Sole Source Justification - Interim Home Oxygen Contract - 36C241-21-AP-0029 - Signed_Redacted.pdf

OFOC SOP Revision 10 Page 1 of 5 Original Date: 03/22/11 Revision 10 Date: 09/10/2020

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID: 36C241-21-AP-0029

Contracting Activity: Department of Veterans Affairs, VISN 1, All Medical Centers The U.S. Department of Veterans Affairs, Contracting Office NCO 1 proposes the following justification for an interim contract for the rental of home oxygen medical equipment and the provision of respiratory services on a basis of other than full and open competition for the VISN 1 Prosthetics Service Line.

There were some unanticipated impacts to the milestone for the long-term solution which included the unforeseen consolidation of the VISN 1 Durable Medical Equipment (DME) services requirement with Home Oxygen. In order to ensure continued coverage for current and anticipated patients, an interim contract is required.

Nature and/or Description of the Action Being Processed: The nature of the requirement is the ability to award an interim contract for the rental of home oxygen medical equipment and the provision of respiratory services based upon the current VISN 1 Home Oxygen Contract (VA241-14-

0103) that sets a specific rental price for the oxygen delivery systems, the provision of respiratory services and ancillary supplies in the VA New England Healthcare System. This proposed interim contract is for a period of six months with 1 option to extend for six additional months, while the long-term solution (5 Year Indefinite Delivery Indefinite Quantity (IDIQ) contract) is solicited, evaluated and awarded. This will also allow for the transitional period if necessary. A new contract will require 30 to 60 days at a minimum to transition all patients into their database, deliver & setup oxygen medical equipment and accomplish required inventories. The transition period will require the incumbent contractor to work with the contractor awarded the long-term solution should they be different. Since this requirement is direct patient care, ongoing services are required. This proposed interim contract will allow for continued services and avoid an unnecessary unauthorized commitment that would require ratification. Interruption of services is not an option as it would place Veteran patients at risk for injury or worse.

Description of Supplies/Services Required to Meet the Agency’s Needs:

The Department of Veterans Affairs (VA) has an ongoing program for the rental of oxygen medical equipment, the provision of respiratory services and ancillary supplies for 4,068 oxygen patients and 24,928 CPAP/BiPAP/ASV/APAP patients. The contract vendor will furnish home oxygen and respiratory equipment, ancillary supplies, ventilator set-up and follow-up services, conduct in-home pulmonary assessments and re-assessments by respiratory therapists, set-up/provision of travel oxygen equipment, set-up/complete overnight oximetries and provide documentation of patient education.

OFOC SOP Revision 10 Page 2 of 5

Revision 10 Date: 09/10/2020

Need of contract for:

1) Rental of Oxygen Equipment.

2) Initial starts of oxygen by trained staff/patient service technicians and/or respiratory therapists.

3) Recurring oxygen patient visits/pulmonary assessments by respiratory therapists.

4) Recurring oxygen patient visits by patient service technicians for maintenance of the equipment.

5) Initial starts of ventilators and cough assists by respiratory therapists.

6) Recurring ventilator and cough assist patient visits/pulmonary assessments by respiratory therapists.

7) Provision of patient education.

8) Set-up and provision of travel oxygen equipment.

9) Set-up and pickup of overnight oximetry equipment

10) Initial starts of CPAP/BiPAP/ASV/APAP by trained respiratory therapists

11) Recurring CPAP/BiPAP/ASV/APAP patient visits/assessments by respiratory therapists

12) Maintenance/Secure Storage of VA-purchased CPAP/BiPAP/ASV/APAP equipment.

13) Ancillary Supplies (Humidifiers, masks, tubing, etc.) as prescribed.

As stated above, this requirement is direct patient care and ongoing services are required. This proposed interim contract will allow for continued services and avoid unnecessary unauthorized commitments that would then require ratification. Interruption of services is not an option.

The incumbent contractor (Community Surgical Supply of Toms River, Inc.) has been providing the services required under the pending interim contract for the past five years and there is no transitional period required.

The current contract expires on November 28, 2020. This acquisition is expected to result in a firm fixed Price Indefinite Delivery/Indefinite Quantity interim contract from November 29, 2020 through May 28, 2021 with 1 – six-month option to extend. The realistic estimated dollar value is $820,246.00 per month, for a total estimate of $9,842,952.00 for the entire life of the interim contract.

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

( 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;

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

This contract is being procured on a sole source basis because the long-term solution (Five Year Indefinite Delivery/Indefinite Quantity (IDIQ) contract) has yet to be awarded. The services required are direct patient care services and services cannot be interrupted. VISN 1 patients requiring home

OFOC SOP Revision 10 Page 3 of 5

Revision 10 Date: 09/10/2020 respiratory care services based on an initial VA Physician’s consult (home oxygen systems – concentrator, liquid stationary, liquid portables, ventilator, compressor, large cylinders, small portable cylinders; ventilator equipment; cough assists; suction machines; and CPAP/BiPAP/ASV/APAP equipment) all require urgent delivery or pick-up from the patient’s home.

The cost to the government/VISN 1 Prosthetics and Sensory Aids would be exorbitant without a contract – the contract Statement of Work (SOW) requires the vendor to provide/repair/store/set-up patient -ready oxygen equipment in emergent and non-emergent situations, as well as document that the patient/family understands the proper operation of the item(s) according to set time requirements. If there was no contract, the government would be required to solicit for vendors who can provide the required services, forcing the government to pay extra for this immediate service and delaying patient care. The government would also not have a place to store the CPAP/BiPAP/ASV/APAP equipment for patients in the community, some of which require significant space. The government would be forced to pay another vendor to store the equipment in the community while the vendor with the knowledge of the equipment would pick it up and install. The contract SOW states the vendor is not paid for the storage of the CPAP/BiPAP/ASV/APAP (and some VA-owned ventilators) equipment and has a set charge for the set-up and assessment of the respiratory patients.

Patient care will be adversely impacted without a contract – inpatient discharges will be delayed without a vendor able to deliver and set-up the required home respiratory equipment for the patient to safely reside in the home without inpatient services.

The CPAP/BiPAP/ASV/APAP (and some VA-owned ventilators and cough assists) equipment is purchased by the Government. The items require delivery, installation, storage and routine service/refurbishment to veteran patients served by its eight medical centers and its associated outpatient clinics. The total number of patients at each VA site is subject to change but VISN-wide is over 4,000 oxygen patients and 24,000 CPAP/BiPAP/ASV/APAP patients. Prior to the award, the contractor must meet/exceed the standards of the Joint Commission of Health Care Organizations (Joint Commission) and the Center for Medicare and Medicaid Services (CMS). Written documentation must be provided to support this statement.

Community Surgical Supply of Toms River, Inc. (CCS) received its Joint Commission reaccreditation on 6/15/2019 and the reaccreditation is valid for three years.

Accordingly, Community Surgical Supply of Toms River, Inc. is the only firm capable of providing the supplies and services described in item 3 above without the Department of Veterans Affairs experiencing substantial duplication of cost that could not be expected to be recovered through competition and unacceptable delays in fulfilling its requirements.

The period to be covered by this contract will be November 29, 2020 through May 28, 2021 with one – six-month option to extend. The Department of Veterans Affairs reserves the right to exercise option, subject to availability of funds.

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

Competition is not available. It is only practicable to solicit from one Contractor (the incumbent) for the purposes of the interim contract. This is due to the 30 to 60 day transition period that would be necessary if this was competed and the time it takes to get a contract in place.

OFOC SOP Revision 10 Page 4 of 5

Revision 10 Date: 09/10/2020

Determination by the CO that the Anticipated Cost to the Government will be Fair and Reasonable:

The Contracting Officer determines the pricing will be fair and reasonable based upon a comparison of the prices to the Independent Government Estimate and historical pricing for the same or similar service. The incumbent contractor has not increased the cost of services provided and has continuously offered and applied the % discount per month for timely payments which has saved the Government a significant amount of money.

Description of the Market Research Conducted and the Results, or a Statement of the Reasons Market Research Was Not Conducted:

Related market research was conducted using VIP, SAM, SBA, GSA and other searches based on NAICS code 532283. Community Surgical Supply is an actively registered vendor in SAM through 06/05/2021. The required services are not available under mandatory or other awarded contracts.

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

The incumbent currently has the warehouse space throughout the VISN to store the Government supplied CPAPs, ventilators, cough assists, and supplies in addition to their own equipment and supplies required to perform the contract. As recently experienced, warehouse space is difficult to obtain. A sources sought was issued for warehouse space for VA White River Junction and VA Manchester with no responses received. The incumbent has sufficient inventory of concentrators and cylinders and has the ability to fill them timely. Due to the current pandemic this equipment has been increasingly difficult to obtain.

Additionally, all employees have access to Patient Information and must complete mandatory training Privacy and Information Security Training via the Government’s training site, TMS, prior to performing work. All Community Surgical Supply employees have completed this training.

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

Community Surgical Supply of Toms River, Inc., the incumbent, did reply positively regarding their interest in the contract.

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:

The proposed interim contract will cover the minimal time necessary. The government is anticipating a 6 month contract (With the potential for one (1) six month option) with the incumbent so that the 5 year IDIQ contract can be competed in accordance with the Federal Acquisition Regulations. The 6 month option will only be exercised in the event of a protest or additional time necessary to transition to a new contractor as necessary.

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.

OFOC SOP Revision 10 Page 5 of 5

Revision 10 Date: 09/10/2020

Name: Alexander Dowgiallo, MA Date Title: VISN 1 Prosthetics Health Systems Specialist/COR Facility: VISN 1 – VA New England Healthcare System

13. Approvals in accordance with the VHAPM Part 806.3 OFOC SOP:

a. Contracting Officer or Designee’s Certification (required): I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief.

Name: David Heslin Date Title: Contract Specialist Facility: Network Contracting Office 1 (New England) (90C)

b. One Level Above the Contracting Officer (Required over SAT but not exceeding $700K): I certify the justification meets requirements for other than full and open competition.

Name: Denise West Date Division 2, Division Chief

Facility: Network Contracting Office 1 (New England) (90C)

c. VHA RPO HCA Review and Approval: I have reviewed the foregoing justification and find it to be complete and accurate to the best of my knowledge and belief and recommend approval (if over $68 million) or approve ($700K to $68 million) for other than full and open competition.

Name: Joseph Maletta Date Title: Executive Director

VHA Head of Contracting Activity (HCA)

October 26, 2020 Alexander L.

Dowgiallo 220604

Digitally signed by Alexander L.

Dowgiallo 220604 Date: 2020.10.26 15:20:21 -04'00'

David P.

Heslin 512091

Digitally signed by David P. Heslin 512091 Date: 2020.10.26 15:29:17 -04'00'

Denise M.

West 3503841

Digitally signed by Denise M. West 3503841 Date: 2020.10.27 09:41:06 -04'00'

JOSEPH MALETTA

1347841

Digitally signed by JOSEPH

MALETTA 1347841

Date: 2020.11.05 13:21:04 -05'00'