylor – TX

~160 FTE ~245 FTE ~190 FTE ~215 FTE

Two Phase Evaluations Phase I A virtual oral presentation based around Corporate Experience. This will include a ‘problem scenario’ that offerors will be given and will be expected to provide a response at the end of the presentation.

A written Capability submission.

Advisory Down Select Following Phase I evaluations, highest rated vendors will be advised to continue onto Phase II. Lower rated vendors will be advised to not continue to save time and resources with procurement.

Why: To goal is to streamline the evaluation with smaller phased proposals rather than one large proposal submission from all vendors at once. The best proposals with the highest chance to win will be advised to continue. The small proposals in the beginning will save resources for both Government and offerors if there is a low likelihood of a proposal receiving an IDIQ.

Evaluations

Two Phase Evaluations cont.

Phase II Written Plans (Contract Management Plan, Extended Absence/Backfill

Coverage Plan, Quality Control Plan, and Transition-In Plan) Past Performance (3 references and CPARs) Price

IDIQ and Task Order evaluation teams will be made up of different groups.

IDIQ evaluation will be done by HQ personnel, while TO evaluations will be conducted by IHSC field personnel from the sites.

Evaluations

Break 15 min

Measuring Performance

Quality Assurance Surveillance Plan

Metric AQL/Critical Threshold WHY Overall Staffing 92% and 80% This is a staffing contract

Site Staffing Levels Large Sites: 92% and 80% Small Sites: 80% and 60%

Used to calculate deductions and ensure performance at a facility level not just TO overall

Contract Medical Staff Qualifications

95% of candidates submitted for e-QIP initiation shall be fully qualified according to the position description.

Ensure fully qualified staff are recruited for this contract

Retention

90% of employees that start each quarter shall be remain employed at the end of that quarter.

It benefits the program to retain trained and experience staff to ensure successful performance

Turnover

No more than 18% of the employees who start each quarter shall leave the contract by the end of the same quarter.

It benefits the program to retain trained and experience staff to ensure successful performance

Quality Assurance Surveillance Plan cont.

Metric AQL/Critical Threshold WHY

Backfill for RN and LVN Callouts

85% RN and LVN shifts shall be backfilled by the contractor 40% Critical Threshold

Nursing is backbone of clinic. Shifts must be covered to ensure successful performance.

Start Dates

95% of contract staff start within 30 calendar days of receiving a preliminary favorable fitness determination.

Historically, there have been long delays in clearance approval to start day. Cleared staff needs to onboard promptly

Competency Assessment

95% of staff shall successfully complete their competency assessment* within 90 calendar days of start date.

Ensures new staff pursue a path towards being fully trained and able to successfully perform.

Quality Assurance Surveillance Plan cont.

Metric AQL/Critical Threshold WHY

Collaborative Practice and Prescriptive Authority Agreement (CP&PA Agreement)

95% of APP staff are covered under an IHSC CP & PA Agreement with a contract collaborating physician within 90 calendar days of their start date.

CP&PA Agreements have been an issue at some sites. Must have agreements in place to ensure CP and PA can work. State requirement

Credentialing (Non-LIP)

95% of complete credentialing packets shall be submitted to the government no less than 7 business days before their start date.

APPs – 12 days.

Has been an issue in the past. Applicable staff cannot start without packets reviewed and complete. This delays start days and impacts performance

Privileging

(LIP)

95% of complete privileging packets shall be submitted to the government no less than 14 business days before the start date.

Has been an issue in the past. Applicable staff cannot start without packets reviewed and complete. This delays start days and impact performance

When the performance requirement is 100%, that means the requirement and the Government’s expectation are 100% compliance.

Government understands the reality of staffing contracts and AQLs are established at minimum acceptable levels. This does not mean the requirement is met.

QASP Cont.

CPARs is how the Government reports contract performance.

The Government will use CPARs to report task order (not IDIQ) performance.

Sections 18.5 and 18.7 – Monthly QASP Metric Report and Quarterly Reports have the explicit purpose of making sure condition of performance is understood and there are no surprises.

Meeting the AQL does not guarantee the vendor is anything beyond satisfactory.

CPARs

If overall staffing level of a task order is less than 92% for a month, then the Government will execute deductions on the corresponding invoice.

Deductions percentages are established in the

QASP and are calculated by the COR using the deductions calculator.

Deductions are different for Large Sites (6 staffing categories) and Small sites (2 categories) to account for impact of the staffing on the mission.

Deductions are calculated to culminate for each site

H.6 - Deductions

Solicitation and Contract Specific Elements

Limits IDIQ holder to no more than 66% of total (nation-wide) staffing programmatic requirement This includes being a designated “back-up”

No IDIQ holder with an active TO may provide more than 10% of the labor for any other active task order

Why? – Simple answer…program risk. Goal is to move away from reliance on a single contactor

H.3 – Subcontracting Limitations

To account for changes/evolution in the commercial marketplace, the contractor may resubmit the IDIQ pricing after prior to the conclusion of the IDIQ base period.

This will not occur again at the end of IDIQ option period 1

Any changes will not flow down to price adjustments in existing/ongoing task orders.

Why? To account for changes in market conditions that may occur that puts pressure on ceiling pricing.

H.5 – Re-Proposal of IDIQ Ceiling Rates

QASP Metrics have an AQL and an associated Critical threshold metric.

Overall Staffing (80%) Site Staffing Levels (Large: 80% / Small: 60%) Nursing Backfill (40%).

Critical Threshold is point where performance below seriously threatens ICE’s ability to meet the mission.

If vendor is below threshold for a period of 3 months the Government may initial termination procedures and re-award to designated “back-up”

H.7 – Designated Backup

Instigating the “Back-up” Government initiates complete (entire TO) or partial

(select sites) termination procedures Awards a new TO to designated “back up” New TO will have the same transition-in period as previous vendor.

Pricing will be based on proposal (some negotiation may be required – WD for example) This does not fall outside the Fair Opportunity requirements per FAR 16.505(b) Why? Places a contractual infrastructure to facilitate transfer of failing site(s) before mission criticality. Encourages successful performance.

H.7 – Designated Backup cont.

Waivers are given on a case-by-case basis. CORs reach back to appropriate group within IHSC for a determination.

Do not rely on or expect to get approval for waivers!

Junior bill rate – for Nursing Positions only RN and LVN/LPN positions which a candidate does not have the “minimum of one-year experience in a hospital, medical office, or outpatient clinical setting” may receive a wavier and shall be billed at a Junior rate.

These will still be tracked in the QASP and reported CPARs Why? To encourage staffing levels of qualified personnel but opening recruitment to a new labor pool. Compensation adjustments which are fair for not meeting requirements.

PWS 5.1.2 – Waivers

Discussion

Questions & Discussion