PWS Medical Physics Support 3-Nov-11.pdf

PERFORMANCE WORK STATEMENT

FOR

MEDICAL PHYSICS SUPPORT

Wright-Patterson AFB OH 3 November 2011

Table of Contents

1. Description of Service 4

1.1. Scope 4

1.2. Diagnostic Imaging Quality Assurance Program 5

1.2.1. Test Objectives 5

1.2.2. References 5

1.2.3. Test Equipment 6

1.2.4. Test Frequency 6

1.2.5. Office of Primary Responsibility 6

1.2.6. Monthly Quality Assurance Reports 6

1.2.7. Mammography Quality Standards Act Compliance 7

1.2.8. Observation of QA Testing by MTF Medical Physicist 7

1.3. Locum Tenens Coverage 7

1.3.1. Locum Tenens Radiation Therapy Medical Physicist 7

1.3.2. Locum Tenens Certified Medical Dosimetrist 7

1.4. Availability of Personnel 7

1.4.1. Hours of Operation 7

1.4.2. Work Schedule 8

1.4.3. Federally Observed Holidays 8

1.4.4. Inspections and Surveys 8

1.4.5. Technical Discussions 8

1.4.6. Performance Evaluation Meetings 8

1.5. Education, Training, and Professional Requirements 8

1.5.1. Diagnostic Imaging Medical Physicists 8

1.5.2. Radiation Therapy Medical Physicists 8

1.5.3. Mammography Physicists 8

1.5.4. Medical Dosimetrists 9

1.5.5. Continuing Medical Education Requirements 9

1.5.6. Employee Credentials 9

1.6. General Work Requirements 9

1.6.1. Quality Control Program 9

1.6.2. Point of Contact 9

1.6.3. English Language Requirement 10

1.6.4. Appearance 10

1.6.5. Professional Qualities 10

1.6.6. Changes in Personnel 10

1.6.7. Rights to Information and Reports 10

1.7. Security Requirements 10

1.7.1. Contractor Notification Responsibilities 10

1.7.2. Suitability Investigations 10

1.7.3. Freedom of Information Act Program 11

1.7.4. Reporting Requirements 11

1.7.5. Physical Security 11

1.7.6. Key Control 11

1.7.7. Continuation of Essential Department of Defense (DOD) Contractor 11 Services During Crisis

1.7.8. Conflict of Interest 11

1.7.9. Indemnification and Medical Liability Insurance 11

1.7.10. Medical Quality Assurance/Risk Management 12

1.7.11. Orientation 12

1.7.12. Annual Training 12

1.7.13. Infection Control and Safety 12

1.7.14. The Joint Commission 12

1.7.15. Patient Lists 12

1.7.16. Patient Sensitivity 12

1.7.17. Release of Medical Information 12

1.8. Health Requirements 13

1.8.1. Preassignment Medical Evaluation 13

1.8.2. Preventive, Prophylactic and Follow-up Procedures 13

1.8.3. Medical Records 14

1.8.4. Immunization Waivers/Exemptions 14

1.8.5. Pregnant Employees 14

1.8.6. Communicable Diseases 14

1.9. Environmental Requirements 14

1.9.1. General 14

1.9.2. Hazardous Materials 14

1.9.3. Hazardous Materials Inventory 15

1.9.4. Storage of Hazardous Materials 15

2. Services Summary 16

3. Base Support 17

4. Appendices 17

A. Core Medical Physics Guidelines 18 B. 88 MDG Diagnostic Imaging Equipment 20 C. 88 MDG Radiation Oncology Equipment 21

PERFORMANCE WORK STATEMENT

FOR

MEDICAL PHYSICS SUPPORT

I. DESCRIPTION OF SERVICE

1.1. SCOPE

The Contractor shall provide a comprehensive Diagnostic Imaging Quality Assurance (QA) Program for the 88th Medical Group (also referred to as the Military Treatment Facility, or MTF, in this document) operations occurring on Wright-Patterson AFB, Ohio.

The Contractor shall provide physics services to ensure Diagnostic Imaging Quality Assurance Program shall conform to the most recent applicable American College of Radiology (ACR) and The Joint Commission (TJC) standards. The Contractor shall be able to provide Diagnostic Medical Physics services for the following modalities; computed radiography plate readers, fixed radiographic systems, fixed radiographic-fluoroscopic systems, portable radiographic systems, fixed fluoroscopic systems, portable fluoroscopic systems, digital and stereotactic mammography imaging systems, computed tomography (CT) systems, magnetic resonance imaging (MRI) systems, diagnostic ultrasound (U/S) systems, and nuclear medicine (NM) imaging systems (gamma cameras, single photon emission computed tomography (SPECT) and positron emission tomography (PET)), and dental systems.

The Contractor shall furnish all management, labor, tools, equipment, transportation, and materials, necessary to provide medical physics services in support of 88th Medical Group, Wright-Patterson Air Force Base, Ohio. The Diagnostic Imaging Quality Assurance Program shall meet the requirements of the ACR Programs for Mammography, Stereotactic Breast Biopsy, Magnetic Resonance Imaging, Ultrasound, Barium Enema, and Nuclear Medicine. For those imaging modalities for which an ACR Accreditation Program does not yet exist, the Diagnostic Imaging Quality Assurance Program shall conform to the most recent applicable ACR and TJC standards. The Contractor shall provide physics services that comply with the Mammography Quality Standards Act in accordance with Title 21, Code of Federal Regulations, Section 900 (21 CFR 900.) The contractor shall meet the medical physicist mammography requirements for licensure, board certification, education, continuing education, training, experience per “Compliance Guidance: The Mammography Quality Standards Act Final Regulations: Preparing For MQSA Inspections; Final” which is located at the following website.

http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/u cm094420.htm

The contractor shall provide for locum tenens coverage by a radiation therapy physicist and a certified medical dosimetrist.

http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm094420.htm http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm094420.htm

1.2. DIAGNOSTIC IMAGING QUALITY ASSURANCE PROGRAM.

The Contractor shall provide and submit to Government for review a written Diagnostic Imaging Quality Assurance Program which includes procedures and forms for recording measured data for the following types of medical imaging systems: computed radiography plate readers, fixed radiographic systems, fixed radiographic-fluoroscopic systems, portable radiographic systems, portable fluoroscope systems, mammography imaging systems, computed tomography (CT) systems, magnetic resonance imaging (MRI) systems, diagnostic ultrasound (U/S) systems, and nuclear medicine (NM) imaging systems. All diagnostic imaging equipment currently in use shall be included in the QA Program. The Contractor shall deliver a written Diagnostic Imaging Quality Assurance Program and a projected schedule for performance of all tests not later than 45 days from contract award to the appointed Contracting Officer’s Representative (COR). These procedures and reporting forms shall be reviewed in January, April, July, and October. The QA Program shall be revised in October to meet current recommendations, and revised as changes in equipment occur. For example, a new imaging system is brought into use which replaces one of the aforementioned imaging systems or a significant upgrade of a system occurs. The COR will review and accept the written procedures and reporting forms within 15 days of receipt. The Contractor shall have 15 days to make corrections upon receipt of written comments at no additional cost to the Government.

Each test procedure shall describe the objective of the test, applicable reference(s), office of primary responsibility (OPR), the test frequency, required test equipment, a detailed step-by step test procedure, performance criteria and corrective action, and documentation of results.

1.2.1. TEST OBJECTIVES. The Contractor shall deliver written Diagnostic Imaging Quality Assurance test objectives not later than 45 days from contract award to the appointed COR.

The test objectives must clearly relate to accepted standards of performance and continuing and baseline performance on imaging systems covered under this contract. Tests of Diagnostic Imaging Equipment must pass either the manufacturers specifications or testing criteria commonly accepted in the fields of Diagnostic Imaging Medical Physics and Nuclear Medicine Medical Physics. Diagnostic imaging equipment testing must also meet requirements spelled out in AFI 48-148, sections 4.6, 4.7, 4.8, 4.9 and 4.10. In addition the contractor shall conduct shielding designs in accordance with AFI 48-148 Section 3.2 and NCRP Report No. 145 - Radiation Protection in Dentistry, NCRP Report No. 147 - Structural Shielding Design for Medical X-Ray Imaging Facilities and NCRP Report No. 151 - Structural Shielding Design and Evaluation for Megavoltage X- and Gamma-Ray Radiotherapy Facilities.

1.2.2. REFERENCES. There are a number of standard methods for the evaluation of diagnostic imaging systems. These are described in the various technical reports of the American Association of Physicists in Medicine (AAPM), the Food and Drug Administration (FDA) and the ACR. The Contractor shall have a thorough understanding of the instructions, manuals, and guidelines referenced in Appendix A “Core Medical Physics Guidelines” of the PWS.

1.2.2.1. The Contractor shall utilize the most current commonly accepted references and version thereof as recommended by the regulatory and professional bodies, including: US Nuclear Regulatory Commission (USNRC), US Environmental Protection Agency (USEPA), US Food and Drug Administration (USFDA), American College of Radiology (ACR), American Board of Radiology (ABR), American Association of Physicists in Medicine (AAPM), USAF, The Joint Commission (TJC), AF Health Services Inspection (HSI) under USAF IG, and DOD.

The Contractor shall modify the QA Program to ensure the program remains in compliance with current recommendations and regulatory requirements.

1.2.2.2. The Contractor shall consult with the Medical Physics Element Chief for questions of which reference(s) or standard(s) to follow.

1.2.3. TEST EQUIPMENT. The Contractor shall determine the needs for, specify, and provide all measurement instruments or devices to conduct proper quality assurance tests. The Contractor shall provide all test equipment to perform quality assurance tests. All such test equipment shall remain the property of the Contractor. All measurement instruments or devices shall be calibrated as recommended by the manufacturer and at the frequency required. A current calibration label shall be issued. The Contractor shall provide a copy of current calibration reports for these measurement instruments or devices, to the appointed COR within 45 days of contract award and annually thereafter. The Contractor shall furnish all specialized test equipment; such as radiation detectors, image quality phantoms and image quality tools required for compliance with ACR Accreditation Programs.

1.2.4. TEST FREQUENCY. The Contractor shall follow the frequency guidance provided by the manufacturer or specific procedures identified in Appendix A.

1.2.5. OFFICE OF PRIMARY RESPONSIBILITY. The Contractor shall conduct annual and semi-annual quality control tests on all diagnostic imaging equipment. The Contractor shall conduct acceptance testing of new Diagnostic Imaging equipment. The Contractor shall also conduct investigatory quality control tests to diagnose equipment problems for unacceptable image quality and/or QA/QC test results fail. The Contractor shall take corrective action to correct problem(s).

1.2.6. MONTHLY QUALITY ASSURANCE REPORTS. The Contractor shall provide written reports which fully document both continuing and baseline performance of imaging systems covered under this contract. These reports shall incorporate data obtained by both the Contractor and the Government. These shall include measurement values and, in those cases where a value is outside accepted limits, shall show the value of each limit. These reports shall provide the results in plain language with recommendations for improvement, recalibration, repair or alterations of techniques, to improve image quality and/or reduce exposure to patients. Digital images and digitized test films shall be maintained by the Contractor so that each new test series and the previous series on file may be compared. Written reports shall be submitted not later than the 10th duty day (Monday thru Friday) of each month for the preceding month, to the appointed COR. A monthly meeting shall be held on the first Monday following the 10th duty day of the month to discuss the reports. The COR will review tests performed and results of the tests. The Contractor shall notify in writing the Medical Equipment

Repair Center (MERC) and the COR of any malfunctioning diagnostic imaging system before the end of the workday. If weekend work is scheduled, the accompanying government medical physicist or radiology technologist will contact MERC via established MDG after-hour procedures.

1.2.7. MAMMOGRAPHY QUALITY STANDARDS ACT COMPLIANCE. The Contractor shall provide physics services to comply with the Mammography Quality Standards Act (MQSA) in accordance with Title 21, CFR 900.

1.2.8. OBSERVATION OF QA TESTING BY MTF MEDICAL PHYSICISTS. The Contractor shall provide the assigned active duty or civilian MTF medical physicist(s) the dates and times that specific QA testing shall be performed. Per AFI 48-148, Paragraph 4.2.1.1.2, the Contractor shall allow the MTF medical physicist(s) to accompany contractor personnel on any or all testing performed on MTF diagnostic imaging and radiation therapy equipment for the purpose of understanding (1) what tests are conducted on individual systems, the (2) process by which the test(s) are accomplished, (3) how the test(s) support the Quality Assurance and Quality Control Plans. and (4) provide clinical training and oversight for the purposes of board certification of the Active Duty physicists on site.

1.3. LOCUM TENENS COVERAGE.

1.3.1. LOCUM TENENS RADIATION THERAPY MEDICAL PHYSICIST. The Contractor shall provide locum tenens coverage by an American Board of Radiology board-certified therapy medical physicist for extended absences (more than 5 duty days - Monday thru Friday) by the active duty medical physicist or to provide supplemental support for special projects requested by the COR. The Contractor will be given 30 calendar days advance notification in writing by the Contracting Officer for locum tenens services. Contractor employees shall follow AAPM recommendations and ACR standards.

1.3.2. LOCUM TENENS CERTIFIED MEDICAL DOSIMETRIST. The Contractor shall provide locum tenens coverage by a Certified Medical Dosimetrist (CMD) for extended absences (more than 5 duty days) by the Civil Service Certified Medical Dosimetrist or to provide continuity of services at the request of the COR. The Contractor will be given 10 calendar days advance notification in writing by the Contracting Officer for locum tenens services. Contractor employees shall follow AAPM recommendations and ACR standards.

1.4. AVAILABILITY OF PERSONNEL.

1.4.1. HOURS OF OPERATION. The normal duty hours for the MTF are between 0730 to 1630, Monday through Friday. Contractor employee(s) shall be present during normal duty hours for at least 32 hours per month and shall divide their time evenly throughout the month.

Alternative schedules may be approved by the COR if the Contractor should need access to medical imaging systems after normal duty hours for the purpose of conducting quality assurance testing.

1.4.2. WORK SCHEDULE. A Contractor point of contact shall provide a list by date and time with individual personnel names for days the Contractor shall be providing services. This list shall be provided to the COR by the 20th of each month for the next month. The Contractor shall submit work schedule changes in writing to the COR at least 48 hours in advance of the proposed change.

1.4.3. FEDERALLY OBSERVED HOLIDAYS. The Contractor is not required to provide services on the following Federal holidays: New Years Day; Martin Luther King Day; President’s Day; Memorial Day: Independence Day; Labor Day; Columbus Day; Veterans’ Day; Thanksgiving Day; and Christmas Day.

1.4.4. INSPECTIONS AND SURVEYS. The Contractor shall be available, to discuss technical matters and equipment performance with FDA inspectors, MQSA inspectors, and TJC surveyors. The Contractor shall be notified in advance of any inspection or survey, which requires Contractor participation at no additional cost to the Government.

1.4.5. TECHNICAL DISCUSSIONS. The Contractor shall provide a representative for technical discussions at the request of the Government to groups and committees within the facility that could benefit from specialized scientific knowledge. Contractor shall attend weekly Diagnostic Imaging Equipment and Quality Assurance Support meetings and quarterly Medical Center Radiation Safety Committee meetings. The contractor shall be given advance notification.

1.4.6. PERFORMANCE EVALUATION MEETINGS. The Contracting Officer (CO) shall require the Contractor or his representative to meet with the CO, COR, and other government personnel at least quarterly, and as often as deemed necessary.

1.5. EDUCATION, TRAINING, AND PROFESSIONAL REQUIREMENTS.

1.5.1. DIAGNOSTIC IMAGING MEDICAL PHYSICISTS: All medical physicists providing technical/support services for diagnostic imaging systems under this contract shall be currently certified by either the American Board of Medical Physics in Diagnostic Imaging Physics, or by the American Board of Radiology in Diagnostic Radiological Physics. Documentation shall be provided upon request to Government personnel.

1.5.2. RADIATION THERAPY MEDICAL PHYSICISTS: All medical physicists providing technical/support services for radiation oncology systems under this contract shall be currently certified by either the American Board of Medical Physics in Radiation Oncology Physics, or by the American Board of Radiology in Therapeutic Radiological Physics. Documentation shall be provided upon request to Government personnel.

1.5.3. MAMMOGRAPHY PHYSICISTS: All medical physicists conducting surveys of Mammography facilities and providing oversight of the facility mammography quality assurance program shall meet all requirements which include the education, training, and experience contained in Food and Drug Administration, 21 Code of Federal Regulations, Part 900, Quality Mammography Standards. Documentation shall be provided upon request to Government personnel.

1.5.4. MEDICAL DOSIMETRISTS: All medial dosimetrists providing technical/support service for radiation oncology under this contract shall be currently certified by the Medical Dosimetrist Certification Board. Documentation shall be provided upon request to Government personnel.

1.5.5. CONTINUING MEDICAL EDUCATION (CME) REQUIREMENTS. Contractor employees shall meet the American College of Radiology Standard for Continuing Medical Education. CME shall be obtained at no additional cost to the Government and shall be reported to the COR annually on the first work day in January for the previous calendar year.

Documentation shall be provided upon request to Government personnel.

1.5.6. EMPLOYEE CREDENTIALS. Contractor employee credentials shall be submitted no later than 30 calendar days after receipt of the notice of contract award, or when requested by COR. The following is not an all-inclusive list: a copy of the proposed employee’s professional resume indicating experience, training, and technical expertise in the type of services to be rendered and a copy of relevant board certifications, licensure, and other documentation as appropriate.

1.6. GENERAL WORK REQUIREMENTS

1.6.1. QUALITY CONTROL PROGRAM. Contractor shall develop and maintain a quality control program to ensure medical physics support services are performed in accordance with commonly accepted civilian hospital and commercial practices. The Contractor shall develop and implement procedures to identify and prevent defective services from reoccurring.

Changes to this program will be made at no additional cost to the Government. The Quality Control Plan (QCP) is to be delivered not later than 15 days after contract award for CO approval. Three copies of a comprehensive written QCP shall be submitted to the CO and COR not later than 5 working days when changes are made thereafter. If outside of these timelines then all parties must agree and the CO must approve.

1.6.2. POINT OF CONTACT. The Contractor shall provide a point of contact who shall be responsible for the performance of the work Monday thru Friday between the hours of 0730 to 1630. The point of contact shall have full authority to act for the Contractor on all matters relating to the daily operation of this contract. The Contractor shall designate this individual, in writing, to the Contracting Officer (CO), after contract award and before the period of performance starts on the contract. An alternate may be designated, but the Contractor shall identify those times when the alternate shall be the primary point of contact. If any changes occur in personnel the government will be notified in writing not later than 15 calendar days of the primary point of contact’s last day.

1.6.3. ENGLISH LANGUAGE REQUIREMENT. Contractor personnel engaged in performance of this contract shall read, understand, speak, and write English.

1.6.4. APPEARANCE. Contractor personnel shall present a neat appearance and be easily recognized as contractor employees. Contractor personnel shall display on the front of their uniform or civilian clothes legible Contractor-furnished identification media (badge) which lists the employee and company’s name. Any required MTF identification will be provided by the MTF.

1.6.5. PROFESSIONAL QUALITIES. The Contractor shall ensure contract providers under his/her supervision maintain open and professional communication with members of the MTF.

1.6.6. CHANGES IN PERSONNEL. When a change in an approved contract employee is anticipated, the Contractor shall provide the COR the same credentials required for the initial contract employee not later than two (2) weeks prior to when the proposed change in personnel is to take place. The same review process applies for all replacement contract personnel as for the original contract employee.

1.6.7. RIGHTS TO INFORMATION AND REPORTS. The Contractor shall provide reports to the Government as part of the service in accordance with the guidelines listed in Paragraph

1.0. The Contractor shall provide the Government with all processes and calculation methods by which the reported data was obtained. These documents and materials may not be used or sold by the Contractor without written permission from the Contracting Officer.

1.7. SECURITY REQUIREMENTS.

1.7.1. CONTRACTOR NOTIFICATION RESPONSIBILITIES. The Contractor shall submit a “Notification of Contract” letter to the Contracting Office for endorsement before the letter is forwarded to the 88SFS/S5SP for approval. The “Notification of Contract” must be submitted to the 88SFS/S5SP at least 24 hours prior to the issuance of base identification. The notification shall include: name, address, and telephone number of company representatives; the contract number and contracting agency; the reason for the contract (i.e., work to be performed); the location(s) of contract performance and future performance, if known; the date contract performance begins; any change to information previously provided under this paragraph.

1.7.2. SUITABILITY INVESTIGATIONS. Contractor personnel shall successfully complete, as a minimum, a National Agency Check (NAC), before operating Government-furnished workstations that have access to Air Force e-mail systems. The Government, at no additional cost to the Contractor, will perform these investigations. The Contractor shall comply with the Department of Defense (DOD) requirements of DODI 5200.2R, Personnel Security Program, and AFI 33-119, Electronic Mail (E-Mail) Management and Use. These references will be provided to the Contractor by the Government.

1.7.3. FREEDOM OF INFORMATION ACT PROGRAM (FOIA). The Contractor shall comply with AFI 37-131, Freedom of Information Act Program (FOIA), requirements. The regulation sets policy and procedures for the disclosure of records to the public and for marking, handling, transmitting, and safeguarding For Official Use Only (FOUO) material.

1.7.4. REPORTING REQUIREMENTS. The Contractor shall comply with AFI 71-101, Volume-1, Criminal investigations, and Volume-2, Protective Service Matters, requirements.

Contractor personnel shall report to an appropriate Government authority any information or circumstances of which they are aware that may pose a threat to the security of DOD personnel, contractor personnel, resources, and classified or unclassified defense information. Contractor employees shall be briefed by their immediate supervisor upon initial on-base assignment and as required thereafter.

1.7.5. PHYSICAL SECURITY. Areas controlled by contractor employees shall comply with current 88 Air Base Wing Operations Plans/instructions for FORCE PROTECTION (FPCON) procedures and Random Antiterrorism Measures (RAMS). Valuable materials shall be secured in accordance with Air Force and MTF instructions. These instructions will be provided to the Contractor by the Government.

1.7.6. KEY CONTROL. The Contractor shall establish and implement methods of tracking all keys/combinations issued to the Contractor by the government are not lost or misplaced and are not used by unauthorized persons. The Contractor shall not duplicate any keys issued by the government. The Contractor shall report to the COR any occurrences of lost or duplicated keys within 24 hours of discovery or the beginning of the next work day for the COR, whichever is soonest. In the event keys, other than master keys, are lost or duplicated, the Contractor may be required, upon written direction of the Contracting Officer, to rekey or replace the affected lock or locks without cost to the government. The government may, however, at its option, replace the affected lock or locks or perform re-key and deduct the cost of such from the monthly payment due the Contractor.

1.7.7. CONTINUATION OF ESSENTIAL DEPARTMENT OF DEFENSE (DOD) CONTRACTOR

SERVICES DURING CRISIS. Not applicable to this contract.

1.7.8. CONFLICT OF INTEREST. The Contractor shall not employ any person who is an employee of the United States Government, if the employment of that person would create a conflict of interest, nor shall the Contractor employ any person who is an employee of the Department of the Air Force, either military or civilian, unless such person seeks and receives approval in accordance with DOD Directive 5500.7 and Air Force policy.

1.7.9. INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE. The Contractor shall provide and maintain adequate liability insurance coverage consistent with the risks associated with the performance of all services required in accordance with FAR clause 52.228-5 “Insurance – Work on a Government Installation”.

1.7.10. MEDICAL QUALITY ASSURANCE/RISK MANAGEMENT (QA/RM). Contract employees shall participate and be evaluated in QA/RM activities to the extent required by AFI 44-119 and the individual Military Treatment Facility (MTF) QA/RM plan. The Government will provide these references to the Contractor.

1.7.11. ORIENTATION. The Contractor shall ensure that all contract employees participate in the MTF orientation procedures for newly assigned employees to include regulations specific to their professional specialty and hospital and Air Force policy and procedures. MTF orientation classes are offered on a monthly basis and information regarding these scheduled classes will be provided to the Contractor by the Government.

1.7.12. ANNUAL TRAINING. Contractor employees shall attend annual training at the MTF. Annual training shall include but not be limited to safety, QA, risk management, infection control, fire protection, security, and patient sensitivity training. Classes can be scheduled by the Government individually throughout the year or scheduled at one time. These classes will take approximately four to five hours total per individual.

1.7.13. INFECTION CONTROL AND SAFETY. All contract personnel shall comply with all MTF infection control and safety procedures, practices and standards. MTF policies and guidelines pertaining to these requirements will be provided to the Contractor by the Government.

1.7.14. THE JOINT COMMISSION (TJC). Contract personnel shall comply with all applicable TJC standards during the performance of this contract. MTF policies and guidelines pertaining to these requirements will be provided to the Contractor by the Government.

1.7.15. PATIENT LISTS. All patient lists, no matter how they are developed, shall be treated as privileged information. Lists and/or names of patients shall not be disclosed to or revealed in any way for any use outside the MTF without prior written permission by the Chief of Hospital Services.

1.7.16. PATIENT SENSITIVITY. Contract providers shall respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships.

1.7.17. RELEASE OF MEDICAL INFORMATION. The provider shall only release medical information obtained during the course of this contract to other MTF staff involved in the care and treatment of that individual patient in compliance with current Health Insurance Portability and Accountability Act (HIPAA) regulations.

1.8. HEALTH REQUIREMENTS.

1.8.1. PREASSIGNMENT MEDICAL EVALUATION. No contract employee shall perform health care services under this contract unless a Physician has performed a pre-assignment evaluation, provided by the Contractor, not more than 30 calendar days prior to submission of credentials. The purpose of this medical evaluation is to determine if the individual, from a medical standpoint, possesses the minimum physical abilities needed to perform the proposed job without significant risk to personal health or the health and safety of others. As a minimum, the individual shall be free of physical defects or medical conditions which might reasonably be expected to place other workers, patients, or the public at risk. Not later than five (5) days prior to the commencement or performance of health care services under this contract by any employee, the Contractor shall provide the Public Health certification to the medical appointed COR that such employees has completed the medical evaluation requirements identified below.

This certification shall be provided annually, in October, thereafter. This certification shall state the date of which the examination was completed, the doctor’s name that performed the examination and a statement concerning the physical health of the individual. Initial documentation is required for: MMR (immunization or titer levels for Rubella and rubeola), history of chicken pox disease or positive titer (varicella vaccination must be accomplished if lack of immunity). TB Mantoux skin test (IPPD) if positive, minimum requirement will be follow-up with contractor’s physician and a chest x-ray. Physician must provide documentation of “no active respiratory disease”, Hepatitis B vaccination/series are required for all personnel with occupational risk of exposure (declinations are not acceptable; this is a condition of employment), and if employee will be involved in exposure-prone procedures (ex: dentist, dental hygienist) they will have their surface antigen of the Hepatitis-B-Virus (HbsAg) status determined. This is to be done by providing documentation of the HbsAb, (if positive they will be referred to the MFT Credentials committee to determine scope of practice). If, in the opinion of the evaluating medical practitioner, the individual is found to be qualified for duty, the medical statement shall include the following wording: “(NAME OF EMPLOYEE) possesses the minimum physical abilities to perform the proposed duties of a (insert job title). He/she has documented proof of immunization against/immunity to rebeola, rubella, and hepatitis B and does not have an active infectious condition which might place others at risk.” If, in the opinion of the evaluating medical practitioner, the individual does not possess the minimum capabilities needed to perform the proposed job or does not meet the conditions of employment or will pose a risk to others, the medical statement shall contain the following wording: “For medical reasons, (NAME OF EMPLOYEE is not qualified for employment as a (insert job title).”

1.8.2. PREVENTIVE, PROPHYLACTIC, AND FOLLOW-UP PROCEDURES. The Contractor shall ensure that his/her employees are in compliance with preventive, prophylactic, and follow-up procedures, infection control and employee health program procedures, as established by the MTF. The Contractor shall provide written verification of treatment. MTF policies and guidelines pertaining to these requirements will be provided to the Contractor by the Government.

1.8.3. MEDICAL RECORDS. It is the Contractor's responsibility to report to the COR for this contract, all information to assure hospital records can be correctly maintained, and therefore comply with TJC, US Occupational Safety and Health Administration (OSHA), Centers for Disease Control (CDC), DOD, and USAF health records requirements. This information is to be provided to Public Health to ensure the hospital's Employee Health database is current and up-to-date. MTF policies and guidelines pertaining to these requirements will be provided to the Contractor by the Government.

1.8.4. IMMUNIZATION WAIVERS/EXEMPTIONS. Waivers and exemptions may be granted in accordance with the governing Air Force Instructions. All waivers and exemptions must be coordinated through Public Health.

1.8.5. PREGNANT EMPLOYEES. All Contractor pregnant employees should report the pregnancy to the Contractor. It is the responsibility of the Contractor to notify Public Health of the pregnancy. Public Health will provide information concerning any work hazards in that area.

The Contractor is to notify their pregnant employee of any work hazards. It will be the joint decision of the Contractor and their employee whether the employee works in the environment. This is in accordance with AFI 48-148 “Ionizing Radiation Safety” and AFH 48-125 “The Air Force Dosimetry Program”.

1.8.6. COMMUNICABLE DISEASES. Contract employees with communicable diseases must be reported to the MTF contract project supervisor and the COR. Notification to Public Health will be made by the supervisor. The Contractor shall comply with all MTF work restrictions and return-to-work requirements when performing tasks at the facility. MTF policies and guidelines pertaining to these requirements will be provided to the Contractor by the Government.

1.9. ENVIRONMENTAL REQUIREMENTS.

1.9.1. GENERAL.

1.9.1.1. Material Safety Data Sheets (MSDSs) are mandated as specified by 10 CFR, 29 CFR (both DOL and OSHA), 40 CFR, AFI 40-201, AFI 48-148, and AFI 91-302, and are provided in all work centers using these materials in the MDG. Hazardous materials shall be identified to the Contractor by the Government. The Contractor shall be responsible for identifying materials in the course of performance.

1.9.2. HAZARDOUS MATERIALS.

1.9.2.1 Machine Produced Ionizing Radiation

(Diagnostic Medical Physicist, Therapy Medical Physicist, and Dosimetrist)

1.9.2.2 Radioactive Materials

(Diagnostic Medical Physicist, Therapy Medical Physicist, and Dosimetrist)

1.9.2.3 Strong Magnetic Fields with MRI (Diagnostic Medical Physicist)

1.9.3. HAZARDOUS MATERIAL INVENTORY.

1.9.3.1 Standard Isotopes used in Nuclear Medicine protocols such as PET, SPECT and Therapy (Diagnostic Medical Physicist)

1.9.3.2 Standard Low Dose Rate Brachytherapy sources used in Radiation Oncology (Therapy Medical Physicist, and Dosimetrist)

1.9.3.3 Standard High Dose Rate Brachytherapy sources used in Radiation Oncology (Therapy Medical Physicist, and Dosimetrist)

1.9.3.4 Standard Radioactive Material Check Sources for Radiation Detectors and testing

1.9.4. STORAGE OF HAZARDOUS MATERIALS. Storage of Radioactive Materials takes place in secure locations within Nuclear Medicine and Radiation Oncology.

2. SERVICES SUMMARY

Performance Objective PWS para.

Performance Threshold

Method of Surveillance

Remedy

SS-1 Diagnostic Imaging Quality Assurance Program (Delivery within 45 days of contract award)

a) Submitted on time

b) Complies with QA Program

1.2 Zero (0) defects

within the month

100% Surveillance

Correction within 24 hours of notification

SS-2 Diagnostic Imaging Quality Assurance Test Objectives (Submit within 45 days of contract award)

a) Submitted on time

b) Complies with QA Testing

1.2.1 Zero (0) defects

100% Surveillance

Correction within 24 hours of notification

SS-3 Revision of Diagnostic Imaging Quality Assurance Program have been submitted on time (Quarterly and within 15 days of receipt of written comments by Government)

1.2 Zero (0) defects

100% Surveillance

Correction within 24 hours of notification

SS-4 Calibration Reports for Measurement Instruments and Devices have been submitted on time (Submit within 45 days of contract award & annually thereafter)

1.2.3 Zero (0) defects

within the month of notification

SS-5 Calibration Reports for Measurement Instruments and Devices have been submitted accurately.

1.2.3 Zero (0) defects

within the month of notification

SS-6 Monthly Quality Assurance Reports have been submitted on time.

(10th duty day each month)

1.2.6 Zero (0) defects

of notification

SS-7 Monthly Quality Assurance Reports have been submitted accurately.

1.2.7 Zero (0) defects

within the month of notification

SS-8 Work Schedule submitted on time (20th day of each month)

1.4.2 Zero (0) defects

within the month

SS-9 Contractor participates in Inspections and Surveys

1.4.4 Zero (0) defects

within the month

SS-10 Contractor participates in Technical Discussions

1.4.5 Zero (0) defects

SS-11 Contractor attends Quality Assurance Meeting

1.4.5 Zero (0) defects

within the month

SS-12 Contractor attends Performance Evaluation Meetings (At least quarterly and as often as deemed necessary.)

1.4.6 Zero (0) defects

of notification

SS-13 Contractor employees have received Continuing Medical Education (CME) (Annually, 1st duty day in January)

1.5.5 Zero (0) defects

SS-14 Employees have proper credentials

1.5.6 Zero (0) defects

SS-15 Contractor employees have proper medical evaluations

1.8 Zero (0) defects

within the month

3. BASE SUPPORT

The MTF will provide office space to include one standard telephone and service, facsimile, Internet connectivity (dependent upon existing Contractor security clearance), electronic mail, utilities, trash, and custodial services. These items may only be used in the conduct of work directly associated with the performance tasks related to this PWS. The MTF will provide required Government forms used in the performance services.

4. APPENDICES

A. Core Medical Physics Guidelines B. 88 MDG Diagnostic Imaging Equipment C. 88 MDG Radiation Oncology Equipment

Appendix A: Core Medical Physics Guidelines

Fundamental USAF Instructions and Occupational Health Standards http://www.e-publishing.af.mil (see the Air Force "Departmental" Publications link)

AFI 40-201

AFI 48-148

AFMAN 48-125

AFOSHSTD 48-139

WPBAFI 40-201

MDGI 40-134

Primary American Association of Medical Physicists Reports

Report Year Title

74 2002 Quality Control in Diagnostic Radiology

93 2006 Acceptance Testing and Quality Control of Photostimulable Storage Phosphor Imaging

Systems

96 2008 The Measurement, Reporting, and Management of Radiation Dose in CT

108 2006 PET and PET/CT Shielding Requirement

Reports available on the AAPM website at http://www.aapm.org/

Nuclear Medicine Reference Manuals

Brightview Imaging System Instructions for Use

Document number 459800034151 rev A

Skylight Imaging System User’s Manual

Document number 9201-5071C-ENG rev A

Gemini TF and Gemini LXL System Information

Document number 459800013831 rev A

CT Reference Manuals

Mx8000 IDT Instructions for Use

Gemini TF and Gemini LXL System Information

Primary NCRP Shielding Design Guidelines

NCRP Report No. 145 - Radiation Protection in Dentistry

NCRP Report No. 147 - Structural Shielding Design for Medical X-Ray Imaging Facilities

NCRP Report No. 151 - Structural Shielding Design and Evaluation for Megavolatage X- and Gamma-

Ray Radiotherapy Facilities

Copies available for purchase at http://www.ncrp.com or http://www.ncrponline.org/ http://www.e-publishing.af.mil/

Other Medical Physics Guidance

US Food and Drug Administration for Mammography Quality Standards Act of 1994:

http://www.fda.gov/radiation-emittingproducts/mammographyqualitystandardsactandprogram/default.htm

US Nuclear Regulatory Commission for management and use of radioactive materials for medical use and radiation safety requirements, to include (but not limited to) 10 CFR Parts 19, 20, 30, 33, 35, and 71:

http://www.nrc.gov/reading-rm.html http://www.fda.gov/radiation-emittingproducts/mammographyqualitystandardsactandprogram/default.htm http://www.nrc.gov/reading-rm.html

Appendix B: 88 MDG Diagnostic Imaging Equipment

Number Description Location Manufacturer Model

1 PET/CT Nuclear Medicine/Radiology Philips Gemini 64 TOF

2 SPECT Gamma

Camera

Nuclear Medicine Philips Brightview X

1 SPECT Gamma

Camera

Nuclear Medicine Philips Skylight

1 CT Radiology Philips Brilliance 16

1 MRI Radiology Philips Achieva 1.5 T

2 Mammography Radiology GE Senographe

Essential

1 Mammography-

Stereotactic

Radiology Hologic/Lorad DSM II

4 Radiograph - fixed Radiology Philips

1 Radiograph – fixed Occ Health - Bldg 675 Philips

2 Portable x-ray Radiology Fuji Go

3 Portable x-ray Radiology GE AMX

1 Fluoro Cardiac Cath Philips

1 Fluoro Radiology Siemens Axiom Artis

1 Fluoro Cysto Surgery Covidien Liebel Flarsheim

1 Fluoro Urology Covidien Liebel Flarsheim

1 Rad Fluoro Radiology Siemens

1 Rad Fluoro Radiology GE Legacy

1 Portable Fluoro Radiology GE 9600

3 Portable Fluoro Radiology GE 9800

2 Portable Fluoro Radiology GE Mini-view C-arm

1 Bone Densitometer Nuclear Medicine GE Prodigy

1 CR Reader Occ Health - Bldg 675 Fuji Smart-CR

1 CR Reader Radiology Fuji Multi Reader

6 CR Reader Radiology Fuji Carbon-CR

2 Ultrasound Radiology Philips IU22

1 Ultrasound Radiology Sequoia Accuson

Appendix C: 88 MDG Radiation Oncology Equipment

Number Description Location Manufacturer Model

1 LINAC Radiation Oncology Varian 2100CD

1 HDR Radiation Oncology Varian GammaMed 232

1 Simulator Radiation Oncology Varian Ximatron

1 CR Reader Radiation Oncology Fuji Smart-CR