P03 REDACTED JOFOC Heart Transplant Bridge.19May.pdf

Attachment 1: Request for Sole Source Justification Template >SAT-SAP under RFO 12.102

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The VASLCHCS forecast of 15 VAD cases per year further emphasizes a commitment to maintaining continuity and quality of healthcare for Veterans. All procedures are to be conducted at the affiliate’s site. All Veteran patients will be referred through the VA National Transplant Program and will receive comprehensive and specialized treatment.

This requirement is essential for addressing the inability of the in-house transplant program to meet the demand of heart transplants due to scheduling conflicts; capacity constraints; or lengthy waiting lists. The meticulous standards of care mandated by the VA are not only met but are often exceeded by the affiliate, ensuring that Veterans receive the highest quality of medical attention.

The heart transplant contract uses an all-inclusive per procedure pricing model that will be employed, covering both hospital and professional fees, and accounting for a ten-day length of stay (LOS) starting from the day of admission.

For cases that extend beyond this period, a per diem rate ensures continued care without compromising on quality of care and cost-efficiency. Additionally, the contract includes provisions for other direct costs, including organ acquisition and VAD equipment, which are critical for establishing the overall contract value for budgeting as follows:

LIN Description Estimated Quantity Per POP

Unit Price Per POP

Estimated Price Per POP

Estimated Total Price

Base + Option

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6. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable: No additional solicitation efforts from other potential sources were pursued. Under 38 U.S.C. § 8153(a)(3)(A), the Secretary of Veterans Affairs is authorized to enter into non-competitive agreements with affiliated educational institutions without regard to other procurement laws or regulations. This authority allows VA Medical Centers the ability to acquire healthcare resources from their affiliated institutions without full and open competition when such arrangements are necessary to ensure continuity of care and access to specialized clinical expertise. This short-term requirement will not be solicited and this justification will be published to the Government Point of Entry (GPE) in accordance with RFO 6.301.

7. Determination by the CO that the Anticipated Cost to the Government will be Fair and Reasonable: The anticipated cost will be considered fair and reasonable as the costs have not increased since the expired long-term contract ) was awarded in 2019. The University of Utah has agreed to continue with the same costs for the short term interim contract. The CO will also enlist the services of the Medical Sharing Office (MSO) pricing analyst, if necessary.

8. Description of the Market Research Conducted and the Results, or a Statement of the Reasons Market Research

Was Not Conducted: Market research was conducted February 24, 2026 to determine whether alternative options for this specialized medical care were available within the t was determined that no other medical facilities can offer the same level of integration in compliance with VA requirements and provide continuity of care for the Veteran population. There are no small businesses capable of providing these services due to the unique nature of the services and the affiliation that exists with the University of Utah.

The affiliated institution is qualified to provide these services due to this established relationship with the VA;

integration into the VA’s clinical programs; and ability to supply credentialed and qualified providers who meet or exceed VA standards. No alternate sources were identified. These factors make the affiliated institution the preferred and most practical source for these services.

9. Any Other Facts Supporting the Use of Other than Full and Open Competition:

This short term interim contract is essential to sustain the VA National Transplant Program, as VASLCHCS is the only facility within NCO 19 that provides heart transplant and ventricular assist device (VAD) services, supporting surrounding VA Medical Centers in the region. Further, the University of Utah is an integrated affiliate location whereby the affiliate’s site is the VA’s transplant center site of care for surgical procedures.

The VASLCHCS, located in Utah, is one of only five (5) VA National Transplant Centers providing heart transplants nationwide. Most importantly, it supports the VA National Transplant Program and is also included in the national transplant center list.

, is the only transplant center performing heart transplant surgeries in-house. Given the significant geographical distance between , it is neither financially practical nor logistically feasible for these patients, along with their loved ones, to travel a long distance for their heart transplant surgeries.

The geographic location presents additional challenges to the patients’ fragile health condition, many of whom are too ill to endure the extensive travel, which could involve a strenuous five-hour flight.

The University of Utah, located in close proximity to the VASLCHCS, presents a viable solution by offering comprehensive in-house heart transplant and ventricular assist device (VAD) services. The University is well-

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equipped with the necessary clinical and administrative staff to support Veterans throughout their treatment journey. Their staff has the necessary credentials and qualifications to perform heart transplant surgeries. The intricate clinical needs of heart transplant and VAD patients demand rigorous quality standards and a cohesive, integrated health care system. Unlike other entities, the University of Utah has the capability to provide an all-encompassing range of services, ensuring that Veterans receive consistent, high-quality care within a singular, coordinated healthcare system. With the current contract expiration date of April 30, 2026, this requirement is time sensitive and crucial that we continue heart transplant and VAD service to Veterans by the program need date of May 1, 2026.

This partnership with the University of Utah is vital in addressing the unique challenges faced by heart transplant and VAD patients within the VA system. It not only alleviates the logistical and financial burdens associated with distant travel but also ensures that patients receive the necessary care without compromising their health. This integrated approach fulfills the VA's commitment to delivering superior healthcare services, tailored specifically to meet the specialized needs of our nation's Veterans.

Accordingly, the University of Utah is the only source capable of providing the required services described in Section 3 above by May 1, 2026 without the VAMC experiencing unacceptable delays in fulfilling its requirements. Award to a new contractor with fully qualified and credentialed staff and a suitable facility that meets or exceeds VA healthcare standards could take up to two (2) years to award and establish services. Therefore, there is insufficient time to accomplish this prior to the need date.

10. Listing of Sources that Expressed, in Writing, an Interest in the Acquisition:

University of Utah, 201 Presidents Circle, Salt Lake City, UT 84112

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: Not applicable. This requirement is authorized under VA Directive 1663 and falls within the statutory buying authority of 38 U.S.C. § 8153, which permits VA to enter into non-competitive contracts with affiliated educational institutions for healthcare resources without regard to other regulations.