36C24120Q0262-003.docx

36C24120Q0262 Contract Opportunity Combined Synopsis/Solicitation Notice

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* = Required Field Contract Opportunity Combined Synopsis/Solicitation Notice Q522 Health Physics Services 02301 36C24120Q0262 03-30-2020 N

SBA

541690 Department of Veterans Affairs VA Boston Healthcare System Contracting Officer (90C) 940 Belmont Street Brockton MA 02301 John Shawki issa.shawki@va.gov please see the performance work statement in the solicitation for this information.

USA

Issa.Shawki@va.gov Issa.Shawki@va.gov This solicitation is for Health Physics Services.

PAGE 1 OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9.

ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE

WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15

CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

DUNS:

DUNS+4:

PHONE:

FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only) 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE

ARE NOT ATTA

CHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNAT

URE OF OFFEROR/CONTRACTOR

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

523-20-2-7050-0029 36C24120Q0262 03-24-2020 Issa Shawki 774-826-3192 03-30-2020 12 PM EST time 36C241 Department of Veterans Affairs

VA

Boston Healthcare System Contracting Officer (90C) 940 Belmont Street Brockton MA 02301 X X 541690 $16.5 Million N/A X 36C241 Department of Veterans Affairs VA Boston Healthcare System 940 Belmont Street Brockton MA 02301 36C241 Department of Veterans Affairs VA Boston Healthcare System Contracting Officer (90C) 940 Belmont Street Brockton MA 02301 http://www.fsc.va.gov/einvoice.asp

X See CONTINUATION Page The contractor shall provide Health Physics Services according to the Performance Work Statement.

See CONTINUATION Page X X Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C241 John Shawki Department of Veterans Affairs VA Boston Healthcare System Contracting Officer (90C) 940 Belmont Street Brockton MA 02301

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

3. INVOICES: Invoices shall be submitted in arrears:

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

http://www.fsc.va.gov/einvoice.asp

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

Page 1 of Page 1 of Page 1 of Page 1 of

PERFORMANCE WORK STATEMENT (PWS)

Health Physics Services

Part 1

General Information

1. GENERAL: This is a non-personnel services contract to provide Health Physics Services. The Government shall not exercise any supervision or control over the contract service providers performing the services herein. Such contract service providers shall be accountable solely to the Contractor who, in turn is responsible to the Government.

1.1 Description of Services/Introduction: The Contractor, a.k.a. Consulting Physicist, shall furnish all labor, material, supplies, equipment, and qualified personnel to provide on-site diagnostic Qualified Medical Physics support; and on-site and off-site Health Physics Services for the Veterans Health Administration (VHA) Boston Healthcare System (BHS), under the terms and conditions defined in this Performance Work Statement, except for those items specified as government furnished property and services. The contractor shall perform to the standards in this contract, and must adhere to VHA Handbook 1105.04, Fluoroscopy Safety, dated July 6, 2012 (or most current), VHA Handbook 1105, Management of Radioactive Materials, dated February 5, 2015 (or most current), and VHA Directive 1129, Radiation Protection For Machine Sources Of Ionizing Radiation dated February 5, 2015 (or most current). Additionally, the Contractor shall comply with radiation protection standards in 29 CFR 1910.1096 and immediately report any unsafe conditions with the potential to adversely impact the facility radiation workers or patients to the Radiation Safety Officer (RSO), and to the individual responsible for the equipment. A Fault Report shall be placed on equipment that is found unsafe to use, with the reason for the condition.

1.2 Background: For purposes of this contract, the term “Contractor/Consulting Physicist” is an individual(s) with offices nearby VA Boston Healthcare System (BHS) facilities; and capable of ensuring that BHS is compliant with applicable provisions of Title 10 Chapter 20, Title 10 Chapter 35, NUREG-1556, 49CFR, and with other pertinent State and Federal regulations, and with conditions specified in the NHPP Permit. The Contractor shall be familiar with VHA regulations, and practices of other medical licensees in the vicinity of BHS. Work under this contract may be carried out at the Jamaica Plain Campus, West Roxbury Campus, Brockton Campus, Lowell, and/or other Community Based Outpatient Clinics. Contactor required to be on site a minimum of 2 eight-hour days per month and up to 4 days a month as needed with advanced notice.

1.3 Objectives: The Consulting Physicist may provide services including but not limited to the following:

· Physics testing on x-ray equipment

· Perform x-ray machine shielding evaluations and surveys

· Annual accuracy tests on dose calibrators

· Handheld instrument calibrations

· Sit in person on the Radiation Safety Committee

· Act as the RSO during temporary leaves of absence of the VA RSO

· In the event the current RSO permanently discontinues duties, act as temporary licensed RSO until a permanent RSO is named.

· Verify adequacy and integrity of lead aprons

· Analyze, design, develop, implement, and evaluate training programs in selected radiation safety areas.

· Provides guidance for the Radiation Safety Program

· Review and conduct annual audits of BHS Radiation Safety Program

· Provide emergency services to estimate doses from accidents and/or misadministration of radioactive material.

· Develop curriculum and provide necessary Radiation Safety training to new Radiation Safety Officer at VA Boston. This includes contractor availability onsite a minimum of 2 eight-hour days per month

NOTE: All bid responses must include example reports, surveys, documents, etc. demonstrating recent performance and documentation for completing tasks required by this PWS.

1.4 Scope: The contractor shall provide Health Physics Services

1.5 Period of Performance: The period of performance shall be for one (1) Base Period of seven (7) months and four (4) 12-month option years. The Period of Performance reads as follows:

Base Period 2020 Option CY I 2021 Option CY II 2022 Option CY III 2023 Option CY IV 2024

NOTE: Bid responses must include the total cost of testing all equipment in Exhibit 3 and other services required by this PWS for the Base Period and each Option Year. Actual equipment levels will vary.

1.6 General Information

1.6.1 Quality Control The contractor shall develop and maintain an effective quality control program 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.

1.6.3 Recognized Holidays:

1.6.4 Hours of Operation: The contractor is responsible for conducting routine business, between the hours of 7:00 and 15:30 Monday thru Friday except Federal holidays or when the Government facility is closed due to local or national emergencies, administrative closings, or similar Government directed facility closings. For other than firm fixed price contracts, the contractor will not be reimbursed when the government facility is closed for the above reasons. The Contractor must at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS when the Government facility is not closed for the above reasons. Some equipment testing may require scheduling on back shifts and holidays, so as not to interfere with the clinical operation of the equipment. When hiring personnel, the Contractor shall keep in mind that the stability and continuity of the workforce are essential. Emergency services shall be available 24/7.

1.6.5 Place of Performance: The work to be performed under this contract will be performed at the Jamaica Plain Campus, West Roxbury Campus, Brocton Campus, Lowell, and/or other Community Based Outpatient Clinics.

1.6.6 Type of Contract: The government will award a Firm-Fixed Price contract.

1.6.7 Security Requirements: Contractor personnel performing work under this contract shall secure all radioactive material they use.

1.6.7.1 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.

1.6.7.2 Lock Combinations and Keys. The Contractor shall not provide lock combinations or keys to areas containing radioactive material to any unauthorized persons.

1.6.8 Special Qualifications: Contractor staff shall meet the requirements of VA Directives and Policies.

1.6.9 Post Award Conference/Periodic Progress Meetings: The Contractor agrees to attend any post award conference convened by the contracting activity or contract administration office in accordance with Federal Acquisition Regulation Subpart 42.5. The contracting officer, Contracting Officers Representative (COR), and other Government personnel, as appropriate, may meet periodically with the contractor to review the contractor's performance. At these meetings the contracting officer will apprise the contractor of how the government views the contractor's performance and the contractor will apprise the Government of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues. These meetings shall be at no additional cost to the government.

1.6.10 Contracting Officer Representative (COR): The (COR) will be identified by separate letter. The COR monitors all technical aspects of the contract and assists in contract administration The COR is authorized to perform the following functions: assure that the Contractor performs the technical requirements of the contract: perform inspections necessary in connection with contract performance: maintain written and oral communications with the Contractor concerning technical aspects of the contract: issue written interpretations of technical requirements, including Government drawings, designs, specifications: monitor Contractor's performance and notifies both the Contracting Officer and Contractor of any deficiencies; coordinate availability of government furnished property, and provide site entry of Contractor personnel. A letter of designation issued to the COR, a copy of which is sent to the Contractor, states the responsibilities and limitations of the COR, especially with regard to changes in cost or price, estimates or changes in delivery dates. The COR is not authorized to change any of the terms and conditions of the resulting order.

1.6.11 Key Personnel: The follow personnel are considered key personnel by the government: Qualified Medical Physicist and Certified Health Physicist. The contractor shall provide a contract manager who shall be responsible for the performance of the work. The name of this person and an alternate who shall act for the contractor when the manager is absent shall be designated in writing to the contracting officer. The contract manager or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The contract manager or alternate shall be available between 07:00 am and 15:30 pm, Monday thru Friday except Federal holidays or when the government facility is closed for administrative reasons.

1.6.12 Identification of Contractor Employees: All contract personnel attending meetings, answering Government telephones, and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression in the minds of members of the public that they are Government officials. They must also ensure that all documents or reports produced by contractors are suitably marked as contractor products or that contractor participation is appropriately disclosed.

1.6.13 Organizational Conflict of Interest: Contractor and subcontractor personnel performing work under this contract may receive, have access to or participate in the development of proprietary or source selection information (e.g., cost or pricing information, budget information or analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or subsequent Organizational Conflict of Interests (OCI) as defined in FAR Subpart 9.5. The Contractor shall notify the Contracting Officer immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the Contracting Officer to avoid or mitigate any such OCI. The Contractor’s mitigation plan will be determined to be acceptable solely at the discretion of the Contracting Officer and in the event the Contracting Officer unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the Contracting Officer may effect other remedies as he or she deems necessary, including prohibiting the Contractor from participation in subsequent contracted requirements which may be affected by the OCI.

Engineering Health Physicist/RSO Jamaica Plain Campus VA Boston Healthcare System 150 South Huntington Avenue Boston, MA 02130 Phone: (857) 364-5852 Fax: (857) 364-4545 Cell: (914) 443-0929 joseph.darman@va.gov

The following standard items relate to records generated in executing the contract and should be included in a typical Electronic Information Systems (EIS) procurement contract:

1. Citations to pertinent laws, codes and regulations such as 44 U.S.C chapters 21, 29, 31 and 33; Freedom of Information Act (5 U.S.C. 552); Privacy Act (5 U.S.C. 552a); 36 CFR Part 1222 and Part 1228.

2. Contractor shall treat all deliverables under the contract as the property of the U.S. Government for which the Government Agency shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest.

3. Contractor shall not create or maintain any records that are not specifically tied to or authorized by the contract using Government IT equipment and/or Government records.

4. Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected by the Freedom of Information Act.

5. Contractor shall not create or maintain any records containing any Government Agency records that are not specifically tied to or authorized by the contract.

6. The Government Agency owns the rights to all data/records produced as part of this contract.

1.11.5 The Government Agency owns the rights to all electronic information (electronic data, electronic information systems, electronic databases, etc.) and all supporting

PART 2

DEFINITIONS & ACRONYMS

2. DEFINITIONS AND ACRONYMS:

2.1. DEFINITIONS

2.1.1. 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.

2.1.2. 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.

2.1.3. 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.

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

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

2.1.6. 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.

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

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

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

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

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

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

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

2.2. ACRONYMS:

PART 3

GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

The Contractor shall provide all property, equipment and services to perform the Consulting Physicist Services.

PART 4

CONTRACTOR FURNISHED ITEMS AND SERVICES

The Contractor shall provide all items and services to perform the Consulting Physicist Services

PART 5

SPECIFIC TASKS

5. Specific Tasks:

5.1 ROUTINE

Routine Service shall normally be reconciled within one week or scheduled mutual consent. Routine Service shall normally be in accordance with current applicable standards. VA may request routine services from the Consulting Physicist including but not limited to the following:

5.1.1 Performance

All work shall be performed by a qualified diagnostic medical physicist. A qualified diagnostic medical physicist is a person who is certified by the American Board of Radiology, American Board of Medical Physics, or the Canadian College of Physicists in Medicine. For mammography, a qualified medical physicist can have state licensure to perform mammography inspections in lieu of board certification. For diagnostic computed tomography (CT), nuclear medicine, PET, or MRI, a qualified medical physicist can meet the following requirements in lieu of board certification:

● A graduate degree in physics, medical physics, biophysics, radiologic physics, medical health physics, or a closely related science or engineering discipline from an accredited college or university

● Formal graduate-level coursework in the biological sciences with at least one course in biology or radiation biology and one course in anatomy, physiology, or a similar topic related to the practice of medical physics

● Documented 3 years of clinical experience in CT, nuclear medicine, PET, or MRI. The physicist must document the 3 years of experience for the modality being inspected.

5.1.2. Mandatory Services to be Performed

a. The qualified diagnostic medical physicist shall perform imaging equipment (x-ray equipment, CT’s, nuclear medicine cameras, PET/CT cameras, and MRIs) inspections to ensure compliance with the current American College of Radiology (ACR) and Mammography Quality Standards Act (MQSA) requirements. Any deficiencies or non-conformances discovered during the inspection shall be verbally communicated to the service supervisor or RSO prior to the qualified diagnostic medical physicist leaving the facility. Deficiencies or non-conformances which represent unsafe conditions with the potential to adversely impact the facility radiation workers or patients shall be reported to the RSO immediately upon discovery and to the individual responsible for the equipment. A Fault Report shall be placed on equipment that is found unsafe to use, with the reason for the condition. A written report of the results shall be provided to the service supervisor or RSO within 30 working days after completion of the inspection. All imaging equipment shall be inspected at least annually, not to exceed 14 months.

b. The qualified diagnostic medical physicist shall perform acceptance testing of all new or relocated imaging equipment prior to first clinical use. The acceptance testing shall comply with ACR or MQSA requirements. Any deficiencies or non-conformances discovered during the inspection shall be verbally communicated to the service supervisor or RSO prior to the qualified diagnostic medical physicist leaving the facility. A fault report shall also be attached to the equipment in question. Deficiencies or non-conformances which represent unsafe conditions with the potential to adversely impact the facility radiation workers or patients shall be reported to the RSO immediately upon discovery. A written report of the results shall be provided to the service supervisor or RSO within 30 working days after completion of the inspection.

c. The qualified diagnostic medical physicist shall oversee inspection of imaging equipment after repairs or modifications that may affect the radiation output or image quality. The qualified diagnostic medical physicist shall perform a full inspection of imaging equipment after repairs or modifications that may affect the radiation output or image quality. The inspection shall be completed within 30 days hours after the facility contacts the contractor. Any deficiencies or non-conformances discovered during the inspection shall be verbally communicated to the service supervisor or RSO prior to the qualified diagnostic medical physicist leaving the facility. A fault report shall also be attached to the equipment in question. Deficiencies or non-conformances which represent unsafe conditions with the potential to adversely impact the facility radiation workers or patients shall be reported to the RSO immediately upon discovery. A written report of the results shall be provided to the service supervisor or RSO within 30 working days after performing of the inspection.

d. The qualified diagnostic medical physicist shall provide consultation for additional services including but not limited to the following:

· Physics testing on x-ray equipment

· Perform x-ray machine shielding evaluations and surveys

· Annual accuracy tests on dose calibrators

· Handheld instrument calibrations

· Sit in person on the Radiation Safety Committee

· Act as the RSO during temporary leaves of absence of the VA RSO

· In the event the current RSO permanently discontinues duties, act as temporary licensed RSO until a permanent RSO is named.

· Verify adequacy and integrity of lead aprons

· Analyze, design, develop, implement, and evaluate training programs in selected radiation safety areas.

· Provides guidance for the Radiation Safety Program

· Review and conduct annual audits of BHS Radiation Safety Program

· Provide emergency services to estimate doses from accidents and/or misadministration of radioactive material.

e. The qualified diagnostic medical physicist shall spot check CT protocols at least annually.

f. The qualified diagnostic medical physicist shall provide shielding design calculations for each new, replaced, or relocated x-ray imaging system. The calculations for each shall comply with the National Council for Radiation Protection and Measurements (NCRP) Report No. 147, and, for dental units, NCRP Report No. 145, and shall be documented in a written report which includes a diagram showing adjacent areas. The qualified diagnostic medical physicist shall perform a shielding survey to verify the structural shielding was installed per the shielding design report and complies with the design goals. A written report of the shielding survey shall be provided to the RSO within 30 workings days after the shielding survey has been completed.

g. The qualified diagnostic medical physicist shall assist in the development of a comprehensive technical quality assurance (QA) program (e.g., technique charts, repeat/reject analysis monitoring, monitoring of exposure indices to radiographic image receptors, QA program for display monitors, QA for CT, monitoring of dose metrics from fluoroscopy studies), which complies with ACR recommendations, for all modalities. The qualified diagnostic medical physicist shall review at least annually the QA program. A written report of the results shall be provided to the service supervisor or RSO within 30 working days after performing of the inspection.

h. The qualified diagnostic medical physicist shall perform a follow-up inspection to verify compliance of any necessary corrective action performed to correct deficiencies found.

5.1.3. Equipment Inspections

The Contractor shall conduct equipment inspections or quality control surveys of the imaging equipment listed in Attachment 3/Technical Exhibit 3. Attachment A//Technical Exhibit 3 is a living document and equipment will likely be add and removed during the term of the contract. The Contractor shall ensure the imaging equipment’s compliance with applicable Federal regulations and ACR recommendations, and shall include, but not be limited to, monitoring the following basic performance characteristics.

A. Radiographic and Fluoroscopic Equipment

Physics inspections of radiographic and fluoroscopic equipment shall comply with the ACR Technical Standard for Diagnostic Medical Physics Performance Monitoring of Radiographic and Fluoroscopic Equipment. The performance of each radiographic and fluoroscopic unit must be evaluated at least annually. This evaluation should include, but not be limited to, the following tests (as applicable).

(1) Integrity of unit assembly.

(2) Collimation and radiation beam alignment.

(3) Fluoroscopic system spatial resolution.

(4) Automatic exposure control system performance.

(5) Fluoroscopic automatic brightness control performance (high-dose-rate, pulsed modes, field-of-view [FOV] variation).

(6) Image artifacts.

(7) Fluoroscopic phantom image quality.

(8) kVp accuracy and reproducibility.

(9) Linearity of exposure versus mA or mAs.

(10) Exposure reproducibility.

(11) Timer accuracy.

(12) Beam quality assessment (half-value layer).

(13) Fluoroscopic entrance exposure rate (or air kerma rate). Maximum output and output using a phantom representing a standard size patient for all clinically used settings. [The mode of operation [e.g., magnification mode, frame rate, and any other mode selected) must be documented for each measurement.]

(14) Fluorographic (image recording) entrance exposure rate (or air kerma rate) for cine imaging, if performed and entrance exposure (or air kerma) for spot images (if performed). Maximum output and output using a phantom representing a standard size patient for all clinically used settings. [The mode of operation (e.g., magnification mode, frame rate, etc.) must be documented for each measurement.]

(15) Image receptor entrance exposure.

(16) Equipment radiation safety functions.

(17) Patient dose monitoring system calibration. This includes, for radiographic systems, the metric of dose to the image receptor (IEC Exposure Index or proprietary index) and, for fluoroscopy systems, the displays of cumulative air kerma and, if available, DAP.

(18) Display monitor performance.

(19) Digital image receptor performance.

(20) Grids used with portable x-ray units shall be imaged for uniformity.

(21) For radiographic units, measurement of entrance skin exposure (or air kerma) for a standard size patient for common radiographic projections and comparision to published diagnostic reference levels and achievable doses (e.g., ACR practice parameter.

Note: The information on entrance exposure rates (or air kerma rates) from fluoroscopy and from fluorography, in Items (13) and (14) above, for each fluoroscope, shall be in a format suitable for providing to the physicians who operate the fluoroscope.

B. Computed Radiography (CR) and Digital Radiography (DR)

Physics inspections of CR and DR equipment shall comply with the American Association of Physicist in Medicine (AAPM) Report Number 93, Acceptance Testing and Quality Control of Photostimulable Storage Phosphor Imaging Systems. The performance of CR and DR must be evaluated at least annually. This evaluation should include, but not be limited to, the following tests (as applicable).

(1) Component and Imaging Plate Physical Inspection and Inventory.

(2) Imaging Plate Dark Noise and Uniformity.

(3) Exposure Indicator Calibration.

(4) Linearity and Auto-ranging Response.

(5) Laser Beam Function.

(6) Limiting Resolution and Resolution Uniformity.

(7) Noise and Low-Contrast Resolution.

(8) Spatial Accuracy.

(9) Erasure Thoroughness.

(10) Aliasing/Grid Response.

(11) IP Throughput.

(12) Positioning and Collimation Errors.

C. CT Scanners

The physics inspection shall conform to the 2012 ACR Computed Tomography Quality Control Manual. The performance of each CT scanner shall be evaluated at least annually. This evaluation should include, but not be limited to, the following tests (as applicable).

(1) Review of Clinical Protocols.

(2) Scout Prescription and Alignment Light Accuracy.

(3) Image Thickness – Axial Mode.

(4) Table Travel Accuracy.

(5) Radiation Beam Width.

(6) Low-Contrast Performance.

(7) Spatial Resolution.

(8) CT Number Accuracy.

(9) Artifact Evaluation.

(10) CT Number Uniformity.

(11) Dosimetry (the scanner displayed CTDIvol values must be within +/- 20% of the measured CTDIvol values).

(12) Gray Level Performance of CT Acquisition Display Monitors.

D. Dental

The physics inspection shall conform to the Conference of Radiation Control Program Directors (CRCPD), Quality Control Recommendations for Diagnostic Radiography Volume 1 Dental Facilities July 2001. The performance of dental x-ray inspections shall be annually or every 2 years. This evaluation should include, but not be limited to, the following tests (as applicable).

(1) Collimation.

(2) Beam quality (half value layer).

(3) Timer Accuracy and Reproducibility.

(4) kVp Accuracy and Reproducibility.

(5) mA or mAs Linearity.

(6) Exposure Reproducibility.

(7) Entrance Skin Exposure Evaluation, with comparison to published diagnostic reference levels and achievable doses (e.g., NCRP Report No. 172).

(8) Technique Chart Evaluation.

(9) Image uniformity (artifact evaluation).

Dental CBCT Acceptance and Performance Testing

1. Acceptance Testing. Acceptance testing and measurements of air kerma at the isocenter for each kVp station for a range of clinically used mAs settings will performed initially when the CBCT unit is installed, and following any move of the CBCT to another area inside or outside the initial clinical site. This testing is to ensure that the equipment performance is in agreement with the manufacturer’s technical specifications.

2. Performance Testing. Each CBCT unit shall undergo periodic quality control tests to insure that the performance of the machine has not significantly deteriorated and is operating within the manufacturer’s technical specifications. This performance testing is performed by a qualified expert annually, at intervals not to exceed 14 months, and after repairs to the CBCT unit that may affect the radiation output or image quality.

3. Some manufacturers provide a phantom and procedures to perform machine specific quality assurance (QA) tests. In cases where the manufacturer provides a phantom and procedures to perform specific tests but the tests are not included in this SOW, then the manufacturer’s machine-specific QA tests shall be performed in addition to the QA tests in this SOW.

Acceptance and Annual physics testing for Dental CBCT

1. Radiation output Repeatability

Make four measurements of the air kerma at the isocenter at a clinically used setting. The measurements should be less than +/-5% of the average of the five measurements and the measurements should be less than +/- 5% of the previous year’s measurement.

2. Radiation Output Reproducibility

Measure the air kerma at the isocenter for each kVp station and a range of clinically used mAs setting. Compare the results to the baseline values established at the initial acceptance testing. The values should be +/-5% of the baseline.

3. kVp Accuracy

Measure the kVp at all clinically used settings. The measured kVp should be +/-5% of the selected kVp.

4. kVp Repeatability

Make five kVp measurements each for two clinically used kVp settings. All measured values should be +/-5% of the mean kVp.

5. kVp Reproducibility

Measure the kVp at all available kVp settings. The measured values should be +/-5% of the baseline.

6. Beam quality

Measure the half value layer (HVL) for aluminum. The minimum shall comply with Section F.4.d of the Suggested State Regulations for Control of Radiation, Conference of Radiation Control Program Directors.

7. Radiation field of view (FOV)

Measure the width of the radiation field at the isocenter. The width of the beam should be 3 mm or 30% of the total nominal collimated width.

8. Image Quality

Image the phantom provided by the manufacturer or another suitable phantom. Assess high contrast spatial resolution, uniformity of transaxial images, and image noise. Imaging uniformity shall be assessed over the entire range of axial images.

9. Accuracy of Linear Measurements

Using images of an appropriate phantom, assess the accuracy of distance measurements.

10. Accuracy of Patient Dose Metric Indication

Assess the accuracy of the indicated dose metric (typically DAP).

11. Patient Dose Assessment

From a scan or scans using the facility’s standard techniques, record the dose metric (typically DAP) and compare to achievable levels and diagnostic reference levels (if available)

12. Review of the technical QA program

The qualified expert shall review the technical QA program. The review shall include a trend analysis of the QA data. The results of the technical QA program review shall be included in the written report. Any trends that identify problems shall be included in the report along with recommended corrective actions.

13. Display Monitors

Perform a visual analysis of the SMPTE test pattern.

· Display the test pattern on the imaging console. Set the display window width/level to the manufacturer-specified values for the pattern. Do not set the window/level by eye; doing so invalidates the procedure.

· Examine the pattern to confirm that the gray level display in the imaging console is subjectively correct.

Review the line pair patterns in the center and at each of the corners.

Review the black-white transition.

Look for any evidence of “scalloping” (loss of bit depth) or geometric distortion.

· Use a photometer to measure the maximum and minimum monitor brightness (0% and 100% steps)

· Measure additional steps within the pattern to establish a response curve.

· Measure the brightness near the center of the monitor and near all 4 corners (or all 4 sides, depending on the test pattern used).

14. Viewing Conditions

Assess the viewing conditions for the area in which the monitor used to evaluation the CBCT studies is located.

E. Mammography

The qualified diagnostic medical physicist inspecting mammography equipment must meet the qualifications outlined in the MQSA and shall provide the facility with up-to-date documentation demonstrating the qualified diagnostic medical physicist is MQSA qualified. Inspections of mammography equipment must comply with the latest requirements posted on the ACR Web site for the manufacturer of the digital mammography unit being inspected. Inspection items may include:

(1) Mammographic Unit Assembly Evaluation.

(2) Collimation assessment.

(3) Artifact evaluation.

(4) kVp accuracy and reproducibility.

(5) Beam quality assessment – HVL measurements.

(6) Evaluation of system resolution.

(7) Automatic Exposure Control (AEC) function performance .

(8) Breast entrance exposure, AEC reproducibility, and average glandular dose.

(9) Radiation output rate.

(10) Phantom image quality evaluation.

(11) Signal–to–noise ratio and contrast–to noise ratio measurements.

(12) View box luminance and room illuminance.

(13) Review Work Station (RWS) tests.

F. MRI

The physics inspection shall conform to the 2004 ACR Magnetic Resonance Imaging Quality Control Manual. The performance of each MRI scanner shall be evaluated at least annually. This evaluation should include, but not be limited to, the following tests (as applicable).

(1) Magnetic field homogeneity.

(2) Geometric accuracy.

(3) Inter-slice RF interference.

(4) Slice position accuracy.

(5) High-contrast resolution

(6) RF coil performance.

(a) Volume coils’ signal-to-noise ratio

(b) Volume coils’ image uniformity

(c) Volume coils’ ghosting ratio

(d) Phased array coils' signal-to-noise ratio

(e) Surface coils’ signal-to-noise ratio

(7) Slice thickness accuracy

(8) Low-contrast detectability

(9) Soft copy displays

(10) Technologist’s QC program

(11) Site phantom inventory

(12) Site RF coil inventory

G. PET

The physics inspection shall conform to the ACR PET Phantom Instructions for Evaluation of PET Image, ACR Nuclear Medicine Accreditation Program PET Module. The performance of each PET scanner shall be evaluated at least quarterly. For PET/CT units the CT must be inspected at least annually per Item C above. This evaluation should include, but not be limited to, the following tests (as applicable).

(1) Uniformity.

(2) Spatial resolution.

(3) SUV analysis.

H. Nuclear Medicine

The physics inspection shall conform to the ACR annual performance tests for nuclear medicine cameras. The qualified diagnostic medical physics shall also perform the quarterly testing as outlined by the ACR, as required. The performance of each nuclear medicine scanner shall be at least annually. This evaluation should include, but not be limited to, the following tests (as applicable).

(1) Intrinsic Uniformity

(2) System Uniformity

(3) Intrinsic or System Spatial Resolution

(4) Relative Sensitivity

(5) Energy Resolution

(6) Count Rate Parameters

(7) Formatter/Video Display

(8) Overall System Performance for SPECT

(9) System Interlocks

(10) Dose Calibrators (Geometry, if applicable, Accuracy)

(11) Thyroid Uptake and Counting Systems

I. Display Monitors

The annual performance evaluation conducted by the diagnostic medical physicist includes testing of image acquisition display monitors for maximum and minimum luminance, luminance uniformity, resolution, and spatial accuracy. The image acquisition display monitors for nuclear medicine, PET, CT, and MRI units shall be tested.

J. Additional Requirements

The Consulting Physicist conducts radiation protection surveys on each x-ray unit in the institution upon initial installation, annually, and after equipment re-configuration (e.g., after major repairs, upon suspected equipment malfunction, after major modification to equipment location and/or after major modification to structures surrounding the equipment). The Consulting Physicist shall perform evaluations of the measured radiation exposure resulting from the use of the equipment and its compliance with existing regulations.

Examination of its location with reference to controlled and uncontrolled areas, and an assessment of the potential exposure to the environment surrounding the equipment shall be performed.

Initial Survey. Prior to medical use, an initial survey of all new equipment including a checkout of all routine operating parameters shall be conducted on each x-ray unit before clinical use. Conduction of such a checkout is required of installation personnel, but a qualified medical physicist/ Consulting Physicist shall also perform this procedure prior to clinical use.

Resurveys. The above survey should be repeated whenever any major maintenance or repair is performed, or whenever there appears to be a major change in the performance of the system.

Periodic Routine Surveys. A qualified medical physicist/ Consulting Physicist shall conduct an annual survey of all diagnostic x-ray units in the Medical Center. Included shall be measurements of skin entry doses using appropriate phantoms. Complete reports shall be submitted to the RSO who shall forward copies to Radiology Service and the Clinical Engineering Service. The final report shall include skin entry doses for all routine procedures on each system including photo-controlled measurements plus calculations for all manual procedures based on measurements for each system.

The Consulting Physicist conducts and/or reviews shielding evaluations and shielding surveys in accordance with NCRP-147 on each new or…