JOFOC CMS Reentry residents_Redacted.pdf

JUSTIFICATION FOR OTHER THAN FULL AND OPEN COMPETITION

MEDICAL SERVICES FOR FEDERAL ADULTS IN CUSTODY UNDER THE CARE OF

THE FEDERAL BUREAU OF PRISONS

1. Identification of the agency and the contracting activity, and specific identification of the document as a "Justification for other than full and open

Federal Bureau of Prisons (Bureau) Residential Reentry Contracting 320 First St. N.W., Room 901-5 Washington, DC 20534

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

Pursuant to the Federal Acquisition Regulation (FAR) Part 6.302-2, this action is urgent and compelling for a six-month contract to provide medical services for federal offenders housed in the community. The period of performance will be from December 1, 2023 through May 31, 2024. The action is subject to the availability of funds (FAR 52.232-18).

3. A description of the supplies or services required to meet the value):

The mission of the reentry program is to assist federal offenders during the transition from prison to the community. Offenders are typically assigned to a Residential Reentry Center (RRC1) near the location where they will eventually be released. The Bureau contracts or establishes agreements with these facilities to provide assistance to community-based residents who are nearing release from federal custody. However, the Bureau remains responsible for the cost of providing medical services for the offenders in the reentry program.

The requirement for medical services includes providing a network of physicians, scheduling appointments for approved patient encounters both in-network and out-of-network, adjudication of claims received from medical providers and payments to providers for emergency and non-emergency medical care as well as delivery of approved medications. The service area of this contract is nation-wide and includes Hawaii, Alaska and Puerto Rico.

This approximate value of this requirement is $25,000,0002.

1 For the purpose of this document, the term RRC includes services for In-House residents, Home Confinement placements, Federal Location Monitoring, Day Reporting Center services, and Intergovernmental Agreement placements.

2 Based off of the price of services from the previous year, FY 2023.

4. An identification of the statutory authority permitting other than full and open competition:

Other than full and open competition for a procurement to address a need of unusual and compelling urgency is authorized by 41 U.S.C. § 3304(a)(2) as implemented by FAR 6.302-2, Unusual and Compelling Urgency.

5.

qualifications or the nature of the acquisition requires use of the authority cited:

Due to law changes over the last few years the healthcare needs of the types of individuals incarcerated also known as residents, living in the community has become more complex. As a result, the Bureau transferred program control of this requirement on March 2023, to the Health Services Division (HSD). Significant market research has been completed and the Bureau is exploring legislative changes which will impact the design of the future requirement.

A six-month contract will allow for continuity of services while the Bureau solicits and awards a new longer-term contract and will provide the time required for an awarded contractor to establish the medical network in order to provide services3.

NaphCare, Inc. (NaphCare) is the incumbent contractor who already has an established network of medical and pharmaceutical providers available for existing locations across the United States to continue to treat residential reentry and home confinement residents. Additionally, it has the required approvals necessary to perform this requirement.

Failure to award to NaphCare would cause approximately 14,000 individuals living in the community who remain in the custody and care of the Bureau of Prisons to be without routine healthcare, including prescriptions. This would lead to serious physical and mental injury to those in custody who are unable to obtain proper care; as well as financial and legal injury to the Government as emergency care would need to be obtained and the impending lawsuits as a result of not providing the basic right of healthcare to those in Bureau custody. Therefore, it is in the best interest of the Government to procure these services from NaphCare to avoid a lack of interruption of healthcare services.

3 A typical RRC is less than one-hundred residents while an institution can be in the high hundreds and even in the thousands at Bureau complexes.

The price analysis for pharmaceuticals consisted of comparing a sample size of commonly prescribed drugs for Bureau inmates.

This contract uses the Department of Veterans Affairs (VA) Pharmaceutical Catalog. Based on the resident's ten most commonly ordered medications, the results showed that NaphCare pricing for the top brand and Generic drugs is lower than the VA Pharmaceutical catalog.

Without a contract in place, the Bureau would be paying retail pricing for this population. The Bureau would be unable to control costs as the resident would choose to fill the Rx wherever was most convenient.

The following 7 CLINs were compared to published pricing of third party payors and billing services. A third-party payer is an intermediary between the healthcare provider and the patient, either public or private, that partially or fully covers the cost of a healthcare bill. This is essentially the service mechanism that is provided to the Bureau. NaphCare pays the provider and collects from the government.

Market research indicates third party payor and medical billing related services can range from 2% to 12%. The companies at the lower end of the scale add monthly service fees.

The Bureau believes six months is the minimum time required to make a competitive award. The Bureau anticipates to receives proposal at least a 45-day response time for receipt of bids or proposals from the date of publication of the notice. The Bureau also acknowledges that there will be an evaluation period, competitive range determination, discussions, an award determination.

Because the prior contract was terminated on November 30, 2023 and the competed contract cannot be awarded until May 31, 2024, the use of other than full and open competition for a 6-month contract services.

10. A listing of the sources, if any, that expressed, in writing, an interest in the acquisition

The following sources express interest in the acquisition:

Naphcare, Inc.

Wellpath, LLC Choctaw Defense Munitions, LLC AmerisourceBergen University of North Texas Health Science Center at Fort Worth CDR Health

11. A statement of the actions, if any, the agency may take to remove or overcome any barriers to competition before any subsequent acquisition for the supplies or services required:

The Bureau has worked over the years to meet better the healthcare needs of residents located in the community. Through lessons learned, various agency audits, and extensive acquisition planning and market research, the Bureau has achieved savings over the years and expects to continue that trend. The Bureau is finalizing the solicitation documents and is expected to be issued on January 31, 2024.