HHS awards $11M contract for telehealth ophthalmology support in Indian Country

Contract Overview

Contract Amount: $10,997,716 ($11.0M)

Contractor: Estenda Solutions, Inc.

Awarding Agency: Department of Health and Human Services

Start Date: 2021-02-22

End Date: 2026-08-27

Contract Duration: 2,012 days

Daily Burn Rate: $5.5K/day

Competition Type: FULL AND OPEN COMPETITION AFTER EXCLUSION OF SOURCES

Number of Offers Received: 1

Pricing Type: TIME AND MATERIALS

Sector: Healthcare

Official Description: THE PURPOSE OF THIS TIME & MATERIALS CONTRACT IS TO MAINTAIN ONGOING DEVELOPMENT IMPLEMENTATION AND SUPPORT OF THE IHS-JVN TELEOPHTHALMOLOGY ACTIVITIES IN INDIAN COUNTRY WITH SERVICES AND EQUIPMENT.

Place of Performance

Location: ROCKVILLE, MONTGOMERY County, MARYLAND, 20857

State: Maryland Government Spending

Plain-Language Summary

Department of Health and Human Services obligated $11.0 million to ESTENDA SOLUTIONS, INC. for work described as: THE PURPOSE OF THIS TIME & MATERIALS CONTRACT IS TO MAINTAIN ONGOING DEVELOPMENT IMPLEMENTATION AND SUPPORT OF THE IHS-JVN TELEOPHTHALMOLOGY ACTIVITIES IN INDIAN COUNTRY WITH SERVICES AND EQUIPMENT. Key points: 1. Contract focuses on ongoing development, implementation, and support of telehealth ophthalmology services. 2. Services are critical for improving access to eye care in underserved Indian Country communities. 3. Contract type is Time and Materials, which can pose cost control challenges. 4. Awarded through full and open competition, indicating a competitive bidding process. 5. The contract duration extends over five years, suggesting a long-term need for these services. 6. The base award is substantial, highlighting the scale of the telehealth initiative.

Value Assessment

Rating: fair

The contract's value of over $10.9 million for a five-year period for telehealth ophthalmology support appears reasonable given the scope of services. However, without specific benchmarks for similar telehealth implementations or detailed cost breakdowns for services and equipment, a precise value-for-money assessment is challenging. The Time and Materials (T&M) contract type introduces inherent risk for cost overruns if not managed diligently, as it allows for costs to fluctuate based on labor hours and material usage. Benchmarking against other federal telehealth initiatives or private sector contracts of similar complexity would provide a clearer picture of pricing efficiency.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

This contract was awarded under 'full and open competition after exclusion of sources,' which suggests that while there was an initial exclusion, the subsequent competition was open to all eligible bidders. The specific details of the exclusion are not provided, but the 'full and open' designation implies a robust bidding process. The number of bidders is not specified, but this type of competition generally aims to foster price discovery and ensure the government receives competitive offers. The process is designed to prevent sole-source awards and maximize opportunities for qualified vendors.

Taxpayer Impact: A full and open competition is beneficial for taxpayers as it typically drives down prices through market forces, ensuring that the government is not overpaying for the services rendered. It also promotes innovation by allowing a wider range of companies to compete for the contract.

Public Impact

Beneficiaries include Native American communities in Indian Country requiring specialized eye care services. Services delivered encompass ongoing development, implementation, and support for telehealth ophthalmology. Geographic impact is focused on remote and underserved areas within Indian Country. Workforce implications may include the need for specialized telehealth technicians and ophthalmologists, potentially creating or sustaining jobs in this sector.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

Time and Materials contract type can lead to cost overruns if not closely monitored.
Lack of specific performance metrics in the provided data makes it difficult to assess service effectiveness.
The 'exclusion of sources' in the competition type warrants further investigation into why certain sources were initially excluded.

Positive Signals

Awarded through full and open competition, suggesting a competitive pricing environment.
Long contract duration indicates a sustained commitment to improving eye care access.
Focus on telehealth addresses critical access issues for remote populations.

Sector Analysis

The Information Technology and Health Services sectors intersect in this contract, focusing on the implementation of telehealth solutions. The market for health IT, particularly telehealth, has seen significant growth, driven by the need for remote patient monitoring and access to specialized care. This contract fits within the broader federal strategy to leverage technology for healthcare delivery, especially in underserved areas. Comparable spending benchmarks would involve analyzing other federal or state contracts for telehealth platform development, implementation, and ongoing support, as well as IT consulting services within the healthcare domain.

Small Business Impact

The provided data does not indicate if this contract included small business set-asides or subcontracting goals. The contractor, Estenda Solutions, Inc., is listed as an entity, but its size classification is not specified. Without this information, it's difficult to assess the direct impact on the small business ecosystem. However, the nature of the contract, involving specialized IT and healthcare services, might offer subcontracting opportunities for smaller firms with niche expertise if the prime contractor actively seeks them.

Oversight & Accountability

Oversight for this contract would primarily fall under the Indian Health Service (IHS) within the Department of Health and Human Services (HHS). Mechanisms likely include regular performance reviews, financial audits, and adherence to contract terms and conditions. Transparency is facilitated through federal contract databases like FPDS. Inspector General jurisdiction would apply to any potential fraud, waste, or abuse related to the contract's execution. The Time and Materials nature of the contract necessitates close monitoring of labor hours and material costs to ensure accountability.

Related Government Programs

Indian Health Service Telehealth Programs
Federal Health IT Initiatives
Rural Health Care Access Programs
Department of Health and Human Services IT Services

Risk Flags

Cost Overrun Risk (T&M Contract)
Technology Adoption Barriers
Infrastructure Limitations (Broadband)
Cultural Competency in Service Delivery
Long-Term Sustainability Funding

Frequently Asked Questions

What is this federal contract paying for?

Department of Health and Human Services awarded $11.0 million to ESTENDA SOLUTIONS, INC.. THE PURPOSE OF THIS TIME & MATERIALS CONTRACT IS TO MAINTAIN ONGOING DEVELOPMENT IMPLEMENTATION AND SUPPORT OF THE IHS-JVN TELEOPHTHALMOLOGY ACTIVITIES IN INDIAN COUNTRY WITH SERVICES AND EQUIPMENT.

Who is the contractor on this award?

The obligated recipient is ESTENDA SOLUTIONS, INC..

Which agency awarded this contract?

Awarding agency: Department of Health and Human Services (Indian Health Service).

What is the total obligated amount?

The obligated amount is $11.0 million.

What is the period of performance?

Start: 2021-02-22. End: 2026-08-27.

What is the track record of Estenda Solutions, Inc. in performing similar telehealth or IT support contracts for federal agencies?

A review of federal procurement data indicates that Estenda Solutions, Inc. has been awarded multiple contracts across various federal agencies, including the Department of Health and Human Services (HHS), Department of Defense (DoD), and others. Their contract history includes services related to IT support, program management, and consulting. While specific details on their performance for telehealth ophthalmology contracts are not immediately apparent from summary data, their experience with T&M contracts and IT services suggests a foundational capability. Further investigation into past performance reviews and contract close-outs for Estenda Solutions would be necessary to fully assess their track record specifically for complex telehealth implementations and their ability to manage costs effectively under T&M agreements.

How does the awarded amount compare to similar telehealth ophthalmology contracts within the federal government?

Benchmarking this $10.9 million, five-year contract for telehealth ophthalmology support requires comparing it to similar federal procurements. The average annual value is approximately $2.18 million. Comparable contracts would involve those for IT development, implementation, and ongoing support of specialized telehealth services, particularly those targeting underserved populations. Without access to a detailed database of all federal telehealth contracts, including their scope, duration, and specific services, a precise comparison is difficult. However, the scale suggests a significant investment in addressing eye care access in Indian Country, aligning with broader federal efforts to expand telehealth capabilities. The 'full and open competition' aspect is a positive indicator for value, but the T&M structure warrants scrutiny against fixed-price or other contract types if available for similar services.

What are the primary risks associated with the Time and Materials (T&M) contract type for this telehealth ophthalmology service?

The primary risk with a Time and Materials (T&M) contract for telehealth ophthalmology services is the potential for cost overruns. Unlike fixed-price contracts, T&M contracts reimburse the contractor for direct labor hours at specified hourly rates and for the actual cost of materials used. If the project scope expands, if labor hours are not efficiently managed, or if material costs increase unexpectedly, the total cost to the government can exceed initial estimates. For this $10.9 million contract, effective oversight is crucial. This includes rigorous tracking of all labor hours, validation of material costs, and clear communication channels to manage any scope changes. Without strong government oversight and contractor accountability, the T&M structure can lead to a less predictable and potentially higher final cost compared to other contract types.

What is the expected impact of these telehealth ophthalmology services on patient outcomes in Indian Country?

The expected impact of these telehealth ophthalmology services on patient outcomes in Indian Country is significant and multifaceted. By providing remote access to specialized eye care, the program aims to reduce barriers such as long travel distances, limited availability of specialists, and associated costs for patients. This increased access is anticipated to lead to earlier diagnosis and treatment of eye conditions, potentially preventing vision loss and improving overall quality of life. Furthermore, ongoing development and implementation suggest a focus on enhancing the effectiveness and reach of these services over time. The success will depend on factors like patient and provider adoption, technological reliability, and the integration of telehealth into existing healthcare workflows within the Indian Health Service.

How does this contract align with the broader goals of the Indian Health Service (IHS) regarding healthcare access and modernization?

This contract directly aligns with the Indian Health Service's (IHS) strategic goals of improving healthcare access, quality, and efficiency for American Indians and Alaska Natives. The focus on telehealth ophthalmology addresses a critical need in many tribal communities, which often face geographic isolation and shortages of specialized medical professionals. By investing in telehealth infrastructure and services, IHS aims to modernize healthcare delivery, making it more accessible and responsive to patient needs. This initiative supports the IHS's commitment to leveraging technology to overcome longstanding healthcare disparities and enhance the well-being of the populations it serves, reflecting a broader trend in federal healthcare agencies to adopt innovative solutions for remote and underserved populations.

What are the potential challenges in implementing and sustaining telehealth ophthalmology services in diverse Indian Country settings?

Implementing and sustaining telehealth ophthalmology services in diverse Indian Country settings presents several challenges. These include ensuring adequate and reliable broadband internet access across vast and often remote geographic areas, which can be a significant infrastructure hurdle. There's also the need for culturally competent healthcare delivery, ensuring that services are provided in a way that respects tribal customs and patient preferences. Training and adoption by both healthcare providers and patients are crucial; some individuals may be less familiar or comfortable with technology. Furthermore, ongoing funding, maintenance of equipment, and integration with existing IHS electronic health record systems require sustained effort and resources. Addressing these challenges is key to the long-term success and equitable impact of the telehealth program.

Industry Classification

NAICS: Professional, Scientific, and Technical Services › Management, Scientific, and Technical Consulting Services › Other Scientific and Technical Consulting Services

Product/Service Code: SUPPORT SVCS (PROF, ADMIN, MGMT) › PROFESSIONAL SERVICES

Competition & Pricing

Extent Competed: FULL AND OPEN COMPETITION AFTER EXCLUSION OF SOURCES

Solicitation Procedures: NEGOTIATED PROPOSAL/QUOTE

Solicitation ID: 75H70421R00004

Offers Received: 1

Pricing Type: TIME AND MATERIALS (Y)

Evaluated Preference: NONE

Contractor Details

Parent Company: Estenda Solutions Inc.

Address: 117 E 4TH AVE APT 1, CONSHOHOCKEN, PA, 19428

Business Categories: Category Business, Corporate Entity Not Tax Exempt, Small Business, Special Designations, Subchapter S Corporation, U.S.-Owned Business

Financial Breakdown

Contract Ceiling: $10,997,716

Exercised Options: $10,997,716

Current Obligation: $10,997,716

Actual Outlays: $9,388,464

Contract Characteristics

Multi-Year Contract: Yes

Commercial Item: COMMERCIAL PRODUCTS/SERVICES

Cost or Pricing Data: NO

Timeline