PWS_Dosimetrist_June_15.pdf

PERFORMANCE WORK STATEMENT (PWS)

DOSIMETRIST SERVICES

MEDICAL TREATMENT FACILITY, DAVID GRANT MEDICAL CENTER

TRAVIS AFB, CA

15 June 15

TABLE OF CONTENTS

Section Title

1 Description of Services 3

2 Contractor Responsibilities 3

3 Services Summary 8

4 Government Furnished Property 9

5 General Information 10

6 Health Requirements 11

7 Conduct 13

8 Security Requirements 13

9 Dress and Appearance 13

10 Training Requirements 13

11 Physical Requirements 13

12 Records, Files, Documents, Data and 14 Work Papers

13 Contractor Identification 14

14 Federal Holidays 14

Appendix A Applicable Publications 15

Appendix B Standard Abbreviations and Terms 17

PERFORMANCE WORK STATEMENT (PWS)

DOSIMETRIST SERVICES

DAVID GRANT MEDICAL CENTER

TRAVIS AFB, CA

1. DESCRIPTION OF SERVICES

1.1. The objective of this service is to provide a qualified, competent Dosimetrist to deliver dosimetry services at David Grant Medical Center (DGMC), hereafter referred to as the "Medical Treatment Facility" (MTF) at Travis AFB, CA. The contractor shall comply with all applicable civilian, Department of Defense (DoD), Air Force and Medical Treatment Facility (MTF) directives and instructions to include, The Joint Commission (TJC) and Health Services Inspection (HSI). Dosimetrist services shall work 8 hours per day, 40 hours per week.

2. CONTRACTOR RESPONSIBLITIES

2.1. The Contractors shall provide personnel possessing the skills, knowledge, abilities, and training to satisfactorily perform the service requirements included in this PWS. Contractor personnel performing work in support of dosimetry activities shall be fully trained in all aspects of the work to be performed.

Private sector personnel performing work under this PWS shall remain employees of the Contractor and shall not be considered employees of the government.

2.1.1. Dosimetrist shall meet the following qualifications:

a. Must be a graduate of a formally recognized hospital or a college affiliated Medical Dosimetry program with clinical and classroom curriculum, and other training and /or experience as a certified Medical Dosimetrist so that the total duration of study, training and experience is at least 15 years.

b. Must be certified by the Medical Dosimetrist Certification Board (MDCB).

c. Must have a minimim of 48 months full time experience (documented) as a certified medical dosimetrist (CMD) under the supervision of a board certified radiation oncologist or a medical physicist.

d. Must hold a current Basic Cardiac Life Support (BCLS) Certification

2.1.2. Skills required

a. Must be board certified in medical dosimetry and able to understand the technical aspects of radiation oncology and medical physics to devise computerized treatment plans, and communicate these aspects to the radiation oncologist for plan approval, and to the radiation therapist for plan implementation.

b. Perform routine duties independent of supervision, but consults with the radiation oncologists and medical physicists as required.

c. Operate and perform quality assurance, under the direction of the qualified medical physicist, on the treatment planning computer.

d. Has working knowledge of radiation safety and current rules and regulation of the Nuclear

Regulatory Commission.

e. Has the ability to interpret and execute treatment plans as defined in relevant treatment protocols.

f. Must possess mathematical skills including algebra, trigonometry, and introductory calculus and be able to visualize objects in three-dimensional image space to facilitate the treatment planning process.

g. Must possess knowledge of On Board Imaging (OBI) systems, Intensity Modulated Radiation

Therapy (IMRT) and Image Guided Radiation Therapy (IGRT) plans, Stereotactic Radiation Surgery (SRS) systems, High Dose Rate (HDR) Brachrytherapy systems, and optimization of Volume Modulated Arc Therapies (VMAT)

2.1.3. Service will include furnishing all labor, teaching, reports and consultation, except as provided in section 4 Government and Contractor Furnished Property and Services.

Services shall cover the range of dosimetry services provided in a civilian practice/hospital of similar size. Performance shall be according to the requirement contained in this PWS and as directed by the Qualified Military Medical Physicists (QMMP) or the Joint Radiation Oncology Center (JROC) Director.

2.1.3.1 Specific Tasks:

a. Design a treatment plan by means of computer and/or manual computation that will deliver a prescribed radiation dose and field placement technique in accordance with the Radiation Oncologist’s prescription to a defined tumor volume. The dosimetrist will be expected to be proficient in three-dimensional conformal radiation therapy (3D-CRT), IMRT, IGRT, VMAT, Stereotactic Body Radiation Therapy (SBRT), and SRS. Additionally, documented clinical experience with HDR Brachytherapy is desired.

b. Consider dose-limiting structures in the design of treatment plans and document dose in accordance with the radiation oncologist prescription.

c. Coordinate treatment simulations and tumor localization on dedicated devices, including Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and Position Emission Tomography (PET) when indicated, for radiation oncology treatment planning.

d. Supervise, perform, or assist in the planning and production of the fabrication of compensation filters, custom shields, dynamic and physical wedges, and other beam modifying devices as designated by the QMMP.

e. Supervise, perform, or assist in the planning/production of moulds, casts, and other immobilization devices as designated by the radiation oncologists and/or qualified medical physicists.

f. Supervise the therapist staff in the implementation of the treatment plan including: the correct use of immobilization devices, compensators, wedges, field arrangement, and other treatment variables as designated by the radiation oncologists and/or qualified medical physicists.

g. Perform calculations for the accurate delivery of the radiation oncologist's prescribed dose, document all pertinent information in the patient verification record system, and verify the mathematical accuracy of all calculations using a system established by the medical physicist.

h. Provide physics and technical support to the medical physicist, in radiation protection, quantitative machine calibrations, and quality control of the treatment planning systems and radiation oncology equipment.

i. Supervise, perform, or assist in the application of specific methods of dosimetry including ion chamber, thermoluminescent dosimeter (TLD), or film measurement as directed by the medical physicist.

j. Assist in intracavitary and interstitial brachytherapy procedures, to include HDR

Brachytherapy, and in the subsequent manual and/or computer calculation of the dose distributions of these treatments.

k. Teach all aspects of medical dosimetry to students, medical physics staff and residents, as assigned by the QMMP. The teaching curriculum will be scheduled and structured to include classroom and clinical instruction.

l. Participate in clinical research for the development and implementation of new techniques and new clinical trial protocols.

m. Participate in continuing education in the area of current treatment planning techniques, and advances in medical dosimetry.

n. Perform treatment simulations and all duties associated with the treatment simulation as directed.

o. Participate in quality improvement initiatives, customer service initiatives, chart rounds, and medical readiness activities designed to enhance health services.

p. Contribute to professional environment using appropriate leadership skills.

q. Evaluation and management of emergency problems immediately as they occur.

Inform the medical physicist and JROC Director of any problems/errors in treatment planning and/or treatment delivery.

r. Prepare all documentation to meet or exceed established standards of the MTF to include but not limited to, timeliness, legibility, accuracy, content and signature.

Only MTF and Air Force approved abbreviations will be used for documentation of care in the health care record.

s. Attend and participate in meetings, professional staff conferences, and other appropriate professional activities as requested by the QMMP or JROC Director during the contract personnel’s scheduled duty hours.

t. Input all necessary information related to billing and workload into ARIA (Radiation

Therapy Electronic Medical Record Database), Composite Health Care System, (CHCS) II, and Armed Forces Health Longitudinal Technology Application (ALTA) and other computer programs as directed for the performance/accountability of dosimetry. The government will provide CHCS II/ALTA training /or other procedures that the medical activity’s staff is required to use. Access to such patient data systems is an “Automated Data Processing Sensitive” position requiring compliance with AFI 41- 210 (Chapter 2) and Air Force Systems Security Instruction (AFSSI) 5027. Time will not be billable to the Government.

u. Review, update, and provide input/prepare (write) dosimetry operation instructions or standard operating procedures as needed or requested/assigned by the QMMP or JROC Director.

2.2 Validation of Qualification, Licensure and Certification.

2.2.1 The contractor must provide documentation on the above licensure and certification.

2.2.2. A copy of the proposed contract personnel professional resume, indication experience, training, and technical expertise in the type of care to be rendered.

2.2.3 A signed consent for release of information.

2.3. English Language Requirement. Contract personnel shall read, understand, speak, and write English.

2.4. The contractor is required to begin full performance of the contract requirements within 15 days after contract award.

2.5. If the Dosimetrist has ever been a defendant or the subject of a malpractice liability claim, settlement, judicial or administrative adjudication, or any other resolved or open charges or inappropriate, unethical, unprofessional, or substandard care, then the Dosimetrist shall provide information regarding the actions(s). The Dosimetrist shall indicate if the action(s) were settled prior to final court action; judgment rendered by a court, defendant found liable; or if the matter is still pending for each action. In any of the above cases, if the defendant was not exonerated, the malpractice history will be considered unsatisfactory and is an exclusionary item.

2.6. Prior to commencement of work, certification will be provided as part of Section 6, “Health Requirements.” This certification shall state the date on which the examination was completed, the doctor's name that performed the examination, and a statement concerning the physical health of the individual. Contracted personnel engaged to provide direct patient care should have no physical limitations to provide care to include, but not limited to strenuous bending, lifting, and standing for several hours per shift. The certification shall also contain the following statement:

"(name of contract employee) is suffering from no contagious diseases to include, but not limited to, Tuberculosis, Hepatitis, and Venereal Disease” See Section 6." Additionally, as a condition of employment, Occupational Safety and Health Administration (OSHA) requires that all contract personnel who will have occupational exposure to blood or body fluids, or other potentially infectious materials, receive the Hepatitis B vaccine, sign a voluntary declination, or have documented proof of immunity to Hepatitis B infection. Personnel who sign declinations may change their minds at any time and receive the Hepatitis B vaccine without penalty. It is the Contractor's responsibility to report (to the appropriate MTF staff member) all information necessary to assure hospital records can be maintained correctly, and therefore comply with the TJC, OSHA, and Center for Decease Control (CDC) health records requirements.

2.7. Medical Quality Assurance/Risk Management (QA/RM): Contract personnel will participate in QA/RM activities to the extent required by AFI 44-119 and the individual MTF QA/RM plan or instruction.

2.8. Orientation: Contractor will participate in the MTF orientation procedures for newly assigned personnel to include regulations specific to their professional specialty, MTF, and Air Force policy and procedures.

2.9. The contractor will comply with and attend Government provided annual training that will include topics such as compliance, patient safety, performance improvement, risk management, infection control, fire protection, security, patient sensitivity training, automation processing, and local in-service and safety briefings.

2.10. Continuing Education (CE) Requirements: the contractor will maintain CE’s commensurate with his/her professional licensure and certifications. CE’s shall be obtained at no additional cost to the Government and shall be reported to the FRED to be placed in their competency assessment folder as earned. At the discretion of the QMMP or the JROC Director, the Government may grant five days for attaining these requirements at national or local meetings. These days must be coordinated with the military medical physicist and requests should be submitted with scheduled absence requests.

2.11. Off-site visits to other clinics or equipment/software manufacturers as requested by the QMMP. There shall be no costs incurred by the Government except for payment of time to equal time spent during normal duty hours. The off-site visit must be related to radiation oncology and deemed necessary for the continuation or advancement of radiation oncology care at the MTF.

2.12. Procedure Guidance: The contractor will perform procedures compatible with the MTF’s operating capacity and equipment. New medical procedures/services will not be introduced without prior recommendation to, and approval of, the MTF commander or authorized representative.

2.13. The contractor will be a member of the radiation oncology team. The contractor must possess knowledge of the overall characteristics and clinical relevance of radiation oncology treatment machines and equipment, in addition to being cognizant of procedures commonly used in brachytherapy. Education and expertise necessary to generate radiation dose distributions and dose calculations in collaboration with the Medical Physicists and Radiation Oncologist is required.

2.14. The contractor shall comply with all applicable civilian, DoD, MTF and elements directives and instructions, to include TJC HSI, and abide by the “Statement on the Scope and Standards of Medical Dosimetry Practice” as found on the Medical Dosimetrist Certification Board web site www.mbcd.org. The terms, “must, “shall” and “will” denote mandatory actions in this PWS.

2.15. The contractor shall provide full time dosimetry services during normal duty hours as scheduled by the Government. Care will be provided in Government supplied facilities at the MTF. The dosimetrist shall primarily perform services in radiation oncology. Additional services may include image fusion of PET/CT and MRI files in respect to treatment plan dosimetry. The dosimetrist will be expected to interact with imaging departments to obtain images and resolve and address any transmission issues or concerns. The dosimetrist will need to coordinate with Veteran Administration facilities to obtain external images.

3. SERVICE DELIVERY SUMMARY

The service requirements are summarized into performance objectives that relate directly to mission essential items. The performance threshold briefly describes the minimum acceptable levels of service required for each requirement. The thresholds are critical to mission success and the percentages shown indicate acceptable (satisfactory) performance.

Performance Objective

PWS Paragraph Reference

Performance Threshold/Standard

Design a treatment plan in accordance with Radiation Oncologist’s prescription

Para 2.1.3.1 Specific Tasks: a, b, c, & g

100%

Coordinate / perform treatment simulations, beam

Para 2.1.3.1 Specific Tasks: d, e, f, 100% modification device development & production.

& n

Provide support to physics staff (clinical and administrative tasks). Assist in intracavitary and interstitial brachytherapy procedures.

Para 2.1.3.1, Specific Tasks: h & i.

95%

Support the HDR brachytherapy program per direction of medical physics and JROC Director.

Assist in Brachytherapy procedures including planning

Specific Task: j

Input billing and workload information

Specific Task: t

4. GOVERNMENT FURNISHED PROPERTY AND SERVICES

4.1. Property and Services: The Government will furnish facilities and equipment at the MTF for the contractor to effectively perform dosimetry services in accordance with the PWS. Contractor and government representative shall certify their agreement as to the working order of the equipment within 15 days of contract start. The MTF will provide all required preventive maintenance on Government-owned equipment. Telephone and computer equipment use will be for official use only IAW applicable DOD and Air Force Instructions. The contractor shall have the use of the following facilities for performance under this contract only:

4.1.1 Property: Office area provided for contract manager will appear in an orderly appearance.

4.1.2. Issued Items: The MTF will provide a nametag for the purposes of identifying the employee and Personal Protective Equipment i.e., protective gloves. This does not include any type of uniform or laboratory coat.

4.1.3. Housekeeping: Housekeeping services will be provided by MTF.

4.1.4. Security Forces and Fire Protection: Phone Numbers: Non-Emergency Fire

Department: 424-3683, Non-Emergency Security Police: 424-3293. Emergencies (call): 4-911

4.1.5. Utilities: The government will provide gas, electricity, sewage disposal, and water.

4.1.6. Equipment: On site equipment includes one class A telephone per desk and one desktop computer.

4.1.7. Installation equipment and services: This will include, but is not limited to, copy and fax machines, Defense Switching Network lines and a medical library. The same restrictions to utilize these items for Government official business apply to the contractor. The Government will provide training on Government equipment and initial facility orientation.

4.1.8. Supplies: The MTF will provide commonly used non-medical supplies to include pens, paper, stapler, calendar, and required government forms used in the performance of services.

4.1.9. Dining Facilities: The contractor personnel will be allowed to use the hospital dining facilities while on duty.

4.1.10. Emergency Health Care. The MTF will provide emergency health care to save loss of life or limb and preserve undue suffering for contract personnel for injuries or illness occurring while on duty in the MTF. These services shall be billed to the contractor at the current full reimbursement rate.

4.1.11. The Government will provide a briefing to familiarize contract personnel with the policies and procedures of the MTF. Orientation will occur at the onset of employment at the MTF; attendance will be mandatory for all contract personnel.

Time will not be billable to the Government.

5. GENERAL INFORMATION: CONTRACTOR GENERAL REQUIREMETS

5.1. In the event of an adverse action, the contracting officer (CO) and the contractor shall be notified by the Contracting Officer Representative (COR) as soon as possible when the necessity to exercise such authority becomes apparent. The Quality Assurance Personnel will also provide the contracting officer and the contractor with a written statement advising the contractor of an adverse action involving a health care provider, a brief statement of the basis for the action to provide the contractor sufficient information in order to make employment substitution decision as necessary, and if required, the final outcome of the adverse action process. The written notice will be marked by government as covered by 10 USC 1102. No other information pertaining to the adverse action will be released without MTF/CC permission.

5.2. Continuing Medical Education (CME) Requirements: Health care providers, licensed registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current as prescribed in AFI 44-117, Medical Service Officer Education. CME shall be obtained at no additional cost to the Government and shall be reported to the MTF Credentials Committee annually on the first normal duty day in January or previous calendar year.

5.3. Health care providers shall be in good standing, and under no clinical restrictions, with state licensure board in any state in which a license is held or has been held within the past 10 years.

5.4. Health care providers shall maintain current certification in required training as stated in contract.

5.5. Health care providers shall be current with and have completed all continuing education requirements specified by their professional licensure or certification.

6. HEALTH REQUIREMENTS

The Health Care Worker (HCW) shall report (to the appropriate MTF staff member) all information necessary to assure hospital records can be maintained correctly, and therefore comply with TJC, OSHA, and CDC health records requirement. In addition, prior to commencement or assignment to the MTF. Contracted healthcare provider will be current on all listed immunizations as listed below:

60th Medical Group Medical Employee Health Program Requirements

References:

MDGI 48-10, Medical Employee Health Program, 31 August 2013

Air Force Instruction 44-108, Infection Prevention and Control Program, 1 March 2012

Air Force Instruction 41-210, TRICARE Operations and Patient Administration Functions, 06 June 2012

Air Force Joint Instruction (AFJI) 48-110, Immunizations and Chemoprophylaxis, 29 September 2006

Centers for Disease Control Morbidity and Mortality Weekly Report (MMWR), Immunization of Healthcare Workers, 25 November 2011, / 60(RR07);1-45

Centers for Disease Control Morbidity and Mortality Weekly Report (MMWR), Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-care Settings, 30 December 2005, Vol 54/No.

RR-17

MEHP Immunization / Screening Requirement Presumptive evidence of immunity to measles, mumps and rubella includes any of the following

Measles, Mumps, Rubella (German Measles) NOTE: If a HCW with 2 documented doses of MMR vaccine is tested serologically and determined to have negative or equivocal measles titer results, it is not recommended that the person receive an additional dose of MMR vaccine. Such persons should be considered to have presumptive evidence of measles immunity.

1. Written documentation of vaccination with 2 doses of live measles, mumps, and rubella or MMR vaccine administered at least 28 days apart OR

2. Laboratory evidence of immunity (Positive “Convalescent” Measles, Mumps and Rubella immunoglobulin G (IgG) in the blood; equivocal results should be considered negative) OR

3. Laboratory confirmation in the HCWs record that the HCW had measles, mumps and rubella disease (Positive “Acute” Measles, Mumps, and Rubella immunoglobulin M (IgM) in the blood OR

4. Birth before 1957 (The majority of persons born before 1957 are likely to have been infected naturally and may be presumed immune)

Tuberculosis (TB) Screening NOTE: HCWs with a baseline positive or newly positive test result for M. tuberculosis infection (i.e., TST or BAMT) or documentation of treatment for LTBI or TB disease should receive one chest radiograph result to exclude TB disease (or an interpretable copy within a reasonable time frame, such as 6 months).

1. Two-step tuberculin skin test (TST) for M. tuberculosis (BAMT)) that was performed within the previous 12 months

OR

2. An approved blood assays for M.

tuberculosis (BAMT)) that was performed within the previous 12 months

Varicella (Chicken Pox)

All HCWs require proof of varicella immunity. Evidence of immunity includes

1. Written documentation of vaccination with 2 doses of varicella vaccine OR

2. Laboratory evidence of immunity or laboratory confirmation of disease OR

3. Diagnosis or verification of a history of varicella disease by a health-care provider OR 4. Diagnosis or verification of a history of Herpes Zoster by a health-care provider

Tetanus, Diptheria and Pertussis (Tdap).

All HCWs, regardless of age, will receive a one-time dose of the Combined Tetanus, Diphtheria and Pertussis (Tdap) vaccine if not previously vaccinated. HCWs will receive Td boosters every 10 years thereafter.

Influenza

Immunization against seasonal influenza each year is required unless there is a documented medical contraindication.

Hepatitis B Virus (HBV) Vaccine and Immunity NOTE: All high-risk (1) and exposure-prone (2) HCWs who do not have a protective concentration of anti-HBs (>10 mIU/mL) after completion of the second vaccination series (i.e., after receiving a total of 6 doses) will be tested for Hepatitis B surface antigen (HBsAg) and Hepatitis B core antibody (anti-HBc) to determine infection status.

Completion of three doses of hepatitis B vaccine and serologic testing for Hepatitis B surface antibody (anti-HBs) within 30-60 days after completion of the three dose vaccination series is required for all HCWs with direct patient care duties.

(1) High-risk personnel: Personnel who have direct contact with patients or blood/body fluids, and are at ongoing risk for injuries with sharp instruments/needle sticks.

(2) Exposure-prone personnel: Medical and dental providers, nurses, and technicians who perform invasive procedures with sharp instruments in a poorly visualized or highly confined anatomic site, as defined by the most current CDC guidelines. All exposure-prone personnel are also high-risk.

6.1. Preventative, Prophylactic, and Follow-Up Procedures. The HCW shall ensure that he/she is in compliance with preventive, prophylactic and follow-up procedures, as well as infection control and employee health program procedures, as established by the MTF. Required preventive, prophylactic and follow-up procedures will be provided by the Government to contract employees in the military MTF.

The HCW shall reimburse payment for these services. If care is received elsewhere, the HCW shall provide written verification of treatment.

7. CONDUCT. The Contracting Officer may request that any contracted employee or contract personnel whose conduct in the opinion of the Contracting Officer interferes with proper order or professionalism at the installation where services are performed, be removed from such installation and the contractor will comply with such request.

8. SECURITY REQUIREMENTS. Contractor shall not employ individuals who are potential threats to health, safety, security general wellbeing or operational mission of the DoD and its population.

This shall include individuals who are a potential threat because of prior felony convictions.

8.1. The contractor is responsible to ensure all government-issued identification badges, keys, equipment and car passes are returned to the COR when an individual’s is leaving employment under this contract.

9. DRESS AND APPEARANCE. Contract personnel will maintain good personal hygiene and a well groomed, professional appearance. Business casual dress attire is appropriate for the majority of the positions. If a specific position requires the wearing of a uniform (i.e., scrubs, etc), it will be detailed in the individual position description. Unless otherwise identified, required uniforms will be provided by the contractor.

10. TRAINING REQUIREMENTS. The Corporate Contractor Management Staff shall ensure that personnel are trained before arriving to the MTF. Maintain complete and accurate training records of Medical Support Service Personnel, ensure that annual training (i.e. Health Information Portability Accountability Act, Cardiopulmonary Resuscitation, Information Assurance,) is completed before expiration and that new mandatory training is completed within timeframes designated by the Air Force.

10.1 The contractor shall ensure that all Medical Support Service Personnel receive initial CHCS/AHLTA, Privacy Act, Information Assurance and HIPAA training through Military Health Services (MHS) Learn.

10.2. Using MHS Learn as the platform and training instrument, the Contractor trainers will facilitate, monitor and validate training of Medical Support Service Personnel as required by each position and duty assignment according to the required curriculum established by MTF (i.e., log on, mailbox, Manage Care Program, Ambulatory Data Module and specific modules within the computer system applicable to duties, etc.).

10.3. For each Contracted Employee trained for placement, the contractor shall submit evidence of training completion and competence assessment to the MTF Security Manager before he or she is granted access to Government computer information systems by the requesting location authority.

11. PHYSICAL REQUIREMENTS. Any specifications regarding physical requirements will be in the position descriptions. In most cases, the positions or services do not require any unusual physical demands. The majority of time is spent stationary at a desk and computer terminal. However, the position descriptions may describe prolonged sitting, walking, bending, and ability to carry up to a specified weight or capability to reach high shelving units with the assistance of step ladders to retrieve and file medical records.

12. RECORDS, FILES, DOCUMENTS, DATA, AND WORK PAPERS. All records, files, documents, data and work papers provided by the government remain Government property. The Functional Requirements Evaluator Designee (FRED) will provide guidance to the contract personnel who shall maintain and dispose of these records, files, and documents in accordance with AFM 33-363, and IAW applicable HIPAA requirements as stated in the HIPAA clause.

13. CONTRACTOR IDENTIFICATION: All contractor management staff or contracted employee shall clearly be identified as such at ALL times, including conversations, mail, email, faxes, and/or other electronic communication whether with government personnel, other contractor personnel, or with public when supporting this contract. Likewise, the contractor shall abide by all applicable laws and regulations when using government equipment and services in performance of this contract. As a minimum, contractor management staff or contracted personnel shall clearly identify themselves as contractors by: wearing badges which clearly and legibly identify the employee as a contractor; using the label “contractor” in email addresses in accordance with Federal Acquisition Regulation (FAR) 37.114, Special Acquisition Requirements.

14. FEDERAL HOLIDAYS

Federal Holidays New Year’s Day Martin Luther King, Jr. Birthday Washington’s Birthday

Memorial Day Independence Day Labor Day Columbus Day Veterans Days Thanksgiving Day Christmas Day

Appendix A

Applicable Publications

Publications and forms applicable to this Performance Work Statement (PWS) are listed below. The website for publications is http://www.e-publishing .af.mil. Publications and forms are available electronically through the internet. DoD Directives can be found at http://west.dtic.mil/whs/directives.

Regulations are followed by a “- R” (e.g., DoD 6025.18-R) and can be located on the website by clicking on “Publications” instead of “Directives.”

DEPARTMENT OF DEFENSE (DoD) REGULATIONS/MANUALS

INSTRUCTIONS/DIRECTIVES

PUB NO. TITLE

DoD 5200.01 Information Security Program and Protection of Sensitive Compartmented Information DoD 5200.2-R Personnel Security Program DoDD 5400.11 Privacy Program DoDD 5500.7 Standards of Conduct DoDi 5400.7-R Freedom of Information Act DoD 6025.5 Personal Services Contracts for Healthcare Providers DoDi 6025.13 Medical Quality Assurance and Clinical Quality Management in the Military Health System DoDi 6025.8 Ambulatory Procedure Visit DoD 6025.18-R Health Information Privacy Regulation Jan 03 DoD 6025.40 Military Health System Data Quality Management Controls Procedures DoD 6040.41 Medical Records Retention and Coding at Military treatment Facilities DoD 6040-42 Medical Encounter and Coding at Military Treatment Facilities DoD 6040.42 Custody and Control of Outpatient Medical Records DoDD 8500.1 Information Assurance DoD 8580.02-R HIPAA Security Rule DoDI 1402.5 Criminal History Background Checks on Individuals in Child Care Services DoDI 6040.43 Custody and Control of Outpatient Medical Records

AIR FORCE INSTRUCTIONS/MANUALS

PUB NO. TITLE

AFI 41-209 Medical Support AFI 31-401 Information Security Program Management AFI 31-501 Personal Security Program Management AFI 33-119 Air Force Messaging AFI 33-129 Web Management and Internet Use AFI 33-200 Information Assurance Management AFI 33-202V1 Network and Computer Security AFI 33-322 Records Management Program AFI 33-332 The Air Force Privacy and Civil Liberties Program

AFI 33-364 Records Disposition – Procedures and Responsibilities AFI 34-242 Mortuary Affairs Program AFI 36-1004 The Air Force Civilian Recognition Program AFI 36-2201 Air Force Training Program AFI 36-2910 Line of Duty (Misconduct) Determinations AFI 36-3002 Casualty Services AFI 40-102 TRAVISAFBSUP_1 Tobacco Use in the USAF AFI 40-201 Radioactive Materials Management AFI 40-701 Special Needs Identification and Assignment Coordination AFI 41-102 Air Force Medical Expense and Performance Reporting Systems for Fixed Military Medical and Dental treatment Facilities AFI 41-104 Professional Board and Nation Certification Examinations AFI 41-106 Medical Readiness Program Management AFI 41-210 TRICARE Operations and Patient Administration Functions AFI 44-102 Medical Care Management AFI 41-117 Medical Service Officers Education AFI 44-119 Medical Quality Operations AFI 46-101 Nursing Services and Operations AFI 48-105 Surveillance, Prevention, and Control of Diseases and Conditions of Public Health or Military Significance AFI 48-110 Immunizations and Chemoprophylaxis for the Prevention of Infectious Diseases AFI 48-123 Medical Examinations and Standards AFI 48-148 Ionizing Radiation Protection AFI 33-360 Publications and Forms Management AFMAN 33-152 User Responsibilities and Guidance for Information Systems AFMAN 33-363 Management of Records AFSSI 5027 Air Force Systems Security Instruction 5027

OTHER DIRECTIVES:

All 60 MDG/Unit-Specific Operating Instructions/Protocols/Guidelines

MDGI 48-10 Hospital Employee Health Program MDGI 48-22 Radiation Safety and Protection Program MDGI 44-61 Emergency Cardiovascular Care (ECC) Program MDGI 31-02 Notification, Dissemination, Protection, Reproduction, Destruction and Removal of Messages and Classified Information

Publications Code:

AFI--Air Force Instruction AFMAN--Air Force Manual AFP--Air Force Pamphlet

AFSSI-- Air Force Systems Security Instruction AF Form--Air Force Form DD Form--Department of Defense Form MDGI -- Medical Group Instruction

Appendix B

Standard Abbreviations and Terms

Abbreviation and acronyms

• 3D-CRT: Three-dimensional conformal radiation therapy

• AHLTA: Armed Forces Health Longitudinal Technology Application

• Anti-HBc: Hepatitis B core antibody

• BAMT: M. tuberculosis

• CDC: Center for Decease Control

• CE: Continuing Education

• CHCS: Composite Health Care System

• CME: Continuing Medical Education

• COR: Contracting Officer Representative

• CT: Computed Tomography

• DGMC: David Grant Medical Center

• DoD: Department of Defense

• DSN: Defense Switching Network

• FAR: Federal Acquisition Regulation

• FRED: Functional Requirements Evaluator Designee

• HBsAg: Hepatitis B surface antigen

• HBV: Hepatitis B Virus

• HCW: Health Care Worker

• HDR: High Dose Rate (Brachytherapy)

• HIPAA: Health Information Portability Accountability Act

• HSI: Health Services Inspection

• IgG: Rubella immunoglobulin G

• IgM: Rubella immunoglobulin M

• IGRT: Image Guided Radiation Therapy

• IMRT: Intensity Modulated Radiation Therapy

• JROC: Joint Radiation Oncology Center

• MDCB: Medical Dosimetrist Certification Board MHS: Military Health Services

• MMR: Measles, Mumps, Rubella

• MMWR: Morbidity and Mortality Weekly Report

• MRI: Magnetic Resonance Imaging

• MTF: Medical Treatment Facility

• OBI: On Board Imaging

• OSHA: Occupational Safety and Health Administration

• PET: Position Emission Tomography

• PPE: Personal Protective Equipment

• PWS: Performance Work Statement

• QAP: Quality Assurance Personnel

• QA/RM: Medical Quality Assurance/Risk Management

• QMMP: Qualified Military Medical Physicist

• QQ: Quality Control

• SBRT: Stereotactic Body Radiation Therapy

• SRS: Stereotactic Radiosurgery

• SS: Services Summary

• TB: Tuberculosis

• Tdap: Tetanus, Diptheria and Pertussis

• TJC: The Joint Commission

• TLD: Thermoluminescent Dosimeter

• TST: Two-step tuberculin skin test

• VMAT: Volumetric Modulated Radiation Therapy

Terms

ARIA - Radiation Therapy electronic medical record database.

Commander - MTF Commander, Flight Commander or other activity head, or a designated representative, e.g., Contracting Officer’s Representative (COR) or Department Head, of the activity designated in the contract.

Contracting Officer Representative (COR) - Individuals designated to perform quality assessment functions. They serve as on-site technical managers assessing contractor performance 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; however, their duties are essentially the same.

Contractor - the Company identified in block 15A of Standard Form 33. The Contractor is an independent contractor and is responsible for its own liability. Contractor refers to the prime Contractor.

The prime Contractor retains responsibility for any teaming partner or subcontractor and shall be accountable for their performance.

Functional Requirements Evaluator Designee (FRED) - Individual/s who is appointed to provide technical surveillance over contracted healthcare workers and who will provide feedback on a regular basis to the COR.

Medical Treatment Facility (MTF) - Air Force hospitals or clinics, including all activities providing outpatient and/or in-patient healthcare services for authorized personnel.

Performance Work Statement (PWS) - The standard of work that describes the core requirements in clear, specific, and objective terms with measureable outcomes.

Qualify - Qualifying is the process by which the contractor screens potential applicants to ensure workers possess the qualifications required by this performance work statement.

Quality Control (QC) - Those actions taken by a Contractor to control the quality of output and to ensure that they conform to contract requirements.

Recruit - Recruiting is the process by which medical administrative and support workers from outside of the Government are located, contacted and hired for specific positions.

Retain - The continuity of high quality workers is a vitally important component in maintaining quality of care to Air Force beneficiaries. The Contractor shall design and manage a retention program that ensures low turnover and customer satisfaction.

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.

Substitution Personnel - Temporary employees providing backfill for a permanent contract staff member. The coverage will be for scheduled or unscheduled absences.