Sole Source Justification Ambulance Services VANCHCS.pdf

VHAPG Part 813.106 Simplified Acquisition Procedures: Soliciting from a Single Source

Attachment 1: Single Source Justification for SAP under the SAT

DEPARTMENT OF VETERANS AFFAIRS

Justification for Single Source Awards IAW FAR 13.106-1

For

Over Micro-Purchase Threshold but Not Exceeding the SAT ($250K)

Acquisition Plan Action ID: 36C261-24-AP-2286

JOFOC Tracker ID: FY24 - NCO 21 - 1100

1. Contracting Activity: Department of Veterans Affairs (VA), Regional Procurement Office West

(RPOW), Network Contracting Office (NCO) 21 on behalf of the Veterans Integrated Service

Networks (VISN) 21, VA Northern California Health Care System (VANCHCS).

Purchase Request # 612-24-3-0921-0020.

2. Brief Description of Supplies/ Services required and the intended use/Estimated Amount:

The acquisition is for twenty-four-hour ambulance services as needed for beneficiaries of the

Department of Veterans Affairs. These services are to assure appropriate transportation for authorized beneficiaries between designated sites. The services will be classified as Standard or

Urgent and encompass the VA medical centers and community‐based outpatient clinics which make up the catchment area for all VANCHCS. Basic Life Support (BLS) transportation services will be provided by licensed/certified Emergency Medical Technicians (EMTs) and all of the attendants on a

BLS transport, including the driver, will be a fully certified EMT as defined by California State laws/regulations, county regulations, and local ordinances. Advance Life Support (ALS) transportation is at the BLS level but one of the attendants will be a licensed/certified paramedic. The catchment areas for the VANCHCS are the urban and rural counties of Sacramento, Butte, Colusa, Glenn, Siskiyou, Tehama, Tuolumne, Stanislaus, San Joaquin, Trinity, Solano, Amador, El Dorado, Sutter, Yolo, Yuba, Shasta, and Contra Costa.

The estimated contract value for American Medical Response West’s services is $127,071.20. The period of performance will be for 6 months from April 1, 2024 – September 30, 2024.

3. Unique characteristics that limit availability to only one source, with the reason no other supplies or services can be used:

VANCHCS has an urgent and compelling need for acute and basic life support ground ambulance transportation services for authorized Veteran beneficiaries. Ambulance Medical Response is the only vendor that can continue to provide ambulance transportation services at the start of April 1, 2024 for the urban and rural areas of VANCHCS.

Previously, NCO 21 awarded a sole source multiple-award Indefinite Delivery Indefinite Quantity

(IDIQ) contract to two vendors, American Medical Response West (Large Business) and Bay Medic

Transportation (Small Business). A justification for other than full and open competition (JOFOC) for the sole source multiple-award IDIQ contracts was reviewed and approved by Curtis Jordan, Executive Director, RPOW Head of Contracting. The multiple-award IDIQ contracts are expiring on

March 31, 2024 and currently, there is insufficient time to compete the long-term procurement because there is less than 30 days before contract expiration. This is a new JOFOC request for a sole source procurement of a 6-month bridge contract with American Medical Response West to allow time to procure a long-term contract for ground ambulance transportation services. American Medical https://www.acquisition.gov/?q=/browse/far/13

Response West provides about 10% of the essential ambulance transportation services that authorized

Veterans require.

The unusual and compelling urgency arose due to several reasons, including shortage in staff for the

Ambulatory Care Service, major changes in the performance work statement for the long-term procurement, and also challenges with finding fully licensed ambulance companies that can cover rural areas within VANCHCS. The Ambulatory Care Service experienced turnover in the past several months, which resulted in delays in submitting a long-term procurement package for ground ambulance transportation services. Due to staff turnover, new employees and new Contracting

Officer’s Representatives encountered large learning curves on how to prepare a complete procurement package. Additionally, there were major changes to the performance work statement that still require the Service to review, revise, and ensure the changes meet VANCHCS’ specific requirements for ground ambulance transportation services. Lastly, competition for ambulance transportation services has been historically challenging for VANCHCS. The nature of the industry requires ambulance vehicles that meet regulatory standards and sufficient staffing of skilled paramedics and emergency medical technicians (EMT). Medicare reimbursement rates are traditionally used to pay for ambulance transportation services, but these rates are low so the recruitment for these professionals have been difficult. In October 2021, a congressional letter addressed the workforce shortage of paramedics and emergency medical technicians

(https://ambulance.org/2021/10/04/workforceshortage/). Furthermore, ambulance companies must also have the ability to provide twenty-four hour ambulance services on an as needed basis and can meet response times for standard and urgent care.

This sole source vehicle is needed to provide essential services and prevent further delays and a potential lapse in services that may cause life-threatening circumstances to arise. Failure to award a contract would jeopardize patent safety, as the contract provides a means of transportation for

Veterans through Basic Life Support (BLS), Advanced Life Support (ALS), and Critical Care

Transport (CCT) ambulatory services. A short-term solution is needed to compete the long-term procurement in accordance with national policy and standards. American Medical Response West has been performing satisfactorily.

4. Description of market research conducted and results or statement why it was not conducted:

Conducted an acquisition history review and found there are no other vendors that have provided similar services in the catchment area other than the two incumbent vendors. SAM entity records were reviewed, and although multiple vendors were found under the related NAICS 621910, most vendors were vendors that provide supplemental supplies and services for ambulances, such as gurneys, oxygen, and other life-support-related supplies and services. The Dynamic Small Business

Search resulted in similar findings as SAM, where multiple small vendors provide supplemental ambulance supplies or services. FPDS review resulted in many vendors identified within California, but a majority of the vendors are located outside the catchment area – in areas such as Los Angeles and San Diego. The Veteran Small Business Certification (VetCert) was searched and lastly, a search for ambulance in GSA eLibrary found 621-032 for EMT Paramedic (Includes Certified Emergency

Medical Technician and Certified Paramedic) Scheduler (Drug & Alcohol Testing) Blood & Alcohol

Technician Ambulance Driver and MAS for Children’s Air Ambulance which do not meet the

Government’s requirement.

https://ambulance.org/2021/10/04/workforceshortage/

5. Contracting Officer's Certification: Purchase is approved in accordance with FAR13.106-1(b). I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief.

Emily Trinh

Contracting Officer

Network Contracting Office (NCO) 21 https://acquisition.gov/far/current/html/Subpart%2013_1.html#wp1125466