Redacted_Urgency_JA_FINAL_28Apr16.pdf

Control Number: 16-RHCO-P-215

For Official Use Only (See FAR 2.101 and 3.104-4)

(1 October 2015)

Justification Review Document for Other than Full and Open Competition

Program/Equipment: The Tripler Army Medical Center (TAMC), Honolulu, HI requires an urgent bridge contract to Matrix Providers for per diem nursing services notwithstanding a protest.

Authority: 10 United States Code 2304(c)(2) as implemented in Federal Acquisition Regulation 6.302-2(a)(2), Unusual and Compelling Urgency.

Amount: (90 days base + 6 month Option to Extend Services, FAR 52.217- 8)

Prepared by:

Contracting Officer:

Requirements Representative:

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Reviews: I have reviewed this justification and find it adequate to support other than full and open competition.

Legal Counsel

Advocate for Competition

DSN: ______N/A_____________

Signature: _________________________________ Date: ______________________

Principal Assistant Responsible for Contracting (Only applies if total dollar value over $13.5M)

Typed Name: ____N/A________________________DSN: ______________________

Signature: _________________________________ Date: ______________________

Head of the Contracting Activity (Only applies if total dollar value over $93M)

Typed Name: ___N/A_________________________DSN: ______________________

Signature: _________________________________ Date: ______________________

N/A

Per Diem Nursing Services, TAMC

(See FAR 2.101 and 3.104-4)

(25 February 2016)

Justification and Approval for Other than Full and Open Competition

1. Contracting Activity: Regional Health Contracting Office – Pacific (RHCO-P), U.S.

Army Command, Tripler Army Medical Center, Hawaii.

2. Description of Action: The Tripler Army Medical Center (TAMC), Honolulu, HI requires an urgent bridge contract to Matrix Providers for the per diem nursing services notwithstanding a protest. Funding will be provided through Direct Healthcare Provider dollars. The contract will include FAR 52.217-8, Option to Extend Services.

3. Description of Supplies/Services: A short term personal services FFP contract for per diem nursing services to include Registered Nurses (Standard and Specialty), Licensed Practical Nurses (Standard and Specialty), Emergency Medical Technicians/Operating Room Technicians, Nurse Assistants, Certified Registered Nurse Anesthetists, and Advanced Practice Registered Nurses in support of TAMC for a period of 90 days from on or about April 6, 2016 through July 5, 2016 in the total estimated amount of (90 day base + 6 month Option to Extend Services)

The estimated price of this purchase order is as follows:

Base period 90 days FAR 52.217-8 (if exercised)

4. Authority Cited: 10 United States Code 2304(c)(2) as implemented in Federal Acquisition Regulation 6.302-2(a)(2), Unusual and Compelling Urgency.

5. Reason for Authority Cited: The requirement is for a contract for per diem nursing services to ensure continuation of services notwithstanding a protest. Contract W81K02-16-D-0001 was awarded to Matrix Providers on March 18, 2016 with an effective date of April 1, 2016. On Friday, April 1, 2016, a protest was filed with GAO and the Contracting Officer was notified by GAO on Monday, April 04, 2016. The Contracting Officer was directed to issue a Stop Work Order against the awarded contract. These critical services to provide patient care to servicemen and their families must continue to meet the Health Readiness Platform (HRP) mission. Outpatient settings, including primary care medical homes and specialty clinics, rely on contract nursing personnel to support providers in meeting target Relative Value Unit (RVU) and maintaining appointment availability for access to care. TAMC Emergency Department (ED) and Schofield Barracks Acute Care Clinic (USAHC-SB ACC) also rely on contract staff to provide patient care in a timely manner and to reduce long waits and prolonged visits in the urgent/emergent care setting. Average volume continues to remain high, averaging greater than 150 daily patient encounters at TAMC ED and 60 – 70 daily patient encounters at USAHC-SB ACC. Average nursing care hours (NCH) have been trending up throughout the organization. Over the last six months NCH have remained at about 46,000 hours every month.

The nurses under this contract have a critical role in providing health care services to the beneficiary population for these military treatment facilities. They provide services in the critical care, emergency room, operating room, psychiatry, labor and delivery, pediatrics, medical/surgical inpatient wards and outpatient care clinics. If services cannot continue, it will present a significant negative impact in the treatment facilities’ staffing and ability to provide safe patient care. Staffing shortages will result in a reduction of operational beds. It will cause cancellation of surgical cases as well as the need to send patients to civilian health care facilities outside of the TRICARE network. It will also negatively impact access to care in the outpatient settings and increased wait times in the Emergency Room and Acute Care Clinic. Although there are military and civilian nurses, they can only cover for a certain extent and due to the nature of the work, patient safety must be maintained. Each shift requires enough nurses and there is only so much overtime each person can work.

Matrix Provider has transitioned all of the filled positions from the incumbent, with the exception of two nurses. A total of 60 nurses were transitioned; therefore, since employee transfer has completed and performance has begun, it is in the best interest of the Government to award this urgent bridge contract to Matrix Provider, the awardee under the protested contract W81K02-16-D-0001.

(a) As stated above, under the circumstances it is not practicable to request offers from potential sources and it is in the best interest of the Government to award to Matrix Providers. The nurses have already transitioned to Matrix and it will be very disruptive to the hospital to transition them to another contractor and will definitely affect the moral.

If the nurses do not feel secure due to turmoil, they may decide to leave and this will jeopardize the safety of the patients. Also, it is not cost effective as administrative costs to implement such a transition would be passed on to the Government.

(b) Although the statement of work is suitable for full and open competition, due to the urgency it is not in the Government’s best interest to compete the requirement. The statement of work was used in the competitive award of the current contract that is being protested, contract W81K02-16-D-0001.

6. Efforts to Obtain Competition: The contract period of performance will be for 90 days. FAR 52.217-8, Option to Extend Services, will allow for up to an additional six months if needed. Due to the urgency of this requirement, it will be very disruptive and will jeopardize patient safety if the Government were to obtain competition. As stated above in paragraph 5.a., it would be in the best interest of the Government to award to Matrix Providers.

a. Effective competition. These critical services to provide patient care to servicemen and their families must continue to meet the Health Readiness Platform (HRP) mission.

The nurses under this contract have a critical role in providing health care services to the beneficiary population for these military treatment facilities. As stated in paragraph 5 above, if services cannot continue, it would present a significant negative impact in the treatment facilities’ staffing and ability to provide safe patient care.

b. Subcontracting competition. In accordance with FAR 19.702(b)(1) and (b)(2), a subcontracting plan is not required from small business concerns or for a personal services contract. The nursing services required are personal services and are therefore exempt.

7. Actions to Increase Competition: The protested contract, W81K02-16-D-0001, was solicited on a full and open competitive basis. Due to the urgency of this current acquisition, there are no actions to increase competition and it is in the best interest of the Government to award to Matrix Providers.

8. Market Research: Market Research was performed on the initial requirement under contract W81K02-16-D-0001. This is a short term urgent bridge contract to the current contractor, Matrix Providers, to continue performance notwithstanding a protest.

9. Interested Sources: Exception at FAR 5.202(a)(2), unusual and compelling urgency applies. This urgency J&A will be posted to FBO within 30 days after award in accordance with FAR 6.305(b).

10. Other Facts: This bridge contract will be a short-term contract for 90 days to avoid a lapse in healthcare services, notwithstanding a protest, and will include FAR 52.217-8, Option to Extend Services.

a. Procurement history. The protested contract, W81K02-16-D-0001, was solicited under full and open competitive procedures. The contact was awarded to Matrix Providers on March 18, 2016 with an effective date of April 1, 2016. On Friday, April 1, 2016, a timely protest was filed with GAO and the Contracting Officer was notified on Monday, April 04, 2016. As of April 1, 2016, majority of employees from the incumbent contractor were transferred to Matrix Providers.

(1) Contract numbers and dates of the last several contracts for these same requirements.

W81K02-10-D-0004: 1 Aug 2010 – 31 Mar 2015 (base + four 1-year options + 6 months Extension of Services)

W81K02-15-P-0026; 1 Apr 2015 – 31 Mar 2016 (6 month base + 6 months Extension of Services). This was a bridge contract for contract W81K02-10-D-0004.

W81K02-16-D-0001; 1 Apr 2016 – 30 Sep 2020 (6 month base + four 1-year options)

(2) The competitive status of these actions. Contracts W81K02-10-D-0004 and W81K02-16-D-0001 were awarded based on full and open competition. Contract W81K02-15-P-0026 was awarded as a sole source bridge contract.

(3) The authority cited for the previous bridge contract W81K02-15-P-0026 was 41 U.S.C. 1901, sole source acquisition under the authority of the test program for certain commercial items as implemented by FAR 13.501(a)(1)(ii).

(4) The procurement made before this one, contract W81K02-16-D-0001, was awarded under full and open competition.

(5) This action is now being solicited under the authority 10 U.S.C. 2304(c)(2) as implemented in Federal Acquisition Regulation 6.302-2(a)(2), Unusual and Compelling Urgency, due to a GAO protest under contract W81K02-16-D-0001 and critical services to provide patient care to servicemen and their families must continue to meet Health Readiness Platform mission.

(6) This is the first urgent buy due to the GAO protest. No unusual patterns revealed by the history.

(7) No justification was prepared to support the procurement made before this one and it was awarded based on full and open competition.

b. Other facts. None, all facts were previously stated above.

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11. Technical Certification:

I certify 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.

12. Requirements Certification:

I certify 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.

13. Fair and Reasonable Cost Determination:

I hereby determine that the anticipated cost to the Government for this contract action will be fair and reasonable based on price analysis, comparison to the independent Government estimate, and knowledge of current market prices for the same or similar services. Prices will also be compared to the recently awarded contract, W81K02-16-D- 0001, as price was determined to be fair and reasonable based on competition.

Certified cost and pricing data is not required IAW FAR Part 15.403-1(c)(iii)(3), Commercial Items.

Signature: ________ __ ________Date: __________

14. Contracting Officer Certification:

I certify that this justification is accurate and complete to the best of my knowledge and belief.

Signature: ______

Approval

Based on the foregoing justification, I hereby approve the procurement of per diem nursing services for a total dollar value of (90 day base + 6 month Option to Extend Services) on an other than full and open competition basis pursuant to the authority of 10 United States Code 2304(c)(2) as implemented in Federal Acquisition Regulation 6.302-2(a)(2), Unusual and Compelling Urgency., subject to availability of funds, and provided that the services and property herein described have otherwise been authorized for acquisition.