Sole_Source_Justification_MRTC_14_Jan_2016_Redacted.pdf

Control No: 16-

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

Sole Source Justification and Approval Under FAR 13.501

l. Contracting Activity: U.S. Army Health Contracting Activity (Provisional) (USAHCA (P)), Health Readiness Contracting Office (Provisional) (HRCO (P)), 2199 Storage Street, Building 4197, Suite 68, Joint Base San Antonio (JBSA) - Fort Sam Houston, Texas 78234-5074.

2. Description of Action: The HRCO (P) requests approval to negotiate a new sole source for training facility usage services with Mayo Clinic. This is a non-personal service requirement. award a

Firm-Fixed-Price (FFP) t . The type of funds to be used is Fiscal Year (FY) 16 Defense Health Program (DHP) funds. Estimated share and ceiling arrangements and fee or profit are not applicable to this acquisition.

3. Description of Supplies/Services: The contractor shall provide medical simulated training support to the United States Army Reserve (USAR) medical units through the Medical Readiness Training Center (MRTC). Training support includes access to Mayo Clinic Multidisciplinary Simulation Center and any associated classrooms, meeting rooms storage areas located at Mayo Clinic four to six times per year on the scheduled training dates, which will fall on four consecutive days that will begin on a Friday and end that following Monday.

The estimated value of the proposed action is $345,147.36 for a 12-month base period of performance from 01 February 2016 through 31 January 2017 and two 12-month option periods.

The Federal Acquisition Regulation (FAR) Clause 52.217-8, Option to Extend Services, will be included in the resultant contract to allow for up to 6-months of additional services, thereby increasing the overall value to $402,671.92.

4. Authority Cited: The statutory authority permitting other than full and open competition is 41 United States Code 1901 as implemented in FAR 13.50l(a)(l)(ii), sole source (including brand name) under the authority of the test program for certain commercial items.

5. Reason for Authority Cited: The minimum needs of the Government are that the required facility has the ability to simulate the flow of patients normally encountered in a deployed contingency operations environment which are flowing through the echelons of medical care from points of injury to initial damage control surgical capabilities (Forward Surgical Team) or to more definitive care facilities and capabilities of the Combat Support Hospital; that care will involve initial triage and management of multisystem trauma patients with injuries observed in a combat situation (massive blast injuries to include multiple limb amputations) as well as patients of varying degree of acuity to fully task and train the entire health care team, and that the training simulates a combat situation to stress the teams and to provide them an atmosphere to focus on improving team work and communication using the Team STEPPs framework. Team STEPPS is an evidence-based set of teamwork tools, aimed at optimizing patient outcomes by improving communication and teamwork skills among health care professionals. It was created jointly by the Department of Defense and the Agency for Healthcare Research and Quality; it is now a mandatory training requirement for all deploying Army medical units.

(See FAR 2.101 and 3.104-4)

a. The Mayo Clinic, College Of Medicine Rochester, MN has a Multidisciplinary Simulation Center capable of meeting all the minimum needs of the Government and is located 103 miles from Fort McCoy, WI. Fort McCoy is the location of Regional Training Site-McCoy (RTS-MED McCoy), a Medical Readiness Training Center (MRTC) facility staffed and equipped to provide and support collective and individual training to medical units and personnel. RTS-MED McCoy regularly hosts medical field training exercises which involve entire medical units (i.e. Combat Support Hospitals, Field Surgical Teams (FSTs), etc.) MRTC has two other regional training sites, one located at Fort Hunter Liggett, CA and one located at Fort Gordon, GA. The close proximity of the Mayo Clinic to RTS-MED McCoy allows the Mayo Clinic location to be utilized to exercise split operations and other similar real world field activities while an FST or other small element extracts from ongoing field exercise activities at Fort McCoy and proceed via convoy to the Mayo Clinic to engage in a two day simulator exercise to practice combat trauma medical care on a variety of simulated combat victims. A number of the same Observer Controller Trainers who are supporting the field exercises at Fort McCoy could also be tasked to support the off-site training exercise at the Mayo Clinic. Given that this is only a 4 day training event, utilizing a facility within close proximity to an MRTC center will increase the time available to conduct training and maximize the student’s ability to complete the required training objectives.

b. Mayo Clinic’s Multidisciplinary Simulation Center is capable of meeting all the requirements of the Government and is in close proximity to of the three Regional Training Sites-Medical (RTS-MED) .

6. Efforts to Obtain Competition: Effective Competition. The Government conducted market research in an effort to locate training sites that are able to fulfill this requirement within a close proximity to one of the three RTS-MED training sites. Market research revealed only one training center within approximately 100 miles of Fort McCoy and the other two Government training locations that is capable of fulfilling this requirement. The utilization of any other training facility would not meet the specific level of training requested and reduce student training time due to an increase in travel time to the facility. There are similar medical training facilities available, but due to location and equipment/training measures requested these facilities are not feasible for fulfilling this requirement.

a. Effective Competition. Given the specific nature of this requirement no further action to increase competition is contemplated.

b. Subcontracting Competition. Subcontracting plan is not required in accordance with FAR 19.702(a)(1).

7. Actions to Increase Competition: The requiring activity will continue to monitor the market for this type of service. If additional sources capable of providing this service within a close proximity to any one of the three RTS-MED training sites become available at a later date, future requirements will be awarded on a competitive basis.

(See FAR 2.101 and 3.104-4)

8. Market Research: The requiring activity conducted market research sources of these services. Market research was conducted via a search of the internet and by telephone. Market research identified multiple sources that provide medical educational training and although several entities exist that are capable of providing similar services; the distance to alternate locations from the nearest RTS-MED training site is cost prohibitive to the Government. The only source capable of providing the required service that is within a minimal distance to one of the three RTS-MED training sites is Mayo Clini . The search was further refined by utilizing the Small Business Administration (SBA) Dynamic Small Business Search Engine (DSBS). Searches of the NAICS code 611310 for results in Rochester, MN are as follows: Currently SDB Certified (O); Currently 8(a) Certified (O);

Woman or Women Owned (3); Service-Disabled Veteran (O); Veteran (I); and Currently HUBZone Certified (0)

The Mayo Clinic Simulator Center contains 10,000 square feet of simulation space and is located in Rochester, MN. The center includes simulation laboratories, debriefing rooms, classrooms and offices adjacent to each of the simulator suites. There are four simulation suites with life size, high fidelity adult mannequins that respond physiologically to treatment provided in response to trauma scenarios that are administered from three control rooms. The four simulation suites can be opened up to provide a patient flow area from emergency room to operating room to intensive care unit. There is an extensive trauma and surgical scenario based data library available to the trainers and additional scenarios provided by the Army can be added to the library for utilization if sufficient data is not available in the data library. In addition to the four adult SIMMan mannequins there are two pediatric and two neonatal mannequins. There are six small classrooms adjacent to each suite where specific sections can debrief the students. There is a fifty seat classroom for lectures and generalized debriefing. Each room is monitored with video cameras which are used to debrief each group participating in the sessions. Control Rooms can view all of the classrooms especially when the rooms are opened up. Students are exposed to emergency room trauma, resuscitation, intubating skills and various other trauma and emergency medicine skill sets. The simulator staff includes physicians, respiratory therapists, program coordinators and administrative support.

Rochester, MN is located 102 miles from Fort McCoy, WI. Fort McCoy is the location of Regional Training Site- McCoy (RTS-MED McCoy), a Medical Readiness Training Center (MRTC) facility staffed and equipped to provide and support collective and individual training to medical units and personnel. RTS-MED McCoy regularly hosts medical field training exercises which involve entire medical units (i.e. Combat Support Hospitals, Field Surgical Teams (FST), etc) MRTC has two other regional training sites, one located at Fort Hunter Liggett, CA and one located at Fort Gordon, GA. The close proximity of the Mayo Clinic to RTS-MED McCoy allows the Mayo Clinic location to be utilized to exercise split operations and other similar real world field activities while an FST or other small element extracts from ongoing field exercise activities at Fort McCoy and proceeds via convoy to the Mayo Clinic to engage in a two day simulator exercise to practice combat trauma medical care on a variety of simulated combat victims. A number of the same Observer Controller/Trainers who are supporting the field exercise at Fort McCoy could also be tasked to support the off-site training exercise at the Mayo

(See FAR 2.101 and 3.104-4)

Clinic.

Hotels and eating establishments are within walking distance of the Mayo Clinic campus and the simulation center itself. The close proximity of hotels and eating establishments to the Mayo Clinic significantly reduces the need for vehicle transport and eliminates the need for vehicles other than "convoy" vehicles utilized for transport to and from Fort McCoy.

The close proximity of the Mayo Clinic to RTS-MED McCoy which enables MRTC to provide class eight equipment and other medical equipment at very minimal cost to the Army. RTS-MED McCoy can also provide additional mannequins or subject matter experts from their training staff at minimal transport and TDY costs.

Henry Ford Hospital Simulator

Henry Ford Hospital Simulator Center is located in Detroit, Michigan. The 15,000 square foot facility offers procedural simulation technologies using computerized mannequins and other mechanical devices. Reconfigurable suites replicate the emergency department, operating room, intensive care unit, labor and delivery suite and other hospital environments. Mannequins allow staff to realistically challenge their skills, perfect new care protocols and practice code situations.

One 50 seat classroom is available for lectures and review. There is an integrated Audiovisual system which enables videotape activity in the simulation labs. This enables debriefing sessions with the students.

The Henry Ford facility is located approximately 528 miles from Fort McCoy, WI;

approximately 800 miles from Fort Gordon, GA and approximately 2400 miles from Fort Hunter-Liggett, CA. There are few hotels and eating establishments within easy walking distance of the Henry Ford facility. Transportation would be required both to and from the simulation site each day.

All personnel participating in the exercise would have to fly to Detroit in TDY status and engage government provided transportation or rental vehicles to drive to the exercise location and to and from the hotel, airport and eating establishments.

Class eight equipment or other medical equipment would have to be shipped separately in a push package with a full advance party to receive and secure the equipment for each exercise iteration.

Subject matter experts or other Army training staff would have to fly to Michigan for each exercise in full TDY status.

The distance from all RTS-MED locations make split operations, convoy operations and similar mini-exercise activities too challenging at this time.

University of Louisville Simulator

University of Louisville contains 10,000 square feet of space and is located in Louisville, Kentucky. The simulator center has four simulator suites with a state of the art computer

(See FAR 2.101 and 3.104-4) controlled patient simulator (METIMan) in each room. There are several control rooms which dictate the specific hemodynamic changes seen in the specific scenario being given to the student. There are also three portable Emergency Care simulator systems which also contains monitoring systems. Participants can administer drugs, evaluate and manage airways, perform patient assessment using a standard intensive care unit monitoring and engage in similar medical procedures. There is an integrated audiovisual system which enables them to videotape activity in the simulation Jabs. This enables debriefing sessions with the students.

The Louisville Simulation Center is located approximately 550 miles from Fort McCoy, WI; 800 miles from Fort Gordon, GA and approximately 2300 miles from Fort Hunter-Liggett, CA.

There are few hotels and eating establishments within easy walking distance of the Louisville facility. Transportation would be required both to and from the simulation site each day.

All personnel participating in the exercise would have to fly to Louisville in TDY status and engage government provided transportation or rental vehicles to drive to the exercise location and to and from the hotel, airport and eating establishments.

Class eight equipment or other medical equipment would have to be shipped separately in a push package with a full advance party to receive and secure the equipment for each exercise iteration.

Subject matter experts or other Army training staff would have to fly to Kentucky for each exercise in full TDY status.

The distance from all RTS-MED locations make split operations, convoy operations and similar mini-exercise activities too challenging at this time.

University of Texas Galveston Simulator

University of Texas Medical Branch has 6,000 square feet of space and is located in Galveston, Texas. It has two simulator suites with a control room that overseas both suites and two simulator mannequins (SIMMan). Besides the two adult simulators there is a pediatric as well as a neonatal simulator. The simulator center is capable of providing point of injury to emergency room, to operation room capability. There are also two portable Emergency Care simulator systems which also contains monitoring systems. This allows that control room the ability to dictate

Changing scenarios within the same treatment area. There is a twenty seat conference room where participants are briefed and allowed to discuss the videotaped scenarios. The UT- Galveston is located approximately 1300 miles from Fort McCoy, WI; approximately 930 miles from Fort Gordon, GA and approximately1850 miles from Fort Hunter-Liggett, CA. There are few hotels and eating establishments within easy walking distance of the UT-Galveston facility.

Transportation would be required both to and from the simulation site each day.

All personnel participating in the exercise would have to fly to Galveston in TDY status and engage government provided transportation or rental vehicles to drive to the exercise location and to and from the hotel, airport and eating establishments.

(See FAR 2.101 and 3.104-4)

Class eight equipment or other medical equipment would have to be shipped separately in a push package with a full advance party to receive and secure the equipment for each exercise iteration.

Subject matter experts or other Army training staff would have to fly to Michigan for each exercise in full TDY status.

The distance from all RTS-MED locations make split operations, convoy operations and similar mini-exercise activities too challenging at this time.

9. Interested Sources: The University of Wisconsin was contacted while conducting market research to determine if their medical simulation center could meet the specific training requirements. Their program manager expressed interest in fulfilling this requirement however stated that based on the number of trainees their Sim Center could not support the training. In accordance with FAR 13.501(1)(iii) this justification and approval will be made publicly available within 14 days after contract award.

10. Other Facts:

a. Procurement history.

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

A prior contract, W91247-13-P-0155, issued by MICC Center - Fort Bragg was awarded to Mayo Clinic on 11 April 2013 for a 4 day training exercise from11 April 2013 to 14 April 2013. Total value of contract after modifications was $19,500.00

(2) The competitive status of this action is unknown, but is believed to have been awarded on a non-competitive basis. The contract was recovered via the EDA website and does not provide the justification and approval documentation.

(3) Authority previously cited for other than full and open competition is unknown.

(4) Justification prepared to support the procurement made before this one with a summary of the contents of paragraph 7, Actions to Increase Competition, of the justification for that procurement and an explanation of the results. Not available.

(5) If prior award accomplished by full and open competition, a detailed explanation of the changed circumstances. Not applicable.

(6) Explanation of unusual patterns revealed by history, e.g., several consecutive, urgent buys. Not applicable.

(7) Justification prepared to support the procurement made before this one and description of circumstances for justification & any significant changes. Not available.

(See FAR 2.101 and 3.104-4)

b. Other facts. None.

(See FAR 2.101 and 3.104-4)

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.

Signature: _______________________________ Date: ______________

Typed Name: Cheryn L. Fasano Title: RTS-MED Program Manager/COR

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.

Signature: _______________________________ Date: ______________

Typed Name: Cheryn L. Fasano Title: RTS-MED Program Manager/COR

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 and comparison with the IGE and previous prices.

Services are considered commercial and therefore certified cost and pricing data is not required per FAR 15.403-1(b)(3).

Signature: _______________________________ Date:

Typed Name: Yesenia C. Rodriguez Title: Contracting Officer

14. Contracting Officer Certification:

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

Signature: _______________________________

Typed Name: Yesenia C. Rodriguez Title: Contracting Officer

11-Jan-16

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(See FAR 2.101 and 3.104-4)

Approval

Based on the foregoing justification, I hereby approve the procurement of non-personal services to provide medical simulation training support to United States Army Reserve (USAR) medical units, through the Medical Readiness Training Command (MRTC) on an other than full and open competition basis pursuant to the authority of 41 U.S.C. 1901 as implemented by FAR 13.501, subject to availability of funds, and provided that the services and property herein described have otherwise been authorized for acquisition.

Signature: _______________________________ Date: ______________

Typed Name: Yesenia C. Rodriguez Title: Contracting Officer

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