PWS_-_FY16_RADIATION_THERAPY_20_Jul_15.pdf

Attachment 1

FA3010-15-R-0021

20 Jul 2015

PERFORMANCE WORK STATEMENT

for

RADIATION THERAPY SERVICES

Personal Services

1. DESCRIPTION OF SERVICES AND GENERAL INFORMATION.

The Government requires services of six full time equivalent (FTE) Radiation Therapy staff members

- 1 Senior Certified Medical Dosimetrist

- 1 Staff Certified Medical Dosimetrist/Radiation Therapist

- 1 Administrative Radiation Therapist

- 1 Simulation Radiation Therapist

- 1 Staff Radiation Therapist

- 1 Radiation Therapy Certified Senior Medical Physicist

Contractor personnel shall work in Radiation Oncology department providing services for

Government beneficiaries at the Keesler Medical Center (KMC), Keesler Air Force Base

(KAFB), Mississippi (MS), also referred to as the "medical treatment facility" (MTF) herein.

Performance shall be in accordance with (IAW) the ethical, professional, and technical standards of the healthcare industry, the requirements contained in this Performance Work Statement

(PWS), the professional standards of practice of the Joint Commission (JC), the Air Force

Inspection Agency Office of the Health Service Inspector, and applicable Air Force (AF) regulations.

1.1. CONTRACTOR MANAGMEMENT STAFF RESPONSIBILITIES.

1.1.1. Verification and Validation of Candidate Qualifications. The Contractor shall verify and validate candidate qualifications against Government minimum requirements prior to submission of qualifying documents.

1.1.2. Placement of Contractor Personnel. The Contractor shall recruit and place contractor personnel in a timely manner:

a.) Non-credentialed Contractor Personnel. The non-credentialed contractor personnel shall physically start work no later than 30 calendar days from the initial date on the period of performance.

1.1.4. 3. Replacement of Contractor Personnel. The Contractor shall replace permanent contractor personnel such that vacancies will not exceed 30 consecutive calendar days for non-credentialed positions. When replacing a contractor personnel, the consecutive calendar days begin when the contractor personnel terminates employment. For non-credentialed positions, the replacement contractor personnel must begin work within thirty (30) consecutive calendar days after the previous contractor personnel departed the position. The Contractor shall substitute permanent contractor personnel whenever a temporary absence is expected to exceed 30 consecutive calendar days. The Contractor shall promptly notify the COR and Government supervisor of any projected absences exceeding three consecutive calendar days and ensure no temporary absence exceeds 30 consecutive calendar days through the use of a qualified substitute.

1.1.5. Resolve Performance Issues. The Contractor shall adequately resolve MTF and patient complaints regarding contractor personnel which satisfy Government concerns.

1.2. SPECIFIC PROCEDURES FOR WHICH THE CONTRACTOR SHALL BE

RESPONSIBLE. The Contractor shall furnish all labor, management, supervision, teaching, and reports required to provide personal services of the following Contractor personnel:

- 1 Senior Certified Medical Dosimetrist

- 1 Staff Certified Medical Dosimetrist/Radiation Therapist

- 1 Administrative Radiation Therapist

- 1 Simulation Radiation Therapist

- 1 Staff Radiation Therapist

- 1 Radiation Therapy Certified Senior Medical Physicist

1.2.1. SENIOR CERTIFIED MEDICAL DOSIMETRIST. Contractor personnel shall be accountable to the Chief of Radiation Oncology and the Medical Physicist. Contractor personnel shall:

1.2.1.1. Develop, maintain, and revise quality of care surveys and measurements in coordination with the physicians and physicists, instituting corrective systems when necessary. Comply with all reviews and standards established in the Radiation Therapy Clinic’s Quality Assurance and

Quality Improvement programs.

1.2.1.2. Provide information regarding both operating and capital needs for the dosimetry section.

1.2.1.3. Participate in research and development activities involving formulation of new treatment aids and devices for radiotherapy. Assist in performing work of innovative nature, developing new techniques, and/or working on complex therapeutic procedures.

1.2.1.4. Participate in research protocols within the Radiation Therapy Oncology Group or other protocol groups as necessary.

1.2.1.5. Work directly under the supervision of the Medical Physicist and Chief of Radiation

Oncology for dosimetry, simulation, and treatment operations; providing oversight to Radiation

Therapists, as needed. Identify areas for improvement, develop plans, and coordinate implementation to ensure high standards of professional performance.

1.2.1.6. Maintain effective working relationship with military and medical staff.

1.2.1.7. As requested by the Chief of Radiation Oncology or Medical Physicist, Contractor personnel shall evaluate the quality and quantity of performance of the dosimetry, treatment, and simulation therapist staff.

1.2.1.8. Advise and direct the therapists in new and difficult procedures, ensuring coordination and appropriate set-up instructions are recorded and followed.

1.2.1.9. Coordinate patient treatment planning.

1.2.1.10. Check charts of patients under treatment for completeness and accuracy.

1.2.1.11. Develop and maintain an ongoing continuing education program in cooperation with the physicians and physicists on staff.

1.2.1.12. Attend planning conferences, chart rounds, continuing education conferences and seminars, department meetings, quality assurance meetings, and medical physics staff meetings.

1.2.1.13. Establish and maintain an effective working relationship with other professionals and administrative staff within the Radiation Oncology Clinic; working with section heads and individuals (i.e., nursing, front office, Medical Equipment Repair Center (MERC), etc.) on an ad hoc basis to solve problems and improve patient care and service. Work with other departments in the MTF to provide input for new programs, to improve communication and service, and to resolve problems.

1.2.1.14. See Section 2, Services Summary (SS), for Performance Objectives and Performance

Thresholds.

1.2.2. STAFF CERTIFIED MEDICAL DOSIMETRIST/RADIATION THERAPIST.

Contractor personnel shall hold the same duties as a Staff Radiation Therapist (see section 1.2.5), but shall also be responsible for assisting the Senior Certified Medical Dosimetrist with treatment plans development when necessary and when sufficient Radiation Therapist staffing is available to perform patient treatments in his/her absence. Accountable to the Chief of Radiation Oncology and the Senior Certified Medical Dosimetrist, the Contractor personnel shall:

1.2.2.1. Develop, maintain, and revise quality of care surveys and measurements in coordination with the physicians, physicists, and dosimetrist, instituting corrective systems when necessary.

Comply with all reviews and standards established in the Radiation Therapy Clinic’s Quality

Assurance and Quality Improvement programs.

1.2.2.2. Provide information regarding both operating and capital needs for the dosimetry section.

1.2.2.3. Participate in research and development activities involving formulation of new

1.2.2.4. Participate in research protocols within the Radiation Therapy Oncology Group or other protocol groups as necessary.

1.2.2.5. Work directly under the supervision of the Senior Certified Medical Dosimetrist, Medical Physicist, and Chief of Radiation Oncology for dosimetry, simulation, and treatment operations; providing direction to Radiation Therapists as needed. Identify areas for improvement, develop plans, and coordinate implementation to ensure high standards of professional performance.

1.2.2.6. As requested by the Senior Certified Medical Dosimetrist, Chief of Radiation Oncology or Medical Physicist, Contractor personnel shall evaluate the quality and quantity of performance of the dosimetry, treatment, and simulation therapist staff.

1.2.2.7. Advise the radiation therapists in new and difficult procedures, ensuring coordination and appropriate set-up instructions are recorded and followed.

1.2.2.8. Coordinate patient treatment planning.

1.2.2.9. Check charts of patients under treatment for completeness and accuracy.

1.2.2.10. Develop and maintain an ongoing continuing education program in cooperation with the physicians and physicists on staff.

1.2.2.11. Attend planning conferences, chart rounds, continuing education conferences and seminars, department meetings, quality assurance meetings, and medical physics staff meetings.

1.2.2.12. See Section 2, Services Summary (SS), for Performance Objectives and Performance

1.2.3. ADMINISTRATIVE RADIATION THERAPIST. Contractor personnel shall hold the same duties as a Staff Radiation Therapist (see section 1.2.5), but shall also be responsible for scheduling, programmatic and logistical functions for all Contractor therapist personnel.

Accountable to the Chief of Radiation Oncology the Contractor personnel shall:

1.2.3.1. Oversee scheduling for daily simulation and treatment operations. Identify areas for improvement, develop plans, and coordinate implementation to ensure high standards of professional performance. Coordinate treatment machine assignments for treatment therapists so that staffing is adequate to meet patient needs.

1.2.3.2. Participate in Radiation Therapy and Medical Physics Quality Assurance/Risk

Management program.

1.2.3.3. Provide information regarding both operating and capital needs for simulation and therapist sections, including billing and coding data.

1.2.3.4. Help Chief of Radiation Oncology develop standards for therapist productivity and monitor workload for adherence to those standards.

1.2.3.5. Maintain orderliness and cleanliness of Radiation Oncology Clinic.

1.2.3.6. Maintain Radiation Oncology Clinic compliance with infection control program requirements as outlined in KAFB medical group instructions.

1.2.3.7. Ensure Radiation Oncology Clinic supplies are adequately stocked, and coordinate the proactive ordering of supplies as necessary.

1.2.3.8. See Section 2, Services Summary (SS), for Performance Objectives and Performance

1.2.3.9. Ensure orderliness and cleanliness of the Radiation Oncology Clinic.

1.2.4. SIMULATION RADIATION THERAPIST. Contractor personnel shall hold the same duties as a Staff Radiation Therapist (see section 1.2.5), but shall also be responsible for all aspects of CT simulation. He/she shall be responsible for ensuring the accuracy of simulations and radiation treatments as deemed acceptable by the physicians. Contractor Personnel shall also advise other Radiation Therapy staff on standardizing, upgrading, modifying techniques of radiotherapy to improve simulation/treatment results resolving questions on procedures and techniques. Accountable to the Chief of Radiation Oncology the Contractor personnel shall:

1.2.4.1. Oversee treatment and evaluate overall daily simulation and treatment operations. As the Radiation Therapist technical expert, he/she will identify areas for improvement, develop plans, and coordinate implementation to ensure high standards of professional performance.

1.2.4.2. Participate in research and development activities involving formulation of new

1.2.4.3. Develop, maintain, and revise quality of care surveys and measurements in coordination with the physicians, physicists, and dosimetrist, instituting corrective systems, if necessary.

Comply with all reviews and standards established in the Radiation Therapy Clinic’s Quality

Assurance and Quality Improvement programs.

1.2.4.4. As requested by the Chief of Radiation Oncology, Medical Physicist, or Medical

Dosimetrist Contractor personnel shall evaluate the quality and quantity of performance of the radiation therapist staff.

1.2.4.5. Advise the radiation therapists in new and difficult procedures, ensuring coordination and appropriate set-up instructions are recorded and followed.

1.2.4.6. Participate in Radiation Therapy and Medical Physics Quality Assurance/Risk

Management program.

1.2.4.7. See Section 2, Services Summary (SS), for Performance Objectives and Performance

1.2.5. STAFF RADIATION THERAPIST. Contractor personnel shall ensure all radiation therapy procedures are performed IAW established protocols and only upon the order of a person lawfully authorized to prescribe radiation therapy. Contractor personnel shall refer any ambiguous procedures or requisitions to the Chief of Radiation Oncology or Medical Physicist. Contractor personnel shall assist in administrative functions within the Radiation Oncology Clinic.

Accountable to the Chief of Radiation Oncology, the Contractor personnel shall:

1.2.5.1. Be full partners in assuring that all treatments are delivered as prescribed by radiation oncologist.

1.2.5.2. Assemble and review patient information in preparation for simulation. Document information, create patient charts, and coordinate treatment time with other staff. Check prescriptions, diagnosis, charts, and patient identification. Secure x-ray, lab reports, and patient coding/billing information as needed.

1.2.5.3. Receive patients, explain treatment procedures, position patients, obtain patient contours, and confer with the radiation oncologist and dosimetrist regarding the volumes to be treated.

Simulate treatment, mark patient’s skin, and prepare specialized, tailor-made accessories; such as bolus, blocks, immobilization devices, and compensating filters.

1.2.5.4. Perform computerized tomography simulation for treatment planning.

1.2.5.5. Maintain the mold lab, linear accelerator vault, control console, and simulator room;

ensuring all needed equipment and supplies are on hand and in compliance with infection control standards as defined by the Joint Commission and medical group instructions.

1.2.5.6. Ensure all simulation documentation is properly completed and filed.

1.2.5.7. Confer with radiation oncologist and physicist to establish requirements of nonstandard treatment and determine factors, such as positioning and blocking to satisfy those requirements.

1.2.5.8. Check operating parameters of radiation therapy simulators, treatment system, and linear accelerators to ensure compatibility of simulation setup and treatment machine setup.

1.2.5.9. Assist dosimetrist in initiating patient treatment charts to record radiation therapy treatment parameters for each treatment field.

1.2.5.10. Assist in pre-treatment monitor unit calculations in emergent setting.

1.2.5.11. Assist in treatment and simulation operations as required, particularly at the first treatment, to ensure correct position and alignment of fields as simulated.

1.2.5.12. Provide a supportive and caring environment for patients undergoing radiation treatment, showing empathy to patient and family, and representing the department with a pleasant, professional behavior. Explain procedure, means of communication during treatment, and procedures to follow if emergency arises during treatment to patient. Respect the patient’s right to refuse treatment. If the patient does not want the procedure performed, the patient’s wish shall be respected and the incident shall be brought to the attention of the patient’s assigned radiation oncologist.

1.2.5.13. Perform checks of safety equipment (i.e., eye wash station). NOTE: All liquids resulting from this process shall be drummed for proper disposal. No resulting liquids will be poured on the ground, down a sink, or disposed of in any other manner.

1.2.5.14. Perform daily, weekly, and monthly checks of the simulator as required. Perform daily

Quality Control (QC) checks of radiation simulation and therapy equipment under the supervision of a dosimetrist and/or a medical physicist and maintain QC records. Document and report any problems/discrepancies to the physician, Senior Certified Medical Dosimetrist, and/or Medical

Physicist.

1.2.5.15. Obtain kV x-rays and cone-beam computed tomography (CBCT) images as prescribed and according to the standards of care practices on patient setups for documentation and QC purposes. Review images with the radiation oncologist, following policy, and make corrections deemed necessary by the physician. Ensure all simulation films, set-up verification images, and charts are ready for chart rounds.

1.2.5.16. Prepare room and equipment for patient according to prescription regarding immobilization devices, field size, treatment distance, protection devices, etc. Transfer patient safely to treatment couch, taking special care with catheters, intravenous drips, etc., while maintaining patient treatment markings. Maintain both visual and audio contact with the patient at all times during treatment. If either the television camera system or intercom system is not working, the patient shall not be treated.

1.2.5.17. Prepare and use treatment aids (molds, blocks, tissue compensating devices, bolus, etc.). Assist in tumor localization, dosimetry, procedures, follow-up, and other clinical examinations of patients.

1.2.5.18. Observe patient for unusual reactions and events, reporting observations to the attending physician and/or the Chief of Radiation Oncology. Assist in an emergency treatment of patients when needed.

1.2.5.19. Bring irregularities or difficulties during treatment immediately to the attention of the

Medical Physicist or Radiation Oncologist, as appropriate.

1.2.5.20. Assist dosimetrist in setup of patients.

1.2.5.21. Provide ongoing education and reinforcement to patients regarding side effects and technical aspects of radiation therapy.

1.2.5.22. Document treatment as delivered clearly and concisely according to departmental procedures. Maintain records of daily treatment and other records as required on Record & Verify

Computer System ARIA. Communicate information regarding treatment to other therapists.

Review and recommend prescriptions for planned modifications and anticipate activity related to such.

1.2.5.23. Maintain QC of patient records by reviewing charts on a regular basis to verify that all

QC procedures and documentation are correct. Participate in other QC activities or programs as assigned by the medical physicist or physician.

1.2.5.24. Ensure the treatment machine is operated IAW the manufacturer’s guidance, all applicable laws, Radiation Oncology Clinic and medical group guidance, and any additional directions provided by medical physicist. Check treatment monitor units daily and deliver prescribed dose. Observe radiation safety measures for patients and staff, including the use of thermoluminescent dosimeters (TLDs). Report problems with the treatment machines to the Chief of Medical Physics, the support engineer (if applicable), Medical Equipment Repair Center

(MERC) (if applicable), and assist in documenting and ensuring resolution of the problem.

1.2.5.25. Secure and maintain required supplies. Requisition of material will be accomplished through the assigned Property Custodian of the Radiation Oncology Clinic and in coordination with the Administrative Therapist.

1.2.5.26. Orient new staff to procedures for simulation and treatment machines.

1.2.5.27. Maintain orderliness and cleanliness of Radiation Oncology Clinic.

1.2.5.28. Participate in department seminars and trainings.

1.2.5.29. Assist with other duties, including administrative duties within clinic, as needed.

1.2.5.30. Maintain familiarity with and observe all Federal, State, Department of Defense

(DOD), AF, MTF, and departmental regulations and requirements applicable to the services to be performed under this contract.

1.2.5.31. Maintain effective working relationship with military and medical staff.

1.2.5.32. See Section 2, Services Summary (SS), for Performance Objectives and Performance

1.2.6. RADIATION THERAPY CERTIFIED SENIOR MEDICAL PHYSICIST.

Contractor personnel shall be accountable directly to the Chief of Radiation Oncology.

Contractor personnel shall be responsible for directing the Radiation Oncology physics program, including technical direction, education and training of active duty physicists, medical dosimetrists, radiation therapists, and other physics support staff personnel. The Contractor provider shall:

1.2.6.1. Manage the Radiation Oncology clinic QA Programs at the direction of the Chief of

Radiation Oncology.

1.2.6.2. Develop, technically supervise, and analyze technologist QC testing of radiation producing, detecting, and measurement equipment.

1.2.6.3. Perform physics QC testing, calibration, and evaluation of equipment used for radiation therapy purposes IAW the American Association of Physicists in Medicine (AAPM) Task Group reports and applicable Air Force, state, and federal regulations.

1.2.6.4. Monitor maintenance of treatment devices, dosimetry, and radiation therapy imaging equipment and pertinent accessory options.

1.2.6.5. Develop equipment procurement specification and perform acceptance-testing evaluation of all new equipment.

1.2.6.6. Consult with physicians, physicists, dosimetrist, and radiation therapists to develop and obtain improved technology and techniques.

1.2.6.7. Provide radiation safety support during all facets of radiation therapy.

1.2.6.8. Be available during the patient treatment hours, unless approved by Chief or Radiation

Oncology, and be willing to work after hours as needed.

1.2.6.9. Attend all departmental and 81st Medical Group Radiation Safety Committee meetings, if required.

1.2.6.10. Computer System Support: Contractor personnel shall:

1.2.6.10.1. Manage the treatment planning systems (TPS).

1.2.6.10.2. Manage the Varian Linear Accelerator with On Board Imaging and Cone Beam CT, Philips CT simulator, ARIA Record and Verify System, Eclipse TPS, secondary dose calculation software (i.e. RadCalc), BrainLab, and other equipment not listed or yet to be acquired.

1.2.6.11. Clinical Linac Support: Contractor personnel shall:

1.2.6.11.1. Consult on patient simulation and treatment with medical staff.

1.2.6.11.2. Consult with radiation oncologist, dosimetrist, and radiation therapists to determine positioning of patient and equipment.

1.2.6.11.3. Perform treatment QC chart checks.

1.2.6.11.4. Measure the actual radiation doses being received during treatment delivery.

1.2.6.11.5. Evaluate and validate treatment plans. Work closely with dosimetry and physician on final plan.

1.2.6.11.6. Perform duties of the medical dosimetrist when the dosimetrist is unavailable and in extenuating circumstances. Develop treatment plans in coordination with the medical dosimetrist.

Confer with physician; develop treatment plan for physician approval; discuss final plan with radiation therapist and annotate in treatment chart.

1.2.6.11.7. Be responsible for the technical aspects of Stereotactic Body Radiation Therapy

(SBRT) and Stereotactic Radiation Surgery (SRS) treatments.

1.2.6.11.8. Be responsible for the technical aspects of Intensity-Modulated Radiation Therapy

(IMRT), Image-Guided Radiation Therapy (IGRT), and Volumetric Modulated Arc Therapy

(VMAT), which includes: acceptance testing, commissioning, and implementation of the IMRT, IGRT, and VMAT treatment planning systems and all subsequent upgrades, including software and hardware units; establish and manage the QA program to include the planning system, the delivery system and the interface between them; review each patient’s plan for agreement with physician’s intent and planning note requirements; provide physical measurements for verification for the developed plans.

1.2.6.12. Commissioning. Be responsible for commissioning of linear accelerators, simulators, treatment planning software, and any new radiation oncology equipment as necessary using existing testing equipment.

1.2.6.13. See Section 2, Services Summary (SS), for Performance Objectives and Performance

1.2.7. Contractor personnel shall be productive and perform with minimal supervisory direction.

1.2.8. Contractor personnel shall be in the work area and available for work at the appointed times.

1.2.9. Contractor personnel shall ensure all equipment is properly cleaned and stored at the end of each work shift and ensure preventive maintenance and routine cleaning are performed as directed.

1.2.10. Contractor personnel shall ensure a safe work environment and employee safe work habits.

1.2.11. Contractor personnel shall complete all job specific training as required by the MTF.

1.2.12. Contractor personnel shall complete all in-processing and out-processing within MTF requirements (e.g., badges, e-mail accounts, Privacy Act, etc.).

1.2.13. All patient charting is included as part of the patient visit and must be completed within department standards. There is an adequate amount of administrative time scheduled for each

Contractor personnel, with the expectation that patient charting be completed during the normal duty day.

1.3. PROCEDURE GUIDANCE. Contractor personnel shall perform procedures compatible with the MTF’s operating capacity and equipment. New medical procedures/services shall not be introduced without prior recommendation to, and approval of, the MTF Commander or authorized representative.

1.4. PATIENT SENSITIVITY. Contractor personnel shall provide patients with the utmost care and attention. All patients shall be assured of their privacy and personal dignity.

1.5. COMMUNICATION. Contractor personnel shall maintain open and professional communication with members of the MTF staff. Complaints validated by the Functional

Requirements Evaluator Designee (FRED) shall be reported in writing to the Contract

Administrator and the Contractor for action. Failure of the Contractor to correct validated complaints raised by the MTF staff and the Contracting Officer (CO) will be considered a failure to perform.

1.6. DOCUMENTATION. Contractor personnel shall prepare all documentation (to include patient records) to meet or exceed established standards of the MTF, to include but not limited to, timeliness, accuracy, content, and signature. Only MTF and Air Force-approved abbreviations shall be used for documentation of the patient health record.

1.7. MAINTENANCE OF CERTIFICATION (MOC) REQUIREMENTS. Contractor personnel registered or certified by national/medical associations and boards shall continue to meet the minimum standards for MOC/registry to remain current as prescribed in Chapter 5, AFI

41-117, Medical Service Officer Education, 25 Mar 15. Current certification/registry status with supporting documentation will be reported to the contract FRED if requested.

1.7.1. Periodically, Continuing Health Education (CHE) may be conducted at the MTF and may be available, at no cost, should Contractor personnel desire to attend. Attendance will be at the discretion of the Chief of Radiation Oncology. Time spent by the Contractor personnel attending meetings/conferences will not be billable.

1.7.2. Replacement staff for Contractor personnel attending extended continuing education will be provided by the Contractor upon request of the CO.

1.7.3. Contractor shall ensure all Contractor personnel maintain their qualifications (CHEs).

Time spent by Contractor personnel attending meetings/conferences will not be billable.

1.8. PERSONNEL.

1.8.1. POINT OF CONTACT (POC). The Contractor shall provide a POC who shall be responsible for the performance of the work. The POC shall have full authority to act for the

Contractor on all matters relating to the daily operation of this contract. The POC may be

Contractor personnel providing care IAW this PWS. The Contractor shall designate this individual, in writing, to the CO before the contract start date. An alternate may be designated, but the Contractor shall identify those times when the alternate shall be the primary POC.

1.8.2. AVAILABILITY. The Contractor’s designated project manager shall notify the Chief of Radiation Oncology, as early as possible of programmed absences of the Contractor personnel to allow for planning of service coverage and workload distribution.

1.8.2.1. Hours of Operation. KAFB and the MTF operate Monday-Friday 7:00 a.m. to 5:00 p.m., excluding Federal holidays.

1.8.2.2. Work Schedule/Duty Hours. Duty hours will be Monday through Friday between 0600 and 1800 (with a 60 minutes lunch break) with flexible individual schedules based on the department needs not to exceed 8 hours per day and 40 hours in any weekly work period (defined as Monday through Friday, Not to Exceed 8 hrs per day). Any changes to the work schedule must be approved by the Chief of Radiation Oncology. Contractor personnel shall be in the clinic and available for work during the hours specified in their respective work schedules unless released by the Chief of Radiation Oncology.

1.8.2.3. Contractor staff shall be required to log in time worked in both the Defense Medical

Human Resource System – internet (DMHRSi) - every two weeks, as well as in the MDG locally established duty tracking system – for every day of work.

1.8.2.4. Holidays. The Contractor shall not be required to provide services on the following

Federal holidays (or the actual day set aside for observation): New Year’s Day, Martin Luther

King Jr. Day, Presidents’ Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans’ Day, Thanksgiving Day, and Christmas Day.

1.8.2.5. Air Education and Training Command (AETC) Family Days. Services will be required on the following AETC Family Days:

2015: 2 Jan 15, 22 May 15, 2 Jul 15, 4 Sep 15, 27 Nov 15, 24 Dec 15, 31 Dec 15

2016: 27 May 16, 5 Jul 16, 2 Sep 16, 25 Nov 16, 27 Dec 16

2017: 26 May 17, 3 July 17, 24 Nov 17, 26 Dec 17

2018: 25 May 18, 5 July 18, 31 Aug 18, 23 Nov 18, 24 Dec 18, 31 Dec 18

The Contractor shall be given prior notice for Family Days of subsequent years.

1.8.2.6. Vacation/Absences. Contractor personnel are authorized absences for vacation, sick leave, and miscellaneous reasons. Absences are to be coordinated at a minimum two weeks in advance with, and at the discretion of, the Chief of Radiation Oncology.

1.8.2.7. Overtime. Overtime is time outside the normal duty hours listed in section 1.8.2.2..

1.8.2.8. Unplanned Closures. In the event of an unplanned closure of the facility due to natural disasters, military emergency, or severe weather, Contractor personnel shall be allowed to account for those hours as billable to the Government if the following two conditions exist: (1) local base policy and base access procedures prevented the Contractor personnel from performing duties at the place of performance; and, (2) the Contractor personnel was scheduled to work, but unable to work because of the unplanned closure. If any of these conditions do not exist (e.g., the

Contractor personnel was on leave), the Contractor cannot bill the Government for hours during the unplanned closure.

1.8.2.9. Emergency Situations. In the instance where the Government Supervisor directs the

Contractor personnel to remain on duty in excess of the scheduled shift due to an unforeseen emergency or to complete patient treatment where lack of continuity of care would otherwise jeopardize patient health (e.g., equipment malfunction, emergency treatment, special procedure request, increased patient workload), the Contractor personnel shall remain on duty and may be required to work outside the previously defined clinic hours (Monday-Friday, between 0600 and

1800). This provision is not intended to apply to the time required to complete routine tasks (e.g., completion of paperwork or routine administrative tasks at the end of a shift) which are to be completed as part of the shift. If the contract includes overage hours, the Government Supervisor may use those overage hours. If the contract does not include overage hours, the Government

Supervisor shall adjust the Contractor personnel’s work schedule for the additional hours such that the number of duty hours on the contract is not exceeded.

1.8.3. SUPERVISION. Contractor personnel shall be supervised or controlled by the Contractor for the purposes of directing the terms and conditions of employment. However, this does not preclude Contractor personnel from complying with directions received from MTF professional personnel in the course of patient care activities. Contractor personnel shall comply with privileging requirements, utilization review/management criteria and procedures, quality assessment procedures and criteria, as well as peer review to include quality of care reviews IAW the policy, procedures, and regulatory provisions established for Government practitioners.

1.8.4. CONTRACTOR MANPOWER REPORTING. The Contractor shall report ALL

Contractor labor hours (including subcontractor labor hours) for performance of services under this contract via a secure data collection site. The Contractor is required to completely fill in all required data fields at http://www.ecmra.mil. Reporting inputs will be for all labor executed during the performance for each Government fiscal year (FY), which runs 1 October through 30

September. While inputs may be reported at any time during the FY, all data shall be reported no later than 31 October of each calendar year. Contractors may direct questions to the Contractor

Manpower Reporting Application (CMRA) help desk.

1.9. PERSONNEL REQUIREMENTS.

1.9.1. ENGLISH LANGUAGE REQUIREMENT. Contractor personnel shall read, understand, speak, and write English fluently.

1.9.2. APPEARANCE AND CONDUCT. Contractor personnel shall present a professional, conservative, and neat appearance. Contractor personnel shall report for duty in appropriate attire http://www.ecmra.mil/ befitting a health care setting and having complied with socially acceptable standards of personal hygiene expected of health care workers. The Contractor personnel shall display a professional, positive, and cooperative attitude while in the workplace.

1.9.2.1. While on duty, the Contractor personnel shall be neat and clean, free from visible dirt and stains, well groomed, and appropriately dressed. The Contractor personnel’s clothing shall fit correctly to provide a professional, modest appearance, in keeping with normally accepted community standards of dress for the work being performed.

1.9.2.2. Facial hair (including beards, mustaches, and sideburns) shall be controlled (restrained) or trimmed. It shall not interfere with safe work practices, look unkempt, or be unclean. Facial hair shall not interfere with the face seal if a tight-fitting respirator (e.g., N95) is required to be worn for normal duties.

1.9.2.3. The Contractor personnel shall display legible MTF-provided identification media on his/her outer clothing.

1.9.2.4. Protective Clothing. When required and supplied by the Government, Contractor personnel shall wear special protective clothing and shoe covers. When duties will be performed in specified areas, a disposable protective suit with other appropriate personal protective equipment (PPE) (for example, gloves, boots, etc.) shall be worn to ensure universal precautions are observed. The Government will provide ALL PPE. These items shall remain the property of the Government and shall not be removed from the MTF. After use, protective clothing shall be turned in or destroyed as directed by the Chief of Service.

1.9.3. FORMAL EDUCATION. All services shall be rendered IAW established principles and ethics of the medical profession, the national standards established by the JC, HIPAA, Occupational Safety and Health Administration (OSHA), the professional standards at MTF, and the respective professional organizations (i.e. AAPM, AAMD, ARRT, ACR, and ASTRO).

Contractor personnel shall provide services to all patients eligible for care at the MTF for treatment or as directed by the designated Government representatives. The Contractor employees shall provide services and support typically provided in a civilian MTF of similar size.

The Government will evaluate the quality of professional and administrative services provided and retain control over the medical and professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment). The Contractor shall ensure that the following Contractor personnel have the minimum qualifications/training indicated.

1.9.3.1. Senior Certified Medical Dosimetrist and Staff Certified Medical

Dosimetrist/Radiation Therapist shall have a minimum of a Bachelor of Science degree in a physical, radiological, biological science, or engineering field from an accredited educational institution.

1.9.3.2. Simulation and Staff Radiation Therapist shall be a graduate from a JRCERT accredited radiation therapist training program.

1.9.3.3. Administrative Radiation Therapist shall be a graduate from a JRCERT accredited radiation therapist training program. And have a minimum of a Bachelor of Arts or Science degree with a Master’s degree in management preferred.

1.9.3.4. Radiation Therapy Certified Senior Medical Physicist shall have minimum qualifications and training as indicated by the American Board of Radiology (ABR) for

Therapeutic Medical Physics.

1.9.3.5. Board Certification, Licensure/Registration. IAW paragraph 3.1, AFI 44-119, Medical Quality Operations, 16 Aug 11, military, civil service, and personal services Contractor personnel who require a license, certification, or registration to perform their duties must maintain a license or other authorizing document such as certification or registration from any

U.S. jurisdiction.

1.9.3.5.1. Radiation Therapy Certified Senior Medical Physicist shall be certified by the

American Board of Radiology (ABR) in Therapeutic Medical Physics and enrolled in the ABR

Maintenance of Certification (MOC) program – e.g. ‘DABR-T’.

1.9.3.5.2. Senior Certified Medical Dosimetrist and Staff Certified Medical

Dosimetrist/Radiation Therapist shall be certified by the Medical Dosimetrist Certification

Board – e.g. ‘CMD’.

1.9.3.5.3. Administrative, Simulation, and Staff Radiation Therapist, as well as Staff

Certified Medical Dosimetrist/Radiation Therapist shall be registered by the American

Registry of Radiologic Technologists, Radiation Therapy Technology – e.g. ‘R.T.(T)(ARRT)’.

1.9.3.5.4. Copies of required certification for each Contractor personnel shall be furnished to the

CO prior to performance on this contract.

1.9.4. EXPERIENCE.

1.9.4.1. Senior Certified Medical Dosimetrist shall have a minimum of ten (10) years of a full time dosimetry experience, five years as a radiation therapist treatment experience, and three years of management experience in a radiation therapy clinical environment. The Contractor personnel shall be knowledgeable in the operation of Varian linear accelerators with cone-beam

CT (CBCT) and On-Board Imaging (OBI) and have an extensive working knowledge of Varian

Real-Time Position Management (RPM) system, Varian software package (version 11 or later), including Varian Eclipse 3-D Treatment Planning System (TPS) and ARIA Record and Verify

System (RVS). Personnel shall be skilled in designing electron and photon treatment plans, using

3-D planning such as conformal 3D, IMRT, hybrid 3D/IMRT planning, IGRT (gated), VMAT

(RapidArc), SBRT and SRS planning. Proficiency in working with Armed Forces Health

Longitudinal Technology Application (AHLTA) is highly desired.

1.9.4.2. Staff Certified Medical Dosimetrist/Radiation Therapist shall have a minimum of five years of full time medical dosimetry and treatment planning experience and a minimum of ten (10) years of full time working experience as a radiation therapist. Contractor personnel shall be knowledgeable in the operation of Varian linear accelerators with CBCT/OBI and have an extensive working knowledge of Varian RPM system, Varian software package (version 11 or later), including Varian Eclipse TPS and ARIA RVS. Personnel shall be skilled in designing electron and photon treatment plans, using 3-D planning such as conformal 3D, IMRT, hybrid

3D/IMRT planning, IGRT (gated), VMAT (RapidArc), SBRT and SRS planning. Proficiency in working with AHLTA is highly desired.

1.9.4.3. Administrative Radiation Therapist shall have a minimum of ten (10) years of full time experience as a radiation therapist and/or simulator therapist in a radiation therapy center and five years of management experience in a radiation therapy clinical environment. Contractor personnel should have extensive working experience in medical billing and coding in radiation therapy settings. Contractor personnel shall be knowledgeable in the operation of Varian linear accelerators with CBCT/OBI and have an extensive working knowledge with Philips CT simulators, Varian RPM system, Varian ARIA RVS software package (version 11 or later). Proficiency in working with Armed

Forces Health Longitudinal Technology Application (AHLTA) is highly desired.

1.9.4.4. Simulation Radiation Therapist shall have a minimum of ten (10) years of full time experience as a radiation therapist and/or simulator therapist in a radiation therapy center. Contractor personnel shall be knowledgeable in the operation of Varian linear accelerators with CBCT/OBI and have an extensive working knowledge with Philips CT simulators, Varian RPM system, Varian ARIA RVS software package (version 11 or later). Proficiency in working with Armed

Forces Health Longitudinal Technology Application (AHLTA) is highly desired.

1.9.4.5. Staff Radiation Therapist shall have a minimum of ten (10) years of full time experience as a radiation therapist and/or simulator therapist in a radiation therapy center. Contractor personnel shall be knowledgeable in the operation of Varian linear accelerators with CBCT/OBI and have an extensive working knowledge with Philips CT simulators, Varian RPM system, Varian ARIA

RVS software package (version 11 or later). Proficiency in working with Armed Forces Health

Longitudinal Technology Application (AHLTA) is highly desired.

1.9.4.6. Radiation Therapy Certified Senior Medical Physicist shall have a minimum of ten

(10) years of full time experience as Radiation Therapy Physicist. Contractor personnel shall have extensive experience that incudes acceptance and commissioning testing of linear accelerators, CT simulators, TPS, and associated radiation oncology equipment; overseeing all aspects of radiation therapy QA/QC program and advising staff on safe radiation practices. Physicist shall have an extensive working knowledge of the operation of Varian linear accelerators with

CBCT/OBI (including calibration), Philips CT simulators, Varian RPM system, Varian Eclipse

TPS and ARIA RVS software package (version 11 or later) and shall have at least three years of experience as administrator managing Varian software. Contractor personnel shall be skilled in designing electron and photon treatment plans, using 3-D planning such as conformal 3D, IMRT, hybrid 3D/IMRT planning, IGRT (gated), VMAT (RapidArc), SBRT and SRS planning. Ability to identify and troubleshoot hardware and software problems is desired. Proficiency in working with Armed Forces Health Longitudinal Technology Application (AHLTA) is highly desired.

1.9.5. CRIMINAL HISTORY BACKGROUND CHECKS. Contractors shall perform criminal history background checks IAW Chapter 4, Addendum B, DoDI 1402.5, Criminal

History Background Checks on Individuals in Child Care Services, 19 Jan 93, for resource sharing and clinical support agreement personnel working in an MTF involved on a frequent and regular basis in the provision of care and services to children under the age 18. The background checks are required by Criminal Control Act, P.L. 101-647, Section 231 (CC Act 1990, 42 U.S.C.

Section 13041). The Contractor shall assemble all necessary documentation required by Chapter

4, Addendum B for the background checks and forward the documentation to the office designated by the Administrative CO (ACO) or to the office designated in the Memorandum of

Understanding (see Chapter 16, Addendum A).

1.9.5.1. Background checks will be based on fingerprints of individuals obtained by a

Government law enforcement officer and inquiries conducted through the Federal Bureau of

Investigation (FBI) and state criminal history repositories.

1.9.5.2. With the consent of the CO, the Contractor personnel may provide contract services prior to completion of background checks. However, at all times while children are in the care of that individual, the Contractor personnel shall be within sight and continuous supervision of a staff person whose background check has been completed.

1.9.5.3. Individuals shall have the right to obtain a copy of any background check pertaining to themselves and to challenge the accuracy and completeness of the information contained in the report.

1.9.5.4. Individuals who have previously received a background check shall provide proof of the check to the Chief of Service or obtain a new one.

1.9.6. CONFLICT OF INTEREST. The Contractor shall not employ any person who is an employee of the United States Government if the employment of that person would create a conflict of interest. The Contractor shall not employ any person who is an employee of the

Department of the Air Force, either military or civilian, unless such person seeks and receives approval IAW DoD Directive (DoDD) 5500.7, Standards of Conduct, 29 Nov 07, and AF policy.

1.10. HEALTH REQUIREMENTS.

1.10.1. Contractor personnel shall receive a pre-employment physical examination prior to commencement of work and annually thereafter. The Contractor personnel shall report to a civilian physician to receive a pre-employment examination and immunizations prescribed by the

MTF, IAW CDC guidelines.

1.10.2. Not later than five working days prior to commencement of work, certification shall be provided to the Functional Commander/Director (FC/D) that the Contractor personnel has completed the medical evaluation required above. This certification shall state the date on which the examination was completed, the name of the doctor who performed the examination, and a statement concerning the physical health of the individual. The certification shall also contain the following statement: “(Name of Contractor personnel) is suffering from no contagious diseases to include, but not limited to, Tuberculosis, Hepatitis, and Venereal Disease.”

1.10.3. The Occupational Safety & Health Administration (OSHA) requires that all Contractor personnel who will have occupational exposure to blood or body fluids, or other potentially infectious materials, shall receive Hepatitis B vaccine, sign a voluntary declination, or have documented proof of immunity to Hepatitis B infection. Contractor personnel who sign declinations may change their minds at any time and receive the Hepatitis B vaccine without penalty.

1.10.4. The Contractor is responsible for reporting to the Flight Commander/Medical Director, all information necessary to assure hospital records can be maintained correctly, and therefore comply with the JC, OSHA, and Centers for Disease Control (CDC) health record requirements.

1.11. EMERGENCY HEALTH CARE. The MTF will provide emergency health care for the

Contractor personnel for injuries incurred while on duty in the MTF. These services will be billed to the Contractor at the current full reimbursement rate.

1.12. MEDICAL TESTS. No medical tests or procedures required by the contract will be performed by the Government, with the exception of Tuberculosis testing; post blood borne exposure protocols after start of work or exposure; and occupational exposure programs, such as the Thermoluminescent Dosimetry (TLD) monitoring program. Expenses for all required tests and/or procedures identified in the contract (e.g., N95 particulate respirator duckbill mask fitting) shall be borne by the Contractor or Contractor personnel at no additional expense to the

Government.

1.13. MEDICAL QUALITY IMPROVEMENT/RISK MANAGEMENT (QI/RM).

1.13.1. Contractor personnel shall participate in QI/RM activities to the extent required by

Section 2C, AFI 44-119, and the individual MTF QI/RM plan or regulation.

1.13.2. The Government will evaluate the Contractor personnel’s professional, as differentiated from administrative, performance under this contract using Quality Improvement standards specified in paragraphs 2.12 and 2.13, AFI 44-119. Nothing in this paragraph precludes the

Government from also conducting inspections under the Inspection/Acceptance requirement of

FAR clause 52.212-4.

1.14. PERFORMANCE EVALUATION MEETINGS. The CO will require the Contractor to meet with the CO, Contract Administrator, FC/D, and other Government personnel as often as deemed necessary. Contractor personnel may request a meeting with the CO when deemed necessary.

1.15. ORIENTATION. The Contractor shall ensure that all Contractor personnel participate in the MTF orientation procedures for newly assigned personnel to include regulations specific to their professional specialty and hospital and Air Force policy and procedures.

1.16. RECORDS. The Contractor shall create, maintain, and provide Government-owned/Contractor-held records, regardless of media, in performance of this contract IAW the following directives:

AFI 33-322, Records Management Program, 4 Jun 12, Incorporating Change 1, 18 Dec

AFMAN 33-363, Management of Records, 1 Mar 08; Incorporating through

Change 1, 28 Jan 15, and Keesler Supplement, 23 Apr 14

AFI 33-364, Records Disposition—Procedures and Responsibilities, 22 Dec 06 and AFGM2014-01, 28 May 14

Air Force Information Management System database (AFRIMS) (access through the Air

Force Portal at https://www.my.af.mil/afrims/afrims/afrims/rims.cfm

Air Force Electronic Records Management Solution

1.16.1. The Contractor shall segregate the Government-owned records from the Contractor-owned records and identify all records required to be created by the PWS on the AFRIMS file plans. The Contractor shall create and maintain paper and electronic records (\\52mahg-fs-106) as appropriate. The Contractor shall maintain the software and background data to retrieve official electronic Government records throughout the lifecycle of the records.

1.16.2. The Contractor maintains and disposes of records IAW the AF records disposition schedules.

1.16.3. Electronically Stored Information (ESI).