OCC Equip Svcs_JandA_Transition_FINAL APPROVED.pdf

Source Selection Information in Accordance with FAR 2.101 and 3.104 Page 1 of

JUSTIFICATION FOR OTHER THAN FULL AND OPEN COMPETITION

Office of Connected Care Equipment and Services Transition Effort

1. Contracting Activity: Department of Veterans Affairs (VA) Office of Acquisition Strategic Acquisition Center (SAC) 103 S00 potsylvani Ava Suie, t 40e 0 Fredericksburg, 22VA 408

2. Description of Action: This justification and approval sets forth the facts and requests approval for the establishment of a sole source Requirements Contract on behalf of VA’s Veteran Healthcare Administration (VHA) Office of Connected Care, Equipment and Services. This is a transition effort for the existing procurement with Iron Bow Technologies LLC under VA119-15-A-0131. This action will avoid a gap in service for critical and essential digital health technology equipment and services while the agency continues to work toward a follow on, competitive procurement. The proposed term of this contract is 6 months, plus two 3-month option periods, plus up to 6-months option utilizing FAR 52-217-8. The estimated value of this Requirements Contract is $640,922,754.42. The proposed effort will be established under the statutory authority permitting other than full and open competition is 41 U.S.C.3304(a)(1) as implemented by the Federal Acquisition Regulation (FAR) Subpart 6.302-1 entitled, "Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements”. This transition contract will be awarded to the current contractor, Iron Bow Technologies, LLC, 2303 Dulles Station Blvd, Ste. 400, Herndon, Virginia 20171.

3. Description of Supplies or Services: The mission of the Department of Veterans Affairs (VA), Veterans Health Administration (VHA), is to provide benefits and services to Veterans of the United States, their caregivers, and beneficiaries. VHA consistently seeks advances in digital health technologies to 1) improve the quality of health for Veterans, 2) increase the quality of health care available throughout VHA, 3) enhance the efficiency of health care providers and staff, and 4) increase Veterans' overall satisfaction with VA. To that end, VA has made a considerable investment organizationally as well as in medical technologies to support digital health technology capabilities.

The Office of Connected Care (OCC) is responsible for creating an environment, through Web and Mobile Solutions (WMS), Telehealth Services, and My HealtheVet that will empower Veterans and their caregivers, to become an active participant in the management of their own health care. In support of this mission, OCC has established a digital health technology network for the distribution of health care and related services that consists of telehealth devices, web and mobile medical applications, and online health platforms.

Office of Connected Care Equipment and Services Transition Effort Justification and Approval

To facilitate the mission of WMS, OCC has implemented the Mobile Applications Platform. The platform is hosted in the VA Enterprise Cloud procured from Amazon Web Services (AWS), ensuring the combined ecosystem of mobile medical apps, mobile devices, source systems, and open Application Programming Interfaces (APIs) function in concert with one another in a unified architecture and infrastructure. The Mobile Applications Platform includes a new shared services library, a deep integration of patient-generated data (PGD), and patient-centered design principals. OCC is developing and/or procuring many web and mobile medical applications (apps) and other digital health technologies that help bring patient information closer to the point of care. Apps are currently developed using an Agile Continuous Integration / Continuous Deployment (CI/CD) methodology as well as Office of Information and Technology (OIT) and OCC-specific processes, such as app versioning procedure, metadata protocols, change control processes, and OIT Veteran Integrated Process (VIP) requirements.

These mobile medical applications include, but are not limited to, educational tools, tools for VA health care providers, and tools for Veterans and their caregivers.

In support of OCC's digital health technology program and associated OCC projects, the Contractor shall provide digital health technology equipment, software licenses, and subscriptions (as defined in the attached Equipment List) as well as provide integrated services and solutions. OCC's digital health technology network is an enterprise-wide, complex, and diverse system for the distribution of health care and related services. The digital health technology network requires multiple clinical disciplines and procedures as well as equipment, items, components, online health platforms, web and mobile medical applications, software, and infrastructure platforms that must be integrated through interfaces and enhancements to OCC digital health technologies. OCC requires all digital services, applications, platforms, architecture, and equipment to be integrated to ensure VA's digital health technology system provides safe, effective, and quality medical and critical care.

4. Statutory Authority: The statutory authority permitting other than full and open competition is 41 U.S.C.3304(a)(1) as implemented by the Federal Acquisition Regulation (FAR) Subpart 6.302-1 entitled, "Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements".

5. Rationale Supporting Use of Authority Cited Above: It is critical that VA has a contractual vehicle in place to procure digital health technology equipment, software licenses, and subscriptions as well as provide integrated services and solutions. OCC requires all digital services, applications, platforms, architecture, and equipment to integrate effectively so that all components work together seamlessly to ensure VA's digital health technology system provides safe, effective, and quality medical and critical care. This vehicle provides OCC continued contract support that delivers the standardized equipment and services necessary to procure, maintain, enhance, remediate, integrate, deploy, and support OCC's digital health technology network. It is

Justification and Approval essential that uninterrupted and seamless support is in place during the time period in which the agency solicits for the procurement competitively.

Recent impacts as a result of COVID-19 and Cares Act, have expanded the mission of OCC to provide supplies and services to Housing and Urban Development Veteran Affairs Supporting Housing (HUD-VASH) homeless program, which was unknown at the time of conception of the competitive follow-on and must be expanded to support as directed. The Cares Act has directed the VA to “ensure telehealth capabilities are available during a public health emergency for case managers of, and homeless veterans participating in, the Department of Housing and Urban Development – Department of Veteran Affairs Supportive Housing program (commonly referred to as “HUD-VASH”).” Since COVID-19 and the implementation of the Cares Act, the use of Telehealth has increased 1000% as well as the number of rural veterans seen via telehealth has doubled in 2020 versus the total number of unique veterans seen during all of FY19. Additionally, the VA has been directed to partner with Department of Defense (DoD) telehealth program. The additional support, direction to partner with DoD, COVID-19 and Cares Act, and the redirection of 99% of resources working acquisitions to provide telehealth services to all veterans, have all dramatically affected the follow-on, competitive effort.

The only reasonable and viable solution to avoid an interruption in the services and the shutdown of the Telehealth CEVN program is to establish a Requirements Contract for the period of 6 months, plus two 3-month option periods, plus up to 6-months option utilizing FAR 52-217-8 to the incumbent Iron Bow Technologies, LLC. Iron Bow Technologies possesses the specialized experience to continue to procure equipment and provide maintenance and help desk support services without a break in service.

The Telehealth Network is complex and diverse as it involves many clinical disciplines and spans enterprise wide. In order to provide the level of service required to procure, maintain, and provide help desk support for the varied range of equipment located throughout the country, Iron Bow is required to deliver customized solution delivery to advanced integration of complex, multi-disciplined systems. This requirement is to support and expand VA's existing network for telehealth comprised in part of more than 10,175 videoconferencing codec devices, 44,000 patient issued iPads, 30,000 Provider issued iPads, and more than 70,000 peripheral devices such as stethoscopes, cameras, etc., operating out of more than 170 VA medical centers and 1,063 VA clinics providing access to VA healthcare to more than 642,000 Veterans, through more than 1.1M appointments. All VA sites and telehealth equipment are supported by VA’s single National Telehealth Technology Help Desk, this Help Desk is both Veteran and employee facing and is staffed by a team of contractors who have been equipped and trained appropriately with Government Furnished Equipment, and VA privacy and information security requirements to seamlessly support the registration of the equipment and components onto VA national network, the initiation and continuation of the service and warranty for each device, the troubleshooting, repair and or replacement for each device. A new vendor cannot replace Iron Bow in terms of

Justification and Approval comprehensive device offering of VA-OIT-and-Telehealth-approved devices; integration of the clinical and videoconferencing devices; nor comprehensive technical support through a help desk staff that has been appropriately vetted, completed T4 level background Investigations, and trained to support VA's national telehealth network.

Knowledge of the breadth of the telehealth system is required in order to immediately provide the strategic insight that ensures the highest standards of IT performance critical to ensure the telehealth equipment is maintained in a manner to ensure proper health care of Veterans.

Awarding to a new contractor would require a significant learning curve to become familiar with the existing inventory of telehealth systems and the various maintenance and help desk services required before services could be immediately provided.

Specifically, a new awardee would be required to hire and train new employees while obtaining security credentials. VA would need to appropriately equip and train new help desk staff to enable their access to VA network for support of our Veterans and VA end users. Additionally, a new awardee would need to compile and centralize the various maintenance agreements. It is estimated by the Government subject matter experts that it will take a new contractor a minimum of four months to complete VA background checks, comply with Health Insurance Portability and Accountability Act (HIPAA) and VA Privacy Act and receive credentials necessary to perform the services for all the various locations involved in the Telehealth program. There are four maintenance agreement cycles (1. VA Video Connect hardware, application, and software maintenance agreement; 2. Clinical Video codec maintenance Agreement; 3. Clinical Video cart and peripheral maintenance Agreement; 4. Clinical Video tablet maintenance Agreement) that a new vendor would inherit from the Iron Bow. The new vendor would need to transition and understand what is included and covered in each of the four separate but related Service Agreement contracts. The new vendor would need to understand and ensure renewal option dates and deadlines. This would ensure that there are no gaps in service for the existing and expanding inventory of telehealth technology. The new vendor would then need to work with Telehealth Services to move all four Service Agreements to a single renewal time frame (e.g. end of August for all Service Agreement renewals) to simplify this one aspect of support for the national Clinical Video Enterprise Network. Iron Bow Technologies is the only responsible source that can provide the critical services to ensure that there is not a break in services while the new longer competitive action is being procured.

Interrupted services would have a deleterious effect on the health and wellbeing of Veterans who access VA healthcare through telehealth services nationwide. Veterans who are homebound would not be able to be serviced timely. This could result in serious injury and prolonged appointment wait times due to the understaffed VA Hospitals. Equipment malfunctions will cause Veterans to be without medical care.

Veterans nationwide and their caregivers cannot afford travel and time from work for travel to and from VA Medical Centers to access care. The loss of Telehealth Services could result in the loss of life or limb.

Justification and Approval

6. Efforts to Obtain Competition: Market research efforts were conducted via vendor websites to determine if a competition is viable for this action. There are other sources available for this requirement according to Requests for Information (self-certifying), but only Iron Bow Technologies possesses the known specialized experience to prevent an interruption of maintenance and services. No additional market research was conducted recognizing a competitive procurement is in process. Additionally, in accordance with FAR 5.301, this action will be synopsized at award on Contract Opportunities, and the justification will be made publicly available.

7. Actions to Increase Competition: The Strategic Acquisition Center is in the process of developing a long-term competitive contract vehicle for OCC's digital health technology network's equipment and services, including the National Telehealth Technology Helpdesk (NTTHD).

The establishment of the 6 months, plus two 3-month option periods, plus up to 6-months option utilizing FAR 52-217-8 effort will allow the VA to conduct the follow-on Competitive effort, which is complex due to the wide variety of clinical applications and the coordination of various VISNs and health professionals throughout VHA necessary for this initiative. The current milestone schedule for the competitive effort included the issuance of a Sources Sought Notice in July 2019. The solicitation for OCC Equipment and Services is planned to be released late Fiscal year 2020. The anticipated establishment of the competitive contract action is mid-Fiscal Year 2021. Upon establishment of the follow-on contract, the new awardee, if not the incumbent, will require a ramp-up time of at least four months, further supporting the requirement of the sole source (Transition Contract) to ensure there is no loss of support for the existing Telehealth equipment. The Requirements Contract will be canceled in the event that the follow-on contract vehicle is in place, and the ramp-up is completed prior to the expiration of the Transition contract vehicle. This will also ensure that medical professionals will continue to have the ability to procure equipment when in their medical judgment, it is required for the appropriate care of Veterans.

8. Market Research: Market research includes the issuance of sources sought announcement, specifically for the follow-on, competitive effort, in July 2019, through the Office of Small & Disadvantaged Business Utilization (OSDBU). Results indicate there are sources available for this requirement, however, not without the interruption in the services and the shutdown of the Office of Connected Care Telehealth, Web and Mobile Solutions and MyHealtheVet programs (OCC's digital health technology network's equipment and services) before the current contract vehicle expires.

In addition, the NAICS code for this effort is 334111 Electronic Computer Manufacturing. These are commercial products. The most applicable Product Service Code (PSC) is 6515 – Medical and Surgical Instruments, Equipment, and Supplies.

Justification and Approval

Several databases have been queried during the market research process, and the result of the queries are below.

Services on the Procurement List maintained by the Committee for Purchase From People Who Are Blind or Severely Disabled, known as Ability One (FAR subpart 8.7) http://www.abilityone.gov/procurement_list/index.html. The Procurement List was reviewed for "Electronic Computer Manufacturing” on August 15, 2019, and it was determined that these services are not currently available.

Note: Supplies and services on the Procurement List maintained by the Committee for Purchase from People Who Are Blind or Severely Disabled, known as AbilityOne, are mandatory if added to the list prior to January 7, 2010. The VA Rule of Two applies to all items added after January 7, 2010. Please see the following link to the Ability One Procurement List for the applicable product and services at:

https://www.va.gov/oal/docs/business/pps/listProductsServices-VAAbilityOne.xlsx.

Additionally, no new items may be added to the Ability One Procurement List without first applying the VA Rule of Two and obtaining approval of the Senior Procurement Executive (SPE) which must be coordinated through the appropriate Head of Contracting Activity (HCA).

VetBiz databases (IAW VAAR 810.001) was queried on June 19, 2019, using keywords "Electronic Computer Manufacturing" and NAICS code 334111. The VetBiz query resulted in total of 121 SDVOSBs and Veteran-Owned Small Businesses (VOSB).

GSA eLibrary databases (IAW VAAR 810.001) were queried on August 15, 2019 using keywords "Electronic Computer Manufacturing" and NAICS code 334111. This search resulted in over 100 vendors resolved under this search and the description was General Purpose Commercial Information Technology Equipment, Software, and Services under the title "Electronic Computer Manufacturing" with GSA source 70 Schedule. Additionally, GSA Advantage identified Source 51 V, 105 002 Hardware Store, Home Improvement Center, or MRO – Catalog; Source 70, category 132 8, Purchase of New Equipment - Subject to Cooperative Purchasing and Source 75, 75 200 OFFICE PRODUCTS/SUPPLIES AND SERVICES AND

NEW PRODUCTS/TECHNOLOGY.

A query of DSBS was completed on August 15, 2019 (IAW VAAR 810.001) using NAICS code 334111 and resulted in one contractor.

9. Other Facts: There are no other supporting facts.

Justification and Approval

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.

Suzanne Snider CEVN Program Analyst VHA Office of Health Informatics, Telehealth Services (10A7D)

11. Fair and Reasonable Cost Determination: I hereby determine that the anticipated cost to the Government of the resulting non-competitive contract award will be fair and reasonable based on the following information. In negotiating pricing for non-competitive contracts, the Government will evaluate and approve pricing based on comparison to commercial pricing and previous contracts.

Vicki Whiteman Procuring Contracting Officer Strategic Acquisition Center

12. Procuring Contracting Officer Certification: I certify that this justification is accurate and complete to the best of my knowledge and belief.

Vicki Whiteman Procuring Contracting Officer Strategic Acquisition Center

Suzanne L. Snider 247776

Digitally signed by Suzanne L.

Snider 247776 Date: 2020.06.10 10:09:29 -05'00'

Vicki L. Whiteman 728668

Digitally signed by Vicki L.

Whiteman 728668 Date: 2020.06.10 11:14:01 -04'00'

Vicki L. Whiteman 728668

Digitally signed by Vicki L.

Whiteman 728668 Date: 2020.06.10 11:14:26 -04'00'

Justification and Approval

In my role as Head of the Contracting Activity, based on the forgoing justification, I hereby the Veteran Healthcare Administration (VHA) Office of Connected Care, Equipment and Services Transition contract in accordance with Federal Acquisition Regulation (FAR) Subpart 6.302-1 entitled, "Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements " subject to availability of funds, and provided that the property and services herein described have otherwise been authorized for acquisition.

Date: __________ _____________________________________ Phillip W. Christy Head of Contracting Activity

Approval

In my role as Senior Procurement Executive, based on the forgoing justification, I hereby the Veteran Healthcare Administration (VHA) Office of Connected Care, Equipment and Services Transition contract in accordance with Federal Acquisition Regulation (FAR) Subpart 6.302-1 entitled, "Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements " subject to availability of funds, and provided that the property and services herein described have otherwise been authorized for acquisition.

Date: __________ ____________________________________ Angela Billups

Christy, Phillip Digitally signed by Christy, Phillip Date: 2020.06.18 07:20:35 -04'00'

Angela Billups 1724054

Digitally signed by Angela Billups 1724054 Date: 2020.06.25 15:07:56 -04'00'