Limited Sources JAmdc.pdf

VHAPG Part 808.405-6 Limiting Sources Attachment 2: Request for Limited Sources Justification Format >SAT

Effective Date: 02/01/2022 Page 1 of 8

LIMITED SOURCES JUSTIFICATION

ORDER >SAT

FAR PART 8.405-6

Acquisition Plan Action ID: _______________________________

(1) Contracting Activity: NCO 23 Black Hills Contracting; Fort Meade, SD for Department of Veterans Affairs: VISN 23 (VA Midwest Health Care Network)

(2) Description of Action: This acquisition is conducted under the authority of the Multiple- Award Schedule Program (41 U.S.C. 152(3) and 40 U.S.C. 501).

Order against: FSS Contract Number:

Name of Proposed Contractor: Press Ganey Associates, Inc.

Street Address: 404 Columbia Street

City, State, Zip: South Bend, IN 46601-2355

Phone: 574-232-3387 / 1-800-232-8032

The Department of Veterans Affairs requires non-personnel services contract to provide the Upper Midwest Health Care Network (VISN 23) with systematic surveys of patient experiences. VISN 23 will develop and implement a process to provide timely, actionable, and accessible patient satisfaction data from the facility/division-level to the unit/clinic-level to prioritize improvement efforts throughout the VISN 23 catchment area. The primary goal is to improve patient satisfaction by having a survey service provide real-time feedback, identify, root cause of dissatisfaction and offer solutions for progress.

The Network serves more than 440,000 enrolled Veterans residing in the states of Iowa, Minnesota, Nebraska, North Dakota, South Dakota and portions of Illinois, Kansas, Missouri, Wisconsin, and Wyoming. Health care services are delivered through an integrated system of 8 VA Health Care Systems, 10 VA Medical Centers, 63 community outpatient or outreach clinics (CBOCs), 8 community living centers, 6 domiciliaries and 7 residential rehabilitation treatment programs. Locations included for services identified in this contract include:

36C263-22-AP-2981

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VA Midwest Health Care Network (VISN 23) o VA Black Hills Health Care System (Hot Springs & Fort Meade) o VA Central Iowa Health Care System (Des Moines) o VA Fargo Health Care System o VA Iowa City Health Care System o VA Minneapolis Health Care System o VA Nebraska-Western Iowa (NWI) Health Care System (Omaha) o VA Sioux Falls Health Care System o VA St. Cloud Health Care System

Manufacturer/Contractor: Press Ganey Associates, Inc.

Current Order Against Contract: GS-10F-0205R 36C26319F0003 for VISN 23 (currently in final Option Year of task order expires 09/30/2022).

Manufacturer/Contractor POC & phone number: Stephanie Whalen, Regional Director, at 570-406-0564 or Stephanie.Whalen@pressganey.com , June Anderson, RN, MSN, Patient Experience Advisor at 574-213-4685 or June.anderson@pressganey.com Manufacturer/Contractor Address: 404 Columbia Street, South Bend, IN 46601-2355 Dealer/Rep address/phone number: See above.

(3) Description of Supplies or Services:

The estimated total value of the proposed action is $6,281.200.24 (Base plus 3 option years)

The purpose of this service is to continue utilizing current outpatient satisfaction survey instruments that include customized questions for each Health Care System as well as questions that permit comparison to other VA, non-VA facilities, and teaching facilities. The primary goal is to improve the patient experience by having a service that provides real time feedback and identifies the root cause of dissatisfaction and offers solutions for progress.

The contractor shall provide all necessary personnel, supervision, labor, equipment, materials, and disposal necessary to perform systematic surveys of patient experience as defined in this Performance Work Statement except for those items specified as government furnished property and services. The contractor shall perform to the standards in tis contract. The primary objective of this contract is to increase patient satisfaction in VISN 23 outpatient clinics and services, including the emergency department by providing clinic staff with real time feedback on patient perceptions that will enable employees to improve their performance and deliver excellent care.

The Contractor shall provide systematic surveys to key service areas including:

Customization of survey instrument (from existing vendor surveys and/or Consumer

Assessment of Healthcare Providers and Systems {CAHPS} instruments), including a process for survey administration and collection

A platform for survey response data that does not require local software installation A response data analytics and reporting system Support/training/coaching

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(4) Identify the Authority and Supporting Rationale (see below and if applicable, a demonstration of the supply or service.

FAR 8.405-6(a)(1)(A): An urgent and compelling need exists and following the ordering procedures would result in unacceptable delays.

FAR 8.405-6(a)(1)(B): Only one source is capable of providing the supplies or services required at the level of quality required because the supplies or services are unique or highly specialized. Millions of tax-payer dollars and over ten years of quality data will be lost if we change systems at this juncture, negatively impacting care and service to our Patient Veterans and their families.

FAR 8.405-6(a)(1)(C): In the interest of economy and efficiency, the new work is a logical follow-on to an original Federal Supply Schedule order provided that the original order was placed in accordance with the applicable Federal Supply Schedule ordering procedures. The original order must not have been previously issued under sole source or limited source procedures. The original order was not previously issued under sole source or limited source procedures.

FAR 8.405-6(b): Items peculiar to one manufacturer:

A patent, copyright, or proprietary data limits competition. The proprietary data is as follows:

Press Ganey holds a copyright on its questions and our knowledge base which consists of our benchmarks, quality improvement and educational contact, etc.

All of this data is currently used by VISN 23 and all of its VA Facilities and CBOCs;

hence, this consistency is necessary to allow for seamless tracking of results for 440,000+ patients who use our services.

If this information and database are forfeited by contracting with a new Contractor, best value will not be attained, because the amount of time and money to recoup said database and information cannot best Press Ganey in this situation.

o Over 10 years of data (millions of data points) will be forfeited for the VISN 23 as this information will not be available for comparison to the proprietary copyright on its questions and comparison to VA and the community utilized by this VISN 23 contract with Press Ganey.

o It would take over 2 years to start over, losing momentum with sustaining patient satisfaction rates validated in SAIL reports, etc.

o Because the vendor has been conducting surveys for VISN 23 for over ten years, using a different vendor will not only skew the current/potential data results, but the new vendor will not have the past data for comparison and therefore, will not produce accurate results that the VISN 23 needs.

Effective Date: 02/01/2022 Page 4 of 8 o When Press Ganey was set up, all questions were approved through the OPM including a bank of additional questions which can/will be used in the future.

Press Ganey is the ONLY vendor who utilizes both VA and Commercial benchmarks.

o benchmarks along with its patient experience improvement services, provides a unique mix of services not available from any other source.

That is unique to this particular Contractor and the only entity who provides it.

o There are several VISNs and VA facilities (e.g. VISNs 1, 6, 7, 8, 10, 12, 16, 20, 21 & 23) that use this same vendor for patient satisfaction, as the market research demonstrated. These benchmarks are required, so VISN 23 may continue to strive for improvement, particularly as VISN 23 does not wish to lose unique Veterans to the private sector, as Veterans now have a broader choice than ever where they receive their care.

o Our organization does not have to wait for several months to see their national ranking; instead, this vendor provides real time results 24/7, resulting in more accurate benchmarking.

Press Ganey provides Medical Practice Reports (i.e. provider-level data) which is critical information for patient experience improvements.

o Refer to example of NWI procurement package.

o If we are to compete with the private sector, this unique data from Press Ganey will be crucial going forward.

o ies access hundreds of different type reports available thru Press Ganey for trending and validating where to focus improvements on patient care so they choose to use our services.

VISN 23 MCAA built an interactive database that allows specification of which stop codes to survey and specification of the type of survey. This allows each Facility to customize what surveys are utilized. This is then sent to Press Ganey as part of data upload process. If we start over with a new contractor all this work will be forfeited, and it will take at least 2 years to change the MCAA data base and retrain all the VA Facilities in our VISN 23. This would be very costly and is not in the funding budget.

o Millions of of data points (hundreds of reports) obtained for comparison over these past 10 years.

o VISN 23 has approximately 1,563,000 encounters per year, requiring a calculated number of surveys distributed to result in statistically valid response rates.

o The Network services more than 440,000 enrolled Veterans residing in the states of Iowa, Minnesota, Nebraska, North Dakota, South Dakota and portions of Illinois, Kansas, Missouri, Wisconsin, and Wyoming.

Health care services are delivered through an integrated system of 8 VA

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Health Care Systems, 10 VA Medical Centers, 63 community outpatient or outreach clinics (CBOCs), 8 community living centers, 6 domiciliaries and 7 residential rehabilitation treatment programs. Locations included for services identified in this contract.

o Press Ganey has the greatest number of contracts with VA which allows benchmarking with our VA peers.

o Press Ganey is the only company that can provide the services required, as they are able to deliver existing (already developed and customed) measurement tools that meets the requirements comparing VA benchmarks to commercial markets. Press Ganey has the largest database of real-time data, quicker ranking feedback.

All managers and programmatic specialists have been trained on running Press Ganey reports, and it would take at least 2 years to retrain and re-establish reporting structures, at the same time, losing all capability for comparison data that will be lost as Press Ganey is proprietary over the survey questions/data.

These are for existing equipment.

The material/service must be compatible in all aspects (form, fit and function) with existing systems presently installed/performing.

(5) Describe Why You Believe the Order Represents the Best Value consistent with FAR 8.404(d) to aid the contracting officer in making this best value determination:

Services offered on the Federal Supply Schedule are priced either at hourly rates, or at a fixed price for performance of a specific task (e.g., real-time survey feedback data).

GSA has already determined the prices of fixed-price services, and rates for services offered at hourly ratees, under schedule contracts to be fair and reasonable. GSA has already determined the prices of fixed-price services, and rates for services offered at hourly rates, under schedule contracts to be fair and reasonable, except for a price evaluation as required by 8.405-2(d). By placing an order against a schedule contract using the procedures in 8.405, NCO 23 Contracting has concluded that the order represents the best value (as defined in FAR 2.101) and results in the lowest overall cost alternative (considering price, special features, administrative costs, etc.) to meet the Government otiated fair and reasonable pricing the CO will make that determination via a technical review of the Contractor proposed labor mix based on services requested in the SOW and will seek additional discounts before placing an order.

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(6) Describe the Market Research Conducted among schedule holders and the results or a statement of the reason market research was not conducted.

Press Ganey is listed in the GSA eLibrary NAICS 541611; GSA-FSS Contract Number:

GS-10F-0205R.

Government Market Research dictates that GSA-FSS pricing is competitive, as it has already been completed.

The results of market research conducted pursuant to FAR Part 10, the Class Deviation Implementation of the Veterans First Contracting Program as a Results of the U.S.

Supreme Court Decision (Class Deviation Veterans First Contracting Program {VFCP 2016}, VHAPM Part 810.001, and PPM 2016-05) are as follows: Per PPM 2016-05, Implementation of the Veterans First Contracting Program because of the U.S. Supreme Court Decision: §8127 is mandatory, not discretionary and its text requires the Department to apply the Rule of Two to all contracting determinations. In order to meet the VA Rule of Two, the CO reviewed the Vendor Information Pages (VIP) data base in accordance with VAAR Class Deviation 810.001-70 to determine if two or more service-disabled veteran-owned businesses (SDVOSBs) and veteran-owned small businesses (VOSBs), in the appropriate NAICS code, are listed as verified in the VIP database. Further, VAAR 810.002 requires the CO to record VIP queries in the solicitation file by printing the result of the search(s) along with the specific query used to generate the search(s). This is complete; the VetBiz VIP Database search resulted in zero possibilities under the NAICS 541611 patient or medical surveys.

A Sources Sought FBO Notice posted with intent to Sole Source.

Regarding further market research in summary: A logical, best value cannot be attained if a new Contractor is brought on at this time, because the amount of time and money (years and millions) to recoup the VISN database and information cannot best Press Ganey in this situation.

(7) Any Other Facts Supporting the Justification:

In summary, a loss of significant time (years) and money (millions) to the U.S. taxpayers and Veterans if this LSJ is rejected.

(8) A Statement of the Actions, if any, the agency may take to remove or overcome any barriers that led to the restricted consideration before any subsequent acquisition for the supplies or services is made:

Press Ganey is the only company that provides the specific services NCO 23 requires, as they can deliver existing (already developed and customized) measurement tools that meets the requirements comparing VA benchmarks to commercial markets. Press Ganey has the largest database of real-time data, quicker ranking feedback, and a higher number VAs in the benchmarking data base. Their CAHPS database is proprietary and current, with rapid turnaround time and posting data results.

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(9) Requirements Certification: I certify that the requirement outlined in this justification is a Bona Fide Need of the Department of Veterans Affairs and that the supporting data under my cognizance, which are included in the justification, are accurate and complete to the best of my knowledge. I understand that processing of this limited sources justification restricts consideration of Federal Supply Schedule contractors to fewer than the number required by FAR Subpart 8.4.

_ 07/15/22 ____________

SIGNATURE DATE

Sharon Skoblik Staff Assistant to AD/NE Executive Office (618/00)

NAME TITLE SERVICE LINE/SECTION

Minneapolis VA HCS (for VISN 23 contract)

FACILITY

(10) Approvals in accordance with the VHAPM Part 806.3 OFOC SOP:

a. (required): I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief.

CONTRACTING OFFICER SIGNATURE DATE

NAME AND TITLE FACILITY/NCO/PCO

b. One Level Above the Contracting Officer (Required over the SAT but not exceeding $750K):

I certify the justification meets requirements for other than full and open competition.

SIGNATURE DATE

Michael Casper NCO 23 Branch Chief Services

07/15/2022

Pamela Phillips Contracting Officer NCO 23

Effective Date: 02/01/2022 Page 8 of 8

HIGHER LEVEL APPROVAL (Required for orders over $750,000):

c. VHA RPO HCA Review and Approval (over $750,000 to $75 million): I have reviewed the foregoing justification and find it to be complete and accurate to the best of my knowledge and belief and approve for restricting consideration of the Federal Supply Schedule contractors to fewer than the number required by FAR Subpart 8.4.

DATE Terry L. Spitzmiller

Executive Director Regional Procurement Office Central VHA Head of Contracting Activity (HCA)