2.2.1_Attachment 1_Teleradiology PWS.docx

DEPARTMENT OF HOMELAND SECURITY (DHS)

U.S. IMMIGRATION AND CUSTOMS ENFORCEMENT (ICE)

ENFORCEMENT AND REMOVAL OPERATIONS (ERO)

PERFORMANCE WORK STATEMENT (PWS)

ICE HEALTH SERVICE CORPS (IHSC)

TELERADIOLOGY DIGITAL X‐RAY SERVICE

April 2021

Listed below are the documents associated with this requirement

Appendix 1 - IHSC Facility Locations Appendix 2 - X-Ray Historical Data Appendix 3 - Chest X-Ray Templates

DHS/ICE/IHSC

PWS IHSC Teleradiology Services

I. BACKGROUND

The U.S. Immigration & Customs Enforcement (ICE) Health Service Corps (IHSC) provides and arranges for health care services for non-US citizens being detained by ICE. As ICE’s medical authority for detainee health care, IHSC provides health care delivery and oversight to individuals in ICE custody that may be housed in Service Processing Centers (SPC), Contract Detention Facilities (CDF) and Staging Facilities located throughout the country.

Provision of health care to this population is critical to the law enforcement mission of ICE. Of utmost importance is the rapid detection and treatment of communicable diseases, including pulmonary tuberculosis (TB), in order to prevent cases of these diseases from being transmitted to staff, other detainees or be released to the citizens of the United States or abroad. ICE also requires x-ray imaging (other than chest x-rays for TB testing to assess a detainee’s medical condition and need for additional therapy. Some examples of necessary x-rays include assessing the impact of trauma (e.g., the presence of broken bones), assessing broken bones for proper healing, verifying nasogastric tube placement for detainees engaged in hunger strikes who require court ordered involuntary feeding, and assessing for a lung infection or the presence of fluid in the lungs due to congestive heart failure. It is also an essential provision for providing a safe and humane environment for the detained noncitizen.

II. SCOPE OF WORK

IHSC is seeking to procure a coordinated, comprehensive system for the provision of teleradiology digital imaging services within the designated IHSC facilities noted as locations in this PWS in Appendix 1. These services may be provided using on-site equipment (permanent solution) and/or via the use of mobile radiology equipment and technologists (during transition). For the purpose of this solicitation, the term “teleradiology” will be used in reference to any radiograph taken digitally and transmitted for reading at a remote site(s) by a licensed and qualified radiologist. The majority of teleradiology images will be single view chest X-ray images to screen detainees for pulmonary TB; however, plain radiographic imaging of any body part will be utilized as needed in the management of illness and injury.

The Contractor shall provide delivery, installation, testing and maintenance of the digital X‐ray equipment in addition to procurement of mobile radiology services, when needed. The fixed equipment shall be inspected by a physicist upon installation and receive certification in the state the equipment is located. Training shall be provided by the Contractor to all designated IHSC personnel in operating the digital X‐ray equipment.

Teleradiology services will include interpretation of radiographs, providing reports on the results, availability for consultation, providing the digital interface and compatibility necessary to transmit images and reports to and from IHSC’s eHR’s, uploading and comparing digital images from other radiology vendors and/or download digital images on a some form of transportable media, storing of images in a rapidly retrievable format, and annual certification/calibration of X‐ray machine unit containment.

The Contractor shall ensure radiologic technologists (RT) staffed at each IHSC location have access to orientation and annual training to any radiology equipment they will operate, and that a competency assessment of their practice is documented. The orientation and competency assessment documentation will be provided to the COR for the RT’s credential file.

III. OBJECTIVE

The objective of this project is to procure coordinated, teleradiology services for the purpose of medical screening of TB through digital chest X‐rays as well as the routine care of illness and injury through other digital radiographs of the body as practicable with plain film radiography. Services will include teleradiology equipment purchase, installation, maintenance, and technical support, Teleradiology onsite equipment training to all designated staff, X‐ray interpretation, consultation, reporting, and storage of images offsite. Other routine digital radiographs may include skeletal films, acute abdominal series etc. See Appendix 2 - X-Ray Historical Data for full list.

The Contractor shall provide all supervision, administrative and technical support, labor, subcontractors, tools, transportation, materials, supplies and equipment, and shall plan, schedule, coordinate and assure effective completion of all services described herein.

IV. APPLICABLE DOCUMENTS

a. Reference Documents

The following documents provide specifications, standards, or compliance guidelines in order to meet the requirements of this contract:

· Health Level Seven International (HL7) http://www.hl7.org/

· The Joint Commission: National Patient Safety Goals 2019 https://www.jointcommission.org/standards/national-patient-safety-goals/

· American College of Radiology http://www.acr.org/

· Procedure and Process Guides Occupational Safety and Health Administration (OSHA)

· Health Insurance Portability and Accountability Act (HIPAA)

b. Compliance Documents

The Contractor shall also adhere to the latest version of all technology standards and architecture policies, processes, and procedures applicable to the ICE IT environment when the teleradiology services have information technology components. These publications are available on request and include, but are not limited to the following:

· Department of Homeland Security (DHS) 4300A Sensitive Systems Handbook

· DHS 4300A Sensitive Systems Policy Directive

· DHS 4300B National Security Systems Handbook

· DHS Management Directive (MD) 4300, IT Systems Security Publication

· DHS MD 4010.2, Section 508 Program Management Office & Electronic and Information Technology Accessibility

· Section 508 1194.2, Section 508 of the Rehabilitation Act (29 U.S.C. 794d), as amended by the Workforce Investment Act of 1998 (P.L. 105-220)

· National Institute of Standards and Technology (NIST) Computer Security Resources Center (CSRC) standards, guidelines, and special publications

· Privacy Act of 1974

· OMB M-06-16, Protection of Sensitive Agency Information requires that agencies protect PII that is physically removed from Department locations or is accessed remotely. Physical removal includes both removable media and media in mobile devices (e.g., laptop hard drives). Refer to the following documents for additional information and policies on protecting PII and Sensitive PII at DHS:

· DHS Policy Directive 140-10, “Handbook for Safeguarding Sensitive PII Information.”

V. PERFORMANCE REQUIREMENTS

a. Teleradiology Services

i. Radiologists

The Contractor shall provide a sufficient number of board‐certified radiologists necessary to provide remote interpretation image reads, for coverage 24 hours a day, 7 days a week, 365 days per year (24/7/365) and can support licensure requirements for practice in the state where the facility is located. The services shall include any necessary consultation, and all required transition in and transition out activities.

ii. Interpretations (Radiologist)

The Contractor shall provide qualified and trained personnel who are fully competent to perform the work required under this agreement. All radiologists proposed under this agreement shall maintain current certifications and insurance as follows:

· Board Certification in Diagnostic Radiology Medicine by the American Board of Radiology.

· Contractor will ensure radiologists/physicians comply with all licensure and State law requirements.

· General liability and malpractice insurance as required by industry and the resultant contract

The Contractor shall provide proof of these documents (Board Certification, Licensure, and Insurance) with the proposal and when radiologists are added to the staffing plan, as applicable. Should the Government elect to exercise any options under the resulting contract, upon Contractor’s receipt of notice to exercise an option, the Contractor is required to provide updated certifications and proof of insurance to the IHSC Contracting Officer’s representative (COR). This shall be accomplished before the option is exercised.

The Contractor shall provide the staffing necessary to accomplish all x‐ray interpretations within the timeframes required by the contract with sufficient licensed staff to allow for coverage of high-volume states, such as Texas. Appendix 2 - X-Ray Historical Data, provides radiology study estimates for planning purposes. While these numbers are not definitive, they represent a reasonable guide to the current radiology imaging workload by an IHSC facility.

If there is a change to this staffing plan after contract award, a modification will not be required. The Contractor will provide the COR an up-to-date monthly spreadsheet with the names of all current radiologists that are performing work under this contract and have access to detainee proprietary information. The list shall include the radiologists’ licenses’ expiration dates, as well as concurrence that the radiologists holds general and malpractice insurance. Within one (1) business days after a license expires, the Contractor shall provide proof of an updated license.

The Contractor will provide notice of 30 days prior to a major shift in staffing (e.g., change in radiologist sub-contractor) as an influx of new radiologists can impact facility operations as they are acclimating to our specific TB screening templates and procedures.

If the radiologist with an expired license does not renew his/her license in a particular state, the Contractor shall provide a memo to the CO and COR within one (1) business day, after expiration date, stating that the radiologist in question will no longer be reading any x-ray studies in the state where he/she does not have a current active Medical License and insurance.

iii. Meet Industry Certification and Standards

The Contractor shall meet the following industry standards:

· Physicians/Radiologist resources shall have appropriate licensures both in the state where physician/radiologist is reading the images and, in the state, where images originated. (http://www.acr.org/Advocacy/State-Local- Relations/Legislative-Issues/TeleRadiology/TeleRadiology-Licensing- Requirements-by-State)

· The Contractor is ultimately responsible for compliance for all applicable laws, rules, and regulations regarding licensure of its staff.

· Any licensing Changes and or allegations of malpractice or medical negligence shall be reported immediately to the COR verbally and in writing.

iv. Critical Imaging Results

The Joint Commission’s National Patient Safety Goal 2 requires timely communication of critical imaging results. Once an interpreting radiologist identifies critical imaging results, the interpreting radiologist shall communicate this result by telephone to the ordering IHSC facility staff and document the contact and the provider’s “read back” of the results in the official exam report. This communication shall be conducted telephonically by the appropriate radiologist or nurse (not an automatic or computer‐generated contact) using the English language, and shall occur immediately, but no later than 15 minutes of identification of a critical result. This includes significant abnormal findings on routine studies that may impact a patient’s care or treatment in accordance with Joint Commission standards. More effective alternative means of communication may be proposed but shall be approved by the Government prior to implementation.

The Contractor shall also immediately telephone the sending site clinician to verbally communicate any concerns and/or discrepancies between preliminary interpretations and final interpretations.

v. Final Interpretations

The Contractor is required to provide final interpretations to the requesting facility within four (4) hours of taking the x‐ray study, regardless of when preliminary interpretations were provided. If unable to speak directly with the appropriate IHSC staff from the respective site, the Contractor shall leave a voice mail message with the results and shall follow up with an email.

vi. IHSC Chest X-Ray Results Template

Appendix 3 – A Chest X-Ray Template is the template for the chest X-ray impression that shall be utilized by the radiologist to better inform and direct IHSC staff in TB screening management. There is currently no template for other than chest x-rays.

Chest X-ray findings should clearly identify the abnormality(ies) with location and size to the best of the radiologist’s ability. The impressions, however, will include, verbatim, one of the following two options:

· Negative screening for active TB disease by radiographic criteria: normal CXR. Requires nurse review; Clear for general population.

· POSITIVE screening for active TB disease by radiographic criteria: pulmonary parenchymal and/or pleural finding(s) and/or mediastinal lymphadenopathy, cannot exclude Active TB; findings as noted above. A provider should apply IHSC TB Clinical Guideline screening algorithm (Category A, B or C) for further action, if necessary.

vii. Consultation

The Contractor shall provide professional consultation, in real time by phone, for discussion and/or consultation. The Contractor's radiologists shall be readily available to provide oral, telephonic consultation to physicians and technologists twenty‐four hours a day and seven days a week including weekends and holidays. If not available immediately, the Contractor shall provide a call back to the appropriate IHSC contact within fifteen (15) minutes of request for consultation.

The Contractor must notify the nursing coordinator at the site within fifteen (15) minutes of identifying a radiograph with a critical value (e.g., the chest X-ray has a finding consistent with TB) and requires further urgent management decisions.

viii. Comparison Requirement

Sequential chest radiographs with direct comparison are part of clinical management and decision making in cases of confirmed or suspected tuberculosis. The Contractor shall provide comparison studies between their own studies as well as between the Contractor’s and outside institution studies (health departments, hospitals, other radiology contractors). Such reports should be requested as “comparison read” by providers when ordering the study.

· Compare images created within the Contractor’s environment (i.e., 2 or more studies at different points in time).

· Compare image/s received from outside Contractor’s environment (uploaded into their system in DICOM format), to image/s created w/in the Contractor’s environment

· Compare image/s received from outside the Contractor’s environment (uploaded into their system in DICOM format), to another image/s received from outside the Contractor’s environment (uploaded into the Contractor’s system in DICOM format)

· The Contractor’s radiologist shall provide one of the following impressions for comparison chest films: 1) Unchanged, 2) overall worse, or 3) overall improved

· Provide said report and interpretation to the requesting clinician within 1 business day of receipt of both studies (baseline and comparison)

b. Teleradiology Equipment

The Contractor shall deliver current state‐of‐the‐art commercial teleradiology X‐ray equipment required to perform services under this agreement. Currently, no sites have a requirement for X-ray tables, however, this requirement does include X-ray tables or other equipment at limited sites that may be needed to properly position patients for radiography (chest, abdomen, pelvis and skeletal) and capture the image. The Contractor shall also provide all required hardware and software installation and related testing, maintenance, technical support, image storage, system integration, final testing, and training. The following equipment specifications apply to both the mobile (if chosen for transition) and permanent equipment solutions. IHSC provides on-site direct patient care to the detainee population throughout the country. Please see Appendix 2 for average historical data information The detainee population is fluid and the throughput are extremely high in response to applicable ICE and correctional health care standards and the immigration process. It is not uncommon to receive up to 100 detainees for intake at a single facility who all need timely health screening, which includes screening for TB through digital chest X‐rays. The chest X‐ray is typically completed on the patient in a standing position. During the course of routine medical care other films may be requested, including axial skeleton and limb radiographs. For these reasons the equipment solution should be versatile enough to accommodate multiple studies in short periods of time.

The Contractor shall also deliver and install one hand-held unit at each site.

i. Digital Chest X-Ray Equipment Specifications

The diagnostic radiographic equipment for chest X-ray shall be DIGITAL with a rotating anode tube with a 1.0-millimeter (mm) source (focal spot), if available and capable of sufficient output. It is highly recommended that x-ray tubes have both large and small focal spots. The focal spot shall be no larger than a 2.0 mm. The voltage, current, and regulation of the electric power supply for the X‐ray generator shall comply with the manufacturer’s specification. Standard beam filters shall be included to assure an appropriate energy profile. If the manufacturer or installer of the radiographic equipment recommends equipment for control of electrical power fluctuations, this shall also be installed and utilized. The generators of units shall have a minimum rating of 300 mill amperes (mA) at 125 kVp or 35 kW, ratings of 65 kW can increase image sharpness for larger patients.

To ensure high quality chest radiographs, the distance from source or focal spot to digital detector shall be at least 70 inches (180 cm). Examinations shall utilize at least the minimum voltage recommended by the digital imaging system manufacturer for chest radiography, preferably using high kV technique (up to 125 kVp), and at least 90 kVp, while minimizing radiation exposure.

ii. Imaging Equipment Requirements

The imaging plate shall be a minimum of 35×43 centimeter (cm) or 1505 cm2, with maximum pixel pitch of 200 micrometers (μm), and a minimum matrix size of 3.75 megapixels (MP), with a minimum bit depth of 10. Spatial resolution shall be at least 2.5-line pairs per mm in both vertical and horizontal directions. Detector signals shall undergo routine amplification as well as standard image post‐processing. Image signal‐to‐noise and detective quantum efficiency shall meet or exceed current professional recommendations as appropriate for the body part being radiographed.

The image data file and associated transmission and storage should conform to the current DICOM® (Digital Imaging and Communication in Medicine) standard and relevant substandard. Data systems should have error‐checking capability, reliability, and redundancy sufficient to assure integrity of information, and sufficient physical, technical, and administrative controls to prevent unauthorized access to protected health information and confidential medical findings during data transfers.

The Picture Archiving Communication System (PAC) provided shall be compliant with the DICOM standard and HL7 standards. Products shall be integrated with the electronic Health Records system (eHRs) and produce quality images.

The Contractor shall utilize HIPAA compliant systems with a web viewing capability tool, encrypted data transmission, and cloud storage. The systems shall provide quality assurance solutions with community radiologist level review. The contractor shall certify in their submission they are and will maintain HIPAA compliance.

There may be occasions when the Contractor will be required to remove or install teleradiology equipment from one or more of the IHSC facilities as directed by the Government, and either relocate the equipment to new facilities or store the equipment for a specified period. This removal and relocation requirement will be specified and authorized under the “Changes” provision of the contract.

iii. Network Connections/Interconnection Security Agreement (ISA)

The Contractor shall be responsible for all Information Technology (IT) connections between the X-ray device and the Radiologists’ workstations. The Contractor shall be required to work with the ICE IT Field Office support at each facility to set up connectivity that does not interface with ICE’s secure network. The Contractor shall be responsible for configuring, installing and maintaining its secure network from the X-ray devices to all software residing on the remote radiologists’ workstation. The network must adhere to Government and/or ICE standards. The Contractor shall also have an Interconnection Security Agreement (ISA) between their Teleradiology system and ICE’s electronic Health Records (eHR) system that will transmit HL7 X-ray requests from eHR to their teleradiology system and HL7 X-ray results from teleradiology to the detainee’s medical record within ICE’s eHR. This information will move independently from the ICE IRMnet.

1. ISA Terms and Conditions

Interconnections between DHS/ICE and non-DHS/ICE IT systems shall be established only through controlled interfaces and via approved service providers. The controlled interfaces shall be authorized at the highest security level of information on the network. Connections with other Federal agencies shall be documented based on interagency agreements, memoranda of understanding, service level agreements or interconnection security agreements IHSC may require other medical devices to connect to the network installed by the Contractor in the future.

iv. IT Security Plan

The Contractor shall be responsible for IT security for all systems connected to a DHS network or operated by the Contractor for DHS, regardless of location. This requirement applies to all or any part of the contract that includes information technology resources or services for which the Contractor must have physical or electronic access to sensitive information contained in DHS unclassified systems that directly support the agency’s mission.

The Contractor shall provide, implement, and maintain an IT Security Plan. This plan shall describe the processes and procedures that will be followed to ensure appropriate security of IT resources that are developed, processed, or used under this contract.

Within 30 days after contract award, the contractor shall submit for approval its IT Security Plan, which shall be consistent with and further detail the approach contained in the offeror's proposal. The plan, as approved by the Contracting Officer (CO), shall be incorporated into the contract as a compliance document.

The Contractor’s IT Security Plan shall comply with Federal laws that include, but are not limited to, the Computer Security Act of 1987 (40 U.S.C. 1441 et seq.); the Government Information Security Reform Act of 2000; and the FISMA of 2002; and with Federal policies and procedures that include, but are not limited to, OMB Circular A-130.

The security plan shall specifically include instructions regarding handling and protecting sensitive information at the Contractor’s site (including any information stored, processed, or transmitted using the Contractor’s computer systems), and the secure management, operation, maintenance, programming, and system administration of computer systems, networks, and telecommunications systems.

At the expiration of the contract, the contractor shall return all sensitive DHS information and IT resources provided to the contractor during the contract and certify that all non-public DHS information has been purged from any contractor-owned system. Components shall conduct reviews to ensure that the security requirements in the contract are implemented and enforced.

v. Contractor IT Security Accreditation

Within 6 months after contract, the contractor shall submit written proof of IT Security accreditation to DHS for approval by DHS CO. Accreditation will proceed according to the criteria of DHS Sensitive System Policy Publication, 4300A (most current version) or any replacement publication, which the CO will provide upon request. This accreditation will include a final security plan, risk assessment, security test and evaluation, and disaster recovery plan/continuity of operations plan. This accreditation, when accepted by the CO, shall be incorporated into the contract as a compliance document. The contractor shall comply with the approved accreditation documentation.

vi. Maintenance and Technical Support

The Contractor shall:

· Provide all maintenance and technical support on Contractor’s installed equipment,

· Ensure the teleradiology services are fully operable, able to stand alone, and able to integrate with ICE’s eHR,

· Provide 24/7/365 technical support,

· Provide a 1‐800/866 number available for technical support 24/7/365,

· Provide all network capabilities, hardware, and software installation,

· Provide network connectivity. Full connectivity and testing of equipment shall be established and verified during the transition period, and

· Provide a system that maintains at least a 99% uptime performance rate.

· Ensure the equipment is in compliance with state regulations and guidelines.

Equipment repair shall not exceed four (4) hours in any 24‐hour period. The four (4) hours begins upon the notice to contractor via telephonic and email contact. In the event an equipment repair exceeds this four (4) hour requirement, the Contractor will provide resources to ensure there is no gap in service (e.g. mobile units).

The Contractor shall be responsible for all Information Technology (IT) connections and shall be required to work with the ICE IT department at each facility to set up connectivity. The Contractor shall be responsible for configuring, installing, and maintaining the secure remote connectivity and all remote workstation software residing on the remote radiologists’ workstation. Equipment shall be reliable and functional to prevent disruption in the delivery of services. The radiologist review stations shall meet all specifications required by the ACR for primary image interpretation. Data transmission security shall always be maintained.

vii. Hardware and Software

Computer monitors utilized by the Contractor for purposes of radiograph interpretations shall be calibrated in a timely fashion consistent with proper quality control procedures at the reading site. This calibration shall be in compliance with Food and Drug Administration (FDA) recommendations for monitor calibration. The Contractor shall provide the IHSC with documentation of equipment quality control policies and certifications upon request.

viii. Image Storage and Integration

The Contractor must certify in writing at submission they will only utilize a GSA FedRAMP certified adhering to HIPAA standards.

FedRAMP certification must be maintained continuously throughout the life of the contract. If the Contractor’s FedRAMP provider loses its FedRAMP certification, the Contractor must report this information to the Government immediately in writing. The Contractor must, within thirty (30) days after losing FedRAMP certification, re‐certify or contract with an authorized FedRAMP provider. Failure to comply will result in termination of the contract.

The image files and interpretation reports shall be stored solely in a GSA FedRAMP compliant environment. Non‐compliant FedRAMP systems will result in proposals being evaluated as technically unacceptable. The contractor shall provide certificate or evidence of compliant FedRamp system. The Contractor shall only store images in a single location, and support integration of the interpretation reports via an interface to the ICE electronic Health Record system via an HL7 interface. The Contractor shall propose an integrated solution that the ICE electronic Health Records contractor has reviewed and approved for implementation. This effort will include project management, development, testing, and deployment. The Government will provide the appropriate access and permissions to complete this task. Stored Images by the Contractor will be readily available to the Government and to the radiologists (if subcontracted). The Contractor shall provide a notification each time interpretation reports are transmitted to the ICE eHR.

The ICE eHR version interface shall follow the order and response HL7 message pattern similar to the Correctional Institution Pharmacy Software (CIPS) interface.

The Contractor shall accept HL7 Request for Material or Services (ORM) messages from eHR over a TCP/IP via a VPN tunnel. The Contractor shall return an HL7 Observation Result message (ORU) with final interpretation results, including a link to the image which will be maintained and stored by the Contractor. The Contractor shall provide access to the link to IHSC users communicating through the ICE network. The Contractor shall utilize the Alien Number (A#) as a main patient identifier and be capable of using the ICE eHR version order number.

Service Provider (Azure) Figure 1 - Conceptual Architecture

The eHR provider may be contacted via web, email, or phone Reference DHS / ICE eHR Teleradiology Integration.

The Contractor shall support Certification and Accreditation (C&A) efforts to ensure Federal Information Security Management Act (FISMA) compliance to ICE. The images files and interpretation reports are the exclusive property of the Government. The Contractor shall support the Government in accessing the raw data and assisting with extracting, transferring, and loading the image files and reports to another storage location within seven (7) days after notification. Additionally, the Contractor shall provide written notification to the Government ninety (90) days prior to changing an image file location and shall assume all related transition costs to include certifications and approvals updates.

The images files shall be saved for the duration of the contract period of performance, organized in a rapidly retrievable way such as to facilitate comparison studies. Upon completion of the contract, the Contractor shall transfer all images to the Government.

The online storage of the image files will also be required for the duration of the contract.

ix. Data Exchanges/Interfaces

The Contractor’s solution shall:

· Support integration with the medical X-ray images with the ICE eHRs through the cloud service provider through a reference link (note: images shall not be copied to the ICE eHR system);

· Support integration with the image interpretation data via an interface with the ICE eHR. The data shall be stored as part of the detainee medical record; and

· Include the capabilities and necessary protocols to interface with Government’s electronic Health Record version (eHR). Contractor shall be able to establish all necessary requirements and operational procedures to interface with the Government Electronic Health Record System (eHR) 90 days after contract award.

x. Connectivity Support

The Contractor’s solution shall support:

· HL7 Version 3 CCD, and

· American Society for Testing and Materials (ASTM) International CCR Standard E2369.0

c. Training

At no additional cost to the Government, the Contractor shall provide the following training as required during the term of this agreement. A schedule for each training shall be provided to the COR and facility POC’s at least 14 calendar days prior to each training event.

i. Initial Training

The Contractor will provide initial training on the Contractor’s installed equipment operation and Contractor’s Teleradiology workflow. Initial training is required upon installation of equipment to IHSC staff at each of the facilities. The Contractor shall provide training packages, user manuals and any other materials reasonably necessary to assist in the training process.

ii. New Hire Training

The Contractor shall provide training for new hires (i.e. radiology technicians) within 2 business days of notification by the Government. The Contractor shall provide training packages and materials, such as training manuals, PowerPoint presentations and any other training tool designed to assist in the learning method.

iii. Training for Upgrades

Contractor shall provide additional training that may be required by the Government as the result of software and/or hardware upgrades. The Contractor shall provide modifications to user manuals if required by an upgrade.

iv. Refresher Training/Competency Assessment

Contractor shall provide annual and refresher training sessions for all IHSC radiology technicians to comply with all state certification requirements. Training shall include:

· A brief orientation on digital radiography (DR), clinical DR system uses and applications, digital radiography (DR) room and radiation safety,

· DR system troubleshooting basics; and

· An IHSC field radiology technicians Hands-on-the-job skills application section

d. Contractor Personnel

The Contractor shall provide qualified personnel to perform all requirements specified in this PWS.

i. Key Personnel

The Contractor shall provide a project manager (PM) who shall be responsible for all Contractor work performed under this PWS. The PM shall be a single point of contact for the CO and the COR. The name of the Project Manager, and the name(s) of any alternate(s) who shall act for the Contractor in the absence of the Project Manager, shall be provided to the Government as part of the Contractor's proposal. The Project Manager is further designated as Key by the Government. During any absence of the Project Manager, only one alternate shall have full authority to act for the Contractor on all matters relating to work performed under this contract. The PM and all designated alternates shall be able to read, write, speak, and understand English. Additionally, the Contractor shall not replace the Project Manager without prior approval from the Contracting Officer.

The PM shall be available to the COR via telephone between normal business hours EST, Monday through Friday, and shall respond to a request for discussion or resolution of technical problems within 48 hours of notification.

Before replacing any individual designated as key by the Government, the Contractor shall notify the CO no less than 15 business days in advance, submit written justification for replacement, and provide the name and qualifications of any proposed substitute(s). All proposed substitutes shall possess qualifications equal to or superior to those of the key person being replaced, unless otherwise approved by the CO. The Contractor shall not replace key contractor personnel without approval from the CO. The following Contractor personnel are designated as key for this requirement; Program Manager (PM).

ii. Employee Identification

Contractor employees visiting Government facilities shall wear an identification badge that, at a minimum, displays the Contractor name, the employee’s photo, name, clearance-level, and badge expiration date. Visiting Contractor employees shall comply with all Government escort rules and requirements. All Contractor employees shall identify themselves as Contractors when their status is not readily apparent and display all identification and visitor badges in plain view above the waist at all times.

Contractor employees working on-site at Government facilities shall wear a Government issued identification badge. All Contractor employees shall identify themselves as Contractors when their status is not readily apparent (in meetings, when answering Government telephones, in e-mail messages, etc.) and display the Government issued badge in plain view above the waist at all times.

iii. Employee Conduct

The following paragraph is an example of language that may be included in the PWS to address employee conduct. Use the following paragraph or develop language of your own.

Contractor’s employees shall comply with all applicable Government regulations, policies, and procedures (e.g., fire, safety, sanitation, environmental protection, security, “off limits” areas, wearing of parts of DHS uniforms, and possession of weapons) when visiting or working at Government facilities. The Contractor shall ensure Contractor employees present a professional appearance at all times and that their conduct shall not reflect discredit on the United States or the DHS. The PM shall ensure Contractor employees understand and abide by DHS established rules, regulations and policies concerning safety and security.

iv. Removing Employees for Misconduct or Security Reasons

The Government may, at its sole discretion (via the Contracting Officer*), direct the Contractor to remove any Contractor employee from DHS facilities for misconduct or security reasons. Removal does not relieve the Contractor of the responsibility to continue providing the services required under the contract. The Contracting Officer will provide the Contractor with a written explanation to support any request to remove an employee.

v. Use of Subcontractors and Independent Contractors

Contractor is permitted to use independent contractors and or subcontractors for services rendered under this contract unless debarred from government contracts. If Contractor deems it necessary to obtain the services of a subcontractor to fulfill its obligations under this PWS, the Contractor will notify the CO in writing of its intent to use subcontractors for particular positions. No approval is necessary for use of a subcontractor that is a subsidiary of the Prime Contractor or if the subcontractor was identified in the Prime Contractor’s proposal in response to the RFP. Responsibility remains with the prime Contractor for all subcontractor and independent Contractors. Any subcontractor utilized by the prime Contractor will be held to the same standards as those required of the prime Contractor. All staff working under this contract shall identify themselves as employees of the Contractor. The prime Contractor will remain the sole point of contact for the government in all matters related to the delivery of services under this contract without exception. Any and all documentation, memos etc. submitted to the government will be identified as the product of the prime Contractor.

VI. OTHER APPLICABLE CONDITIONS

a. Facility Access

The Contractor is required to provide to the COR and the facility POCs, a list of all personnel who require access to IHSC facilities, including access during the Transition‐In phase, installation of equipment, training, testing, and etcetera. All applicable Contractor personnel shall be capable of passing the ICE‐required building access procedures and vendor authorization in order to enter IHSC facilities. The contractor employees are required to complete the Building Access Request Form, prior to facility access granted.

The Contractor’s personnel shall be required to obtain the necessary clearance required under this PWS to be granted access to the facility and its grounds. Contractor’s personnel criminal history checks shall be part of the general background check for performance of services in and around the facility. This process is strictly confidential, and access to the information must be limited to the Agency.

b. Period of Performance

The period of performance for this contract includes a base period of one year (with transition included) and four one‐year option periods.

c. Place of Performance

Work performed during the transitioning in and transitioning out periods and some technical support may be required onsite at various Government facilities. All other support shall be provided at the Contractor’s locations.

d. Coverage (Hours of Operation)

The Contractor shall provide adequate coverage for each of the facilities. The hours of operation at all sites utilizing teleradiology services operate 24/7/365.

e. Travel

Contractor travel shall not be required for this requirement.

f. Post Award Conference

The Contractor shall attend a post award conference with the CO and the COR no later than ten (10) business days after the date of award. The purpose of the post award conference, which will be chaired by the CO, is to discuss technical and contracting objectives of this contract and review the Contractor's draft project plan. The conference will be held at the Government’s facility, located at 500 12th St. NW, Washington DC 20004 or via Microsoft Teams Conference.

g. Continuation of Services

The Contractor shall prepare and submit a Business Continuity Plan (BCP) to the Government. The BCP Plan shall be due 30 business days after the date of award and will be updated on an annual basis. The BCP shall document Contractor plans and procedures to maintain support during an emergency, including natural disasters and acts of terrorism. The BCP, at a minimum, shall include the following:

· A description of the Contractor’s emergency management procedures and policy

· A description of how the Contractor will account for their employees during an emergency

· How the Contractor will communicate with the Government during emergencies

· A list of primary and alternate Contractor points of contact, each with primary and alternate:

· Telephone numbers

· E-mail addresses

Individual BCPs shall be activated immediately after determining that an emergency has occurred, shall be operational within 2 hours of activation or as directed by the Government, and shall be sustainable until the emergency situation is resolved and normal conditions are restored or the contract is terminated, whichever comes first. In case of a life-threatening emergency, the COR shall immediately make contact with the Contractor PM to ascertain the status of any Contractor personnel who were located in Government controlled space affected by the emergency. When any disruption of normal, daily operations occurs, the Contractor PM and the COR shall promptly open an effective means of communication and verify:

· Key points of contact (Government and contractor)

· Temporary work locations (alternate office spaces, telework, virtual offices, etc.)

· Means of communication available under the circumstances (e.g. email, webmail, telephone, FAX, courier, etc.)

· Essential Contractor work products expected to be continued, by priority

The Government and Contractor PM shall make use of the resources and tools available to continue contracted functions to the maximum extent possible under emergency circumstances. Contractors shall obtain approval from the CO prior to incurring costs over and above those allowed for under the terms of this contract. Regardless of contract type, and of work location, Contractors performing work in support of authorized tasks within the scope of their contract shall charge those hours accurately in accordance with the terms of this contract.

The Contractor shall provide uninterrupted transitioning in support services and equipment, such as onsite mobile units and/or onsite local vendors, X‐ray interpretation services, and any additional operational and technical support as needed to preserve the integrity of the service during the transition in period while the current incumbent’s equipment is being removed and the Contractor’s equipment is being installed at each of at each facility location.

The Contractor shall also provide uninterrupted transition-out support services as will be specified in its Transition-Out Plan.

h. Contractual Reports

The Contractor shall utilize the Equal Business Optimizer (EBO) reports that are generated by the electronic Health Record (ICE eHR version), at each site for invoicing. This report contains all the x-rays that have been performed.

The Contractor shall provide the following reports:

· Weekly Other-Than-Normal Report: The Contractor shall provide a weekly excel report of all chest x-rays reports from the previous week that were other than negative/normal to the Facility POC and the COR with a minimum of Alien Identification numbers and facility as identifiers. The contact information (when, by what method, etc.) shall also be provided).

· Monthly Utilization Report: The report shall be broken down by site and report type (ex. chest x-ray, non-chest x-ray).

· Quarterly Quality Assurance (QA) Report: The report shall contain the percentage of negative films vs. positive films for each radiologist and any discordance should be identified and sent to pertinent clinical application. The Contractor should also track the number of Addendums for each radiologist.

With regards to any issues that are discovered by the Contractor, (e.g., outage, downtime, etc.) the Contractor shall notify the site POC the moment that it is discovered, resolve the issue immediately, and inform the COR via email no later than 4 hours after the issue is discovered, as well as include the issue on the Weekly, and Monthly Report for the CO and CS.

The Contractor shall provide all written reports in electronic format with read/write capability using applications that are compatible with DHS workstations (Windows XP and Microsoft Office Applications). For purposes of this contract, any requirement due by “close of business” shall be provided no later than 5:00 pm, Eastern Standard Time on the date or day specified under each requirement.

i. Progress Meetings

The PM shall meet with the COR on a bi-weekly basis to discuss progress, exchange information and resolve emergent technical problems and issues. These meetings shall take place telephonically or through Microsoft Teams.

j. Government Furnished Equipment

This contract does not include any government‐furnished equipment.

k. Use of Proprietary Software

The Contractor shall NOT use, as part of the solution, any proprietary software that is not commercially available.

l. Government Furnished Information (GFI)

The Government will provide an image library of previous films and reports.

m. Intellectual Property Ownership

Any forms of intellectual property first developed under this contract shall be considered government property. All teleradiology data shall be the property of DHS and will be returned in the manner specified by the government.

n. Accessibility Requirements (Section 508)

Section 508 of the Rehabilitation Act, as amended by the Workforce Investment Act of 1998 (P.L. 105-220) (codified at 29 U.S.C. § 794d) requires that when Federal agencies develop, procure, maintain, or use information and communications technology (ICT), it shall be accessible to people with disabilities. Federal employees and members of the public with disabilities must be afforded access to and use of information and data comparable to that of Federal employees and members of the public without disabilities.

All products, platforms and services delivered as part of this work statement that, by definition, are deemed ICT shall conform to the revised regulatory implementation of Section 508 Standards, which are located at 36 C.F.R. § 1194.1 & Appendix A, C & D, and available at https://www.gpo.gov/fdsys/pkg/CFR-2017-title36-vol3/pdf/CFR-2017-title36-vol3-part1194.pdf. In the revised regulation, ICT replaced the term electronic and information technology (EIT) used in the original 508 standards. ICT includes IT and other equipment.

Exceptions for this work statement have been determined by DHS and only the exceptions described herein may be applied. Any request for additional exceptions shall be sent to the Contracting Officer and a determination will be made according to DHS Directive 139-05, Office of Accessible Systems and Technology, dated November 12, 2018 and DHS Instruction 139-05-001, Managing the Accessible Systems and Technology Program, dated November 20, 2018, or any successor publication.

i. Section 508 Requirements for Technology Services

1. When providing installation, configuration or integration services for ICT, the Contractor shall not reduce the original ICT item's level of Section 508 conformance prior to the services being performed.

2. When providing cloud hosting services (Infrastructure as a Service, Platform as a Service, Software as a Service, etc.) the Contractor shall ensure user administrative screens, dashboards and portals used to configure, and monitor cloud services conform to the Section 508 standards.

3. The Contractor shall ensure cloud hosting services shall not reduce the level of Section 508 conformance for ICT migrated by DHS to the cloud hosting environment.

4. When modifying, installing, configuring, or integrating commercially available or government-owned ICT, the Contractor shall not reduce the original ICT Item’s level of Section 508 conformance.

5. Contractor personnel shall possess the knowledge, skills, and abilities necessary to address the accessibility requirements in this work statement.

VII. DELIVERABLES AND DELIVERY SCHEDULE

This contract includes a Performance Requirements Summary (PRS). The PRS plays an integral role in the administration of the contract. In addition to any applicable inspection clauses or other related terms and conditions contained in the contract, the PRS shall serve as a primary tool for inspection and acceptance of services as facilitated by the COR. Evaluation of the Contractor’s overall performance shall be in accordance with the performance standards set forth in the PRS, and shall be conducted by the COR. The PRS (Section IX) constitutes a material aspect of the contract and shall not be changed or otherwise modified without prior written approval of the CO.

The…