FBODaily.com | FedBizOpps: FILE | Q | CBOC Interim Contract Authority (ICA) Stewart County (Dover) TN CBOC - Initial period of performance 04-03-2014 through 09-30-2014 - Justification and Approval (J&A)

FBO DAILY - FEDBIZOPPS ISSUE OF APRIL 23, 2014 FBO #4533
DOCUMENT

Q -- CBOC Interim Contract Authority (ICA) Stewart County (Dover) TN CBOC - Initial period of performance 04-03-2014 through 09-30-2014 - Justification and Approval (J&A)

Notice Date: 4/21/2014
Notice Type: Justification and Approval (J&A)
NAICS: 621498 — All Other Outpatient Care Centers
Contracting Office: Department of Veterans Affairs;Network Contracting Office 9;1639 Medical Center Parkway;Suite 400;Murfreesboro TN 37129
ZIP Code: 37129
Solicitation Number: VA24914R0294
Archive Date: 7/8/2014
Point of Contact: Carol L. Franklin
E-Mail Address: k
Small Business Set-Aside: Veteran-Owned Small Business
Award Number: VA249-14-D-0077
Award Date: 3/31/2014
Description: Attachment 2: Request for Sole Source Memo Format DEPARTMENT OF VETERANS AFFAIRS Justification and Approval For Other Than Full and Open Competition 1.Contracting Activity: Department of Veterans Affairs, VISN 09, Tennessee Valley Healthcare System (TVHS) - Nashville Campus, Network Contracting Office 9 (NCO 9). 2.Nature and/or Description of the Action Being Processed: Under the authority of Public Law 104-262, and Title 38 U.S.C. §8153, the Contractor shall provide continuous delivery of Contractor operated primary care services, including primary care mental health and preventive medical care services in accordance with the terms, conditions, and provisions stated herein, and to furnish services to eligible veteran beneficiaries enrolled with the Tennessee Valley Healthcare System (hereafter called TVHS). The contract will be structured as a firm-fixed-price (FFP) Per Member Per Month (PMPM) Capitated Rate Indefinite Delivery Indefinite Quantity (IDIQ) using Interim Contract Authority (ICA) in accordance with VA Directive 1663 for a period not to exceed 180-days or 360-days if an exception is granted. This interim contract authority is necessary to ensure minimum disruption of primary health care (PHC) services for eligible veterans as the sole-source with a Veteran Owned Small Business (VOSB) proceeds through the Medical Sharing Office (MSO) Contract Review Team (CRT) process for contract community-based outreach clinics On or about January 10, 2014, the State of Tennessee notified the Director of the Tennessee Valley Health System that they had decided to terminate the contract for the Dover (Tennessee) Community Based Outpatient Clinic effective April 30, 2014. The Health and Human Services has designed this catchment area as a Healthcare Professional Shortage Area. This shortage of healthcare providers limits alternative sourcing plans. The Government will incur additional cost to procure these healthcare resources through Non-VA Care (Fee Bases) as these services are reimbursed at a non-facility Current Procedure Terminology (CPT) Code rate, due to the inadequate level of healthcare professions within this region the Government will incur additional travel reimbursement expenses to compensate veterans for their travel outside of acceptable travel distances. In addition, the Government ability to provide continuity of care through a single provider will be disrupted - this will directly impact eligible beneficiary's satisfaction with care provided due to elongated appointment times, decrease patient/provider appointment-interaction times, reduced appointment opportunities, increase travel to and from appointments, as well as, increase demands on veterans families and/or caregivers. 3.Description of Supplies/Services Required to Meet the Agency's Needs: A contractor needs to provide primary health care (PHC) and mental health care (MHC) for eligible beneficiaries residing in the communities and counties surrounding the Dover, Tennessee Community Based Outreach Clinic with an effective date of May 1, 2014 to prevent disruption in healthcare services. This is a Congressional approved community based outpatient clinic. 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): This CBOC has been in continuous operation since (approximately) July 1, 1995. It has historically been a sole-source procurement with the State of Tennessee to jointly operate an Outreach Clinic to provide primary health care (PHC) to the counties of Benton, Houston, Humphries and Stewart (Henry County was originally included in this community based outpatient clinic, but was realigned during the current contract period with the Memphis VA Medical Center). On January 10, 2014 the State of Tennessee notified Tennessee Valley Healthcare System that it has decided to terminate the current contract effective March 31, 2014, through discussions the effective date has been extended to April 30, 2014. This does not provide TVHS and Network Contracting Office 9 (NCO-9) adequate time to procurement these healthcare services through normal procurement strategies without disrupting healthcare and creating undue financial injury to the Government and a hardship to the eligible veteran population living within these counties. Through market research and recent solicitations for similar community based outreach clinics throughout the Mid-South Healthcare Network (VISN 9) a veteran-owned small business (VOSB) was identified. Onsite Occupational Healthcare and Safety, Inc. is registered with VET-100 and is registered VOSB in the VETBIZ VIP database. Veterans Affairs Acquisition Regulation (VAAR) Part 819.7008 allows contracting officers to award contracts to VOSB concerns on a sole source basis provided: The anticipated award price of the contract (including options) will not exceed $5-million. The IGCE for this procurement is established for a firm-fixed-price Per Member Per Month at $82,290.00 per month for the estimated period of performance (POP) 04-03-2014 through 10-31-2014 based on the current vested enrollment of 750 eligible beneficiaries. The total estimated period of performance (POP) is $493,740.00; The contracting officer will synopsize the requirement in accordance with Federal Acquisition Regulation (FAR) Part 5; The VOSB concern has been determined to be a responsible contractor with respect to performance. The contractor provides health care resources to both commercial industries and governments globally in geographically rural or isolated environments often providing the only healthcare within the region. They have previously received "exceptional" rating for a similar contract providing temporary healthcare services to the United States Air Force. They are currently providing Occupational Healthcare & Safety services to the Department of Veterans Affairs new regional medical center located in New Orleans, LA; Award can be made at a fair and reasonable price. The Network Contracting Office 9 (NCO-9) has recently completed or is in the process of solicitations for similar healthcare resources throughout the geographical area supported by the contracting office (NCO-9) to compare cost/price information provided by the VOSB concern; Market research is supported by the lack of offers by Service Disabled Veteran Owned Small Business (SDVOSB) concerns in recent solicitations for similar community -based outreach clinics for the Mid-South Healthcare Network (VISN-9)and that there are no responsible SDVOSB concerns that can provide these commercial healthcare services at this time; The VOSB concern is currently registered with VET-100 and verified in VETBIZ VIP database as a VOSB organization. Extensive market research of alternative sourcing plans indicates that the Government will be financially impacted due to mandated procurement lead times, formal approval processes, and elongated review processes for healthcare resources, as the government will need to utilize Non-VA Care (Fee Based) providers outside of the catchment area of the Dover (TN) CBOC. In addition, this will adversely impact Veterans and their families/caregivers as they will need to travel outside of the community to receive healthcare services due to a shortage of healthcare providers within this geographical area. The State of Tennessee sites its inability to hire qualified healthcare professionals for this rural community, this inability to recruit and retain qualified providers has limited healthcare services to PHC, which has resulted in intermediate gaps in coverage while they backfill these positions. This has also impacted the contractor's (State of Tennessee) ability to expand services to include MHC, which is currently provided by the TVHS - Nashville Campus Mental Health Department for eligible beneficiaries. A single contract for an optimal contract period ensures continuity of care is provided to this veteran population, while providing the Government adequate time to procure a long-term solution. It is not economically feasible to contract for a community-based outpatient clinic for a less-than optimal contract period (base year with four (4), one (1) year options). The Government acquires a great cost benefit by allowing the contractor to spread the start-up cost over a longer period of performance, opposed to front-loading these costs in a 12-month contract. Surrounding DoD Medical Treatment Facilities are above capacity and regional VA CBOCs are at or above capacity and unable to absorb these eligible veterans without elongated wait times for PHC and MHC. The closest VA CBOC is the Clarksville (TN) CBOC which is currently preparing the supporting documents to expand the existing facility from 10,000 square feet to approximately 25,000 square feet of usable footage for Congressional approval. This process is estimated to take six (6) months to a year to complete, another 18-months to 24-months to complete the leasing agreement and additional 12-months to 18-months to complete the build-out for a facility this size. The use of Interim Contact Authority, as prescribed in VA Directive 1663 limits the use of this authority for a period not to exceed 180-days, an exception can be granted to which allows the agency to include Federal Acquisition Regulation (FAR) Clause 52.217-8. 6.Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable: As prescribed in FAR part 6.305(b) the justification for this urgent sole source procurement shall be posted within 30-days after contract award. VAAR Part 819.7008 allows contracting officers to award a sole source basis to a VOSB concern, provided the following criteria have been met: The anticipated award price of the contract (including options) will not exceed $5.0-million; the IGCE for this Interim Contract Authority (not to exceed 360-days), estimates a firm-fixed-price Per Member Per Month cost at $82,290.00 for the current number of 750 vested eligible veterans; this estimate is dependent on several factors that might increase start-up cost such as the Government's ability to provide IT Equipment (to include a T-1 line), Tele-Health Equipment, temporary building to start initial services until build-out can occur at an acceptable site that meets current accessibility criteria and adequate space to provide all contracted PHC and MHC services. It is anticipated that these factors will be limited to the interim contract, but are dependent on the Government to acquire and provide the items identified within the agreement. The VOSB is registered with VET-100 and verified in VETBIZ's VIP database as a VOSB concern that has provided healthcare services to other commercial industries and federal agencies in rural and/or isolated locations globally. As previously stated this action can be made at a fair and reasonable price. Market research is supported by the fact that no responsible SDVOSB concern has responded to previous solicitation for similar commercially available healthcare service contracts. 7.Determination by the Contracting Officer that the Anticipated Cost to the Government will be Fair and Reasonable: The negotiated price/cost for this sole-source contract with a Veteran Owned Small Business (VOSB) concern can be determined to be "fair and reasonable" based on a comparison between the negotiated firm-fixed-price Per Member Per Month (PMPM) Capitated Rate for PHC and MHC. Network Contracting Office (NCO-9) has completed several unrestricted solicitations for similar sized contracted CBOCs, providing similar health care resources to eligible beneficiaries. 8.Description of the Market Research Conducted and the Results, or a Statement of the Reasons Market Research Was Not Conducted: As prescribed in FAR Part 10.002(b)(1), contracting officers may use market research conducted within 18-months before the award of any task or delivery order if the information is still current, accurate, and relevant. There was a Request for Information (RFI) / Sources Sought Notice issued for the current contract (VA249-12-D-0285) to identify interested parties to provide these commercial healthcare services to the communities and counties currently served by the Dover (TN) CBOC, the results are provided below: Valor Healthcare, a subsidiary of Humana Government Business, Inc., is a large business who provides similar outpatient clinic services across the Mid-South Healthcare Network (VISN-9). This firm is Joint Commission accredited under the Ambulatory Care Program. Premier medical Group, PC is assumed to be a large business as their SAM registration expired on April 16, 2013; this firm provided notification that due to the American Care Act (ACA) the Board of Directors determined that they would not be consider this opportunity. Deltec.com made an inquiry into the incumbent contractor for these services, failed to respond to the RFI/Sources Sought Notice. A search of Duns and Bradstreet suggest this firm is no longer in business, there is no record of this firm registering in the System for Award Management (SAM), and a search of SBA Dynamic Small Business Search database was unsuccessful. The final response to this RFI/Sources Sought Notice was Onsite Occupational Health & Safety, Inc., a Veteran Owned Small Business concern (verified in VETBIZ VIP database effective July 25, 2012). In addition, this firm is Joint Commission accredited for Ambulatory Care and has received the Joint Commission Gold Seal of Approval for Health Care Staffing Services. This firm has extensive experience providing Primary Health Care (PHC) for the Department of Defense (DoD) operating 26 Forward Operating Bases in Afghanistan South and eight (8) additional clinics in Afghanistan North. In addition, they provide healthcare services to other commercial industries such as energy (oil drilling sites) globally. Market research and review of recent community-based outpatient clinics (CBOC) across Mid-South Healthcare Network (VISN-9) indicates a tread to utilize unrestricted procurement strategies due to inadequate competition by small business concerns. The Network (VISN-9) has not had success with previous small business concerns providing these commercially available healthcare services, requiring the VA Medical Centers (VAMC) to use alternative sourcing to provide primary health care (PHC) and mental health care (MHC) to beneficiaries until a long term solution could be implemented. Additional market research suggests that current healthcare providers within the region are at or beyond capacity. Alternative sourcing for primary health care (PHC) through Non-VA Care (fee basis) will require Veterans and their families/caregivers to travel outside of this geographical area to receive care. This is not an economically feasible solution; this will greatly increase the cost for the Tennessee Valley Healthcare System to provide primary health care (PHC) to beneficiaries. 9.Any Other Facts Supporting the Use of Other than Full and Open Competition: Under the authority of 38 U.S.C. §8128, the VA has established contracting priority for veteran-owned and controlled small businesses. VAAR Part 819.7004 states in determining the acquisition strategy applicable to an acquisition, the contracting officer shall consider, in the following order of priority, contracting preferences that ensure contracts will be awarded: (a)To SDVOSBs; (b)To VOSB, including but not limited to SDVOSBs; (c)Pursuant to - 1.Section 8(a) of the Small Business Act (15 U.S.C. §637(a); or 2.The Historically - Underutilized Business Zone (HUBZone) program (15 U.S.C §657(a); (d)Pursuant to any other small business contracting preference. VAAR Part 819.7008, provides criteria for contracting officer to award to a VOSB on a sole source basis, On Site Occupational Health and Safety, Inc. is registered in VET100 and has been verified in the VETBIZ VIP database as a VOSB (July 25, 2012). 10.Listing of Sources that Expressed, in Writing, an Interest in the Acquisition: See section 8 above. 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: An Interim Contract Authority (ICA) shall be used to mitigate financial impairment due to increased cost to provide primary health care (PHC) to these eligible beneficiaries with minimum disruption while the Agency seeks a long-term contract solution with an optimum contract period of performance. The ICA will provide adequate time for the government to review the business plan for this Congressional approved Community Base Outreach Clinic (CBOC), evaluate alternative sourcing strategy to provide PHC and mental health care (MHC) for beneficiaries residing within the designated geographical area for this CBOC, prepare supporting documents to revise the current business plan for Congressional review and approval, and implement revisions to the original business plan approved by Congress. 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. (This signature is the requestor's supervisor, fund control point official, chief of service, someone with responsibility and accountability)
Web Link: FBO.gov Permalink
(https://www.fbo.gov/spg/VA/NaVAMC/VAMCCO80220/VA24914R0294/listing.html)
Document(s): Justification and Approval (J&A); File Name: VA249-14-R-0294 VA249-14-R-0294_1.docx (https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=1319097&FileName=VA249-14-R-0294-000.docx); Link: https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=1319097&FileName=VA249-14-R-0294-000.docx; Note: If links are broken, refer to Point of Contact above or contact the FBO Help Desk at 877-472-3779.
Record: SN03344413-W 20140423/140421234905-a72bfc5cc5a5e3c56cb6e87d34c93406 (fbodaily.com)
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Q -- CBOC Interim Contract Authority (ICA) Stewart County (Dover) TN CBOC - Initial period of performance 04-03-2014 through 09-30-2014 - Justification and Approval (J&A)