NMLC NORTH EAST MEDICAL MATO - NURSE SERVICES

DEPARTMENT OF THE NAVY NAVAL MEDICAL LOGISTICS COMMAND FORT DETRICK, MARYLAND 21702-9203 CLASS JUSTIFICATION AND APROVAL FOR OTHER THAN FULL AND OPEN COMPETITION 1. Identify the agency and contracting activity This justification is executed by the Naval Medical Logistics Command (NMLC), Fort Detrick, Maryland on behalf of the military treatment facilities (MTFs) located in the Northeastern Region of the United States to include: Naval Medical Center Portsmouth, VA; Naval Health Clinic Annapolis, MD; Naval Health Clinic Patuxent River, MD; Naval Health Clinic Quantico, VA; Naval Health Clinic Newport, RI; Naval Health Clinic Great Lakes, IL; Naval Branch Health Clinic Groton, CT; Naval Branch Health Clinic Portsmouth, NH; Naval Branch Health Clinic Saratoga Springs, NY; and any associated branch clinics in the Northeast Region of the United States. 2. Nature/ description of the action/contract type The government intends to increase the maximum contract value identified in the "Contract Minimum/ Maximum Quantity and Contract Value" table in Section B, as well as the maximum quantities associated with Advanced Practice Nurse (CLIN 0003), Nursing (CLIN 0004), and On Call (CLIN 0009) existing Northeast Nursing MATO contracts. The current Northeast Nursing MATO contracts that require modification are as follows: N62645-14-D-5013 (Federal Staffing Resources LLC), N62645-14-D-5014 (Loyal Source Government Services LLC), N62645-14-D-5015 (Medtrust LLC), and N62645-14-D-5016 (RAO Radiologists Inc). 3. Description of supplies/ services The current maximum contract value of the Northeast Nursing MATO contracts is $152,250,696.18. Pending approval of this justification for approval for other than full and open competition the new maximum contract value will increase by $13,398,061.26 to a new total of $165,648,757.44. The increase to the maximum contract value will facilitate continuity of care for existing nursing services at MTFs identified in paragraph 1. In addition, the increase in maximum contract value will allow for new requirements that may precipitate prior to the end of the ordering period. Based on the dollar value of contract actions that have been awarded, unexercised options, and contract modifications that are anticipated to be completed, the current maximum contract value will be exceeded. The $13,398,061.26 increase to the Northeast Nursing MATO contracts will ensure that the dollar value of contract actions that have been awarded, unexercised options, and contract modifications that are anticipated to be completed will not exceed the maximum contract value identified in the contract. The above referenced four contractors are in the best position to fulfill current requirements and new requirements that may precipitate prior to the end of the contract ordering period. The increase to the maximum contract value is requested in anticipation of new contract awards under the competitive Northeast Medical MATO solicitation. The anticipated start date of the new Northeast Medical MATO is 01 October 2018; the current set of Northeast Nursing MATO contracts will expire 30 September 2018. The current set of Northeast Nursing MATO contracts was modified in 2017 to revise the period of performance in Section F from 01 July 2014 through 30 September 2017 to 01 July 2014 through 30 September 2018. An increase to the maximum contract value or associated maximum quantities identified in the aforementioned CLINs 0003, 0004, and 0009 has not previously been completed. In light of the extension to the period of performance, NMLC will need to increase the maximum contract value to accommodate the extended period of performance. The award of the aforementioned four Northeast Nursing MATO contracts (inclusive of a period of performance scheduled to expire 30 September 2017) was made under the pretenses that the new Defense Health Agency (DHA) contracts would be awarded in time to transition the requirements from the Northeast Nursing MATO on 01 October 2017. Given that the DHA contracts were awarded for a period of performance starting 01 December 2017, it was not feasible to transition the Northeast Nursing requirements prior to the original period of performance expiration date of 30 September 2017. Alternatively, NMLC's established plan of action included issuing the aforementioned competitive Northeast Medical MATO solicitation to allow services to begin 01 October 2018. Consistent with this plan of action, the period of performance was extended to align with the start date of the new Northeast Medical MATO. The approval of this justification for approval for other than full and open competition will allow for an increase to the maximum contract value of $13,398,061.26, which represents an increase of approximately 8.8%. As a result, the maximum quantities identified in the aforementioned CLINs 0003, 0004, and 0009 will be increased by 8.8% as identified below: CLIN 0003 Advanced Practice Nurse currently stipulates 327,137 hours. As a result of factoring an 8.8% increase, the new total hours available will be 355,925. CLIN 0004 Nursing currently stipulates 3,207,163 hours. As a result of factoring an 8.8% increase, the new total hours available will be 3,489,393. CLIN 0009 On Call currently stipulates 5,500 hours. As a result of factoring an 8.8% increase, the new total hours available will be 5,984. Without skilled nursing services, the MTFs served by these contractors will not be able to deliver the total scope of care required for them to meet mission requirements. The MTF will need to refer patients out to the Tricare network at a greater cost to the Government. Most importantly, access to care will be delayed, particularly to the Wounded Warriors who depend on the MTFs covered by these contracts for their care. In order to meet known mission requirements and allow for the possibility of additional contract requirements, the maximum contract value and aforementioned CLIN maximum quantities need to be increased. 4. Identification of statutory authority 10 U.S.C. 2304(c)(1): Only one responsible source and no other source of supply or service will satisfy agency requirements. 5. Determination by the ordering activity Contracting Officer that the anticipated cost to the Government will be fair and reasonable. The prices for the services currently being provided were determined fair and reasonable. The contracting officer will use a procedure consistent with the Federal Acquisition Regulations in order to assure a fair and reasonable price is negotiated for contract actions under the Northeast Nursing MATO. 6. Any other fact supporting the justification. Federal Staffing Resources LLC, Loyal Source Government Services LLC, Medtrust LLC, and RAO Radiologists Inc. already have personnel in place to continue providing healthcare services for the remainder of the current Northeast Nursing MATO period of performance that is scheduled to expire 30 September 2018. No other contractors would be able to recruit, submit employee packages and immunization forms, obtain credentialing (as necessary), complete orientation and have their employees in place in order to avoid a lapse in service. Due to the rapidly approaching maximum contract value ceiling associated with the Northeast Nursing MATO, approval of this justification for approval for other than full and open competition is requested. This action is required to establish stop gap measures to provide the required services to meet the existing missions of all affected activities. Federal Staffing Resources LLC, Loyal Source Government Services LLC, Medtrust LLC, and RAO Radiologists Inc. are the only known sources that are able to meet this short fused requirement. 7. Statement of actions to remove of overcome barriers to exception to fair opportunity. The services currently in performance under the Northeast Nursing MATO will transfer to the new competitive Northeast Medical MATO that is currently being solicited effective 01 October 2018.