JA_PTEMS_Extension 04.16.24 redacted.pdf

PTEMS Total Task Order Value Increase Control Number VA-24-00069015

JUSTIFICATION

FOR AN EXCEPTION TO FAIR OPPORTUNITY

1. Contracting Activity: Department of Veterans Affairs (VA) Office of Procurement, Acquisition and Logistics

Technology Acquisition Center 23 Christopher Way Eatontown, NJ 07724

2. Description of Action: The proposed sole source action is for a modification to the Firm-Fixed-Price (FFP) Task Order (TO) 36C10B21N10150056 titled “Product and Technology Ecosystem Management Services (PTEMS)” issued under Transformation Twenty-One Total Technology Next Generation (T4NG) Contract VA118-16 -D-1015 with Liberty IT Solutions, LLC., which has since been acquired by Booz Allen Hamilton Inc., (referred to herein as BAH) 8283 Greensboro Drive, McLean, VA 22102. On January 8, 2021, the TO was awarded with a 12-month Base Period beginning on January 8, 2021, with 4 12-month Option Periods and 8 Optional Tasks. Subsequently, on January 8, 2024, the third option period was exercised and currently expires on January 7, 2025. VA is in the process of competitively awarding a new TO; however, the current PTEMS TO will reach its total TO value by April 25, 2024. The purpose of this justification is to only request an increase of the total TO value for the current PTEMS T4NG TO. No increase to the period of performance is required. This total task order value increase will serve as a bridge of support until a new competitive TO is awarded and transitioned. In addition, this justification would modify Optional Task 8, “Transition” from 60 to 90 days to ensure sufficient time for onboarding and technical knowledge transfer to a new potential vendor.

3. Description of the Supplies or Services: The scope of the PTEMS TO is to enable the delivery of enterprise technology-agnostic capabilities across a broad range of Digital Transformation Center (DTC) Ecosystem solutions for business transformation and digital modernization while mitigating technology debt from developing and maintaining enterprise or monolithic systems. This includes Software-as-a-Service (SaaS), Platform-as-a-Service (PaaS), and emerging technology implementation, lifecycle management and delivery, systems/software engineering, web services development, software release and change management services, data migration and integration including application programming interface (API) development, configuration and development, and operations and maintenance support.

The overall support for VA is critical to ensure continued sustainment services, cybersecurity support, and mission-critical healthcare modernization support services, currently supporting approximately 21 on-going efforts. PTEMS is critical to VA’s digital modernization by leveraging a technology-agnostic acquisition strategy that scales across the enterprise and helps VA customers accelerate business outcomes by leveraging the benefits of the cloud ‘as a service’ marketplace and optimizing technology investments through scalability and reusability. DTC requires that the current services outlined in Section 5 below via Optional Task Three (CLIN 7001) and Optional Task Four (CLIN 8001), under TO 36C10B21N10150056, continue without interruption to prevent a negative impact to sustainment of mission-critical applications, VA’s cybersecurity posture, and delivery of healthcare and benefits services to the nation’s Veterans. The total estimated value of the proposed action is $61,950,750.24. This total TO value increase will allow these critical services to continue from April 25, 2024, through September 2, 2024. This will allow the competitive solicitation to be awarded by June 4, 2024, and then provide 90 days for a transition period over to the new awardee, if necessary.

4. Statutory Authority: The statutory authority permitting an exception to fair opportunity is Section 41 U.S.C. 4106(c)(2), as implemented by the Federal Acquisition Regulation (FAR) 16.505(b)(2)(i)(B), entitled “Only one awardee is capable of providing the supplies or services required at the level of quality required because the supplies or services ordered are unique or highly specialized.”

5. Rationale Supporting Use of Authority Cited Above: The proposed source for this action is BAH, 8283 Greensboro Drive, McLean, VA 22102. BAH is the Contractor on the PTEMS TO, which is currently in Option Period Three, expiring January 7, 2025. VA is in the process of competitively awarding a new TO which would encompass all the services detailed in this justification.

The requirements development for the competitive TO began in the fourth quarter of fiscal year (FY) 2023, with additional requirements refinement throughout the first quarter of FY 2024. The solicitation was released on April 9, 2024, with award currently projected by June 4, 2024. Once the competitive task order is awarded, there is also a requirement for 90 days of overlap to support a seamless transition of the services to a new vendor. Without a proper transition, there would be a break in service. For these reasons, VA requires a modification to increase the total TO value so that these critical services can continue beyond April 25, 2024, which is the date that the total TO value is projected to be reached under the current TO. VA also requires a TO modification to the existing PTEMS PWS Optional Task 8, “Transition” task, to increase the task duration from 60 to 90 days. When the PTEMS requirements were originally written, the Transition task did not anticipate the demand that the PTEMS TO would experience over the life of the TO (this demand was heavily driven by COVID-19 response requirements that could not have been foreseen). A 90-day transition period is critical to ensure a seamless handoff to a new potential vendor as there are currently 65 active projects on the current PTEMS TO. In order to properly transition activities to the new competitive TO, it is critical to address technical and functional requirements spanning functional, compliance, non-functional, and visualization aspects to include End-User Requirements and Research, Mock-Ups, Wireframes, Prototypes, Screen Flows and Navigation, Taxonomy and Information Architecture, Business Rules and Reporting, Configuration and Change Management, Acceptance Criteria and Testing Scenarios, and Measurable Success Metrics to comply with critical VA requirements that include Section 508, FedRAMP Authorization, Authority to Operate (ATO), Privacy Impact Assessments, and Interoperability standards.

This 90-day transition is required for all of the following critical knowledge transfer activities, for on-boarding to occur, and for the current efforts to be sustained:

o Some projects have mandates for decommissioning legacy systems and firm requirements for the new system to go-live. A new vendor would not only have to learn the new system but also be able to train thousands of users on how to use the system prior to go-live (training and change management) plus perform data migration of critical data.

o The PTEMS BAH team is currently working to integrate systems with other agency’s authoritative data sources. The PTEMS BAH team has active service requests in a queue with other agencies for critical integrations that would need to be re-submitted and the requirements process restarted if another vendor were to take over.

o A new vendor would need to become familiar with the VA Lighthouse API capabilities in order to ensure current service level agreements continue to be met, avoiding degradation to APIs and Veterans not being able to access their information.

o A new vendor must learn all existing DTC processes and procedures for building and releasing applications within the ecosystem.

o A new vendor must become familiar with the Veterans Crisis Line (VCL) Medora system and VA Health Connect (VAHC) system to perform the on-call 24x7 support for both programs.

o A new vendor must obtain access to all of the applicable environments in order to learn all of the respective systems and become experts to support issues that arise in production.

o A new vendor must be able to functionally administer and monitor multiple platforms and tools (Medora, Lighthouse, Salesforce, VA.gov, Centralized Data Repository, DTC Integration Platform, etc.).

o A new vendor must take ownership of numerous projects that are in the middle of enhancements development that have not yet been released and then perform the subsequent testing and release process to push those features into production.

o A new vendor must obtain the knowledge on existing project backlogs and gain technical understanding of each user story and associated priorities.

BAH is currently performing all the sustainment services, cybersecurity support, and mission-critical healthcare modernization support services, as described in Section 3.

Without this continuation of services, VA faces a gap in service for the critical sustainment, cybersecurity, and modernization support provided under the current TO, which would negatively impact VA’s mission-critical sustainment support, cybersecurity posture, and digital modernization efforts while the new TO is being competed and awarded. This total TO value increase will ensure continuity of sustainment support for mission-critical applications (such as Medora, used by the Veteran Crisis Line), VA’s cybersecurity compliance support, digital modernization of healthcare related applications, as well as continued compliance with Federal mandates and mandatory Federal reporting and a seamless transition to a new vendor. Any interruption of these tasks executed by the BAH team supporting VA would immediately result in direct impacts to VA mission-critical programs such as the Veterans Crisis Line, the Veteran Homelessness Program, VA 24x7x365 healthcare services, Tele-Emergency Care, VA.gov, and many other systems/programs, which would cause degradation of systems, services, and applications VA-wide and would severely and negatively affect

VA’s ability to provide suicide crisis support, homelessness benefits, and healthcare to our Veterans.

Specifically, interruption of the tasks currently being executed by the BAH team would impact the following projects/applications:

• VCL Medora: VCL Medora is a web-based application utilized by over 1,500 National VA Suicide Prevention Hotline staff to refer Veterans to the appropriate field-based Suicide Prevention Coordinators. If the VCL Sustainment project is not extended, VA will not be available to address real time issues for the current Medora solution which would negatively affect a VCL coordinator’s ability to care for Veterans reaching out for suicide prevention assistance.

• Tele-Emergency Care (Tele-EC): Tele-EC is a component of the VA Health Connect (VAHC) Customer Relationship Management (CRM) solution to enable a Clinical Contact Center (CCC) Registered Nurse (RN) with an emergency to connect with a Tele-EC medical provider within acceptable timeframes. The CCC RN will also be able to escalate non-emergency, urgent encounters to a Tele-EC medical provider allowing non-scheduled virtual care if the CCC RN determines it necessary. Should there be a gap in support, VA will be unable to support the Veterans Health Administration’s (VHA) National Emergency Medicine Office in establishing Tele-Emergency Care practices that leverage the Tele-EC CRM capability across the country.

• Provider Connect: Provider Connect is a tool that enables VA healthcare providers to connect with specialty care in a near real-time manner, eliminating the wait time associated with obtaining a standalone appointment with a specialist and improving Veterans’ access to the best and most timely care.

Provider Connect is adding another site, Veterans Integrated Service Network (VISN) 16, to allow better access for rural Veterans to specialists with a plan to add 4 more rural sites in 6 months. Should there be a lapse in support for the Provider Connect application, the opportunity to solve the lack of access for rural Veterans would continue to be unresolved, leaving hundreds of Veterans without the possibility of quick and accessible care with VA specialist providers.

• VAHC CRM: VAHC CRM is an application used in 15 of 18 VISNs that provides a full view of Veteran healthcare information and outcomes, enabling streamlined and real-time support of Veterans, families, and their caregivers 24 hours per day, 7 days per week, 365 days per year (24/7/365) through the VAHC program.

VAHC CRM has been a leader in establishing and maturing relationships, coordination, and integration of service and platforms across VA’s information technology (IT) systems enterprise, driving improvements in availability, integrated maintenance practices, and incident resolution. Should there be a gap in support, development, sustainment and maintenance, and implementations would cease. This would put the application’s committed future functionality, to enable scaling, stability and user perception, and further deployments at risk.

Further, it would limit the continued progress towards an integrated and modernized VAHC program, designed to ensure the most timely and best care for Veterans, their families, and their caregivers.

• VAHC CRM Executive Integration Team (EIT): The VAHC EIT is a VA Integrated Veteran Care (IVC) and OIT effort to support the modernization and transformation of the enterprise-level VAHC program. EIT is focused on ensuring alignment between the program office, service owners, business owners, and end users on national policy, health care field operations, and technology development, implementation, and support, furthering the expansion and maturation of the program and enhancing benefits for VA and Veterans, their families, and their caregivers. Direct support of the EIT resulted in the adoption of VAHC CRM in 15 of 18 VISNs, with documented implementation targets for the remaining three VISNs. Should there be a gap in support for VAHC EIT, key pre-implementation support, which sets the stage for continued adoption of CRM services, would be jeopardized. Further, all progress made toward driving consistency of VAHC operations,, providing enhanced access to care for VA health and supportive services, as well as ensuring the availability of services for Veterans, their families, and their caregivers would be threatened.

• Lung Cancer Screening (LCS) App: The LCS app, through actionable data and streamlined workflow, is responsible for accurate lung screening care for all Veterans to assist in early cancer detection. Coordinators at the six EHRM Cerner-solution converted sites would lose access to the LCS development support, which have been instrumental in supporting VA sites as they transition to Cerner, by defining standard processes and operating procedures within the new Electronic Health Record (EHR) as it relates to LCS and continued refinements of the tool. Additionally, VA relies heavily on the Contractor for system training. Lastly, VA continues to learn about data in EHR, which leads to identifying gaps where Veteran records may require additional information.

• API Lighthouse: The API Lighthouse program enables OIT to deliver valuable software applications with higher quality and reduced risk through agile development and continuous delivery. This program led to the development of Lighthouse Delivery Infrastructure with its Secure Release pipeline, which simplifies software development at VA, making it more efficient, repeatable, and secure. The Lighthouse program supports the maintenance of Lighthouse APIs, which serve over 400 million monthly service calls for over 118,000 Veterans. If the Lighthouse Program were to experience a gap in service, the support would be degraded.

• Community Care Scheduling Solution: The Community Care Scheduling solution provides an enterprise-wide, unified interface that delivers digital access to Community Care providers’ availability and capabilities to schedule directly in the Community Care EHR systems, reducing the average time to schedule a Community Care appointment from days to minutes while providing an integrated, unified view of all scheduling activities with external providers. Should there be a gap in support, VA’s ability to rollout the Community Care Scheduling solution to additional VISNs will be impacted, as would its ability to continue to enhance the solution to include additional integrations which make scheduling with Community Care Providers easier for the Veteran. Not having this capability will cause VA to rely on phone calls when scheduling Veteran Community Care appointments, negatively impacting the ability for Veterans to receive timely care.

• Community Care Centralized Data Repository (CDR): CDR provides a unified data platform through which informatics and analytics can be gathered to improve the Veteran healthcare services’ visibility, understanding, and quality.

The CDR project currently has in-progress work that, if not continued, would hinder the decommission of claims processing and eligibility of legacy systems and impact progress on a more efficient and secure application for Veteran Community Care. Additionally, CDR is providing Revenue Operations the claims data sets in order for all revenue functions to continue despite the Program Integrity Tool system being down.

• Whole Health Mobile App: The Whole Health mobile application allows Veterans to develop a personalized health plan based on their values, needs, and goals. Without continued operations and maintenance support, key content updates and sustainment activities would not be completed, potentially impacting the ability for Veterans to utilize the application for their health goals and needs.

• Veteran-Home CRM (VET-HOME CRM): The VET-HOME application is a centralized intake contact center that serves as a national hub for information and services on military environmental exposures. This project needs to continue in order to enhance and maintain the application to support exposed Veterans.

Should there be a lapse in support for maintenance and sustainment activities, this application would go unsupported which could impact Veterans’ ability to get timely access to information and services related to military environment exposures.

• Medical Calculator App: The Medical Calculator app streamlines the clinical care process with reliable, evidence-based patient assessment calculators. The Contractor has prioritized the highest impact calculators alongside clinical experts to ensure that the physicians who need it most are supported by the development efforts under this task order. Should there be a lapse in support, physicians would be forced to rely on external and unproven methods, and calculators that create inconsistencies and gaps in equitable care. Should the work not continue, and these calculators would not be made available to clinicians, and clinician burden would continue to be a challenge to Veteran care.

• DTC Integration Platform (DIP) Sustainment: The DIP platform currently supports over 30 integrations for the Salesforce platform, hosting applications, security updates to platforms and applications, maintaining security controls for the Federal Information Security Modernization Act (FISMA) High ATO, and 24/7 monitoring and support. In case of loss of continuity of BAH support, there would need to be a transition of these services, or the overall platform would not be able to meet security requirements for a FISMA High system. Also, all system health and application health monitoring would cease or be forwarded to teams with limited experience with the platform and supported applications. Onboarding of new applications by other teams would also be interrupted due to lack of personnel to configure new deployment pipelines.

• Chief Technology Office (CTO) VA.gov Content and Accessibility: CTO’s VA.gov Content and Accessibility provides content migration, training, and support to non-CTO content authors so that VA can reduce accessible content errors, increase plain language, and find and remove duplicative Veteran-facing web content at the program and local level. Should there be a lapse in support, new and improved products developed by the VA Office of the CTO, often mandated by Congress, would not meet 508 accessibility nor Plain Language Act requirements for written content, creating an undue burden for Veterans seeking guidance on health, burial, educational, and other VA benefits.

• Robotics Process Automation (RPA) National Call Center (NCC): The RPA- NCC project, supporting the VA National Call Center, streamlines various business processes within the organization, enhancing operational efficiency, reducing errors, and improving overall productivity. The continuation of the RPA- NCC effort will enable the complete deployment of the final automation and continue to support the deployed automations. Should there be a gap in support, this will disrupt the ability to respond to outages, automation needs, and negatively impact Call Center agents’ response time in service of Veterans.

• Chief Information Security Officer (CISO) Security Support: The CISO

Security Support project works directly with the Office of the CISO to ensure VA systems are secure. Without this support, VA would lose its adversarial emulation, vital detection, and response testing capabilities currently being delivered. Veterans will be more at risk if security operations do not remain supported and tested for detection and response to malicious threats.

• Continuous Authority to Operate (cATO) Lighthouse Security Support: The cATO Lighthouse Security Support provides assessment processes for multiple applications in the Lighthouse API platform and ensures that applications going into production have reduced risk, while ensuring they meet VA policies and requirements. If there was a gap in support, the onboarding process would come to a complete standstill for at least 55 percent of Lighthouse applications as well as eliminate the possibility of bringing any new applications on-board or expanding the program at all. Without this support, there would be a severe impact in the ability to efficiently move teams through the ATO process. A lack of assessor support would create a severe bottleneck, greatly impairing the program’s mission to modernize VA. This would introduce risk to Veterans and the program as bug fixes and feature improvements would not be able to be deployed as needed.

• Continuous ATO (Rise8): The Continuous ATO gains approval for ongoing authorizations from the Authorizing Official under National Institute of Standards and Technology Risk Management Framework (RMF) by utilizing a Continuous RMF model. With the continuous RMF process in place and proven, this support will continue to aid the expansion and engagement for the security release pipeline. This support is critical to gain user adoption to ensure the products can scale and maintain the positive customer experience needed by applications currently onboarded and onboarding. Without this support, there would be a severe impact to the program’s ability to efficiently support teams throughout the cATO process.

• VHA Energy-Capital Asset and Energy Optimization (CAEO) Project: The CAEO project is comprised of a turn-key solution with healthcare industry facility infrastructure benchmarks and modeling capabilities that enable VHA to rapidly transform from disparate, reactive facility management practices to a new paradigm of advanced modeling informed predictive management regimens.

Continuing the CAEO project will enable further support to the pilot facilities (Denver, Salt Lake City, and Cincinnati VA Medical Centers) in the implementation of energy savings recommendations and allow the identification and implementation of additional healthcare facility optimization recommendations. By implementing these innovative recommendations and generating operational/utility savings, additional medical facilities’ funding will be available for facilities to execute further infrastructure improvements to the VHA Environment of Care in which Veterans are provided continued treatment and support. Without continuing with the CAEO project, VHA will not have a standardized, enterprise-wide solution to acquire, aggregate, and predictively model its capital asset and energy performance management optimization opportunities across its portfolio of 170 VA Medical Centers nationwide.

• Veterans Enterprise Integration Services (VEIS) Integration Platform Operational Component: The VEIS Integration Platform provides interfaces to many Veteran-facing Microsoft Dynamics 365 CRM applications that support multiple VA operations. The VEIS Integration Platform Operational Component provides support for Logging Enhancements, Education Call Center Integration, On-Call Operations Establishment, Monitoring & Alerts, and Simplification of Certificate Management. Should there be a lapse in support, continuous improvement and sustainment initiatives will not be completed, which will negatively affect the overall robustness and reliability of the VEIS Integration Platform.

• VoiceBot: The VoiceBot project is an effort that provides Veterans enhanced customer engagement, automated processes, and provides a personalized experience which allows for faster service that can answer more complex questions without the need for an agent, thus also reducing burden on the contact center agents so they are freed up to support more complex requests. A gap in service will delay the timeline to launch this service, which will cause a significant delay in enhancing how VA supports Veterans’ needs. As a result, Veterans will incur long wait times.

Due to the demand for the PTEMS 1.0 TO, much of which was driven by VA’s emergent COVID-19 response requirements that could not be foreseen, the PTEMS 1.0 total TO value was utilized nearly two years earlier than originally expected. Additionally, due to the continued emerging demand of new business customers, including recent PACT Act related requirements that were previously unknown, as well as the size and complexity of the PTEMS 2.0 requirements, the acquisition package needed thorough development to ensure all applicable requirements were captured in their totality. As such, the recompete TO will not be awarded prior to the projected date when the PTEMS total TO value will be reached, which would result in a gap of critically required services. Loss of BAH support during this gap will result in significant direct impacts to patient care, system degradation of mission-critical applications, such as Medora (impacting VA’s ability to assist suicidal Veterans) and failing to comply with Federal and VA cybersecurity mandates.

Based on market research which can be found in Section 8 of this document, it was determined that BAH remains the only responsible source capable of satisfying PTEMS requirements within the required timeframe, until a follow-on TO is awarded and an orderly 90-day transition can occur. No other source can provide the aforementioned support or continuity of services required as a result of the delays in the award and execution of the new TO. This total TO value increase will provide for the timely continuance of this critically needed support to ensure there is no gap in service, where this continuance is crucial to ensuring continued daily operations and sustainment of mission-critical VA applications, cybersecurity posture, and digital modernization.

Additionally, there are critical custom components and applications which require elevated privileges that rely upon the technical expertise and VA specific knowledge of PTEMS BAH contractors in order to maintain functionality and provide maintenance.

Any impact to the level of support for these applications would result in system degradation for mission-critical applications, like Medora (impacting VA’s ability to assist suicidal Veterans), and applications that directly impact Veteran patient care, such as VAHC CRM and Tele-EC. It would also result in VA failing to comply with Federal and VA cybersecurity mandates. Over the years, PTEMS developed very specific methods and applications to maintain operations and meet the VA mission. A new vendor, without intimate VA knowledge, would not be able to correctly operate or maintain the applications (e.g.: Medora, VAHC CRM, Tele-EC, Provider Connect, Lighthouse) or apply the appropriate processes/procedures until after a lengthy timeframe, which would have cascading negative effects across VA, resulting in potential adversarial cyber infiltration, loss of VA data, and significant impacts to patient care. Interruption to any of the above mentioned critical operational activities and essential service tasks executed under the existing TO with BAH would immediately impact operations of the 21 programs listed above. Any source, other than BAH, would require a ramp-up period of 90 days to onboard and/or transition appropriate staff, develop a PTEMS intake/level of effort process, conduct site visits to fully understand end user processes, understand the backend interdependencies with VA authoritative data sources, obtain necessary permissions and access to VA systems, recruit and train staff with the appropriate skill sets, and properly transition all required tasks and workloads. This 90-day onboarding time period is based on lessons learned and past experience on this effort in addition to similar OIT support contracts. Failure of DTC to provide all current functions until such a time as a follow-on TO and an orderly and complete transition can occur between VA, BAH, and the new TO awardee, would cause undue negative impacts to VA such as interruptions to patient care, Federal mandates being missed or not adhered to, and cyber threats going unmitigated, all of which would be unacceptable to VA. Therefore, VA needs to increase the total TO value to ensure critical services are continued until a competitive award is finalized. The total TO value increase accounts for the time needed to have a new TO awarded as well as the 90 days needed for the transition period. The estimated total TO value increase amount was determined by utilizing a program-specific total cost of ownership model level of effort based on previous and existing requirements.

6. Efforts to Obtain Competition: Market research was conducted, the details of which are in Section 8 of this document. This effort did not yield any additional potential sources that could provide the seamless support while the competitive procurement is being solicited and awarded. Due to the critical need for continuity of support, there is no competition for this acquisition. In accordance with FAR 5.301 and 16.505(b)(2)(ii)(D), the award notice for this action will be synopsized on the Contracting Opportunities website, SAM.gov, and the justification will be made publicly available within 14 days of award.

7. Actions to Increase Competition: No barriers to future competition are anticipated. VA anticipates awarding a competitive task order on June 4, 2024, and future acquisitions will be awarded on a competitive basis.

8. Market Research: Throughout FY24 Q2-Q3, DTC Subject matter experts regularly reviewed industry trade publications and conducted internet research to ascertain what vendors might be capable of providing the required PTEMS support. DTC subject matter experts conducted market research of the following companies: BAH, Cognosante MVH, LLC, Accenture Federal Services, Huron Consulting Services, LLC, TISTA, Acumen Solutions, Inc., and Deloitte Consulting, LLP. From these research efforts, the Government’s technical experts determined that only the current technical support team from BAH can meet VA’s immediate requirements for continued sustainment, cybersecurity support, and digital modernization support. While DTC subject matter experts concede that other vendors may have the general capabilities to perform the current PTEMS requirements, none other than BAH could meet the immediate requirements in a seamless manner as detailed above in Section 5 of this justification.

9. Other Facts: None.