36C242-22-AP-2114 Nurse and Nurse Support Staff Services Rev:13 Effective Date: 02/01/2022 Page 2 of 6 DEPARTMENT OF VETERANS AFFAIRS Justification and Approval (J&A) For Other Than Full and Open Competition (>SAT) Acquisition Plan Action ID: 36C242-22-AP-2114 Contracting Activity: Department of Veterans Affairs, Regional Procurement Office East, Network Contracting Office 2 (NCO 2), Canandaigua VA Medical Center, 400 Fort Hill Avenue, Canandaigua, NY 14424. The Purchase Request Number is 526-22-3-082-0222 Nature and/or Description of the Action Being Approved: Network Contracting Office (NCO) 2 intends to award a sole source contract to Ghost RX, Inc., a Service-Disabled Veteran Owned Small Business (SDVOSB), registered in the Vendor Information Pages (VIP) for Temporary Nurse and Nurse Support Staff Services in support of the James J. Peters VA Medical Center (JJP) while recruitment continues to fill nursing vacancies. This requirement seeks to fill 14 vacancies on a temporary basis, comprising of 4.0 FTE Registered Nurses (RNs), 5.0 FTE Licensed Practical Nurses (LPNs), and 5.0 FTE Certified Nursing Assistants (CNAs). The proposed sole source contract is for a six-month Firm Fixed Price (FFP) Indefinite Delivery | Indefinite Quantity (IDIQ) contract with one (1) six-month option period. The anticipated base period of performance is August 1, 2022 January 31, 2023, with the option to extend services for up to an additional six-months should there continue to be difficulty recruiting, hiring, and onboarding permanent VA staff at these locations. In accordance with FAR 13.5 Simplified Procedures for Certain Commercial Items and specifically FAR 13.501 Special Documentation Requirements, acquisitions conducted under Simplified Acquisition Procedures are exempt from the requirements of FAR Part 6, but still require a justification using the format of FAR 6.303-2. Description of Supplies/Services Required to Meet the Agency s Needs: The JJP VA Medical Center has an immediate need for nurse and nurse support staff services. Presently, JJP has experienced staffing levels that are critically low due to absence, retirements, transfers, resignations, re-assignments, and terminations. A robust recruitment process has been in progress, but the hiring lag time is a factor in getting qualified staff on board. To continue to provide care to their Veteran inpatient long-term care residents 24 hours/7 days a week during this staffing shortage, Nursing has been detailing staff from other areas, which results in increased workload in those areas and decreased nurse satisfaction, in addition to utilizing voluntary and involuntary overtime. Temporary staffing is needed to fill the gaps between vacancies and on-board nursing staff and to prevent staff fatigue and exhaustion, which is occurring as a result of overtime use to fill the work hours/vacancy gaps needed to provide care. Specifically, JJP has requested a total of 4.0 FTE RNs, 5.0 FTE Licensed Practical Nurses and 5.0 FTE Certified Nursing Assistants, which includes overtime and holiday pay. The government estimate for these services is $2,859,175.20 based on the number of hours estimated for one base 6-month period plus one (1) six-month option period. Due to the amount of time it takes to on-board and train VA nurses, it is felt that this timeframe will offer VA efficiency and well-trained contract staff as recruitment activities continue. It is expected that staffing needs will likely change throughout the year as permanent VA hires are made. The resulting contract will need to allow variation in the number of hours required, so an IDIQ contract is best suited to meet this need. In accordance with 38 USC 8127(c), the contract maximum will not exceed $5,000,000.00. Statutory Authority Permitting Other than Full and Open Competition: 41 USC 3304(a)(5), 38 U.S. Code 8127(c), as implemented by FAR 6.302-5 (Authorized or Required by Statute). COs may use the non-competitive (sole source) procedures authorized in VAAR 819.7007 or 819.7008 up to $5,000,000. Check the specific VAAR clause used below: (X ) 819.7007 Sole source awards to a verified service-disabled veteran-owned small business; or ( ) 819.7008 Sole source awards to a verified veteran-owned small business Demonstration that the Contractor s Unique Qualifications and/or Nature of the Acquisition Requires the Use of the Authority Cited Above (applicability of authority): Pursuant to 38 U.S.C. 8127(c) a sole source award to a SDVOSB concern is authorized where the SDVOSB concern is determined to be a responsible source with respect to performance of the contract; the anticipated award will exceed the simplified acquisition threshold but will not exceed $5,000,000; and the contract award can be made at a fair and reasonable price that offers best value to the United States. Ghost RX, Inc. (DUNS No. 879125743) is a verified SDVOSB by the Center for Veteran Enterprise (CVE) on the Vendor Information Pages (VIP), last verified on June 17, 2020, with an expiration date of June 17, 2023. Additionally, Ghost RX, Inc. has performed satisfactorily on contracts for similar services both within JJP and with other VA locations. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable, including whether a notice was or will be publicized as required by subpart 5.2 and, if not, which exception under 5.202 applies: This action is to fulfill an immediate need for the procurement of temporary nursing staff services for 6 months with one (1) option to extend for an additional 6-months. It is not anticipated that the services will be needed longer than 12-months. If additional services are required, they will be procured on a competitive basis. Due to the urgent and immediate need for the requested staffing, limited market research was done and 3 SDVOSB s were considered for award. No additional outreach was conducted. In the event services are needed beyond the short-term contract actions, they will be procured on a competitive basis. Determination by the CO that the Anticipated Cost to the Government will be Fair and Reasonable: The Contracting Officer will determine fair and reasonableness of the proposed prices through a comparison of those prices to the Independent Government Cost Estimate (IGCE), market research, and other available price analysis techniques in accordance with FAR 13.106-3(a)(2). The Government has ample recent pricing information available through other contracts for similar services to assist with this determination as temporary staffing services have been utilized extensively. Description of the Market Research Conducted and the Results, or a Statement of the Reasons Market Research Was Not Conducted: NCO 2 conducts ongoing market research for temporary health care staffing firms to fulfill various staffing needs within VISN 2. Market research to identify sources has historically been conducted through the publishing of Sources Sought Notices on www.beta.sam.gov, review of Federal Supply Schedule (FSS) Professional and Allied Healthcare Staffing Services (Schedule 621i) and informal RFIs, as well as outreach among Health Care Resource (HCR) Contracting Officers both within NCO 2 and other NCOs that have temporary staffing requirements. A search was conducted in VIP for both SDVOSBs and VOSBs under NAICS 561320 Temporary Help Services resulting in the identification of 780 SDVOSBs and 120 VOSBs. It was impossible to determine whether the identified companies were capable of fulfilling the subject requirement as the NAICS code is very broad. A search was conducted in SBA s Dynamic Small Business Search resulting in the identification of 1,511 SDVOSBs and 386 VOSBs under NAICS 561320 Temporary Help Services. Recent market research has shown there are many SDVOSBs that provide nurse staffing services, and there is typically interest from SDVOSBs regarding health care staffing requirements for this region. Of those vendors that express interest, CO knowledge of existing contracts provides insight about how well they have performed on current and prior staffing requirements in order to make an educated determination on the likelihood of success in fulfilling this requirement. SDVOSB s considered include Ansible Government Solutions, A-Team Staffing and Ghost RX. Award will be made to Ghost RX since they had the most favorable past performance at JJP when they provided COVID emergency nurse and nurse support staff services. As a result of the award to Ghost, the following tasks were completed: In a query of Center for Veteran Enterprise (CVE) on the Vendor Information Pages (VIP), Ghost RX, Inc. was listed as a verified Service-Disabled Veteran Owned Small Business. In a review of the System for Award Management (SAM) website, Ghost RX, Inc. (DUNS No. 879125743) is listed as a small business under this requirement s NAICS Code 561320 (Temporary Help Services) with Size Standard of $30.0M. In discussion with Ghost RX, Inc., it was confirmed that they foresee no difficulties fulfilling the described requirement expeditiously. Ghost RX meets the eligibility criteria outlined in VAAR 819.7003, they are verified in VIP and the action is below the $5,000,000 threshold. Any Other Facts Supporting the Use of Other than Full and Open Competition: None. Pursuant to 38 U.S.C. 8127(c) a sole source award to a SDVOSB concern is authorized where the SDVOSB concern is determined to be a responsible source with respect to performance of the contract; the anticipated award will exceed the simplified acquisition threshold but will not exceed $5,000,000; and the contract award can be made at a fair and reasonable price that offers best value to the United States. Ghost RX, Inc. is a verified SDVOSB by the Center for Veteran Enterprise (CVE) on the Vendor Information Pages (VIP). Ghost RX, Inc. (DUNS No. 879125743) has performed satisfactorily under other temporary staffing services contracts for similar services within VISN 2, as well as for other Veteran Integrated Service Networks. Given the urgent need for nurse and nurse support staff, it is in the best interest of the Government to fulfill the immediate need by utilizing the statutory authority to negotiate on a sole source basis with a VIP-verified SDVOSB. Listing of Sources that Expressed, in Writing, an Interest in the Acquisition: In addition to Ghost RX, the following sources expressed interest in the requirement: Ansible Government Solutions and A-Team Solutions. These and other potential sources may be considered for any future competitive procurements. 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: This procurement will result in a 1-year contract to fulfill an urgent and immediate need for temporary nurse and nurse support staff services. In the event the JJP VA Medical Center is unable to hire permanent VA employees at the required levels, NCO 2 will work with JJP towards award of a competitive contract action for the stated requirement in order to minimize the need for future sole source requirements. 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. _____________________________________________ Mehmet Bagriyanik Date James J Peters VA Medical Center Approvals in accordance with the VHAPM Part 806.3 OFOC SOP: 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. _____________________________________________ Jeanette Crooks Date Contracting Officer Network Contracting Office, NCO 2 One Level Above the Contracting Officer (Required over the SAT but not exceeding $700K): I certify the justification meets requirements for other than full and open competition. _____________________________________________ Allan M. Preston Date Branch Chief, Medical Sharing Network Contracting Office, NCO 2 VHA RPO HCA Review and Approval: I have reviewed the foregoing justification and find it to be complete and accurate to the best of my knowledge and belief and recommend approval (if over $68 million) or approve ($700K to $68 million) for other than full and open competition. _____________________________________________ Joseph P. Maletta Date Executive Director, RPO East Head of Contracting Activity (HCA)