Attachment 1 -PWS v 11 Apr 24.docx

PERFORMANCE WORK STATEMENT (PWS)

Therapeutic Medical Physicist & Medical Dosimetrist Support Services

David Grant Medical Center Travis AFB, CA

11 April 2024

TABLE OF CONTENTS

APPENDIX

APPENDIX A: LIST OF GOVERNMENT FURNISHED PROPERTY 24

APPENDIX B: HIPAA CLAUSE 25

Part 1

General Information

1. GENERAL: This is a non-personal services contract to support David Grant Medical Center’s (DGMC) Radiation Oncology Department. The Government shall not exercise any supervision or control over the contract service providers performing these services herein. Such contract service staff shall be accountable solely to the Contractor who in turn is responsible to the Government. The Contractor shall provide all materials, equipment, phantoms necessary for testing conducted by Physicist and qualified staffing. Specific support services to include on-site board-certified Radiation Oncology Therapeutic Medical Physics and Certified Medical Dosimetry staff. The Contractor shall possess the skills, knowledge, abilities, and training to satisfactorily perform the service requirements included in this PWS. Staff performing work in support of services 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.

1.1. Description of Services/Introduction: The Contractor shall provide all materials, equipment, phantoms necessary for testing conducted by Physicist and qualified on-site staffing necessary to perform services as defined in this Performance Work Statement (PWS) except for those items specified as government furnished property and services. The Contractor shall perform to the standards in this contract.

1.2. Overall Background: The Joint Radiation Oncology Center (JROC) is an American College of Radiology (ACR) accredited Joint Venture program at DGMC between the Air Force and the Veterans Affairs (VA). DGMC recently completed a multi-million-dollar renovation and equipment upgrade in 2021. DGMC Radiation Oncology treats approximately 420 patients per year on two state-of-the-art radiation therapy machines capable of delivering radiation in a precise way. As a result, we currently offer Intensity-Modulated Radiation Therapy (IMRT), RapidArc™ therapy, Image-Guided Radiation Therapy (IGRT), Stereotactic Radiosurgery (SRS), and Stereotactic Body Radiotherapy (SBRT), which are sophisticated methods of delivering radiation to tumors while sparing surrounding normal tissues.

1.3 Objectives: The objective of the requested service contract is for the Contractor to provide all materials, equipment, phantoms necessary for testing conducted by Physicist and a fully qualified staffed on-site support team for therapeutic physic and medical dosimetry in the Radiation Oncology clinic to support DGMC’s mission providing high quality treatments to active-duty airman, military retirees, and their dependents, with zero gaps in contracted support coverage as outlined in this PWS.

1.4. Scope: Provide all materials, equipment and phantoms necessary for testing. As well as on-site board-certified Therapeutic Medical Physicist/Dosimetrist staff. The Therapeutic Medical Physicist will support the education and clinical expertise necessary to generate radiation dose distributions and dose calculations in collaboration with the Certified Medical Dosimetrist and Radiation Oncologist. In addition, the Therapeutic Medical Physics on-site personnel must be thoroughly familiar with the physical and geometric characteristics of the radiation-producing equipment and radioactive sources commonly employed in radiation oncology treatment planning. Therapeutic Medical Physics on-site personnel must be engaged in the design, optimization and technical evaluation of radiation treatment plans as well as ensuring precise and accurate radiation dose delivery. They are also responsible for radiation protection of patients and staff. The Certified Medical Dosimetrist on-site personnel must process patient data acquisition, radiation treatment planning for the administration of ionizing radiation, and quality management for radiation oncology patients. Certified Medical Dosimetrists are medical specialists recognized by the Medical Dosimetrist Certification Board (MDCB). Dosimetry support is a requirement for safety, efficacy, and compliance for radiation treatment planning.

1.5. Period of Performance (POP): Period of performance shall be for one (1) Base Year of 12 months, and two (2) 12-month option years. The POP reads as follows:

Base Year: 01 Jul 2024 – 30 Jun 2025 Option Year I: 01 Jul 2025 – 30 Jun 2026 Option Year II: 01 Jul 2026 – 30 Jun 2027 6 Month Extension: 01 July 2027 – 01 January 2028

1.6. Contractor’s Quality Control: The Contractor shall develop and maintain an effective Quality Control Program (QCP) to ensure services are performed in accordance with this PWS. The Contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The Contractor’s QCP is the means by which vendor assures required services complies with the requirement of the contract. The Contractor shall maintain a plan for Radiation Therapy Services that demonstrates a process for transitioning to higher workload within 30 days of notification from CO. See Exhibit 2. The Contractor shall maintain a plan that demonstrates a process for all materials, equipment, phantoms necessary for testing. The Contractor shall maintain a plan that demonstrates a process for finding, pre-screening, and submitting qualifying documentation against preliminary government minimum requirements for Contractors. The plan will effectively place fully qualified Contractors to perform at the MTF. The plan will ensure the verification and validation of candidate qualifications meet the minimum qualifications as identified in the PWS. The plan must also ensure that Contractors meet the security requirements. The Contractor shall have in place a management plan to ensure qualified candidates are recruited, screened, qualified, trained, monitored, and retained to fulfill service requirements under this contract. These systems and controls for performing and monitoring this data shall address the areas covered by the Services Summary. The Contractor shall employ these commercial QCP/procedures to identify, prevent and ensure non-recurrence of defective services. Through implementation of the Contractor’s QCP/procedures, the Government shall receive quality services meeting the requirements of this contract.

1.6.1. The Contractor shall appoint a designated Contractor Representative/Program Manager (PM) within 5 business days upon the award of the contract with name and contact information and shall be responsible for the performance of the work, all materials, equipment and phantoms necessary for testing and ensuring scheduled staff is on site and available to provide services with zero gaps in contracted support coverage. The PM and an alternate shall be designated in writing to the Contracting Officer (CO) and have the authority to act for the Contractor on all contracting matters relating to daily operation of this contract, to include solving MTF complaints regarding contracted personnel performance issues. The PM or alternate shall be available during normal duty hours (7:30 am – 4:30 pm PST) to meet with Medical Logistics Personnel and the CO’s authorized Contracting Officer’s Representative (COR) to discuss and solve problems. The Contractor shall have staff credentialed and approved through the MTF and will be ready to work on-site by the contract effective date. The QCP is to be delivered to the CO within 15 days after contract award. After acceptance of the QCP, the Contractor shall receive the CO’s acceptance in writing of any proposed change to his QC system. The Contractor shall be responsive to contracting requirements to include but not limited to submitting invoices, responding to complaints, and responding to any communication requests.

1.6.2. Workload Estimates: The vendor must be able to meet workload as described in Exhibit 2.

1.7. Recognized Holidays: The Contractor is not required to perform services on the following holidays:

Independence Day

1.8. Hours of Operation: The Contractor is responsible for conducting business during normal duty hours (7:30 am – 4:30 pm PST). The Contractor must at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS. When hiring personnel, the Contractor shall keep in mind that the stability and continuity of the workforce are essential.

1.9. Place of Performance: The work to be performed under this contract will be performed on site at David Grant Medical Center (DGMC), Travis AFB, California.

1.10. Type of Contract: The Government will award a Firm Fixed Price Contract.

1.11. Security Investigative Requirements: The Contractor shall ensure Contractors comply with the following security requirements not already identified in the contract PWS:

1.12. Contractors shall be subject to the following additional security investigative processes, to include appointments with Security Managers: To initiate security review, the contractor will submit the following information to the MTF Security Manager: CONTRACTOR full name, other names used (maiden), date of birth, social security number, email address, physical address, home telephone and mobile phone numbers, place of birth (city, state, country), citizenship, prior military end date, reserve status and branch, prior government end date.

1.13. The contractor shall advise their Contractors that favorable fingerprints with an open investigation, verified through Defense Information System for Security (DISS) Web Application (DISS) is needed as a condition of employment under this TO. The contractor understands that while the MTF may allow contracted Contractors temporary or interim access to Government systems in a non-sensitive position, pending the outcome of the T1, this contract requires the immediate removal of a contracted CONTRACTOR from the position if their investigation return with an “unfavorable” adjudication.

1.14. Contractors shall be subject to the following security processes for fingerprints: Fingerprints will be taken during the first week of assignment to the MTF at the Travis AFB Information Protection office. Appointment date and time will be provided on the first day of assignment.

1.15. The CONTRACTOR shall complete either a ☒SF-85P or an ☐SF-86 Questionnaire for National Security Positions (or equivalent OPM investigative product)

1.15.1. Physical Security: The Contractor shall be responsible for safeguarding all government equipment, information and property provided for Contractor use. At the close of each work period, government facilities, equipment, and materials shall be secured.

1.15.2. Keys: CONTRACTOR may be issued keys. The CONTRACTOR shall safeguard the keys from loss, theft or destruction, and shall present, for accountability purposes, all keys signed for at scheduled or unscheduled key control inspections IAW MTF policy. Government keys shall not be duplicated. Lost keys and/or locks shall be reported to the issuing party immediately upon recognition of the loss. The Contractor may be required to reimburse the Government for lost keys, or lockset (if locksets are required to be replaced) as a result of lost keys.

1.15.3. Contractor Identification: All Contractor Management staff or Contracted Healthcare Workers 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. MTF issued identification badge shall be worn above the waistline during the individual’s duty hours.

1.16. Special Qualifications and Training Requirements:

1.16.1. The Therapeutic Medical Physicist on-site personnel must have master’s or doctoral degree in Physics, Medical Physics, Bio physics, Radiological Physics, Medical Health Physics, or equivalent discipline from an accredited college or university. Possess Board Certification in Therapeutic Medical Physics, by the American Board of Radiology (ABR). Must possess a current, active, valid, and unrestricted medical physicist license. The government will accept ABR board certification in lieu of a state medical physics license This contractor shall ensure the professional license is current and does not expire to ensure compliance with the contract. Must have three (3) years, excluding training years, of recent clinical therapeutic physics experience and be proficient in the technology and other support services, demonstrated by active practice of at least 12 months within the last 18 months, to include: Patient and Equipment quality assurance test systems, Laser Patient Alignment Systems, Brachytherapy systems and applicators, National standards for quality assurance and radiation treatments, Varian ARIA oncology information system, Varian Eclipse treatment planning system, Varian TrueBeam linear accelerator, Vision RT Surface Guided System (patient alignment and monitoring, in real time), Respiratory gating for scanners (RGSc), radiation physics aspects of the ACR or American Society for Radiation Oncology (ASTRO), Accreditation Program for Excellence (APEx) accreditation process, national research protocols, requirements of the US Nuclear Regulatory Commission contained in 10 CFR 20 and 35, coordinating and implementing systems upgrades on Varian, Nucletron, Sun Nuclear, Siemens, and other radiation therapy treatment and quality assurance platforms.

1.16.2. The Therapeutic Medical Physicist on-site personnel must have the capability to perform the following: photon irradiation (TBI), total skin electron irradiation (TSE), low dose rate (LDR) and high dose rate (HDR) brachytherapy modalities, including both interstitial and intracavitary brachytherapy approaches, plan and implement LDR/HDR brachytherapy for prostate applications, including all quality assurance testing, plan and implement HDR brachytherapy for gynecologic applications, including all quality assurance testing, plan and implement HDR brachytherapy for breast applications, including all quality assurance testing, gynecological and prostate brachytherapy using a treatment planning system, intensity modulated radiotherapy (IMRT) including volumetric modulated arc therapy (VMAT), stereotactic body radiotherapy (SBRT), stereotactic radiosurgery (SRS) using a linear accelerator (LINAC) based treatment and planning platform, image guided radiotherapy (IGRT), surface guided radiation therapy (SGRT) including optical surface monitoring systems (OSMS), on-board imaging (OBI), triggered imaging (TI) with both manual and auto beam hold, fluoroscopic image guidance with both manual and auto beam hold, acceptance testing and commissioning of a dual-photon and multiple-electron energy linear accelerator with multi-leaf collimator and electronic portal imaging device capable of both IGRT, IMRT, VMAT, SRS, and SBRT, with Varian equipment experience, acceptance testing and commissioning of a three-dimensional (3D) treatment planning system capable of producing IGRT, IMRT, VMAT, SRS, SBRT, and brachytherapy plans, routine quality assurance / performance testing equipment (ion chambers, diodes, film, optically stimulated luminescent dosimetry, and Thermoluminescent dosimetry and techniques necessary to verify the accuracy and reproducibility of contemporary 3D, IGRT, IMRT, and brachytherapy-based treatments and equipment, to include daily monthly, and annual testing in accordance with current AAPM recommendations, Performing quality assurance for Seimens CT simulator or equivalent, coordinate and implement systems upgrades on Varian, Nucletron, Sun Nuclear, Siemens, and other radiation therapy treatment and quality assurance platforms.

1.16.3. Certified Medical Dosimetrist (CMD) must have Bachelor’s degree from a formal medical dosimetry program accredited by the Joint Review Committee on Education in Radiologic Technology (JRCERT), certification - certified by the Medical Dosimetrist Certification Board (MDCB) as a CMD. The Contractor shall ensure the provider’s certification stays active and does not expire to ensure compliance with the contract. Must have a minimum of two (2) years’ experience , excluding training years, demonstrated by active practice of at least 12 months within the last 18 months in the following: clinical dosimetry experience with all treatment planning modalities, documentation detailing experience in performing quality assurance procedures, documentation detailing CMD experience in a healthcare system that is ACR certified, experience with Varian Linear Accelerators: TrueBeam with Rapidarc (or equivalent), Eclipse treatment planning system; and ARIA record & verify system, experience with Siemens CT Simulator (or equivalent).

1.16.4. The CMDs must have the capability to perform the following: both hand-based and computer-based monitor unit (MU) calculations, low dose rate (LDR) and high dose rate (HDR) brachytherapy modalities, intensity modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), image-guided radiotherapy (IGRT), surface guided radiotherapy (SGRT), stereotactic body radiation therapy (SBRT), stereotactic radiosurgery (SRS), and respiratory gating for scanners (RGSc), total body photon irradiation (TBI), total skin electron irradiation (TSE), fabricating custom treatment aids, such as custom blocks, shields, compensators, molds, casts, and other immobilization devices, LDR and HDR brachytherapy, planning and implementing LDR/HDR brachytherapy for prostate applications, planning and implementing HDR brachytherapy for gynecologic applications, planning and implementing HDR brachytherapy for breast applications, planning and implementing HDR brachytherapy for skin applications, Hyperarc, standard and virtual simulation techniques and image fusion for tumor and normal tissue localization to include the use of positron emission tomography (PET), magnetic resonance (MR), and computed tomography (CT) imaging, and treatment planning using national protocols.

1.16.5. Training: Must be current in the completion of the American Heart Association Basic Life Support (BLS) for Healthcare Providers Course and other certifications required by AFI 44-102, AFI 44-119 and MDGI 44-61, Emergency Cardiovascular Care (ECC) Program. Web-based training courses do not meet the standards.

1.16. 6. Contractors shall be in good standing, and under no clinical restrictions with the state licensure board in any state in which a license is held, or has been held, within the last 10 years.

1.16.7. Contractors shall be current with, and have completed, all continuing education requirements specified by their professional licensure or certification.

1.16.8. The Contractor shall ensure compliance with completion of all MTF-specified orientation and onboarding program(s), initial and annual training requirements, and comply with all MTF policies, procedures, productivity standards and instructions as provided by the MTF.

1.16. 9. All Contractors must complete annual training required in accordance with Health Insurance Portability and Accountability Act (HIPAA), The Joint Commission (TJC), AF Computer Security Policy and AF Safety Policy.

1.16.10. The Contractor shall ensure that all Medical Support Service Personnel receive initial Military Health System (MHS) Privacy Act, Information Assurance and HIPAA training through MHS Learn. https://mhslearn.csd.disa.mil/ilearn/en/learner/mhs/portal/home.jsp

1.17. Post Award Conference/Periodic Progress Meetings: The Contractor agrees to attend any post award conference convened by the contracting activity or contract administration office in accordance with Federal Acquisition Regulation Subpart 42.5. The CO, COR, and other government personnel, as appropriate, may meet periodically with the Contractor to review the Contractor's performance. At these meetings the CO will apprise the Contractor of how the Government views the Contractor's performance and the Contractor will apprise the Government of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues. These meetings shall be at no additional cost to the Government.

1.18. Contracting Officer’s Representative (COR): The COR will be identified by separate designation letter. The COR monitors all technical aspects of the contract and assists in contract administration. The COR is authorized to perform the following functions: assure that the Contractor performs the technical requirements of the contract; perform inspections necessary in connection with contract performance; maintain written and oral communications with the Contractor concerning technical aspects of the contract; issue written interpretations of technical requirements, including government drawings, designs, specifications; monitor Contractor's performance and notifies both the CO and Contractor of any deficiencies; coordinate availability of government furnished property; and provide site entry of contractor personnel. A letter of designation issued to the COR, a copy of which is sent to the Contractor, states the responsibilities and limitations of the COR, especially with regard to changes in cost or price, estimates or changes in delivery dates. The COR is not authorized to change any of the terms and conditions of the resulting order.

1.19. Key Personnel: The following personnel are considered key personnel by the Government: COR and CO. The Contractor shall provide a PM who shall be responsible for the performance of the work. The name of this person and an alternate who shall act for the Contractor when the manager is absent and shall be designated in writing to the CO. The PM or alternate shall have full authority to act for the Contractor on all contract matters relating to daily operation of this contract. The PM or alternate shall be available during normal duty hours (7:30 am – 4:30 pm PST).

1.20. Data Rights: The Government has unlimited rights to all documents/material produced under this contract. All documents and materials, to include the source codes of any software, produced under this contract shall be Government-owned and are the property of the Government with all rights and privileges of ownership/copyright belonging exclusively to the Government. These documents and materials may not be used or sold by the Contractor without written permission from the CO. All materials supplied to the Government shall be the sole property of the Government and may not be used for any other purpose. This right does not abrogate any other government rights.

1.22. Phase In/Phase Out Period: The CONTRACTOR will perform a phase in/phase out (hand-off report) anytime the responsibility and accountability for the care of the patient is transferred from one CONTRACTOR to another.

1.23. Contractor Reporting Requirement: The Contractor will report manpower data relating to the performance of services contracts to the Functional Requirements Evaluator Designee (FRED) on a weekly basis.

1.24. Performance Requirements Summary

1.24.1. As a minimum, COR and/or FRED will monitor, review, and report on the Contractor’s performance and compliance with all Service Summary (SS), refer to Exhibit 1. The performance thresholds referenced in the table briefly describes the minimum acceptable levels of service required for each service requirement. The performance thresholds established for each of the performance objectives are the number of allowable defects permitted before the COR notifies the CO IAW FAR 52.212.4, Contract Terms and Conditions-Commercial Items, or FAR 52.246-4, Inspection of Services-Fixed Price.

1.24.2. Quality Assurance Evaluations. The FRED will evaluate the Contractor’s performance through intermittent on-site inspections of services performed as well as evaluate complaints from military personnel. The Government may inspect each task as completed or increase the number of quality control inspections if deemed appropriate because of repeated failures discovered during quality control inspections or because of repeated customer complaints. Likewise, the Government may decrease the number of quality control inspections if performance dictates.

1.24.3. Method(s) of Surveillance. The COR and/or FRED will inspect services provided by observing actual service, after a service has been completed and interviews with the customers. The Contractor will be monitored and assessed throughout the period of performance of the contract thru Third Party Audits. Third Party Audits will be conducted by federal, state, or local agencies (i.e. DGMC Public Health, Food Service Accountant, Occupational Safety and Health Administration, Environmental Management).

1.24.4. Random/Periodic Inspections. Random or periodic inspections consists of the bulk of evaluations accomplished by the COR and/or FRED. The COR and/or FRED must ensure the number of inspections is accomplished as set by the monthly surveillance schedule. The Government reserves the right to increase or decrease inspections of the Contractor's performance. The decision will be based on whether the Contractor's performance is in alignment with performance thresholds/standards in the PWS.

1.24.5. Customer Complaint. The COR/FRED will collect all customer complaints. Before submitting this form to the COR, the COR will first investigate the complaint to verify validity and if there were any contributory factors or Government delays attributable to the complaint. The COR will submit the complaint to the CO or Contract Specialist (CS) for their review before submitting the customer complaint record to the Contractor’s point of contact (POC) to resolve the complaint. If, after investigation, the CO determines there were no contributory factors or Government delays, the CO will validate the complaint and submit the customer complaint record to the Contractor’s POC to resolve the complaint. Validated customer complaints must be resolved within 24-hours of the Contractor’s POC's receipt of the complaint form. If additional time is needed, the Contractor shall request, in writing, additional time to resolve complaints and obtain approval from the CO. All the circumstances and actions taken must be documented (in writing) by the Government and Contractor on the Customer Complaint Record. Validated customer complaint forms become a permanent part of the COR file/electronic file in Surveillance and Performance Monitoring (SPM).

1.24.6. Performance Evaluation. Performance of a service will be evaluated to determine whether or not it meets the performance requirements of the contract. When the performance requirement is not met, the COR will draft a Corrective Actions to the CO. The Contractor shall respond to the correction actions IAW instructions provided and return it to the COR within the time permitted from the CO. Inspection of accomplished/re-accomplished work shall be performed by COR.

1.24.7. Inspection/Acceptance. The Contractor shall only invoice for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect any services that have been tendered for acceptance. The Government may require re-performance of non-conforming services at no increase in contract price.

1.25. Records Files, Documents, Data and Work Papers

1.25.1. The Contractor shall comply with the Privacy Act of 1974 (the Act) and AFI 33-322, the Air Force Privacy Act Program and the agency rules and regulations issued under the Act in the design, development operation of any system of records. Operation of a system means performance of any of the activities associated with maintaining the system of records, including the collection, use and dissemination of personal information. Systems of Records on individuals are defined as a group of any records under the control of an agency from which information is retrieved by the name of the individual or by some identifying number, symbol or other identification unique to the individual.

1.25.1.1. All records generated during the performance of the contract are considered Government records and shall be turned over to the Government upon termination of the contract.

1.25.1. 2. Records are considered to be all books, papers, maps, photographs, machine-readable materials or other documentary materials, regardless of physical form or characteristics, made or received by any agency of the Government under federal laws, or in connection with the transactions of public business, and preserved or appropriate for preservation by any agency, or its legitimate successor, as evidence of the organization, functions, policies, decisions, procedures, operations or other activities of the Government or because of the informational value of data in them. This includes all electronic records, which must meet the requirements of DODSTD50152.

1.25.2. For Official Use Only (FOUO). The Contractor shall create and Maintain FOUO material IAW DoD 5400-7,R, DoD Freedom of Information Act Program, Chapter 4, AFI 33-129, Transmission of Information Via the Internet, paragraphs 7.4, 8.23, 16 and 17; and AFI 33-201, Communications Security (COMSEC), Table 1. Mark all documents meeting the requirements identified in DoD Regulation 5400.7/Air Force Supplement, paragraphs C3.2.1.2 thru C3.2.1.9 as “For Official Use Only” IAW instructions identified in paragraph C4.2.1. Safeguard all sensitive data IAW DoD Regulation 5400.7/Air Force Supplement. When documents containing FOUO material are authorized for destruction, shred the records so that the pieces cannot be reconstructed. Degauss or overwrite magnetic tapes or other magnetic media. Proper records maintenance and disposition shall be IAW with the Records Disposition Schedule available on the AFRIMSS website at: https://afrims.amc.af.mil/.

1.25.3. Patient Lists: Patient lists, no matter how developed, shall be treated as privileged information. Add the following to the bottom of all patient lists: “FOR OFFICIAL USE ONLY.” This document contains information exempt from mandatory disclosure under the Freedom of Information Act (FOIA). Title 5 U.S.C 552 (b)(6) apply.” Lists and/or names of patients shall not be disclosed or revealed in any way for any use outside the MTF without prior written permission by the Chief of Hospital Services.

1.25. 4. Privacy Act Program: The Contractor shall create and maintain Privacy Act data IAW AFI33-129, Transmission of Information Via the Internet, paragraphs 7.4, 8.2.3, 16 and 17 and supplements; AFI 33- 201, Communications security (COMSEC), Table 1; AFI 33-332, Air Force Privacy Act Program, paragraphs 1.4.7, 1.4.8, 3.3.3, Chapter 7, Chapter 9, Chapter 10 and supplements and Privacy Act systems of records notice(s), which are posted on the internet at (http://www.defenselink.mil/privacy/notices/usaf). 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 the Government official who, as authorized official, will make the decision on releasing Government records.

1.25.5. DoD Freedom of Information Act (FOIA) Program: If the Contractor receives a FOIA request, the Contractor shall immediately hand-carry it to the base FOIA manager for processing. The FOIA manager will task a Government official. When tasked, 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 Government records.

1.25.6. Functional Requests: A written request for DoD records that does not cite either the FOIA or Privacy Act may be received from any person (including a member of the public), or organization, or a business. 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 Government records.

1.26. Health Insurance Portability and Accountability ACT (HIPAA)/Maintenance of Patient Privacy

1.26.1. The Government shall continue to have exclusive possession, control, and all rights regarding any and all government health information regardless of form or recording media that is used, produced, or derived by the Contractor and its subcontractors in the performance of this contract in the government furnished premises.

1.26.2. No protected health information shall be removed from the government furnished premises, copied, or transmitted from the government furnished equipment except as expressly authorized by the Government. The Contractor shall within 3 days return to the Government any and all health information related to its performance of this contract that may come into its possession or control. Until the health information is returned, the Contractor shall protect it in accordance with the Privacy Act of 1974, HIPAA, the privacy regulations of the United States Department of Health and Human Services (DHHS)(42 CFR 160 and 164), and Department of Defense Regulation 6025.18-R. Additionally, the Contractor shall not disclose any health information to anyone except as expressly authorized by the Government, and it shall include these information protection requirements in any and all of it subcontracts related to the performance of this contract. The Contractor and its subcontractors shall also comply with all of the following general requirements of HIPAA that may be more protective of government health information than this contract.

1.26.3. Except as otherwise limited in this Agreement, the Contractor may use protected health information for the proper management and administration of the Contractor or to carry out the legal responsibilities of the Contractor.

1.26.4. Except as otherwise limited in this Agreement, the Contractor may disclose protected health information for the proper management and administration of the Contractor, provided that disclosures are required by law, or the Contractor obtains reasonable assurances from the person to whom the information is disclosed that it will remain confidential and used or further disclosed only as required by law or for the purpose for which it was disclosed to the person, and the person notifies the Contractor of any instances of which it is aware in which the confidentiality of the information has been breached.

1.26.5. The Contractor shall immediately notify the Government about any use or disclosure of health information permitted by federal privacy regulations and this contract.

1.26.6. The Contractor shall have written agreements with all its subcontractors in the performance of this contract, which shall include these HIPAA requirements and any information protection requirements of this contract.

1.26.7. The Contractor shall allow the U.S. Department of Health and Human Services access to the Contractor’s books, practices, and records relating to health information in the Contractor’s possession or control pursuant to this contract.

1.26.8. Breach by the Contractor of this clause may subject the Contractor to termination under any applicable default or termination provision of this contract.

1.27. Health Requirements:

1.27.1. IAW AFI 48-105 and AFJI 48-110, all Contractors shall follow the methods for controlling and preventing disease as described in the American Public Health Association publication, Control of Communicable Diseases Manual and the Centers for Disease Control (CDC) and Prevention publications, Morbidity and Mortality Weekly Report (MMWR) and its supplements. The Contractor shall maintain workforce health qualifications as published in the most recent guidelines from these publications throughout the life of the contract and therefore comply with TJC, OSHA, and Center for Disease Control (CDC) health records requirement. In addition, prior to commencement or assignment to the MTF. Contracted Health Care Workers will be current on all listed immunizations as listed below prior to assignment to the MTF and shall provide proof of all immunizations from the following diseases:

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 CONTRACTOR does not have up-to-date blood test evidence with documentation of the complete series of 2 Measles, Mumps, and Rubella vaccinations or a positive titer for all 3 components, the CONTRACTOR will require a MMR panel vaccination.

If the CONTRACTOR’s titer result is determined as either negative or equivocal the CONTRACTOR will require two doses of the MMR vaccine.

Written documentation of vaccination with 2 doses of live measles, mumps, and rubella or MMR vaccine administered at least 28 days apart OR Laboratory evidence of immunity (Positive “Convalescent” Measles, Mumps and Rubella immunoglobulin G (IgG) in the blood; equivocal results should be considered negative) OR Laboratory confirmation in the Contractors record that the CONTRACTOR had measles, mumps and rubella disease (Positive “Acute” Measles, Mumps, and Rubella immunoglobulin M (IgM) in the blood OR 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: Contractors 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).

Two-step tuberculin skin test (TST) for M. tuberculosis (BAMT) that was performed within the previous 12 months OR An approved blood assays for M. tuberculosis (BAMT) that was performed within the previous 12 months

Varicella (Chicken Pox)

All Contractors require proof of varicella immunity. Evidence of immunity includes Written documentation of vaccination with 2 doses of varicella vaccine OR Laboratory evidence of immunity or laboratory confirmation of disease OR Diagnosis or verification of a history of varicella disease by a health-care provider OR Diagnosis or verification of a history of Herpes Zoster by a health-care provider

Tetanus, Diphtheria and Pertussis (Tdap).

All Contractors, regardless of age, will receive a one-time dose of the Combined Tetanus, Diphtheria and Pertussis (Tdap) vaccine if not previously vaccinated. Contractors will receive Tdap 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) Contractors 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 Contractors 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.

1.27.2. Preventative, Prophylactic, and Follow-Up Procedures. The CONTRACTOR 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.

PART 2

DEFINITIONS & ACRONYMS

2. DEFINITIONS AND ACRONYMS:

2.1. DEFINITIONS:

2.1.1. CONTRACTING OFFICER. A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the Government. Note: The only individual who can legally bind the Government.

2.1.2. CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S. Government appointed by the CO to administer the contract. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.3. CONTRACTOR. A supplier or vendor awarded a contract to provide specific supplies or service to the Government. The term used in this contract refers to the prime.

2.1.4. DEFECTIVE SERVICE. A service output that does not meet the standard of performance associated with the PWS.

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

2.1.6. FRED. Functional Requirements Evaluator Designee

2.1.7. HEALTHCARE WORKER (CONTRACTOR) - An individual employed by the Contractor to provide healthcare services in the MTF. Contractors are either credentialed or non-credentialed.

2.1.8. KEY PERSONNEL. Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the Key Personnel listed in the PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

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

2.1.10. PERFORMANCE WORK STATEMENT (PWS): The standard of work that describes the core requirements in clear, specific, and objective terms with measurable outcomes.

2.1.11. QUALITY ASSURANCE. The Government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

2.1.12. QUALITY ASSURANCE SURVEILLANCE PLAN (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of Contractor performance.

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

2.1.14. SUBCONTRACTOR. One that enters into a contract with a prime contractor. The Government does not have privity of contract with the subcontractor.

2.1.15. WORK DAY. The number of hours per day the Contractor provides services in accordance with the contract.

2.1.16. WORK WEEK. Monday through Sunday, unless specified otherwise.

2.2. ACRONYMS:

PART 3

GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

3. GOVERNMENT FURNISHED ITEMS AND SERVICES:

3.1. See Appendix A.

PART 4

CONTRACTOR FURNISHED ITEMS AND SERVICES

4. CONTRACTOR FURNISHED ITEMS:

4.1. All materials, test equipment, and phantoms necessary for testing conducted by Physicist shall be furnished by the Contractor (other than those specified as Government furnished, See Appendix A.).

PART 5

SPECIFIC TASKS REQUIRED

5. SPECIFIC TASKS:

5.1. The Contractor shall accomplish the following tasks:

5.1.1. Therapeutic Medical Physicist:

5.1.1.1. Manage the Radiation Therapy Service Equipment Quality Control Program.

5.1.1.2. Develop, oversee, and analyze technician quality control testing of radiation producing, detection, and measurement equipment.

5.1.1.3. Perform physics quality control testing, calibration, and equipment evaluation on equipment to be used directly for radiation therapy purposes.

5.1.1.4. Monitor and coordinate maintenance of treatment device, dosimetry, and radiation therapy imaging equipment, and pertinent accessory purposes.

5.1.1.5. Perform dosimetry inter-comparison.

5.1.1.6. Provide expert guidance for procurement of new and emerging technologies related to treatment and quality assurance equipment. Assist the Government in developing specifications for the procurement of this equipment.

5.1.1.7. Provide consulting services for equipment acceptance testing.

5.1.1.8. Support and manage multiple computer systems.

5.1.1.9. Develop, oversee, and perform quality control testing.

5.1.1.10. Enter therapy and radioisotope data.

5.1.1.11. Certify computer output against measurements for treatment planning system, beam-scanning system, and computers interfaced with linear accelerator.

5.1.1.12. Coordinate maintenance of imaging, treatment planning, accelerator control, and physics computer systems.

5.1.1.13. Consult on patient simulation and treatment.

5.1.1.14 Perform treatment chart checks.

5.1.1.15. Perform and analyze special dosimetry on selected procedures.

5.1.1.16. Consult with physician concerning the radiation effects upon patient. Perform fetal exposure evaluation.

5.1.1.17. Plan treatment. Develop treatment plan. Confer with physician; construct patient models and cross sections. Develop treatment plans and obtain physician approval. Calculate treatment times. Discuss final plan with radiation therapist and annotate treatment chart. Check dosimetrist's plan and calculations.

5.1.1.18. Validate treatment plan, check dosimetrist's plan and calculations. Collaborate with physician on final treatment plans. Design and oversee construction of treatment aid device. Verify accuracy and integrity of treatment aid device. Oversee design of treatment aids. Develop specification for custom designed commercially constructed device.

5.1.1.19. Provide LDR and HDR brachytherapy support.

5.1.1.20. Provide direct support. Monitor the purchase, delivery, handling, and disposition of brachytherapy radioactive material in accordance with Nuclear Regulatory Commission (NRC) guidelines. Verify activity and prepare radioactive material for insertion.

5.1.1.21. Assist physician in surgical insertion of brachytherapy device.

5.1.1.22. Review scout localization film, direct simulation procedure, assist physician with placement of radioactive material and later removal, and maintain source accountability record.

5.1.1.23. Perform quality control procedures required in support of LDR and HDR brachytherapy.

5.1.1.24. Review radioactive material, assist in simulation, and transfer radioactive material to treatment room.

5.1.1.25. Develop/improve procedures. Consults with physician and radiation therapist to develop and obtain improved technology or technique.

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

5.1.1.27. Provide radiation safety consultation for Radiation Oncology.

5.1.1.28. Participating member of the DGMC Radiation Safety Committee.

5.1.1.29. Oversee the coordination and timing of systems upgrades, implement installation and application of radiation therapy treatment and quality assurance platforms. This is to be performed with system specific vendor expert personnel.

5.1.1.30. Enter pertinent patient billing and workload information into DHA and VA electronic medical records as instructed by the Chief Radiation Oncologist (RO).

5.1.1.31. Coordinate and participate in training all other CONTRACTOR’s within the radiation oncology clinic on pertinent aspects of all system upgrades.

5.1.2. Certified Medical Dosimetrist:

5.1.2.1. Provide all necessary dosimetry support for the aid of the treatment with the Radiation Oncologist.

5.1.2.2. Confer with Radiation Oncologist to establish requirements of treatment and determine factors such as positioning and blocking to satisfy these requirements.

5.1.2.3. Maintain all licenses, certifications, insurance and other requirements to legally provide services at DGMC in accordance with the orders…