Medical_Radiation_Physicist_PWS.pdf

PERFORMANCE WORK STATEMENT

FOR

RADIATION THERAPY CERTIFIED MEDICAL PHYSICIST

Personal Service

Wright Patterson Medical Treatment Facility

Wright Patterson A.F.B., Ohio

21 Jul 2015

Table of Contents

1. Description of Service 4

1.1. Scope 4

1.2. Radiation Therapy-Certified Medical Physicist 6

1.3. Availability of Personnel 7

1.3.1. Hours of Operation 7

1.3.2. Work Schedule 8

1.3.3. Federally Observed Holidays 8

1.3.4. Performance Evaluation Meetings 8

1.4. Education, Training, and Professional Requirements 8

1.5. Continuing Medical Education (CME) Requirements 8

1.6. Employee Credentials 9

1.7. General Information 9

1.7.1. Quality Control Program 9

1.7.2. Point of Contact 10

1.7.3. English Language Requirement 10

1.7.4. Appearance 10

1.7.5. Professional Qualities 10

1.7.6. Changes in Personnel 10

1.7.7. Rights to Information and Reports 10

1.7.8. Existing Staff 10

1.7.9. MTF Workload Estimates 10

1.8. Security Requirements 10

1.8.1. Contractor Notification Responsibilities 10

1.8.2. Suitability Investigations 11

1.8.3. Freedom of Information Act Program 11

1.8.4. Reporting Requirements 11

1.8.5. Physical Security 11

1.8.6. Key Control 11

1.8.7. Continuation of Essential Department of Defense (DOD) Contractor 11

Services During Crisis

1.8.8. Conflict of Interest 12

1.8.9. Indemnification and Medical Liability Insurance 12

1.8.10. Medical Quality Assurance/Risk Management 12

1.8.11. Orientation 12

1.8.12. Annual Training 12

1.8.13. Infection Control and Safety 12

1.8.14. The Joint Commission 12

1.8.15. Patient Lists 13

1.8.16. Patient Sensitivity 13

1.8.17. Release of Medical Information 13

1.9. Health Requirements 13

1.9.1. Preassignment Medical Evaluation 13

1.9.2. Preventive, Prophylactic and Follow-up Procedures 14

1.9.3. Medical Records 14

1.9.4. Immunization Waivers/Exemptions 14

1.9.5. Pregnant Employees 14

1.9.6. Communicable Diseases 14

1.10. Environmental Requirements 14

1.10.1. General 14

1.10.2. Hazardous Materials 15

1.10.3. Hazardous Materials Inventory 15

1.10.4. Storage of Hazardous Materials 15

2. Services Summary 16

3. Government Furnished Equipment, Property, and Services 16

4. Appendices

A. Core Medical Physics Guidelines 18 B. 88 MDG Radiation Oncology Equipment/Software 19

PERFORMANCE WORK STATEMENT

FOR

RADIATION THERAPY PHYSICS SUPPORT

I. DESCRIPTION OF SERVICE

1.1. SCOPE

1.1.1. The Contractor shall furnish all labor, management, and supervision of contractor staff, and the reports required to provide the services of the Radiation Therapy Physicist listed in PWS on a personal services basis at the 88 th

Medical Group (MG), Wright

Patterson Medical Center, Wright Patterson Air Force Base (WPAFB), Ohio, also referred to as the "Medical Treatment Facility" (MTF) herein.

1.1.2. The Contractor shall perform services in accordance with (IAW) the ethical, professional, and technical standards of the health care industry and the Air Force medical department. Performance shall be according to the requirements contained in this Performance Work Statement (PWS), the guidelines of the National Council on

Radiation Protection (NCRP), the American College of Radiology (ACR), the Nuclear

Regulatory Commission (NRC), and professional standards of practice of The Joint

Commission (TJC), the Air Force Inspection Agency Office of the Health Service

Inspector, and applicable Air Force regulations found in this PWS. Contractor shall cover radiation services provided in the MTF and as needed at the Dayton VA Medical Center through our joint sharing agreement.

1.1.3. Contractor shall furnish all labor, management, supervision, teaching, and reports required to provide personal services of a Radiation Therapy Board Certified or Board

Eligible Medical Physicist. MTF and Dayton VA Medical center (as part of sharing agreement) will furnish all physical equipment necessary for the performance of duties required by this contract. Required coverage is for 0.8 of a full time employee (FTE), or

32 hours a week. Contractor shall comply with Air Force and departmental policy along with procedure, federal, and local regulations, TJC requirements, and national and international standards of practice and care.

Specific tasks performed by the contractor include but are not limited to:

1.1.3.1 Optimize treatment dosimetry and systems performance in accordance with national guidelines and standards (e.g. American Association of Physicists in

Medicine/AAPM). Measuring, testing and assessing radiation equipment, sources, and computer systems. Acquiring and applying data from physical measurements and radiological, optical, ultrasonic, and other imaging. Working with engineers and vendors to repair and upgrade radiation therapy machines and devices. QA testing requirements include:

- Overseeing clinical treatment planning

- Inspecting the daily operations of the clinical dosimetry team

- Testing linear accelerator for performance deviations

- Measuring radiation output and calibrating the radiation equipment

1.1.3.2 Work with radiation oncologists to design radiation treatment plans.

Acquiring patient-specific anatomic data to plan, deliver, and document treatments. Designing beam or sources placement, and treatment aids and modulators including multi-leaf collimator’s (MLCs) and positioning devices.

Timeline for accomplishing these tasks will be at discretion of radiation oncologist and based on clinical needs.

QA testing requirements include:

- Devloping radiation treatment plans

- Modifying and testing radiation treatment plans

1.1.3.3 Oversee and participate in treatment procedures. Lead technical aspects of complex treatment procedures including, but not limited to, Total Body Irradiation

(TBI), Stereotactic Radiosurgery (SRS), Stereotactic Body Radiation Therapy

(SBRT), Low Dose Rate Brachytheraphy (LDR), and High Dose Rate

Brachytherapy (HDR) brachytherapy treatments. Quality assurance, treatment planning, radiation safety, and record keeping shall also be accomplished by the contractor.

1.1.3.4 Reviewing, evaluating, verifying quality compliance with the services summary, and providing physics approval of patient treatment plans. QA testing requiremtns include evaluating the adequacy of planned tumor dose, normal tissue dose tolerance, and ease of treatment plan implementation. Timeline for accomplishing these tasks will be at discretion of radiation oncologist and based on clinical needs.

1.1.3.5. Developing, implementing, and maintaining regulatory compliance of quality assurance (QA) procedures will be provided by the MTF. Reviewing and maintaining records including charts, QA indicators including equipment QA.

Reporting incidents, hazards, errors, and misadministrations shall be performed by the contractor in accordance with established national guidelines (AAPM, Nuclear Regulatory Commission/NRC).

1.1.3.6. Perform acceptance tests, commissioning and lead technical and processing implementation of new technology including both hardware and software. Coordinate systems implementation and processes with physicians, nurses, therapists and other patient care associates.

1.1.3.7. Teach and demonstrate principles and applications of radiological physics. The curriculum shall include treatment planning, imaging, dosimetry, delivery of radiation, verification of radiation dose, electronic process and data management, and use of computer systems to junior physicists, physics residents, dosimetrists, therapists, physicians, nurses, administrators, students, vendors, visitors, and others.

1.1.3.8. All contract personnel shall attend weekly departmental chart rounds as well as any additional required Wright-Patterson Medical Center (WPMC) meetings. In addition, they shall attend professional, research, educational, governmental, and other meetings to acquire continuing education credits needed to maintain board certification and state licensure.

1.2. RADIATION THERAPY BOARDCERTIFIED MEDICAL PHYSICIST. The Radiation

Therapy Board-Certified Medical Physicist shall assist in overseeing the Radiation Oncology physics program, including technical direction of the staff physicist, medical dosimetrist(s), therapy biomedical engineers and other physics support staff personnel. Board-eligible physicists will work under the direct supervision of the department’s board-certified medical physicist. The Contractor provider shall:

1.2.1 Perform physics associated with radiation therapy beams and radioactive sources in terms of calibration and utilizing standard measurement and testing protocols ( AAPM

Task Group Reports #51 &#142). Tasks may include:

-Serve as the clinical physics lead for acceptance, commissioning, annual and monthly testing

- Ensuring contract employees comply with federal, professional (e.g. AAPM), Air Force and manufacturer requirements.

- Consult with and provide testing status/reports as requested by Chief Radiation

Oncologist and the Contracting Officer Representative (COR) in compliance with scheduled monthly and yearly requirements.

- Support the medical physics training program in compliance with AFI 40-201 and AFI 48-148.

1.2.2. The contractor shall provide the physics support associated with radiation therapy beams in terms of beam characteristics including:

- Develop and implement appropriate quality control programs.

- Provide technical direction to the staff responsible for machine and repair.

- Perform the calibration requirements of testing devices.

- Maintain the medical physics lab and associated equipment.

- Identify and prepare equipment procurement packages.

- Measure and document beam parameters, validate data against the commissioning data and using established guidelines.

- Perform and document annual (independent) TLD study of beam output.

1.2.3. Contractor shall provide commissioning, treatment planning, and quality assurance for the following modalities: Stereotactic Radiotherapy (SRT), Intensity-Modulated

Radiation Therapy (IMRT), Arc therapy, Image-Guided Radiotherapy (IGRT), low dose rate brachytherapy (LDR), high dose rate brachytherapy (HDR) and Total Body

Irradiation (TBI).

1.2.4. Monitors the technical components of the various treatment modalities to include quality control programs and dosimetry including:

- Support radiation oncology team members for technical components of the treatment modality

- Consult with and provide testing status/reports to the Chief Radiation Oncologist

- Oversee and lead the medical physics training program

1.2.5. Contractor shall provide radiation dosimetry pertinent to the development of and/or evaluation of patient treatment plans including:

- Overseeing clinical treatment planning

- Inspect the daily operations of the clinical dosimetry team

- Assist in establishing treatment planning policies

-Lead and monitor the internal training programs

1.2.6. Contractor shall review the radiation oncology dosimetry information noted in patient records including:

- Review and approve plans produced by dosimetry for proper patient treatment

- Validate doses associated with the treatment plans using the treatment planning system, secondary calculations, and actual measurements

- Assist the radiation safety team with on-site clinic radiation safety information.

1.2.7. Contractor shall use imaging procedures for simulation, treatment planning and treatment delivery in therapeutic radiological procedures including:

-Contractor shall perform medical imaging modalities, in support of radiation therapy.

-Perform and document quality control testing programs for imaging devices and monitor proper operation and/or testing procedures performed by the clinical staff.

1.2.8. Contractor shall both orally and in writing:

- Document history of positive and effective interaction and communication regarding job-related tasks with the entire radiation oncology team.

-Document history of various job tasks in clinic, local, regional, and national medical physics and radiation therapy meetings.

-Provide consultation with the staff and Radiation Oncologists on technical issues and clinical objectives as established by the Radiation Oncology leadership.

1.3. AVAILABILITY OF PERSONNEL.

1.3.1. HOURS OF OPERATION. The normal duty hours for the MTF are between

0730 to 1630, Monday through Friday. Contractor radiation therapy physics employees shall be present during normal duty hours in the radiation oncology clinic for at least 4 days per week or

32 hours per week for 31 weeks and shall divide their time evenly throughout the month. These duty hours shall include 1 hour unbillable lunch. Hours per month may vary somewhat depending on mission and special procedures. Alternative schedules shall be approved by the

Radiation Oncology Chief if the Contractor should need access to equipment after normal duty hours for the purpose of conducting quality assurance testing and equipment maintenance/repairs.

1.3.2. WORK SCHEDULE. A Contractor point of contact shall provide a schedule that lists the date, times, and names of Contractor personnel who 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.

1.3.3. 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.

1.3.4. MISSION ESSENTIAL PERSONNEL. This effort is not Mission Essential. However, if there is inclement weather and the Medical Treatment Center remains open, contract employee is still required to come in.

1.3.5. PERFORMANCE EVALUATION MEETINGS. The Contractor or his representative shall meet with the Contracting Officer’s Representative (COR), and other government personnel at least quarterly, and as requested.

1.4. EDUCATION, TRAINING, AND PROFESSIONAL REQUIREMENTS.

All services shall be rendered IAW established principles and ethics of the medical profession, the national standards established by the TJC, Health Insurance Portability and

Accountability Act (HIPAA), Occupational Safety and Health Administration (OSHA), the professional standards at MTF, and the American Association of Physicists in Medicine

(AAPM). The Contractor shall provide services to all patients eligible for care at the MTF for treatment or as requested by the Radiation. The Government will evaluate the quality of professional and administrative services provided based on nationally accepted guidelines

(AAPM, NRC, American Society for Radiation Oncology) and will retain control over the medical and professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment). The Contractor physics personnel shall be locally based (within a three hour drive of the medical center) in order to provide physics support during patient treatment. The Contractor shall certify that the following Contractor personnel have the minimum qualifications/training indicated.

1.4.1. The Radiation Therapy Medical Physicist must be board certified in Radiation

Therapy Physics by the American Board of Radiology (ABR) with at least 12 months of board-certified practice/experience within 36 months of beginning employment at MTF.

Board eligible physicist may provide support services under the direction and supervision of the board certified Radiation Therapy Medical Physicist.

1.4.2. The contractor shall provide a radiation therapy physicist with at least 12 months radiation therapy experience within 36 months of beginning employment at MTF with the following platforms:

-- Eclipse Version 11

-- Aria Version 11

-- RadCalc

--Brachyvision

-- Portal Dosimetry

-- Varian Trilogy Linear Accelarators

1.4.3. The contractor shall provide written documentation of the above minimum qualifications/training/experience requirements.

1.5. CONTINUING MEDICAL EDUCATION (CME) REQUIREMENTS. Contractor employees shall meet the ABR Standard for Continuing Medical Education. CME shall be obtained at no additional cost to the Government. Information on CME completion by Contractor employees shall be provided to the COR annually on the first work day in January for the previous calendar year. Documentation shall also be provided to the Government upon request.

1.6. EMPLOYEE CREDENTIALS. Contractor employee credentials shall be submitted to

COR no later than 10 calendar days after receipt of the notice of contract award, and as requested by the COR. The following minimum documentation is required: a copy of the proposed employee’s professional resume indicating experience, training, technical expertise in the type of services to be rendered, and references, as well as copies of relevant board certifications, licensure.

1.7. GENERAL INFORMATION

1.7.1. QUALITY CONTROL PLAN. 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 shall 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 to CO for acceptance. 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.

1.7.2. POINT OF CONTACT. The Contractor shall provide a point of contact who shall be available 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 or individuals, in writing, to the Contracting Officer (CO), after contract award and before the period of performance starts on the contract. The Contractor shall identify the specific individual and times when different individuals will be the primary and alternate point of contact. If any changes occur in personnel the government shall be notified in writing not later than 5 calendar days of the primary point of contact’s last day.

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

1.7.4. APPEARANCE. All Contractor personnel shall 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 company’s name and individual’s name. Any required MTF identification will be provided by the MTF.

1.7.5. PROFESSIONAL QUALITIES. The Contractor shall ensure contract employees interact professionally with members of the MTF and patients.

1.7.6. CHANGES IN PERSONNEL. When a permanent change in a contract employee is anticipated, the Contractor shall provide the COR the same credentials required for the initial contract employee no later than two (2) weeks prior to outgoing employee’s departure date. The permanent replacement candidate should begin work within 3 business days of outgoing contract employee’s departure. When a temporary change in a contract employee is required (at discretion of Radiation Oncologist, length of physicist absence, and clinical needs of the department) the Contractor shall provide a replacement candidate within 3 business days of notification of need; this temporary replacement shall be provided to Government at no additional expense and the same credentials and requirements (and verification process) apply for the temporary contract employees. All replacements provided shall be at no additional expence to the Government.

1.7.7. 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 are the property of the Government. The Government determines the final disposition of reports and information.

1.7.8. EXISTING STAFF. The Contractor will support the existing staff within the

Physics and Dosimetry departments. The existing staff is subject to change throughout the period of the requirement. The Dosimetry staff includes but is not limited to one Certified Medical

Dosimetrists (CMD). The Physics staff includes but is not limited to one active duty military member with a Masters Degree in Medical Physics.

1.7.9. MTF WORKLOAD ESTIMATES. Current MTF workload estimates are based on historical data and are subject to fluctuations. The MTF provides service to an estimated 10 to

15 patients per day. 60% of this workload is typically IMRT. An estimated one HDR brachytherapy treatment is performed a month.

1.8. SECURITY REQUIREMENTS.

1.8.1. 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.

1.8.2. SUITABILITY INVESTIGATIONS. Contractor personnel shall successfully complete, at 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.

1.8.3. 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.

1.8.4. 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.

1.8.5. 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 including equipment and facility area shall be secured in accordance with Air Force and MTF instructions. These instructions will be provided to the Contractor by the Government.

1.8.6. KEY CONTROL. The Contractor shall establish and implement methods of tracking all keys/combinations issued to the Contractor. The Contractor shall establish that all keys issued by the Government shall be used only by contractor authorized personnel. 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 to the COR. In the event keys, other than master keys, are lost or duplicated, the Contractor shall, upon written direction of the Contracting Officer shall rekey or replace the affected lock or locks without cost to the Government. The Government has the option to replace/reprogram the affected lock or locks or perform re-key and deduct the cost from the monthly payment due to the Contractor.

1.8.7. CONTINUATION OF CONTRACTOR SERVICES DURING BASE

EXERCISES, LOCAL EMERGENCIES, CONTINGENCIES, OR IMPLEMENTATION

OF LOCAL CONTINGENCY PLANS. This contract is considered mission essential as it allows continued treatment of patients with radiation at the MTF (patients cannot receive therapeutic radiation without physics support/oversight).

1.8.8. 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.

1.8.9. INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE. The

Contractor shall provide the Contracting Officer documentation of liability insurance prior to the start of the contract and annually thereafter 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”.

1.8.10. MEDICAL QUALITY ASSURANCE/RISK MANAGEMENT (QA/RM).

Contract employees shall participate and be evaluated in QA/RM activities per requirements in

AFI 44-119 and the individual Military Treatment Facility (MTF) QA/RM plan. The

Government will provide the AFI 44-119 and MTF QA/RM plan.

1.8.11. ORIENTATION. All contract employees shall 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.

1.8.12. ANNUAL TRAINING. All contractor employees shall attend annual training classes 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 as training requirements become due. The class length of time is approximately four to five hours total per individual.

Training certification shall be provided to the COR within 5 business days of training completion

1.8.13. 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.

1.8.14. 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.

1.8.15. 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 COR.

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

1.8.17. 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.

1.9. HEALTH REQUIREMENTS.

1.9.1. 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, no 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 employees have 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).” All documentation shall be provided to the COR.

1.9.2. PREVENTIVE, PROPHYLACTIC, AND FOLLOW-UP PROCEDURES. All Contractor employees shall comply 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 to the COR. MTF policies and guidelines pertaining to these requirements will be provided to the Contractor by the

1.9.3. MEDICAL RECORDS. The Contractor shall provide to the COR for this contract, all medical information for hospital records, and therefore comply with TJC, OSHA, Centers for Disease Control (CDC), DOD, and USAF health records requirements. This information shall be provided to the COR 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.

1.9.4. 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 and the COR.

1.9.5. PREGNANT EMPLOYEES. All Contractor pregnant employees should report the pregnancy to the Contractor. The Contractor shall notify Public Health of the pregnancy within 1 business day of notification. Public Health will provide information concerning any work hazards in that area. The Contractor shall 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”.

1.9.6. COMMUNICABLE DISEASES. Contract employees with communicable diseases must be reported to the MTF contract project supervisor and the COR. Notification to

Public Health shall be made by the Contractor. 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

1.10. ENVIRONMENTAL REQUIREMENTS.

1.10.1. GENERAL.

1.10.1.1. 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 MTF. Hazardous materials shall be identified to the Contractor by the Government. The Contractor shall identify all hazardous materials discovered in the course of performance.

1.10.2. HAZARDOUS MATERIALS.

1.10.2.1 Machine Produced Ionizing Radiation

1.10.2.2 Radioactive Materials

1.10.3. HAZARDOUS MATERIAL INVENTORY.

1.10.3.2 Standard Low Dose Rate Brachytherapy sources used in Radiation

Oncology

1.10.3.3 Standard High Dose Rate Brachytherapy sources used in Radiation

Oncology

1.10.3.4 Standard Radioactive Material Check Sources for Radiation Detectors and testing

1.10.4. STORAGE OF HAZARDOUS MATERIALS. Storage of Radioactive

Materials shall be in secure locations within Nuclear Medicine and Radiation Oncology.

2. SERVICES SUMMARY

Performance Objective PWS para.

Performance

Threshold SS-1 Assessment of treatment dosimetry and systems performance.

a) Submitted on time

b) Complies with QA Testing requirements

1.1.3.1 Zero (0) defects within

the month

SS-2 Design/test radiation treatment plans.

b) Complies with QA Testing

1.1.3.2 Zero (0) defects within

SS-3 All procedures were correctly performed. 1.1.3.3 Zero (0) defects within the month

SS-4 Patient treatment plans:

b) Complies with QA Testing requirements

1.1.3.4 Zero (0) defects within

the month

SS-5 Attendance at all required meetings 1.1.3.8 Zero (0) defects within the month

SS-6. Teaching and demonstrating principles and applications of radiological physics including treatment planning, imaging, dosimetry, delivery, verification, electronic process and data management, and use of computer systems

1.1.3.7

Zero (0) defects within the month

SS-7 Work Schedule submitted on time

(20th day of each month)

1.3.2 Zero (0) defects within

the month

SS-8 Contractor attends all required

Performance Evaluation Meetings

1.3.4 Zero (0) defects within

SS-9 Employees submitted proper credentials

1.6 Zero (0) defects within

SS-10 Contractor provided current documentation of employees who received

Continuing Medical Education (CME)

1.5 Zero (0) defects within

the month

SS-11 Contractor provided accurate documentation for proper medical evaluations for all contract employees

1.9 Zero (0) defects within

the month

SS-12 Personnel available during required hours of operation

1.3 0 Defects

3. GOVERNMENT FURNISHED EQUIPMENT, PROPERTY, AND SERVICES

The MTF will provide office space to include one standard telephone and service, facsimile, Internet connectivity (dependent upon existing Contractor security clearance), electronic mail, and utilities. These items shall only be used for performance of tasks related to this PWS. The

MTF will provide required Government forms required in the performance of this contract.

4. APPENDICES

A. Core Medical Physics Guidelines

B. 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 http://www.aapm.org/pubs/reports/

Other Medical Physics Guidance

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.e-publishing.af.mil/ http://www.nrc.gov/reading-rm.html

Appendix B: 88 MDG Radiation Oncology Equipment/Software

Number Description Location Manufacturer Model

1 LINAC Radiation Oncology Varian Trilogy Silhouette

1 HDR Radiation Oncology Varian GammaMed 232

1 Simulator Radiation Oncology Varian Ximatron; Philipps

PET/CT scannner

1 Treatment Planning

System

Radiation Oncology Aria/Eclipse 11.0

Notes:

The current Linear Accelerator is from 2013.

Service for the LINAC is currently being provided by the Manufacturer Varian.