P03 - JA - Sole Source Over SAT - Radiology Interpretation Bridge - Signed.pdf

Request for Sole Source Justification Format >SAT

VHAPG Part 806.3 OFOC Page 1 of 4 Revision: 01 Effective Date: 04/01/23

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID: 36C262-24-AP-0004

1. Contracting Activity: Department of Veterans Affairs, VISN 22, New Mexico VA Healthcare System (NMVAHS), by the Network Contracting Office (NCO) 22; 2237: 501-24-1-081-0001.

2. Nature and/or Description of the Action Being Processed: A bridge contract requirement is for the University of New Mexico (UNM) to continue to provide Board Certified/Board Eligible Abdominal/GU, Breast Imaging, Cardiovascular, General, Nuclear Medicine, Muscoskeletal, Thoracic and Neuroradiology Radiology Physician Services on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the NMVAHS. In addition to, the UNM shall provide resident supervision and teaching. Currently, contract VA258-17-D-0001 ends 9/30/2023 and a solicitation, 36C25822R0001, was issued on 8/31/2023 to UNM for a 10-Year contract. The solicitation ends 9/21/2023 and additional time is required for price negotiations and pre-award reviews. Therefore, a bridge contract is necessary for continutity while both parties come to an agreement for the long-term contract.

3. : NMVAHS has an overall need for 11,454 hours (5.5 FTE), of radiology services to perform the anticipated radiological needs. The Radiologists at NMVAHS are unable to accommodate the additional workload. The medical center requires health care resources to provide services by interpreting and providing preliminary reads of imaging examinations such as General Readiologic Procedures (Plain Film and X-ray), Computed Tomography (CT)/Computerized Axial Tomography (CAT Scan), Magnetic Resonance Imaging (MRI)/Magnetic Resonance Angiography (MRA), Nuclear Medicine (NM) and Ultrasound (Doppler/Duplex) Exams. A bridge contract Independed Government Cost Estimate (IGCE) yields about 921 hours are required to provide continutity services.

Additionally, the Contractor shall supervise all residents providing radiology interpretation services.

According to the guidelines dictated by the Residency Review Committee of ACGME, the shall also perform any administrative duties relative to documentation of resident training, as required and directed by the VA clinical direction to and oversight of residents/fellows consistent with current accreditation guidelines, clinical research, protocol development, data management of protocols, quality assurance conferences and meetings, and affiliate /VA staff meetings. Ensure on-site resident supervision in accordance with the national VHA Directive 1400.01: Supervision of Physician, Dental, Optometry, Chiropractic, and Podiatry Residents, dated November 07, 2019.

4. Statutory Authority Permitting Other than Full and Open Competition: Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements per 41 USC §3304(a)(1) as implemented by FAR 6.302-1.

5.

Requires the Use of the Authority Cited Above (applicability of authority): 38 U.S.C. Title 8153 is the authorizing statute allowing Sole Source contracting in accordance with FAR 6.305-5(a)(2) and VHA Directive 1663- Health Care Resources Contracting- Buying allows the VA to contract with institutions that it has affiliation agreements with.

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This acquisition is being procured under the authority of 38 U.S.C. Title 8153 paragraph (a)(1). As stated in paragraph 4.a.(2)(a) of VA Directive 1663, sole-source contract awards to affiliates must be considered the preferred option whenever education and supervision of graduate medical trainees are required in the area of services contracted. Additionally, Accreditation Council for Graduate Medical Education (ACGME) and medical school policies require that physicians supervising resident trainees hold faculty appointments at the accredited institution (see VA Directive 1663 4(a)(2)(b). As an affiliate of the University of New Mexico School of Medicine (hereafter referred to as UNMSM), NMVAHS actively sponsors an ACGME program number 4203421120 In Radiology-Diagnostic Services. It is in the best interest of the NMVAHS to acquire the required services from UNMSM on a sole-source basis. The justification includes all the information required under paragraph 4.a.(1) of VA Directive 1663, a statement indicating that the contract shall be FTE based and documentation verifying that the NMVAHS actively sponsors UNMSM in an ACGME In Radiology Services.

Additionally, the NMVAHS provides resident training through the affiliation agreement at the NMVAHS with the intent of encouraging one or more of the residents to reside in the local community and take position at the NMVAHS.

6. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable: Market research reveals that at this moment, no vendor can provide Radiology Interpretation and Training for this requirement. In addition to, 38 U.S.C. Title 8153 is the authorizing statute allowing Sole Source contracting in accordance with FAR 6.305-5(a)(2) and VHA Directive 1663- Health Care Resources Contracting- Buying allows the VA to contract with institutions that it has affiliation agreements with.

7. Determination by the CO that the Anticipated Cost to the Government will be Fair and Reasonable: Salary Surveys determined Radiologists receive an annual salary of $449,390.00 per year. A conservative 23.30% was added to the salary amount for fringe benefits, payroll taxes, and insurance for a total compensation of $585,848.00 per FTE. Locum Tenens would cost approximately $3,000,000.00. Locums Tenens would not participate in after-hours coverage, which would add an additional amount of $576,000.00 in Tele-Radiology costs. More complex examinations (e.g., Cardiac CT, CTAs, and unusual Nuclear Medicine Procedures) would be outsourced. This cost is estimated at $260,000.00 (5 exams weekly at approximately $1000 per exam). The total estimated cost would be $3,836,000.00. This also does not include the resident training and supervision as needed in this requirement.

Radiologist Services estimate was obtained by analyzing historical prices and based on the current contract, VA258-17-D-0001, priced at $379.75 an hour for estimated 954 hours totaling $362,471.38 per month. However, a bridge contract is needed for continutity while the long-term solicitation is currently in a negotiation phase. Due to inflation and the increase of FY24 Fringe, UNM prices has increased by 2.8%. As a result, the direct labor is now priced at $390.69 an hour for estimated 921 hours totaling $406,384.49 per month. Price reasonableness will be determined for fair and reasonable. An supporting document will be available in the contract briefcase in eCMS tagged as S19.

8. Description of the Market Research Conducted and the Results, or a Statement of the Reasons Market Research Was Not Conducted: Market research confirms that the service being acquired is a commercial item. Radiology Interpretation Services are available to both the Government and private sector entities. However, the resident training component is not. While there has been an increase in the last three years of small businesses becoming capable of providing the services, none are capable of providing the resident training component of the acquisition. A search using the

GSA Library, and SAM yielded zero (0) results of vendor capable of meeting this requirement. The same search criteria through VIP yielded one (1) vendor, JIC Global LLC. However, the vendor provides technical solutions to operational and resource requirements and nothing with radiology interpretation with resident training.

Market Research Sources:

Internet Search Dynamic Small Business Search (https://web.sba.gov/pro-net/search/dsp_dsbs.cfm) Department of VA-Vendor Information Page (https://www.vetbiz.va.gov/vip/) System for Award Management (www.SAM.gov) Other Agency i.e., GSA, (https://www.gsaelibrary.gsa.gov/ElibMain/home.do) Patient-Centered Community Care (PC3) Contracts - Service is Not Available on PC3 Historical Data i.e. prior contract. Market research data.

Based on the market research conducted, no two (2) or more VIP verified and capable SDVOSBs or VOSBs were identified and appeared capable of performing the requirement. In addition, no small business in any of the other targeted socio-economic groups appeared to qualify for a set-aside or sole source procurement. This requirement falls under HCR authority pursuant to 38 U.S.C. 8153 and 38 U.S.C. 7302 to sole source contracts to affiliated educational institutions or other health care entities affiliated with the VA. UNMSM is an affiliate to the VA.

FAR Part 19.502-2, states that if the contracting officer does not have a reasonable expectation that two (2) or more small business concerns owned and controlled by service-disabled veterans will submit an offer for the contracting opportunity then no set-aside need not be accomplished.

9. Any Other Facts Supporting the Use of Other than Full and Open Competition: Currently, these services are being provide by UNMSM Contract VA258-17-D-0001 in expiring September 30, 2023.

Services are required to prevent our Veteran population from having to travel great distances for medical care. Solicitation: 36C25822R0001 for the long-term contract is currently in a negotiation phase. Therefore, a bridge contract is required to provide services continually and prevent work stoppage as the department is short of Radiologist for NMVAHS.

10. Listing of Sources that Expressed, in Writing, an Interest in the Acquisition: The NMVAHS has an Academic Affiliation with the University of New Mexico School of Medicine, (UNMSM). They are the only vendor that have expressed their interest in this acquisition.

11. A Statement of the Actions, if any, the Agency May Take to Remove or Overcome any Barriers to Competition before Making subsequent acquisitions for the supplies or services required:

This acquisition is being procured under the authority of Title 38 U.S.C. Section 8153 paragraph (a)

(3) (A) and the health-care resource required is a commercial service that is authorized under VA Directive 1663. NMVAHS lacks the necessary VA staff to provide the services during the required times, the entire projected workload is considered the gap to be filled and shall be supported by the contractor. In addition to, the NMVAHS has an Academic Affiliation with UNMSM. UNMSM can provide radiology interpretation and resident training. The education and supervision of Radiology residents shall be conducted according to the currently implemented Academic Affiliation Agreement.

Sole source contracts to affiliated educational institutions or other related health care entities affiliated with VA (as defined in 38 U.S.C. 7302) shall be the preferred method used to procure HCR services when services to be provided to the VA include duties relating to a professional health residency program within the area of the services contracted or when the affiliate has the capacity to deliver health care resources in a manner that represents best value to the government. Therefore, there is no action that the agency can take to remove or overcome any barriers to competition.

VHAPG Part 806.3 OFOC Revision: 01 Effective Date: 04/01/23

VHAPG Part 806.3 OFOC Page 4 of 4 Revision: 01 Effective Date: 04/01/23

The plan is get a 10-year contract with UNMSM since they are the only vendor that can meet this requirement. At this time, a solicitation was issued to University of New Mexico and expected to end 9/21/2023. Price negotiations will follow and a 10-year contract will be awarded to UNM.

12. 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 and belief.

Gurugot, Khalsa Acting Chief of Imaging, NMVAHS, VHA

13. Approvals in accordance with the VHAPM Part 806.3 OFOC SOP:

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

Michael Cordiero Contracting Officer, NCO22

b. One Level Above the Contracting Officer (Required over SAT but not exceeding $750K): I certify the justification meets requirements for other than full and open competition.

James Moran NCO22 Division Chief, Healthcare Resources