PWS _06152015.pdf

Performance Work Statement (PWS) Mobile MRI Services Phoenix Area Indian Health Service

RFP 15-247-SOL-00074

June 15, 2015

Performance Work Statement (PWS) Table of Contents Section I, Description of Services/General Information

I.1. General

I.2. Background

I.3. Description of Service

I.4. Point of Contact

I.5. Conflict of Interest

I.6. Billing

I.7. Scheduling

I.8. English Language Requirement

I.9. Government Furnished Property and Services

I.10. Contractor Furnished Equipment

I.11. Equipment Maintenance

I.12. Health Requirements

I.13. Staffing

I.14. Validation of Qualifications, Licensure, and Certification

I.15. Quality Control Program (QCP)

I.16. Quality Assurance (QA)

I.17. Federal Holidays

I.18. Personnel Security Requirements

I.19. Physical Security

I.20. Confidentiality of Information

I.21. Housekeeping

I.22. References/Past Performance

I.23. Reporting Requirements

I.24. Pricing

I.25. MRI Study Interpretation

I.26. MRI Data Ownership

I.27. Indemnification and Medical Liability Insurance

I.28. Emergencies on Mobile MRI Unit

I.29. Disruption of MRI Services

I.30. Pre-Operation Provider/PAIHS Test of MRI Operation

Section II, Performance Work Objectives/Standards

RFP 15-247-SOL-00074

Section III, ESBHC Location Specific Requirements III.1. ESBHC General Requirements

III.2. MRI Unit Positioning

III.3. Hours

III.4. ESBHC Minimum Examination Requirements

III.5. ESBHC Minimum Equipment Requirements

III.6. ESBHC MRI Location Photo & Drawing

Section IV, HHCC Location Specific Requirements

IV.1. HHCC General Requirements

IV.2. MRI Unit Positioning

IV.3. Hours

IV.4. HHCC Minimum Examination Requirements

IV.5. HHCC Minimum Equipment Requirements

IV.6. HHCC MRI Location Photo & Drawing

Section V, PIMC Location Specific Requirements

V.1. MRI Unit Positioning

V.2. Hours

V.3. Training

V.4. PIMC Minimum Examination Requirements

V.5. PIMC Minimum Equipment Requirements

V.6. PIMC MRI Location Photo

Section VI, IHSWR Location Specific Requirements VI.1. MRI Unit Positioning

VI.2. Hours

VI.3. Base Year Period of Performance

VI.4. Training

VI.5. IHSWR Minimum Examination Requirements

VI.6. IHSWR Minimum Equipment Requirements

VI.7. ISHWR MRI Location Photo & Drawing

Section VII, Definitions & Acronyms Section VIII, Attachments

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Section IX, Fee/Schedule Pricing IX.1. Base Year

IX.2. Option Year 1

IX.3. Option Year 2

IX.4. Option Year 3

IX.5. Option Year 4

RFP 15-247-SOL-00074

Performance Work Statement (PWS)

SECTION I

DESCRIPTION OF SERVICES/GENERAL INFORMATION

1. GENERAL: The Phoenix Area Indian Health Service (PAIHS) Office in Phoenix, Arizona, oversees the delivery of health care to approximately 140,000 Native American users in the tristate area of Arizona, Nevada, and Utah. Through ten Service Units including two Youth Regional Treatment Centers, and a network of heath care facilities, we are a health care partner to over forty tribes.

Our Area Office is based in Phoenix, Arizona. Our system of care includes Indian Health Service (IHS) and tribally-operated health care facilities that serve tribal communities as well as three Urban Indian health programs. These services are comprehensive and range from primary care (inpatient and outpatient) to tertiary care and specialty services.

2. BACKGROUND: The PAIHS currently has a variety of different contracts in place used to provide Mobile Magnetic Resonance Imaging Services (MRI) at several different geographical locations throughout the PAIHS area. The PAIHS seeks to create an area-wide contract for the locations listed below:

2.1 Elko Southern Bands Health Center (ESBHC)

515 Shoshone Circle Schurz, NV 89427

2.2 Hopi Health Care Center (HHCC)

Hwy 264, Mile Marker 388 Polacca, AZ 86042

2.3 Phoenix Indian Medical Center (PIMC)

4212 N 16th Street Phoenix, AZ 85016

2.4 Whiteriver PHS Indian Hospital (IHSWR)

200 W. Hospital Dr.

Whiteriver, AZ 85941

Resultant contract will be non-personal in nature, as defined by FAR 31.101, and as such, will be provided independent of Government supervision.

3. DESCRIPTION OF SERVICE: The contractor shall provide all supervision, labor, parts, materials, tools, supplies (with the exception of Government furnished supplies listed in paragraph I.10.), maintenance, and equipment necessary to provide Mobile Magnetic Resonance Imaging (MRI) units and qualified technical staff to operate the MRI scanners and equipment. The contractor shall be responsible for performing a variety of MRI examinations for government beneficiaries in the PAIHS area at four (4) different geographic locations as detailed in section I.2. above.

The contractor shall obtain and maintain all required Federal, State, and Local licenses associated with the operation/transportation of the equipment and performance of the services being requested.

Contractor shall maintain all Federal and State licenses required for possession and operation of equipment.

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Performance shall be according to the Performance Work Statement (PWS) and supporting documents and shall also conform with:

3.1 The Accreditation Association for Ambulatory Health Care (AAAHC);

3.2 Health Insurance Portability and Accountability Act (HIPPA);

3.3 Infection Control, National Fire Protection Association (NFPA);

3.4 Health Service Inspection (HSI);

3.5 Centers for Medicaid and Medicare Services (CMS);

3.6 The Joint Commission (TJC);

3.7 Indian Health Service (IHS) standards and,

3.8 The American College of Radiology (ACR).

4. POINT OF CONTACT: The contractor will provide a Point of Contact (POC) who will be available via the telephone Monday through Friday, 0700 to 1700, excluding Federal holidays and scheduled down days.

4.1 The POC shall be responsible for the performance of the work.

4.2 The POC shall have full authority to act for the contractor on all matters relating to daily operations.

4.3 The contractor shall designate this individual, in writing, to the Contracting Officer (CO) before the contract start date.

4.4 An alternate may be designated, but the contractor shall identify those times when the alternate will be the primary point of contact.

5. CONFLICT OF INTEREST: The contractor shall not employ any person who is an employee of the United States Government if the employment of that person would create a conflict of interest.

6. BILLING: Contractor shall sign authorization giving the Government permission to bill for all patient and 3rd party billing.

7. SCHEDULING: The Government shall provide scheduling for patient exams.

8. ENGLISH LANGUAGE REQUIREMENT: The health care workers(s) shall read, understand, speak, and write English fluently.

9. GOVERNMENT-FURNISHED PROPERTY AND SERVICES

9.1 GENERAL: The government will provide all direct patient care medical supplies. These include, but are not limited to, contrast materials, syringes, IV tubing, oxygen masks and tubing, needles, emesis basins, gowns, and other similar direct patient care items.

9.2 EQUIPMENT: The government will provide a telephone line, utilities (power supply), internet connectivity, network connection to hospital or clinic network, MRI pad, and parking.

10. CONTRACTOR FURNISHED EQUIPMENT: Mobile MRI scanner shall include a ramp and/or a lifting device for non-walking patients. Services shall include equipment maintenance, (scheduled and unscheduled) and required supplies necessary to perform services detailed herein. Contractor shall also be responsible for the control of waste management and proper disposal of all waste materials.

Equipment shall include, but not be limited to, a fully equipped MRI (see Section III for location specific specifications). Contractor shall submit an equipment specification list of all equipment by location, including the MRI unit(s) with contractor’s signed quote. Contractor shall provide all equipment service records upon request.

RFP 15-247-SOL-00074

Include name of manufacturer, model number, manufacturer’s brochures cut sheets, equipment specifications and all pertinent data with offer. All equipment to be used will be FDA approved imaging equipment placed at a location designated by the COR/PM at each of the locations listed in Section I.2. MRI equipment shall include the following:

10.1 MRI pads and restraints

10.2 MRI compatible nonferrous wheelchair and stretcher with IV pole (gurney)

10.3 Nonferrous oxygen cylinder

10.4 Capability to provide patient exam on CD

10.5 Dressing and storage areas

10.6 MRI license for PACS

10.7 Interface between MRI scanner and PACS, Dicom print, store and worklist

10.8 Optical disk archival device compatible with PACS

10.9 Code kit and code call button

10.10 MRI compatible 02 saturation monitor

10.11 Contrast media and warmer

10.12 MRI compatible power injector

11. EQUIPMENT MAINTENANCE: Contractor shall perform Preventative Maintenance (PM) as recommended by the original equipment manufacturer (OEM) and repairs for both the MRI System and the Mobile Unit. The Mobile Unit includes, but is not limited to, generator, MRI contrast injector, air conditioning/heating systems, and patient lift.

11.1 Contractor shall provide a service contact and phone number for hospital/clinic employees to call in the event of equipment failures.

11.2 Contractor shall have phone response within 1 hour and onsite service within 24 hours for the MRI System and 24 hours for Mobile Unit.

11.3 Contractor shall perform initial set-up and annual Physicist review as required per TJC and the ACR and provide copies of the review to the Government including, but not limited to:

11.3.1 Image uniformity for all coils

11.3.2 Signal-to-noise for all coils

11.3.3 Slice thickness accuracy

11.3.4 Slice position accuracy

11.3.5 Alignment light accuracy

11.3.6 High-contrast resolution

11.3.7 Contrast-to-noise ratio

11.3.8 Geometric accuracy

11.3.9 Magnetic field homogeneity, 11.3.10Artifact evaluation 11.3.11Proper function/performance of display monitors (luminance max/min, uniformity, resolution and spatial accuracy.)

12. HEALTH REQUIRMENTS:

12.1 Immunizations: Maintain all immunizations required of practicing medical professionals, and work in a professional manner at all times. Before start of work, health care workers shall provide proof of immunization from the following diseases according to CDC guidelines: Hepatitis B, measles, mumps, rubella, varicella, and influenza. The health care worker shall also provide proof of a negative TB skin test within 12 months (if positive, proof of negative chest X-ray within 12 months) prior to start of work.

12.2 Grooming and Hygiene: Contractor personnel shall present a clean, neat appearance and be

RFP 15-247-SOL-00074

easily recognized as contractor employees. Contractor personnel will not be allowed to wear fake nails due to infection control guidelines.

13. STAFFING: Provider shall be solely responsible for all driver-staffing issues related to set-up and operation of the systems. Provider shall perform arrival, set-up, take-down, and departure of mobile systems in a manner that causes limited or no disruption to normal operations at the locations listed in Section I.2. of the PWS. Provider shall perform arrival and departure such that the MRI unit operates full days on days scheduled. Appropriate arrival and departure schedules shall be developed such that the MRI unit is fairly accommodated regarding its operation.

13.1 Provider shall be solely responsible for all technologist-staffing issues related to operation of the mobile systems.

13.2 Provider is responsible for cleaning of mobile units and for disposal of trash in a responsible manner.

13.3 Contractor’s technologists shall be registered and in compliance of the American Registry of

Radiological Technologists Magnetic Resonance Imaging (ARRT) (MRI) or American Registry of Magnetic Resonance Imaging technologists (ARMRIT).

13.3.1 All MRI technologists working in the MRI unit shall be Basic Life Support (BLS) certified and remain current in BLS training. Copies of certifications shall be kept in personnel training record for periodic review.

13.3.2 All MRI technologists are required to attend Government orientation before providing direct patient care.

13.3.3 Contractor will be solely responsible for all technologist-staffing responsibilities, except patient scheduling related to operation of the mobile systems.

13.4 Contractor personnel shall be not be considered Government employees for any purposes.

13.5 The contractor is required to check the Health and Human Services-Office of Inspector General

(HHS/OIG), list of Excluded Individuals/Entities on the OIG website: www.hhs.gov/oig for each person providing services under this contract to ensure that individuals providing services under the contract have not engaged in fraud or abuse of Section 1128/A of the Social Security Act regarding Federal health care programs. Contractor shall certify that persons listed in Contractor’s proposal have been checked against the HHS/OIG list and are not on the list. During the performance of this contract the contractor shall not use any individual or business listed on the list of Excluded Individuals/Entities.

13.6 Contractor is required to maintain applicable insurance policies commensurate with normal business practices and as required by Federal/State/Local laws.

14. VALIDATION OF QUALIFICATIONS, LICENSURE, AND CERTIFICATIONS (as applicable): Contractor shall provide written verification/documentation of technologist’s credentials/certification with offer.

14.1 Education

14.2 Training

14.3 Experience

14.4 Licensure

14.5 Current Basic Life Support (BLS)

14.6 Continuing Medical Education (CME) Requirements. Health care workers, licensed, registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. CME shall be obtained at no additional cost to the Government and shall be reported to the COR/PM annually on the first normal duty day in January for the previous calendar year.

http://www.hhs.gov/oig

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15. QUALITY CONTROL PROGRAM (QCP): The contractor shall develop and maintain an effective QCP to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services.

The contractor’s QCP is the means by which it assures that work will be in compliance with the contract requirements. This QCP is part of the evaluation of proposals.

16. QUALITY ASSURANCE (QA): The government shall evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan (QASP). This plan is primarily focused on what the Government must do to ensure that the contractor performs in accordance with the contract performance standards. The QASP defines how the performance standards will be applied, the frequency of surveillance, and the minimum acceptable defect rate(s).

17. FEDERAL HOLIDAYS - There are ten (10) federal holidays each year. When a holiday falls on a Saturday, it is observed on Friday. When a holiday falls on a Sunday, it is observed on Monday. Federal holidays:

17.1 New Year’s Day (observed 1 January);

17.2 Martin Luther King, Jr’s Birthday (observed the third Monday in January);

17.3 President’s Day (observed the third Monday in February);

17.4 Memorial Day (observed the fourth Monday in May);

17.5 Independence Day (observed 4 July);

17.6 Labor Day (observed the first Monday in September);

17.7 Columbus Day (observed the second Monday in October);

17.8 Veterans Day (observed 11 November);

17.9 Thanksgiving Day (observed the fourth Thursday in November);

17.10 Christmas Day (observed 25 December)

18. PERSONNEL SECURITY REQUIREMENTS: Contractor personnel performing work under this contract must be fingerprinted, background checked, and cleared before performing on-site direct patient care.

19. PHYSICAL SECURITY: The contractor shall be responsible for safeguarding all Government equipment, information, and property provided for contractor use. At the close of each work period, Government facilities, equipment, and materials shall be secured.

19.1 KEY CONTROL: The Contractor shall establish and implement methods of ensuring all keys/key cards issued to the Contractor by the Government are not lost or misplaced and are not used by unauthorized person (note: all references to keys includes key cards).

19.1.1 No keys issued to the Contractor by the Government shall be duplicated.

19.1.2 The Contractor shall develop procedures covering key control that shall be included in the

QCP. Such procedures shall include turn-in of any issued keys by personnel who no longer require access to locked areas.

19.1.3 The Contractor shall immediately report any occurrences of lost or duplicate keys to the Government COR/Project Manager (PM), and Contracting Officer (CO).

19.1.4 In the event keys, other than master keys, are lost or duplicated, the Contractor shall, upon direction of the Contracting Officer, re-key or replace the affected lock or locks; however, the Government, at its option, may replace the affected lock or locks or perform re-keying.

When the replacement of locks or re-keying is performed by the Government, the total cost of re-keying or the replacement of the lock or locks shall be deducted from the monthly payment due the Contractor.

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19.1.5 In the event a master key is lost or duplicated, all locks and keys for that system shall be replaced by the Government and the total cost deducted from the monthly payment due the Contractor.

19.1.6 The Contractor shall prohibit the use of Government issued keys by any persons other than the Contractor’s employees. The Contractor shall prohibit the opening of locked areas by Contractor’s employees to permit entrance of persons other than Contractor’s employees engaged in the performance of assigned work in those areas, or personnel authorized entrance by the Contracting Officer.

19.1.7 Lock Combinations: The Contractor shall establish and implement methods of ensuring that all lock combinations are not revealed to unauthorized persons. The Contractor shall ensure that lock combinations are changed when personnel having access to the combinations no longer have a need to know such combinations. These procedures shall be included in the Contractor’s QCP.

20. CONFIDENTIALITY OF INFORMATION: Unless otherwise specified, all financial, statistical, personnel, and/or technical data which is furnished, produced or otherwise available to the contractor or health care worker during the performance of this contract are considered Government confidential business information and shall not be used for purposes other than performance of work under this contract. The contractor and/or the health care worker shall not release any of the above information without prior written consent of the Contracting Officer. All medical records, scans, and reports remain the property of the Government.

20.1 PATIENT LISTS: No matter how developed, patient lists shall be treated as confidential information in accordance with the Privacy Act and the Health Insurance Portability and Accountability Act (HIPAA). Lists and/or names of patients shall not be disclosed to or revealed in any way for any use outside the PAIHS, except through PAIHS specified processes.

20.2 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) of 1996: All individuals performing services are required to complete initial and annual refresher HIPAA Privacy and Security training and will be held accountable for complying with health information privacy and security policies and procedures.

20.3 Contractor is required to maintain the confidentiality of patient records IAW the Privacy Act, Title 5, U.S.C. 552a, Title 38 U.S.C. 5701, 5705, and 7362.

21. HOUSEKEEPING: Contractor shall be responsible for the overall housekeeping inside of the unit including, but not limited to, removal and proper disposal of all debris on a daily basis or as often as necessary to maintain a sanitized and neat environment. Contractor will dispose of waste in appropriate Hospital receptacles.

22. REFERENCES/PAST PERFORMANCE: Contractor shall provide a minimum of three references for MRI services performed within the last five (5) years at government facilities with offer. Must provide brief description of work performed, location of work performed, and name, title, phone number, and email address of references.

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23. REPORTING REQUIREMENTS:

Report

Description # of Copies

Recipient Due Date

1 Quality Control 1 COR Quarterly 2 Equipment Maintenance Log 1 COR Quarterly 3 Personnel Licensure 1 COR 10 days prior to start of contract or new employee start date.

4 Required Accreditations 1 COR Annually 5 Liability Insurance 1 COR Annually

24. PRICING: Pricing shall be for an all-inclusive monthly rate. Detailed pricing schedule shall be included with offer for the Base period and 4 option years. Offerors are required to use the pricing schedule located in Section IX of the PWS.

25. MRI STUDY INTERPRETATION: The PAIHS will be responsible for reading/interpreting all MRI studies and dictation of all required study reports.

26. MRI DATA OWNERSHIP: The PAIHS will own solely the data of the studies performed on the mobile MRI under the contract

27. INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE: The Contractor shall provide and maintain adequate liability coverage consistent with the risks associated with the performance of all services required by this PWS. A certificate of insurance evidencing the required coverage shall be provided to the Contracting Officer prior to the commencement of services under this contract. Minimum liability insurance will be one million per occurrence, three million aggregate.

28. EMERGENCIES ON MOBILE MRI UNIT: A crash cart will be appropriately located within each of the locations listed in Section I.2. The mobile provider will provide written emergency plans addressing emergencies such as patient coded, personal injury, fire, and disruptive behavior.

29. DISRUPTION OF MRI SERVICES: The MRI mobile provider will communicate to the COR/PM any possible and actual disruptions of MRI services. Upon becoming aware of possible or actual disruption of MRI service, the provider will communicate such service-disruption information to the COR/PM as soon as possible (ASAP). Provider will inform the COR/PM in a timely manner so the patient and service schedule can be appropriately modified with as little inconvenience as possible to patients and services. Contractor will reimburse the Government for downtime per month at the PIMC and IHSWR locations prorated based on scheduled clinic hours divided by actual clinic hours equals percent of performance. Contractor will reschedule the MRI Services for the HHCC and ESBHC within 7 (seven) work days from disruption date.

30. PRE-OPERATION PROVIDER/PAIHS TEST OF MRI OPERATION: Provider and Government personnel will conduct a test of the MRI system and the links to PAIMC equipment at each location a minimum of one week before the date of the first scheduled patients. The test will be performed to insure that the system is working properly and to insure that it is functioning to provide services as, when, and how required per the PWS and supporting documents.

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SECTION II

PERFORMANCE WORK OBJECTIVES/STANDARDS

Performance Requirements Summary: The contractor service requirements are summarized into performance objectives that relate directly to mission essential items. The performance threshold briefly describes the minimum acceptable levels of service required for each requirement. These thresholds are critical to mission success.

Performance Objective

(The Service required -usually a shall statement)

Performance Standard Performance Threshold

(This is the maximum error rate. It could possibly be "Zero deviation from standard")

Method of Surveillance

PRS #1. The contractor shall provide on-site MRI scanner and technical support

The contractor provided on site MRI scanner and technologists to provide the scans.

The scanner and technologist will be available for services 95% of the time

Monthly stats. % uptime is number of clinical hours performed divided by scheduled Clinical hours in the month.

PRS #2. The contractor will provide quality customer service

Validated customer complaints

No more than one validated customer complaint per 6 month time period

*Validated customer complaints from providers and patients.

PRS #3. The contractor will provide quality MRI images and exams

All MRI study/exams will be high quality excluding factors not under technical control i.e. patient was non-compliant

No more than one validated low quality study/exam per month

**Validated complaint from Radiologist or orthopedic surgeon.

PRS #4. Adhere to HIPPA requirements

Within acceptable standards

Zero deviation from standard

Subject to contract termination

PRS #5. Complete scheduled scans daily

Daily Complete scheduled daily scans at a rate > 98%

Monitored by COR/PM

* Validated Customer Complaint: Complaints must be validated. Complaints are validated if found to be reasonable and true after an administrative investigation.

**Validated complaint from Radiologist or orthopedic surgeon: Complaints are validated if found to be reasonable and true after an administrative investigation Defective or low quality MRI scans are limited to image quality issues under the technologists control such as proper sequencing protocols, positioning and demonstration of attempts to resolve poor quality studies. Complaints are validated if found to be reasonable and true after an administrative investigation.

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SECTION III

ESBHC LOCATION SPECIFIC REQUIREMENTS

1. ESBHC GENERAL REQUIRMENTS: The contractor will provide the MRI unit 18 (eighteen) days per year as follows: One (1) regularly scheduled day per month with the remaining six (6) days scheduled as required to meet patient needs. Scheduling of the six additional days will be coordinated in advance with the contractor.

2. MRI UNIT POSITIONING: The MRI unit will be positioned at the ESBHC Medical Facility located at

515 Shoshone Circle, Elko, NV 89801 (see ESBHC MRI Location Photo and Drawing).

3. HOURS: Scanning of the first patient is to begin by 0800 and completion of the last patient by 1700, AZ

Time. The registered MRI technologist, or a vendor-provided support person, will present to the Imaging Department, collect and transport the patient to and from the scanner. Most patients will be ambulatory, however, use of a wheelchair might be required.

3.1 Scheduling and initial screening of the patient will be performed by the ESBHC Imaging staff in accordance with vendor procedure.

4. ESBHC Minimum Examination Requirements See “Scan Requirements” spreadsheet, ESBHC worksheet.

5. ESBHC MINIMUM EQUIPMENT REQUIRMENTS:

5.1 General Requirements

5.1.1 Estimated patients per month is 15 (fifteen).

5.1.2 On occasion, the scanner is required a second day in the month

5.1.3 Images must be sent from the scanner to the Imaging Department’s PACs system for pushing to the interpreting radiologists. Vendor will comply with protocols consistent with the radiologist requirements and respond to any issue deemed related to quality of image acquisition or performance of exams.

5.2 Minimum Equipment Requirements

5.2.1 Description/Configuration: Siemens, Espree 1.5T Mobile MRI System (or equal)

5.2.2 Wide bore

5.2.3 Patient table accommodates patient a minimum weight of 350 lbs

5.2.4 Dicom 3.0 Compliant

5.2.5 Dicom print

5.2.6 Dicom Store

5.2.7 Worklist

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6. ESBHC MRI Location Photo

To be provided via Amendment.

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SECTION IV

HHCC LOCATION SPECIFIC REQUIREMENTS

1. HHCC GENERAL REQUIRMENTS: The contractor will provide the MRI unit 18 (eighteen) days per year as follows: One (1) regularly scheduled day per month with the remaining six (6) days scheduled as required to meet patient needs. Scheduling of the six additional days will be coordinated in advance with the contractor.

2. MRI UNIT POSITIONING: The MRI unit will be positioned at the HHCC Medical Facility loading dock, located at Hwy 264, Mile Marker 388, Polacca, AZ 86042 (see HHCC MRI Location Photo and Drawing).

3. HOURS: Scanning of the first patient is to begin by 0800 and completion of the last patient by 1700, AZ

Time. The registered MRI technologist, or a vendor-provided support person, will present to the Imaging Department, collect and transport the patient to and from the scanner. Most patients will be ambulatory, however, use of a wheelchair might be required.

3.1 Scheduling and initial screening of the patient will be performed by the HHCC Imaging staff in accordance with vendor procedure.

4. HHCC Minimum Examination Requirements See “Scan Requirements” spreadsheet, HHCC worksheet.

5. HHCC MINIMUM EQUIPMENT REQUIRMENTS:

5.1.4 Estimated patients per month is 15 (fifteen).

5.1.5 On occasion, the scanner is required a second day in the month

5.1.6 Images must be sent from the scanner to the Imaging Department’s PACs system for pushing to the interpreting radiologists. Vendor will comply with protocols consistent with the radiologist requirements and respond to any issue deemed related to quality of image acquisition or performance of exams.

5.2 Minimum Equipment Requirements

5.2.8 Description/Configuration: Siemens, Espree 1.5T Mobile MRI System (or equal)

5.2.9 Wide bore

5.2.10 Patient table accommodates patient a minimum weight of 350 lbs

5.2.11 Dicom 3.0 Compliant

5.2.12 Dicom print

5.2.13 Dicom Store

5.2.14 Worklist

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6. HHCC MRI Location Photo

To be provided via Amendment.

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SECTION V

PIMC LOCATION SPECIFIC REQUIREMENTS

1. MRI UNIT POSITIONING: The contractor will provide the MRI unit on a fulltime basis. The MRI unit will be positioned at the PIMC Medical Facility located at 4212 N. 16th St, Phoenix, AZ 85016 on the MRI pad (see PIMC MRI Location Photo).

2. HOURS: Duty hours will vary from 0800-1630 AZ Time depending on the patients scheduled. See section 17 for a list of Federal holidays. Overtime and holiday pay are not authorized under this contract. Deviation from normal operating hours shall be agreed upon between the contractor and government point of contact 48 hours in advance.

3. TRAINING: Contractor will be required to train PIMC radiology ARRT technologists to operate the MRI scanner and ancillary equipment if requested by PIMC.

4. PIMC Minimum Examination Requirements

See “Scan Requirements” spreadsheet, PIMC worksheet.

5. PIMC MINIMUM EQUIPMENT REQUIREMENTS:

5.1.1 The contractor will provide a wide bore, mobile 1.5 T Magnetic Resonance Imaging (MRI) unit with auto-shim meeting the minimum specifications as described herein. Trailer shall have a separate area included within the trailer for a patient changing area.

5.1.2 The unit should be set up for 3 phase, 480volt/200 amperes service;

5.1.3 The contractor will provide coils for routine examinations, including but not limited to:

5.1.3.1 Abdominal /Pelvic exams

5.1.3.2 Spine exams

5.1.3.3 Head exams

5.1.3.4 Soft tissue neck

5.1.3.5 Magnetic Resonance Angiography(MRA) exams excluding heart

5.1.3.6 Magnetic Resonance Cholangiopancreatography (MRCP)

5.1.3.7 Musculoskeletal exams (shoulder and wrist coils)

5.1.3.8 Breast imaging (breast coil)

5.1.4 Images must be sent from the scanner to the Imaging Department’s PACs system for pushing to the interpreting radiologists. Vendor will comply with protocols consistent with the radiologist requirements and respond to any issue deemed related to quality of image acquisition or performance of exams.

5.2 Minimum Equipment Requirements:

5.2.1 GE HD 12.0, 8 channel 1.5T Mobile MR System (or equal)

5.2.2 Magnet, closed, wide bore

5.2.3 Patient Bore minimum size is 70 cm

5.2.4 Patient table accommodates patient a minimum weight of 400 lbs

5.2.5 Variable table height from 26 inches to 38 inches

5.2.6 Minimum 8 channel coil technology

5.2.7 High performance Gradient Subsystem

5.2.8 Gradient strength minimum of 27 mT/m

5.2.9 Minimum Slew rate is 100 T/M/s

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5.2.10 Variable FOV from 2 cm to 48 cm

5.2.11 Dicom 3.0 Compliant

5.2.12 2D Spin Echo (SE), 2D Inversion Recovery (IR), 2D and 3D Gradient Echo (GRE), 2D/3D

Spoiled Gradient Recalled (SPGR), 23D/3D Fast Spin Echo, Fast Spin Echo XL, 2D/3D Fast Gradient Echo (FGRE), 2D/3D Fast spoiled Gradient Echo (FSPGR), Cine, Fast Flair, EPI, IVI, 3D Surface Rendering and ClairView.

5.2.13 2D/3D Time of Flight Angiography (TOF)

5.2.14 2D/3D Phase Contrast MR Angiography

5.2.15 High b-Valve DWI

5.2.16 SmartPrep 2000 including automated triggering

5.2.17 Single Shot diffusion Weighted Imaging

5.2.18 MIP, MPR, DWI Processing Software

5.2.19 Quadrature Extremity and Foot Coil

5.2.20 8 channel Phased Array CTL Spine Coil

5.2.21 Phased Array Shoulder Coil Set, small and large

5.2.22 8 channel Phased Array Torso Array Coil

5.2.23 8 channel Phased Array Head Coil

5.2.24 Breast Coil

5.2.25 Dicom print

5.2.26 Dicom Store

5.2.27 Worklist

RFP 15-247-SOL-00074

6. PIMC MRI Location Photo

RFP 15-247-SOL-00074

SECTION VI

IHSWR LOCATION SPECIFIC REQUIREMENTS

1. MRI UNIT POSITIONING: The contractor will provide the MRI unit on a fulltime basis. The MRI unit will be positioned at the IHSWR Medical Facility located at 200 W. Hospital Drive, Whiteriver, AZ 85941 on the MRI pad (See IHSWR MRI Location Photos and Drawing).

2. HOURS: Duty hours will be from 0800-1700. See section 17 for a list of Federal holidays. Overtime and holiday pay are not authorized under this contract. Deviation from normal operating hours shall be agreed upon between the contractor and government point of contact 48 hours in advance. Contractor will reimburse the Government for downtime per month, prorated based on percentage uptime. Percentage uptime is the number of clinical hours performed divided by scheduled Clinical hours in the month.

3. BASE YEAR PERIOD OF PERFOMANCE: 09/01/2015-07.31/2016

4. TRAINING: Contractor will be required to train IHSWR radiology ARRT technologists to operate the MRI scanner and ancillary equipment if requested by IHSWR.

5. IHSWR Minimum Examination Requirements

See “Scan Requirements” spreadsheet, IHSWR worksheet.

6. IHSWR MINIMUM EQUIPMENT REQUIREMENTS:

6.1 General Requirements

6.1.1 The contractor will provide a mobile 1.5 T Magnetic Resonance Imaging (MRI) unit with auto-shim meeting the minimum specifications as described herein. Trailer shall have a separate area included within the trailer for a patient changing area.

6.1.2 The unit should be set up for 3 phase, 480volt/200 amperes service;

6.1.3 The contractor will provide coils for routine examinations, including but not limited to:

6.1.3.1 Abdominal /Pelvic exams

6.1.3.2 Spine exams

6.1.3.3 Head exams

6.1.3.4 Soft tissue neck

6.1.3.5 Magnetic Resonance Angiography(MRA) exams excluding heart

6.1.3.6 Musculoskeletal exams (shoulder and wrist coils)

6.1.3.7 Breast imaging (breast coil)

6.2 Minimum Equipment Requirements:

6.2.1 GE HD 12.0, 8 channel 1.5T Mobile MR System (or equal)

6.2.2 Open short Bore Magnet with Dual Flared Enclosures

6.2.3 Patient Opening of not less than60 cm

6.2.4 Patient Bore minimum size is (L xW x H) 70 cm x 60 cm x 60 cm

6.2.5 Patient table accommodates patient a minimum weight of 350 lbs

6.2.6 Variable table height from 26 inches to 38 inches

6.2.7 Minimum 8 channel coil technology

6.2.8 High performance Gradient Subsystem

6.2.9 Gradient strength minimum of 27 mT/m

6.2.10 Minimum Slew rate is 100 T/M/s

6.2.11 Variable FOV from 2 cm to 48 cm

RFP 15-247-SOL-00074

6.2.12 Dicom 3.0 Compliant

6.2.13 2D Spin Echo (SE), 2D Inversion Recovery (IR), 2D and 3D Gradient Echo (GRE), 2D/3D

Spoiled Gradient Recalled (SPGR), 23D/3D Fast Spin Echo, Fast Spin Echo XL, 2D/3D Fast Gradient Echo (FGRE), 2D/3D Fast spoiled Gradient Echo (FSPGR), Cine, Fast Flair, EPI, IVI, 3D Surface Rendering and ClairView.

6.2.14 2D/3D Time of Flight Angiography (TOF)

6.2.15 2D/3D Phase Contrast MR Angiography

6.2.16 High b-Valve DWI

6.2.17 SmartPrep 2000 including automated triggering

6.2.18 Single Shot diffusion Weighted Imaging

6.2.19 MIP, MPR, DWI Processing Software

6.2.20 Quadrature Extremity and Foot Coil

6.2.21 8 channel Phased Array CTL Spine Coil

6.2.22 Phased Array Shoulder Coil Set, small and large

6.2.23 8 channel Phased Array Torso Array Coil

6.2.24 8 channel Phased Array Head Coil

6.2.25 Dicom print

6.2.26 Dicom Store

6.2.27 Worklist

RFP 15-247-SOL-00074

7. IHSWR MRI Location Photos and Drawing

Photo 1, IHSWR MRI Site

Photo 2, IHSWR MRI Site

RFP 15-247-SOL-00074

IHSWR MRI Location Drawing

RFP 15-247-SOL-00074

SECTION VII

DEFINITIONS & ACRONYMS

1. DEFINITIONS AND ACRONYMS:

1.1 DEFINITIONS:

1.1.1 CONTRACTOR A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.

1.1.2 CONTRACTING OFFICER. A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

1.1.3 CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S.

Government appointed by the contracting officer to administer the contract. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

1.1.4 DEFECTIVE SERVICE. A service output that does not meet the standard of performance associated with the Performance Work Statement.

1.1.5 DELIVERABLE. Anything that can be physically delivered, but may include non-manufactured things such as meeting minutes or reports.

1.1.6 KEY PERSONNEL. Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the Key Personnel listed in the PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

1.1.7 PHYSICAL SECURITY. Actions that prevent the loss or damage of Government property.

1.1.8 QUALITY ASSURANCE. The government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

1.1.9 QUALITY ASSURANCE Surveillance Plan (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

1.1.10 QUALITY CONTROL. All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements.

1.1.11 SUBCONTRACTOR. One that enters into a contract with a prime contractor. The Government does not have privity of contract with the subcontractor.

1.1.12 WORK DAY. The number of hours per day the Contractor provides services in accordance with the contract.

1.1.13 WORK WEEK. Monday through Friday, unless specified otherwise.

1.2 ACRONYMS:

ACOR Alternate Contracting Officer's Representative HHSAR Health & Human Services FAR Supplement ARRT American Registry of Radiologic Technologists ArMRIT American Registry of Magnetic Resonance Imaging Technologists CCE Contracting Center of Excellence CFR Code of Federal Regulations CONUS Continental United States (excludes Alaska and Hawaii) COR Contracting Officer Representative

RFP 15-247-SOL-00074

COTR Contracting Officer's Technical Representative COTS Commercial-Off-the-Shelf FAR Federal Acquisition Regulation HIPAA Health Insurance Portability and Accountability Act of 1996 KO Contracting Officer MRI Magnetic Resonance Imaging OCI Organizational Conflict of Interest OCONUS Outside Continental United States (includes Alaska and Hawaii) ODC Other Direct Costs PIPO Phase In/Phase Out PM Project Manager POC Point of Contact PRS Performance Requirements Summary PWS Performance Work Statement QA Quality Assurance QAP Quality Assurance Program QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Program TE Technical Exhibit TJC The Joint Commission

RFP 15-247-SOL-00074

SECTION VIII

ATTACHMENTS

1. Scan Requirements Spreadsheet

2. WD, ESBHC

3. WD, HHCC, PIMC, & IHSWR

4. AZ State Tax Exemption

5. NV State Tax Exemption

6. RFI Form

RFP 15-247-SOL-00074

SECTION IX

FEE /SCHEDULE PRICING

The following shall be the fee schedule for the contract period. The cost shall be inclusive of six

(6) acquisitions per exam and all associated costs, excluding training.

1. BASE YEAR

ESBHC

Item Rate Unit Monthly Cost

Total Annual Cost

MRI Services Flat Monthly Rate

LS $ $

HHCC

Item Rate Unit Monthly Cost

Total Annual Cost

MRI Services Flat Monthly

PIMC

Cost

Total Annual Cost

MRI Services Flat Monthly

IHSWR

Cost

Total Annual Cost

MRI Services Flat Monthly

RFP 15-247-SOL-00074

2. OPTION YEAR 1

Item Rate Unit Monthly Cost

Total Annual Cost

MRI Services Flat Monthly

Cost

Total Annual Cost

MRI Services Flat Monthly

Cost

Total Annual Cost

MRI Services Flat Monthly

Cost

Total Annual Cost

MRI Services Flat Monthly

RFP 15-247-SOL-00074

3. OPTION YEAR 2

Cost Total Annual

Cost MRI Services Flat Monthly

Cost

Total Annual Cost

MRI Services Flat Monthly

Cost

Total Annual Cost

MRI Services Flat Monthly

Cost

Total Annual Cost

MRI Services Flat Monthly

RFP 15-247-SOL-00074

4. OPTION YEAR 3

Cost Total Annual

Cost MRI Services Flat Monthly

Cost

Total Annual Cost

MRI Services Flat Monthly

Cost

Total Annual Cost

MRI Services Flat Monthly

Cost

Total Annual Cost

MRI Services Flat Monthly

RFP 15-247-SOL-00074

5. OPTION YEAR 4

Item Rate Unit Monthly Cost

Total Annual Cost

MRI Services Flat Monthly

Cost

Total Annual Cost

MRI Services Flat Monthly

Cost

Total Annual Cost

MRI Services Flat Monthly

Cost

Total Annual Cost

MRI Services Flat Monthly