HT940724Q0008 Attachment 1 Performance Work Statement.pdf

PERFORMANCE WORK STATEMENT

FOR

MOBILE MAGNETIC RESONANCE IMAGING SERVICES

Period of Performance: Mobile Magnetic Resonance Imaging (MRI) Base plus one (1) option year and two (2) six (6) month options.

CLIN 1: 1 October 2024 – 30 September 2025

Base PoP: 15 October 2024 – 14 October 2025 OY1: 15 October 2025 – 14 October 2026 OY2: 15 October 2026 – 14 April 2027 OY3: 15 April 2027 – 14 October 2027 Mobile MRI needs to be in place within 30 days of award.

1. DESCRIPTION OF SERVICES. The Contractor will provide mobile Magnetic Resonance Imaging (MRI) to the 375th Medical Group (MDG), Scott Air Force Base (SAFB) IL. 375th MDG will provide MRI Technicians to provide services for our Government beneficiaries. Performance will be according to the requirements contained in this Performance Work Statement (PWS) and be in compliance with The Joint Commission (TJC), Health Insurance Portability and Accountability Act (HIPAA), Centers for Disease Control and Prevention (CDC), Infection Control, National Fire Protection Association (NFPA), Health Service Inspection (HSI) standards, and all local 375th AMC and MDG policies.

1.2. SPECIFIC PROCEDURES FOR WHICH THE CONTRACTOR WILL BE

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

1.2.1. EQUIPMENT. The Contractor will provide a mobile MRI unit with Auto-shim and a power rating of at least 1.5T (tesla). The unit must not be beyond the manufacturer determined End of Life for the duration of the entire contract, starting from the first day of award and/or each CLIN option (defined as the model being out of production for more than 10 years). The unit will be set up for 3 phase, 480volt/200 amperes service. The unit manufacturer shall be one of the following: Siemens, GE, Philips, or Toshiba. The Contractor will provide coils for routine examinations, musculoskeletal exams, neurological exams, body exams (shoulder, knee, wrist, foot/ankle, brain, body, flex coils), and auto pressure injector (carotids, liver, kidneys, etc.). Software programs to optimize unit performance and abilities such as Smart Prep (equivalent or greater) and Diffusion Weighted Imaging will be provided by the Contractor.

The Contractor will provide MRI safe equipment to include at least one MRI safe wheelchair and other necessary transport devices. The Contractor will provide a field technician to set up the MRI unit upon arrival, within the first 24-hrs; perform warm up, calibration, and imaging test procedures as recommended by MRI unit manufacturer and/or TJC standards (attached) (whichever is most stringent). The Contractor will conduct and document routine maintenance of the MRI unit to ensure the proper operation of the MRI unit to produce quality diagnostic scans in support of MDG desired patient care. The Contractor will conduct sound level measurement at initial set up, and as necessary, to ensure patients and staff are not exposed to hazardous sound levels of 105 decibels (db) or above at any time for the duration of the exam/image procedure. The contractor will also provide a minimum of 3 days and up to 5 days of applications training (upon request of technicians) to train technicians on MRI equipment, software, (etc).

Equipment will comply with Air Force occupational and public safety requirements to include AFMAN 48-148. Annual physic survey to be provided prior to mobile MRI unit instillation. Power to the MRI is 5 wire, 480v, 200amp dedicated service. The service is hardwired and on commercial power only. The service disconnect is located at the rear of building 1529 on asphalt surface in the loading dock area. The MRI contractor will at the time of set-up ensure trailer is kept a minimum of 15’ from the exterior of the facility, leveled for weight distribution as needed for outriggers, and all environmental controls (HVAC, Lighting, etc.) are operational. MRI trailer will be supplied with an MRI approved fire extinguisher. Note: no water or sewer drains are located near the loading dock area.

1.3. PROCEDURE GUIDANCE. MRI exams not currently listed on Radiology’s capability report services shall not be introduced without prior recommendation to and approval of the MDG Commander or authorized representative, and approval by the Contracting Officer (CO).

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

1.3.3. AVAILABILITY/CONTINUITY. The Contractor will provide a point of contact that will be available via the telephone Monday through Friday, 0700 until 1700 CST, excluding federal holidays and down/family days. Additionally, the Contractor will provide a point of contact that is available via telephone at 24 hours a day, 7 days a week for emergency situations.

1.3.4. LOCATION/HOURS OF OPERATION. The MRI unit will be positioned behind the 375 Medical Group, building 1529, eastern lot on the designated MRI pad. Duty hours will vary between 0700-1600, depending on the patients scheduled. If at any time the equipment, patients or staff become compromised, it is the Government MRI technologist’s (refer to 1.3.2) responsibility to notify the Diagnostic Imaging Flight Commander, Flight Chief and the COR within 30 minutes of the known issue(s) that are prohibiting services and the duration of service outage. See paragraph 4.9 for a list of federal holidays and paragraph 4.14 for instances of clinical down times.

3. GENERAL INFORMATION.

3.1. GOVERNMENT-FURNISHED SUPPLIES/EQUIPMENT/TRAINING

3.1.1. EQUIPMENT. The Government will provide a telephone line, utilities (power supply), copy/scan/fax services, MRI pad, and parking.

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

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

3.1.4. GOVERNMENT ORIENTATION/TRAINING. The Government will provide training on Government provided forms and equipment, initial and continuing 375 MDG Radiology Department orientation.

3.1.4.1. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT

(HIPAA) OF 1996. All individuals performing services at an Air Force MTF will be held accountable for complying with health information privacy and security policies and procedures. Reference Local Information Clause SAFB-0018 for detailed HIPAA language. Each employee will complete the Air Force Medical Services (AFMS) Business Associate Agreement (BAA) as outlined in the HIPAA Privacy Rule, DoD 6025.18-R dated 24 Jan 03, DoD Health Information Privacy regulation, and AFI 41210, TRICARE Operations and Patient Administration Functions, dated 6 Jun 12. See attachment AFMS BAA Guidance.

3.2. CONTRACTOR FURNISHED ITEMS/SERVICES/TRAINING. Except for those items or services specifically stated above to be Government furnished, the Contractor will furnish everything required to perform this contract in accordance with all its’ terms.

3.2.1 COMBATING TRAFFICKING IN PERSONS (CTIP) TRAINING. N/A

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

3.4. APPEARANCE. N/A

3.4.1. CONTRACTOR IDENTIFICATION. At all times contractor personnel will be introduced and identified as such when meeting with government personnel. Contractor personnel shall display distinguishing badges or other visible identification for meetings with Government personnel. In addition, Contractor personnel shall appropriately identify themselves as Contractor employees in telephone conversations and in formal and informal written correspondence.

3.5. PHYSICAL SECURITY

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

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

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

3.5.3. PASS AND IDENTIFICATION ITEMS. The Contractor shall ensure the following pass and identification items required for contract performance are obtained for employees:

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

3.5.5. REPORTING REQUIREMENTS. The Contractor shall comply with AFI 71101, Volume- 1, Criminal Investigations Program, and Volume-2, Protective Service Matters, requirements. Contractor personnel shall report to an appropriate authority, any information or circumstances of which they are aware may pose a threat to the security of DOD personnel, Contractor personnel, resources, and classified or unclassified defense information. Contractor employees shall be briefed by their immediate supervisor upon initial on-base assignment and as required thereafter.

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

3.5.7. ENTRY PROCEDURES TO CONTROLLED / RESTRICTED AREAS. The Contractor shall comply and implement local base procedures for entry to AF controlled and restricted areas Contractors will be responsible for procuring Controlled Area Training from the assigned restricted/controlled area monitors.

3.5.8. TRAFFIC LAWS. The Contractor and its employees shall comply with (installation) base traffic regulations. Driver Distractions: In accordance with AFI 31- 218(I), Motor Vehicle Traffic Supervision, Paragraph 4-2c(3), vehicle operators on a Department of Defense (DoD) installation and operators of Government owned vehicles will not use cell phones unless the vehicle is safely parked or unless they are using a hands–free device. The wearing of any other portable headphones, earphones, or other listening devices (except for hands–free cellular phones) while operating a motor vehicle is prohibited. Use of those devices impairs driving and masks or prevents recognition of emergency signals, alarms, announcements, the approach of vehicles, and human speech.

The potential for driver distractions such as eating and drinking, operating radios, compact disc players, global positioning equipment, and so on should only be done when the vehicle is safely parked, when possible.

3.5.9. WEAPONS, FIREARMS, AND AMMUNITION. Contractor employees are prohibited from possessing weapons, firearms, or ammunition on themselves or within their Contractor-owned or privately owned vehicle while on SAFB.

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

3.6. CONFLICT OF INTEREST. The Contractor will not employ any person who is an employee of the United States Government if the employment of that person would create a conflict of interest.

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

3.8. QUALITY CONTROL

3.8.1. CONTRACTOR QUALITY SYSTEMS. Contracts for commercial items rely on Contractor’s existing quality assurance systems as a substitute for Government inspection.

The Government will rely on the Contractor’s assurances that the commercial services tendered for acceptance conforms to the contract requirements. Quality control is the responsibility of the Contractor and not the Government.

3.8.2. QUALITY ASSURANCE. N/A

3.8.3. SURVEILLANCE METHODS. N/A.

3.9. ENVIRONMENTAL REQUIREMENTS.

3.9.1. CONFORMANCE WITH ENVIRONMENTAL, SAFETY AND

OCCUPATIONAL HEALTH MANAGEMENT SYSTEM (ESOHMS). The Contractor shall perform all work under this contract consistent with the relevant policy and objectives identified within SAFB.

3.10. EMERGENCY HEALTHCARE. N/A

3.11. OCCUPATIONAL HEALTH SERVICES. IAW Air Force Instruction 48-145, Occupational and Environmental Health Program, Contractors are solely responsible for compliance with Occupational Safety and Health Administration (OSHA) standards and the protection of their employees unless otherwise provided by law or regulation.

Occupational Health services to be provided by the employer include but are not limited to Hearing Conservation, Respiratory Protection, Hazard Communication, the provision of Personal Protective Equipment (PPE) and Occupational Health Exams.

3.12. HEALTH REQUIREMENTS. N/A

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

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

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

4.3. FUNCTIONAL REQUIREMENTS EVALUATOR DESIGNEES

(FREDs). N/A

4.4. CONTRACTING OFFICER REPRESENTATIVE (COR). Individuals

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

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

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

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

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

4.9. FEDERAL HOLIDAYS. There are eleven (11) federal holidays each year. They are New Year’s Day (observed 1 January), Martin Luther King, Jr’s Birthday (observed the third Monday in January), President’s Day (observed the third Monday in February), Memorial Day (observed the fourth Monday in May), Juneteenth (observed 19 June), Independence Day (observed 4 July), Labor Day (observed the first Monday in September), Columbus Day (observed the second Monday in October), Veterans Day (observed 11 November), Thanksgiving Day (observed the fourth Thursday in November), and Christmas Day (observed 25 December). If New Year’s Day, Independence Day, Veterans Day or Christmas Day falls on a Saturday, it is observed on Friday; if it falls on Sunday, it is observed on Monday.

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

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

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

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

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

Standard down time usually includes the day after Thanksgiving, a day in conjunction with Christmas and New Years’, and the third Wednesday of every month (readiness training). The 375th Medical Group reserves the right to schedule down days as needed.

4.15. INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE. The

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

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

4.16. PERFORMANCE OF SERVICES DURING CRISIS DECLARED BY THE

NATIONAL COMMAND AUTHORITY OR OVERSEAS COMBATANT COMMANDER. This service is determined not to be essential for performance during crisis according to DODI 3020.37, Continuation of Essential DOD Contractor Services During Crisis. However, in the event of a crisis or if a significant emergency is declared, the Contracting Officer (CO) will contact Contractor personnel to notify them of the situation and any possible changes to their contract responsibilities. Upon notification by the CO, the Contractor shall perform special event services due to contingencies, natural disasters, or facility operation on an extended basis up to 24 hours per day, as required. If additional contract costs are incurred under this paragraph, the Contractor will have up to 30 calendar days to request an equitable contract price adjustment.

Attachment:

The Joint Commission (TJC) standards