1._Performance_Work_Statement_-_Mobile_MRI.pdf

PERFORMANCE WORK STATEMENT

FOR

MOBILE MAGNETIC RESONANCE IMAGING SERVICES

1. DESCRIPTION OF SERVICES. The contractor will provide a mobile Magnetic Resonance Imaging (MRI) to the 82d Medical Group (MDG), Sheppard Air Force Base (SAFB) TX. The contractor will provide MRI technicians to schedule and perform a variety of MRI examinations for government beneficiaries. The contractor will provide the exams to the 82 MDG to transmit to the 10 MDG radiologists located at United States Air Force Academy, CO for interpretation and transcription. Performance will be according to the requirements contained in this Performance Work Statement (PWS), The Accreditation Association for Ambulatory Health Care (AAAHC), Health Insurance Portability and Accountability Act (HIPAA), Infection Control, National Fire Protection Association (NFPA) and Health Service Inspection (HSI) standards and all local 82 TRW and MDG policies.

1.2. SPECIFIC PROCEDURES FOR WHICH THE CONTRACTOR WILL BE

RESPONSIBLE: Areas of responsibility are: (1) Equipment (2) Patient Services/ Documentation.

1.2.1. EQUIPMENT: The contractor will provide a mobile 1.5 T (MRI) unit with Auto-shim. The unit should be set up for 3 phase, 480volt/200 amperes service. The contractor will provide coils for routine examinations, musculoskeletal exams (shoulder and wrist coils), and auto pressure injector (carotids, liver, kidneys, etc.). Software programs to optimize unit performance and abilities such as Smart Prep (or equivalent) and Diffusion Weighted Imaging. The contractor will set up the MRI unit upon arrival;

perform warm up, calibration and imaging test procedures as recommended by MRI unit manufacturer. Ensure the proper operation/maintenance of the MRI unit to produce quality diagnostic scans in support of patient care.

1.2.2. PATIENT SERVICES/DOCUMENTATION: The contractor will provide MRI Technicians that shall schedule and perform approximately 30 to 100 difficult and complex MRI examinations per month to include Neurological, Musculoskeletal and Body imaging, Magnetic Resonance Arteriography and Venography. Notify staff radiologist of significant scans requiring immediate attention or visualization while patient is undergoing examination. Based on well-established references, recommend new protocols and procedures to the 10 MDG/Radiology and the 82 MDG Radiology Functional Requirements Evaluator Designee (FRED). The contractor will schedule, change and cancel appointments. Greet, receive and escort patients to and from Radiology Clinic/MRI unit. Screen patients and explain procedures to patients. Ensure all exams are performed in accordance with (IAW) established MTF protocols and only upon the order of a person who is lawfully authorized to diagnose, treat and prescribe.

Start IV for contrast enhanced studies. Perform intravenous injections of contrast by standard techniques under the supervision of a physician. Consult with radiologist on

TASK ORDER

PWS-MRI

P a g e 2 | 11 difficult or complex examinations. Conduct urgent studies. Adhere to regulations and directives concerning the Privacy Act and AFI 41-210, chapter 4, Tricare Operations and Patient Administration Functions, concerning the release of medical information. Provide digital imaging to radiologist for interpretation.

1.3. PROCEDURE GUIDANCE. The contractor will perform procedures compatible with the medical facility's operating capacity and equipment. New medical services shall not be introduced without prior recommendation to and approval of the MDG Commander or authorized representative, and approval by the Contracting Officer (CO).

1.3.1. DOCUMENTATION. The contractor will prepare all documentation to meet or established standards of the MDG to include, but not limited to: timeliness, legibility, accuracy, content, format, and signature and security. The contractor will ensure complete patient identifying information is on all documentation and that it is medically consistent and error free.

1.3.1.1. PATIENT LISTS/RELEASE OF MEDICAL INFORMATION. Patient lists, no matter how developed will be treated as privileged information. Lists and/or names of patients will not be disclosed to or revealed in any way for any use outside the MDG. Contractor personnel will only release medical information obtained during the course of this contract to MDG staff involved in the care and treatment of that individual patient. Any other releases will be coordinated and accomplished by the appropriate MDG staff member(s).

1.3.1.2. PATIENT SENSITIVITY. Contract personnel will respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships.

1.3.1.3. PHYSICAL SECURITY. Contract personnel will be responsible for safeguarding all medical information provided for contractor use. At the close of each work period, information will be secured.

1.3.1.4. Contractors under this contract have a responsibility to complete and submit an 82 MDG Event Statement, IAW MTF instructions, when they identify potentially serious patient care problems, safety concerns, infection control issues, equipment malfunctions, and defective products whether or not there was a resulting injury. An 82 MDG Event Statement is also completed when a sentinel event occurs. A sentinel event is an unexpected occurrence involving death, serious physical or psychological injury, or the risk thereof. Serious injury specifically includes loss of limb or function. 82 MDG Event Statement is written within 24 hours or next duty day of the incident and the original hand carried to the Performance Improvement (PI) office. *82MDG Event Statements are considered confidential and privileged information which may not be copied nor placed in an individual’s medical record. 82d Medical Group equipment involved in an incident should be immediately reported to the Medical Equipment Repair (MER) with all settings and controls unchanged after the incident. Portable equipment will be moved

P a g e 3 | 11 to the MER shop and investigated by MER personnel. Fixed equipment will be locked out and tagged until the MER investigation is complete. Before the equipment is moved, annotate dial setting at the time of incident and other pertinent information, i.e., location, method of use, and other equipment in use to complete the Event Statement.

1.3.2. POINT OF CONTACT. The contractor will provide a point of contact that will be responsible for the performance of the work. The point of contact will have full authority to act for the contractor on all matters relating to the daily operation of this contract. The contractor will designate this individual, in writing, to the CO and the MDG before the contract start date. An alternate may be designated, but the contractor will identify those times when the alternate will be the primary point of contact.

1.3.3. AVAILABILITY/CONTINUITY. The contractor will provide a point of contact that will be available via the telephone Monday through Friday, 0700 until 1700, excluding federal holidays and down days.

1.3.4. LOCATION/HOUR OF OPERATION The contractor will provide the mobile MRI unit and staff two to three times a week, depending on workload, not to exceed 10 hours per day, Monday – Friday, excluding holidays and down days. The MRI unit will be positioned at the 82 Medical Group, building 1200 on the MRI pad within Horseshoe Drive. Duty hours will vary between 0700-1700, depending on the patients scheduled.

See paragraph 4.9 for a list of federal holidays and paragraph 4.14 for instances of hospital down times.

1.4. QUALIFICATIONS – MRI TECHNICIAN.

1.4.1. Graduation from a radiography program accredited by the Joint Review Committee on Education in Radiological Education (JRCERT).

1.4.2. Current registration as a Magnetic Resonance Imaging Technologist.

1.4.3. Must hold certification in Magnetic Resonance with the American Registry of Radiologic Technologists (ARRT).

1.4.4. Have a minimum of one (1) year of MRI Technologist experience within the last two (2) years, of performing MRI’s with any form of MRI equipment. Must possess and maintain current certification in Basic Life Support (BLS).

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2. SERVICES SUMMARY

SS PERFORMANCE

OBJECTIVE

PWS REF PERFORMANCE

THRESHOLD

1 Quality of Service. The contractor will provide qualified MRI personnel/services that fulfill the requirement of the PWS enabling the MTF to provide services at a high quality level.

1.2.1, 1.2.2, 1.4, 1.4.1, 1.4.2, 1.4.3, 1.4.4

100% of the time

2 Promptness of Service. The contractor will contact patient within 24-48 hrs to schedule appointment. Patient wait time for scheduled appointment should not exceed 30 mins.

1.2.2 No more than two

“not met” in a one year period

3 Standard of Care. MRI Technician shall perform all exams IAW established protocols and ensure diagnostic quality and ensure complete and accurate documentation in patient records.

1.2.1, 1.2.2, 1.3.1 No more than one “not met” in a six month period

4 Staff/Customer Complaints.

The contractor shall meet the standard of care and the requirements of the PWS.

1.2.1, 1.2.2, 1.3, 1.3.1, 1.3.1.1, 1.3.1.2, 1.3.1.3, 1.3.1.4, 3.3, 3.4, 3.4.1, 3.5, 3.9, 3.9.1

No more than two valid complaints within a six month period

3. GENERAL INFORMATION.

3.1. GOVERNMENT-FURNISHED SUPPLIES/TRAINING/EQUIPMENT

3.1.1. EQUIPMENT. The government will provide a telephone line, utilities (power supply), reproduction services, MRI pad, and parking.

3.1.2. SUPPLIES. The MTF will provide all medical supplies and linen to include contrast agents.

3.1.3. FORMS. The MTF will provide required government forms used in the performance of services.

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3.1.4. GOVERNMENT ORIENTATION/TRAINING. The government will provide training on government provided forms and equipment, initial and continuing 82 MDG Radiology Department orientation.

3.2. CONTRACTOR FURNISHED ITEMS AND SERVICES. Except for those items or services specifically stated above to be government furnished, the contractor will furnish everything required to perform this contract in accordance with all of its terms.

3.3..ENGLISH LANGUAGE REQUIREMENT. Contract personnel will proficiently read, understand, speak, and write English.

3.4. APPEARANCE. Contractor personnel will present a professional appearance and be easily recognized as contract personnel. The MDG will provide an identification badge that will be worn by the contractor while on duty.

3.4.1. CONTRACTOR IDENTIFICATION. Contractor employees shall identify themselves as contractor personnel by introducing themselves or being introduced as contractor personnel and displaying distinguishing badges or other visible identification for meetings with Government personnel. In addition, contracts shall require contractor personnel to appropriately identify themselves as contractor employees in telephone conversations and in formal and informal written correspondence.

3.4.2. Manpower Reporting. The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the 82d Medical Group via a secure data collection site. The contractor is required to completely fill in all required data fields at http://www.ecmra.mil.

3.4.2.1. Reporting inputs will be for labor executed during the period of performance for each Government fiscal year (FY), which runs 1 October through 30 September. While inputs may be reported anytime during the FY, all data shall be reported no later than 31 October of each calendar year. Contractors may direct questions to the CMRA help desk.

3.5. Physical Security

Contractor Access Requirements. The contractor shall comply with all requirements and procedures IAW AFFAR 5352.242-9000, Contractor Access to Air Force Installations, and local clause, Security Requirements. Contractor employees shall comply with SAFB security requirements imposed by the Installation Commander at all times while on premises. The contractor shall obtain all necessary passes, or other items required for access to perform contract services. The contractor is responsible for accountability of all such media, which shall be surrendered to the Security Forces Squadron Visitor Control Center (VCC) upon completion or termination of the contract or upon termination of an individual’s employment for the contractor. If all identification is not provided, a portion of the final payment (to be determined by the Contracting Officer) will be withheld pending its submission. The contractor shall comply with all

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SAFB policies and procedures regarding entry to the installation, rules of the road, contingency operations compliance, and photography prohibitions.

Pass and Identification Items. IAW AFMAN31-113, Installation Perimeter Access Control, All perspective employees (Non-Appropriated Funds, Civilian Services, Appropriated Funds, etc.), including personnel already in possession of an access credential, must be proofed and vetted by SF during in-processing to ensure proper fitness determination prior to allowing access and issuance of employment access credentials.

DoD Common Access Card (CAC), (AFI 36-3026V1_IP) OR a Defense Biometric Identification System (DBIDS) card is required for employees of contracts over six months in length. To receive a DBIDS card, the employee must provide a Sheppard AFB Form 151 to the COR or other designated representative and an unexpired, valid picture identification card or other credential, and accomplish an Installation Access Application with favorable results on the Criminal History Check.

Pass and Identification Items. The contractor shall ensure the following pass and identification items required for contract performance are obtained for employees:

Defense Biometric Identification System (DBIDS). DBIDS card is required for employees of contracts over 6 months in length. To receive a DBIDS card, the employee must provide a Sheppard AFB Form 151 to the COR or other designated representative and an unexpired, valid picture identification card or other credential (IAW AFMAN 31- 113), and accomplish an Installation Access Application with favorable results on the Criminal History Check.

Reporting Requirements. The contractor shall comply with AFI 71-101, Volume- 1, Criminal Investigations Program, and Volume-2, Protective Service Matters, requirements. Contractor personnel shall report to an appropriate authority, any information or circumstances of which they are aware may pose a threat to the security of DOD personnel, contractor personnel, resources, and classified or unclassified defense information. Contractor employees shall be briefed by their immediate supervisor upon initial on-base assignment and as required thereafter.

Physical Security. Areas controlled by contractor employees shall comply with base Operations Plans/Instructions for FPCON procedures, Random Antiterrorism Measures (RAMS) and local search/identification requirements. The contractor shall safeguard all government property, including controlled forms, provided for contractor use. At the close of each work period, government training equipment, ground aerospace vehicles, facilities, support equipment, and other valuable materials shall be secured.

Entry Procedures to Controlled / Restricted Areas. The contractor shall comply and implement local base procedures for entry to AF controlled and restricted areas contractors will be responsible for procuring Controlled Area Training from the assigned restricted/controlled area monitors.

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Traffic Laws. The contractor and its employees shall comply with (installation) base traffic regulations. Driver Distractions: In accordance with AFI 31-218(I), Motor Vehicle Traffic Supervision, Paragraph 4-2c(3), vehicle operators on a Department of Defense (DoD) installation and operators of Government owned vehicles will not use cell phones unless the vehicle is safely parked or unless they are using a hands–free device. The wearing of any other portable headphones, earphones, or other listening devices (except for hands–free cellular phones) while operating a motor vehicle is prohibited. Use of those devices impairs driving and masks or prevents recognition of emergency signals, alarms, announcements, the approach of vehicles, and human speech. The potential for driver distractions such as eating and drinking, operating radios, compact disc players, global positioning equipment, and so on should only be done when the vehicle is safely parked, when possible.

WEAPONS, FIREARMS, AND AMMUNITION

Contractor employees are prohibited from possessing weapons, firearms, or ammunition on themselves or within their Contractor-owned or privately owned vehicle while on

SAFB.

Anti-Terrorism. SAFB has an anti-terrorism program that is responsible for helping secure and protect the base and its personnel from terrorist attacks as directed in DoDI 2000.16, AFI 10-245, Antiterrorism (AT) Program Implementation, the HQ AETC Supplement and SAFB AT Plans Volume I and II. As a contractor working on SAFB or its geographically separated sites, you and your sub-contractors are required to obey all orders from Security Forces, and adhere to all security measures implemented as a result of Force Protection Condition (FPCON) changes (security posture changes). Additionally, you and your sub-contractors are expected to report to base security forces any suspicious activities, packages, or items you see while conducting work on SAFB or its geographically separated sites. Suspicious activities could include personnel conducting surveillance of the installation, unauthorized personnel requesting access to the installation, or somebody asking a lot of questions about the base. In an effort to help familiarize you, your employees, and sub-contractors about antiterrorism, SAFB has an antiterrorism binder with all of the pertinent information for awareness training available for mandatory review contact the installation Antiterrorism Program Manager (ATPM) at 676-2079.

3.6. CONFLICT OF INTEREST. The contractor will 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.

3.7. MULTIFUNCTION TEAM (MFT) MEETINGS. The CO shall require the Contractor or his representative to meet with the CO, contract administrator, COR, FRED and other government personnel as often as deemed necessary. The Contractor may request a meeting with the CO when deemed necessary. Meetings will be documented in the contract file with written minutes signed by the contract manager and the CO, or contract administrator. Should the Contractor not concur with the minutes, such non-

P a g e 8 | 11 concurrence shall be provided in writing to the CO within ten calendar days of receipt of the minutes.

3.8. QUALITY CONTROL

3.8.1. CONTRACTOR QUALITY SYSTEMS. Contracts for commercial items rely on contractor’s existing quality assurance systems as a substitute for government inspection. The government will rely on the Contractor’s assurances that the commercial services tendered for acceptance conforms to the contract requirements. Quality control is the responsibility of the Contractor and not the Government.

3.8.2. QUALITY ASSURANCE. The Government will periodically evaluate and monitor the Contractor’s performance by designating one or more representative(s) to conduct surveillance of the contracted MRI Technologist’s performance by determining whether or not the performance meets the standards contained in the contract. The Government may increase or decrease the number of inspections as deemed appropriate.

3.8.3. SURVEILLANCE METHODS. The surveillance method may be determined by, but not limited to, continual valid customer complaints or failure to meet quality standards set forth in this contract. Failure to meet any services summary (SS) threshold(s) for any of the performance objectives may result in an immediate warning or letter of concern from the CO. Failure to meet any SS threshold(s) for any two months during an annual contract period may result in an immediate Progress Meeting with the

MTF.

3.9. ENVIRONMENTAL REQUIREMENTS.

3.9.1. Conformance with Environmental, Safety and Occupational Health Management System (ESOHMS). The contractor shall perform all work under this contract consistent with the relevant policy and objectives identified within SAFB.

3.10. EMERGENCY HEALTHCARE. The MDG will provide emergency health care for contract personnel for injuries occurring while on duty. These services will be billed to the contractor at the full reimbursement rate.

3.11. HEALTH REQUIREMENTS. All employees shall be free from communicable diseases and up to date on adult immunizations per the Centers for Disease Control and Prevention, Immunization of Health Care Personnel, Administration and the Advisory Committee on Immunization Practices, 25 Nov 2011.

4. GENERAL DEFINITIONS. The following terms shall have the meaning set forth in accordance with the terms of this PWS and the contract.

4.1. GOVERNMENT. The federal government of the United States of America.

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4.2. COMMANDER. MTF Commander, Flight Commander or other activity head, or a designated representative.

4.3. FUNCTIONAL REQUIREMENTS EVALUATOR DESIGNEES (FREDs).

Individuals designated to carry out inspection and surveillance duties as described in the Quality Assurance Evaluation Plan. They serve as on-site technical managers assessing contractor performance against contract performance standards.

4.4. CONTRACTING OFFICER REPRESENTATIVE (COR). Individuals

designated to perform quality assessment functions for contracted services. They serve as managers assessing contractor performance reported by the FRED against contract performance standards. Personnel in this area may have many titles, such as Quality Assurance Evaluator (QAE), Quality Assurance Specialist, Contracting Officer Technical Representative (COTR), Quality Assurance Personnel (QAP), Service Contract Manager (SCM); however, their duties are essentially the same.

4.5. CONTRACTING OFFICER (CO). A person duly appointed with the authority to enter into, administer, and terminate contracts on behalf of the government.

4.6. CONTRACTOR. The offeror identified in block 17a of Standard Form 1449. The Contractor is an independent contractor and responsible for its own liability.

4.7. MEDICAL TREATMENT FACILITY (MTF). Air Force hospitals or clinics, including all activities providing outpatient and/or in-patient healthcare services for authorized personnel.

4.8. COMPOSITE HEALTH CARE SYSTEM (CHCS). Computer system, which stores clinical and administrative data. This system provides on-line communication for users in any supported location.

4.9. FEDERAL HOLIDAYS. There are ten (10) federal holidays each year. They are New Year’s Day (observed 1 January), Martin Luther King, Jr’s Birthday (observed the third Monday in January), President’s Day (observed the third Monday in February), Memorial Day (observed the fourth Monday in May), Independence Day (observed 4 July), Labor Day (observed the first Monday in September), Columbus Day (observed the second Monday in October), Veterans Day (observed 11 November), Thanksgiving Day (observed the fourth Thursday in November), and Christmas Day (observed 25 December). If New Year’s Day, Independence Day, Veterans Day or Christmas Day falls on a Saturday, it is observed on Friday; if it falls on Sunday, it is observed on Monday.

4.10. GOVERNMENT QUALITY ASSURANCE. Those actions taken by the government to assure services meet the requirements of the contract.

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4.11. QUALITY CONTROL (QC). Those actions taken by a Contractor to control the quality of output and to ensure that they conform to contract requirements and reasonable standards of medical care.

4.12. SERVICES SUMMARY (SS). Prescribes how the Government plans to (1) assess contractor performance, and (2) manage the contract to obtain efficiencies, improved performance, and cost savings throughout its life cycle.

4.13. PERFORMANCE WORK STATEMENT (PWS). A Statement of Work for performance-based acquisitions that describes the required results in clear, specific and objective terms with measureable outcomes

4.14. HOSPITAL DOWN TIME. Hospital down time usually occurs when the Secretary of Defense issues a down day or the wing/group commander has scheduled an event for all hospital staff and has directed that all patient appointments be blocked.

Standard down time usually includes the day after Thanksgiving, a day in conjunction with Christmas and New Years’, and the first Wednesday of every month between 1330- 1630 (readiness training). The 82d Medical Group reserves the right to schedule down days as needed.

4.15. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT

(HIPAA) OF 1996. All individuals performing services at an Air Force MTF will be held accountable for complying with health information privacy and security policies and procedures. Reference Local Information Clause SAFB-0018 for detailed HIPAA language.

4.16. INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE. The

Contractor shall provide and maintain adequate liability coverage consistent with the risks associated with the performance of all services required by this PWS. Refer to Federal Acquisition Regulation (FAR) clause 52.237-7, “Indemnification and Medical Liability Insurance” in this solicitation/contract/order.

4.16.1. A certificate of insurance evidencing the required coverage shall be provided to the CO prior to the commencement of services under this contract/order.

4.17. PERFORMANCE OF SERVICES DURING CRISIS DECLARED BY THE

NATIONAL COMMAND AUTHORITY OR OVERSEAS COMBATANT

COMMANDER. This service is determined not to be essential for performance during crisis according to DODI 3020.37, Continuation of Essential DoD Contractor Services During Crisis. However, in the event of a crisis or if a significant emergency is declared, the Contracting Officer (CO) will contact Contractor personnel to notify them of the situation and any possible changes to their contract responsibilities. Upon notification by the CO, the Contractor shall perform special event services due to contingencies, natural disasters, or facility operation on an extended basis up to 24 hours per day, as required. If

P a g e 11 | 11 additional contract costs are incurred under this paragraph, the Contractor will have up to 30 calendar days to request an equitable contract price adjustment.