36C25619Q0092-0002001.pdf

5. PROJECT NUMBER (if applicable)

CODE 7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO. 1. CONTRACT ID CODE

FACILITY CODE CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR

ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office. is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES

SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER 16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30 PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243

(Type or print) (Type or print)

(Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code)

(If other than Item 6)

(Specify type of modification and authority)

(such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer)

1 36

0002 02-28-2019 None

Department of Veterans Affairs

Network Contracting Office 16

Michael E. DeBakey VA Medical Center

2002 Holcombe Boulevard

Houston TX 77030 4298

Department of Veterans Affairs

Network Contracting Office 16

Michael E. DeBakey VA Medical Center

2002 Holcombe Boulevard

Houston TX 77030 4298

To all Offerors/Bidders 36C25619Q0092

01-25-2019 X x x

3/4/2019 at 4:00 PM CST x 1 (one)

The purpose of this amendment is to post Questions and Answers (Q&A) and to revise language in the solicitation.

A. See attached Q&A.

B. Performance Work Statement (PWS) and Addendum to 52.212-1 is updated and replaced with the attached version.

C. This amendment will need to be signed and returned with quote submission to be eligible for award.

Christopher D. Vu

Contracting Officer

VH-VHA-SAOC-2018-E8E15CC2

36C256 36C256

Questions and Answers #1

The Michael E. DeBakey Veteran Affairs Medical Center (MEDVAMC) Network Contracting Office (NCO) 16 received questions in response to Request for Quotation (RFQ) 36C25619Q0092.

Please see below for the Contractor’s questions and NCO 16’s respective answers accordingly.

Question Answer

With respect to the requirement for providers to hold a BLS and/or ACLS certificate, PWS Paragraph 2.1.6 lists ACLS/BLS as ‘N/A’, the deliverables table at PWS Paragraph 6.1.2 requires certifications ‘Upon award and every two years after award”, and then the RFP’s Instruction to Contractor states at

Paragraph 5 that copies of ACLS/BLS certificates must be submitted with the proposal.

Question 1: Are providers required to hold a BLS and an ACLS certificate? Or will either suffice?

Question 2: Are certificates to be presented upon award during the credentialing process or with the proposal?

BLS and ACLS certification not required.

Amendment 0002 is issued to remove languages from the deliverables table in the PWS

Paragraph 6.1.2 “ACLS/BLS

Certification ‘Upon award and every two years after award”.

Amendment 0002 is issued to remove languages from

Addendum to FAR 52.212-1

Instruction to offerors, Instruction to Contractor

“Copies of Advanced Cardiac

Lift Support/Basic Lift Support

(ACLS/BLS) Certificate.”

See attached updated PWS and

Addendum to FAR 52.212-1

Instruction to offerors.

Section 2.9.3 Medical Physicist Coverage – providing coverage within 2 hours. Can this requirement be removed based on the number of credentialed medical physicists we would have to have available for the VA, this is a very difficult task for any large or small organization to meet.

Amendment 0002 is issued to remove languages from the

PWS Section 2.9.3 “coverage within 2 hours” and revised to

“coverage within 24 hours”.

We will need to have physics coverage at all times during VA

Hours of Operations in order to keep the clinic open. We would like the contractor to have enough people credentialed in case for emergency coverage.

Section 4.4.2 – please provide the name of the currently approved Chief

Therapeutic Medical Physicist that was approved by the VHA National

Radiation Oncology Program.

We cannot provide the names of the Medical Physicist.

Section 4.4.2 – Can you please provide the process and policies of the VHA

National Radiation Oncology Program relevant to the Chief Therapeutic

Medical Physicist. What are the requirements to meet standards? How long does approval take? Will this process prevent the Chief from starting on time on contract? Etc.

Guidelines for Radiation

Oncology can be found in the

PWS Section 4.2.1 link http://www.acr.org/Quality-

Safety/Standards-

Guidelines/Practice-Guidelines-by-Modality/Radiation-

Oncology

Basis for award, page 78 of the RFP, Section 9. States: “Contractor shall submit

ACR accreditation with their quote. ACR accreditation must matches the name of the contractor and/or an explanation is provided that any submitted ACR accreditation applies to that contractor if the accreditation is for a different named entity. Failure to provide the requested information shall be considered technically unacceptable and your quote could be removed from the evaluation process.”

a. The ACR does not accredit organizations that provide Physicists to facilities like the VA. It only provides ACR Rad Onc Accreditation to actual Facilities providing Rad Onc Services. This was confirmed in a phone call with ACR on

1/31/2019, and is also seen in the below referenced guidelines for ACR accreditation – Radiation Oncology Practice Accreditation Program

Requirements https://www.acraccreditation.org/-

/media/ACRAccreditation/Documents/ROPA/Requirements.pdf?la=en

b. The ACR only has five ACR accredited Rad Onc Programs in the Houston area to include:

• University of Texas MD Cancer Center

• Michael E Debakey VAMC

• Harris Health System Atwell Center for Radiation

• MD Anderson Proton Therapy Center

• CHI St Lukes Radiation Therapy and Cyber Knife

c. This requirement is set-aside for SDVOSB; you can see that none of the ACR accredited facilities are SDVOSB organizations. Can the VA please remove this requirement from the evaluation criteria.

Amendment 0002 is issued to remove languages from Section

9 that states: “Contractor shall submit ACR accreditation with their quote. ACR accreditation must matches the name of the contractor and/or an explanation is provided that any submitted

ACR accreditation applies to that contractor if the accreditation is for a different named entity. Failure to provide the requested information shall be considered technically unacceptable and your quote could be removed from the evaluation process.”.

Attached updated Addendum to

FAR 52.212-1 Instructions to

Offerors.

http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Radiation-Oncology http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Radiation-Oncology http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Radiation-Oncology http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Radiation-Oncology http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Radiation-Oncology https://www.acraccreditation.org/-/media/ACRAccreditation/Documents/ROPA/Requirements.pdf?la=en https://www.acraccreditation.org/-/media/ACRAccreditation/Documents/ROPA/Requirements.pdf?la=en

It is our understand that the services for this opportunity will be provided at the

VA location. Subsequently our interpretation of the ACR accreditation is required for facilities and the individuals. With that being said is it governments requirement is for the Physicist to have the ACR not our company?

We have removed the language in the evaluation requirement

Section 9 about ACR accreditation. See responses to question 5 above.

Is this for 2 or 3 FTE. Pricing is for 2, but in the PWS it looks like 1 Senior

TMP and 2 TMP’s for a total of 3 FTE

This is for 3 FTE.

Pricing - i.e.

•CLIN (0001a and 0001b) -

Board Certified Therapeutic

Medical Physicist required to be on-site 2.0 FTE

•CLIN (0002a) - Board

Certified Senior Therapeutic

Medical Physicist (Chief) required to be on-site 1.0 FTE

Can you please provide the # of FTE and title of the current medical physicists providing service; i.e. 1 FTE Chief, 1 FTE Medical Physicist, etc.

See responses to question 7 above.

Page 20, 2.9.3: The Contractor shall be responsible for providing coverage to the

VA during periods of vacancies of the Contractor’s personnel due to sick leave, personal leave, vacations and additional coverage as required. In the event a scheduled medical physicist is unable to complete an assigned shift, the contractor shall provide replacement medical physicist coverage within 2 hours and notify the Contracting Office Representative (COR) at the MEDVAMC immediately of the schedule change.

Question: Will the government remove this requirement as it is not practical for a contractor to provide a replacement chief physicist within a 2-hour window.

Amendment 0002 is issued to remove languages from the

PWS Section 2.9.3 “coverage within 2 hours” and revised to

“coverage within 24 hours”.

See updated PWS.

Will the government provide a list of equipment and supplies provided to the contractor? Specifically, does the government provide all equipment needed to perform quality assurance testing, calibration and other special measurements?

Yes, we provide the necessary equipment for the physicist to perform the needed duties.

Please define health safety items.

Our interpretation:

RFP asks for “proof of Health Records,” they are asking for some demonstration of completion of a health safety training program or confirmation of the candidate’s adherence to technical standards for some aspect of Medical

Physics.

Amendment 0002 is issued to remove Addendum to FAR

52.212-1 Instructions to

Offerors section 5 “Heath

Safety Item – Provide Proof of

Heath Records as required by solicitation.”

Contractor shall provide after award items listed under section

2.1.7 in the PWS.

12 Can you please provide the current contract # for the incumbent vendor providing services?

Task Order Contract Number

V797P-7366/ 36C25618N5461.

Is this a new opportunity and what is your procurement method? This is not a new opportunity.

If these requirements are currently being performed under a contract,

a. Who is the Contractor?

b. What is the contract number?

c. When does the contract expire?

d. What is the current contract value?

a. Who is the Contractor?

Mission Search International

b. What is the contract number?

Task Order Contract Number

V797P-7366/ 36C25618N5461

c. When does the contract expire? 6/30/2019

d. What is the current contract value? $1,085,531

(End of Question/Answer)

B.3 PERFORMANCE WORK STATEMENT (PWS)

ONSITE MEDICAL PHYSICS AND SUPPORT SERVICES

1. GENERAL

1.1. SERVICES REQUIRED: The VA Radiation Oncology Services are accredited by ACR and follow the standards

& guidelines set forth by American College of Radiology (ACR). As such any Contractor providing on-site radiation oncology services must adhere to all the American College of Radiology Guidelines & Technical

Standards for Radiation Oncology: A contractor providing on-site radiation oncology services must provide evidence the radiation oncology practice meets or exceeds the American College of Radiology Guidelines for

Radiation Oncology.

http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Radiation-Oncology http://www.acr.org/Quality-Safety/Appropriateness-Criteria/New-and-Revised http://www.acr.org/Quality-Safety/Standards-Guidelines/Technical-Standards-by-Modality/Medical-Physics

1.2. PLACE OF PERFORMANCE: Services shall be provided on site in Radiation Oncology Service, Michael E.

DeBakey VA Medical Center, 2002 Holcombe Blvd., Houston, TX 77030.

1.3. Authority: Title 38 USC 8153 Contracting Authority combination with FAR Part 13.5.

1.4. Policy/Handbooks:

1.4.1. VA Directive 1663: Health Care Resources Contracting - Buying https://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2

1.4.2. VHA Directive 1105.04, Fluoroscopy Safety

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=2ahUKE wigzvCijNLfAhVxmeAKHUHqA_YQFjAAegQIBxAC&url=https%3A%2F%2Fwww.va.gov%2Fvhapubli cations%2FViewPublication.asp%3Fpub_ID%3D7454&usg=AOvVaw0Dh8OtZsXdabmrPbZ4TWBH

1.4.3. VHA Directive 2006-041 “Veterans’ Health Care Service Standards” (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

1.4.4. VHA Directive 2010-018 “Facility Infrastructure”

www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2227

1.4.5. VHA Directive 1192 “Seasonal Influenza Prevention Program” https://www.publichealth.va.gov/docs/flu/VHA_Directive_1192_Sep

1.4.6. VHA Handbook 1100.17: National Practitioner Data Bank Reports -http://www1.va.gov/vhapublications/ViewPublication.asp?pubID=2135

1.4.7. VHA Handbook 1100.18 Reporting And Responding To State Licensing Boards -http://www1.va.gov/vhapublications/ViewPublication.asp?pubID=1364

1.4.8. VHA Handbook 1100.19 Credentialing and Privileging -

http://www1.va.gov/vhapublications/ViewPublication.asp?pubID=1806

1.4.9. VHA Directive 2012-030 Credentialing of Health Care Professionals – http://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=2815

1.4.10. VHA Handbook 1907.01 Health Information Management and Health Records:

http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Radiation-Oncology http://www.acr.org/Quality-Safety/Appropriateness-Criteria/New-and-Revised http://www.acr.org/Quality-Safety/Standards-Guidelines/Technical-Standards-by-Modality/Medical-Physics https://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2 https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=2ahUKEwigzvCijNLfAhVxmeAKHUHqA_YQFjAAegQIBxAC&url=https%3A%2F%2Fwww.va.gov%2Fvhapublications%2FViewPublication.asp%3Fpub_ID%3D7454&usg=AOvVaw0Dh8OtZsXdabmrPbZ4TWBH https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=2ahUKEwigzvCijNLfAhVxmeAKHUHqA_YQFjAAegQIBxAC&url=https%3A%2F%2Fwww.va.gov%2Fvhapublications%2FViewPublication.asp%3Fpub_ID%3D7454&usg=AOvVaw0Dh8OtZsXdabmrPbZ4TWBH https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=2ahUKEwigzvCijNLfAhVxmeAKHUHqA_YQFjAAegQIBxAC&url=https%3A%2F%2Fwww.va.gov%2Fvhapublications%2FViewPublication.asp%3Fpub_ID%3D7454&usg=AOvVaw0Dh8OtZsXdabmrPbZ4TWBH https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443 http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2227 https://www.publichealth.va.gov/docs/flu/VHA_Directive_1192_Sep http://www1.va.gov/vhapublications/ViewPublication.asp?pubID=2135 http://www1.va.gov/vhapublications/ViewPublication.asp?pubID=1364 http://www1.va.gov/vhapublications/ViewPublication.asp?pubID=1806 http://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=2815 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791

1.4.11. Privacy Act of 1974 (5 U.S.C. 552a) as amended

http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.5. DEFINITIONS/ACRONYMS:

1.5.1. AAPM: American Association of Physics in Medicine

1.5.2. ACGME: Accreditation Council for Graduate Medical Education

1.5.3. ACR: American College of Radiology (www.acr.org/)

1.5.4. ACO: Administrative Contracting Officer

1.5.5. AOA: American Osteopathic Association

1.5.6. BAA : Business Associate Agreement

1.5.7. CAMPEP: Commission on Accreditation of Medical Physics Educational Programs

(http://www.campep.org/default.asp)

1.5.8. CDC: Centers for Disease Control and Prevention

1.5.9. CEU: Certified Education Unit

1.5.10. CME: Continuing Medical Education

1.5.11. CMS: Centers for Medicare and Medicaid Services

1.5.12. CO: Contracting Officer

1.5.13. COR: Contracting Officer’s Representative

1.5.14. COS: Chief of Staff

1.5.15. CPARS: Contractor Performance Assessment Reporting System

1.5.16. CPRS: Computerized Patient Recordkeeping System- electronic health record system used by the VA.

1.5.17. FSMB: Federation of State Medical Boards

1.5.18. Full Time Equivalent (FTE): VA’s definition for full time- working the equivalent of 80 hours every two weeks, 2080 hours per year. In calculating FTE, any hours not worked on national holidays shall not be included.

1.5.19. HHS: Department of Health and Human Services

1.5.20. HICPAC: Healthcare Infection Control Practices Advisory Committee- a federal advisory committee made up of 14 external infection control experts who provide advice and guidance to the CDC and the Secretary of HH.S regarding the practice of health care infection control, strategies for surveillance and prevention and control of health care associated infections in United States health care facilities.

1.5.21. HIPAA: Health Insurance Portability and Accountability Act

1.5.22. IGRT: Image Guided Radiation Therapy is the process of frequent two and three-dimensional imaging, during a course of radiation treatment, used to direct radiation therapy utilizing the imaging coordinates of the actual radiation treatment plan.

1.5.23. IMRT: Intensity Modulated Radiation Therapy is the process of delivering highly conformal radiotherapy to the tumor while sparing the surrounding normal tissues by varying radiation intensity across treatment portals.

1.5.24. ISO: Information Security Officer

1.5.25. MU: Monitor Unit is a measure of machine output of a linear accelerator in radiation therapy.

1.5.26. IROC: Imaging and Radiation Oncology Core.

1.5.27. NHPP: National Health Physics Program

1.5.28. NROP: National Radiation Oncology Program

1.5.29. NRSC: National Radiation Safety Committee

1.5.30. POP: Period of Performance

http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm http://www.acr.org/ http://www.campep.org/default.asp

1.5.31. PPD: Purified Protein Derivative

1.5.32. PWS: Performance Work Statement

1.5.33. QA/QI: Quality Assurance/Quality Improvement

1.5.34. QM/PI: Quality Management/Performance Improvement

1.5.35. QASP: Quality Assurance Surveillance Plan

1.5.36. QMP: Quality Management Program

1.5.37. RPC: Radiological Physics Center

1.5.38. SPE: Senior Procurement Executive

1.5.39. SRS: Stereotactic Radio Surgery: a minimally invasive form of surgical intervention which makes use of a three-dimensional coordinated system to locate small targets inside the body and to perform on them some action such as ablation, biopsy, lesion, injection, stimulation, implantation, radiosurgery (SRS) etc.

1.5.40. SRT: Stereotactic Radio Therapy

1.5.41. TJC: The Joint Commission

1.5.42. TLD: Thermoluminescent Dosimeter- a device that measures radiation dose

1.5.43. VA: Department of Veterans Affairs

1.5.44. VAMC: Veterans Affairs Medical Center

1.5.45. VETPro: a federal web-based credentialing program for healthcare providers.

1.5.46. VHA: Veterans Health Administration

2. QUALIFICATIONS:

2.1. Staff and Facility:

2.1.1. License – License – Therapeutic Medical Physicists (TMP) assigned by the Contractor to perform the services covered by this contract must have board certification by the American Board of Radiology, but for the VA they do not have to hold a valid TMP state license, Territory, or Commonwealth of the United States or the District of Columbia) when services are performed onsite on VA property.

2.1.2. Board Certification - All TMP (s) shall be Board Certified. All continuing education courses required for maintaining certification must be kept up to date at all times. Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance.

2.1.2.1. Medical Physicists must be Board Certified in Medical Physics or Therapeutic Medical Physics by the ABR and maintain licensure with the Board of Licensure for Professional Medical Physicists, if applicable. Certification must be maintained throughout the contract POP. In the event that

Contractor’s medical physicist(s) is/are not directly employed by the treating facility, documentation must be provided to ensure adequate certification.

2.1.3. Credentialing of Health Care Professionals other than medical physicists: In accordance with VHA

Directive 2012-030, all health care professional who claim licensure, certification, or registration, as applicable to the position (this applies to all who are appointed or utilized on a full-time, part-time, intermittent, consultant , without compensation, on-station fee-basis, on-station contract, or on-station sharing agreement basis) and who are not currently credentialed in accordance with VHA Handbook

1100.19, must be credentialed in accordance with this directive.

2.1.3.1. If a contractor’s medical physicist (s) and/or other contract provider (s) are not credentialed and privileged or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.

2.1.3.2. Credentialing of Health Care Professionals other than medical physicists. In accordance with

VHA Directive 2012-030, all health care professional who claim licensure, certification, or registration, as applicable to the position (this applies to all who are appointed or utilized on a full-time, part-time, intermittent, consultant , without compensation, on-station fee-basis, on-station contract, or on-station sharing agreement basis) and who are not currently credentialed in accordance with VHA Handbook

1100.19, must be credentialed in accordance with this directive. NOTE: The credentialing requirements are found in Attachment A of this Directive.

2.1.4. Technical Proficiency - Contractor’s medical physicist (s) and other contract provider (s) shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documents upon request of the

CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contractor’s medial physicist (s) s and other contract provider (s) shall have knowledge of professional care theories, principles, practices, and procedures to serve radiation oncology patient population. Contractor’s medial physicist (s) and other contract provider

(s) shall demonstrate knowledge of growth and development, and pathophysiology of disease processes specific radiation oncology patient population. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contractor’s medical physicist (s) and other contract provider (s) shall be responsible for abiding by the Facility's Medical Staff

By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

2.1.5. Continuing CME/CEU Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the VAMC. Contractors registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. CME hours shall be reported to the credentials office for tracking. These documents are required for initial and renewal privileging. Failure to provide shall result in loss of privileges.

2.1.6. Training and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contractor’s medial physicist (s) as required by the VA. Other training may become required. Items listed as N/A are not applicable. VA will communicate any changes to the training requirement to the contractor.

Training Frequency (once a year, etc)

Annual Hours

Age Specific and Cultural Competencies N/A N/A

Active Threat Training N/A N/A

Blood Administration: Complications N/A N/A

Blood Administration: Administration

(all contract employees who administer blood components)

N/A N/A

Government Ethics N/A N/A

Hospice and Pallative Care for VA

Clinicians

N/A N/A

Military Sexual Trauma (MST) for

Medical Providers

N/A N/A

Moderate Sedation In-Service Training N/A N/A

Prevention of Workplace

Harassment/No Fear Act

Every 2 years 1.0 hr

VHA MRI Safety Training Level 1

Training (all who enter MRI suites)

N/A N/A

VA Core Values Training (ICARE

Recommitment)

N/A N/A

VA Privacy and Information Security

Awareness and Rules of Behavior

Annually 1.0 hr

VHA Privacy and HIPAA Focused

Training

Annually 1.0 hr

ACLS/BLS N/A N/A

Patient Safety N/A N/A

Patient Rights N/A N/A

Patient Abuse N/A N/A

Prevention/Management of Disruptive

Behavior/Violence Prevention Level I

N/A N/A

Suicide Prevention: Suicide Risk

Management Training for Clinicians

N/A N/A

SUX Infection Control and Bood Borne

Pathogens

N/A N/A

CPRS N/A N/A

VISTA Imaging N/A N/A

2.1.7. Standard Personnel testing (PPD, etc.): Contractor shall provide proof of the following tests for medical physicists within five (5) calendar days after contract award and prior to the first duty shift to the COR and

Contracting Officer. Tests shall be current within the past year.

2.1.7.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative Tuberculosis Skin

Test (TST) or interferon-gamma release assays (IGRA) for all Contractor’s medical physicist (s) {This is applicable to all health care workers}. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results. The TST or IGRA testing shall be repeated annually.

2.1.7.2. MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor medial physicist s {This is applicable to all health care workers}.

2.1.7.3. VARICELLA: Contractors shall provide proof of immunity for all Contractor medial physicist s

{This is applicable to all health care workers}.

2.1.7.4. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all

Contractor medial physicists {This is applicable to all health care workers}.

2.1.7.5. INFLUENZA: Contractors shall provide proof that all Contractor medical physicists have received the annual Influenza vaccine unless it is contraindicated. If the Contractor medial physicist has a medical contraindication to the vaccine they shall be required to wear a mask during the Influenza season. {This is applicable to all health care workers}.

2.1.7.6. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE

PATHOGENS: Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all Contractor’s medial physicist (s) {This is applicable to all health care workers}; provide their own Hepatitis B vaccination series and hepatitis B surface antigen test results following the hepatitis B vaccination series; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident.

2.1.7.7. The VAMC shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel (as published in American Journal for Infection Control- AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.1.8. National Provider Identifier (NPI): NPI is not required for the contract

2.1.9. DEA - DEA certificate not applicable.

2.1.10. Conflict of Interest: The Contractor and all contractor’s Medical Physicist (s) and other contract provider

(s) are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of quotes and during the entirety of contract performance. At the time of quotes, the Contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided. The Contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf services. The Contractor must also provide relevant facts that show how it’s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70 Organizational

Conflicts of Interest (Jan 2008) and fully outlined in response to the subject attachment in Section D of the solicitation document.

2.1.11. Citizenship related Requirements:

2.1.11.1. The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the

U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals.

2.1.11.2. While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the Contractor is required to comply with all “E-

Verify” requirements consistent with “Executive Order 12989” and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations.

2.1.11.3. If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its

Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs

Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor’s place of business that services Department of Veterans Affairs patient referrals; or other place where the Contractor provides services to veterans who have been referred by the Department of Veterans

Affairs; and shall form the basis for termination of this contract for breach.

2.1.11.4. This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001.

2.1.11.5. The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFQ using the subject attachment in Section D of the solicitation document.

2.1.12. Annual Office of Inspector General (OIG) Statement: In accordance with HIPAA and the Balanced Budget

Act (BBA) of 1977, the Department of Health and Human Services (HHS) Office of Inspector General

(OIG) has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

2.1.12.1. Therefore, Contractor shall review the HHS OIG List of Excluded Individuals/Entities on the

HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed contractor’s medical physicist (s) is not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP’s may also be imposed against the Contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries.

2.1.12.2. By submitting their quotes, the Contractor certifies that the HHS OIG List of Excluded

Individuals/Entities has been reviewed and that the Contractors are and/or firm is not listed as of the date the offer/bid was signed.

2.2. Clinical/Professional Performance: The qualifications of Contractor personnel are subject to review by VA

Medical Center COS or his/her clinical designee and approval by the Medical Center Director as provided in

VHA Handbook 1100.19. Clinical/Professional performance monitoring and review of all clinical personnel http://oig.hhs.gov/exclusions/index.asp covered by this contract for quality purposes will be provided by the VAMC COS and/or the Chief of the Service or his designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.

2.3. Non Personal Healthcare Services: The parties agree that the Contractor and all contractor’s medical physicist (s) and other contract provider (s) shall not be considered VA employees for any purpose.

2.4. Indemnification: The Contractor shall be liable for, and shall indemnify and hold harmless the Government against, all actions or claims for loss of or damage to property or the injury or death of persons, arising out of or resulting from the fault, negligence, or act or omission of the Contractor, its agents, or employees.

2.5. Prohibition Against Self-Referral: Contractor’s Medical Physicist are prohibited from referring VA patients to contractor’s or their own practice(s).

2.6. Inherent Government Functions: Contractor and Contractor’s Medical Physicist (s) and other contract provider

(s) shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal

Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.7. No Employee status: The Contractor shall be responsible for protecting Contractor’s Medical Physicist (s) and other contract provider (s) furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

2.7.1. Workers’ compensation

2.7.2. Professional liability insurance

2.7.3. Health examinations

2.7.4. Income tax withholding, and

2.7.5. Social security payments.

2.8. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contractor’s medical physicist (s) and other contract provider (s). When a Contractor or contractor’s medical physicist (s) and/or other contract provider (s) have been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor’s (or contractor’s medical physicist (s) or other contract provider (s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.9. Key Personnel:

Contractor shall provide the number of qualified staff as is necessary to perform the services required under this contract, at the staffing level determined to be professionally acceptable by the Diagnostic and Therapeutic Care

Line Executive or designee and in accordance with American College of Radiology staffing guidelines.

2.9.1. Board Certified Senior Therapeutic Medical Physicist (Chief) required to be on-site 1.0 FTE per daily during clinical hours.

2.9.2. Board Certified Therapeutic Medical Physicist required to be on-site 2.0 FTE daily during clinical hours.

2.9.3. The Contractor shall be responsible for providing coverage to the VA during periods of vacancies of the

Contractor’s personnel due to sick leave, personal leave, vacations and additional coverage as required. In the event a scheduled medical physicist is unable to complete an assigned shift, the contractor shall provide replacement medical physicist coverage within 24 hours and notify the Contracting Office

Representative (COR) at the MEDVAMC immediately of the schedule change.

2.9.4. Personnel Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment. The Contractor shall notify the CO, in writing, within 15 calendar day (s) after the occurrence of any of these events and provide the information required below. After 90 days, the

Contractor shall submit the information required below to the CO at least 15 calendar days prior to making any permanent substitutions.

2.9.4.1. The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The CO will notify the Contractor within 15 calendar days after receipt of all required information of the decision on the proposed substitutes. The contract will be modified to reflect any approved changes of key personnel.

2.9.4.2. For temporary substitutions where the key person shall not be reporting to work for three 3 consecutive work days or more, the Contractor shall provide a qualified replacement for the key person.

The substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure as stated above.

2.9.4.3. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any Contractor’s Medical Physicist (s), s/he may request, without cause, immediate replacement of said Contractor’s Medical Physicist (s). The CO and

COR shall deal with issues raised concerning Contractor’s Medical Physicist (s) conduct. The final arbiter on questions of acceptability is the CO.

2.9.4.4. Contingency Plan: Because continuity of care is an essential part of VAMC’s medical services, The

Contractor shall have a contingency plan in place to be utilized if the Contractor’s Medical Physicist (s) leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

3. VA HOURS OF OPERATION/SCHEDULING:

3.1. VA Business Hours: Contract staff shall be available for clinic during normal treatment hours, Monday through Friday Local Time, 8:00 a.m. to 4:30 p.m. Tours may vary, on a rotating basis, as needed. Tour times could be 8:00 a.m. to 4:30 p.m., 9:00 a.m. to 5:30 p.m., 10:00 a.m. to 6:30 p.m., or 11:00 a.m. to 7:30 p.m.

3.1.1. Full time equivalent (FTE) is defined by VA as a minimum of 80 hours every 2 weeks and does not include holidays.

3.1.2. Medical physics quality assurance testing, calibration and other special measurements are performed after patients are through being treated for the day. Hours are paid the same as normal duty hours.

3.1.3. Physicists’ regular tours of duty will be determined by the COR and shall be on a rotating basis to ensure normal clinic hours and quality assurance duties are regularly covered.

3.1.4. Contractor’s medical physicist (s) shall be available and present in clinic during normal MEDVAMC clinic hours, MEDVAMC which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Radiation Oncology or designee. Currently, normal clinic hours are listed under section 3.1.

3.1.5. There is no on-call requirement for these services.

3.1.6. Federal Holidays: The following holidays are observed by the Department of Veterans Affairs:

• New Year’s Day

• President’s Day

• Martin Luther King’s Birthday

• Memorial Day

• Independence Day

• Labor Day

• Columbus Day

• Veterans Day

• Thanksgiving

• Christmas

• Any day specifically declared to be a national holiday.

3.1.7. When a holiday falls on a nonworkday -- Saturday or Sunday -- the holiday usually is observed on Monday

(if the holiday falls on Sunday) or Friday (if the holiday falls on Saturday).

3.1.8. Unless a state of emergency has been declared, the Contractor shall be responsible for providing services.

4. CONTRACTOR RESPONSIBILITIES

4.1. SERVICES REQUIRED:

Board Certified Senior Therapeutic Medical Physicist (Chief) required to be on-site 1.0 FTE per daily during clinical hours.

Board Certified Therapeutic Medical Physicist required to be on-site 2.0 FTE daily during clinical hours.

4.2. Standards of Practice: The medical practice and patient care provided by Contractor shall be evidence based best practices that meet or exceed all standards of professional practice and performance measures applicable to

MEDVAMC medical professionals, including, but not limited to, NHPP, AAPM and TJC standards and ACR current practice guidelines in radiation oncology.

Contractor’s care shall cover the range of services as would be provided in a state-of-the-art civilian medical treatment facility. Contractor shall provide evidence the Contractor’s radiation oncology standard of care is of a quality that meets or exceeds currently recognized VA and ACR national standards as established by:

4.2.1. The American College of Radiology (ACR) Guidelines for Radiation Oncology.

http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Radiation-

Oncology http://www.acr.org/Quality-Safety/Appropriateness-Criteria/New-and-Revised http://www.acr.org/Quality-Safety/Standards-Guidelines/Technical-Standards-by-Modality/Medical-

Physics

4.2.2. The professional standards of the TJC or equivalent accreditation http://www.jointcommission.org/standards_information/hap_requirements.aspx

4.2.3. VA Standards: VHA Directive 2006-041 “Veterans’ Health Care Service Standards” (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

4.2.4. The standards of the American Hospital Association http://www.hpoe.org/resources?show=100&type=8 and;

4.2.5. The requirements contained in this PWS

4.3. MEDICAL RECORDS

4.3.1. Authorities: Contractor’s medical physicist (s) providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the U.S.C.551a (Privacy

Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705

(Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Radiation-Oncology http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Radiation-Oncology http://www.acr.org/Quality-Safety/Appropriateness-Criteria/New-and-Revised http://www.acr.org/Quality-Safety/Standards-Guidelines/Technical-Standards-by-Modality/Medical-Physics http://www.acr.org/Quality-Safety/Standards-Guidelines/Technical-Standards-by-Modality/Medical-Physics http://www.jointcommission.org/standards_information/hap_requirements.aspx https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443 http://www.hpoe.org/resources?show=100&type=8 records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and

164 (HIPAA).

4.3.2. HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment. Based on this exception, a BAA is not required for this contract. Treatment and administrative patient records generated by this contract or provided to the Contractors by the VA are covered by the VA system of records entitled ‘Patient Medical Records-VA’ (24VA19). Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations. Contractor shall ensure that all records pertaining to medical care and services are available for immediate transmission when requested by the VA. Records identified for review, audit, or evaluation by VA representatives and authorized federal and state officials, shall be accessed on-site during normal business hours or mailed by the Contractor at his expense.

Contractor shall deliver all final patient records, correspondence, and notes to the VA within twenty-one

(21) calendar days after the contract expiration date.

4.3.3. Disclosure: Contractor’s medical physicist (s) may have access to patient medical records: however, Contractor shall obtain permission from the VA before disclosing any patient information. Subject to applicable federal confidentiality or privacy laws, the Contractor, or their designated representatives, and designated representatives of federal regulatory agencies having jurisdiction over Contractor, may have access to VA ‘s records, at VA’s place of business on request during normal business hours, to inspect and review and make copies of such records. The VA will provide the Contractor with a copy of VHA

Handbook 1907.1, Health Information management and Health Records and VHA Handbook 1605.1, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor.

4.3.4. Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA Handbook 1907.01

Health Information Management and Health Records:

http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 and all guidelines provided by the

VAMC.

4.3.5. Release of Information: The VA shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to Privacy Act requirements. In the case of the VA authorizing the Contractor to release patient information, the Contractor in compliance with VA regulations, and at his/her own expense, shall use VA Form 3288, Request for and Consent to Release of Information from Individual’s Records, to process “Release of Information Requests.” In addition, the Contractor shall be responsible for locating and forwarding records not kept at their facility. The VA’s Release of

Information Section shall provide the Contractor with assistance in completing forms. Additionally, the

Contractor shall use VA Form 10-5345, Request for and Authorization…