Attachment 1 - Performance Work Statyement (PWS) dated 11-06-23.pdf

B.3 PERFORMANCE WORK STATEMENT (PWS) dated 3 November 2023

PERFORMANCE WORK STATEMENT (PWS)

Medical Physics Certification Services for Radiology and Quarterly Audits for Nuclear Medicine at

Dayton VAMC, Cincinnati VAMC, Wylie P. Chalmers VAACC (Columbus) and Chillicothe VAMC

3 November 2023

1. GENERAL. This is a non-personnel services contract in which the contractor shall provide medical physics certification services for radiology and quarterly audits for nuclear medicine at Dayton VA Medical Center (VAMC), Cincinnati VA Medical Center (VAMC), Wylie P. Chalmers VA Ambulatory Care Clinic (VAACC) in Columbus and Chillicothe VA Medical Center (VAMC) in Ohio. The government shall not exercise any supervision or control over the contract service providers performing the services herein.

1.1 SCOPE SUMMARY. The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items necessary to provide medical physics certification services for radiology and quarterly audits for nuclear medicine at Dayton VA Medical Center (VAMC), Cincinnati VA Medical Center (VAMC), Wylie P. Chalmers VA Ambulatory Care Clinic (VAACC) in Columbus and Chillicothe VA Medical Center (VAMC) as established in this Performance Work Statement (PWS) and in accordance with terms and conditions established in the contract for locations in the state of Ohio as follows:

Dayton VA Medical Center (VAMC), 4100 W. Third Street 45428, Dayton, Ohio Wylie P. Chalmers VA Ambulatory Care Center (VAACC), 420 North James Rd, Columbus, OH 43219 Cincinnati VA Medical Center (VAMC), 3200 Vine Street 45220, Cincinnati, Ohio Chillicothe VA Medical Center (VAMC), 17273 State Route 104, 45601, Chillicothe, Ohio

1.2 PERIOD OF PEFORMANCE. The periods of performance for base period and all option periods for this contract are summarized as follows:

Base Year: 25 February 2024 to 24 February 2025 Option Year One (1): 25 February 2025 to 24 February 2026 Option Year Two (2): 25 February 2026 to 24 February 2027 Option Year Three (3): 25 February 2027 to 24 February 2028 Option Year Four (4): 25 February 2028 to 24 February 2029

1.3 GENERAL REQUIREMENTS

1.3.1 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 identify and define the management concept for ensuring compliance with all contract requirements. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor will have an on-going quality assurance and /or quality improvement program designed to objectively and systematically measure, assess, and improve performance to enhance patient care and all patient care services. The contractor’s quality control program is the means by which the contractor assures that all work complies with the requirement of the contract. The contractor shall provide a copy of the QCP with their offeror as specified by the Contracting Officer and upon request thereafter. After acceptance of the quality control plan, the contractor shall immediately notify the contracting officer of any proposed changes to their quality control program and submit a change request in writing to the contracting officer. The contractor shall furnish copies of these records if requested by the Contracting Officer, PM/COR or individual(s) designated by the PM/COR and/or CO in writing. The contractor’s quality control program shall include the following:

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

1.3.3 Federally Recognized Holidays. The contractor is not anticipated but may be required to provide services on Federally recognized holidays in accordance with the terms and conditions established in this PWS to include but not limited to the following:

New Year’s Day Labor Day Martin Luther King Jr.’s Birthday Columbus Day President’s Day Veteran’s Day Memorial Day Thanksgiving Day Independence Day Christmas Day Juneteenth

1.3.4 Hours of Operation. The contractor shall be available to schedule services from Monday through Friday from 0800-EST to 1630-EST, except on Federally recognized holidays. The contractor shall coordinate with the PM/COR and/or authorized government representative designated in writing by the PM/COR and/or Contracting Officer to schedule services prior to the first working day of the calendar month. All services shall be performed at the rates established in the PRICE/COST SCHEDULE in accordance with the terms and conditions of this contract.

The contractor must maintain an adequate workforce to ensure that uninterrupted services are performed for all requirements defined within this PWS. When hiring personnel, the contractor shall keep in mind that the stability and continuity of the workforce are essential.

1.3.5 Place of Performance. The contractor shall furnish provide services in accordance with the terms and conditions of this contract as requested by the authorized government representative(s) designated in writing by the PM/COR and/or CO in accordance with the procedures specified within this PWS for the following locations:

Dayton VA Medical Center (VAMC), 4100 W. Third Street 45428, Dayton, Ohio Wylie P. Chalmers VA Ambulatory Care Center (VAACC), 420 North James Rd, Columbus, OH 43219 Cincinnati VA Medical Center (VAMC), 3200 Vine Street 45220, Cincinnati, Ohio Chillicothe VA Medical Center (VAMC), 17273 State Route 104, 45601, Chillicothe, Ohio

1.3.6 Type of Contract and Task Orders. The government intends to award a single-award indefinite-delivery indefinite quantity (IDIQ) type contract for the effort specified herein. The base and option periods (if any) specified in the PRICE/COST SCHEDULE shall be exercised at the discretion of the government through the issuance of a task order for the entire period of performance. The authority that will be utilized to award this effort is FAR Part

13.5 (Simplified Procedures for Certain Commercial Items).

1.3.7 Security Requirements and Background Checks. All contractor employees shall comply with the security and background check requirements required by Federal, State, Local and the Department of Veterans Affairs to provie services in support of this VA medical facility in the state of Ohio.

1.4.12.1 VAMC/VAACC Identification Badges: The contractor shall ensure that all personnel obtain VAMC/VAACC identification badges from the each VAMC/VAACC security personnel office as appropriate in compliance with all federal and local VAMC/VAACC facility policies.

1.4.12.2 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.

1.4.12.3 Key Control: Not Applicable.

1.4.12.4 Lock Combinations: Not Applicable.

1.3.8 Special Qualifications. See requirements below.

1.3.9 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 government contracting officer (CO), government program manager (PM), Contracting Officers Representative (COR), and other government personnel as designed by the government

CO in writing 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.

1.3.10 Government Program Manager (PM) / Contracting Officer’s Representative (COR). The government Program Manager (PM) and/or Contracting Officers Representative (COR) if designated will be identified by separate letter issued by the cognizant government Contracting Officer (CO). The PM/COR monitors all technical aspects of the contract and assists in contract administration. The PM/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 (CO) 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 PM/COR, a copy of which is sent to the contractor, states the responsibilities and limitations of the PM/COR, especially with regards to changes in cost or price, estimates or changes in delivery dates. The PM/COR is not authorized to change any of the terms and conditions of this contract.

1.3.11 Key Personnel. The following personnel are considered key personnel by the government: Project Manager/Alternate Project Manager and Officer in Charge. 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.

1.3.11.1 Personnel Roster. Not later than ten calendar days after notification of award prior to commencement of any services, the contractor shall provide a list of all personnel that will perform services under this contract to include copies of their certification in diagnostic medical physics by the ABR or similar qualifications per VHA Directive 1105.04, their work schedules, and information regarding a contact person for this contract to the government Contracting Officer (CO). Thereafter, any changes to the personnel roster of the contractor shall be submitted to the government CO and PM/COR to include all authorized government representative(s) designated in writing by the government CO and PM/COR (if appointed) within 24 hours of any change in staff.

1.3.12 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.

1.3.13 Contractor Travel: Not Applicable

1.3.14 Other Direct Costs: Not Applicable

1.3.15 Data Rights: Not Applicable

1.3.16 Organizational Conflict of Interest: Not Applicable

1.3.17 Phase-In /Phase-Out Period: Not Applicable

2. DEFINITIONS AND ACRONYMS

2.1. DEFINITIONS

AMERICAN BOARD OF RADIOLOGY (ABR): The ABR is a not-for-profit physician-led organization which oversees the certification and ongoing professional development of specialists in Diagnostic Radiology, Radiation Oncology and Medical Physics.

BENEFICIARY. Veterans and other members determined to be eligible for benefits by the VA.

COMMUNITY LIVING CENTER (CLC). The Community Living Centers (CLCs) are inpatient units for VAMC nursing homes.

CONTRACT TASK ORDERS. Award of a funded contract task order for the appropriate period of performance is required prior to the commencement of any/all work in accordance with FAR part 16.506 as specified herein.

CONTRACTOR. A vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime contractor and its employees. The contractor is fully responsible for performance of their sub-contractor(s) and shall ensure that their subcontractor(s) are fully compliant with the terms and conditions of this contract at all-times.

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.

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.

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

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

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.

NOT TO EXCEED (NTE). The price and/or quantity that the contract or purchase order shall not exceed.

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

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

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

QUALITY ASSURANCE. Those actions taken by the Government to assure services meet the requirements of this contract.

QUALITY ASSURANCE EVALUATOR(S): Government personnel responsible for surveillance of contractor performance.

QUALITY ASSURANCE SURVEILLENCE PLAN (QASP). An organized written document specifying the surveillance methodology to be utilized by the government for surveillance of contractor performance.

QUALITY CONTROL PLAN (QCP): The QCP is the contractor's management plan for executing the contract which shall be provided to the government upon request and whenever updated by the contractor. The contractor QCP describes the way in which the contractor will produce the deliverables, and the step-by-step approach that will be taken to ensure the quality of service provided to the government.

SUBCONTRACTOR(S). A subcontractor is one who enters into a contract with a contractor (or prime contractor).

THE JOINT COMMISSION (TJC). A national not-for-profit organization dedicated to administering accreditation programs that improve the care, safety and treatment of patients in a health care facility and environment.

UNIVERSAL PRECAUTIONS. The standard precautions which shall be taken by the contractor when it is anticipated that an individual may encounter blood or body fluid while performing normal duties which require the use of personal protective equipment (e.g., gloves).

2.2. ACRONYMS:

ABR American Board of Radiology ACOR Alternate Contracting Officer's Representative CBOC Community Based Outpatient Clinic CFR Code of Federal Regulations CLC Community Living Centers CO Contracting Officer CONUS Continental United States (excludes Alaska and Hawaii)

COR Contracting Officer’s Representative COTR Contracting Officer's Technical Representative COTS Commercial-Off-the-Shelf FAR Federal Acquisition Regulation HIPAA Health Insurance Portability and Accountability Act of 1996 NHCU Nursing Home Care Unit NTE Not to Exceed OCI Organizational Conflict of Interest OCONUS Outside Continental United States (includes Alaska and Hawaii) ODC Other Direct Costs OAC Ohio Administrative Code ORC Ohio Revised Code PBS Patient Business Services PCOR Primary Contracting Officers Representative PIPO Phase In/Phase Out PM Program Manager (Government PM is designated by the CO) POC Point of Contact PRS Performance Requirements Summary PWS Performance Work Statement QA Quality Assurance QAP Quality Assurance Plan QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Program TE Technical Exhibit VAAR Veteran’s Administration Acquisition Regulation VISTA Veteran’s Health Information Systems and Technology Architecture VSC VHA Service Center VAACC Veteran’s Administration Ambulatory Care Clinic VAMC Veteran’s Administration Medical Center VHA Veteran’s Health Administration VHA PM Veteran’s Health Administration Procurement Manual

3. GOVERNMENT FURNISHED ITEMS AND SERVICES:

3.1.Services: Not applicable

3.2 Facilities: Not applicable.

3.3 Utilities: Not applicable.

3.4 Equipment: Not applicable.

3.5 Materials: Not applicable.

4. CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES:

4.1 General: The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items necessary to perform all services under this contract as defined in this PWS and in accordance with the terms and conditions of this contract.

4.2. Materials, Supplies and Equipment: The contractor shall furnish all material, supplies and equipment required to perform work under this contract. The contractor shall NOT be permitted to borrow medical equipment from the medical facilities. The contractor shall at no time and under any circumstances exchange supplies and/or equipment with VA. The prices quoted in the PRICE/COST SCHEDULE shall be inclusive of consumables.

5. REQUIREMENTS:

5.1 The contractor shall furnish all labor, material, supplies, equipment, and qualified personnel to provide on-site diagnostic medical physics support or services, including annual on-site radiation compliance testing and performance monitoring services of indicated equipment for each Veterans Affairs Medical Center (VAMC) to include the following:

5.1.1. The contractor shall ensure compliance with the applicable provisions of the following publications:

5.1.1.1. VHA Directive 1139, Radiation Protection for Machine Source of Ionizing Radiation;

5.1.1.2. VHA Directive 1105.04 Fluoroscopy Safety and;

5.1.1.3. VHA Directive 1105, Management of Radioactive Materials

5.1.2. The contractor shall comply with Joint Commission standards for testing of diagnostic imaging equipment in effect at the time of testing.

5.1.3. The contractor shall perform services in accordance with the most current version of the following performance requirements documents:

ACR-AAPM Technical Standard for Diagnostic Medical Physics Performance Monitoring of Computed Tomography (CT) Equipment CT-Equip.pdf (acr.org)

ACR-AAPM Technical Standard for Diagnostic Medical Physics Performance Monitoring of Fluoroscopic Equipment Fluoro-Equip.pdf (acr.org)

ACR-AAPM Technical Standard for Diagnostic Medical Physics Performance Monitoring of Radiographic Equipment RadEquip.pdf (acr.org)

ACR-AAPM Technical Standard for Medical Physics Performance Monitoring of PET/CT Imaging Equipment PET-CT-Equip.pdf (acr.org)

ACR-AAPM Technical Standard for Medical Physics Performance Monitoring of SPECT-CT Imaging Equipment SPECT-CT-Equip.pdf (acr.org)

ACR-AAPM Technical Standard for Medical Physics Performance Monitoring of Gamma Cameras Gamma-Cam.pdf (acr.org)

ACR-AAPM Technical Standard for Medical Physics Performance Monitoring of Magnetic Resonance (MR) Imaging Equipment MR-Equip.pdf (acr.org)

ACR-AAPM Technical Standard for Medical Physics Performance Monitoring of Real Time Ultrasound Equipment. US-Equip.pdf (acr.org)

ACR-AAPM Technical Standard for Medical Physics Performance Monitoring of Real Time Dual- Energy X-Ray Absorptiometry (DXA) Equipment DXA-Equipment-Standard.pdf (acr.org)

AAPM Task Group Report 175, Acceptance Testing and Quality Control of Dental Imaging Equipment. (Link Not Available)

AAPM Task Group 270A, Practical application of AAPM Report 270 in display quality assurance: A report of Task Group 270 Practical application of AAPM Report 270 in display quality assurance: A report of Task Group 270 - Bevins - 2020 - Medical Physics - Wiley Online Library

The IAC Standards and Guidelines for Dental CT Accreditation IACDentalCTStandards2015B.pdf (intersocietal.org)

5.1.4. 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 PM/COR.

5.1.5. The contractor shall adhere to each VAMC facilities written policy for annual certification and failure resolution as well as facility policies for repairs and validation testing to resolve any failures or repairs.

5.1.6. The contractor shall ensure that all on-site work is performed by a qualified diagnostic medical physicist.

A qualified diagnostic medical physicist is defined as a person who is certified by the American Board of Radiology in Diagnostic Medical Physics or similar qualifications IAW definition provided in AAPM Qualified Medical Physicist and shall be qualified as a Radiation Expert according to the Ohio Department of Health IAW OAC 3701:1-66-01(A)(56). The contractor shall ensure that their qualified diagnostic physicist provides continuing experience of at least ten (10) Computerized Tomography (CT) units and ten (10) Magnetic Imaging Resonance (MRI) units within the past two years to survey those modalities and provide documentation of such continuing experience.

5.1.7. The contractor shall ensure that their qualified diagnostic medical physicist has the ability to independently operate units. Furthermore, the contractor shall ensure that identified training and experience documentation is available for review with their offeror and upon request with 24 hours of request by the government contracting officer (CO) or authorized government PM/COR designed by the CO in writing.

5.1.8. Performance Requirements Standards. The performance requirements standards for this contract to include required response times are defined in the Performance Requirements Summary (PRS) section of this

PWS.

5.2 SCHEDULED SERVICES. The contractor shall ensure that only qualified diagnostic medical physicist(s) perform annual inspection and testing of imaging equipment (x-ray equipment, fluoroscopy equipment), nuclear medicine cameras (including SPEC/CT units), CT scanners, MRI scanners and PET/CT scanners to ensure compliance with the current American College of Radiology (ACR) requirements. The contractor’s qualified diagnostic medical physicist shall verbally communicate any deficiencies or non-conformances discovered during the inspection to the service supervisor, PM/COR, and Biomed supervisor prior to the qualified diagnostic medical physicist leaving the facility. The contractor’s qualified diagnostic medical physicist shall report deficiencies or non-conformances, which represent unsafe conditions may potentially adversely affect the facility radiation workers or patients, to the service supervisor, PM/COR and Biomed supervisor immediately upon discovery. In addition, the contractor shall provide a written report of the results to the PM/COR within fifteen calendar days after completion of the inspection. Furthermore, the contractor shall inspect and test all imaging equipment annually, plus or minus thirty days from the last inspection date summarized as follows:

5.2.1 The contractor’s 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.

5.2.2 The contractor shall ensure a qualified diagnostic medical physicist performs quarterly audits of the diagnostic imaging program (all modalities) including QA/QC. Provide a written report of the results to the PM/COR within fifteen calendar days after completion of the audit.

5.2.3 The contractor shall ensure a qualified diagnostic medical physicist performs a review of patient skin doses for maximum possible and likely peak skin doses when procedure doses (single or cumulative) are at or exceed 5 Gray (3 Gray for procedures when the beam is in one position). The report will provide information on clinical follow-up needed. The report will be available within 5 business days of notification of a high dose procedure.

5.2.4 The contractor shall ensure a qualified diagnostic medical physicist provides phone and email consultation on radiation safety and related compliance issues as needed. The qualified diagnostic medical physicist shall attend, participate in and review minutes for completeness and accuracy of the Radiation Safety Committee Quarterly Meeting. The contractor shall present a quarterly summation report. Upon award of contract, Contractor shall be provided a schedule of times and places of meetings for the contract period by the VAMC Radiation Safety Committee Chairman.

5.2.5 The contractor shall ensure that qualified diagnostic medical physicist provides integrity testing for all forms of personnel radiation protective devices (aprons, thyroid collars, gonad shields, etc.). This service shall include the integrity testing using either fluoroscopic or radiographic modes, verifying IDs on all devices, providing an ID number were needed, and inventorying all protective devices. Each facility will identify the amount of lead items they wish to have certified, and any lead items discovered that were not identified will be billed under unscheduled services.

5.2.2 UNSCHEDULED SERVICES. All requests for unscheduled services will only be authorized by the government Contracting Officer (CO) in accordance with the term, conditions and unit pricing established in this contract. The contractor may provide a recommendation to the designated government PM and/or COR and/or authorized government representative designated in writing by the PM/COR and/or Contracting Officer of the need a specified quantity of unscheduled services by contract line-item number (CLIN). However only the CO is authorized to increase the contract value to provide unscheduled services which must be funded by the government and awarded with a bilaterally signed contract modification.

5.3 UNSCHEDULED SERVICES. All requests for unscheduled services will only be authorized by the Contracting Officer (CO) in accordance with the term, conditions and unit pricing established in this contract. The contractor may provide a recommendation to the PM/COR and/or authorized government representative designated in writing by the government PM/COR and/or Contracting Officer of the need a specified quantity of unscheduled services by contract line-item number (CLIN). However only the CO is authorized to increase the contract value to provide unscheduled services which must be funded by the government and awarded with a bilaterally signed contract modification:

5.3.1 The contractor shall ensure a qualified diagnostic medical physicist performs acceptance testing of all new or relocated imaging equipment prior to first clinical use. The scope of acceptance testing shall be in accordance with applicable ACR-AAPM Technical Standards listed in paragraph 5.1 and any applicable AAPM and NCRP publications pertaining to acceptance testing for the type of equipment. Furthermore, the contractor shall ensure a qualified diagnostic medical physicist verbally communicates any deficiencies or non-conformances discovered during the inspection to the service supervisor, PM/COR and Biomed supervisor prior to the qualified diagnostic medical physicist leaving the facility. Moreover, the contractor shall ensure a qualified diagnostic medical physicist reports deficiencies or non-conformances, which represent unsafe conditions may potentially adversely affect the facility radiation workers or patients, to the service supervisor, PM/COR and Biomed supervisor immediately upon discovery. In addition, the contractor shall provide a written report of the results to the PM/COR within fifteen calendar days after completion of the inspection. The physicist will be available to schedule acceptance testing within one week of notice.

5.4 EMPLOYEE STANDARDS AND CERTIFICATION REQUIREMENTS. All services performed by contractor employees under this contract shall comply with all applicable Federal, State, Local and Department of Veterans Affairs requirements which to include following additional requirements:

5.4.1 Only those certified in Diagnostic Medical Physics by the American Board of Radiology or similar qualifications as stated in VHA Directive 1105.04 may perform required services under this contract.

Diagnostic medical physicists must bear the Contractor's signed designation. On each visit, the qualified diagnostic medical physicist shall report to the PM/COR or his/her designee prior to performing any work.

5.4.2 The contractor and any subcontractors performing services for the government shall comply with all Occupational Safety and Health Administration (OSHA), Nuclear Regulatory Commission (NRC), National Health Physics Program (NHPP), State, County and Municipal Safety and Occupational Health Standards, and any other applicable rules and regulations. Also, all Contractors and Subcontractors shall be held responsible for the safety of their employees and any unsafe acts or conditions that may cause injury or damage to any persons or property within and around the work site area under this contract. All ladders, scaffolding, tools, equipment, personal protective equipment, etc. shall be OSHA compliant. Contractor shall use caution signs as required by OSHA Regulations. Caution signs shall be on-site on commencement of this contract.

5.4.3 The contractor shall purchase and issue all chemicals in their original containers. Materials that require precautionary warnings shall have affixed to all containers such labels or markings as are prescribed by law, regulatory agencies or this Contract. Any violation of OSHA may be subject to default action.

5.4.4 The contractor shall furnish to the PM/COR or authorized government individual designated in writing by the PM/COR and/or Contracting Officer for approval two copies of Safety Data Sheets (SDS) for all products proposed for use, a minimum of seven days prior to beginning service. Contractor must update copies of the SDS on an annual basis. In addition, each time a new chemical product is proposed, Contractor shall provide a copy of that product's SDS to the PM/COR for approval prior to the product being used at the facility.

5.5 EQUIPMENT INSPECTIONS. The contractor shall conduct equipment inspection, testing, and quality control surveys of the imaging equipment listed below with qualified diagnostic medical physicist(s). The qualified diagnostic medical physicist 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:

5.5.1 Radiographic and Fluoroscopic Equipment. Physics inspections of radiographic and fluoroscopic equipment shall comply with the ACR-AAPM Technical Standards for Diagnostic Medical Physics Performance Monitoring of Radiographic Equipment and the ACR-AAPM Technical Standard for Diagnostic Medical Physics Performance Monitoring of Fluoroscopic Equipment. Moreover, the contractor shall evaluate the performance of each radiographic and fluoroscopic unit annually.

5.5.2 Inspection of Computed Radiography (CR) Equipment. The contractor shall ensure that inspections of CR equipment comply with the American Association of Physicist in Medicine (AAPM) Report Number 93, Acceptance Testing and Quality Control of Photo stimulable Storage Phosphor Imaging Systems. Evaluate the performance of CR annually.

5.5.3 Inspection of CT Scanners. The contractor shall ensure that inspections conform to the ACR-AAPM Technical Standard for Diagnostic Medical Physics Performance Monitoring of Computed Tomography (CT) Equipment. Furthermore, the contractor shall evaluate the performance of each CT scanner annually.

5.5.4 Inspection of Dental X-Ray Equipment. The contractor shall ensure inspections shall conform to AAPM Task Group Report 175, Acceptance Testing and Quality Control of Dental Imaging Equipment for intraoral, panoramic, and cephalometric units. The contractor shall ensure inspections conform to The IAC Standards and Guidelines for Dental CT Accreditation. Furthermore, the contractor shall evaluate the performance of each unit annually. Furthermore, the contractor shall evaluate the performance of dental x-ray equipment annually.

5.5.6. Inspection of MRI Equipment. The contractor shall ensure that inspections comply with ACR-AAPM Technical Standard for Medical Physics Performance Monitoring of Magnetic Resonance (MR) Imaging Equipment. Furthermore, the contractor shall evaluate the performance of each MRI scanner annually.

5.5.7. Inspection of US Equipment. The contractor shall ensure that inspections comply with ACR-AAPM Technical Standard for Medical Physics Performance Monitoring of Real Time Ultrasound Equipment.

Furthermore, the contractor shall evaluate the performance of each MRI scanner annually.

5.5.8. Nuclear Medicine. The contractor shall ensure that physics inspections comply with ACR-AAPM Technical Standard for Medical Physics Performance Monitoring of PET/CT Imaging Equipment, ACR-AAPM Technical Standard for Medical Physics Performance Monitoring of SPECT-CT Imaging Equipment, ACR- AAPM Technical Standard for Medical Physics Performance Monitoring of Gamma Cameras, and ACR- AAPM Technical Standard for Medical Physics Performance Monitoring of Real Time Dual-Energy X-Ray Absorptiometry (DXA) Equipment. Furthermore, the contractor shall evaluate the performance annually.

5.5.9 Diagnostic Review Monitors. The contractor shall ensure that physics inspections comply with AAPM Task Group 270A, Practical application of AAPM Report 270 in display quality assurance: A report of Task Group 270. Furthermore, the contractor shall evaluate the performance annually.

NOTE: Diagnostic Review Monitors provide the critical high resolution viewing capability for the Picture Archiving and Communications System (PACS) for Radiology and Nuclear Medicine.

5.5.10. Documentation/Reports. The contractor shall ensure the documentation includes detailed descriptions of each piece of equipment tested, all procedures performed, and the results. In addition, the contractor shall deliver reports to the PM/COR or authorized government representative(s) designated in writing by the PM/COR and/or Contracting Officer in electronic portable document file (pdf) format via e-mail, CD-ROM, or

DVD-ROM.

5.5.11. Equipment Inventory. The contractor shall be provided an inventory of all equipment at each location by the PM/COR or authorized government representative(s) designated in writing by the PM/COR and/or Contracting Officer. This inventory shall include the following: AEMS MERS Ref ID (EE Number), Item Description, and Location. The contractor shall include the EE number on the medical physics report for each piece of equipment.

5.6 OTHER REQUIREMENTS. The contractor shall also provide the following services at no additional cost to the government which shall be in strict compliance with all Federal, State, Local and Department of Veterans Affairs requirements to include the following:

5.6.1 Radioactive Materials Permit. The contractor shall assist in the preparation of new, renewal, or amendment application(s) for Radioactive Materials Permit with a qualified diagnostic medical physicist. This includes assistance in preparation of new, renewal, or amendment application(s) and aid/review in keeping all pertinent Radioactive Materials Permit(s) current.

5.6.2 Upkeep of Radioactive Materials Laboratory. The contractor shall provide consulting and reference assistance for installation or upkeep of a radioactive materials laboratory in accordance with Federal Regulations with a qualified diagnostic medical physicist.

5.6.3 Establishment of Radiological Health Program and Record System. The contractor shall assist in the establishment of a radiological health program and record system in accordance with Federal Regulations and provide guidance for applicable radiation safety policies with a qualified diagnostic medical physicist.

5.6.4 Regulation Documentation, In-house Education and Annual Review Programs. The contractor shall assist and provide as appropriate maintenance of current Federal Regulations documentation and offer in-house education and annual review programs to technical staff as requested and which coincides with routinely scheduled audits with a qualified diagnostic medical physicist.

5.6.5 Selection of Equipment and Supplies. The contractor shall provide advice and assistance as appropriate in the selection of equipment and supplies to achieve maximum economy and service with qualified diagnostic medical physicist(s).

5.6.6 Wipe/Leak Tests. The contractor shall perform wipe/leak tests on sealed sources semi-annually with qualified diagnostic medical physicist(s).

5.6.7 Calibration of Survey Meters. The contractor shall review calibration of survey meters on an annual basis at no additional charge.

5.6.8 Quarterly Requirements. The contractor shall provide qualified diagnostic medical physicist(s) to provide at each government facility as appropriate the following services which shall be performed on a quarterly basis:

5.6.8.1. The contractor shall provide consultation on problems pertaining to the Radiation Safety Program for each location;

5.6.8.2. The contractor shall perform quality assurance evaluations on uptake probe and well detector units, as time and patient schedules permits. Review required gamma camera QC;

5.6.8.3. The contractor shall evaluate geometry, accuracy, constancy, and perform or evaluate activity linearity checks on dose calibrators, as required by License condition or applicable regulations;

5.6.8.4. The contractor shall review record system (e.g., radioactive materials shipment, receipt, use and disposal) for Federal License or Regulatory compliance, counting and handling procedures for proper techniques, and health physics program to assure continued safe management of radioactive materials;

5.6.8.5. The contractor shall ensure Occupational Dosimetry records are reviewed and action recommended in case(s) of apparent overexposures. Provide occupational dose estimates as needed. Online service will be used if available and authorized;

5.6.8.6. The contractor shall survey facilities for possible contamination or excessive radiation exposure levels;

5.6.8.7. The contractor shall provide lectures on nuclear medicine techniques and radiation physics, as requested, if arranged to coincide with routinely scheduled consulting visit;

5.6.8.8. The contractor shall attend Radiation Safety Committee meetings or Staff meetings, if arranged to coincide with routinely scheduled consulting visit; and

5.6.8.9. The contractor shall review facility Inventory sealed sources as required by License condition or Regulation.

5.6.9 Room Shielding Survery (UNSCHEDULED). The contractor shall provide*************:

5.6.8.1. *********;

5.7 INVOICING PROCEDURES, BILLING RATES AND MANDATORY REPORTS. The contractor shall comply with the terms and conditions established in this contract for invoicing procedures, billing rates and mandatory reports which shall include the following:

5.7.1 Invoicing Procedures. The contractor shall submit invoices only upon completion of work authorized by a government representative designated by the Contracting Officer in writing. The contractor shall only invoice for authorized work completed not-to-exceed (NTE) the amounts established in the PRICE SCHEDULE for this contract. The contractor shall ensure all invoices reference the following information to be considered for payment by the government:

Contract Number Contract Task Order Number Funding PO Number Actual quantity of authorized work completed by SLIN (Sub-Contract Line-Item Number) Other information requested by the PM/COR or authorized government representative(s) designated in writing by the PM/COR and/or CO.

5.7.2 Contract Line-Item Numbers (CLINs) and Sub-CLINs (SLINs). The CLINs and short titles of SLINs anticipated to be incorporated in the PRICE/COST SCHEDULE of the resultant contract are summarized as follows:

Contract Line-Item Numbers (CLINs):

o DAYTON: CLIN-0001 (BASE), 1001 (OY1), 2001 (OY2), 3001 (OY3) & 4001 (OY4) o COLUMBUS: CLIN-0002 (BASE), 1002 (OY1), 2002 (OY2), 3002 (OY3) & 4002 (OY4) o CINCINNATI: CLIN-0003 (BASE), 1003 (OY1), 2003 (OY2), 3003 (OY3) & 4003 (OY4) o CHILLICOTHE: CLIN-0004 (BASE), 1004 (OY1), 2004 (OY2), 3004 (OY3) & 4004 (OY4)

The SLIN short titles for SCHEDULED SERVICES which shall be unit priced individually by quantity in the PRICE/COST SCHEDULE are summarized as follows:

o Audits for Nuclear Medicine - Department Certification (QUARTERLY) o X-Ray Equipment Tube Certifications (ANNUAL) o CT Equipment Tube Certifications (ANNUAL) o SPEC-CT & PET Equipment Tube Certification WITH Diagnostic Continuation (ANNUAL) o SPEC-CT & PET Equipment Tube Certification WITHOUT Diagnostic Continuation

(ANNUAL)

o MRI Equipment Certification (ANNUAL) o Mammography Equipment Certification (ANNUAL) o Lead Apron Equipment Certification (ANNUAL) o Ultrasound (US) Equipment Tube Certification (ANNUAL) o Dental (Pan/Ceph) Tube Certification (BI-ANNUAL) o Dental (Pan/Ceph) Tube Certification (BI-ANNUAL)

The SLIN short titles for UNSCHEDULED SERVICES which shall be unit priced individually with a quantity of “0” in the PRICE/COST SCHEDULE are summarized as follows:

o UNSCHEDULED: Audits for Nuclear Medicine - Department Certification o UNSCHEDULED: X-Ray Equipment Tube Certifications o UNSCHEDULED: CT Equipment Tube Certifications o UNSCHEDULED: SPEC-CT & PET Equipment Tube Certification WITH Diagnostic

Continuation o UNSCHEDULED: SPEC-CT & PET Equipment Tube Certification WITHOUT Diagnostic

Continuation o UNSCHEDULED: MRI Equipment Certification o UNSCHEDULED: Mammography Equipment Certification o UNSCHEDULED: Lead Apron Equipment Certification o UNSCHEDULED: Ultrasound (US) Equipment Tube Certification o UNSCHEDULED: Dental (Pan/Ceph) Tube Certification o UNSCHEDULED: Dental (Pan/Ceph) Tube Certification o UNSCHEDULED: Room Shielding Survey o NOTE: These “as needed” services shall be only authorized by a warranted government contracting officer (CO) which IAW Federal Law shall be executed with a fully funded contract modification that will be signed bilaterally by both the government contracting officer and contractor.

5.7.2 Billing Rates. The contractor shall submit all invoices in accordance with the terms and conditions of this contract at the rates specified in the PRICE/COST SCHEDULE which shall be priced as all-inclusive of all costs required to perform services under this contract summarized as follows:

5.7.2.1 All Inclusive Pricing | Fully Burdened. All rates established in the PRICE SCHEDULE shall be priced by the contractor as fully burdened (or fully inclusive) of all costs required to perform services under this contract such as overhead, general and administrative (G&A) costs, indirect costs, and other direct costs (ODCs) to include travel.

5.7.3 Mandatory Reports | Ad Hoc Reports and Data Calls. The contractor shall provide ad hoc reports and respond to data calls on an as needed basis as requested by either the PM/COR or CO.

5.8 PATIENT RIGHTS, WELFARE, AND SAFETY. The rights, welfare and safety of all Veteran patient beneficiaries shall strictly comply with all Federal, State, Local and Department of Veterans Affairs requirements which shall include the following:

5.8.1 Prevention and Control of Infectious Agents. The contractor shall use universal precautionary measures for the prevention and control of the spread of infectious agents to all persons.

https://www.osha.gov/SLTC/etools/hospital/hazards/univprec/univ.html

5.9 SUB-CONTRACTORING AND SERVICE DISRUPTIONS. The contractor shall comply with all Federal, State, Local and Department of Veterans Affairs requirements and the terms and condition established in this contract to include the following:

5.9.1 Service Disruptions and Government Rights. In the event, the contractor is unable to perform services or have services performed as required, the contractor shall immediately notify the PM/COR or authorized government representative(s) designated in writing by the PM/COR and/or CO and provide a justification for non-performance. The VA reserves the right to re-procure services which cannot be performed by the contractor, in accordance with the terms, conditions, and schedule of this contract. The contractor shall indemnify the VA for excess re-procurement cost, which may result from the contractor’s inability to perform the required service. Payment of re-procurement costs shall not relieve the contractor from any other provision in this contract covering inspection, acceptance and deductions from payment. The VA will be the sole judge in determining when services will be re-procured. The failure of the contractor to perform services within the required time frames and in accordance with terms and conditions may also provide cause for termination of the contract for “cause” [see FAR clause 52.212-4(m)].

5.10 DISASTER PLANS. In case of a disaster, natural or man-made, the contractor shall utilize maximum available resources to assist in providing services to government.

5.11 WAGE RATES AND SERVICES CONTRACT ACT.

5.12.1 Wage Rates. The contractor shall provide services which comply with the Department of Labor wage rate determinations as applicable in the county in which the services are provided.

5.12.2 Services Contract Act. The contractor shall ensure full compliance with all requirements of the Services Contract Act (SCA) during the performance of the resultant contract (if any) to include any task orders issued under the resultant contract.

6. APPLICABLE PUBLICATIONS, CERTIFICATIONS AND OTHER REQUIREMENTS. The contractor must abide by all applicable regulations, publications, manuals, and local policies and procedures to include Federal, State, Local and Department of Veterans Affairs policies to include but not limited to the following:

American Board of Radiology (ABR): https://www.theabr.org/ Ohio Department of Health VA Policy Letter entitled “Medical Physics Inspection of Repair X-Ray Equipment” dated 27 June

2017 (See attached policy).

Other Department of Veterans Affairs policies and procedures as appropriate.

6.1 BACKGROUND CHECKS AND INFORMATION SECURITY. The contractor, 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, information system security and background checks.

6.2 TRAINING. All contractor employees shall comply with the training requirements required by Federal, State, Local and Department of Veterans Affairs policies and procedures.

6.3 CONTRACTOR PERFORMANCE ASSESSMENT RATING SYSTEM (CPARS). The contractor is required to register in the Contractor Performance Assessment Rating System (CPARS). As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the Department of Veterans Affairs (VA) evaluates contractor past performance on all contracts that exceed the dollar threshold specified in the FAR and may share those evaluations with other Federal Government contract specialists and procurement officials. The FAR requires that the contractor be provided an opportunity to comment on past performance evaluations prior to each report closing. To fulfill this requirement VA uses an online database. The CPARS database information is shared with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal Agencies.

6.3.1 Each contractor whose contract award is estimated to exceed the dollar threshold specified in the FAR shall be required to register with the Contractor Performance Assessment Rating System (CPARS) database at the following https://www.cpars.gov/ or by calling (207) 438-1690. Registration should occur no later than thirty days after contract award and must be kept current should there be any change to the contractor’s registered representative.

6.3.2 For contracts with a period of one year or less, the contracting officer will perform a single evaluation when the contract is complete. For contracts exceeding one year, the contracting officer will evaluate the contractor’s performance annually. Interim reports will be filed each year until the last year of the contract when the final report will be completed.