Medical Equipment Acquisition for Community Based Primary Care Clinic Initiative

Bruley

New Member
US Army MEDCOM expands services for Healthcare beneficiaries through the development of Community Based Primary Care Clinics...in a neighborhood near you!

US Army policies to attain services and supplies are governed by the Federal Acquisition Regulation (FAR). All purchases are subject to this regulation, regardless of the source of funding or supply, authorization document or dollar threshold. Purchase agents work daily in accordance with the FAR to obtain things the Army needs, from the Government Purchase Card (GPC) Holder in a company supply room to the multi-million dollar Contracting Officer working at the highest level of the Army Materiel Command. Typically these purchases are made as a normal part of ongoing operations. However, it is unusual to be able to observe all levels of acquisition for every manner of supply and service as part of a single initiative within a specific timeframe. Such opportunities are normally limited to newly funded initiatives on a restricted timeline that reach from the most costly pieces of equipment to expendable materials. The Community Based Primary Care Clinic venture fits this description. This is a new concept developed by the US Army Office of the Surgeon General (OTSG) and Medical Command (MEDCOM) to improve access to healthcare by bringing treatment facilities closer to the homes of families. It is in the final stage of development and initial stage of execution and is rich in acquisition examples at every level.

MEDCOM will open 22 Community Based Primary Care Clinics in 14 markets across the Continental US during fiscal year 2011 to improve access to healthcare for military beneficiaries. The OTSG technical consultants built the Table of Distribution and Allowances (TDA) authorizing the mission, personnel, and equipment for each facility. An estimated $2M was identified for each clinic from the Defense Health Program (DHP) budget for the Health Facility Planning Agency (HFPA) in support of initial acquisitions. The levels of procurement are best categorized in three groups; small purchases costing less than $25,000, Capital Expense Equipment Program (CEEP) items costing between $25,000 and $250,000, and Medical Care Support Equipment (MEDCASE) costing more than $250,000.

Before contracting, the HFPA provides the subject matter expertise necessary to develop purchase requests for the clinics. Those requests are sent to the appropriate purchasing agent depending on the cost and nature of the item or service. GPC Holders have been authorized for each clinic to make small purchases of items or services costing up to $25,000, which will be deducted from each clinic’s separate operating budget. CEEP purchases and services costing more than $25,000 but less than $250,000 are being sent to the Health Care Acquisition Activity (HCAA). The HCAA is currently receiving those purchase requests and obligating funds for major equipment items, facility rentals, nurses, physicians and a variety of technicians. The HCAA is also prepared to contract for housekeeping, laundry, linen distribution and regulated medical waste disposal; however, it is possible that such services will be provided by modifying existing contracts in nearby military treatment facilities.

The acquisition of medical equipment costing more than $250,000 per item is managed through the MEDCASE at Medical Command and executed by the US Army Medical Materiel Agency (USAMMA) at Fort Detrick, Maryland. MEDCASE requirements are submitted to USAMMA through the HFPA and are centrally funded by the DHP at MEDCOM, above and beyond the 2 million dollars allocated to each clinic for initial acquisitions. The purchase requests are then sent to the HCAA or an equal contracting office for acquisition. One final aspect of acquisitions for the new Community Based Clinics is the non-medical furnishings authorized for the clinics by the Common Table of Allowances (CTA) 50-909. Clinic Commanders will have approval authority for these buys and are able to use their small purchase agents for requirements under $25,000. Furnishings required for patient contact areas such as waiting rooms, clinician offices, reception areas and so forth are required to provide an aesthetic and pleasant atmosphere and will not be limited by CTA 50-909. Therefore, these purchases are made as needed and in accordance with the appropriate local approval procedures and availability of funds.

As mentioned, all Army purchases are governed by the Federal Acquisition Regulation (FAR) regardless of their funding, authorization or dollar threshold. MEDCOM, like any other Direct Reporting Unit (DRU), typically executes purchases daily at all levels as a normal part of operations. However, the Community Based Primary Care Clinic venture is an unusual opportunity to observe all levels of acquisition as part of a single initiative. The outcome of technicians identifying needed equipment and services for life cycle management and contracting agencies is the timely acquisition of goods and services for our Soldiers and their families. The Community Based Primary Care Clinic will improve access to healthcare by bringing treatment facilities closer to the homes of families, due largely to these acquisitions.

Major Kari Bruley, AN
CGSC-ILE Student

“The views expressed in this medical equipment acquisition article are those of the author and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the U.S. Government.”
 
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