2016_PWS_Radiation_Therapy_Staff_Final-3-17-2016.pdf

Attachment 1

Solicitation # FA3010-16-R-0011

17 March 2016

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 support personnel to include one FTE Medical Physicist, one FTE Senior Medical Dosimetrist, one FTE

Medical Dosimetrist, one FTE Lead Radiation Therapist, and two FTE Radiation Therapists.

Contractor personnel shall work in Radiation Oncology department providing services for

Government beneficiaries at the Keesler Medical Center, 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 (TJC), 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. The contractor personnel shall physically start work no later than

15 calendar days from the initial date on the period of performance.

1.1.3. Replacement of Contractor Personnel. The Contractor shall replace permanent contractor personnel such that vacancies will not exceed 30 consecutive calendar days. When replacing a contractor personnel, the consecutive calendar days begin when the contractor personnel terminates employment. The replacement contractor personnel must begin work within thirty (30) consecutive calendar days after the previous contractor personnel departed the position.

1.1.4. Substitute or Temporary Coverage. If requested by the Government supervisor and the

Contracting Officer Representative (COR), 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 30 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 Medical Physicist

- 1 Senior Medical Dosimetrist

- 1 Medical Dosimetrist

- 1 Lead Radiation Therapist

- 2 Radiation Therapists

1.2.1. MEDICAL PHYSICIST. Contractor personnel shall be accountable directly to the Chief of Radiation Oncology and be responsible for directing the Radiation Oncology physics program, including technical direction and training of medical Dosimetrist, radiation therapists, and other physics support staff personnel. The Contractor personnel shall:

1.2.1.1. Manage the Radiation Oncology clinic Quality Assurance (QA) Programs at the direction of the Chief of Radiation Oncology. Develop, technically supervise, and analyze technologist Quality Control (QC) testing of radiation producing, detecting, and measurement equipment. 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, applicable Air Force instructions and federal regulations.

1.2.1.2. Be responsible for all technical aspects of Intensity-Modulated Radiation Therapy

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

(VMAT), Stereotactic Body Radiation Therapy (SBRT), and Stereotactic Radiation Surgery

(SRS) treatments which includes: acceptance testing, commissioning, and implementation of the

IMRT, IGRT, VMAT, and SBRT/SRS treatment planning systems and all subsequent upgrades, including software and hardware units;

1.2.1.3. Be responsible for commissioning of linear accelerators, simulators, treatment planning software, and any new radiation oncology equipment, as necessary.

1.2.1.4. 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 requirements. Evaluate and validate all approved treatment plans. Measure radiation doses during treatment delivery for verification of the developed plans. Perform treatment QC chart checks and documentation, as required.

1.2.1.5. Manage the treatment planning systems (TPS), Varian Linear Accelerator with On

Board Imaging (OBI), Cone Beam CT (CBCT), 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.

1.2.1.6. Monitor maintenance of treatment devices, dosimetry, and radiation therapy imaging equipment and pertinent accessory options. Develop equipment procurement specification and perform acceptance-testing evaluation of new equipment.

1.2.1.7. Consult with other staff members on patient simulation and treatment and development of improved technology and techniques. Provide radiation safety support during all facets of radiation therapy.

1.2.1.8. Work closely with Dosimetrist and physician on development of treatment plans.

Perform duties of medical Dosimetrist when Dosimetrist is unavailable or in extenuating circumstances.

1.2.1.9. Attend planning conferences, chart rounds, and other required departmental and hospital meetings. Be available during scheduled work hours, unless absence is approved by the

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

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

Thresholds.

1.2.2. SENIOR MEDICAL DOSIMETRIST. Contractor personnel will work under direct supervision of Medical Physicist and shall be accountable to the Chief of Radiation Oncology.

Contractor personnel shall:

1.2.2.1. Develop 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.

1.2.2.2. Coordinate and perform radiation therapy treatment planning, assist with patient simulation and setup. Generate documentation (paper or electronic) of treatment plans, as required.

1.2.2.3. Identify areas for improvement, develop plans, and coordinate implementation to ensure high standards of professional performance. Assist in developing new techniques, and/or working on complex therapeutic procedures. Participate in research protocols within the Radiation

Therapy Oncology Group or other protocol groups, as necessary. Participate in continuing education to maintain certification and familiarity with modern radiation oncology techniques and practices.

1.2.2.4. Advise and direct the Dosimetrist and therapists in new and difficult procedures, ensuring coordination and appropriate set-up instructions are recorded and followed. Assist in fabrication of treatment blocks and patient positioning devices.

1.2.2.5. Check charts of patients under treatment for completeness and accuracy. Attend planning conferences, chart rounds, and other required departmental and hospital meetings.

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

1.2.3. MEDICAL DOSIMETRIST. Contractor personnel will work under direct supervision of Senior Medical Dosimetrist and shall be accountable to the Chief of Radiation Oncology.

Contractor personnel shall:

1.2.3.1. When required, perform duties of Radiation Therapist (see section 1.2.5.)

1.2.3.2. Develop quality of care surveys and measurements in coordination with the physicians and physicists, instituting corrective systems when necessary. Comply with all standards established in the Radiation Therapy Clinic’s QA and Quality Improvement programs.

1.2.3.3. Coordinate and perform radiation therapy treatment planning, assist with patient simulation and setup. Generate documentation (paper or electronic) of treatment plans, as

1.2.3.4. Advise and direct the therapists in new and difficult procedures, ensuring coordination and appropriate set-up instructions are recorded and followed. Assist in fabrication of treatment blocks and patient positioning devices.

1.2.3.5. Check charts of patients under treatment for completeness and accuracy. Attend

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

1.2.4. LEAD RADIATION THERAPIST. Contractor personnel shall hold the same duties as a

Radiation Therapist (see section 1.2.5.), but shall be responsible for scheduling, programmatic and logistical functions for all Contractor therapist personnel. Accountable to the Chief of

Radiation Oncology the Contractor personnel shall:

1.2.4.1. 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.

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

Management program.

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

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

1.2.4.5. Ensure orderliness and cleanliness of Radiation Oncology Clinic. Maintain Radiation

Oncology Clinic compliance with infection control program requirements as outlined in Medical

Group Instructions (MDGIs).

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

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

1.2.5. RADIATION THERAPIST. Contractor personnel shall perform all aspects of radiation therapy delivery and assist in administrative functions within the Radiation Oncology Clinic, as needed. Accountable to the Chief of Radiation Oncology, the Contractor personnel shall:

1.2.5.1. 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. Confer with Radiation Oncologist and physicist to establish requirements of nonstandard treatment and determine factors, such as positioning and blocking to satisfy those requirements. Contractor personnel shall refer any ambiguous procedures or requisitions to the

Chief of Radiation Oncology and Medical Physicist.

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. 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 respective Radiation Oncologist.

1.2.5.4. 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.

1.2.5.5. Oversee treatment and evaluate overall daily treatment operations. Ensure the correct position and alignment of fields, as simulated, and that all treatments are delivered as prescribed by Radiation Oncologist.

1.2.5.6. Perform computerized tomography (CT) simulation for all patients. Check operating parameters of radiation therapy simulators, treatment system, and linear accelerators to ensure compatibility of simulation setup and treatment machine setup. Ensure all simulation documentation is properly completed and filed. Assist Dosimetrist during patient setup to record radiation therapy treatment parameters in treatment charts.

1.2.5.7. Prepare room and necessary equipment for patient treatment/CT simulation. Transfer patient safely to treatment/simulation couch. 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.

1.2.5.8. Obtain kV x-rays and CBCT images of patient setups for documentation and QC purposes, as prescribed. Review images with the Radiation Oncologist and make corrections deemed necessary by the physician.

1.2.5.9. Perform daily, weekly, and monthly checks of the simulator and safety equipment (i.e., eye wash station), as required. Under the supervision of Dosimetrist and/or medical physicist perform daily QC checks of simulation and radiation therapy equipment and maintain QC records. Document and report any problems/discrepancies to Medical Physicist or Chief of

Radiation Oncology, as applicable.

1.2.5.10. 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.

1.2.5.11. Assist in an emergency treatment of patients and with pre-treatment monitor unit calculations in emergent setting, as needed.

1.2.5.12. Provide ongoing education and reinforcement to patients regarding side effects and technical aspects of radiation therapy. Observe patient for unusual reactions and events, reporting observations to the Radiation Oncologist. Bring irregularities or difficulties during treatment immediately to the attention of Medical Physicist or Radiation Oncologist, as appropriate.

1.2.5.13. Document delivered treatment clearly, according to departmental procedures. Maintain records of daily treatment and other records as required in 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.

1.2.5.14. 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.

1.2.5.15. 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. Observe radiation safety measures for patients and staff.

Report problems with the treatment machines directly to Medical Physicist and Chief of

Radiation Oncology, the service support engineer (if applicable), Medical Equipment Repair

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

1.2.5.16. 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 the MDGIs.

1.2.5.17. Secure and maintain required supplies. Requisition of material will be accomplished through the assigned Property Custodian of the Radiation Oncology Clinic.

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

1.2.5.19. Maintain orderliness and cleanliness of Radiation Oncology Clinic. Assist with other duties, including administrative duties within clinic, as needed.

1.2.5.20. 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.

1.2.5.21. Check charts of patients under treatment for completeness and accuracy. Attend

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

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

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

1.2.8. 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.

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

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

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

1.2.12. 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 AFI 41-117, Chapter 2, 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 Medical Education (CME) 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 considered as leave, but must be approved by the

Chief of Radiation Oncology or designated representative.

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 (CMEs).

Time spent by Contractor personnel attending meetings/conferences will not be considered work and attendance to a meeting/conference, and leave must be approved in advance by the Chief of

Radiation Oncology or designated representative. Travel funding will not be provided by the contract.

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. The MTF/Clinic operates Monday through Friday from 0730 to

1630, excluding Federal holidays.

1.8.2.2. Work Schedule/Duty Hours. Duty hours will be Monday through Friday between 0700 and 1700 according to established individual schedules based on the department needs not to exceed 8 hours/day excluding a 1 hour lunch. 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, and in the MTF 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. At the discretion of the Chief of Radiation Oncology, services will be required on the following AETC Family Days:

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. Overage. An overage hour is an hour directed/scheduled for the contractor personnel to perform services beyond the normal duty hours outlined in the contract for continuity of care purposes. Overage hours are billable to the Government whenever the contractor personnel performs duties outlined in the work schedule to include continuity of care purposes beyond the contractor personnel's normal duty hours. Overage hours on the work schedule are established by the MTF and are clearly stated in the contract. Any variation of overage hours on the work schedule must be authorized by the Government supervisor in advance to the extent practicable.

The total number of overage hours worked cannot exceed the number identified in the contract.

The contractor personnel shall record and report time worked IAW MTF policy. The Contractor shall establish a process for contractor personnel to accurately record and report overage hours worked without relying on the Government.

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 0700 and

1700). 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 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 http://www.ecmra.mil/ 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 hood shall be worn to ensure infection control standards are met. The Government will provide this hood. 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. Medical Physicist shall have minimum qualifications and training as indicated by the

American Board of Radiology (ABR) for Therapeutic Medical Physics.

1.9.3.2. Senior Medical Dosimetrist and Medical Dosimetrist shall have a minimum of a

Bachelor of Science degree in a physical, radiological, biological science, or engineering field from an accredited educational institution.

1.9.3.3. Lead 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.

1.9.3.4. Radiation Therapist shall be a graduate from a JRCERT accredited radiation therapist training program.

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. 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 Medical Dosimetrist and Medical Dosimetrist shall be certified by the

Medical Dosimetrist Certification Board – e.g. ‘CMD’.

1.9.3.5.3. Radiation Therapist, Lead Radiation Therapist, and Medical Dosimetrist 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, and must be provided with resume/qualification package.

1.9.4. EXPERIENCE.

1.9.4.1. Medical Physicist shall have a minimum of five and preferably ten (10) years of full time experience as Radiation Therapy Physicist. Contractor personnel shall have extensive experience that includes 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 desired.

1.9.4.2. Senior Medical Dosimetrist shall have a minimum of ten (10) years of a full time dosimetry experience, and three years of supervisory/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 desired.

1.9.4.3. Medical Dosimetrist shall have a minimum of five years of full time medical dosimetry and treatment planning experience and a minimum of five 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 desired.

1.9.4.4. Lead Radiation Therapist shall have a minimum of ten (10) years of full time experience as a radiation 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.

1.9.4.5. Radiation Therapist shall have a minimum of ten (10) years of full time experience as a radiation 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 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.

1.9.6. 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.

1.9.7. PRIVILEGING/CREDENTIALLING REQUIREMENTS. N/A

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 Centers for Disease Control (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 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. Meetings will be documented in the contract file with written minutes signed by the

Contractor and the CO, or Contract Administrator. Should the Contractor not concur with the minutes, such non-concurrence shall be provided in writing to the CO within ten (10) calendar days of receipt of the minutes.

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 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.

http://www.e-publishing.af.mil/shared/media/epubs/AFI33-322.pdf http://www.e-publishing.af.mil/shared/media/epubs/AFMAN33-363.pdf http://www.e-publishing.af.mil/shared/media/epubs/AFMAN33-363.pdf https://www.my.af.mil/afrims/afrims/afrims/rims.cfm

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

1.16.3. Electronically Stored Information (ESI). The Contractor shall maintain Government owned electronic non-official records on the organizational shared network drive according the subjective categories (example: template, common, reference material, and working files). Grant the base records manager access to all files located on the organizational shared network drive.

The Contractor shall maintain the official electronic records on the base designated shared network drive (\\52mahg-fs-106) IAW the Air Force Electronic Records Management System and AFMAN

33-363, Chapter 6. Radiation therapy patient’s information shall be stored in the hospital’s approved Electronic Medical Records system, such as Armed Forces Health Longitudinal

Technology Application (AHLTA) and Varian ARIA.

1.16.4. Upon completion of this contract, all Government-owned/Contractor-held records

(regardless of media) received, created, maintained, or provided in the performance of the PWS shall be turned over to the Government. Background electronic data and records specified for delivery to the contracting agency must be accompanied by sufficient technical documentation and software to permit the Air Force to use the data. In the event of default or non-performance, the

Government will have access to all records in order to ensure mission support is not interrupted.

1.16.5. Contractor-Owned Records. Maintain records that relate exclusively to the Contractor’s internal business or are of a general nature not specifically related the performance of work under the contract separately from the Government-owned records.

1.16.6. Freedom of Information Act (FOIA) Program. The Contractor shall comply with the requirements of DOD 5400.7-R/AFMAN 33-302, Freedom of Information Act Program, 21 Oct

10, and incorporating through Change 2, 22 January 2015. If the Contractor receives a FOIA request, the Contractor shall ensure it is delivered immediately to the base FOIA manager (81

CS/SCOK) for processing. The FOIA manager will task a Government official who, as the authorized official, will make the decision on releasing Government records.

1.16.7. Privacy Act Program. The Contractor shall create, maintain, and destroy Privacy Act data IAW AFI 33-332, The Air Force Privacy and Civil Liberties Program, 12 Jan 15; and

Privacy Act systems of records notice(s) (http://dpcld.defense.gov/Privacy/SORNs.aspx). The

Contractor shall not create or maintain a Privacy Act system of records prior to public notice. If the Contractor receives a Privacy Act request, the Contractor shall be responsible for searching for the records and providing those records to a Government official who, as the authorized official, will make the decision on releasing the Government records.

1.16.8. Functional Requests. A functional request is a written request for DoD records received from any person (including a member of the public), or a business that does not cite either the

FOIA or Privacy Act. The Contractor shall be responsible for searching for the records and providing those records to a Government official who, as the authorized official, will make the decision on releasing the Government records.

http://dpcld.defense.gov/Privacy/SORNs.aspx

1.17. SECURITY.

1.17.1. Security Clearance: National Agency Check with Written Inquiries (NACI). As a minimum, Contractor personnel shall successfully complete a NACI before operating

Government-furnished workstations that have access to AF automated information systems.

Requests for Contractor personnel hired at the beginning of the contract shall be submitted to the

Government not later than 45 workdays from the contract start date. Requests for Contractor personnel hired subsequent to contract start date shall be submitted to the Government not later than ten workdays from the Contractor personnel’s first duty day. Contractor personnel receiving unfavorable NACIs shall not be employed. The Government will submit requests for investigations on AF 2583, Request for Personnel Security Action, at no additional cost to the

Contractor. Any personnel with access to classified material will be submitted by the

Contractor’s Facility Security Officer (FSO) for a Secret security clearance. The Contractor shall comply with the requirements of DoD 5200.2-R, Personnel Security Program, 1 Jan 87, (Incorporating Through Change 3, 23 Feb 96); AFI 31-501, Personnel Security Program

Management, 27 Jan 05; and Air Force Manual (AFMAN) 33-152, User Responsibilities and

Guidance for Information Systems, 1 Jun 12.

1.17.2. Contractor personnel shall comply with the requirements of AFI 71-101, Volume 1, Criminal Investigations, 4 Feb 15 and AFI 71-101, Volume 2, Protective Service Matters, 23 Jan

15. These regulations require Contractor personnel to report any information or circumstances of which they are aware that may pose a threat to the security of DoD personnel, Contractor personnel, resources, and classified or unclassified Defense information to their immediate supervisor. The immediate supervisor of Contractor personnel shall brief on this requirement during initial on-base assignment and as required thereafter.

1.17.3. The Unit Security Manager will assist the Contractor with any Joint Personnel

Adjudication System (JPAS) Joint Clearance and Access Verification System (JCAVS) and eQIP by Design information for inputting NACIs with assistance from 81 SFS/IP.

1.17.4. Security Monitoring. The Contractor shall comply with all security requirements.

Submit reports, classified if appropriate, of any information coming to their attention concerning any of their employees who have been cleared or are in the process of being cleared for access to classified information, which indicates that such access or determination may not be clearly consistent with the national interest. Reports shall be submitted to the Defense Industrial Security

Clearance Office (DISCO) immediately upon notification of any adverse information, change in employee’s status, official investigation, or any other reason. In addition, a copy of this report shall be furnished to the Contracting Officer’s Representative(s) (COR(s)) and 81 TRW

Installation Commander (81 TRW/CC).

1.17.5. Listing of Employees.