LIH Optos Silverstone SOW (003).pdf

Department of Health and Human Services

Indian Health Service

Statement of Work (SOW)

Ultra-Widefield Retinal Camera with Swept-Source OCT System

1. PURPOSE OF THE PROJECT

The Indian Health Service (IHS), a federal agency within the Department of Health and Human Services, is responsible for providing federal health services to American Indians and Alaska Natives. The mission of IHS is to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level and assure that comprehensive, culturally acceptable personal and public health services are available and accessible to members of the 574 federally recognized Tribes across the United States.

The Lawton Service Unit is a Joint Commission accredited federal facility in Oklahoma. To meet our mission, Ultra-Widefield Retinal Camera with Swept-Source OCT System is a medical modality that has been deemed necessary to augment the services as such are necessary to support and supplement health care within the hospital. The mission of the Lawton Service Unit is to deliver quality care in order to attain positive health outcomes for all our valued patients with emphasis on cultural sensitivity and human dignity.

The Lawton Indian Hospital (LIH) has a requirement to maintain and have this equipment as is stated in the

Indian Health Manual Part 3 Chapter 9 Section 5.

2. DETAILED DESCRIPTION OF THE TECHNICAL REQUIREMENTS

2.1. The contractor shall provide:

2.1.1. Multiple imaging map modalities to include optomap, optomap af, optomap fa, optomap icg and swept source OCT scans

2.1.2. Map image - 200 degree single capture in less than .5 second

2.1.3. OCT light source - 1050nm

2.1.4. Laser wavelengths: Blue laser – 488 nm, Red laser – 635 nm, Green laser – 532 nm, and Infrared

– 802 nm.

2.1.5. Signal source wavelength - 1050nm

2.1.6. Scan depth up to 2.5 mm

2.1.7. A-scan rate up to 100k cycles per second

2.1.8. Line scan types - 6mm, 14 mm, and 23 mm

2.1.9. Must be VistA compliant and DICOM compatible to meet Federal Regulations Code

2.1.10. Wheelchair accessible table to fit camera footprint; 2-leg high-low

2.1.11. Browser based image review software

2.2. Date of manufacture must not be greater than 2 years before the purchase order date. The equipment must not be used or refurbished and must have the latest manufacturer’s software/hardware updates installed.

Any batteries provided with the unit will not be manufactured more than 12 months before the purchase order issue date.

2.3. The contractor shall provide service manuals that includes theory of operation, maintenance requirements, repair information, schematics, part lists and troubleshooting information in electronic format for use by the

Lawton Indian Hospital Biomedical Department.

3. PERIOD OF PERFORMANCE

12 months from date of award

4. LEVEL OF EFFORT

4.1. The contractor shall provide equipment with capabilities as outlined in section 2.

4.2. The contractor shall provide training on set up, operation, shut down, and troubleshooting procedure to

Optometry Staff. The contractor shall coordinate training dates with the on-site Project Manager. The contractor shall provide documentation and/or certification to each staff member that has successfully completed the training.

5. SPECIAL REQUIREMENTS

5.1. In accordance with HHSAR 304.1300(b) non-routine contractor employees shall comply with OPDIV

DHHS/SE Region – Human Resources, Security Clearance Guidance – Visitors (3/29/12) policy for contract performance period. Contractor employees will be required to obtain a visitor’s pass upon arrival for services from Facilities Management. - (Security Clearance for on-site human services)

5.2. The USPHS Lawton Service Unit is a tobacco/smoke free environment (buildings and grounds). No tobacco/smoking use will be tolerated during service.

5.3. Security Requirements: Contractor personnel will be required to contact the government designated point of contact upon arrival when reporting for service calls or delivery supplies. The contractor shall be responsible for the security of all organizational information. Current rules and regulations applicable to the premises, where the work shall be performed shall apply to the contractor and its employees while working on the premises. These regulations include but are not limited to, escort by Lawton Service Unit official, presenting valid identification, smoking restriction and any safety procedures.

5.4. The contractor shall not disclose or cause to disseminate any information concerning operations of Lawton

Service Unit. Such action(s) could result in violation of the contract and possible legal actions.

5.4.1. All inquiries, comments, or complaints arising from any matter observed, experienced or learned of as a result of or in connection with the performance of the contract, the resolution of which may require the dissemination of official information, shall be directed to the government’s designated representative.

6. DELIVERABLES AND REPORTING REQUIREMENTS

6.1. Delivery: The contractor will coordinate the delivery, installation and training date with the designated government employee. The contractor shall deliver to Lawton Indian Hospital at 1515 Lawrie Tatum Rd, Lawton OK 73507 with all installation instructions, warranty documents, and specifications. No deliveries can be made after 4:15pm. Driver needs a valid ID.

6.2. Contractor Point of Contact: The contractor shall furnish one designated point of contact (POC) to the government’s designated representative for coordination of supplies, delivery, and/or maintenance. The

POC will be empowered to make daily decisions to ensure that the contract implementation and day-to-day maintenance meets the terms and conditions of this contract.

6.3. Contractor’s Phone Numbers: The contractor shall provide a toll-free telephone number for service calls, which must be answered during at least eight working hours, between 8:00 am and 4:30 pm, Monday through Friday.

7. GOVERNMENT FURNISHED PROPERTY, FACILITIES AND SERVICES

7.1. The Government shall supply the facilities, supplies and the equipment of the Optometry Department and all hospital specialty/support staff. Use of government furnished facility space, equipment, supplies, and personnel are for the provision of services set forth in this contract only.

8. CONTRACTOR FURNISHED PROPERTY, FACILITIES AND SERVICES

8.1. Required personnel, materials, supplies and equipment: The contractor shall furnish all personnel, materials, supplies and equipment required to perform work under the contract.

9. CHANGES TO THE STATEMENT OF WORK (SOW)

9.1. Any changes to this SOW shall be authorized and approved only through written correspondence from the

Contracting Officer. Costs incurred by the contractor through the actions of parties other than the

Contracting Officer shall be borne by the contractor.

10. DELIVERABLES/PERFORMANCE MATRIX

Deliverable/Performance

Satisfied

Deliverable/Performance Item

☐ Optos Silverstone System

☐ VistA compliant and DICOM compatible

☐ Power Supply

☐ Wheelchair accessible table to fit camera footprint

☐ Dust Cover

☐ Installation

☐ Calibration (if required)

☐ On-Site Training

Services delivered and completed within time frame as set forth in contract Yes or No

Contractor was professional Yes or No

Item delivered meets specifications of this SOW Yes or No

Contractor provided a POC Yes or No

Department Supervisor Signature:_________________________

Department Director Signature:_________________________ Laura L. Alexander - S

Digitally signed by Laura L.

Alexander -S Date: 2025.01.29 18:09:25 -06'00'