____________________________________________________________________________________ The Department of Veterans Affairs intends to negotiate and award a sole source commercial Basic Ordering Agreement for Nursing Home services with Mid Atlantic Berlin located at 1922 Greenspring Dr., Ste. 3, Lutherville-Timonium , MD. The purpose of the award is to allow for the placement of Veterans in a facility that is within close proximity to their home or family. The Government intends to negotiate a Basic Ordering Agreement for the period of one base year plus four option years. The proposed contract action is for services which the Government intends to solicit and negotiate with only one source in accordance with FAR 6.302. This notice is not a request for competitive quotes, proposals, or information. Please direct any questions to Krista Shreet at
[email protected]. DEPARTMENT OF VETERANS AFFAIRS VISN 5 Justification and Approval For Other Than Full and Open Competition 1. Contracting Activity: Department of Veterans Affairs, NCO 5, 849 International Dr., Ste. 450, Linthicum, MD 21090 Requisition Funded/Paid through VA Form 1358, Obligation or Change in Obligation, in accordance with Volume II- Chapter 6 2. Nature and/or Description of the Action Being Processed: Pursuant to FAR 6.302-1 and 41 U.S.C. 253(c)(1), the VA has a requirement which can only be reasonably met by a single supplier. This action is to establish a new Basic Ordering agreement with the current contractor, Mid-Atlantic Berlin Nursing and Rehabilitation Center for Nursing Home (CNH) services. Services at this time may be deemed to be available only from the original source in the case of a follow-on contract, when it is likely that award to another source would result in unacceptable delays in fulfilling the agency's requirement and substantial duplication of cost to the Government which is not expected to be recovered through competition. The VA Maryland Health Care System (VAMHCS) anticipates entering into a sole source acquisition negotiation for eligible Veterans to continue receiving CNH services. Mid-Atlantic Berlin is currently supporting the VAMHCS by providing nursing home services. CNH services will be furnished to Veterans for whom such care is specifically authorized by the VAMHCS. Provided services include: provider visits, laboratory work, x-ray, special services, room, meals, nursing care, and other services or supplies commensurate with the VA authorized level of care. The Government anticipates awarding a Basic Ordering Agreement (BOA), in accordance with FAR 16.703. A binding contract will be formed, in accordance with the terms and conditions of this BOA, when the Department of Veterans Affairs (VA) agrees non-VA care is required and the contractor agrees to accept the patient and provide direct patient care services. Upon acceptance by the contractor of beneficiaries of VA, all clauses and terms and conditions of this BOA shall apply and become part of the resultant contract during such time as the VA patient remains in the contractor's care at the expense of the VA. 3. Description of Supplies/Services Required to Meet the Agency's Needs: A sole source award will be made to Mid-Atlantic Berlin for continuous services to Veterans and eligible beneficiaries. Mid-Atlantic Berlin, hereafter referred to as "CNH" will provide services to include: provider visits, laboratory work, x-ray, special services, room, meals, nursing care, and other services or supplies commensurate with the VA authorized level of care. Striving to meet healthcare needs and promote maximum wellbeing, a break in continuity of care to our Veterans would prove detrimental and negatively impact the quality of life for this aged Veteran population who require critical assisted services and supportive environment. The Basic Ordering Agreement cost is as follows: Five Year Cost Estimate: $395,009.64 Period of Performance Annual Amount Annual Increase Increase Amount Annual Amount Base Period $77,005.20 00 00 $77,005.20 Option Year 1 $77,005.20 1.28% $985.67 $77,990.87 Option Year 2 $77,990.87 1.28% $998.28 $78,989.15 Option Year 3 $78,989.15 1.28% $1,011.06 $80,000.21 Option Year 4 $80,000.21 1.28% $1,024.00 $81,024.21 Total (5 years) NA NA NA $395,009.64 " COR IGCE: $395,009.64 " Contracting Officer Cost Estimate: Placements will be made in contract facilities based on availability of facilities and the desires of the Veterans and their respective families. As it is impossible to determine actual usage of any particular contract facility, the VA uses Basic Ordering Agreements with no guaranteed minimums. However, based on a typical usage rate of one Veteran for 365 days, a reasonable estimate for the value of any particular contract would be around $50,000 per year, with many facilities experiencing authorized Veteran populations in excess of five per year. Daily rates differ depending on location. 4. Statutory Authority Permitting Other than Full and Open Competition: . FAR 6.302-1 and 41 U.S.C. 253(d)(1)(a): Only one responsible source and no other supplies or services will satisfy agency requirements. 5. Demonstration that the Contractor's Unique Qualifications or Nature of the Acquisition Requires the Use of the Authority Cited Above (applicability of authority): PL 88-450, PL 106-117 and 38 U.S.C. 1720 create the expectation that qualified veterans will receive Community Nursing Home (CNH) services in their community. The VA Medical Center (VAMC) provides care to veterans whose primary residence is Mid-Atlantic Berlinl home, the Veteran's Health Administration (VHA) has a policy that nursing home care may be provided in licensed nursing facilities at the Department of Veterans Affairs (VA) expense. The VA Community Nursing Home (CNH) Program is designed to assist Veterans and their families in making the transition from an episode of hospital care, nursing home care, or domiciliary care to the community. The primary goal of the CNH program is to maintain or restore the Veteran to the highest attainable level of health and well-being. A break in the continuity of care to our Veterans would prove detrimental and negatively impact the wellbeing of the aged Veteran population who require assisted services and a supportive environment. Re-competing the services would result in a change in services to the existing Veterans who have already been enrolled and have been receiving service based on medical necessity for years. A change in vendor may lead to a decline in function or an exacerbation in the level of mental, emotional, or physical function. Consistency in therapeutic milieu is warranted. The primary goal is to maintain or restore the Veteran to the highest attainable level of health and well-being, thus Veteran treatment should be focused on stabilizing symptoms as much as possible. The CNH program has two cornerstones: some level of patient choice in choosing a nursing home in close proximity to their home and family and an approach to local oversight of CNHs consisting of annual reviews and monthly patient visits. Following this approach, the VAMC has established contracts in various areas throughout Maryland. This entails placement of the Veteran in a facility that is in proximity to the Veteran's home or place of residence or in proximity to the Veteran's family or social connections. Contracts and agreements under the referenced authority carry out the essential purpose of providing nursing home services to the Veteran and in the Veteran's social community. Discontinuation of the current services will cause an unacceptable delay in fulfilling the agency's requirement for Veteran support and cause substantial duplication of cost to the Government that is not expected to be recovered through competition. A break in the continuity of care to our veterans would prove detrimental and negatively impact the wellbeing of the veteran requiring assistance. The Contractor is to provide nursing home care in accordance with the VHA CNH procedures specified in VHA 1143.2. The facility has to meet all state licensing requirements including the state requirement pertaining to level of medical liability insurance. 6. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable: A notice of Intent to Sole Source will be published on FedBizOpps. 7. Determination by the Contracting Officer that the Anticipated Cost to the Government will be Fair and Reasonable: In order to determine whether the contractor's proposed price is fair and reasonable, the Contract Specialist will review the proposed rates against State Medicaid rate. If the contractor's proposed price appears to be questionable for reasonableness, a justification from the contractor will be required in order to determine whether the proposed price is fair and reasonable before award. The negotiated rates are required to be within the guidelines established by M-5, Part II, Chapter 3, dated March 28, 1995 and IL 049-02-15 dated September 19, 2002. The guidelines require: a factor of not more than 18 percent be added to routine ancillary services; the daily cost of rehabilitation therapy would require written permission or approval. 8. Description of the Market Research Conducted and the Results, or a Statement of the Reasons Market Research Was Not Conducted: Research was conducted on a limited basis due to the limitation of the geographic area. Research was conducted to establish CNH contract services throughout the local VA's catchment area to provide CNH services to Veterans near or as near as possible to family or friends. Market research for future agreement is dependent on the needs of the patient population in the catchment area and resource availability of the VA Medical Center. The objective is to maximize patient care while maintaining compliance with VA regulations. 9. Any Other Facts Supporting the Use of Other than Full and Open Competition: Continuing service is critical to Veterans to sustain a quality of life at an acceptable level. 10. Listing of Sources that Expressed, in Writing, an Interest in the Acquisition: Not applicable for this requirement. 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: The Contracting Office has identified a way to improve and increase competition for the medical services in areas where competition can be considered. Approval not to compete does require VA Director and Chief of Staff approval prior to acquiring the medical services. The procurement action will be posted to the Government Point of Entry. Any responses will be referred to the GEC Coordinator for future consideration and market research of source availability. 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. I certify the technical requirements are accurate and complete to support the recommendation of other than full and open competition.