PWS RADIATION PHYSICIST Wagner 2026.pdf

PERFORMANCE WORK STATEMENT

MEDICAL PHYSICIST RADIOLOGICAL SERVICES

WAGNER SERVICE UNIT

I. STATEMENT OF PURPOSE

This is a non-personal services contract to provide medical physics services for the Wagner IHS Health Center. The

Government shall not exercise any supervision or control over the contract service providers performing the services herein. Such contract service providers shall be accountable solely to the Contractor who, in turn is responsible to the

Government.

II. Place of Performance:

Wagner IHS Health Center

111 Washington AVE NW

Wagner, South Dakota 57380

III. Period of Performance: June 15, 2026, to May 31, 2027.

IV. Hours of Operation:

All work shall be performed during business hours of 8:00 am to 5:00 PM. If a service has begun during regular business hours and it must be completed before any patients can be imaged according to the American College of

Radiology (ACR), The Accreditation Association for Ambulatory Health Care (AAAHC), or the Mammography

Quality Standards Act (MQSA), then the physicist must complete the service.

V. Type of Contract:

The government will award a Firm Fixed Price One Year Contract.

VI. SCOPE OF WORK

A. The contractor shall conduct the “Optimizing Patient Dose” and “Staff Exposures” activities listed in Table 2, including but not limited to:

1) Review, recommend improvements, provide examples if needed, and evaluate compliance with each radiology program’s policies, procedures, and protocols to ensure the program has policies in place consistent with their scope of work that are sufficient to protect staff and patients and minimize patient dose and are reviewed annually. Policies on the following minimum topics should be in place and implemented:

a) Imaging referral justification and verification

b) Pre-procedure screening and patient condition assessment

c) Safe use of sedation and anesthesia (if in use)

d) Staff qualifications

e) Continuing education (radiology staff, and medical providers)

f) Equipment maintenance process and documentation

g) Personnel monitoring and means to prevent/reduce exposure

h) Appropriateness and ALARA in imaging; Decision Support Systems (if in use)

i) Patient dose estimation, documentation, and reporting

j) Protection of pregnant patients and workers; fetal protection and dose calculation

k) Equipment Performance Monitoring

l) Protective equipment inspection

m) Quality Assurance/ Performance improvement

n) Patient rights, education, and consent; and medical over-ride

o) Annual imaging program evaluation

p) Management of imaging records

q) Equipment planning

r) Infection control (including housekeeping, standard and Transmission-based precautions)

s) Chemical hygiene and hazardous material/waste handling

t) Radiation Safety Officer appointment and scope of responsibilities

u) Patient incident and over-exposure reporting and analysis.

2) Contactor shall provide consultation to assure an optimized balance between image quality and patient dose by ensuring the optimum technique factors are utilized by the facility

3) Contractor shall evaluate patient dose/Entrance Skin Exposure with comparison to FDA NEXT or equivalent diagnostic reference levels via patient dose estimates using appropriate phantoms.

4) Verify optimization process (whether they have a Clinical Decision Support mechanism/software in place, and if so, how well it was being implemented to limit patient dose) and dose documentation in the medical records while conducting the Appropriateness Criteria Audit (Section A above).

B. Contractor shall conduct “Device Performance” and “Quality Control Measures” activities listed in table 2 and according to AAPM Report 74 (http://www.aapm.org/pubs/reports/rpt_74.PDF) and consistent with the below cited references and will assist in establishing a facility radiology quality assurance program. Table 3 lists the equipment by location.

C. The contractor will provide details to the local site contact on any equipment that is not in proper working condition, or any environmental condition negatively impacting patient safety/privacy or program operations.

The local site contact will follow up on necessary service calls or maintenance under a separate purchase order through proper acquisition channels. It is not expected that the contractor bidding will provide any maintenance services, just recommendations for repair or servicing.

D. The contractor will provide acceptance testing for new x-ray devices installed during the contract period when directed by a properly executed supplement agreement/change order.

E. The contractor shall include additional equipment and Radiation Shielding Surveys under this contract when directed by a properly executed supplement agreement/change order.

F. The contractor shall consult with the Lead X-Ray Technologist concerning patient and fetal dose determinations under this contract when needed. This will be charged at the contracted hourly rate.

VII. BID SCHEDULE

Wagner Service Unit

PHS Indian Health Service

Conduct the “Optimizing Patient

Dose” and “Staff Exposures” activities per scope of work

Annually

Wagner

Clinic

Medical Above Table X-ray (1qty)

Dental Operatory X-ray (3 qty ) and Panorex (1qty)

Due

Due http://www.aapm.org/pubs/reports/rpt_74.PDF

Conduct “Device Performance” and

“Quality Control Measures” activities per scope of work

Annually

Note: Dental units only require performance survey every four years, so inspection for dental operatories will be done in the base year only.

Report writing Annually

Travel to this site Annually

VIII. BID SUBMITTAL: Bidders are responsible to familiarize themselves with the location of the facilities, kinds and types of equipment required to be inspected, condition of equipment, road conditions, and with any difficulties which could arise in the performance of required services. Bidders should contact: David Stimpson RT(R)ARRT regarding technical interpretation, scope, documentation or intent of services required.

IX. SPECIFICATIONS

A. Medical Physicist Certification Requirements: The Services shall be performed by a certified qualified medical physicist meeting the American Association of Physicists in Medicine (AAPM) definition. AAPM defines a qualified medical physicist as, “an individual with the following credentials:

1. Has earned a master's or doctoral degree in physics, medical physics, biophysics, radiological physics, medical health physics, or equivalent disciplines from an accredited college or university; and

2. Has been granted certification in the specific subfield(s) of medical physics with its associated medical health physics aspects by an appropriate national certifying body and abides by the certifying body's requirements for continuing education. (AAPM, 2012)

a. These certification requirements are consistent with the national practice guidelines referenced in

Table 1. Medical physicist performance monitoring reports shall include verification of professional certification. For the subfield of Diagnostic Medical Physics, AAPM recommends certification by the American Board of Radiology; or the American Board of Medical Physics; or the Canadian

College of Physicists in Medicine. (AAPM, 2012).

B. Radiation Safety Surveys - Performance Monitoring and Testing of Medical and Dental Imaging Equipment:

Services to meet the most recent nationally recognized standards of practice regarding x-ray equipment performance monitoring and testing according to the American College of Radiology (ACR) and the National

Council on Radiation Protection and Measurement (NCRP) Technical Standards. Contractor shall provide all supplies, kits, test equipment, tools and parts required to perform monitoring and testing services. All required services as noted below will be conducted.

1. Radiation Safety Surveys will be conducted according to ACR and NCRP standards and equipment manufacturers’ recommendations.

2. Performance Monitoring Tests and Services will be conducted according to the schedule noted in the table below, verify that new equipment meets manufacturer specifications and regulatory requirements, as well as identify any corrective maintenance or modifications to process or procedures that need to be addressed.

3. Contractor shall schedule visits with each site’s Lead Radiologist or X-Ray Technologist for medical x-rays and Dental Chief for dental x-ray tubes at least two weeks in advance of the proposed site visit.

4. With thorough testing and measurements, contractor shall verify that any new radiology equipment meets manufacturer specifications and regulatory requirements, as well as identify any problem areas that need to be addressed.

Table 1 – Medical Physicist Performance Monitoring Services

Modality Reference Physicist Services

Radiology – CT

American College of Radiology

(ACR) Technical Standard for

Diagnostic Medical Physics

Performance Monitoring of

Computed Tomography (CT)

Equipment (ACR, 2012)

-Acceptance testing upon installation and before clinic use.

-Annual device performance monitoring.

-Performance check after replacement or repair of major components.

-Annual assessment of patient radiology dose. Review and, when necessary, recommend improvements to radiology program’s policies, procedures, and protocols to minimize patient dose.

-Assist in establishing a facility quality radiology assurance program.

Radiology -above table, portable x-ray

ACR-AAPM Technical Standard

For Diagnostic Medical Physics

Performance Monitoring Of

Radiographic Equipment, 2016.

-Acceptance testing upon installation and before clinic use.

-Annual device performance monitoring.

-Performance check after replacement or repair of major components.

-Annual assessment of patient dose.

-Review and, when necessary, recommend improvements to radiology program’s policies, procedures, and protocols to minimize patient dose.

-Establish and monitor performance of a facility quality assurance program.

Fluoroscopy – under-table, and

C-Arm

ACR-AAPM Technical Standard

For Diagnostic Medical Physics

Performance Monitoring Of

Fluoroscopic Equipment, 2016.

-Acceptance testing upon installation and before clinic use.

-Annual device performance monitoring.

-Performance check after replacement or repair of major components.

-Annual assessment of patient dose.

-Review and, when necessary, recommend improvements to radiology program’s policies, procedures, and protocols to minimize patient dose.

-Establish and monitor performance of a facility quality assurance program.

Mammography

Mammography Quality Standards

Act (MQSA) Regulations – 21

CFR Part 900 – Mammography

(FDA, 2009)

-Food and Drug Administration

(FDA) Guidance for

Mammography Facility Surveys, Mammography Equipment

Evaluations, and Medical Physicist

Qualification Requirements under

MQSA (FDA, 2005)

-Acceptance testing upon installation and before clinic use.

-Annual device performance monitoring which includes a summary of the evaluation of the facility quality control testing with any recommendations for necessary improvements and/or corrective actions, as needed.

-Performance check after replacement or repair of major components (including image processors).

Dental (includes portable, hand-held, and panoramic devices)

NCRP Report Number 145:

Radiation Protection in Dentistry

(NCRP, 2003)

-All new dental x-ray installations and existing installations not previously surveyed shall have a radiation protection survey.

-Resurveys shall be performed; resurvey interval should not exceed 4 years.

-A resurvey shall be made after any change in the installation, workload, or operating conditions that might significantly increase occupational or public exposure (including x-ray machine service or repair that could affect the x-ray machine output or performance).

Table 2 – Standard Physicist Performance Monitoring Tests

Standard Physicist

Performance

Monitoring

Medical Fluoroscopy Dental Mammography CT

Optimizing Patient Dose

Policies are in place and followed regarding protection of pregnant patients, credentialing and competencies verification of operators, who can prescribe, apron testing and frequency, etc.

X X X X As recommended by the ACR

2012 Computed

Tomography

Quality Control

Manual Tests include:

A. Review of

Clinical

Protocols

B. Image

Uniformity

C. Scout

Prescription and Alignment

Light Accuracy

C. Image

Thickness –

Axial Mode

D. Table Travel

Accuracy

E. Radiation

Beam Width

F. High/Low-

Contrast Performance

G. Spatial

Resolution

H. CT Number

Accuracy

I. Artifact

Evaluation

J. CT Number

Uniformity K. Dosimetry

L. Gray Level

Performance of

CT Acquisition

Display

Monitors

Appropriateness of technique factors X X X X

Patient Dose/Entrance

Skin Exposure

Evaluation with comparison to FDA

NEXT or equivalent reference value via

CDRH phantoms –

Provide recommendations for reducing exposure if beyond expected 3rd quartile.

Adult Chest, Abdomen, & Spine

Maximum exposure rate

Intraoral

Adult

Bitewing

MQSA required medical physicist tests for certification.

21 CFR 900.12(e)(9)

- Surveys

Fluoroscopic entrance exposure rates.

X

Patient dose monitoring system calibration

X

Review or establishing technique charts X X X

Recommended fastest screen-film system available, as needed

X X

Performance

Monitoring

Medical Fluoroscopy Dental Mammography CT

Staff Exposures

Policies are in place and followed regarding protection of staff, including pregnant staff, personnel monitoring, etc.

X X X X X

Appropriately donning radiation dosimeters, providing summary reports to staff, and maintaining exposure records

X X X X X

Device Performance

Integrity of unit assembly.

X X X MQSA required medical physicist tests for certification.

21 CFR 900.12(e)(9)

- Surveys

As recommended by the ACR 2012

Computed

Tomography Quality Control

Manual Tests include:

A. Review of Clinical Protocols

B. Scout

Prescription and

Alignment Light Accuracy

C. Image Thickness –

Axial Mode

D. Table Travel

Accuracy E. Radiation

Beam Width

F. Low-Contrast Performance

G. Spatial

Resolution H. CT Number

Accuracy

I. Artifact Evaluation

J. CT Number

Uniformity K. Dosimetry

L. Gray Level

Performance of

CT Acquisition

Display Monitors

Automatic exposure control system performance

X X kVp accuracy and reproducibility X X X

Linearity of exposure versus mA or mAs X X

Exposure reproducibility X X

Timer accuracy X X

Beam quality assessment (half-value layer)

X X X

Equipment radiation safety functions.

X X X

Digital image receptor performance If Digital X If Digital MQSA required medical physicist tests for certification.

21 CFR 900.12(e)(9)

- Surveys

Tube Head Stability X

Collimation Acceptance

Test (AT)

X AT

Center and Bucky

Alignment

AT

Source to Imaging

Receptor Distance

AT AT

Other performance tests recommended by the manufacturer or physicist

AT AT AT MQSA required medical physicist tests for certification.

21 CFR

900.12(e)(10) –

Mammography

Equipment

Evaluations

Performance

Monitoring

Medical Fluoroscopy Dental Mammography CT

Verification of preventive maintenance of devices.

X X X X

Fluoroscopic system resolution

X

Fluoroscopic automatic brightness control performance (high-dose-rate, pulsed modes, field-of-view [FOV] variation

X

Fluoroscopic phantom image quality

X

Quality Control Review

Repeat analysis X X X

See Above

Artifact Review X X X

Diagnostic Workstation

- View boxes, image monitors, and viewing conditions

X X X X

Darkroom and screen cleanliness, darkroom fog, analysis of fixer retention, screen-film contact analysis

If

Film/Screen

Processing

If

Film/Screen

Processing

If Film/Screen

Processing

Processor quality control (time, temperature, chemical, reference film for daily comparisons and manufacturer recommendations as needed.

If

Film/Screen

If

Film/Screen

If Film/Screen

Processing

Computed Radiography and Digital

Radiography (CR&DR) system performance –

Uniformity. noise, contrast/sharpness, erasure

If CR&DR If CR&DR If CR&DR

Video and digital monitor performance

X

Laser film printer quality control As needed. As needed. As needed. As needed.

Exposure Indicator

Analysis If CR&DR If CR&DR If CR&DR

Integrity Test of

Protective Clothing and other devices

X X X X

Quality assurance log with record of observable quality variance and corrective action taken.

X X X X

Table 3 – Equipment list by location

5. Completion of Service and Documentation: On completion of all performance monitoring and testing services, the contractor’s representative shall brief the locations Lead X-Ray Technologist for medical x-rays and Dental Chief for dental x-ray tubes and provide documentation of all services that were performed; in addition a copy of the report is to be provided to the Chief Medical Officer and the Division of Environmental

Health Services (DEHS) Director of the Great Plains Area Office. The documentation shall be a prepared form that provides at a minimum the following information:

A. Documents of the services performed for each item or system.

B. Results on Appropriateness Use Criteria audit:

1. Facility risk profile/stratification

2. Decision support system name/process type if available,

3. Exam prioritization selection,

4. Data sources available and reviewed,

5. Number of exams/data evaluated,

6. Number of exams lacking data needed for review,

7. Number of exams consistent, inconsistent, and undefined with appropriateness criteria,

8. Notable findings or facility comments,

9. Potential trends or areas for further facility QAPI/Medical Committee review,

10. Exams for which dose is/not reported, comparison of reported doses to diagnostic reference levels C. Shall be in an easily readable format.

D. Shall be of ink or print type that can be photocopied on a standard copy machine.

E. Documentation shall include:

1. Facility Location

2. Names of key staff contacted, interviewed, and/or briefed while on site

3. Equipment Model Number

4. Equipment Manufacturer’s Serial Number

5. Location of Equipment

6. Date of Service

7. Type of service performed

8. Identification of methods and instrumentation and supplies used

9. Results of any tests or inspections performed

a. Automatic Exposure Level Standards based on latest Conference of

Radiation Control Program Directors (CRCPD).

10. Provide for a check off or sign off to indicate “unit fully operational as specified by original manufacturer”.

11. If deficiencies in equipment or operation are found, corrective action plan is provided to

Radiation Program Manager at each Service Unit and to the Director, DEHS.

12. Method of identifying Contractor’s service personnel

13. Block for local IHS Personnel to sign and date when service is complete.

6. Manner and Time of Conducting Work:

A. Contact the Service Unit Radiology Program Manager or facility CEO 30 days prior to service date for a brief consult and review of site conditions.

B. Contractor shall schedule visits with the site’s Lead Radiologist or X-ray technologist for medical x-rays and Dental Chief for dental x-ray at least two weeks in advance of the proposed site visit.

C. Upon arrival at and before departing from the facility, the contractor’s representative shall physically check in with the location’s Lead X-Ray Technologist for medical x-rays and Dental Chief for dental x-ray tubes.

D. All work shall be performed during the Normal Work Hours of Monday through Friday, except for

Federal Holidays, 8:00A.M. Through 4:30 P.M. Hours can differ if the facility is open for business

24/7 or if mutually agreed between the facility and contractor representative for the benefit of the surveyor.

7. Quality Assurance: The government procedures to verify that services being performed by Contractor are performed according to acceptable standards.

Quality Assurance Surveillance Plan (QASP): An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

Quality Control: All necessary measures taken by the Contractor to ensure that the quality of and end

Product or service shall meet contract requirements.

8. Invoice Submission:

HHSAR 352.232-71 Electronic Submission of Invoice Payment Requests (Feb 2022)

Definitions. As used in this clause – Payment request means a bill, voucher, invoice or request for contract financing payment with associated supporting documentation. The payment request must comply with the requirement identified in FAR 32.905(b), “Content Of Invoices” and the applicable payment clause included in this contract.

Except as provided in paragraph (c) of this clause, the Contractor shall submit payment requests electronically using the Department of Treasury Invoice Processing Platform (IPP) or successor system.

Information regarding IPP, including IPP Customer Support contact information, is available at www.ipp.gov or any successor site.

The Contractor may submit payment requests using other than IPP only when the Contracting Officer authorizes alternate procedures in writing in accordance with HHS procedures.

If alternate payment procedures are authorized, the Contractor shall include a copy of the Contracting

Officer’s written authorization with each payment request.

(END OF CLAUSE)

“Unless otherwise agreed to by the Contracting Officer per HHSAR 352.232-71 (c), the use of IPP shall take precedence over previously established invoice procedures.”

In compliance with the Office of Management and Budget (OMB) M-15-19 memorandum “Improving

Government Efficiency and Saving Taxpayer Dollars Through Electronic Invoicing” directing Federal agencies to adopt electronic invoicing as the primary means to disburse payment to vendors. Invoices submitted under any award resulting from this solicitation will be required to utilize the Invoice

Processing Platform (IPP) in accordance with HHSAR 352.232-71, Electronic Submission and Processing of Payment Requests.

IPP is a secure, web-based electronic invoicing system provided by the U.S. Department of the Treasury’s

Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St. Louis (FRSTL). If your organization is already registered to use IPP, you will not be required to re-register – however, we encourage you make sure your organization, and designated IPP user accounts are valid and up to date.

The IPP website address is:

https://ww.ipp.gov

If you require assistance registering or IPP account access, please contact the IPP Helpdesk at (866) 973-

3131 (M-F 8AM to 6PM ET), or IPPCustomerSupport@fiscal.treasury.gov http://www.ipp.gov/ https://ww.ipp.gov/ mailto:IPPCustomerSupport@fiscal.treasury.gov

Contracting Officer’s Representative Designation

The designated COR for this contract is:

Dwight Josh Janis COR Level 1

Wagner Health Care Facility

111 Washington Ave. NW

Wagner, SD 57380

Direct phone: (605) 384 4809

Email: Dwight.Janis@ihs.gov

The COR is responsible for:

Monitoring the Contractor’s technical progress;

Interpreting the performance work statement;

Technical evaluation as required;

Technical inspections and acceptance required by this contract; and

Assisting the Contractor in the resolution of technical problems encountered during performance of this contract.

Subject matter expert for this contract is:

Dave Stimpson, Radiology Technician

Wagner IHS Health Center

111 Washington AVE NW

Wagner, South Dakota 57380

Office: 605.384.4835 Email: Dave.Stimpson@ihs.gov

The following are brief descriptions of required documents that must be submitted by Contractor: upon award;

weekly; monthly; quarterly; annually, etc. identified throughout the PWS and are provided here as a guide for

Contractor convenience. If an item is within the PWS and not listed here, the Contractor remains responsible for the delivery of the item.

7. Authority

No person other than the Contracting Officer has authority to bind the Government with respect to this contract.

No action or omission of any government employee or representative other than the Contracting

Officer shall increase or decrease the scope of this contract or shall otherwise modify the terms and conditions of this contract.

In no event shall any of the following be effective or binding on the Government or imputed to the Contracting Officer with respect to this contract:

An understanding or agreement between the Contractor and anyone other than the

Contracting Officer;

A purported modification or change order issued by anyone other than the Contracting

Officer;

A promise by anyone other than the Contracting Officer to provide additional funding or making payments; or

An order, direction, consent, or permission from anyone other than the Contracting Officer to:

Incur costs in excess of a specified estimated cost, allotment of funds, or other mailto:Dwight.Janis@ihs.gov mailto:Dave.Stimpson@ihs.gov ceiling; or

Expend hours in excess of a specified level of effort.

References

• ACR–SPR Practice Parameter for General Radiography Res. 30 – 2013, Amended 2014 https://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/General_Radiography.pdf

• American College of Radiology Appropriateness’ Criteria and Diagnostic Radiology Guidelines https://acsearch.acr.org/list)

• Protecting Access to Medicare Act, 2014

• CY 2017 Physician Fee Schedule (PFS) Final Rule https://www.gpo.gov/fdsys/pkg/FR-2016-11-15/pdf/2016-26668.pdf

• Scope of Practice of Clinical Medical Physics https://www.aapm.org/org/policies/details.asp?id=317&type=PP

• Quality Control in Diagnostic Radiology AAPM Report 74 (http://www.aapm.org/pubs/reports/rpt_74.PDF

• FDA, Mammography Quality Standards Act Regulations (MQSA). 21 CFR §900.

http://www.fda.gov/Radiation-

EmittingProducts/MammographyQualityStandardsActandProgram/Regulations/ucm110906.htm

• NCRP, Report Number 145 - Radiation Protection in Dentistry, October 2004.

• ADA/FDA, The Selection of Patients for Dental Radiographic Examinations, November 28, 2012.

http://www.fda.gov/Radiation-EmittingProducts/default.htm

• ACR–AAPM–SIIM Technical Standard for Electronic Practice of Medical Imaging, 2012

• ACR Technical Standard for Diagnostic Medical Physics Performance Monitoring Of Computed Tomography

Equipment. 2007

• ACR-AAPM Technical Standard for Diagnostic Medical Physics Performance Monitoring Of Radiographic

Equipment, 2016.

• ACR-AAPM Technical Standard for Diagnostic Medical Physics Performance Monitoring Of Fluoroscopic

Equipment, 2016.

• ACR Practice Guideline for Diagnostic Reference Levels in Medical X-Ray Imaging, (2009).

• Indian Health Manual – Part 3 Chapter 21 – Diagnostic Imaging (Revised October 30, 2017) https://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/General_Radiography.pdf https://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/General_Radiography.pdf https://acsearch.acr.org/list https://www.gpo.gov/fdsys/pkg/FR-2016-11-15/pdf/2016-26668.pdf https://www.aapm.org/org/policies/details.asp?id=317&type=PP http://www.aapm.org/pubs/reports/rpt_74.PDF http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/Regulations/ucm110906.htm http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/Regulations/ucm110906.htm http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/Regulations/ucm110906.htm http://www.fda.gov/Radiation-EmittingProducts/default.htm