P03 - Redacted Copy Exception to Fair Opportunity - Clinical Database Subscription - HCA Signed - 2.pdf

VHAPM Part 816.5—Indefinite-Delivery Contracts Original Date: 08/30/2017 Date: 02/19/2021 Rev 06

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval for Exception to Fair Opportunity Memo

Acquisition Plan Action ID: 36C776-21-AP-3177

1. Contracting Activity:

Department of Veterans Affairs

Program Contracting Activity Central (PCAC)

6150 Oak Tree Blvd., Suite 300

Independence, OH 44131

2. Description of Action:

The proposed sole source task order against Indefinite Delivery Indefinite Quantity (IDIQ) number 36C77621D0006 awarded on January 25, 2021 to COX Subscriptions, Inc., 201

Village Rd, Shallotte NC 28470, is for a one-year plus four (4) option years firm-fixed price

(FFP) effort for a subscription for Clinical Key Nursing. This action is a justification to support a task order for the Library Network Office (LNO). The Veterans Health

Administration (VHA) LNO provides a core collection of centrally funded authoritative information resources that can be accessed by Department of Veterans Affairs (VA) staff on‐ and off‐site.

3. Description of Supplies or Services:

VHA’s goal is to ensure uniform availability of high quality, clinical nursing healthcare knowledge-based resources across the VHA system to improve clinical decision making. The period of performance will start from 9/30/2021 to 9/29/2022, with four option years. The estimated total value is $8,004,007.00.

The desired goals of the nationwide provision of a commercial nursing healthcare knowledge-based resource, Clinical Key for Nursing and Clinical Skills, are as follows:

Date: 02/19/2021 Rev 06

• Provide access nationwide to standard knowledge-based clinical nursing healthcare information resources will build on the enterprise wide availability of knowledge-based resources in the National Core Collection of Online Resources available to all VA staff.

• Improve clinical decision making at the point of care by insuring a uniform availability to a subscription-based collection of high quality, clinical, full text electronic journals, books, databases, and electronic media.

• Initiate a nationwide, centralized purchase to capitalize on the economies of scale offered by vendors.

• Negotiate one license/contract to decrease the current contracting and reviewing efforts that are required at the facility and/or VISN level and thereby avoid the costs and workload associated with multiple procurements.

• Make this Nursing Healthcare Knowledge Product available through CPRS

(Computerized Patient Record System), the VA’s Electronic Health Record, nationwide to insure consistent access at the bedside for all VHA health professionals and staff.

4. Statutory Authority:

The statutory authority permitting an exception to fair opportunity is Section 41 U.S.C.

4106(c) as implemented by the Federal Acquisition Regulation (FAR) Subpart 16.505

Subpart 16.505(b)(2)(i):

( x ) FAR Subpart 16.505(b)(2)(i)(B): Only one awardee is capable of providing the supplies or services required at the level of quality required because the supplies or services ordered are unique or highly specialized.

5. Rationale Supporting Use of Authority Cited Above:

The publisher offers an all-inclusive clinical product that provides for Nursing and Allied

Health information needs. No other resources that are available to the IDIQ members can do the same.

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It offers employees advanced search technology to provide search results aggregated from many types of media/materials, with most being propriated or with others having longtime licensed media/materials. Products in other nursing and allied health offered resources are not aggregated into one as is Elsevier. These are the types of media and materials exclusively available by one Elsevier information resource. Elsevier, Inc offers world-renowned nursing books, including AACN’s Core Curriculum for Critical Care, Sheehy’s Manual of

Emergency Care, and Saunders Nursing Drug Handbook. Also, Elsevier, offers full text for top journals such as Journal of Emergency Nursing, Nurse Leader, AORN Journal and

Journal for Nurse Practitioners, Customizable Patient Education Handouts and Clinical calculators. Elsevier Inc offers continuing education contact hours, key content includes drug monographs, clinical topic summaries, videos, and images, clinical overviews with topic pages (concise information about disease epidemiology, risk factors, clinical manifestations, and treatments), and Mosby’s evidence-based Nursing Monographs.

In addition to the numerous articles, videos and journals that are proprietary to Elsevier, many articles, while available online at separate sources, are available from Elsevier through the clinical skills and clinical key subscription to provide access to all of the articles at one source. This allows the practitioner to search quickly through all relevant articles for information that is critical to patient care. No other source on the IDIQ has this characteristic to meet the government’s need.

The subscription is “powered by” Elsevier’s Smart Content, tagged with Elsevier Merged

Medical Taxonomy (EMMeT), which enables Clinical Key to understand clinical terms and thus discover medical content that is the most relevant, plus find related content that would be missed by other search engines. Elsevier’s Smart Content has been designed to understand the vast number of relationships between clinical concepts. By organizing these relationships in a hierarchical manner, it guarantees that Clinical Key provides specific, targeted results to nurse’s questions. The tool allows the user to filter search results by clinically meaningful subcategories (content type, specialty, and by relevant clinical categories like treatment and diagnosis). Specialty specific tools enable users to quickly go from topic overview to in

Date: 02/19/2021 Rev 06 depth specialty information to meet clinical challenges, saving time during critical patient care. No other subscription source has the EMMet function.

Elsevier also meets VA’s needs by providing enterprise-wide access to their proprietary and concise content with no geographic or concurrent user limitations, content in both HTML and

PDF formats, access to online only supplements and images, and detailed usage reports.

The publisher was contacted to find out if there were authorized resellers to provide this subscription. Elsevier’s responded stating that WT Cox is Elsevier’s small busines partner and sole authorized reseller of their clinical solutions. LNO continuously researches available products to find the most well rounded and complete products that encompass the needs of the VA. This sole source subscription provides the most up‐to‐date, state‐of‐the‐art research and peer reviewed medical articles by recognized experts in their field and due to their proprietary nature, copyrighted material, and intellectual property, are unique and highly specialized.

6. Efforts to Obtain Competition:

Market research was conducted, details of which are in the market research section of this document. Additionally, LNO’s subject matter experts reviewed the government’s need and evaluated the possible subscriptions to meet that need. Research is conducted continuously throughout the year by the LNO. Suggestions from medical center staff, librarians and program office officials are received on a routine basis. This interdisciplinary group makes recommendations as to what will and what will not be provided nationally to all clinicians and program teams as part of the core collection.

These efforts did not yield any additional sources that can meet the Government’s requirement. There is no competition anticipated for this acquisition. In accordance with

FAR 5.301 and 16.505(b)(2), this action will be synopsized at award on https://www.beta.sam.gov-Contract Opportunities and the justification will be made publicly available.

http://www.beta.sam.gov-contract/

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7. Actions to Increase Competition:

VA will continue to perform market research in attempts to find other sources before exercising options and or soliciting new awards for the same or similar future acquisitions of the services being acquired.

8. Market Research:

Per the Department of Veterans Affairs Acquisition Regulation (VAAR) Sections 810.001‐

70 & 810.002, The Vendor Information Pages (VIP) was queried utilizing NAICS 519130 to search for capable, verified Service‐Disabled Veteran‐Owned Small Business (SDVOSB) &

Veteran‐ Owned Small Business (VOSB) concerns. The VIP search produced approximately

228 SDVOSB & VOSB businesses.

Subsequently, Elsevier’s Inc. was contacted to find out if there were authorized resellers.

Elsevier’s responded stating that WT COX is Elsevier’s small busines partner and only authorized reseller of their clinical solutions.

Based on market research, the CO does not have a reasonable expectation that offers/quotes will be received from at least two capable SD/VOSB concerns. The VA Rule of Two has not been met for this requirement.

9. Other Facts:

Elsevier’s Inc is the sole publisher of this subscription. This publisher does not license this product or its content to other distributors. The only authorized reseller is WT COX. The

VHA benefits from this subscription by providing up-to-date resources in this specific area of health information.

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10. Determination that Anticipated Cost is Fair and Reasonable:

The Contracting Officer will determine the prices to be fair and reasonable prior to award by comparing offered price (quote) to current market price of similar subscriptions and government’s Independent Government Cost Estimate (IGCE).

11. 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.

Tom Waugh Date

Program Manager

Office of Health Informatics

12. Contracting Officer's Certification (required):

I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief.

20 Sept 2021

Katherine Gibney Date

Contracting Officer

Program Contracting activity Central (PCAC)

Katherine D.

Gibney 1632400 Date: 2021.09.20 07:21:40

Thomas P.

Waugh 105835 Date: 2021.09.20 08:28:23

Date: 02/19/2021 Rev 06

13. Approvals in accordance with VHAPM Part 816.505 Indefinite Delivery Contracts:

Ordering.

a. One Level Above the Contracting Officer: I certify the justification meets requirements for an exception to fair opportunity.

20 Sept 2021

Nicholas Sparks Date

Supervisory Contract Specialist

PCAC

b. Director of Contracting: I certify the justification meets requirements for an exception to fair opportunity.

Richard Dahmen Date

Director of Contracting

PCAC

c. VHA Advocate for Competition/Head of Contracting Activity (HCA) REVIEW AND

APPROVAL (over $750,000 to $15 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 the exception to fair opportunity.

TERRY Digitally signed by TERRY

SPITZMILLER

SPITZMILLER Date: 2021.09.20 16:36:42 09/20/2021

Terry L. Spitzmiller Date

Executive Director

Regional Procurement Office Central (VHA)

Nicholas W.

Sparks 452466 Date: 2021.09.20 09:39:26

Dahmen, Richard C.

VHAPM Part 810 Market Research SOP Revision: 07, Effective Date: 03/10/21

Market Research Report

TITLE: Clinical Key Nursing Package Subscriptions

I. Background:

The Department of Veterans Affairs (VA) Veterans Health Administration (VHA) requires an existing commercial, off the shelf, web-based Elsevier Clinical Key Nursing Package Subscriptions that will be made available throughout the VHA healthcare system.

The product includes full text, electronic journal articles, book chapters, book reviews and editorials together with specific research methodologies, such as clinical case reports, empirical studies and literature reviews and documents that have tests or assessment instruments appended.

For the purpose of this requirement, these products must include sources such as electronic textbooks and online full text journals and other information on nursing treatment, diagnosis and therapy. This product’s emphasis is on patient-oriented information, treatment guidelines, and patient health education resources.

VHA’s goal is to ensure uniform availability of high quality, clinical nursing healthcare knowledge-based resources across the VHA system to improve clinical decision making. Clinical Key for Nursing provides online access to mostly journal resources specially designed for nurses, nurse practitioners, licensed practical nurses, physician assistant and other clinical nursing staff which will include drug information, patient education information, professional nursing journals, reference nursing ebooks, current news, clinical practice guidelines, and other relevant evidence-based nursing content and nursing care planning tools.

The overall goal of this acquisition is to support the Network Library, the VACO Library, and approximately 153 VA Medical Centers (VAMC) by fulfilling a requirement of Clinical Nursing Key Package Subscriptions.

II. Procurement Information:

The codes identified below will be used when advertising this requirement, if applicable.

► Product or Service Code: R605 - Support- Administrative: Library

► North American Industry Classification System (NAICS) 519130 – Internet Publishing and Broadcasting and Web Search Portals

This is not a bundled requirement as defined by FAR 2.101. There are no applicable Organizational Conflicts of Interests.

The estimated contract value, including options, is $8,301,929.00.

III. Market Research Techniques:

Market research was conducted for this procurement from 07/15/2021 to 08/16/2021. The following techniques were used to identify potential sources:

A. Reviewed Procurement History B. Interviewed knowledgeable individuals in industry C. Queried Vendor Information Pages (VIP) for registered SD/VOSB vendors in NAICS

519130 D. Researched System for Award Management (SAM) Entity Data E. Reviewed VA Existing Contracts

IV. Market Research Findings:

A. Procurement History Reviewed: This requirement for Clinical Key Nursing Package

Subscriptions was previously awarded as a sole source award to the publisher Elsevier, Inc. in September 2017 with the period of performance running from 09/30/2017 to 09/29/2021. The order number is VA701-17-P-0158 and purchase order number is PO# 776-C70087.

B. Publisher Information: The publisher for this subscription is Elsevier, Inc. The publisher has a registered business size of 1000 employees for NAICS 519130, and is registered as a large business in SAM.

C. Authorized Resellers Elsevier, Inc. was contacted via email on 05/10/2021 to find out if there were authorized resellers. Elsevier, Inc responded on 05/10/2021saying that the only authorized reseller is COX Subscriptions, Inc. As a result of this enquiry, COX Subscriptions, Inc. will be contacted.

Authorized Resellers All Registered

Socioeconomic Category/Categories

Business Size for

NAICS 519130

COX Subscriptions (WT Cox) None Small

D. Vendor Information Pages (VIP) Query: Per the Department of Veterans Affairs Acquisition Regulation (VAAR) 810.002, the Vendor Information Page (VIP.gov) was queried on 07/15/2021to locate verified SDVOSB and VOSB concerns utilizing NAICS code 519130. The search resulted in a list of 229 organizations (Attachment 1 - VIP Search NAICS 519130).

An email blast was not sent to the VIP query vendors based on the market research showing there are no known SDVOSB/VOSB authorized resellers available.

Based on market research, the CO does not have a reasonable expectation that offers/quotes will be received from at least two capable SD/VOSB concerns. The VA Rule of Two has not been met for this requirement.

E. Existing VA contract review: Library IDIQ

A multiple award Indefinite Delivery Indefinite Quantity (IDIQ) was awarded January 26, 2021, for the required subscription-based access to a comprehensive core collection of knowledge-based information (clinical journals, databases, medical information, and textbooks) listed in the J&A. This IDIQ maintains the National Core Collection of Online Resources on behalf of the VA and makes those resources available for use at all VAMCs, community-based outpatient clinics (CBOC), VISNs and Program Offices.

A brand name class Justification and Approval (J&A) was executed on August 7, 2020, to provide the most up-to-date, state-of-the-art research and peer reviewed medical articles by recognized experts in their field and due to their proprietary nature, copyrighted material and intellectual property are unique and highly specialized and only available from one source. A list of required brand-name online subscription titles accompanied the J&A and the subscription required for this effort is on the list.

This IDIQ could be leveraged for this acquisition. The overall contract ceiling for the multiple award IDIQ is $49,000,000.00, which is shared among all IDIQ holders. The current remaining ceiling to order against is $36,844,639.40. The current IDIQ holders are:

Vendor Name Business Size DUNS COX Subscriptions Small 084174804 EBSCO Industries, Inc. Large 052711686 Prenax, Inc Small 127367261 UPTODATE (Wolters Kluwer) Large 824945448

The only IDIQ holder available to receive a task order is COX Subscriptions.

V. Conclusions and Recommendations:

The market research shows only COX Subscriptions is eligible to receive an award as reseller. The research shows the authorized reseller is a small business and a current IDIQ holder for the subscription. It is in the government’s best interest to utilize the existing library IDIQ for this effort because the small business can participate on this established IDIQ for this task order which saves administrative time. Finally, based on market research, the CO does not have a reasonable expectation that offers/quotes will be received from at least two capable SD/VOSB concerns. The VA Rule of Two has not been met for this requirement.

This Clinical Key Nursing Package subscription effort will be solicited as a sole source effort to COX Subscriptions, the small business reseller for Elsevier, Inc., on the library IDIQ.

The Contracting Officer will determine the price of the awardee to be fair and reasonable prior to award.

This market research information is not more than 12 months old.

Name:

Katherine Gibney - Contracting Officer

Date:

14 Sept 2021

List of Attachments: Attachment 1 - VIP Search NAICS 519130

Gibney 1632400