PWS Final Version.pdf

MOBILE MAGNETIC RESONANCE IMAGING (MRI) SERVICES

1. GENERAL.

1.1. Description of Work.

1.1.1. The Contractor shall provide a turn-key mobile Magnetic Resonance Imaging (MRI) unit (operate, train, and maintain) to perform non-personal professional MRI examinations at Weed Army Community Hospital (WACH), Fort Irwin, CA. The contract employee(s) performing this service are hereafter referred to as Contract Providers (CPs).

1.1.2. This contract is a NON-PERSONAL SERVICES contract under which the personnel rendering the services 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 Government and its employees.

1.1.3. The Contractor shall comply with OTSG/MEDCOM Policy Memo 16-033, Policy for Reporting Incidents of Sexual Assault and Sexual Harassment under the Sexual Assault Prevention and Response Program (SHARP),19 Mar 2016. The SHARP reporting requirements apply only to knowledge obtained by Contractor personnel while performing services under this contract.

1.1.3.1. The Contractor shall require all CPs with knowledge of an incident of sexual assault occurring on a Government facility, to include a contracted 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.

1.1.3.2. The Contractor shall require all CPs with knowledge of an incident of sexual harassment occurring on a Government facility, to include contracted 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.

1.1.4. Performance Requirement Summary. The following performance objectives and measures will be used to evaluate Contractor performance and compliance under the contract. This information will be used to prepare annual past performance evaluations. See Enclosure 1, Quality Assurance Surveillance Plan (QASP), for additional details.

PERFORMANCE

OBJECTIVE

STANDARD

ACCEPTABLE

QUALITY LEVEL

METHOD OF

ASSESSMENT

The contractor shall maintain a fill rate of at least 95%. PWS para. 5.1.1.

Maintain fill rates.

Number of hours worked/number of available hours to work of at least 95% per 12 month period.

Documented actual hours worked.

Technologist performs monthly minimum of scans. PWS para.

5.1.1.

Maintain a minimum of 160 scans per month

97% compliance COR will Monitor compliance.

Provide technically competent HCPs. Para 1.9.

Certification packages submitted are for HCPs that are fully qualified per the

PWS.

100% compliance Continuous monitoring of certification documents and licenses. Department and COR Monitor.

HCPs must comply with policies and standards. Para.

1.3.

HCPs must comply with MTF policy and procedures.

97% compliance COR will monitor and immediately report non-compliance to the Contracting Officer (KO

Patient privacy and confidentiality. Para. 8.

Maintains patient privacy and confidentiality.

100% Compliance. Review of Substantiated complaints of breach of privacy. COR Monitor.

Provide patient care according to policies and procedures.

Para. 5.

Complete proper treatment of patients

97% compliance Review charts through Departmental Process Improvement procedures.

Department and COR Monitor.

Patient and customer satisfaction. Para 1.5.4.

Maintain a high level of patient and customer satisfaction.

Max of two substantiated complaints per staff member, per period of performance. 98% compliance

Review and assessment of customer complaints through patient and Government Feedback. COR will Monitor.

Contractor Manpower Report (CMR). PWS Para. 9.

Complete Contractor Manpower Report by 31 Oct each year. Notify COR by the 5th working day of November whether or not completed.

Completed report. 97% compliance

Monitored by COR and Contract Specialist.

Combating Trafficking In Persons (awareness program).

FAR Clause 52.222-50 and FAR Subpart 22.1703.

100% compliance (zero tolerance) regarding trafficking in persons policy.

COR documentation and program review. Any non-compliance must be brought to the immediate attention of the KO.

Sexual Assault Reporting, per Para. 1.1.3.

Report within 24 hours. Reports shall be submitted as required 98% of the time.

COR documentation and program review. Any non-compliance must be brought to the immediate attention of the KO.

Sexual Harassment Reporting per Para. 1.1.3.

Report within 24 hours. Reports shall be submitted as required 98% of the time.

COR documentation and program review. Any non-compliance must be brought to the immediate attention of the KO.

1.1.5. The inspection and acceptance point for all services rendered under this contract will be the Department of Radiology, (760) 383-5030 at Weed Army Community Hospital and/or the COR. The performance by the CPs, the quality of services rendered, and any documentation or written material in support of same, shall be subject to continuous inspection, surveillance and review for acceptance by the Radiologist, the COR or designated representative indicated above. Any services rendered by the CPs to patients or interaction with military/civilian personnel deemed unprofessional, threatening, and/or dangerous by the Government will be considered as grounds for immediate removal of the CP from providing services under this contract and termination under clause 52.212-4

(m) Termination for Cause. Quality Assurance procedures established by the Contractor shall be used for continuous monitoring. Other performance evaluation factors will be monitored that are not quantified by numerical measurements which include: Contractor providing personnel not meeting the minimum qualification standards;

patient customer service comments; CP and Contractor relationship with hospital staff/Government contracting personnel; compliance with contract policies and procedures. Services provided by the CPs shall be reviewed and rated in accordance with TJC standards. A poor rating shall be grounds for immediate termination of the contract.

1.2. Qualifications and Requirements.

1.2.1. CPs shall meet the following Qualifications.

1.2.1.1. The MRI Technologist shall have as a minimum a high school diploma. All MRI Technologists shall have completed an instructional program that follows the American Society of Radiologic Technologists (ASRT) curriculum guide and competencies based on skills identified by the American Registry of Radiologic Technologists (ARRT) and the Joint Review Committee on Education of Radiologic Technologists (JCERT).

1.2.1.2. The MRI Technologist shall possess current registration by the ARRT and current certification in the Magnetic Resonance Imaging modality.

1.2.1.3. The MRI technologist shall be active in the provision of MRI services and have provided MRI services for a minimum of three years within the past five years. Of the three years, the technologist shall have a minimum of 12 months experience under the supervision of a board certified or board eligible Radiologist. Additionally, the technologist performing the MRI exam shall have been trained on the type of unit the Contractor intends to place at WACH, for a period of not less than six months. The MRI technologist should be able to perform all exams but not limited to those listed on Attachment 5 under Current Procedural Terminology (CPT) Description.

1.2.1.4. The CPs must have and maintain current Basic Life Support (BLS) certification. The American Heart Association Basic Life Support for Healthcare Providers is the only program accepted. BLS recertification shall be maintained in a current status at all times while the CP is performing services under this contract.

1.2.2. Requirements:

1.2.2.1. The Contractor shall not employ any individual to provide services who is listed on the Health and Human Services (HHS) list of providers excluded from federally funded health care programs. The list may be found at http://oig.hhs.gov/fraud/exclusions.asp.

1.2.2.2. The CP shall not have been convicted of a felony.

1.2.2.3. The CP shall successfully complete a criminal history background check in accordance with paragraph 7.4.

of the Performance Work Statement (PWS).

1.2.2.4. The CP shall be a U.S. citizen or otherwise meet the requirements of AR 25-2, Information Assurance.

1.2.2.5. The CP shall be able to read, write, and speak English well enough and enunciate with sufficient clarity to effectively communicate with patients and other health care providers.

1.2.2.6. The CP shall have knowledge of medical privacy and confidentiality (Health Insurance Portability and Accountability Act [HIPAA]).

1.2.2.7. Each CP shall have sufficient skills, knowledge and experience to perform the specific tasks (see Paragraph

5. of this Performance Work Statement) listed for their specialty.

1.2.2.8. The CP shall possess sufficient initiative, interpersonal relationship skills and social sensitivity such that the CP can relate to a variety of patients from diverse backgrounds.

1.2.2.9. Working knowledge of computer applications/software to include Microsoft Office programs, MS Outlook (e-mail), and internet familiarity is required.

1.2.2.10. The CP shall use the various clinical automation systems as required, such as, but not limited to Composite Health Care System (CHCS), Armed Forces Health Longitudinal Technology Application (AHLTA), Ambulatory Data System (ADS), and Defense Medical Human Resource System – internet (DMHRSi).

1.2.2.11. The CP shall be required to meet Continuing Medical Education (CME) requirements in AR 351-3 or as determined by the provider’s State of licensure, whichever is more stringent. The Government will not reimburse the Contractor or the CP for these costs. Duty hours are not authorized to complete CME’s.

1.3. Administrative.

1.3.1. The Contractor shall provide adequate pre-credentialed replacement MRI Technologist to prevent any lapse in coverage. The WACH credentialing process can take up to 30 days. Any lapse in coverage will be considered as cause for immediate grounds for termination of the purchase order, at the discretion of the Government.

1.3.1.1. The Contractor may use non-compete provisions in its employment agreements to prevent the loss of personnel by the Contractor during the period of performance of this contract. However, the Contractor shall not use non-compete provisions in its employment agreements that would prevent its personnel s from being employed by or from accepting offers of employment from the new Contractor of the follow-on contract. It would hinder the Government’s ability to accomplish the mission of providing medical care to its beneficiaries.

1.3.2. Reports. The Contractor shall submit reports to the COR/POC or KO as requested for use in monitoring Contractor performance. Such reports may include, but are not limited to, personnel recruitment status, projected losses, quality control/assurance, billing/invoicing, etc.

1.3.3. Contracting Officer’s Representative (COR). The KO will designate and authorize an individual to act as the COR at time of award. Any such representative appointed will be specifically designated by letter from the KO.

The COR exclusively represents the KO in all technical phases of the work, but is not authorized to issue Change Orders, Supplemental Agreements, or direct any contract performance requiring contractual modification or adjustment. Changes in the scope of work can only be made by modification properly executed by the KO. All observations made by persons other than the KO or the COR are strictly advisory and shall not influence the Contractor's operations except for administrative requirements and responsibilities specified herein. The KO will provide a copy of this designation and COR contact information to the Contractor.

1.3.4. Billing. Billing shall occur in arrears on the 1st workday of the month after the month in which work is performed. NOTE: The Government will only pay for days the unit is actually staffed and available for service.

The Contractor shall only submit payment requests for days that the mobile MRI unit is staffed. Submitting a payment request for more than the amount due and/or days the unit was not staffed may constitute fraud or a false claim and may result in administrative or criminal action or both.

1.3.5. Antiterrorism/Operations Security (AT/OPSEC) Requirements.

1.3.5.1. 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 30 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 10 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

1.3.5.2. 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 subcontractors 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.

1.3.5.3. For Contractors requiring Common Access Card (CAC). Before CAC issuance, the contractor employee requires, at a minimum, a favorably adjudicated National Agency Check with Inquiries (NACI) or an equivalent or higher investigation in accordance with Army Directive 2014-05. The contractor employee will be issued a CAC only if duties involve one of the following: (1) Both physical access to a DoD facility and access, via logon, to DoD networks on-site or remotely; (2) Remote access, via logon, to a DoD network using DoD-approved remote access procedures; or (3) Physical access to multiple DoD facilities or multiple non-DoD federally controlled facilities on behalf of the DoD on a recurring basis for a period of 6 months or more. At the discretion of the sponsoring activity, an initial CAC may be issued based on a favorable review of the FBI fingerprint check and a successfully scheduled NACI at the Office of Personnel Management.

1.3.5.4. 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 subcontractors 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 5 calendar days of new employees commencing performance with the results reported to the COR NLT 30 calendar days after contract award.

1.3.5.5. 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.

1.3.5.6. 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.

1.3.5.7. 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 DoDD 8570.01, DoD 8570.01-M and AR 25-2 within six months of appointment to IA/IT functions.

1.3.5.8. For contracts that require handling or access to classified information. Contractor shall comply with FAR 52.204-2, Security Requirements. This clause involves access to information classified “Confidential,” “Secret,” or “Top Secret” and requires contractors to comply with— (1) The Security Agreement (DD Form 441), including the National Industrial Security Program Operating Manual (DoD 5220.22-M); (2) any revisions to DOD 5220.22-M, notice of which has been furnished to the contractor.

1.3.5.9. Threat Awareness Reporting Program. For all contractors with security clearances. Per AR 381-12 Threat Awareness and Reporting Program (TARP), contractor employees must receive annual TARP training by a CI agent or other trainer as specified in 2-4b.

1.3.6. Orientation and Training.

1.3.6.1. The Contractor shall ensure its personnel are knowledgeable of the policies and procedures of their specific place of duty and of the medical activity. The Contractor shall ensure that its employees receive any training required by the MTF as a precondition/condition to performance. Such training may include instruction on automation processing, quality assurance policies and local in-service and safety briefings. This training shall be conducted during the scheduled duty hours of the contract personnel.

1.3.6.2. The Government is responsible for providing the CP’s in-processing and orientation, procedures for use of Government provided forms and imaging protocols for the technologist.

1.3.7. Record Keeping. The Government will ensure all contract personnel are trained on Army medical record keeping.

1.3.7.1. Electronic Medical Record Keeping Systems. The Government will provide training to contract personnel in the Electronic Medical Record Keeping Systems and other procedures that the medical activity's staff is required to use. Access to such patient data systems is an "Automated Data Processing Sensitive" position requiring compliance with AR 25-2 and AR 380-67. Refer to the Additional Information section “ADP Security Requirements” in this purchase order for further guidance.

1.3.8. Deliverables - Quality Control Plan and Assurance.

1.3.8.1. Quality Control Plan (QCP). Within 30 days of contract award, the Contractor shall submit a QCP to the KO and the COR. The QCP shall cover every aspect of the Contractor's operation under the contract. The purpose of the QCP is to monitor, analyze, and improve quality, management and compliance with contract performance standards.

1.3.8.2. Quality Control/Assurance (QC/A). The Contractor is required to implement a Quality Control/Assurance plan as approved by WACH, and then provide a monthly QC/A report to WACH. This report shall confirm that quality control measures are being performed per PWS paragraph 5.1.6.

1.3.9. Security.

1.3.9.1. Safeguarding Material. The Contractor shall be responsible for safeguarding all Government property provided for Contractor use. The Contractor shall safeguard information of a confidential or sensitive nature.

Neither the Contractor nor any of its CPs shall disclose or cause to be disseminated any information concerning the operation of the MTF that could result in or increase the likelihood of the possibility of breach of security or interrupt the continuity of operations or which breach the requirements of the Federal Privacy Act of 1974.

However, the Contractor may be required to provide testimony or deposition in lawsuits or other administrative, civil, or criminal proceedings.

1.3.10. Data Breach Response Notification.

1.3.10.1. The Contractor shall adhere to the reporting and response requirements for PII set forth in Memorandum, Office of the Secretary of Defense, Subject: Safeguarding Against and Responding to the Breach of Personally Identifiable Information (PII), June 5, 2009, ALARACT 050/2009, DoD 5400.11-R, and any amendments.

1.3.10.2. The Contractor or its subcontractor shall immediately notify Mr. Carlos Garcia HIPAA Compliance Officer, at (760) 383-5188 or email: carlos.e.garcia.civ@mail.mil that a suspected or actual breach of PII has occurred. The notification shall include, to the greatest extent possible, the identification of each individual who’s PII has been or possibly has been breached. In addition, the Contractor or its subcontractor shall provide Mr. Carlos Garcia at (760) 383-5188 or email: carlos.e.garcia.civ@mail.mil: with any other available information that must be included in required breach reporting and notifications. The Contractor shall provide this information at the time of the initial notification to the Government or promptly thereafter as information becomes available.

1.3.10.3. The Government will determine whether a breach of PII has occurred, and whether breach notification to affected individuals is required. If breach notification to affected individuals is required, the Government will determine if the contractor shall make the required notification. If the contractor is to notify the impacted population, it shall submit the notification letters to Mr. Carlos Garcia, at (760) 383-5188 or email:

carlos.e.garcia.civ@mail.mil for review and approval.

1.4. Place and Hours of Performance.

1.4.1. Place of Performance: The mobile MRI unit will be positioned on the existing MRI pad 22 feet X 57 feet at WACH, Building 390 and will remain there until the end of the contract period or has to be replaced for other reasons as determined by the COR or Contractor. The Contractor is responsible for the installation of the equipment and its removal and transportation from the site at the end of the lease, not separately priced. The Contractor will restore the area in which the MRI is installed, within the same or greater condition when the mobile unit was initially installed, at no cost to the Government. (The Contractor and COR shall take photos of this area at the time of occupancy.)

1.4.2. Hours of Performance: The Contractor’s mobile MRI unit and MRI Technologist(s) shall perform services in their mobile MRI unit at the WACH MRI location, Monday through Friday, eight hours per day, normally between the hours of 0730 and 1630.

1.4.2.1. The mobile MRI Unit operating hours will be coordinated between the Department of Radiology, COR and Contractor in advance. The Contractor shall have a sign displaying the operating hours attached to the mobile MRI unit’s door (or near-by), and is authorized to have the unit closed for one hour per day for an uncompensated lunch break. Closure times for lunch breaks will be displayed on the sign.

1.4.3. Federal Holidays. Mobile MRI Services are not required on Federal and Training Holidays.

1.5. Conduct.

1.5.1. The Contractor is responsible for the conduct of his/her employees. All services shall be provided in accordance with established standards, principles, and ethics of the profession and applicable professional specialty organizations, and shall ensure the highest regard to patient dignity.

1.5.2. The KO can revoke or otherwise restrict the services of any contract technologist who he/she determines is not qualified to perform the contract service.

1.5.3. The Contractor shall ensure that its personnel abide by MTF bylaws, TJC, DoD, and Medical Department regulations and requirements concerning the nature of limited privileged communication between patients and the CP as may be necessary for security and personnel reliability programs. The Contractor shall also ensure that its personnel abide by federal and local MTF regulations concerning the confidentiality of patient records, as embodied in federal statutes including the Privacy Act of 1974 and the Health Insurance Portability & Accountability Act (HIPAA) of 1996. All regulations referenced are available for review from the COR or MTF. All medical records and reports are and will remain the property of the Government.

1.5.4. Complaints. Complaints will be validated by the COR and be reported in writing to the KO and to the Contractor for action, if it constitutes a failure to perform, as determined by the Government. Patients may also be a source of legitimate complaints that constitute a failure to perform. The Contractor shall have no more than two substantiated complaints per 12-month period per CP. Any patient complaints received on services provided by the CP will be taken very seriously at the MTF and as such will be considered a part of the inspection process. The DC will submit documentation to the COR regarding all patient and/or clinical complaints. Receipt of two valid complaints on the CP within any twelve-month period may be considered grounds for immediate removal.

1.5.5. Inquiries. Contractor shall ensure that its personnel do not respond to any media inquiries. Any inquiries from the media shall be immediately relayed to the COR, who will relay them to the MTF Commander. There shall be no interviews, comments, or any other response without the knowledge and approval of the MTF Commander.

Other than routine inquiries from external agencies, all other inquiries and complaints shall be brought to the attention of the Government.

1.6. Conflict of Interest.

1.6.1. The Contractor shall not bill the patient for services rendered under this purchase order and shall ensure that its personnel do not do so. The Contractor is prohibited from receiving compensation of any kind for patients treated, procedures performed, or any other actions performed, except under the terms and conditions of this contract at the rate specified.

1.6.2. Confidentiality of Information. Unless otherwise specified, all financial, statistical, personnel, and/or technical data which are furnished, produced or otherwise available to the Contractor during the performance of this contract are considered confidential business information and shall not be used for purposes other than performance of work under this contract. The Contractor shall not release any of the above information without prior written consent of the KO and shall ensure that its employees do not do so. The Contractor shall not use patient care rendered pursuant to this purchase order as part of a study, research project, or publication and shall ensure that its employees do not do so.

1.7. Relationship of the Parties, Professional Liability Responsibility and Procedures.

1.7.1. This purchase order is a non-personal services in nature; therefore, the Government will not be liable for malpractice allegations against a MRI Technologist based upon performance of this purchase order. The Contractor shall be required to carry malpractice insurance for its MRI Technologists, at a level acceptable to the KO, prior to commencement of services. Evidence of insurance shall be provided per contract. If an apparent successful offeror, the Contractor shall provide evidence of insurability concerning medical liability insurance prior to award. Upon award, the Contractor shall provide evidence of insurance demonstrating the required coverage prior to commencement of performance. In accordance with Federal Acquisition Regulation (FAR) Clause 52.237-7, the Contractor shall indemnify the Government for any liability producing act or omission by the Contractor, its MRI Technologist(s) and agents occurring during contract performance. If the Contractor uses subcontractors in the performance of this purchase order, the Contractor is required to ensure that its subcontracts for provisions of healthcare services contain the requirements of FAR 52.237-7, including the maintenance of medical liability insurance.

1.7.2. Contractor agrees to be solely responsible for any liability producing acts or omissions arising from the Contractor’s performance. Contractor shall indemnify the Government against all claims by third parties for death or bodily injury (including sickness or disease) to the extent that such a claim arises in any way from Contractor performance under this purchase order. In the event of litigation/investigation of a claim or malpractice, the Contractor shall ensure his employees’ full cooperation with Government authorities and designated officials in investigation of claim and/or preparation of litigation.

1.7.3. Responsibility and Procedures. If any suit or action is filed or any claim is made against the contract CP, which occurred as a result of work performed by the CP under this contract, the CP shall immediately notify the Contractor and the KO, and the DC of the appropriate services and promptly furnish them copies of all pertinent papers received.

1.7.3.1. The Contractor shall ensure its personnel cooperates with the Government, without further Government compensation to either the Contractor or the Contractor personnel, in the processing, review, settlement, or defense of the suit, action, or claim, and authorizes Government representatives to settle or defend the claim and to represent.

1.8. Contractor Representation.

1.8.1. The Contractor shall designate a representative for this contract. At least ten working days prior to performance start date, the Contractor shall provide in writing to the COR, Contractor representative contact information. Changes in the representative, at any time after contract commencement, shall be in writing to the COR at least five working days prior to the change.

1.8.1.1. The Contractor's representative shall, at no additional cost, meet with the COR when requested by the COR to discuss any problems that the Contractor's personnel may be experiencing during the performance of this contract. Problems experienced by the Government with the Contractor's performance will be discussed and resolved. Unresolved problems will be referred to the KO for resolution.

1.8.1.2. The Contractor shall provide points of contact (POC) information for administration of the contract during normal business hours and after normal business hours. The POC for other than normal business hours will be contacted only in the event of emergencies. Accordingly, the named individual(s) shall possess sufficient corporate authority to effectively deal with emergency situations and the telephone number provided shall be functioning at all times other than normal business hours. If there are different POCs for different conditions, such as weekdays, weekends, holidays, clearly provide such information.

1.9. License and Credentials.

1.9.1. The Contractor will ensure that all licenses, registration, and/or certifications relating to the MRI Mobile Unit and the CP are maintained in a current status for as long as they are providing services under this purchase order and are available for KO and COR review upon written request.

1.9.2. The Contractor shall not employ any individual to provide services whom within five years prior to employment: has had his/her clinical privileges limited, suspended, or revoked by any healthcare facility, public or private, anywhere in the world.

1.9.2.1. This prohibition does not apply to any individual whose clinical privileges, although originally limited, suspended or revoked by a healthcare facility, were subsequently fully reinstated by the healthcare facility.

1.9.3. Limitation of clinical privileges, as used in this paragraph, refers to a partial withdrawal/reduction of clinical privileges as a result of a determination that or pending investigation to determine whether an individual has engaged in unprofessional conduct or substandard medical practice or is incompetent to performing certain medical practices.

1.9.4. Is the subject of a current or pending hearing or appeal brought by any healthcare facility, public or private, anywhere in the world, which may result in the limitation, suspension, or revocation of the individuals’ clinical privileges.

1.9.5. Requirements for privileging or for licensing verification are the same for replacement CPs as for the CPs they are replacing.

1.10. Quality Management.

1.10.1. Quality Control Plan (QC). The Contractor is required to follow the current QC program in place at the MTF to ensure that the medical services are provided at a level of quality that meets MTF standards.

1.10.2. Quality Assessment and Improvement (QA&I). The Government will monitor the Contractor's performance under this purchase order using the QA&I procedures established by the medical activity and pursuant to the Contract Terms and Conditions - Commercial Items clause, paragraph entitled Inspection/Acceptance. Additionally, the Contractor's performance is subject to scheduled and unscheduled review by the QA&I Committee as defined by the medical activity Quality Assurance (QA) Plan and AR 40-68.

1.10.3. The Contractor shall have an internal quality control procedure which will ensure the Contractor's performance/medical care evaluation will be at a level commensurate with standards of the medical profession and the American College of Radiology.

2. DEFINITIONS/ACRONYMS.

2.1. Definitions. Following is a list of basic definitions.

2.1.1. BENEFICIARIES OF THE MILITARY HEALTHCARE SYSTEM. Those individuals entitled to care at the MTF in accordance with AR 40-3.

2.1.2. CONTRACTING OFFICER (KO): A person with the authority to enter into, administer, and/or terminate contracts/task orders and make related determinations and findings.

2.1.3. CONTRACTING OFFICER'S REPRESENTATIVE (COR): A Government employee selected and designated in writing by the KO to act as his/her designated representative in administering a contract. A COR has no authority to change or modify the terms of a contract.

2.1.4. PHYSICIAN: Medical healthcare providers possessing a doctorate degree as a Medical Doctor (MD) or Doctor of Osteopathy (DO).

2.1.5. QUALITY ASSESSMENT AND IMPROVEMENT. Those actions taken by the Government to check services to determine if they meet the requirements of the Joint Commission, U.S. Army Medical Command, quality assurance and risk management program, and ensure that the Contractor and its CPs comply with the terms and conditions of the contract.

2.1.6. QUALITY CONTROL. Those actions taken by a Contractor to control the performance of services to ensure that they meet the requirements of the contract.

2.1.7. TRICARE: A regionalized, tri-service, Contractor-supported, DoD-managed healthcare system.

2.2. Acronyms/Abbreviations. Following is a list of basic acronyms/abbreviations used in this contract.

ADP - Automated Data Processing AHLTA - Armed Forces Health Longitudinal Technology Application AR - Army Regulation BCLS - Basic Cardiac Life Support.

BLS - Basic Life Support CFR - Code of Federal Regulations CHAMPUS - Civilian Health and Medical Program of the Uniformed Services CHCS - Composite Health Care System CLIN - Contract Line Item Number CME - Continuing Medical Education CMR - Contract Manpower Report CONUS - Continental United States COR - Contracting Officer’s Representative CPARS - Contractor Performance Assessment Reporting System CPR - Cardiopulmonary Resuscitation CV - Curriculum Vitae DA - Department of the Army DCCS - Deputy Commander for Clinical Services DEA - Drug Enforcement Administration DoD - Department of Defense DODI - Department of Defense Instruction DMHR - Defense Medical Human Resource System - Internet ECFMG - Educational Commission for Foreign Medical Graduates EFT - Electronic Funds Transfer EKG - Electrocardiogram ETS - Expiration Term of Service FAR - Federal Acquisition Regulation FBI - Federal Bureau of Investigation FL - Form Letter FPP - Family Practice Physician FTE(s) - Full Time Equivalent(s) HCAA - Health Care Acquisition Activity

HHS - Health and Human Services HIPAA - Health Insurance Portability & Accountability Act of 1996 IAW - In Accordance With IRC - Installation Record Check IV - Intravenous JC - Joint Commission LOSS - Line of Sight Supervision KO - Contracting Officer MEDC - Medical Command MEDD - Medical Department Activity MTF - Medical Treatment Facility NACI - National Agency Check with Inquiries NCOIC - Noncommissioned Officer in Charge NP - Nurse Practitioner OCON - Outside the Continental United States OIC - Officer in Charge OSHA - Occupational Safety and Health Administration or Act PA - Physician Assistant PAD - Patient Administration Division PALS - Pediatric Advance Life Support Pam - Pamphlet PAR - Performance Assessment Report PCF - Practitioner's Credentials File PCO - Procurement KO/Procuring KO PCS - Permanent Change of Station PL - Public Law POC - Point of Contact PWS - Performance Work Statement QA - Quality Assurance QA&I - Quality Assessment & Improvement OBGY - Obstetrics and Gynecology QC - Quality Control RN - Registered Nurse RFQ - Request for Quotation RFP - Request for Proposal RPO - Radiation Protection Officer SF - Standard Form SRP - Soldier Readiness Processing TAB - Therapeutic Agents Board

3. GOVERNMENT FURNISHED PROPERTY. The Government will provide the following for use only in the performance of this contract.

3.1. Facilities. The Government will furnish the parking space and the necessary connections for the Mobile MRI unit to communicate with the radiology department and the other areas of WACH essential to efficient operation.

The Contractor will provide any additional equipment required for this service. Existing Government specifications are:

One 480v 3ph 200 amp service disconnect with Russellstoll #F33478 receptacle

One 208v 3ph 100 amp service disconnect with Hubbell 5100R9W receptacle

MRI pad, 22 feet X 57 feet

3.1.2. The removal and disposal of trash, hazardous material, bio-hazardous waste will be coordinated with the radiology department. The contractor is not authorized to remove or dispose of this trash on government property without prior authority. If the contractor disposes or removes trash generated under this contract to an off-site disposal location, then it must adhere to all applicable laws and regulations relating to the disposal of hazardous material/bio-hazardous waste in the State of California.

3.2. The Government will provide the radiologists to interpret MRI scans; and all ancillary medical support personnel and ancillary services necessary to support the work required by the mobile MRI unit and the CPs.

Examples of such ancillary support include: clinical and pathological laboratory, radiology, and pharmacy.

3.3. The Government will check in all of the patients and provide eligibility checks of all persons presenting themselves for treatment in the mobile MRI unit at WACH.

3.4. The Government will provide telephone connections and CHCS capability to the MRI unit. The Contractor will be responsible for providing their own personal computers and telephone(s) instrument.

3.5. The Government will provide Cat5E or Cat6 10/100 LAN connections for CHCS, Internet, Email connectivity.

3.6. The Government will provide one analog telephone line. The telephone line is a local hospital phone number and does not have long distance capabilities. The telephone shall be used for official business only.

3.7. The Government will provide official mail and intra- hospital (distribution) mail service. The Contractor shall not receive/send personal mail through the WACH mail distribution system.

3.8. The Government will provide destruction of medical waste generated by the MRI unit during the completion of MRIs on approved patients. Hazmat and biohazard waste will be coordinated for pick up with the radiology department. The CP is responsible for maintaining the MRI unit.

3.9. The Government will provide language translation services as available in situations where interpretation is necessary. This is intended for situations when the patient does not speak fluent English.

3.10. The Government will provide required Government forms and directives necessary for performance of services required by this contract. All records, files, documents, forms, and work papers provided by the Government remain the property of the Government.

3.11. The Picture Archiving Communication System (PACS) at WACH is ISITE proprietary Philips Medical PACS software system with a regionally managed archive and will be transitioning to transitioning to Agfa IMPAX. Agfa IMPAX, the new PACS system. A Digital Imaging and Communications Medicine (DICOM) conformance statement for modalities is available upon request.

3.12. The Government will provide all disposables and medical supplies to include, gloves, needles, syringes, contrast pharmaceuticals, injector kits, linens, pillows, and sharps containers.

TDY - Temporary Duty

TO(s) - Task Order(s) USC - United States Code USPS - United States Postal Service VPN - Virtual Private Network WRCO - Western Regional Contracting Office WRMC - Western Regional Medical Command USPS - United States Postal Service

4. CONTRACTOR FURNISHED PROPERTY: The Contractor shall provide all services/supplies necessary to perform in accordance with the terms of the contract.

4.1. Equipment Requirements and Registration. The Contractor shall have the responsibility of ensuring that all equipment requirements and registration are complied with in accordance with standards set by the State of California. A copy of the current license and inspection will be posted on the mobile MRI unit. The following items and descriptions should be considered to be minimum equipment requirements/capabilities:

4.2. Magnet shall be shielded and a strength of Tesla 1.5 or higher.

4.3. Must be able to provide continuity of Tesla 1.5 strength during periods of preventive maintenance, equipment failure or replacement.

4.4. Must have High Resolution Imaging up to 512 matrixes.

4.5. Must be equipped and capable of performing 2D and 3D Multi-slice and multi-echo imaging, as well as sagittal, axial and coronal imaging. Oblique capabilities are required.

4.6. Must be equipped and capable of respiratory, cardiac, and peripheral gating. Must be equipped and capable of performing Magnetic Resonance Angiography, and diffusion imaging.

4.7. Must be Digital Radio Frequency capable.

4.8. Must provide head, neurovascular, body and designated form fitted wrist and shoulder coils.

4.9. Must provide surface coils for thoracic-lumbar spine, small body parts, neck and extremities.

4.10. Must have the capability of a gradient of 33 mT/m or higher and slew rate of 120 mT/m/ms or higher.

Must have field homogeneity of between 1-10 ppm over 30-50 cm.

4.11. Must contain a magnet safety unit including an oxygen level alarm and emergency magnet shut-off switch.

4.12. Must meet DICOM modality work list compliance, which requires the MRI unit to be able to pull patient information from a remote AE (e.g., modality work list server) to apply that information to the study.

This eliminates the need for the technologist to enter patient demographics.

4.13. The MRI unit must meet the DICOM conformance standard – the MRI unit must be able to send images to a remote AE (i.e., PACs QC Workstations) and must be able to send images to a DICOM print server.

4.14. The processing computer of the system shall be able to provide simultaneous independent clinical functions such as data acquisition, reconstruction, display, review, and archiving. Performance, protocols, and parameters shall be in accordance with the MRI unit manufacturer’s suggested guidelines. These guidelines may be adjusted or modified by the Department of Radiology Chief as needed.

4.15. The mobile MRI unit used and the trailer it is housed in shall not be more than three years old at start of service. The Contractor shall submit certification of the MRI unit and trailer’s age to the KO with their proposal.

Technical upgrades to the mobile MRI unit used in support of this contract shall be accomplished to ensure that the medical diagnostic capabilities meet the existing standard of care for units of this type. The Contractor is responsible for providing and installing manufacturer designed and issued field modifications, safety corrections and revisions for correcting software and equipment deficiencies.

4.16. The mobile MRI unit must be wheel chair and gurney accessible and must have MRI safe wheel chair and gurney in trailer for transfer of patients to MRI. All patients will be escorted by radiology staff or the Contractors CP. The Contractor will provide an MRI safe wheel chair and gurney that best accommodates their specific trailer and MRI unit. The Radiology Department is prepared to work with the Contractor to secure the storage of the MRI safe transfer equipment within the hospital if this is a concern

4.17. The Contractor will provide their own telephone instrument(s).

4.18. The Contractor must provide a system that conforms to manufacturers specifications and provides full (On- Line) line conditioning with Battery Backup, Eliminates Transients, surges, swells, sags, brownouts, noise, and wave-shape faults that is connected to Mobile MRI. If this system is external to MRI Van the Contractor needs to provide shelter for the system in accordance with manufacturer specifications.

4.19. The entire mobile system shall fit the existing MRI pad, 22 feet x 57 feet.

4.20. The mobile MRI trailer must be at least 12 feet wide.

4.21. The MRI bore must be at least 70 cm wide.

4.22. The MRI computer system must be compatible with Microsoft Windows 10.

5. SPECIFIC TASKS AND DELIVERABLES. The Mobile MRI and MRI technologist services specified in this work statement shall be performed in accordance with established principles and ethics of the medical profession.

The CPs shall not introduce new medical procedures or services without prior recommendations to, and approval of the WACH Commander which will be provided by contract modification, issued by the KO.

5.1. Contract Provider Specific Tasks.

5.1.1. The CPs shall evaluate and treat all MHS eligible patients. A minimum of 160 quality MRI scans shall be completed per month. The Contractor shall staff a MRI Technologist during all required work hours of the PWS.

The Contractor shall maintain a fill rate of at least 95% (number of hours worked/number of available hours to work).

5.1.2. The Government will schedule all patients for the Contractor’s Mobile MRI and MRI technologist. On occasion, emergency patients may need to be added to the schedule when approved by the Chief or other designee of the Radiology Department.

5.1.3. The Contractor shall provide and be responsible for the utilization of its own MRI equipment in the completion of treatment on patients referred from the MTF. Within the MRI Unit the contractor must provide a space for the patients to change. The Contractor shall refer all questions concerning patient eligibility for care to the NCOIC or other designee of the Radiology Department.

5.1.4.. CPs shall perform medical treatment of all illnesses that pertain to the specialty of MRI. CPs shall receive all patients from the waiting room in the Department of Radiology. Additionally, the CPs explains the procedure being performed, as well as positions the patient.

5.1.5. CPs shall set scanning parameters and operate the MRI equipment so as to complete the required study.

Check the patient's images with a radiologist. Performance and imaging protocols will be established by the DC and furnished to the CPs as part of the Standard Operating Procedure (SOP). Any deviation from the SOP must be approved by the DC

5.1.6. If the quality of the MRI scans, following proper examination and evaluation by the WACH radiologist is determined to be non-diagnostic due to CP’s error and substandard performance; repeat imaging will be performed with no additional charge to the MTF. If the quality of scans suffers due to the CP’s performance, Contractor shall correct the deficiency through additional training or replacement as the case may require.

5.1.7. The MRI technologist will respect a patient's right to refuse the examination. If the patient does not want the procedure performed, the patient's wish shall be respected and the incident logged in the scanner logbook and brought to the attention of the attending radiologist.

5.1.8. CPs shall assure that all female patients of child bearing age are questioned as to the possibility of pregnancy and all positive responses need to be protocolled by Radiologist.

5.1.9. Pregnant CPs will not be permitted in any area of the MRI unit in which the static magnetic field exceeds 5 Gauss.

5.1.10. MRI Technologist shall not administer anesthesia.

5.1.11. The CP will ensure that the MRI studies are sent electronically to the Government’s Picture Archiving and Communication System (PACS). The CP will perform quality checks of the images before sending them to the PACS to ensure that all images and sequences are included. The technologist will ensure that the entire study is sent to the PACS.

5.1.12. The CP will train Military and GS personnel on the basics of operating the MRI.