I.A.02 PWS.pdf

PERFORMANCE WORK STATEMENT

DIAGNOSTIC MEDICAL PHYSICS SUPPORT

1. BACKGROUND.

1.1 This is a non-personal service requirement for the annual testing for the Philips Ingenia 1.5T at Weed Army

Community Hospital (WACH) as identified in paragraph 3.1 of this Performance Work Statement (PWS), to include all labor, material, and travel, to provide on-site diagnostic medical physics support in accordance with (IAW) manufacturer (MFR) specifications and 29 CFR 1910.1096.

1.2 Information concerning the systems in question is furnished from the best available sources. However, this shall not relieve the Contractor of the requirement to visit the location of the system(s) listed and to be thoroughly familiarized with all components associated with the item(s) and conditions under which the work is to be performed.

2. GENERAL.

2.1 Hours of Operation. WACH provides services 24 hours a day, 365 days a year (366 days during leap years) including holidays.

2.1.1 Normal business hours for the Equipment Management Branch (EMB) are 8:00 AM to 4:30 PM, Monday –

Friday.

2.1.2 The contractor shall make every practical effort to provide services during normal business hours, excluding federal holidays. However, in certain cases, permission may be granted to the contractor to provide services outside of EMB normal operating hours if during these hours (1) access to the equipment being serviced is limited or unavailable, (2) servicing the equipment would cause impactful impedance to patient care, or (3) the contractor provides any other justified reasoning for unavailability that is accepted by the Chief of Equipment

Management Branch. Approval to perform services outside of EMB normal business hours will be given by the

Chief of Equipment Management Branch.

2.1.3 WACH Medical Maintenance provides emergency services after-hours by means of an on-call technician.

In the event any contractor is performing services outside normal business hours, the on-call technician will be available to perform duties of WACH Medical Maintenance (i.e. periodically checking on the progress of contractor personnel to ensure the security of the hospital, verifying the quality of services rendered meets or exceeds the standards set forth in the PWS, and assisting contractor personnel in signing in and out at the Medical Maintenance

Section).

2.1.4 This contract does not cover over-time, after-hours emergencies or federal holiday coverage.

2.1.5 Holidays. The following is a list of legal federal holidays. Any of the federal holidays falling on a Saturday will be observed on the preceding Friday. Any holidays falling on a Sunday will be observed on the following

Monday.

2.1.5.1 FEDERAL HOLIDAYS

New Year’s Day, January 1st

Martin Luther King’s Birthday, 3rd Monday in January

President’s Day, 3rd Monday in February

Memorial Day, Last Monday in May

Juneteenth, June 19th

Independence Day, July 4th

Labor Day, 1st Monday in September

Columbus Day, 2nd Monday in October

Veteran’s Day, November 11th

Thanksgiving Day, 4th Thursday in November

Christmas Day, December 25th

NOTE: Any holidays that are declared by Presidential Executive Order shall be observed in the same manner as the holidays listed above. If the area in which a contract employee is scheduled to work is closed due to the holiday and the employee is not required to report in, payment will not be made for those hours. Closures of the installation due to inclement weather or other such acts of God shall be handled in the same manner.

2.2 Specific Tasks and Deliverables. The contractor, or contractor representative, shall report to the WACH

Equipment Maintenance Section Bldg. 390, Room 1401 (1D140), telephone (760) 383-5652, prior to commencing all on-site services during normal operating hours, 7:30 AM to 4:30 PM PST, Monday through Friday. During other than normal operating hours, the contractor's representative shall report to the Administrative Officer of the Day

(AOD) at Bldg. 390.

2.2.1 All visits shall be coordinated between the contractor, the Medical Maintenance Technician requesting service, and the Medical Maintenance Contracting Officer Representative (COR). The COR or designated representative are the only authorized Medical Maintenance personnel that can request services. Department staff or users where medical devices are located are not authorized to request services.

2.3 Government Point of Contact

WO1 Aleksandr Manuylidi

Chief, Equipment Management Branch

Medical Maintenance Contracting Officer Representative (COR) aleksandr.k.manuylidi.mil@mail.mil

(760) 383-5604

2.4 Place of Performance

Weed Army Community Hospital

ATTN: Medical Maintenance

Bldg. 390 North Loop Road

Fort Irwin, CA 92310-5109

3. SCOPE OF WORK.

3.1 Equipment to be Serviced:

Make Model

Serial

Number

Product

Description

Equipment

Control

Number

Philips Ingenia 1.5T 1058 Magnetic Resonance Imaging System 16017

3.2 General Work Requirements. All work shall be performed by a qualified diagnostic medical physicist. A qualified diagnostic medical physicist is a person who is certified by the American Board of Radiology, American

Board of Medical Physics, or the Canadian College of Physicists in Medicine. For diagnostic computed tomography

(CT), nuclear medicine, PET, or MRI, a qualified medical physicist can meet the following requirements in lieu of board certification:

a. A graduate degree in physics, medical physics, biophysics, radiologic physics, medical health physics, or a closely related science or engineering discipline from an accredited college or university.

b. Formal graduate-level coursework in the biological sciences with at least one course in biology or radiation biology and one course in anatomy, physiology, or a similar topic related to the practice of medical physics.

mailto:aleksandr.k.manuylidi.mil@mail.mil

c. Documented 3 years of clinical experience in CT, nuclear medicine, PET, or MRI. The physicist must document the 3 years of experience for the modality being inspected. This must be submitted to the facility 7 days prior to arrival for inspection.

3.3 The qualified diagnostic medical physicist shall perform imaging equipment (x-ray equipment, nuclear medicine cameras, PET/CT cameras, and MRIs) inspections to ensure compliance with the current American

College of Radiology (ACR) and Mammography Quality Standards Act (MQSA) requirements. Any deficiencies or non-conformances discovered during the inspection shall be verbally communicated to the service supervisor or

Radiation Safety Officer (RSO) prior to the qualified diagnostic medical physicist leaving the facility. Deficiencies or non-conformances which represent unsafe conditions with the potential to adversely impact the facility radiation workers or patients shall be reported to the RSO immediately upon discovery. A written report of the results shall be provided to the service supervisor or RSO within 5 working days after completion of the inspection.

3.3.1 The physics inspection shall conform to the Joint Commission Revised Requirements for Diagnostic Imaging

Service Standard EC.02.04.03 EP 22. The performance of each MRI scanner shall be evaluated at least annually.

This evaluation should include, but not be limited to, the following tests (as applicable).

a. Image uniformity for all radiofrequency (RF) coils used clinically

b. Signal-to-noise ratio (SNR) for all coils used clinically

c. Slice thickness accuracy

d. Slice position accuracy

e. Alignment light accuracy

f. High-contrast resolution

g. Low-contrast resolution (or contrast-to-noise ratio)

h. Geometric or distance accuracy

i. Magnetic field homogeneity

j. Artifact evaluation

3.4 Upon Completion of Service Calls.

3.4.1 Upon completion of work, WACH Medical Maintenance technician shall perform an inspection with the contractor personnel to verify all services were completed to specifications.

3.4.1.1 Required forms and extracts from pertinent directives will be furnished to the contractor’s service representative by the government upon request.

3.4.2 The contractor personnel will sign out at the Medical Maintenance front desk where they signed in upon arrival.

3.4.3 The contractor shall submit a report of the results to the Weed Army Community Hospital (WACH), Bldg.

# 390, Room # 1401, Medical Maintenance technician and/or the COR for review within 72 hours of completion of services. The FSR may be submitted in person upon completion, via mail to the address listed on 2.2.2 or emailed to usarmy.irwin.medcom-wach.list.log-medical-maintenance@mail.mil.

3.4.3.1 The report of the results shall provide a detailed account of the service call to include the requirements listed in section 3.3.1.

3.4.3.2 In the event all information is not available to the contractor's service representative when services are performed, the initial service report/invoice shall include all available information to close work order within 5 days.

The contractor shall provide the balance of the required information to the Medical Maintenance Technician or COR no later than 10 days after services are completed.

4. CONTRACTOR PERSONNEL.

4.1 Minimum Personnel Qualifications are listed in section 3.2.

4.2 Personal Appearance. The contractor or his/her representative(s) performing services under this contract shall practice high standards of personal hygiene and maintain a clean, neat appearance while at WACH and/or its associated areas.

4.3 Compliance. The Contractor and contract personnel shall abide by all WACH standards, rules and procedurals. Such regulations include, but are not limited to, general safety, fire prevention, waste disposal, infection control, JC, and patient safety initiatives. The contractor shall ensure all personnel performing services under this contract shall be informed of the guidelines and contractual requirements set forth in the PWS and contract, including but not limited to, all safety/security protocols and credential verification procedures.

5. SAFETY / SECURITY REQUIREMENTS

5.1 WACH Security. Contractor personnel and/or any representative of the contractor entering WACH shall abide by all security regulations and be subject to security checks. The contractor and/or his representative shall report to the Security office to sign-in and receive a temporary access badge; the badge shall be returned to the

Security office and the representative shall sign out before departing the installation.

5.2 Combatting Human Trafficking. Combating Trafficking in persons (awareness program) shall be 100% compliance (zero tolerance) regarding trafficking in persons policy in accordance with FAR 52.222-50 and FAR

22.1703.

5.3 Sexual Harassment/Assault Response and Prevention (SHARP). The contractor shall ensure all contractor personnel receive Sexual Harassment/Assault Response and Prevention (SHARP) training no later than 60 calendar days after the contractor representative(s) begins performance under this contract. Training can be obtained either online or in person as offered at the installation where services are being provided. If the employee has an AKO account, they can access the Team Bound Self Study course online through Army Learning Management System

(ALMS) at https://www.lms.army.mil.

5.3.1 POLICY FOR REPORTING INCIDENTS OF SEXUAL ASSAULT AND SEXUAL HARASSMENT

UNDER SEXUAL ASSAULT PREVENTION AND RESPONSE PROGRAM (SHARP).

5.3.1.1 The contractor shall comply with OTSG/MEDCOM Policy Memo 13-062, Policy for Reporting Incidents of Sexual Assault and Sexual Harassment under the Sexual Assault Prevention and Response Program (SHARP), 12

Nov 2013. The SHARP reporting requirements apply only to knowledge obtained by contractor personnel while performing services under this contract.

5.3.1.2 The contractor shall require all contractor personnel with knowledge of an incident of sexual assault occurring on a Government facility, to include a Government leased facility, where the contractor is providing services under this contract, to report the incident to the contractor who shall immediately (within 24 hours) report the incident in writing to the government's COR. All incidents shall be reported whether they involve contractor personnel or Government personnel, or other individuals.

5.3.1.3 The contractor shall require all contractor personnel with knowledge of an incident of sexual harassment occurring on a Government facility, to include a Government leased facility, where the contractor is providing services under this contract, to report the incident to the contractor who shall immediately (within 24 hours) report the incident in writing to the government's COR. All incidents shall be reported whether they involve contractor personnel or Government personnel, or other individuals.

6. OPERATIONAL SECURITY (OPSEC).

6.1 Anti-Terrorism (AT) Level I Training: This standard language is for contractor employees with an area of performance within an Army controlled installation, facility or area. All contractor employees, to include subcontractor employees, requiring access Army installations, facilities and controlled access areas shall complete

AT Level I awareness training within 15 calendar days after contract start date or effective date of incorporation of this requirement into the contract, whichever is applicable. The contractor shall submit certificates of completion for each affected contractor employee and subcontractor employee, to the COR or to the contracting officer, if a COR is not assigned, within 7 calendar days after completion of training by all employees and subcontractor personnel. AT

Level I Awareness Training is available at the following website: http://jko.jten.mil

6.2 Access and General Protection/Security Policy and Procedures: This standard language is for contractor employees with an area of performance within Army controlled installation, facility, or area. Contractor and all associated sub-contractors employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency

Services or Security Office. Contractor workforce must comply with all personal identity verification requirements

(FAR clause 52.204-9, Personal Identity Verification of Contractor Personnel) as directed by DOD, HQDA and/or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force

Protection Condition (FPCON) at any individual facility or installation change, the Government may require changes in contractor security matters or processes.

6.3 For Contractors That Do Not Require CAC, But Require Access to a DoD Facility or Installation:

Contractor and all associated sub-contractors employees shall comply with adjudication standards and procedures using the National Crime Information Center Interstate Identification Index (NCIC-III) and Terrorist Screening

Database (TSDB) (Army Directive 2014-05/AR 190-13), applicable installation, facility and area commander installation/facility access and local security policies and procedures(provided by government representative), or, at

OCONUS locations, in accordance with status of forces agreements and other theater regulations.

6.4 iWATCH Training: This standard language is for contractor employees with an area of performance within an Army controlled installation, facility or area. The contractor and all associated sub-contractors shall brief all employees on the local iWATCH program (training standards provided by the requiring activity ATO). This local developed training will be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR. This training shall be completed within 30 calendar days of contract award and within 15 calendar days of new employees commencing performance with the results reported to the COR NLT

45 calendar days after contract award.

6.5 Army Training Certification Tracking System (ATCTS) registration for contractor employees who require access to government information systems. All contractor employees with access to a government info system must be registered in the ATCTS (Army Training Certification Tracking System) at commencement of services, and must successfully complete the DOD Information Assurance Awareness prior to access to the IS and then annually thereafter.

6.6 For contracts that require OPSEC Training. Per AR 530-1 Operations Security, the contractor employees must complete Level I OPSEC Awareness training. New employees must be trained within 30 calendar days of their reporting for duty and annually thereafter.

6.7 For Information Assurance (IA) / Information Technology (IT) training. All contractor employees and associated sub-contractor employees must complete the DoD IA awareness training before issuance of network access and annually thereafter. All contractor employees working IA/IT functions must comply with DoD and Army training requirements in DoD Directive 8570.01, DoD 8570.01-M and AR 25-2 within six months of appointment to

IA/IT functions.

6.8 For Contract Requiring Performance or Delivery in a Foreign Country, DFARS Clause 252.225-7043, Antiterrorism/Force Protection for Defense Contractors Outside the US. The clause shall be used in solicitations and contracts that require performance or delivery in a foreign country. This clause applies to both contingency and non-contingency support. The key AT requirement is for non-local national contractor personnel to comply with theater clearance requirements and allows the combatant commander to exercise oversight to ensure the contractor’s compliance with combatant commander and subordinate task force commander policies and directives.

7. PAYMENT.

7.1 Payment is processed upon receipt and acceptance of completed service report. Invoicing is processed via

Wide Area Work Flow (WAWF). The service report is not to be confused with the billing or invoice document.

7.2 The contractor shall provide a separate invoice for repair or service calls attributed to medical device failure and/or damage through misuse, theft, fire, Acts of God, or deterioration caused by chemicals that are not required for normal equipment operation. The cause listed above will be inspected and validated by the Chief or

NCOIC of Equipment Management Branch prior to a separate purchase order being issued.

8. ACRONYMS.

CLIN Contract Line Item Number

COR Contracting Officer Representative

DA Department of the Army

DMLSS Defense Medical Logistics Standard Support

FDA Food & Drug Administration

HIPAA Health Insurance Portability & Accountability Act of 1996

IAW In Accordance With

JC Joint Commission

KO Contracting Officer

MEDCOM Medical Command

MFR Manufacturer

NCOIC Noncommissioned Officer in Charge

OEM Original Equipment Manufacturer

OTSG Office of the Surgeon General, U.S. Army

PMCS Preventative Maintenance Checks and Services

POC Point of Contact

PWS Performance Work Statement

QASP Quality Assurance Surveillance Plan

SF Standard Form

SN Serial Number

TMDE Test, Measurement, & Diagnostic Equipment

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