J and A 0527_DCCO_Redacted.pdf

J&A 1

“Source Selection Information – see FAR 2.101 and 3.104”

1. Identification of the agency and contracting activity.

a. Federal agency and contracting activity. HHS/INDIAN HEALTH

SERVICE

b. Sponsoring organization. Great Plains Area Office of Health Programs

c. Contracting Officer’s Representative.

• Kelly Thomas

• 3200 Canyon Lake Dr, Rapid City, South Dakota 57702.

• Kelly.Thomas@ihs.gov

• 605-390-8368

2. Nature and/or description of the action being approved.

a. Acquisition purpose and objectives: The purpose of this acquisition is to establish a short-term bridge contract for emergency department (ED) physician and nursing services to ensure uninterrupted delivery of critical healthcare services while a competitive procurement is completed. The emergency department is a Level IV Trauma Center providing critical, life-saving services in a rural area. The next closest emergency room is located over 60 miles away. Due to the geographic isolation and rural nature of the population served, patients face significant barriers to accessing alternative emergency care, including transportation limitations and extended travel times. Any disruption of services would create an immediate and unacceptable risk to human life and safety.

b. Project background.

The urgency was not caused by a lack of advance planning or delay by the Government. This requirement is a follow-on to an existing contract with World Wide Medical #75H70625P00142, the incumbent contractor providing credentialed emergency physicians and nursing staff. The incumbent has completed all credentialing and privileging requirements and is fully integrated into hospital operations. The bridge contract is required due to a delay in the awarding of Schedule B of a GPA-Area wide IDIQ contract. Due to the lengthy, unanticipated and unforeseen delay the Standing Rock Service Unit

Justification and Approval for Sole Source Acquisition Under the Test Program for Commercial Items

J&A 2 is perusing local Emergency Department Nursing and Physician Contracts in absence of a viable area contract vesicle for continued operations.

Due to the extensive time required for credentialing, privileging, and onboarding emergency medical personnel, no other vendor can provide qualified staff within the required timeframe to avoid a lapse in services.

medical policies, procedures, and standards of care.

Contractor health care providers and nurses provide services to eligible beneficiaries of the IHS who present themselves for themselves for emergent. Contracted services encompass the provision of medical services that are emergent and non-emergent at the IHS Fort Yates Hospital at Fort Yates, ND.

c. Project title. Emergency Department Physician and Nursing Services

d. Project description.

• See attached SOW for project specifics.

• Requirement type.

Research & development (R&D) R & D support services Support services (non-R&D) Supplies/equipment Information technology (IT) Construction Architect-engineer (A & E) services Design-build Other (specify):

• Type of action.

New requirement Follow-on Other (specify): This bridge action will be executed as a

Performance-Based Firm-Fixed-Price contract to the maximum extent practicable.

• Proposed contract/order type.

Firm-fixed-price Other fixed-price (specify, e.g., fixed-price award-fee, fixed-price incentive-fee):

Cost-plus-fixed-fee Other cost reimbursement (specify, e.g., cost-plus-award-fee, cost-plus-incentive-fee):

Time and materials Indefinite delivery (specify whether indefinite quantity, J&A 4

5. Description of the efforts made to ensure that offers are solicited from as many potential sources as practicable. Indicate whether a FedBizOpps notice was or will be publicized as required by FAR Subpart 5.2 and, if not, which exception under FAR 5.202 applies. A notice will be posted to SAM.gov in accordance with FAR Part 5. This action is limited to the incumbent due to urgent and compelling circumstances while the Government proceeds with a full and open competitive acquisition for the long-term requirement.

6. Determination by the Contracting Officer that the anticipated cost/price to the Government will be fair and reasonable.

The Contracting Officer will determine price reasonableness through comparison with prior contract pricing, independent government cost estimates, and available market data for similar services. Cost/price analysis will be conducted in accordance with FAR 15.404.

8. Description of the market research conducted (see FAR Part 10) and the results, or a statement of the reasons market research was not conducted.

Outreach to multiple vendors confirmed none could provide credentialed staff within the required timeframe. Market research indicates that while multiple vendors exist, none can provide fully credentialed and privileged emergency department personnel within the timeframe required to prevent disruption of services. Credentialing timelines alone typically exceed several months.

9. Any other facts supporting the use of other than full and open competition.

This acquisition is justified based on unusual and compelling urgency pursuant to FAR 6.302-2. In accordance with FAR 6.302-2(c), the Government would be seriously injured unless the agency is permitted to limit the number of sources.

Specifically, failure to award this bridge contract would result in: Immediate interruption of emergency medical services at a Level IV Trauma Center. Inability to provide life-saving care to patients presenting with trauma, cardiac events, respiratory distress, and other emergent conditions. Patients being required to travel over 60 miles to the next closest emergency department, which is not feasible in time-sensitive medical emergencies. Disproportionate impact on a rural population with limited transportation access, further delaying or preventing care.

The extent of harm includes a high probability of loss of human life, serious bodily injury, and irreversible health outcomes due to delayed or unavailable emergency treatment. Such outcomes represent mission failure and create significant legal exposure, including malpractice liability.

The anticipated period of performance (not to exceed 10 months) represents the minimum time necessary to avoid these harms while completing a competitive procurement. The contract is setup with 2-month option periods to utilize the shortest period feasible due to the time required for recruiting, credentialing, and privileging emergency medical personnel.