Justification For An Exception To Fair Opprotunity - Redacted.pdf

VA-24-00045420

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 action is for award of a firm-fixed price

Delivery Order (DO) to be issued on a sole sourced bases to V3 Gate, LLC under its National Aeronautics and Space Administration (NASA) Solutions for Enterprise-Wide Procurement (SEWP) V Governmentwide Acquisition Contract (GWAC) NNG15SD27B, for continuation of work in the piloting of brand name IncludeHealth Virtual Physical Therapy (PT) platform for the Rural Veterans TeleRehabilitation Initiative (RVTRI).

3. Description of Supplies or Services: VA Veterans Health Administration, Veterans

Rural Health Resource Center is looking to continue deployment of brand name IncludeHealth Virtual PT solution for sites located at Gainesville, FL, Des Moines, IA, White River Junction, VT, Finger Lakes, NY and Augusta, GA with future deployment throughout the VA. This web-browser enterprise subscription-based Software as a Solution (SaaS) application will utilize synchronous clinical video telehealth, store and forward, remote patient monitoring and mobile health patient education to enhance interaction and communication between physical therapist and the Veteran.

Under this proposed effort, the Contractor shall provide monthly software subscriptions for not to exceed quantities of 20 Total Physical Therapist users and 600 Total Veteran patient users for the brand name licenses for the Commercial Off- The-Shelf (COTS) software solution. The solution shall be deployed to the VA Enterprise Cloud but shall not be integrated with any other VA application or system (not including the required internet connection for access). The Contractor will also provide professional support services of a system steward to assist with VA Security and Cloud requirements.

The Period of Performance (PoP) shall be for a 12-month base period and an optional period of 12-months. The estimated price for the base period is $29,651.00.

The total estimate price of this action if all options are exercised is $60,784.55 based on a Five (5) percent price escalation for option year 1.

4. Statutory Authority: The statutory authority permitting an exception to fair opportunity is Section 41 U.S.C. 4106(c)(3) as implemented by the Federal Acquisition Regulation (FAR) 16.505(b)(2)(i)(C), entitled “The order must be issued on a sole-source basis in the interest of economy and efficiency because it is a logical follow-on to an order already issued under the contract, provided that all awardees were given a fair opportunity to be considered for the original order.”

5. Rationale Supporting Use of Authority Cited: Based on Market Research, as noted in Section 8 of this document, the Government has determined that only V3Gate, LLC, 555 Middle Creek Parkway, Suite 120, Colorado Springs, CO 80921 is capable of meeting all the Governments technical and functional requirements as noted below.

In fiscal year 2022, VA competed its requirement for a virtual PT platform on a brand name or equal. Under the resultant Delivery Order, NNG15SD27B 36C10A22F0103, VA commenced work on the piloting of the required brand name solution. The intent of this pilot was to have a virtual physical therapy application lead the Veteran through their at-home physical therapy exercise regimen during/after their engagement with VA physical therapists. Currently, Veterans are given at-home therapeutic exercise programs in writing with periodic in-person follow-up. These at-home programs are typically as a result of long distances from the treatment center and/or availability of VA physical therapists to see the number of patients referred for on-going therapy, whether due to caseload, space, COVID, and/or other barriers. There is currently no mechanism to ensure proper execution of the at-home exercise regimen or compliance with the frequency/duration thereof.

This technology solution is intended to streamline care delivery while harvesting objective, measurable data and creating actionable insights for improved health outcomes.

Further, based on Market Research, as noted in section 8 of this document, the IncludeHealth Virtual PT remains the only application that meets the VA’s functional requirements. Specifically, the proposed solution is not a game-based application, but rather assists in providing skilled rehabilitation services. This solution remains the only viable application that provides a synchronous clinical video telehealth application that can provide remote patient monitoring and mobile health patient education to enhance interaction and communication between physical therapist and Veterans.

In order for VA to complete the pilot at the noted sites which has been partially deployed, VA must continue with the proposed source to complete necessary deployment and therapy activities. This work is critical in supporting of direct patient care, as well as providing data to VA Leadership about direction of telehealth, specifically, remote physical therapy outcomes and capabilities that can be provided to the Veteran.

Further, no other source can meet the Government timeline to complete the Pilot of this program. Based on historical data, at a minimum, it would take an alternative source a minimum of 12-months to get to the current state of the pilot. This includes activities such as user-acceptance testing, obtaining an Authority to Operate (ATO), and other activities, such as training and rollout, to make alternative applications available for use. This estimate is based on historical data for like rollouts of similar applications. Given the above, only the proposed source can continue the completion of this deployment without significant loss of economy or efficiency.

In addition to this, V3Gate, LLC is the only source that can provide the software as well as the required professional support services. Specifically, the required system stewards will need access to the software and its developer to assist in the completion of the deployment and Information Security requirements. As such, a single source must provide both the application and the support services. Failure to obtain these services as proposed will leave VA without a virtual solution for providing PT services and care to the Veteran, and potentially puts the Veteran at risk for additional issues travelling to appointments that could be handled at home.

6. Efforts to Obtain Competition: Market research was conducted, details of which are in the market research paragraph of this document. This effort did not yield any additional sources that can meet the Government’s requirements. However, it was determined that limited competition is viable among authorized resellers for this brand name hardware maintenance. In accordance with FAR 5.301 and 16.505(b)(2)(ii)(D), this action will not be synopsized, and the justification will not be made publicly available on the Contracting Opportunities website as it is under the simplified acquisition threshold. However, the justification will be posted with the solicitation on the NASA SEWP V website.

7. Actions to Increase Competition: To remove barriers to competition in future acquisitions for this requirement, the agency will work with the program office to perform additional market research so that other solutions can be considered.

8. Market Research: The VA Subject Matter Experts began market research in November 2021, which was recertified as of May 2024, in an effort to determine what virtual physical therapy applications were available to support the initial deployment and fielding of the Virtual Physical Therapy to veterans in an effort to reduce costs associated with the use of community care and patient referral outside of the VA. VA identified Reflexion Health, BlueJay Mobile Health, and Jintronix, and IncludeHealth as potential sources, , however no other source can be utilized in the completion of this specific pilot within the Government timeframe, nor meet all the technical and functional requirements outlaid in Section 5. Therefore, only brand name IncludeHealth Virtual PT application can meet the Governments requirements.

Additional Market Research was conducted via discussion with IncludeHealth to ascertain reseller channels. Based on correspondence dated May 28, 2024, V3Gate is the only source that can provide the required application and services for this effort.

As such, the solicitation will be issued on a sole source basis to V3Gate under NASA

SEWP V GWAC.

9. Other Facts: N/A

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

Steven Kostas Date: __________________________

Project Manager Signature: ______________________

11. Fair and Reasonable Cost Determination: I hereby determine that the anticipated price to the Government for this contract action will be fair and reasonable based on the comparison of proposed prices received in response to the solicitation.

Additionally, the successful quote will be compared to the NASA SEWP V GWAC published pricelist. NASA V SEWP GWAC prices already being determined to be fair and reasonable. Finally, the successful quote may be compared to the Independent Government Cost Estimate.

Michael J. Weckesser Date:

Procuring Contracting Officer Signature:

12. Procuring Contracting Officer Certification: I certify that this justification is accurate and complete to the best of my knowledge and belief. As this contract action exceeds $3,500, but does not exceed the simplified acquisition threshold, this document serves as the contracting officer’s basis for using an exception to the fair opportunity process in accordance with FAR 16.505(b)(2)(ii)(A).

Michael J. Weckesser Date:

Procuring Contracting Officer Signature: