Redated.J & A.Cloud Based EMR.pdf

JUSTIFICATION AND APPROVAL FOR OTHER THAN FULL AND OPEN

COMPETITION

(Authority is 41 U.S.C. 3304(a)(1))

Version 2.0 July 2024

1. Agency and Contracting Activity.

Department of Homeland Security, United States Customs and Border Protection, Office of Acquisition proposes to enter into a contract on a basis other than full and open competition on behalf of the CBP Office of the Chief Medical Officer (OCMO).

2. Nature and/or description of the action being approved.

CBP OCMO has a requirement to maintain, enhance, and migrate the existing site-based proprietary Software-as-a-Service (SaaS) solution platform, developed by JUVARE LLC under CBP OCMO contract 70B06C21C00000056, to a cloud-based stand-alone Electronic Medical Record (EMR) system. ESi, an affiliate company owned by Juvare, is the only source with an open-ended licensing agreement for the Juvare WebEOC Unified Command Platform (UCP) who can provide development services for the EMR. The proprietary UCP is the basis for the Electronic Medical Record system. The UCP is a SaaS cloud-based solution that has received an Authority to Operate (ATO) certification.

a) OCMO intends to procure, on a sole source basis, services to maintain, migrate, and further enhance the existing proprietary UCP EMR system into and on a cloud-based platform.

b) Award to be made to:

ESi ACQUISITION, INC.

235 PEACHTREE ST NE

STE 2300

ATLANTA, GA 30303

UEI: PJF7XKQGSDC7

CAGE: 1X6C3

c) Firm Fixed-Price Contract, Software as a Service (SaaS)

d) Estimated Total Value (including option years) Base Period:

Option Period 1:

Option Period 2:

Option Period 3:

Option Period 4:

September 26, 2024 to September 25, 2025 September 26, 2025 to September 25, 2026 September 26, 2026 to September 25, 2027 September 26, 2027 to September 25, 2028 September 26, 2028 to September 25, 2029

Estimated: Total:

3. Description of Supplies/Services.

The contractor shall provide and support the proprietary Juvare EMR Software as a Service (SaaS) at an estimated total cost of . CBP OCMO requires Juvare/ESi Acquisition, Inc. to migrate, develop and maintain an EMR system and migrate to a UCP cloud-based platform. The current EMR system that is on-premises will remain functional until the new EMR system is active to facilitate data information preservation and transfer, from the current on-premises system to the new cloud-hosted system. The current on-premises EMR system was developed by JUVARE LLC under CBP OCMO contract 70B06C21C00000056.

For the new EMR system, OCMO requires development support and hosting services in a FedRAMP (High) cloud environment, continued maintenance of the new cloud-hosted EMR system (UCP), and compatibility with the existing on-premises WebEOC solution currently used by CBP. The existing EMR system will remain in place until all data is migrated and validated to the new solution. This new system will allow CBP to consolidate the existing medical record WebEOC solution, a Juvare product, into a new cloud-based solution. Juvare, an affiliate company owned by ESi Acquisition, is the only source with an open-ended licensing agreement for the Unified Command Platform (UCP) software system. Juvare is also the only vendor who can provide development services for their EMR system in a FedRamp HIGH environment. This SaaS cloud-based solution is currently working through receiving an ATO certification under a separate CBP contract.

4. Identification of Statutory Authority Permitting Other Than Full and Open Competition.

The statutory authority permitting other than full and open competition is 41 U.S.C.

3304(a)(1) pursuant to FAR 6.302-1 entitled “Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements.”

5. Identification of Exception to buy American Statute.

There is no exception to the Buy American Statute.

6. Demonstration that the proposed contractor's unique qualifications or the nature of the acquisition requires use of the authority cited.

The requirement is to utilize the proprietary Juvare software platform to create a new and compatible EMR cloud-based system for CBP OCMO’s requirements. Juvare software has been used as the platform to develop a Unified Command Platform for utilizing the WebEOC application in a cloud-hosted environment. This application proprietary owned by Juvare/ESi. The WebEOC system was designed to supplement the existing electronic health record system for CBP. There is now a substantial amount of data in both systems. This data is crucial to the operations of the OCMO and immigrant health/safety, necessitating the continuous use of the existing solutions to maintain health and safety of our migrating border populations. Juvare/ESi Acquisition developed and provides continuous enhancements to the existing proprietary WebEOC solution, which is compatible with the new Unified Command Platform (UCP) provided by ESi. The Juvare UCP is the only software that is 100% compatible with the complicated logic and code that is written in the existing Juvare WebEOC platform. Using any other vendor for the EMR would create compatibility and functionality issues with the existing WebEOC and greatly depreciate the effectiveness of creating a new viable solution.

The Office of Chief Medical Officer requires a FEDRAMP (High) cloud solution. Juvare/ESi Acquisition is the only vendor with an EMR solution currently in the FedRAMP High environment who is licensed by Juvare to provide the services.

The proposed contract with the proprietary software manufacturer is for the maintenance, migration, and continuous development of, and ongoing operation, upgrade, and maintenance services for the EMR SaaS. A Minimum Viable Product (MVP) is required 12 months after the award of the contract. After the MVP is delivered, there will be continuous development of the system over the following four (4) option years. No other vendor can provide this service as the UCP software application is proprietary to Juvare, which is a subsidiary under ESi ACQUISITION, INC. There are no authorized wholesales or resellers of the UCP.

7. Description of efforts made to ensure that offers are solicited from as many potential sources as is practicable.

CBP intends to post the notice of intent in accordance with FAR 5.201 and 5.203(a)(1) and make this justification publicly available on SAM.gov pursuant to FAR 6.305(a) within 14 days after award.

8. Determination by the Contracting Officer that the Anticipated Cost to the Government will be Fair and Reasonable.

The contracting officer will determine that the price is fair and reasonable based on comparison with historical pricing from other federal agencies and CBP’s existing programs for similar UCP software development, to include CBP’s Contract 70B06C23C00000061, for WebEOC/UCP supporting the Office of Professional Responsibility, and comparison with an in-house estimate from CBP’s OIT for CBP OIT to build an EMR with the required capability and functionality.

9. Description of Market Research.

The internet was searched for a list of contractors that could provide compatible software that would work with CBP’s existing systems in the FedRAMP High environment. Aside from Juvare/ESi Acquisition, there are no other vendors that have the capability to perform the development of the Juvare UCP into the required EMR and provide ongoing development, enhancements, and maintenance of the EMR.

CBP conducted extensive Market Research, including releasing a Request for Information, and found that Juvare/ESi Acquisition is the only vendor with a FedRAMP (High) environment with an EMR compatible with the existing software.

Juvare/ESi Acquisition does not have direct access to any of the preferred DHS Strategic Sourcing Contract Vehicles (SSV) and their proprietary software is not available under any

DHS SSV.

10. Any Other Facts Supporting the Use of Other Than Full and Open Competition.

CBP OCMO has determined that in order to meet mission critical performance requirements, a functional replacement of the existing server based EMR must be in place by September 30, 2024. Failure to utilize the Juvare software platform to develop the OCMO EMR would result in a significant cost increase, operational delays, and multiple compatibility issues; thereby providing high risk of missing the operational date of September 2024. Use of any other solution would require significant time and funds to develop an entirely new platform that is unlikely to be seamlessly compatible with the existing proprietary software CBP already uses. These expenses and time would be prior to any further development to the EMR which OCMO requires. The estimated cost to establish an entirely new software platform, to include FedRAMP (High), Authority to Operate (ATO) certifications, and the use of another cloud based “Unified Command Platform” is estimated to exceed . Additionally, there would be a significant risk that after redundant effort, delay, and expense that an alternate system would work as needed. The duplicative effort and costs would result in unacceptable delays that are detrimental to critical CBP operations. By using the Juvare UCP, CBP OCMO would accept significantly less risk of maintaining and developing a totally compatible solution to meet its immediate mission needs. Taking on the risks and expense of using an incompatible software platform is not in the best interest of the Government.

11. A Listing of the Sources, if Any That Expressed, in Writing, an Interest in the Acquisition.

Four (4) sources replied to the RFI in November 2023. These vendors were Axon, Disaster Tech, DMG & Benniel, and Juvare/ESi Acquisition. While each expressed an interest in the contract, none of them, except Juvare/ESi Acquisition, could offer a system like the existing Unified Command Platform required of this program. Additionally, CBP released an “Intent to Sole Source” notice in SAM.gov on July 30th, 2024, and received a response from just one vendor. The vendor provided their capabilities statement, but it has been determined that the vendor is not offering an EMR solution and only offering to customize the WebEOC/UCP solution as a developer. This capability by itself does not meet the holistic EMR requirements needed by OCMO.

12. A Statement of the Actions, if Any, the Agency May Take to Remove or Overcome Any

Barriers to Competition Before Any Subsequent Acquisition for Supplies or Services Required.

CBP will consider other software systems, whether COTS or developed at Government expense in the future if viable options are available that present a better solution with a cost benefit for the investment. As CBP transitions to cloud-based systems, this will allow for future competition as systems become obsolete and the marketplace for an EMR program in the FedRAMP high environment increases. The Agency could enter into negotiations to purchase the proprietary rights to the product, albeit the price would likely be considerably higher and time constraints would not permit the years of development required to modify another COTS product.

► J&A CERTIFICATIONS

13. REQUISITION/PROGRAM OFFICE CERTIFICATION

I certify that the foregoing just·fication is accurate, meets the Government's m·nimum needs and contains complete ·nformation necessary to support the action described in this document and the authority cited.

Office: Office of The Chief Medical Officer Name (Print):

Title:-

Signature:

14. CONTRACTING OFFICER CERTIIFICATION/APPROVAL*

I certify that the data supporting the recommended use of other than full andopen competition is accurate and complete to the best of my knowledge and belief.

Name (Print):

Contracting Officer

Signature:

* In accordance with FAR 6.304(a}(l), CO certification of a J&A for a requirement not exceeding $750,000 shall constitute approval of the J&A.

► J&A APPROVALS

15. COMPETITION ADVOCATE (Per FAR 6.304(a}{2) - Over $750,000 to $1SM} pproved □Disapproved