Performance Work Statement (PWS)_23 October 2020_Final.pdf

W81K00-21-R-3002

PERFORMANCE WORK STATEMENT (PWS)

23 October 2020

THERAPEUTIC MEDICAL PHYSICS CONTRACT

(Non-Personal Services)

Part 1

GENERAL INFORMATION

1. GENERAL: Non-personal services contract. 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. The contractor shall provide Radiation Oncology specific therapeutic medical physics and support services to include Therapeutic Medical Physics, Certified Medical Dosimetry, and Radiation Therapy Technology.

1.1 Description of Services/Introduction: The Contractor shall establish, staff, operate, manage, and maintain a Therapeutic Medical Physics Team to support BAMC's Radiation Oncology program with specific therapeutic medical physics and support services to include Therapeutic Medical Physics, Certified Medical Dosimetry, Radiation Simulation Therapy, and Radiation Therapy Technology. This turnkey contract for comprehensive Therapeutic Medical Physics Support includes services equivalent to three (3) full-time equivalent (FTE) Radiation Oncology specific Therapeutic Medical Physicists (MP), two (2) FTE Radiation Oncology specific Certified Medical Dosimetrists (CMD), one (1) FTE Radiation Oncology specific Radiation Therapy Technologist (RTT) with expertise in radiation oncology simulation, and four (4) FTE Radiation Oncology specific Radiation Therapy Technologists (RTT) as defined in the Performance Work Statement except for those specified as government furnished property and services. The Contractor shall fully perform to the standards in this contract in a comprehensive manner.

1.2 Background: Therapeutic Medical Physics contract will provide a fully staffed, comprehensive, full-time on-site support team for medical physics, medical dosimetry, daily treatment and simulation in the Radiation Oncology clinic at Brooke Army Medical Center, JBSA-Fort Sam Houston, Texas.

1.3 Objectives: To provide radiation oncology specific therapeutic medical physics support services to include radiation oncology specific therapeutic medical physicists, certified medical dosimetrists, radiation therapy technologist with expertise in radiation oncology simulation, and radiation oncology specific radiation therapy technologists for Brooke Army Medical Center, JBSA-Fort Sam Houston, Texas. Supporting BAMC’s mission in providing high quality treatment planning, high quality dosimetry, and high quality treatments to active duty soldiers, military retirees, and their dependents.

1.4 Scope: The Contractor shall provide a turnkey Therapeutic Medical Physics Team capable of operation in support of all clinical and research aspects of the therapeutic radiation oncology clinic at Brooke Army Medical Center, JBSA-Fort Sam Houston, Texas. This support will include the services equivalent to FTE’s outlined in 1.1.

The lead therapeutic medical physicist will act as the on-site program manager, or supervisor, and will oversee the overall team under this contract. Health Care Workers (HCW) of the Contractor shall have proficiency within the scope of their employed position for the following treatment modalities: interstitial and intracavitary high dose rate (HDR) brachytherapy, interstitial and intracavitary low dose rate (LDR) brachytherapy, image-guided radiation therapy (IGRT), intensity-modulated radiation therapy (IMRT), volumetric-modulated radiation therapy (VMAT), stereotactic radiosurgery (SRS), three-dimensional conformal radiation therapy (3DCRT), electron therapy, surface-guided radiation therapy (SGRT) and stereotactic body radiotherapy (SBRT). Services shall be provided as required by this performance work statement (PWS) and in accordance with the terms and conditions of this PWS and any resulting contract.

1.5 Period of Performance: The period of performance shall be for one (1) Base Period of 12 months and four

(4) 12-month option periods.

1.6 General Information

1.6.1 Quality Control (QC): The Contractor shall develop and maintain an effective quality control program (QCP) to ensure services are performed in accordance with this PWS. The Contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The Contractor’s quality control program provides assurance that work complies with the requirements of the contract. QCP is to be furnished within 30 days after contract award. A comprehensive written QCP shall be submitted to the Contracting Officer (KO) and Contracting Officer Representative (COR) within 5 working days when changes are made thereafter. After acceptance of the QCP the Contractor shall receive the contracting officer’s acceptance in writing of any proposed change to his QC system.

1.6.2 Quality Assurance: The Government will evaluate the Contractor’s performance in accordance with (IAW) a separate Quality Assurance Surveillance Plan (QASP). This Government-only plan is primarily focused on what the Government will do to ensure that the Contractor has performed IAW contract performance standards. The QASP provides a systematic method to evaluate performance to include how the performance standards will be applied, the frequency of surveillance, and the acceptable quality levels for each of the metrics identified in Exhibit 1, Performance Requirements Summary. The QASP is created with the premise that the Contractor is responsible for management and quality control actions to meet the terms of the PWS while the Government is responsible for quality assurance actions.

1.6.3 Recognized Holidays: Contract HCWs will be required to work on federally recognized holidays. Due to the nature of the mission, it may be necessary for contracted HCW(s) to work on any day of the week to include Federal holidays.

New Year’s Day Labor Day Martin Luther King Jr.’s Birthday Columbus Day President’s Day Veteran’s Day Memorial Day Thanksgiving Day Independence Day Christmas Day

1.6.4 Hours of Operation: The Chief, Radiation Oncology shall establish the routine hours of the Radiation Oncology Clinic. Services may be scheduled between 6:00 am and 6:00 pm Monday through Friday, excluding legal federal holidays, depending on patient treatment schedules. Machine warmup procedures will be dictated by patient schedule and can be as early as 5:00 am. Normal routine clinic hours are 7:00 a.m. to 4:00 p.m., Monday through Friday. The contractor is responsible to ensure adequate staffing during operating hours. The total regular duty hours worked shall not exceed 40 hours per week. Duty hours include a one-hour lunch period, which is not paid by the government. Additionally, an on-call schedule will be maintained and staffed for any possible after-hours emergencies. The on-call schedule will be shared with the Chief of Radiation Oncology at least 30 days in advance.

Any changes to this schedule will be immediately submitted to the Chief of Radiation Oncology. Additional overtime pay will not be paid by the government for hour accrued by any member of the Therapeutic Physics Contract Team.

1.6.5 Place of Performance: The work to be performed under this contract will be performed at Brooke Army Medical Center, Radiation Oncology Department, JBSA-Fort Sam Houston, Texas.

1.6.6 Recording Health Care Worker (HCW) Time: The Contract HCW shall be rested and fully physically and mentally capable of performing the duties required under this contract. Each time that services are performed during normal workdays and for scheduled on-call services, the Contractor shall sign-in the time of commencement/termination of services on a timesheet maintained in the location where services are performed.

The department chief will determine the location of this timesheet. These attendance logs are for the sole use of government officials and will not be provided to the Contractor for any reason and/or purpose. The government observes 10 federal holidays per year. Time off is not compensated for any additional declared federal holidays and that holiday is worked.

1.6.7 Closures: During a planned closure of the facility due to training, holiday or unplanned closure due to unusual and compelling circumstances (e.g., natural disasters, military emergencies, severe weather), the

Therapeutic Medical Physics Contractor Team will be required to report in accordance with mission essential / inclement weather procedures announced for each individual circumstance.

1.6.8 Mission Essential: All personnel under this contract are mission essential and inclement weather essential employees. Under mission essential and inclement weather conditions, the HCW will be required to continue the mission of the Radiation Oncology clinic unless properly released by an authorized government supervisor. The HCW may not exceed 40 hours per work week at any time, including during mission essential and inclement weather conditions. No overtime is permitted under this contract.

1.6.9 Periodic Progress Meetings: Contractor will be required to attend periodic progress meetings at no additional cost to the Government. The terms at which the periodic meeting will be conducted include: At least quarterly and within 10 business days of notification.

1.6.10 Security Requirements: HCWs under this contract have access to and/or process information requiring protection under the Privacy Act of 1974, these positions are considered “IT Sensitive” positions. Compliance with Executive Order (EO) 10450, DOD Directive 5200.28, DOD 5200.2-R, AFI 33-119, AR 25-2 and AR 380-67 is mandatory for IT Sensitive positions. Therefore, a National Agency Check for Trustworthiness (NACT) is required for each HCW under this contract. Each individual will be fingerprinted and required to complete the appropriate forms, usually a Standard Form 85-P, Questionnaire for Public Trust Positions. The HCW is responsible for obtaining the Standard Form 85-P, Questionnaire for Public Trust Position, which is available at http://www.dss.mil/epsq/index.htm. The HCW shall advise their employees that a favorable report is required as a condition of employment under this contract. The HCW shall apply for the NACT within three (3) workdays after start of performance. The government will be responsible for all costs associated with the NACT. Offerors shall be advised adjudication constraints may prevent non-U.S. Citizens from performing in a timely manner. No waivers will be contemplated.

1.6.10.1 Physical Security: The Contractor shall be responsible for safeguarding all government facilities, equipment, information, materials, and property provided for Contractor use at the close of each work period. In case of the loss of any government equipment, information, or property the Contractor shall be counselled and may be reported to the Contracting Officer to request reimbursement from the Contractor.

1.6.10.2 Key Control: The Contractor shall establish and implement methods of making sure all keys/key cards issued to the Contractor by the Government are not lost or misplaced and are not used by unauthorized persons.

NOTE: All references to keys include key cards. No keys issued to the Contractor by the Government shall be duplicated. The Contractor shall develop procedures covering key control that shall be included in the QCP. Such procedures shall include turn-in of any issued keys by personnel who no longer require access to locked areas. The Contractor shall immediately report any occurrences of lost or duplicate keys to the Contracting Officer Representative (COR) and the Contracting Officer.

1.6.10.2.1. In the event keys, other than master keys, are lost or duplicated, the Contractor shall, upon direction of the Contracting Officer, re-key or replace the affected lock or locks; however, the Government, at its option, may replace the affected lock or locks or perform re-keying. When the replacement of locks or re-keying is performed by the Government, the total cost of re-keying or the replacement of the lock or locks shall be deducted from the monthly payment due the Contractor. In the event a master key is lost or duplicated, all locks and keys for that system shall be replaced by the Government and the total cost deducted from the monthly payment due the Contractor.

1.6.10.2.2. The Contractor shall prohibit the use of Government issued keys by any persons other than the Contractor’s employees. The Contractor shall prohibit the opening of locked areas by Contractor employees to permit entrance of persons other than Contractor employees engaged in the performance of assigned work in those areas, or personnel authorized entrance by the Contracting Officer.

1.6.11 Post Award Conference/Periodic Progress Meetings: The Contractor agrees to attend any post award conference convened by the contracting activity or contract administration office in accordance with Federal Acquisition Regulation Subpart 42.5. The Contracting Officer, COR, and other Government personnel, as appropriate, may meet periodically with the Contractor to review the Contractor's performance. At these meetings the Contracting Officer will apprise the Contractor of how the government views the Contractor's performance and the Contractor will apprise the Government of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues. These meetings shall be at no additional cost to the government.

1.6.12 Contracting Officer Representative (COR): The COR will be identified by separate letter. The COR monitors all technical aspects of the contract and assists in contract administration. The COR is authorized to perform the following functions: assure that the Contractor performs the technical requirements of the contract;

assure that the Contractor performs inspections necessary in connection with contract performance; maintain written and oral communications with the Contractor concerning technical aspects of the contract; issue written interpretations of technical requirements, including Government drawings, designs, specifications; monitor Contractor's performance and notifies both the Contracting Officer and Contractor of any deficiencies; and, coordinate availability of government furnished property and provide site entry of Contractor personnel. A letter of designation issued to the COR, a copy of which is sent to the Contractor, states the responsibilities and limitations of the COR, especially with regard to changes in cost or price, estimates or changes in delivery dates. The COR is not authorized to change any of the terms and conditions of the contract.

1.6.13 Key Personnel: The Contractor shall assign a contract manager who shall be responsible for the performance of the work. The name of this person and an alternate who shall act on behalf of the vendor when the manager is absent shall be designated in writing to the contracting officer within 15 days after award. The contract manager or alternate shall have full authority to act for the Contractor on all contract matters relating to daily operation of this contract. The contract manager or alternate shall be available between 7:30 a.m. to 4:30 p.m., Monday thru Friday, except Federal holidays or when the government facility is closed for administrative reasons.

1.6.14 Identification of Contractor Employees: All contract personnel attending meetings, answering Government telephones, and working in other situations where their Contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression in the minds of members of the public that they are Government officials. They must also ensure that all documents or reports produced by Contractors are suitably marked as Contractor products or that Contractor participation is appropriately disclosed. Indicate if Contractor personnel will be required to obtain and wear badges in the performance of this service.

1.6.15 Contractor Travel/Training: The government may elect to provide unique government training to the Contractor who is performing services under this contract. If the government elects to provide such training, the government will provide such training at no additional expense to the Contractor. When directed by the contracting officer, Contractor shall attend all such training in a paid status as part of the normal services required and billed under the contract. If determined by the contracting officer, such training may require a performance commitment by the Contractor to reimburse the government (by means of a reduction in an invoice) if a Contractor fails to satisfy the performance commitment after the Contractor receives the unique government training. The amount of the reimbursement shall be the prorated cost of the training, calculated based on the total cost of the training and the number of months by which the Contractor fails to complete the performance commitment. The length of the performance commitment shall be 12 months or until the end of all performance under this contract, whichever occurs first.

1.6.16 Other Direct Costs: The Government will NOT pay the Contractor to relocate HCWs. This category includes travel, reproduction, and shipping expenses associated with training activities and visits to Contractor facilities. It could also entail the renting of suitable training venues.

1.6.17 Data Rights: The Government has unlimited rights to all documents/material produced under this contract.

All documents and materials, to include the source codes of any software, produced under this contract shall be Government owned and are the property of the Government with all rights and privileges of ownership/copyright belonging exclusively to the Government. These documents and materials may not be used or sold by the Contractor without written permission from the Contracting Officer. All materials supplied to the Government shall be the sole property of the Government and may not be used for any other purpose. This right does not abrogate any other Government rights.

1.6.18 Organizational Conflict of Interest: Contractor and subcontractor personnel performing work under this contract may receive, have access to, or participate in the development of proprietary or source selection information (e.g., cost or pricing information, budget information or analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or subsequent Organizational Conflict of Interests (OCI) as defined in FAR Subpart 9.5. The Contractor shall notify the Contracting Officer immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the Contracting Officer to avoid or mitigate any such OCI. The Contractor’s mitigation plan will be determined to be acceptable solely at the discretion of the Contracting Officer and in the event the Contracting Officer unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the Contracting Officer may choose other remedies as he or she deems necessary, including prohibiting the Contractor from participation in subsequent contracted requirements which may be affected by the OCI.

1.6.19 Computer Skill Competency: Each HCW shall demonstrate competency as required in the contract and as follows: HCWs will demonstrate computer competency to operate independently within the MTF’s electronic health records and healthcare provider menus (i.e. Essentris, AHLTA, CHCS, CERNER, Aria, Eclipse, Velocity, Oncentra, PACS) and patient safety reporting systems (i.e. Patient Safety Reporting System (PSR)).

1.6.20 MTF Training: Additional training requirements are as follows: HCWs will remain current in all hospital required training within the specified timelines throughout the life of the contract. COR will notify HCWs on any additional training with a realistic time frame on accomplishment.

1.6.21 MTF Standards: Specific policies, procedures, and instructions/regulations for the place of performance are as follows: HCWs will be familiar and comply with Standard Operating Procedures, located in the shared drive, and Army Regulation 40-3 Medical Services.

1.6.22 Occupational Health: The HCW shall be required to obtain documentation of required physical testing or a report of a physical examination prior to initiation of employment. Documentation of physical examination must be no more than 365 days old.

1.6.22.1 Tuberculosis Screening: The additional immunization/screening requirements for the risk of exposure to tuberculosis (TB) are as follows: None

1.6.22.2 Immunization: The HCW shall be required to obtain immunization IAW the BAMC Memo 40-235 Immunization Requirements for Hospital Employees.

PART 2

DEFINITIONS & ACRONYMS

2. DEFINITIONS AND ACRONYMS:

2.1 DEFINITIONS:

2.1.1 COMPOSITE HEALTH CARE SYSTEM (CHCS): An automated medical information system which will provide integrated support for the functional work centers of inpatient and outpatient care facilities, patient administration, patient appointments and scheduling, nursing, laboratory, pharmacy, radiology, and clinical dietetics.

2.1.2 CONTRACTOR. A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.

2.1.3 CONTRACTING OFFICER (KO). A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

2.1.4 CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S. Government appointed by the contracting officer to administer the contract. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.5 DEFECTIVE SERVICE. A service output that does not meet the standard of performance associated with the Performance Work Statement.

2.1.6 DELIVERABLE. Anything that can be physically delivered, but may include non-manufactured things such as meeting minutes or reports.

2.1.7 HEALTH CARE QUALITY ASSURANCE. The formal and systematic program for monitoring and reviewing health care delivery and outcome; designing activities to improve health care and outcomes identified deficiencies in providers, facilities, or support systems; and carrying out follow-up steps or procedures to ensure that actions have been effective and that no new problems have been introduced.

2.1.8 HEALTH CARE WORKERS (HCW). Refers to contract personnel who provide clinical care. This does not include personnel whose duties are primarily administrative or clerical in nature, or provide maintenance or security services.

2.1.9 KEY PERSONNEL. Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the Key Personnel listed in the PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

2.1.10 PHYSICAL SECURITY. Actions that prevent the loss or damage of Government property.

2.1.11 QUALITY ASSURANCE. The government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

2.1.12 QUALITY ASSURANCE SURVEILLANCE PLAN (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of Contractor performance.

2.1.13 QUALITY CONTROL (QC). All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements.

2.1.14 SUBCONTRACTOR. One that enters into a contract with a prime Contractor. The Government does not have privity of contract with the subcontractor.

2.1.15 WORK DAY. The number of hours per day the Contractor provides services in accordance with the contract.

2.1.16 WORK WEEK. Monday through Friday, unless specified otherwise.

2.2 ACRONYMS:

AAMD American Association of Medical Dosimetrists

ABR American Board of Radiology ACMP American College of Medical Physics ACOR Alternate Contracting Officer’s Representative ADS Ambulatory Data System

AF Air Force AFARS Army Federal Acquisition Regulation Supplement AHLTA Armed Forces Longitudinal Technology Application AIS Automated Information System AMP Authorized Medical Physicist AQL Acceptable Quality Level AR Army Regulation ARRT American Registry of Radiologic Technologists

ASTRO American Society of Radiation Oncology AT Anti-Terrorism Level I ATCTS Army Training Certification Tracking System

BAA Business Associate Agreement BAMC Brooke Army Medical Center BLS Basic Cardiac Life Support

BUMED Bureau of Medicine and Surgery CAC Common Access Card CAF Central Adjudication Facility CCE Contracting Center of Excellence CDC Centers for Disease Control CE Continuing Education CFR Code of Federal Regulations

CHBC Criminal History Background Check CHCS Composite Health Care System CIS Clinical Information System CLIN Contract Line Item Number CMD Certified Medical Dosimetrist CME Continuing Medical Education CMR Contractor Management Reporting CNACI Child Care National Agency Check with Inquiries COG Children’s Oncology Group CONUS Continental United States (excludes Alaska and Hawaii) COR Contracting Officer Representative COTR Contracting Officer's Technical Representative COTS Commercial-Off-the-Shelf CPR Cardiopulmonary Resuscitation CPARS Contractor Performance Assessment Reporting System CSP Contract Service Personnel CT Computed Tomography DA Department of the Army

DD250 Department of Defense Form 250 (Receiving Report) DD254 Department of Defense Contract Security Requirement List DFARS Defense Federal Acquisition Regulation Supplement DHA Defense Health Agency DMDC Defense Manpower Data Center DMHRSi Defense Medical Human Resources System - internet DOD Department of Defense e-QIP Electronic Questionnaires for Investigations Processing eMSM enhanced Multi-Service Market EO Executive Order EPID Electronic Portal Imaging Devices Systems FAR Federal Acquisition Regulation FIPS PUB Federal Information Processing Standards Publication FOIA Freedom of Information Act Program FSC Predominant Federal Service Code

FTE Full-Time Equivalent HCP Health Care Provider HCW Health Care Worker HDR High Dose Rate (remote afterloader brachytherapy) HIPAA Health Insurance Portability and Accountability Act of 1996 IA Information Assurance IF Information Technology IV Intravenous IGRT Intensity Guided Radiotherapy IMRT Intensity Modulated Radiotherapy JC Joint Commission JPAS Joint Personnel Adjudication System KO Contracting Officer

LDR Low Dose Rate MEDCEN Medical Center MEDCOM Medical Command METC Medical Education and Training Campus MP Therapeutic Medical Physicist MLC Multi-Leaf Collimator MLP Multi-Leaf Shaper MTF Medical Treatment Facility

MRT Medical Radiographic Technologist MR Magnetic Resonance MU Monitor Unit NAC National Agency Check NACT National Agency Check for Trustworthiness NCI National Clinical Trials Network NCOIC Non-Commission Officer in Charge NRC Nuclear Regulatory Commission

OBI On-Board Imaging OCI Organizational Conflict of Interest OCONUS Outside Continental United States (includes Alaska and Hawaii) ODC Other Direct Costs OIC Officer In-Charge OPM Office Personnel Management OPSEC Operation Security Compliance OSHA Occupational Safety and Health Administration OSLD Optical Stimulated Luminescent Dosimetry OSMS Optical Surface Monitoring Systems PACS Picture Archiving and Communications Systems

PET Positron Emission Tomography PIPO Phase In/Phase Out POC Point of Contact PRS Performance Requirements Summary PWS Performance Work Statement QA Quality Assurance QAP Quality Assurance Program QASP Quality Assurance Surveillance Plan QA/QI Quality Assurance & Improvement QC Quality Control QCP Quality Control Program

RO Radiation Oncologist ROS Radiation Oncology Service RPC Radiological Physics Center RPM Real-Time Position Management RTOG Radiation Therapy Oncology Group RT Radiologic Technologist RTT Radiation Therapy Technologist SAD Source Axis Distance SBRT Stereotactic Body Radiation Therapy SGRT Surface Guided Radiotherapy SHARP Sexual Harassment/Assault Response and Prevention SSD Source Surface Distance SWOG Southwest Oncology Group

TARP Threat Awareness Reporting Program TB Tuberculosis TBI Total Body Photon Irradiation TE Technical Exhibit TI Triggered Imaging TJC The Joint Commission TLD Thermoluminescent Dosimetry TSE Total Skin Electron UIC Unit Identification Code SAMHS San Antonio Military Health System

VMAT Volumetric Modulated Arc Therapy 2D Two Dimensional 3D Three Dimensional 4D Four Dimensional

PART 3

GOVERNMENT FURNISHED USE OF PROPERTY, EQUIPMENT, AND SERVICES

3. GOVERNMENT FURNISHED ITEMS AND SERVICES:

3.1 Services: N/A

3.2 Facilities: The Government will provide the necessary workspace for the Contractor staff to provide the support outlined in the PWS to include desk space, telephones, computers and pagers.

3.3 Utilities: The Government will provide all utilities in the facility available for the Contractor’s use in performance of tasks outlined in this PWS. If utilities are furnished, the following is required: The Contractor shall instruct employees in utilities conservation practices. The Contractor shall be responsible for operating under conditions that preclude the waste of utilities, which include turning off the water faucets or valves after using the required amount to accomplish cleaning vehicles and equipment.

3.4 Equipment: The Government will provide Contractor with access to equipment listed below, as needed:

BARD Quicklink Loader for brachytherapy Brain Lab treatment planning system (legacy) Elekta CMS Xio treatment planning system (legacy) Fluke electrometer (equipment QA test systems) Gammex/RMI Solid Water Phantom Kit (patient and equipment QA test system) Harshaw TLD system (patient QA test systems) IBA/Scanditronix Scanning System (equipment QA test systems) Kodak ACR2000 digital imaging system Laser Patient Alignment Systems (LAP, Gammex) Nucletron Applicator Sets (Cervical, Vaginal, Y, Venezia) Nucletron MicroSelection remote afterloading system Nucletron Oncentra treatment planning system Qfix Couch Inserts (patient immobilization systems) Pagers Philips AcQSim Philips CT simulation scanner Philips Pinnacle treatment planning system (legacy) PTW ion chambers (equipment QA test systems) Radcalc MU check software Standard Imaging electrometer and ion chambers (equipment QA test systems) Sun Nuclear Arc Check (patient QA test system) Sun Nuclear DQA3 (equipment QA test systems) Sun Nuclear Mapcheck-2 (patient QA test system) Sun Nuclear Profiler-2 (equipment QA test system) Sun Nuclear 1D Water Tank (patient and equipment QA test system) Varian ARIA oncology information system Varian Eclipse treatment planning system Varian Edge linear accelerator Varian Trilogy linear accelerator Varian Variseed treatment planning system Varian Velocity multi-modality image registration system Varian 21EX linear accelerator (legacy) Vision RT Surface Guided System (patient alignment and monitoring, in real time)

3.5 Materials: The Government will provide materials required to adhere to the Standard Operating -

Procedures and Policies at the MTF.

PART 4

CONTRACTOR FURNISHED ITEMS AND SERVICES

4. CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES:

4.1 General: The Contractor shall establish, staff, operate, manage, and maintain a Therapeutic Medical Physics Team to support BAMC's Radiation Oncology program with specific therapeutic medical physics and support services to include Therapeutic Medical Physics, Certified Medical Dosimetry, Radiation Simulation Therapy, and Radiation Therapy Technology. These Contractor provided services will include all necessary HCW personnel as outlined in section 5 of this contract, on-sight Contract Service Personnel (CSP) management by a therapeutic medical physicist, and administrative resources to provide a fully operational Therapeutic Medical Physics Team capable of support and implementation of treatment as outlined in section 1.4 of this contract.

4.1.1 Malpractice Insurance: This task order is for non-personal services. Non-personal task orders are not subject, either by the contract’s terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the United States Government (USG) and its employees. Under this type of contract the USG will not be liable for malpractice allegations against CSP based upon performance of the contract.

Therefore, the Contractor shall be required to carry malpractice insurance for CSP, at a level acceptable to the Contracting Officer, prior to commencement of services. The Contractor shall provide evidence of insurance upon award of each contract. (See FAR Clause 52.237-7 Indemnification and Medical Liability Insurance).

The Contractor shall immediately notify the Contracting Officer and COR of any suit, action filed or claim made against CSP (whether performing under a personal or non-personal services contract), which occurred as a result of work performed by the CSP under the contract. The Contractor is responsible for ensuring that CSP promptly furnish copies of all pertinent documents to the above referenced individuals.

4.1.2 Immunizations/Labs/Other Required Tests: The Contractor will ensure that all CSP working under the Therapeutic Medical Physics contract have and maintain all necessary and legally or institutionally required immunization, lab, and other required testing. The Contractor further ensures that all such testing is consistent with requirements to work in a healthcare setting.

4.2 Secret Facility Clearance: N/A

4.3 Materials: N/A

4.4 Equipment: N/A

PART 5

PERFORMANCE REQUIREMENTS

5. Specific Tasks:

5.1 HCW Qualification: Therapeutic Medical Physicists

5.1.1 Degree/Education: Shall possess a doctorate degree (Ph.D. or Sc.D.) in Therapeutic Radiological Physics, Therapeutic Medical Physics, or equivalent from a university accredited by the Commission on Accreditation of Medical Physics Education Programs, Inc. (CAMPEP)

5.1.2 Certifications: Possess Board Certification by either the American Board of Radiology (ABR) in Therapeutic Medical Physics, Radiological Physics or the American College of Medical Physics (ACMP) in Therapeutic Medical Physics. This non-personal services contract requires that the contract medical physicist maintain a current, active, valid and unrestricted license to practice medical physics in the state (or District of Columbia) where the MTF is located. The Contractor shall ensure that renewal actions are accomplished well before expiration of the provider’s license to ensure compliance with the contract.

5.1.3 Licensure/Registration: Shall possess a current professional medical physicist license in the state of Texas. This non-personal services contract requires that the contract medical physicist maintain a current, active, valid and unrestricted license to practice medical physics. The Contractor shall ensure that renewal actions are accomplished well before expiration of the provider’s license to ensure compliance with the contract.

5.1.4 Basic Life Support (BLS): Contractor personnel shall be certified and remain current in BLS. Proof of this training shall be provided to the Allied Health Credentials Program Specialist in the Credentials Service Department of Quality services.

5.1.5 Experience:

Ten years of recent clinical medical physics experience. Shall be currently proficient in clinical radiation therapy physics technology and other support services, demonstrated by active practice of at least 12 months within the last 18 months.

Meets the training and experience qualifications of 10 CFR 35 to handle NRC license brachytherapy sources. Possess United States (U.S.) Nuclear Regulatory Commission (NRC) qualifications listed in Title 10 of the Code of Federal Regulations Part 35 (10 CFR 35) for an authorized medical physicist (AMP) including specialization with both low dose rate (LDR) brachytherapy and high dose rate (HDR) remote after loading brachytherapy.

Clinical experience with total body photon irradiation (TBI).

Clinical experience with total skin electron irradiation (TSE) is not required, but familiarity is a plus.

Shall have clinical experience with both low dose rate (LDR) and high dose rate (HDR) brachytherapy modalities; including both interstitial and intracavitary brachytherapy approaches.

Shall have clinical experience in planning and implementing LDR brachytherapy for prostate applications; including all quality assurance testing.

Shall have clinical experience in planning and implementing HDR brachytherapy for prostate applications with > 12 catheters; including all quality assurance testing.

Shall have clinical experience in planning and implementing HDR brachytherapy for gynecologic applications; including all quality assurance testing.

Shall have clinical experience in planning and implementing HDR brachytherapy for breast applications; including all quality assurance testing.

Shall have experience with gynecological and prostate brachytherapy using Oncentra treatment planning system.

Shall have clinical experience with intensity modulated radiotherapy (IMRT) including volumetric modulated arc therapy (VMAT).

Shall have clinical experience with stereotactic body radiotherapy (SBRT).

Shall have clinical experience with stereotactic radiosurgery (SRS) using a linear accelerator (LINAC) based treatment and planning platform.

Shall have clinical experience with image guided radiotherapy (IGRT).

Shall have clinical experience with surface guided radiation therapy (SGRT) including optical surface monitoring systems (OSMS).

Shall have clinical experience with on-board imaging (OBI).

Shall have clinical experience with triggered imaging (TI) with both manual and auto beam hold.

Shall have clinical experience with real-time position management (RPM).

Shall have clinical experience with fluoroscopic image guidance with both manual and auto beam hold.

Shall have clinical experience with acceptance testing and commissioning of a dual-photon and multiple-electron energy linear accelerator with multi-leaf collimator (MLC) and electronic portal imaging device (EPID) capable of both IGRT, IMRT, VMAT, SRS, and SBRT.

Shall have clinical experience with acceptance testing and commissioning of a three-dimensional (3D) treatment planning system (TPS) capable of producing IGRT, IMRT, VMAT, SRS, SBRT, and brachytherapy plans.

Shall have experience with routine quality assurance / performance testing equipment (ion chambers, diodes, film, optically stimulated luminescent dosimetry (OSLD), and Thermoluminescent dosimetry (TLD) and techniques necessary to verify the accuracy and reproducibility of contemporary 3D, IGRT, IMRT, and brachytherapy based treatments and equipment, to include daily, monthly, and annual testing in accordance with current American Association of Physicists in Medicine (AAPM) recommendations.

Shall possess experience with the following products and equipment:

o BARD Quicklink Loader for brachytherapy o Brain Lab treatment planning system (legacy) o Elekta CMS Xio treatment planning system (legacy) o Fluke electrometer (equipment QA test systems) o Gammex/RMI Solid Water Phantom Kit (patient and equipment QA test system) o Harshaw TLD system (patient QA test systems) o IBA/Scanditronix Scanning System (equipment QA test systems) o Kodak ACR2000 digital imaging system o Laser Patient Alignment Systems (LAP, Gammex) o Nucletron Applicator Sets (Cervical, Vaginal, Y, Venezia) o Nucletron MicroSelection remote afterloading system o Nucletron Oncentra treatment planning system o Qfix Couch Inserts (patient immobilization systems) o Philips AcQSim o Philips CT simulation scanner o Philips Pinnacle treatment planning system (legacy) o PTW ion chambers (equipment QA test systems) o Radcalc MU check software o Standard Imaging electrometer and ion chambers (equipment QA test systems) o Sun Nuclear Arc Check (patient QA test system) o Sun Nuclear DQA3 (equipment QA test systems) o Sun Nuclear Mapcheck-2 (patient QA test system) o Sun Nuclear Profiler-2 (equipment QA test system) o Sun Nuclear 1D Water Tank (patient and equipment QA test system) o Varian ARIA oncology information system o Varian Eclipse treatment planning system o Varian Edge linear accelerator (including MLC, portal image systems, IGRT modalities and

IMRT).

o Varian Trilogy linear accelerator (including MLC, portal image systems, IGRT modalities and

IMRT).

o Varian Variseed treatment planning system o Varian Velocity multi-modality image registration system o Varian 21EX linear accelerator (legacy) o Vision RT Surface Guided System (patient alignment and monitoring, in real time)

Shall have experience in providing input for MEDCASE CEEP procurement process including SuperCEEP and CEEP items needed for the department, such as: linear accelerators, planning software and hardware, brachytherapy equipment, quality assurance phantoms and testing devices, etc.

Shall have familiarity with the radiation physics aspects of the American College of Radiology (ACR) or American Society of Radiation Oncology (ASTRO) Accreditation Program for Excellence (APEx) accreditation process.

Shall have had all or part of the required clinical experience obtained in a clinic, which actively participates in national research protocols (National Cancer Institute (NCI) National Clinical Trials Network, NRG Oncology, Radiation Therapy Oncology Group (RTOG), Southwest Oncology Group (SWOG), Children’s Oncology Group (COG), and Alliance for Clinical Trials in Oncology) and familiarity with the benchmark and dosimetry requirements of these protocols including: Radiological Physics Center (RPC) Thermoluminescent Dosimetry (TLD) irradiation and RPC site visitation and inspection. Shall possess teaching experience in radiotherapy physics/radiation safety and therapeutic radiological physics.

Shall have experience entering patient prescriptions and treatment parameters into Varian Aria remote access terminal (verify and record system) including MLP (beam shaper) workstation.

Shall have familiarity with the requirements of the US Nuclear Regulatory Commission contained in 10 CFR 20 and 35. Oversight experience over other physicists and dosimetrists.

Shall have familiarity with DA/DHA regulations governing the use of radiation sources (i.e. TB MED 521). Shall have experience as a contract physicist at a DOD clinical facility that sees emergency room patients. Possess oversight experience over other MPs and dosimetrists.

Shall possess oversight experience over other therapeutic medical physicists, radiation oncology specific certified medical dosimetrists, and radiation oncology specific radiation therapy technologists.

Shall have experience as a medical physicist at a hospital-based clinical facility with emergency medicine and trauma services.

Shall have experience as a medical physicist in coordinating and implementing systems upgrades on Varian, Nucletron, Sun Nuclear, Philips, and other radiation therapy treatment and quality assurance platforms.

5.1.6 HCW Duties: Therapeutic Medical Physicist

The HCW shall perform clinical radiation therapy physics and other support services as required by the Department of Radiology, BAMC.

Manage the Radiation Therapy Service Equipment Quality Control Program.

Develop, oversee, and analyze technician quality control testing of radiation producing, detection, and measurement equipment.

Perform physics quality control testing, calibration, and equipment evaluation on equipment to be used directly for radiation therapy purposes.

Monitor maintenance of treatment device, dosimetry, and radiation therapy imaging equipment, and pertinent accessory purposes.

Coordinate maintenance of treatment device, dosimeter, radiation therapy imaging equipment, and accessories with medical maintenance.

Perform dosimetry inter-comparison.

Provide expert guidance for procurement of new and emerging technologies related to treatment and quality assurance equipment. Assist the Government in developing specifications for the procurement of this equipment.

Provide consulting services for equipment acceptance testing.

Serve as Authorized Radiation Safety Officer for Radiation Oncology.

Support computer systems. Manage multiple computer systems.

Monitor/ensure computer maintenance.

Develop and oversee quality control testing.

Enter therapy and radioisotope data.

Certify computer output against measurements for treatment planning system, beam-scanning system, and computers interfaced with linear accelerator.

Coordinate maintenance of imaging, treatment planning, accelerator control, and physics computer systems. Perform quality control testing.

Consult on patient simulation and treatment.

Consult with physician and radiation therapist to determine positioning of patient and equipment.

Provide periodic analysis of consistent and accurate positioning of patient equipment, and treatment aid.

Perform treatment chart checks.

Evaluate special dosimetry.

Perform and analyze special dosimetry on selected procedures.

Consult with physician concerning the effect upon patient. Perform fetal exposure evaluation.

Plan treatment. (a) Develop treatment plan. Confer with physician; construct patient models and cross sections. Develop treatment plans and obtain physician approval. Calculate treatment times. Discuss final plan with radiation therapist and annotate treatment chart. Check dosimetrist's plan and calculations. (b) Validate treatment plan, check dosimetrist's plan and calculations. Collaborate with physician on final treatment plans. Design and oversee construction of treatment aid device. (a) Verify accuracy and integrity of treatment aid device. (b) Oversee design of treatment aids. (c) Develop specification for custom designed commercially constructed device.

Provide LDR and HDR brachytherapy support to include Eclipse planning, Oncentra planning, Variseed planning, RadCalc utilization, Mapcheck utilization, operating room assistance, LDR source handling and procurement assistance/coordination, HDR source exchange coordination, LDR and HDR QA, and clinical process improvement.

Provide direct support. Monitor the purchase, delivery, handling, and disposition of brachytherapy radioactive material in accordance with NRC guidelines. Verify activity and prepare radioactive material for insertion.

Assist physician in surgical insertion of brachytherapy device.

Review scout localization film, direct simulation procedure, assist physician with placement of radioactive material and later removal, and maintain source accountability record.

Perform quality control procedures required in support of LDR and HDR brachytherapy.

Provide ancillary support.

Review radioactive material, assist in simulation, and transfer radioactive material to treatment room.

Develop or improve procedures. Consults with physician and radiation therapist to develop and obtain improved technology or technique.

Provide radiation safety support during all facets of radiation therapy.

Provide radiation safety consultation for Radiation Oncology.

The radiation therapy physicist shall be a participating member of the BAMC/SAMHS Radiation Safety

Committee.

Maintain continuing medical education. Receive continuing medical education by reading journals or books. Participate in professional society's meeting and committee.

Oversees dosimetrist.

Teach in-service training classes as necessary or as dictated by the Chief, Radiation Oncology Service

(ROS) or COR, not to exceed one class per month. Classes will be taught when new procedures or technology are implemented or when new nuclear regulatory directives are implemented that affect the ROS. The quality assurance committee representative will prepare a report upon completion of each class. The report is to include as a minimum: subject, date of class, name of attendees, reference federal regulations cited and scope.

Attendance at meetings. The Contractor's physicist shall attend and participate in all meetings, staff conferences and other appropriate professional activities as required by the Chief, ROS and Chief, Department of Radiology.

Oversee the coordination and timing of systems upgrades on Varian, Nucletron, Sun Nuclear, Philips, and other radiation therapy treatment and quality assurance platforms.

Implement installation and application of systems upgrades on Varian, Nucletron, Sun Nuclear, Philips, and other radiation therapy treatment and quality assurance platforms. This is to be performed with system specific vendor expert personnel.

Coordinate and participate in training all other HCW’s within the radiation oncology clinic on pertinent aspects of all system upgrades.

5.2 HCW Qualifications: Certified Medical Dosimetrist

5.2.1 Degree/Education: Certified by the American Association of Medical Dosimetrist (AAMD) as a Certified Medical Dosimetrist (CMD) or be eligible to take the AAMD Certification exam, and pass the exam within a one year of commencement of work at the facility. Shall be registered by the American Registry of Radiologic Technologist (ARRT) as a Radiation Therapy Technologist (RTT) or have an undergraduate degree in mathematics, physical science, or as is necessary for AAMD certification.

5.2.2 Certifications: Must be certified by the American of Medical Dosimetrist (AAMD) as a Certified Medical Dosimetrist (CMD) or be eligible to take the AAMD certification exam, and pass the exam within one year of commencement of…