JA LVN Oct 2020 Redacted.pdf

Control Number: 21-HRCO-79 Donald L. Mooney Enterprises, LLC (dba Nurses Etc. Staffing)

Licensed Vocation Nurse/Certified Nurse Assistant Services

Justification and Approval for Other Than Full and Open Competition

1. Contracting Activity: U.S. Army Medical Command (MEDCOM), Health Readiness Contracting Office (HRCO), 2199 Storage Street, Bldg 4197, Suite 68, Joint Base San Antonio (JBSA) Fort Sam Houston, TX 78234-5074.

2. Description of Action: The HRCO requests approval to negotiate a new bridge contract for personal services as a 3-month sole-source contract with the incumbent contractor, Donald L. Mooney Enterprises, LLC (dba Nurses, Etc. Staffing), to provide Licensed Vocational Nurse and Certified Nurse Assistant (LVN/CNA) services for the San Antonio Military Healthcare System (SAMHS). This is a personal services requirement. An Indefinite Delivery, Indefinite Quantity (IDIQ) contract with Firm- Fixed-Price (FFP) Contract Line Item Numbers (CLINs) is anticipated. The type of funds to be used is Fiscal Year 21 Defense Health Program appropriations. Estimated share and ceiling arrangements and fee or profit are not applicable to this acquisition.

3. Description of Supplies/Services:

a. These services are necessary to ensure the continuity of operations of essential medical services currently being performed throughout the SAMHS, which is comprised of San Antonio Military Medical Center (SAMMC), Fort Sam Houston, Texas, including the inpatient services at the SAMMC and their outlying clinics throughout the San Antonio, Texas area.

b. The contractor shall provide contract LVN/CNA services in support of the

Government’s medical operations 7 days per week, 24 hours per day, to include holidays.

All contract Healthcare Providers (HCPs) shall perform essentially the same functions, within the scope of acceptable practice for the specific specialty or position, as those required by the Military Treatment Facilities (MTFs) Government service healthcare professionals of similar experience and in similar duty assignments. The scope of services provided throughout the SAMHS covers the same range of services as those that are provided in civilian hospital systems of similar size and complexity. SAMMC is a DoD level one trauma center as well as a burn unit, and has multiple critical care units, intensive care units, step down units, medical surgical units, pediatrics, maternal/child services, surgical services, extensive specialty/subspecialty services supported by Graduate Medical Education program, ambulatory clinics, and other specialty clinics. A core mission of the Center for Intrepid, also located on the SAMMC campus, is to provide rehabilitation for combat and related casualties who have sustained amputations, burns, or functional limb loss.

c. The estimated total value of the proposed action is $8,676,183.62 for a 3-month base period of performance from 1 October 2020 through 31 December 2020 and a 3-month option period from 1 January 2021 – 31 March 2021. Federal Acquisition

Version – September 2018 FOR OFFICAL USE ONLY

Regulation (FAR) Clause 52.217-8, Option to Extend Services will be included in the resultant contract which will allow up to a 6-month extension. However, should the Government exercise this clause it will only be for 3 months thereby increasing the overall estimate to $13,014,275.43. The anticipated contract will be an IDIQ contract with FFP CLINs. The Contracting Officer will place a maximum estimated ceiling value not exceed $13,500,000.00 to account for surges in the requirement after award.

4. Authority Cited: The statutory authority permitting other than full and open competition is 10 United States Code (USC) 2304(c)(1) as implemented in FAR 6.302-1, Only one responsible source and no other supplies or services will satisfy agency requirements.

5. Reason for Authority Cited:

a. As described at FAR 6.302-1(a)(2) when the supplies or services required by the agency are available from only one responsible source, or, for DoD, NASA, and the Coast Guard, from only one or a limited number of responsible sources, and no other supplies or services will satisfy agency requirements, full and open competition need not be provided for. As further described in FAR 6.302-1(a)(2)(iii)(B) for DoD, NASA, and the Coast Guard, services may be deemed to be available only from the original source in the case of follow-on contracts for the continued provision of highly specialized services when it is likely that award to any other source would result in unacceptable delays in fulfilling the agency’s requirement.

b. There is a current bridge contract in place for these services through contract number

W81K04-20-D-0003. Task orders were issued against the basic contract with a 6-month period of performance from 1 January 2020 through 30 June 2020; and FAR Clause 52.217-8 Option to Extend Services was exercised extending services for 3 months from 1 July 2020 through 30 September 2020. The Government awarded a follow-on contract W81K04-19- D-0004 for LVN and CNA services on 17 April 2019. Two of the offerors in the competitive range filed a Government Accountability Office (GAO) protest on the LVN and CNA re-procurement contract. GAO dismissed both protests on 26 July 2019 and 13 September 2019 as a result of the agency’s decision to take corrective action which included reevaluating the proposals.

c. On 14 May 2020, the Government notified the offerors of the results of the corrective action. The offerors were debriefed on 3 June 2020. On 9 June 2020, one of the offerors in the competitive range filed a GAO protest which was later withdrawn on 26 June 2020.

The other offeror in the competitive range submitted debriefing questions on 5 June 2020 and received written responses on 20 June 2020. Another GAO protest was filed on 27 July 2020 and is pending a decision. Due to the GAO protest on the follow-on LVN and CNA contract, it is necessary to award a bridge contract to ensure continuity of service.

The below described barriers make it impossible for a timely transition and start of full performance by 1 October 2020. As a result, it is necessary to award a bridge contract to ensure continuity of services of 220 LVNs and CNAs currently supporting the medical mission of the SAMHS.

d. As to the sole-source approach to the bridge contract, there are certain barriers that make it impossible for another source to perform the Government's requirement as of the required start date. There are approximately 220 LVNs and CNAs that are required to support the MTFs and clinics within the SAMHS. According to the Texas Department Health and Human Service, Texas is currently facing a shortage in the nursing workforce.

There is an increase demand for nursing services. It will be difficult for a contractor other than the incumbent to recruit and retain approximately 220 LVNs and CNAs with the required experience, education, background, and license to provide services beginning 1 October 2020.

e. In addition, the Government requires the contractor to provide profile application packets on each employee who will be performing services under the contract no later than 10 business days prior to the start of work for privileging purposes. The profile application packets shall provide the following information: (a) Completed Centralized Credentials Quality Assurance System (CCQAS) data entry form; (b) primary source verification of state licenses with expiration date, license number, name and contact information for individual performing primary source verification attesting to direct state verification and the method of verification; (c) contractor conducted criminal history background check; (d) education history with primary source verification of college attended/degree; (e) Certifications: Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), Trauma Nursing Core Course (TNCC), and any professional certifications required for the position; (f) employment history and resume; (g) immunization status and health examination date;

and (h) skills assessment checklists, competency assessments, medication examinations, telemetry examinations, or any other skills verification necessary for specialty and location as specified in individual task orders. According to market research, there are a number of interested business concerns that have expressed their capabilities of compiling the information necessary within a minimal amount of time; however, per the Government's requirement, the contractor would have needed to submit the profile application packets by 20 September 2020, and there is simply not a sufficient amount of time for the Government to conduct a competitive acquisition and award a contract in time for another contractor to be able to meet the Government’s requirement.

f. It is not possible to negotiate and award a contract with any source other than

Donald L. Mooney Enterprises, LLC (dba Nurses Etc. Staffing), the incumbent contractor. Only Donald L. Mooney Enterprises, LLC (dba Nurses Etc. Staffing) possesses the unique qualifications to instantly perform the continuation of these services given that only Donald L. Mooney Enterprises, LLC (dba Nurses Etc. Staffing) already has the required resources, trained manpower, and has completed all in-processing requirements for their employees. As such, Donald L. Mooney Enterprises, LLC (dba

Nurses Etc. Staffing) requires no transition efforts to continue performing these essential medical services. Furthermore, any delay in continuation of services will negatively impact the requiring activity's mission of enhancing our Nation’s security through a healthy military force capable of providing the full range of military operations supported by a combat ready healthcare system that also sustains the health of eligible DoD beneficiaries. The Government would suffer serious injury if award of this bridge contract is delayed. Only Donald L. Mooney Enterprises, LLC (dba Nurses Etc. Staffing) can satisfy these mission critical services without causing unacceptable delays or disruption of mission essential services.

g. The period of performance on the current contract and task order can no longer be extended. The current contract and expires on 30 September 2020. The proposed 3-month bridge contract must be awarded no later than 20 September 2020, in order to continue the current level of services. The HCPs are required to be privileged by the MTFs. The incumbent contractor, Donald L. Mooney Enterprises, LLC (dba Nurses Etc.

Staffing), is the only responsible contractor with the required and qualified personnel who have already been privileged at the MTFs that will be ready to start performance on 1 October 2020.

6. Efforts to Obtain Competition: The Contracting Officer shall publish the notices required by FAR 5.201 and any bids or proposals received shall be considered.

a. Effective competition. Because this is a sole source action, effective competition is not applicable. The Government awarded a follow-on contract and is pending a GAO protest decision. In addition, the Contracting Officer previously published a Request for Information (RFI)/Sources Sought (SS) on the Beta.Sam.Gov website on 14 August 2020 to identify potential sources. The Contracting Officer will issue a notice of intent to award sole- source contract through Beta.Sam.Gov. No other efforts are being made to obtain competition as only one responsible source, Donald L. Mooney Enterprises, LLC (dba Nurses Etc. Staffing), is capable of instantly meeting the minimum requirements prior to the expiration of the current contract.

b. Subcontracting competition. In accordance with FAR Subpart 19.705-2, the

Contracting Officer has taken actions to determine whether the proposed contractual obligation requires a subcontracting plan. The current requirement is for personal services and the Contracting Officer has determined that a subcontracting plan is not required per the exemption at FAR 19.702(b)(2).

7. Actions to Increase Competition: It is not possible to compete this proposed bridge contract in time for service to commence on 1 October 2020. In addition, a competitive, service-disabled veteran-owned small business set-aside, acquisition has already been awarded for the follow-on 5-year contract, however, GAO protests were received and the Government is pending a resolution.

8. Market Research: In accordance with Defense Federal Acquisition Regulation Supplement (DFARS) 205.205-71, DFARS 206.302-1(d), and DFARS Procedures, Guidance and Information PFI 206-302-1(d), a request for information was posted to Beta.Sam.Gov on 14 August 2020 for 7 days. Thirteen firms responded. However, they were not considered as no other business concern can perform these short term services as stated above in paragraphs 5d, 5e, 5f, and 5g. In addition, the Government will issue a notice of intent to award a sole source contract to the incumbent contractor, and will notify industry that any quotes, proposals or capability statements received by the stated response time will be considered. Although the Government is required to procure healthcare services via the Defense Health Agency’s Medical Q- Coded Services (MQS) contract, Interim Procedure Memorandum 18-008, Use of MQS, states waivers are not required for solicitations released prior to 31 December 2018. In this case, our solicitation was issued prior to 31 December 2018.

9. Interested Sources: No other contractors have expressed an interest. The notice required by FAR 5.201 of our intent to award a sole-source contract will be published in Beta.Sam.Gov.

10. Other Facts:

a. Procurement History.

(1) Contract numbers and dates of last several awards.

(a) The requirement is currently being performed under bridge contract W81K04-20-

D-0003 with a total maximum value of $13,500,000.00 for a 6-month period of performance (1 January 2020 through 30 June 2020). A 3-month extension of services was exercised from 1 July 2020 through 30 September 2020.

(b) Prior to the current bridge, the services were provided under a number of other bridge contracts. Bridge contract W81K04-19-D-0010 with a total maximum value of $13,500,000.00 for a 5-month period of performance (1 February 2019 through 31 June 2019).

A task order against the basic contract was issued extending the service from 1 July 2019 through 31 December 2019.

(c) Bridge contract W81K04-18-D-0031 with a total maximum value of

$13,500,000.00 was for a 4-month period of performance from 1 October 2018 through 31 January 2019.

(d) Bridge contract W81K04-17-D-0019 with a total maximum value of

$29,000,000.00 was for a 6-month period of performance from 1 October 2017 through 31 March 2018; and the 6-month extension of services was exercised from 1 April 2018 through 30 September 2018.

(e) Bridge contract W81K04-16-D-0038 had a maximum total value of

$34,000,000.00 and was for a 12-month period of performance from 1 October 2016 through 30 September 2017.

(f) Bridge contract W81K04-15-D-0018 had a maximum total value of

$18,500,000.00. The period of performance was from 1 October 2015 through 31 March 2016; and the 6-month extension of services was exercised from 1 April 2016 through 30 September2016.

(g) Bridge contract W81K00-14-D-0015 had a maximum total value of

$35,000,000.00. The period of performance was 1 April 2014 through 31 March 2015 and the 6-month extension of services was exercised from 1 April 2015 through 30 September 2015.

(h) Competitive contract, W81K04-09-D-0016, had a maximum total value of $95,285,050.18. The period of performance was 1 January 2010 through 31 March 2014 (9-month base period of performance, three 12-month option periods, and included the 6-month option to extend services clause)

(2) Competitive Status of These Actions. Contract W81K04-09-D-0016 was solicited as a 100% service-disabled veteran-owned small business set-aside and a commercial, single award task order contract was awarded to Donald L. Mooney Enterprises, LLC (dba Nurses, Etc. Staffing) on a competitive basis.

(3) Authority previously used for less than full and open competition. Bridge contracts W81K04-20-D-0003, W81K04-19-D-0010, W81K04-18-D-0031, W81K04-17-D-0019, W81K04-16-D-0038, W81K04-15-D-0018, and W81K00-14-D- 0015 were issued on a sole source basis using the statutory authority permitting other than full and open competition at 10 USC 2304(c)(1) and FAR 6.302-1, Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements.

(4) Justification prepared to support the procurement made before this one with a summary of the contents of paragraph 7, Actions to Increase Competition, of the justification for that procurement and an explanation of the results. The justification prepared for the current bridge contract, W81K04-20-D-0003, stated the actions to increase competition were limited due to the Government receiving two GAO protest and taking corrective action.

(5) If prior award accomplished by full and open competition, a detailed explanation of the changed circumstances. Not applicable.

(6) Explanation of unusual patterns revealed by history, e.g., several consecutive, urgent buys. Not applicable.

(7) Justification prepared to support the procurement made before this one and description of circumstances for justification & any significant changes. The justification prepared for bridge contract W81K04-20-D-0003 was the Government taking corrective action on a GAO protest.

b. Other facts.

(1) The re-procurement solicitation was issued on 19 January 2017 as a service-disabled veteran- owned small business set- aside. One of the offerors filed a GAO protest on 4 December 2017 challenging their removal from the competitive range.

The Government took corrective action and GAO dismissed the protest on 21 December 2017. While re-evaluating the offers as part of the corrective action, the Government issued Donald L. Mooney Enterprises LLC (dba Nurses Etc. Staffing) a sole-source bridge contract in September 2018, covering the period 1 October 2018 through 31 January 2019.

(2) The Government was prepared to award a follow-on contract in December

2018. Following the requisite small business and contract award notifications, two offerors in the competitive range filed a size protest on 6 and 7 December 2018. The SBA determined the awardee to be a small business concern on 22 February 2019.

(3) The Performance Work Statement (PWS) for this contract is essentially the same as the PWS for the current contract and only includes administrative updates such as date changes, changes to points of contact, and those required by law or regulation.

11. Technical Certification:

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

Type Name: Date:

Title: COR, SAMMC Nursing Operations Signature:

12. Requirements Certification:

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

Type Name: Date:

Title: COR, SAMMC Nursing Operations Signature:

13. Fair and Reasonable Cost Determination:

I hereby determine that the anticipated cost to the Government for this contract action will be fair and reasonable based on a price and cost analysis.

This determination will be made using the following: � cost analysis � price analysis □ should cost IGCE □ audit: □ other:

As a part of this basis, certified cost or pricing data:

□ will be required.

� will not be required and the following exception applies (FAR 15.403):

□ Prices that will be agreed upon are based on adequate price competition.

□ Prices that will be agreed upon are based on prices set by law or regulation.

� A commercial item is being acquired.

□ A waiver has been granted by the head of the contracting activity (HCA) in accordance with DFARS PGI 215.403-1.

□ The contract action is a modification to a contract or subcontract for commercial item(s).

□ The estimated cost of the contract action is less than the threshold for certified cost or pricing data.

Typed Name: Date:

Title: Contracting Officer Signature:

14. Contracting Officer Certification:

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

Title: Contracting Officer Signature:

DXAVID.D.1 .D.1187545990

Digitally signed by

Approval

Based on the foregoing justification, I hereby approve the procurement of Licensed Vocational Nursing/Certified Nurse Assistant (LVN/CNA) services in support of the San Antonio Military Healthcare System (SAMHS) NTE $13,500,000.00 on an other than full and open competition basis pursuant to the authority of 10 U.S.C.2304(c)(1) and FAR 6.302-1 subject to availability of funds and provided that the services herein described have otherwise been authorized for acquisition.

Command Advocate for Competition Signature:

X Righ up"