P03_Justification and Approval - TekTone Nurse Call System - revised 05.24.24.pdf

VHAPG Part 806.3 OFOC Page 1 of 4 Revision: 02 Effective Date: 11/15/23

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition

Project 520-317X: Biloxi Building 1 Renovation – Biloxi, Mississippi Solicitation: 36C10F24R50025

1. Contracting Activity: Department of Veterans Affairs, Office of Construction and Facilities

Management (CFM), Office of Facilities Acquisition (OFA).

2. Description of the Action Being Processed:

The VA Office of Construction and Facilities Management intends to award a firm-fixed price contract which will allow for full and open competition for all elements of construction except for the item specifically identified herein. Therefore, this action is a sole source justification for requiring use of the TekTone Nurse Call System that will be a component of the overall construction project 520-317X: Biloxi Building 1 Renovation.

3. Description of System Required to Meet the Agency’s Needs:

As a part of overall construction, the contractor will be required to supply and install TekTone Model Tek-CARE 400 GEN3 Nurse Call System where specified within the drawings and specifications for construction of the Acute Care Inpatient Unit. The estimated total cost of the proprietary components is which represents of the total construction value to be awarded. The estimated cost is based on the budgetary estimates provided by Anderson Engineering, May 3, 2019 and escalated based on historical Consumer Price Index (CPI) data.

Use of this nurse call system will provide an efficient means of monitoring patients and thereby enchance the provision of patient care for the project being constructed.

4. Statutory Authority Permitting Other than Full and Open Competition:

The statutory authority permitting other than full and open competition is:

( X ) (1) 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;

( ) (2) Unusual and Compelling Urgency per 41 USC §3304(a)(2) as implemented by FAR 6.302-2;

( ) (3) Industrial Mobilization, Engineering, Developmental or Research Capability or Expert Services per 41 USC §3304(a)(3) as implemented by FAR 6.302-3;

( ) (4) International Agreement per 41 USC §3304(a)(4) as implemented by FAR 6.302-4

( ) (5) Authorized or Required by Statute per 41 USC §3304(a)(5) as implemented by FAR 6.302-5;

( ) (6) National Security per 41 USC §3304(a)(6) as implemented by FAR 6.302-6;

( ) (7) Public Interest per 41 USC §3304(a)(7) as implemented by FAR 6.302-7;

VHAPG Part 806.3 OFOC Page 2 of 4

5. Demonstration that the Contractor’s Unique Qualifications or Nature of the Acquisition Requires the Use of the Authority Cited Above (applicability of authority):

There is only one responsible source who can satisfy agency requirements. The TekTone Nurse Call Tek-CARE 400 System exists as the Biloxi Medical Center’s current Nurse Call/Code Blue system as there are currently 228 operating beds at the VAMC and they all have the TekTone nurse call system. A previous project replaced the previous Rauland nurse call system in Bldgs 14, 15, 29 & 30 to the TekTone Nurse Call System and is no longer on campus.

Therefore, introducing a different nurse call system for this project would significantly impede the feasibility, compatibily, functionality and cost-effectiveness of the VAMC nurse call system.

As Tektone is a proprietary system, the Biloxi VAMC requires continuation of TekTone Tek- CARE 400 patient stations in the Building 1 Renovation project to ensure interoperability amongst nurse call system and newly installed stations. Additionally, VACO Telecommunications Specialist, Keith Van Bakel, has stated utilizing a mix match of systems will void UL 1069 compliance.

Patient safety is a key driver and high priority for the Gulf Coast Veterans Healthcare System.

Introducing a new nurse call/code blue system other than the Biloxi Medical’s standard TekTone system creates a potential patient safety issue. This would require all clinical staff to undergo new training and hold two sets of nurse call/code blue training competencies.

6. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable:

Efforts to ensure offers are solicited from as many potential sources as practical will include synopsizing the construction contract as required as FAR Part 5.2. This sole source justification is meant to only allow for the specific nurse call system referenced herein which will comprise a very small portion of the construction contract. Where possible, the construction contract requirements will be tailored to allow full and open competition for all but the specific nurse call system referenced herein with the exception of any other items approved under separate, approved sole source justifications to be included in the solicitation.

7. Determination by the CO that the Anticipated Cost to the Government will be Fair and

Reasonable:

The anticipated cost of this proprietary system is expected to be . The costs of providing a full and open bid nurse call system is not available as there have been no previous bids requested. The only cost is based on the Anderson budgetary estimate. The result of the expense of the added cost results in continuation of a single patient monitoring system at the Biloxi Medical Center facilitating patient safety and patient care best practices. Therefore, a determination has been made by the Contracting Officer that the anticipated cost to the Government will be fair and reasonable.

8. Description of the Market Research Conducted and the Results:

Market Research was conducted to determine the availability of additional nurse call systems above and beyond the TekTone nurse call system in the marketplace via Internet search. The following are the results of the market research.

VHAPG Part 806.3 OFOC Page 3 of 4

Rualand Nurse Call System Cornell Nurse Call System MM Call Nurse Call System Jeron Nurse Call System

Additionally, clarification was needed regarding best industry practice regarding using different nurse call systems within the same VAMC. Therefore, I reached out to BEC Integration Solutions, an industry supplier of both the TekTone and Cornell nurse call systems and the representative stated that two different brands of nurse call systems will not be compatible with each other and it is best practice to use the same system throughout.

The conclusion from market research concludes that incorporating a second system into the VAMC is not a good industry practice and would result in installation challenges and additional unnecessary staff training needs.

Distributors for the TekTone Nurse Call System located in the Southwestern Region include Corrigan Group – Phone 800-327-8466.

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

The VAMC incorporated the TekTone nurse call system as it was unable to get adequate and timely repair services from the previous system. There are cost and implementation concerns with introducing a different system. It raises significant concerns regarding cost efficiency and operational disruption. However, from a performance and features standpoint, the TekTone TekCARE 400 GEN3 Nurse Call System does not hold a significant advantage over other manufacturers of Nurse Call Systems. The following capabilities support the continuation of TekTone standardization throughout the Biloxi Healthcare System.

Single system campus wide: there are currently no manufacturers that offer an interface that will allow their nurse call system hardware to work directly with an existing TekTone system.

The single manufacturer spare part inventory: the campus would only need to maintain an inventory of TekTone nurse call parts allowing for improved material management and economics. Introducing a different nurse call system would increase the need for spare part inventory and require additional warehouse space which is not efficient.

Single system training: staff would only require training on the existing system and its updates as opposed to having to be trained on multiple systems. As far as staff retraining, it would lead to additional and significant training of staff. It would be required on an ongoing basis for the entire life cycle of an additional new nurse call system. The Biloxi VAMC will be unable to provide required routine support services for training, maintenance, and/or repair to an additional nurse call system. Each nurse call system require specific training such as videos, courses, and other training materials which would lead to inefficiencies.

Enterprise Connectivity: The VHA Office of Information and Technology, supported by the VHA Office of Enterprise Integrations, has emphasized the importance of

VHAPG Part 806.3 OFOC Page 4 of 4 enterprise-wide connectivity. In this context, with the TekTone Nurse Call System already installed across 228 beds at the Biloxi VAMC, a pre-established network that supports interoperability and system management efficiency, is critical for the project for the new beds.

Single service contract: the campus would only need to enter into a single Service Level Agreement (SLA) eliminating possible confusion when scheduling maintenance and service calls. This would allow the Engineering Dept to save on overall annual service contract costs as well.

Currently, the VAMC spends approximately $23K a month to provide maintenance and repair services to the facility’s existing TekTone/Fire Alarm System. The TekTone nurse call system and Fire Alarm System are integrated together. If another nurse call system is to be installed, then another maintenance and repair support services contract must be entered into and include the entire life cycle of the new nurse call system.

Therefore, having two nurse call systems on the Biloxi VAMC would diminish the economic efficiency of having one system.

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

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 systems required:

N/A

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.

Jason Hardy CFM Contracting Officer