DRAFT Statement of Work - Dosimetry Badges.pdf

STATEMENT OF WORK

Radiology Personnel Dosimetry Badges Amarillo VA Health Care System

1.0 General

1.1 Introduction

1. The mission of the Amarillo VA Medical Center is to ensure that all Radiology personnel hold a current personnel dosimetry accreditation from the National Voluntary Laboratory Accreditation Program (NVLAP) of the US National Institute of Standards and Technology (NIST) for all radiation testing categories required by the Amarillo VAMC. The mission of the Amarillo VA Medical Center Radiology Service is to ensure that the dosimetry processor is approved in this accreditation process for the type of radiations included in the NVLAP program that most closely approximates the type of radiation for which the individual using the dosimeter is monitored. This acquisition will assure correct purchases and enable all Radiology personnel to be accredited in accordance with the NIST.

1.2 Objective

The objective is for the dosimeter processor must be able to calculate, provide and store the following information: Deep Dose Equivalent (DDE) to the whole body, Eye Dose Equivalent (LDE), Shallow Dose Equivalent (SDE), Committed Effective Dose Equivalent (CEDE), Committed Dose Equivalent (CDE), Total Organ Dose Equivalent (TODE), Total Effective Dose Equivalent (TEDE) as well as reports of radiation exposure being made on Nuclear Regulatory Commission (NRC) Form 4 (Cumulative Occupational Dose History) and NRC Form 5 (Occupational Dose Record for a Monitoring Period) or equivalent.

1.3 Scope of Work

The Amarillo VA Medical Center and the Lubbock Outpatient Clinic requires dosimetry badges to be delivered on a yearly basis. These will provide needed information and protection of radiation levels personnel are exposed to.

1.4 Background

In the past, the Amarillo VA Medical Center has purchased the dosimetry badges on a credit card order. To be more efficient, the Amarillo VA would like to take advantage of a contract.

1.5 Type of Contract Contemplated

Firm-fixed price

1.6 Period of Performance

The period of performance of this contract is one 12-month.

DRAFT

1.7 Place of Performance:

The Amarillo VA Medical Center has five (5) areas that badges are to be delivered:

Radiology, Nuclear Medicine, Surgery, Dental and Biomed. Dosimetry badges will also be needed at the Lubbock Outpatient Clinic in Lubbock, Texas in the Radiology Service.

Addresses:

Amarillo VA Health Care System Lubbock VA Clinic 6010 Amarillo Blvd., West 3510 4th St.

Amarillo, TX 79106-1990 Lubbock, TX 79415-3329

1.8 Applicable Documents

There are two applicable documents Nuclear Regulatory Commission (NRC) Form 4 (Cumulative Occupational Dose History) and NRC Form 5 (Occupational Dose Record for a Monitoring Period), or equivalent.

2.1 Specific Requirements/Tasks

2.1 Task One - The vendor MUST have web-based capability to a data base that contains dosimetry records for VA Amarillo HCS. The government MUST be able to:

• Add, transfer, or delete personnel.

• Add additional badges to existing personnel.

• Review records (wearer, badge type, frequency, dose history, etc.).

• Summarize results (exposure levels, ALARA, etc.).

• Review exposure histories per entire account.

• Review exposure histories for an individual.

• Add current year dose for an individual.

• Reactivate wearers and badges.

• Assign spare badges.

• List unreturned badges.

• Download data files for unreturned badges.

• Download data files for badge readings (exposures for specified periods) The on-line system shall be sufficiently easy to use such that it is more efficient to use than manually requesting changes by telephone.

2.2 Task Two - The vendor MUST be able to automatically compute an estimated dose for a missing dosimeter for a wear period. The vendor MUST be able to replace the computed dose if the dosimeter is found and returned for processing.

2.3 Task Three - Dosimeters MUST have permanent waterproof ID labels that cannot be smeared and/or removed and be color coded for alternate months.

2.4 Task Four - Finger dosimeters MUST be provided in a variety of sizes (Ex. small, medium, large, or extra-large), have permanent waterproof ID labels that cannot be smeared and/or removed, and be color coded for alternate months.

2.5 Task Five - Master controls MUST be provided for all types of dosimeters.

2.6 Task Six - Vendor MUST have capability of providing absent badge reports for each wear period upon vendor reporting in their online portal.

2.7 Task Seven - Exposure reports will be supplied within ten (14) days of receipt of dosimeters or made available via an online portal within the same timeframe.

2.8 Task Eight - Vendor MUST have a separate fetal dosimetry monitoring program which includes cumulative total on exposures from year to year. The occupational exposure of a declared pregnant woman does not exceed 500 mrem.

2.9 Task Nine - Vendor MUST have capability of immediate ALARA notification and memos for high exposures for any dosimeter exceeding specified ALARA Trigger limits.

2.10 Task Ten - Termination report summaries of personnel radiation exposures are to be supplied within forty-five (45) days of receipt of last badge after termination of employee.

2.11 Task Eleven - ALARA report summaries will be provided on a monthly/quarterly basis with an additional annual ALARA review summary (Form 5) for all monitored employees.

2.12 Task Twelve - Fees assessed for lost/late badges will be credited upon return of the badge in accordance with vendors’ policy.

2.13 Task Thirteen - Dosimeters MUST be supplied ten (10) days prior to beginning of wear period to allow time for distribution.

2.14 Task Fourteen - Shipments shall include individual printed packing lists for each group of users as defined by VA Amarillo HCS. The individual packing lists shall include the numerical order of the dosimeters. Other information provided in the listing shall include, but is not limited to, the following:

• Participant name

• Badge control identification

• Badge type

• Prescribed wear period, by date

2.15 Task Fifteen - Vendor MUST supply badges for additions to the program by the next regularly scheduled shipment.

2.16 Task Sixteen - Vendor MUST be able to provide exposure reports or other electronic means.

2.17 Task Seventeen - The Vendor MUST be able to perform/provide all the items listed below included in a flat amount and will be billable monthly.

a. The number of personnel requiring dosimeters or individuals requiring other types of dosimeters (ring, fetal, etc.) may vary during the performance period, with as few as 45 active participants, and as many as 90 active participants as attrition may occur, new staff is recruited, and new programs are initiated. At present, VA Amarillo HCS has the following dosimeter needs:

(1) 85 collar dosimeters

(2) 3 finger dosimeters

b. The below services are required in tracking and/or reporting. You can estimate the following included in the flat rate:

(1) All frequencies, all dosimeters including whole body, collar, fetal, waist, chest, wrist (Maximum of dosimeters per quarter).

(2) All frequencies, all extremity specific dosimeters, including ring dosimeters.

(Maximum of 3 dosimeters per quarter).

(3) Duplicate reporting

(4) Duplicate packing list

(5) Set-up for new participants or dosimeters

(6) Sort and pack fees

(7) ALARA quarterly reporting

(8) Form 5 Annual reports.

(9) Form 5 termination reports.

(10) Estimate reports.

(11) Fetal reports

(12) Absentee reports

(13) Additional dosimeters

(14) Unreturned dosimeters and/or TLD fees

(15) All postage fees (including expedited shipping) shall be provided at vendor’s expense including pre-paid postage and containers.

3.0 Contractor Quality Assurance.

Contractor performance measures and quality assurance will be monitored by the contractor.

4.0 Delivery or Deliverables

The Amarillo VA Medical Center along with the Lubbock Outpatient Clinic will order all needed dosimetry badges for each service listed above on a yearly basis. The badges for the Amarillo Services are to be delivered to Johnathan Riley and/or Christopher Hernandez and at the Lubbock Outpatient Clinic in Lubbock, Texas to Gwen Carrizales.

5.0 Meetings

No meetings required.

6.0 Required Travel and Other Direct Costs (ODCs)

No travel required.

7.0 Special Instructions

Please assure that the above listed personnel have access to add/delete badges as needed.

8.0 Government Furnished Property/Equipment/Information

No government furnished property/equipment needed.

9.0 Glossary of Abbreviations and Acronyms

N/A

SOW REVISION FOR VA SENSITIVE INFORMATION

GENERAL

Contractors, contractor personnel, subcontractors, and subcontractor personnel shall be subject to the same Federal laws, regulations, standards, and VA Directives and Handbooks as VA and VA personnel regarding information and information system security.

Information System Officer, Information Protection: The contractor will not have access to VA Desktop computers they will not have access to online resources belonging to the government.

Privacy Officer: The Contractor will not have access to protected Patient Health Information (PHI), nor will they have capability of accessing patient information during the services provided to the VA and if removal of equipment from the VA is required, any memory storage device will remain in VA control and will not be removed from VA custody. All research data available for Contractor analysis is de-identified.

Records Manager:

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.

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.

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.

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.

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

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

The Government Agency owns the rights to all electronic information (electronic data, electronic information systems, electronic databases, etc.) and all supporting documentation created as part of this contract. Contractor must deliver sufficient technical documentation with all data deliverables to permit the agency to use the data.

Contractor agrees to comply with Federal and Agency records management policies, including those policies associated with the safeguarding of records covered by the Privacy Act of 1974. These policies include the preservation of all records created or received regardless of format [paper, electronic, etc.] or mode of transmission [e-mail, fax, etc.] or state of completion [draft, final, etc.].

No disposition of documents will be allowed without the prior written consent of the Contracting Officer. The Agency and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C. 2701. Records may not be removed from the legal custody of the Agency or destroyed without regard to the provisions of the agency records schedules.

Contractor is required to obtain the Contracting Officer's approval prior to engaging in any contractual relationship (sub-contractor) in support of this contract requiring the disclosure of information, documentary material and/or records generated under, or relating to, this contract. The Contractor (and any sub-contractor) is required to abide by Government and Agency guidance for protecting sensitive and proprietary information.