NSB Contract_JOFOC for HC Services Alcohol Abuse Services Renewal_IHSCA signed.pdf

JUSTIFICATION AND APPROVAL

FOR OTHER THAN FULL AND OPEN COMPETITION

Completion Instructions: The Department of Health and Human Services (HHS) has established a standard template for the preparation of a J&A for Other Than Full and Open Competition. If this is an 8(a) set-aside, please note this form is not required unless the acquisition is valued (including all options) at greater than $22 million. This template is NOT applicable for actions using simplified acquisition procedures (FAR Part 13), Federal Supply Schedule orders (FAR 8.4) or task or delivery orders subject to fair opportunity (FAR 16.505).

Tailor all aspects of this template to the individual acquisition. Consult FAR Subpart 6.3 for guidance. An addendum may be added in case additional space is needed.

When this document is printed, the blue italic instructions are automatically deleted on the printed version.

Acquisition Title:

Agency:

Acquisition Year (FY):

Author and Title:

2. Description of Action:

Nature: New Requirement Follow-on Requirement

Modification to Existing Purchase Order/Contract Number:

Pricing: Firm-Fixed Price Time & Materials Cost

Other:

Funds: OMA Other Funds:

Name of Proposed Contractor(s):

Street Address:

City, State, Zip:

3. Description of Services or Supplies:

Basis for Approval (FAR 6.303-1(d)): Individual Basis Class Basis

The total estimated value of the proposed action, including all options is $

As applicable, briefly describe the services or supplies required to meet the agency's needs, including make & model number where appropriate. Include quantities of supplies or period of performance for services. Provide information for any options included. If the action is a modification to an existing contract, distinguish clearly between the work covered by the original contract and the work to be obtained by the proposed modification.

https://www.acquisition.gov/far/part-8#FAR_Subpart_8_4 https://www.acquisition.gov/far/part-13 https://www.acquisition.gov/far/part-16#FAR_16_505 https://www.acquisition.gov/far/part-6#FAR_Subpart_6_3 https://www.acquisition.gov/far/part-6#FAR_6_303_1

4. Authority and Rationale: Identify the statutory authority, FAR title and FAR citation permitting other than full and open competition. It may be one of the following most commonly used citations by the operating divisions of the Department of Health and Human Services (HHS), but other exceptions may apply per FAR Subpart 6.3.

Actions other than simplified acquisition procedures (select only one and provide an explanation):

FAR 6.302-1: Only one responsible source and no other supplies or services will satisfy agency requirements, 41 U.S.C.

3304(a)(1)

Explain why the intended contractor is the only responsible source who can provide the required supplies or s ervices.

Discuss the unique capabilities, expertise, etc. that support the lack of competition/why no other type of supplies or servic es will satisfy agency requirements. Explain factors/unique qualifications such as proprietary data or exclusive licensing rights, if applicable. When competition is limited to items particular to one manufacturer, this justification must explain why the particular brand name, product, or feature is essential to the Government's requirements, and that market research indicates other companies' similar products, or products lacking the particular feature, do not meet, or cannot be modified to meet the agency's needs in accordance with FAR 11.105. If in connection with a follow-on contract for continued development or production of highly specialized equipment, detail the substantial duplication of cost or unacceptable delays.

FAR 6.302-2: Unusual and compelling urgency, 41 U.S.C. 3304(a)(2)

If unusual and compelling urgency is the basis for the justification, explain the chronological events leading up to the requirement and explain why time constraints cannot permit even a limited competition. Describe the detrimental effects/ serious injury to the mission of the requiring activity or to the government, financial or otherwise, that will result if this justification is not approved. Describe impact of required delivery/performance date. Describe the detrimental effects/ serious injury to the mission of the requiring activity or to the government, financial or otherwise, that will result if this justification is not approved and the product or service cannot be provided by the intended sole source contractor. Failure to plan for expiring funds is not a valid reason for citing this exception. May not exceed one year, including all options, unless the head of the agency determines that exceptional circumstances apply.

FAR 6.302-5: Authorized or Required by Statute, 41 U.S.C. 3304(a)(5)

Provide a citation to the statutory authorization and a brief description of its content, or identify the specified source or other agency.

Other (See FAR Subpart 6.3 for additional authority)

Provide the authority and citation to the applicable section of FAR 6.3.

Provide a full explanation to justify use of the exception.

5. Agency Actions to Take or Remove Barriers That Led to Other Than Full and Open Competition (If applicable):

Describe the actions, if any, the agency may take to remove or overcome any barriers that led to the restricted consideration prior to any subsequent acquisition for the supplies of services is made. If no such actions have been taken, explain why.

https://www.acquisition.gov/far/part-6#FAR_6_302_1 https://www.acquisition.gov/far/part-6#FAR_Subpart_6_3 https://www.acquisition.gov/far/part-11#FAR_11_105 https://www.acquisition.gov/far/part-6#FAR_6_302_2 https://www.acquisition.gov/far/part-6#FAR_6_302_5

6. Bridge Contracts:

For contract extensions or bridge contracts when a competitive follow-on is in the process of being developed, summarize history of current contract and explain the reasons for any delays in the acquisition. Include discussion of the milestones f or the follow-on action; the milestones should be as efficient as possible. Discuss why it would be neither cost effective nor realistic to expect another contractor to perform during the brief interim period; include issues such as start -up costs, phase-in, transfer of GFP, recruitment and staffing, etc. If the action is because of a protest, provide a brief discussion of the protest including the date the protest was filed and the basis of the protest. Explain that the action will provide the minimum quant ity or performance period.

7. Actions to Increase Competition:

Describe efforts made to compete the action, including whether a notice was or will be publicized as required by FAR Subpart

5.2 or which exception under FAR 5.202 applies. If a notice was publicized, discuss the number of written responses to the synopsis and the results of the assessment of the written responses. List sources, if any, that expressed, in writing, an interest in the acquisition. Provide rationale if interested sources were rejected. If applicable, state that no other sources have expressed interest, but all offers received shall be considered. Describe what actions will be taken to increase competition before subsequent acquisition of the supplies or services is required. You may state that an action is a one-time requirement, but if a similar requirement arises, every effort will be made to compete it to the maximum extent possible. If action is sole source because of proprietary data or licensing rights and there will be a continuing need for the requirement, there must be evidence that advanced planning has been initiated to overcome the barriers to competition, or there should be documentation to support an analysis that replacement costs/licensing purchase costs outweigh the benefits of competition. If the action is a contract extension or bridge, explain actions to compete the follow-on. If action is an urgent new requirement and a competitive follow-on is anticipated, explain that efforts are underway to facilitate a full and open competition.

8. Market Research:

Describe the extent of the market research conducted to identify all qualified sources and the results thereof. “Market Research” is defined as those attempts you made to ascertain whether other qualified sources exist, and can include contact with knowledgeable experts regarding similar or duplicate requirements, contact with industry, results of a sources sought synopsis, or draft solicitations. Research of the marketplace may consist of written, electronic (i.e. email) telephonic, or world wide web inquiries. Lack of advanced planning is not an acceptable reason for the lack of market research, but true urgency may necessitate abbreviated market research that is limited to readily available historical and commercial information. If ac tion is a contract extension or bridge contract, describe the market research efforts underway or completed for the follow-on. See FAR 10.002(b)(2).

9. Procurement History:

Purchase order or contract number:

Was action competed? Yes No

If action was not competed, state the cited authority, summarize rationale, and describe the actions that were supposed to be taken to increase competition and the results thereof:

https://www.acquisition.gov/far/part-5#FAR_Subpart_5_2 https://www.acquisition.gov/far/part-5#FAR_Subpart_5_2 https://www.acquisition.gov/far/part-5#FAR_5_202 https://www.acquisition.gov/far/part-10#FAR_10_002

10.Additional Information to support the justification:

If applicable, explain why technical packages or specifications to facilitate competition were not developed or available;

describe actions taken to remedy the situation.

11. Technical / Requirements Certification: By my signature below, I certify that the supporting data included in this

J&A is accurate and complete.

Program Manager

Name:

Position Title:

Email address:

Phone:

Program Manager Supervisor (or one level above Program Manager)

Name:

Position Title:

Email address:

Signature:

Date:

12. Fair and Reasonable Price/Cost Determination: As Contracting Officer, by my signature below, I hereby determine that the anticipated price/cost to the Government for this contract action will be fair and reasonable.

Provide the basis for this determination, e.g., describe techniques to be used to determine fair and reasonable price (FAR Subpart 15.402), such as price analysis, cost analysis, cost realism. Per FAR Subpart 15.403-4(a)(1), the threshold for obtaining cost or pricing data is $750,000.

Name: Phone:

Signature: Date:

13. Contracting Officer's Approval (Required for proposed contract not to exceed $700,000 (value calculated including all options)): I hereby certify that this justification is accurate and complete to the best of my knowledge. I approve this justification subject to availability of funds, and provided that the services and supplies herein described have otherwise been authorized for acquisition.

Name: Phone:

Signature: Date:

https://www.acquisition.gov/far/part-15#FAR_15_402 https://www.acquisition.gov/far/part-15#FAR_15_402 https://www.acquisition.gov/far/part-15#FAR_15_403_4

14. Legal Review:

All J&As greater than $68 million must have a legal review from the General Law Division of the Office of the General Counsel prior to sending it to the Department.

15. OPDIV Competition Advocate Approval (Required for proposed contract over $700,000 but not exceeding $13.5 million (value calculated including all options)):

I have reviewed this justification and find that it adequately supports other than full and open competition.

Name:

Phone:

Signature:

Date:

All J&As greater than $68 million must have a review from the Office of Small & Disadvantaged Business Utilization (OSDBU) prior to sending it to the Department. The OSDBU at their discretion may review any J&A.

16. Office of Small and Disadvantaged Business Utilization Review: (Required for contracts exceeding $68 million (value calculated including all options)):

Concur:

Non-Concur:

17. OPDIV HCA Approval (Required for proposed contract over $13.5 million but not exceeding $68 million (value calculated including all options)):

18. Department Competition Advocate (Required for contracts exceeding $68 million (value calculated including all options)):

Concur:

Non-Concur:

(The below approval paragraph is required if the cumulative contract value, including all options, exceeds $68 million.)

19. HHS Senior Procurement Executive (SPE) Approval:

Based on the foregoing justification, I hereby approve other than full and open competition for the above stated procurement, subject to the availability of funds, and provided that the services herein described have otherwise been authorized for acquisition.

State supplies/services being procured:

State the full statutory authority and FAR cite and title, consistent with paragraph 4, e.g. 41 U.S.C. 3304:

SECTION C

Work Statement

This is a non-personal services contract entered into between the North Slope Borough Department of Health and Human Services, and the Indian Health Service, Alaska Area Native Health Service. The primary purpose of this contract is to facilitate accomplishment of the IHS mission and to enhance the access and quality of care for IHS beneficiaries.

DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

The contractor shall provide an integrated, three-part, public health oriented program consisting of community health aide/practitioner, emergency medical and substance abuse treatment services to the communities of Utqiagvik (Barrow), Atqasuk, Kaktovik, Nuiqsut, Point Lay and Wainwright, Alaska. At the option of the contractor, these services may be provided to the communities of Anaktuvuk Pass and Point Hope, Alaska at no additional cost to the Indian Health Service.

COMMUNITY HEALTH AIDE/PRACTITIONER SERVICES

Except in Utqiagvik, Alaska, provide village health care services in the North Slope Borough/Arctic Slope of Alaska region utilizing persons indigenous to the individual community to the maximum extent possible and in accordance with the Indian Health Service Community Health Aide Program Certification Board Standards and the Alaska Community Health Aide/Practitioner (CHA/P) Manual (CHAM), 4th Edition, 2006.

Note: Each CHA/P works under the medical supervision of a licensed physician. It is the licensed physician’s oversight that enables the CHA/P to practice. This requirement does not preclude other physicians, dentists, and mid-level providers directing the day-to-day activities of a community health aide or community health practitioner under the direction of the physician providing medical supervision. The authorization to treat a patient may be given directly through reporting the patient to the supervising physician or the physician’s designee, for example, a Physician Assistant or Nurse Practitioner; or, indirectly (1) in cases of a CHA/P who has completed at least ETT (or EMT1) and CHAP Session I and are trained to use the CHAM to begin emergency care before contacting the physician, or (2) under a standing order that allows the CHA/P to follow the CHAM Plan (or other specified treatment plan) without consulting the physician.

1. The Community Health Aide/Practitioner (CHA/P) will:

A. Provide emergency medical care on a 24-hour basis, seven days per week.

(Note: An on-call schedule may utilize mid-level or other providers of skill equal to or greater than a CHA/P.)

B. Provide preventive health services, which include, among other things, prenatal and postpartum care, family planning, immunizations, and dental disease prevention activities.

C. Monitor care of chronically and terminally ill patients.

D. Provide home visits for the elderly, chronically ill, or infants and children who are unable to come to the local clinic.

E. Assist itinerant health care providers in the provision of specialized health care services.

F. Provide health care using the CHAM as a guideline and as appropriate to the

CHA/P’s level of training and experience.

G. Escort patients (or send qualified escort) to referral facility as required by supervising physician or physician’s designee.

H. Maintain patient medical records using a patient encounter form using the HEAP format and maintain patient and other information records as described in the

CHAM.

2. This service will provide a system of support, day-to-day supervision, and quality assurance for the CHA/P under the guidance of a health care provider with national certification as a mid-level practitioner or higher. If there is more than one supervisor, the ratio of mid-level practitioner (or higher) positions to other qualified supervisors must be no less than one-to-three. Supervisor’s objectives include the following:

A. Ongoing medication education and skill enhancement in-service training sessions.

B. Review of CHA/P charting procedures.

C. Assistance with re-credentialing skills and procedures, as needed.

D. Investigate and appropriately follow-up all concerns regarding CHA/P job performance.

E. Develop and follow a written plan for CHA/P retention.

F. Provide support and referrals to CHA/Ps experiencing stress, and assist CHA/Ps in problem solving and with problem resolution as needed.

G. The day-to-day supervisor will, at a minimum, attend one annual meeting with the village health board (or equivalent group) and quarterly meetings with the supervising physician. At a minimum, perform the following health care quality assurance activities annually: on-site clinic and CHA/P evaluations, chart review, and medical audit of selected illnesses and identification of CHA/P additional training needs.

H. Review CHA/P’s daily medical logs and do medical record reviews quarterly.

Monitor logged-in lab results for Clinical Laboratory Improvement Amendment (CLIA) compliance.

3. To arrange, and coordinate orientation and training to CHA/Ps consistent with recommendations by the Academic Review Committee (ARC), a subcommittee of the CHA/P program directors. Training objectives include the following:

A. Provide pre-session training within 30 days of hire.

B. Provide ETT or other recommended emergency training prior to or in conjunction with Session I of basic Community Health Aide training.

C. Meet basic training prerequisite requirements in a timely fashion, prior to applying for Session I entry.

D. Provide specific follow-up recommended for Community Health Aides from basic CHA/P training courses.

E. Coordinate CHA/P certification activities.

F. Coordinate Community Health Practitioner credentialing and re-credentialing processes and university credit toward A.D. Program in conjunction with statewide guidelines.

G. Coordinate and provide regular continuing medical education as approved by the

CHA/P certification board.

4. Provide other administrative services related to CHA/Ps. Objectives include the following:

A. Maintain a complete file of information relevant to each CHA/P.

B. CHA/P supervisor and the assigned supervising physician shall receive a full orientation of the CHA/P program and contractual requirements.

C. Contractor will assure that the Coordinator/Instructor staff shall have appropriate teaching/instruction skills.

D. Provide supervisory personnel with regular continuing education to meet, at a minimum, national recertification standards for their position.

E. Submit monthly patient encounter data by month to Arctic Slope Native

Association, Ltd, Tanana Chiefs Conference, and Maniilaq Association.

F. Maintain health surveillance for CHA/Ps (including minimum screening tests, such as T.B., Rubella, and RPR status).

EMERGENCY MEDICAL SERVICES

This service provides education and training throughout the North Slope Borough (NSB) to multiple levels of first responding providers in first aid, emergency trauma training and community disaster planning. This program component is integral to the provision of Community Health Aide/Practitioner services.

1. Maintain and improve the provision of first aid and CPR training in the North Slope

Borough/Arctic Slope region of Alaska.

A. Provide Basic First Aid training in each community of the Borough including Barrow.

B. Provide CPR training in each of the communities including Barrow.

C. Annually provide two CPR refresher courses for Emergency Medical Technicians

(EMT) and interested Arctic Slope Native Association Samuel Simmonds Memorial Hospital staff.

D. Provide first aid and CPR courses to school students, staff, and other North Slope

Borough departments, as requested.

E. As requested by North Slope communities, provide the Home Study Emergency First Aid Project to community members.

6. Increase CPR course opportunities by providing at least two Basic Life Support

Instructor courses per year.

2. Maintain Emergency Trauma Training (ETT) courses in the North Slope Borough/Arctic

Slope region.

A. Provide at least one ETT course in the North Slope Borough per year.

B. Provide ETT courses in each of the North Slope communities including Barrow as requested by local responders.

C. Provide one EMT-l course or EMT-I refresher course in Barrow per year.

D. Train one new ETT or EMT instructor each year.

3. Provide continuing emergency medical education to North Slope providers to include at minimum Community Health Aides/Practitioners, and Samuel Simmonds Memorial Hospital providers.

A. Eight or more in-service training sessions for emergency responders per year.

B. Five or more in-service training sessions for the Samuel Simmonds Memorial

Hospital staff per year.

C. Provide a local EMS newsletter four to six times per year to include a continuing education subject each time.

4. All treatment and aftercare plans must be documented in a client record system and data will be reported using the State of Alaska, Division of Behavioral Health AKAMIS reporting system.

A. Provide EMT recertification and other courses, as needed by the Community

Health Aide/Practitioner services staff.

B. Provide additional EMS training to Community Health Aides/Practitioners as requested.

C. Improve emergency medical information and education to communities through

Community Health Aides/Practitioners access to the EMS newsletter, video/DVD continuing education programs, and other resources.

5. Assist in the development of a North Slope Borough-wide and individual community disaster plans.

A. As requested, work with the Borough designated Disaster Coordinator to update the Borough-wide disaster plan.

B. Work with the Barrow City Council, NSB Fire Department, NSB Public Safety, Arctic Slope Native Association, Samuel Simmonds Memorial Hospital and other local organizations to maintain the Barrow Disaster Plan.

6. Provide broad public education on emergency medical services using a variety of communication mediums.

A. Four to six times per year, circulate an emergency medical services-oriented newsletter containing a variety of information to NSB departments and other organizations within the North Slope.

B. Develop and publish locally oriented pamphlets to educate communities on recognizing the need to call for help in medically emergent situations and how to access the emergency medical system.

C. Conduct at least one radio or television program during each year dealing with emergency medical information.

D. Assist in the production of at least five, public service-type radio announcements on emergency medical system access and/or basic emergency care skills.

E. Develop and maintain volunteer instructors in the Borough to increase educational training opportunities.

7. To enhance the scope of this service beyond that funded through this contract, seek continued funding from the State of Alaska and other sources for the positions of Training Coordinator and Basic Life Support Instructor.

SUBSTANCE ABUSE TREATMENT AND SERVICES

This North Slope Borough-wide service will maintain and build on progress attained by the individual patient/client during the primary substance abuse treatment phase (residential or community-based) by assisting clients and their families to change lifestyle behaviors identified as self-defeating and “at-risk”, including the abusive use of drugs, alcohol, and inhalants. For patients and clients presenting with a co-occurring disorder (mental health as well as substance abuse disorder) particular effort will be made to coordinate the treatment of such persons with other local providers.

1. A system of case delivery will be provided that includes case planning, treatment delivery, and a tracking system to assure service delivery and aftercare for all eligible clients. A register is established and maintained to portray all adolescent referrals into treatment, discharge dates, and length of treatment.

A. The system shall include cases referred by other programs, schools, health departments, mental health, and social services agencies and programs and shall also include an activity directed at identifying adolescent cases referred into primary treatment by any source.

B. Service activities may include the development of a residential program, including individual, group, youth, and family treatment settings.

C. Facilitate the establishment and maintenance within the Borough, of an

“intervention and staffing team” that includes a representation from the NSB Children and Youth Services, the Community Mental Health program and this service. The “intervention and staffing team” will not incur additional work products in excess of:

(1) 24-hour security and monitoring of client’s progress, and

(2) the provision of therapeutic social and recreational activities during free time on weekdays and weekends.

To provide the aforementioned, it is necessary to minimally staff the residential facility with Residential Aides. (This staff will be key to the identification of youth and family affected by chemical abuse and youth at-risk for chemical abuse and consideration of individual needs and service related activities by the intervention and staffing team assigned to each case. Other members of the team could include, for example, aftercare specialist, chemical dependency counselor, mental health counselor, teachers, ministers, village public safety officers, elders, and/or other concerned and interested persons.)

2. With particular emphasis on adolescents, aftercare services will be offered to all clients returning to the North Slope Borough/Arctic Slope region upon discharge from primary treatment. This action will include:

A. Parental contacts for signed consent to treatment and release of information;

B. The development of a workable aftercare plan;

C. Memoranda of agreement will be developed with agencies, boards, committees, and programs having impact upon services received by the adolescent client and his/her affected family; and, D. There will be a case manager assigned for each individual case.

3. All adolescent and family discharges from a primary treatment program shall have a workable aftercare plan developed/redeveloped within 30 days of discharge to aftercare.

The development of an aftercare plan will be done with the following documented considerations:

A. Involvement of the identified youth;

B. Involvement of parents or other responsible adults;

C. Involvement of appropriate service providers;

D. The provision of an assessment of service needs in the areas of:

(1) Family’s capacity and interest in participating in the planned services;

(2) Social/peer group relationships and effects upon being clean and sober;

(3) Educational status and projected desires and needs;

(4) Social development and personal satisfaction;

(5) Physical conditions (handicaps) which might have an affect upon ability to participate in a plan;

(6) Cultural/spiritual needs which may be critical to personal growth;

(7) Vocational/occupational needs; and,

(8) Community and/or environmental factors affecting the continuation of treatment and recovery.

4. All treatment and aftercare plans must be documented in a client record system and will utilize a data system, that is, either the State Office of Alcohol and Drug Abuse Management Information System (SOADAMIS) or the Indian Health Service system (CDMIS), as part of the record keeping and reporting system.

5. Client care recording will be maintained on a current status and will include the following:

A. Progress notes on all contacts, treatment, and activities related to the aftercare plan.

B. Evaluation/assessment summary statement completed every three months for as long as the client is in an active status. These summaries will be specific and will address progress in the areas of school, peers, family, social/cultural/spiritual, and any significant relapse factors.

C. A summary closing statement will be done on each case record placed inactive, which will review all significant events and activities leading to the file being closed/placed inactive.

6. The contractor’s staff assigned to carry out the defined activities will maintain an awareness of community resources, which might be deficient in ensuring a quality opportunity for continued client recovery. Aftercare staff should participate as a member of the “team” involved in identification and case staffing for those persons found to be experiencing problems associated with chemical abuse. The aftercare staff will endeavor to bring those areas of concern to the attention of other program staff and concerned pertinent community or tribal officials. Through facilitation by the aftercare staff, all participate in planning directed toward the development of needed resources, as well as enhancement of existing resources for full client recovery.

7. As a special focus of this service, support groups for adolescent and family will be developed and conducted on a weekly basis to promote continued recovery.

Additionally, peer groups that impact negatively on clients will be identified, and efforts directed through referral toward involving the members of those peer groups in treatment as needed.

8. Staff of this service is responsible for intervention in cases where relapse indicators are present and is responsible as the case manager to facilitate a re-entry into primary treatment. This activity may include consultation and coordination with other local staff to carry out crises assessments and the development of feasible options of intervention within a timely and protective format.

9. Service staff has responsibility to facilitate the involvement of appropriate community leaders and professionals in planning and carrying out continued treatment services. As primary case managers, staff will be committed to organizing on an ongoing basis other community and staff members around aftercare objectives and specific treatment efforts to prevent breakdowns in service delivery.

10. As funds are available, staff will attend at least one yearly related training program giving priority to participation in special training and/or information sessions presented by Indian Health Service funded adolescent residential treatment programs.

11. Service staff should be qualified chemical dependency and/or behavioral health counselors and it is desired that they have experience working with youth and family.

Additionally, all staff will be certified by the employing organization as having no prior record of child sexual assault or any other prosecutable record associated with child welfare or safety.