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VHAPM Part 806.3 Other Than Full and Open Competition (OFOC) SOP Attachment 2: Request for Sole Source Justification Format >$150K

OFOC SOP Revision 06 Page 1 of 4 Original Date: 03/22/11 Revision 06 Date: 08/30/2017

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>$250K (SAT))

Acquisition Plan Action ID: 36C263-19-AP-0687

PR-IFCAP (2237): 636-19-3-4082-0372

1. Contracting Activity: Department of Veterans Affairs, Network 23 Contracting Office (NCO 23), 316 Robert Street N, St Paul, MN 55101

2. Nature and/or Description of the Action Being Processed:

Neurosurgery Locum – Emergency (FAR 6.302-1) for the Iowa City VAHCS. This will be a firm, fixed price contract, from 05.08.2019 to 09.30.2019. This is a follow on requirement to an existing contract that is ending 04.30.2019.

3. Description of Supplies/Services Required to Meet the Agency’s Needs: The Department of Veteran Affairs, Iowa City Heath Care System ( ICHCS ), is seeking contractual services to fill neurosurgery services to eligible veterans. These services would be provided on site, consisting of about 9-10 days per month relief scheduled services and ALSO includes 24/7 pager call coverage on those days. The period of performance will be from 05.08.2019 to 09.30.2019.

The estimated value of the proposed action is $434,400.00

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

( ) (1) Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements per FAR 6.302-1;

( x ) (2) Unusual and Compelling Urgency per FAR 6.302-2;

( ) (3) Industrial Mobilization, Engineering, Developmental or Research Capability or Expert Services per FAR 6.302-3;

( ) (4) International Agreement per FAR 6.302-4 ( ) (5) Authorized or Required by Statute FAR 6.302-5;

( ) (6) National Security per FAR 6.302-6;

( ) (7) Public Interest per 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):

The Iowa City VA only had one (1) neurosurgeon on staff. This neurosurgeon was supplemented by locum coverage for on-call and off-hours. She was working full time in conjunction with three locum neurosurgeons for overflow and on-call services, whose contract was due to expire on 04.30.2019.

OFOC SOP Revision 06 Page 2 of 4

The VA neurosurgeon put in a short departure notice late in March 2019 for another job opportunity, creating an urgent and compelling need for another neurosurgeon at the Iowa City VA.

Since there are NO other neurosurgeons at the Iowa City, and because the originally scheduled “relief” coverage for on-call and off-hours is now necessary and urgent, as the the neurosurgeon on staff then decided to remain at the VA, changing the requirements for this procurement, YET AGAIN.

This situation directly impacts patient care, as surgeries are scheduled well in advance and the schedule for May and June is already set. Depending on the urgency of the surgery needed, these may or may not be able to be rescheduled, without considerable risk to the patient. The nearest VA with neurosurgery services is Omaha and Minneapolis, both of which are at a considerable distance and will need to work around their own established patients, thus creating delays and cost increases, as transportation would have to be arranged.

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

Market research was originally started for a part time relief neurosurgeon, in which the VIP database was queried, as well as GSA and small business. As this type of work is best serviced on a locum basis, a temporary help NAICS code was used. In looking through the GSA FSS schedule holders, it was discovered that several of these companies were SDVOSB, and this requirement would probably be able to be set aside. Just before solicitation, a call was received by the contract specialist from the requesting office stating that the requirement has now changed to a FULL TIME NEUROSURGEON TO START NO LATER THAN 05.25.2019. Notably, now the requirement as indicated in Paragraph 5 above, has REVERTED BACK TO A PART – TIME, RELIEF COVERAGE, since the neurosurgeon decided to remain at the VA. This was due to their one and only staff neurosurgeon, deciding to take another position outside of the VA. Now, market research showed that there are SDVOSB companies out there, and they probably can perform this work. However, getting candidates is only part of the issue. The candidates THEN have to be background checked and credentialed through the VA and this process can take 4-6 weeks, depending on workload.

According to the program office, the surgery schedule was already set for the month of May, and rescheduling would be next to impossible, and a gap in services was not at all desirable. Therefore, an award to a company with a known pool of credentialed candidates is desirable. The only place to find that is to go to the incumbent. The incumbent was queried on staffing and scheduling and responded that they would be able to manage the additional workload ( i.e. full time vs part time ) and can have additional providers credentialed in time.

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

This contractor is a GSA schedule holder and the determination has already been made that the price is fair and reasonable. This task order, considering the urgent need of neurosurgeons and the impact of NOT having any on staff will make to patient care and follow up, is fair and reasonable.

Commercial Rates for Neurosurgeons typically range from $325/hr to $355/hr. Travel and per diem rates run about $10-$20 per hour. Night calls are usually another hour of the regular billed rate. For weekend and holiday calls, the rate can vary from 3.5 -8 hours of the regular hourly rate. These call rates usually deviate from the FSS schedule as it is a scare medical resource.

OFOC SOP Revision 06 Page 3 of 4

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

Market Research Was Not Conducted:

Market research conducted consisted of VIP searches, SBA searches and GSA e-library searches. All of which showed that the SDVOSB pool has grown and the program office would do best to start their next package for a neurosurgeon now, as this requirement could probably be set aside for SDVOSB on the GSA/FSS schedule. The only reason a sole source is being done now is due to time and patient safety issues.

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

This contractor already has several surgeons that are credentialed and are ready to go. He has provided a schedule that is nearly complete through September 2019. This is a significant advantange over awarding a contract and then having to wait for the credentialing of providers.

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

Eskridge and Associates Goldfish Locums

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:

A follow on competitive acquision is definitely planned and preliminary planning is taking place. The program office would like to look into a potential affiliate program with the University of Iowa – however the timeline for that might take up to 18 months. In the meantime, a set aside for SDVOSB companies on the FSS schedule, would be a good option. That task order would probably do well to have options, as an affiliate contract will take some time to put in place. The program office has been supplied with a game plan from contracting and they are working on it. The anticipate submitting a new package to contracting about 10.01.2019.

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.

Dena Dietzler Date Facility

Approvals in accordance with the VHAPM Part 806.3 OFOC SOP:

http://vaww.pclo.infoshare.va.gov/PMWeb/VHAPM_Part_806.3.aspx

OFOC SOP Revision 06 Page 4 of 4

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.

Sandra McAnany Date Contracting Officer

NCO 23

b. One Level Above the Contracting Officer (Required over$150K but not exceeding $700K): I certify the justification meets requirements for other than full and open competition.

Arlene Jorgensen Hillestad Date Branch Chief Medical Sharing Team 2

5/3/2019

VHAMINJorgeA

Typewritten Text

2019-05-03T11:06:05-0500

SANDRA M. MCANANY 201272

2019-05-03T13:39:29-0500

Arlene A. Jorgensen Hillestad 435040

OFOC SOP Revision 06 Page 1 of 4

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>$250K (SAT))

Acquisition Plan Action ID: 36C263-19-AP-0687

PR-IFCAP (2237): 636-19-3-4082-0372

1. Contracting Activity: Department of Veterans Affairs, Network 23 Contracting Office (NCO 23), 316 Robert Street N, St Paul, MN 55101

2. Nature and/or Description of the Action Being Processed:

Neurosurgery Locum – Emergency (FAR 6.302-1) for the Iowa City VAHCS. This will be a firm, fixed price contract, from 05.08.2019 to 09.30.2019. This is a follow on requirement to an existing contract that is ending 04.30.2019.

3. Description of Supplies/Services Required to Meet the Agency’s Needs: The Department of Veteran Affairs, Iowa City Heath Care System ( ICHCS ), is seeking contractual services to fill neurosurgery services to eligible veterans. These services would be provided on site, consisting of about 9-10 days per month relief scheduled services and ALSO includes 24/7 pager call coverage on those days. The period of performance will be from 05.08.2019 to 09.30.2019.

The estimated value of the proposed action is $434,400.00

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

( ) (1) Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements per FAR 6.302-1;

( x ) (2) Unusual and Compelling Urgency per FAR 6.302-2;

( ) (3) Industrial Mobilization, Engineering, Developmental or Research Capability or Expert Services per FAR 6.302-3;

( ) (4) International Agreement per FAR 6.302-4 ( ) (5) Authorized or Required by Statute FAR 6.302-5;

( ) (6) National Security per FAR 6.302-6;

( ) (7) Public Interest per 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):

The Iowa City VA only had one (1) neurosurgeon on staff. This neurosurgeon was supplemented by locum coverage for on-call and off-hours. She was working full time in conjunction with three locum neurosurgeons for overflow and on-call services, whose contract was due to expire on 04.30.2019.

OFOC SOP Revision 06 Page 2 of 4

The VA neurosurgeon put in a short departure notice late in March 2019 for another job opportunity, creating an urgent and compelling need for another neurosurgeon at the Iowa City VA.

Since there are NO other neurosurgeons at the Iowa City, and because the originally scheduled “relief” coverage for on-call and off-hours is now necessary and urgent, as the the neurosurgeon on staff then decided to remain at the VA, changing the requirements for this procurement, YET AGAIN.

This situation directly impacts patient care, as surgeries are scheduled well in advance and the schedule for May and June is already set. Depending on the urgency of the surgery needed, these may or may not be able to be rescheduled, without considerable risk to the patient. The nearest VA with neurosurgery services is Omaha and Minneapolis, both of which are at a considerable distance and will need to work around their own established patients, thus creating delays and cost increases, as transportation would have to be arranged.

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

Market research was originally started for a part time relief neurosurgeon, in which the VIP database was queried, as well as GSA and small business. As this type of work is best serviced on a locum basis, a temporary help NAICS code was used. In looking through the GSA FSS schedule holders, it was discovered that several of these companies were SDVOSB, and this requirement would probably be able to be set aside. Just before solicitation, a call was received by the contract specialist from the requesting office stating that the requirement has now changed to a FULL TIME NEUROSURGEON TO START NO LATER THAN 05.25.2019. Notably, now the requirement as indicated in Paragraph 5 above, has REVERTED BACK TO A PART – TIME, RELIEF COVERAGE, since the neurosurgeon decided to remain at the VA. This was due to their one and only staff neurosurgeon, deciding to take another position outside of the VA. Now, market research showed that there are SDVOSB companies out there, and they probably can perform this work. However, getting candidates is only part of the issue. The candidates THEN have to be background checked and credentialed through the VA and this process can take 4-6 weeks, depending on workload.

According to the program office, the surgery schedule was already set for the month of May, and rescheduling would be next to impossible, and a gap in services was not at all desirable. Therefore, an award to a company with a known pool of credentialed candidates is desirable. The only place to find that is to go to the incumbent. The incumbent was queried on staffing and scheduling and responded that they would be able to manage the additional workload ( i.e. full time vs part time ) and can have additional providers credentialed in time.

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

This contractor is a GSA schedule holder and the determination has already been made that the price is fair and reasonable. This task order, considering the urgent need of neurosurgeons and the impact of NOT having any on staff will make to patient care and follow up, is fair and reasonable.

Commercial Rates for Neurosurgeons typically range from $325/hr to $355/hr. Travel and per diem rates run about $10-$20 per hour. Night calls are usually another hour of the regular billed rate. For weekend and holiday calls, the rate can vary from 3.5 -8 hours of the regular hourly rate. These call rates usually deviate from the FSS schedule as it is a scare medical resource.

OFOC SOP Revision 06 Page 3 of 4

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

Market Research Was Not Conducted:

Market research conducted consisted of VIP searches, SBA searches and GSA e-library searches. All of which showed that the SDVOSB pool has grown and the program office would do best to start their next package for a neurosurgeon now, as this requirement could probably be set aside for SDVOSB on the GSA/FSS schedule. The only reason a sole source is being done now is due to time and patient safety issues.

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

This contractor already has several surgeons that are credentialed and are ready to go. He has provided a schedule that is nearly complete through September 2019. This is a significant advantange over awarding a contract and then having to wait for the credentialing of providers.

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

Eskridge and Associates Goldfish Locums

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:

A follow on competitive acquision is definitely planned and preliminary planning is taking place. The program office would like to look into a potential affiliate program with the University of Iowa – however the timeline for that might take up to 18 months. In the meantime, a set aside for SDVOSB companies on the FSS schedule, would be a good option. That task order would probably do well to have options, as an affiliate contract will take some time to put in place. The program office has been supplied with a game plan from contracting and they are working on it. The anticipate submitting a new package to contracting about 10.01.2019.

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.

Dena Dietzler Date Facility

Approvals in accordance with the VHAPM Part 806.3 OFOC SOP:

http://vaww.pclo.infoshare.va.gov/PMWeb/VHAPM_Part_806.3.aspx

OFOC SOP Revision 06 Page 4 of 4

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.

Sandra McAnany Date Contracting Officer

b. One Level Above the Contracting Officer (Required over$150K but not exceeding $700K): I certify the justification meets requirements for other than full and open competition.

Arlene Jorgensen Hillestad Date Branch Chief Medical Sharing Team 2

2019-05-03T11:06:05-0500

SANDRA M. MCANANY 201272

2019-05-06T09:33:53-0500

SHARON L. PALLISCHECK 238065