RFQ 36C25923Q0458 Medical Physics Services VOSB set-aside.pdf

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. UEI: EFT:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

36C25923Q0458 04-27-2023

Valaria juarez valaria.juarez@va.gov 05-04-2023

12PM MDT

36C259 Department of Veterans Affairs Network Contracting Office

NCO 19

6162 South Willow Drive, Suite 300 Greenwood Village CO 80111 Valaria Juarez valaria.juarez@va.gov

X 100

X

Y

541690

$16.5 Million

N/A

Cheyenne VAMC & Northern Colorado VA Outpatient Clinic See PWS for other address 2360 East Pershing Blvd.

Cheyenne WY 82001

36C259

Department of Veterans Affairs Network Contracting Office

NCO 19

6162 South Willow Drive, Suite 300 Greenwood Village CO 80111

TBD

Department of Veterans Affairs Financial Service Center PO Box 149971 Austin TX 78714-9971

Medical Physics Services The Cheyenne VAMC & Northern Colorado VA Outpatient Clinic are requesting Medical Physicist Services.

This will be a base plus four (4) option years.

Please see the Performance Work Statement (PWS) for details.

This is a VOSB set-aside.

All quotes due by 5/4/2023 @ 12PM MST to valaria.juarez@va.gov.

Please note that ALL certifications, licenses, etc., for both WY & CO, must be provided at time of bid submittal.

X 1

36C25923Q0458

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PERFORMANCE WORK STATEMENT

B.3 PRICE/COST SCHEDULE

ITEM INFORMATION

B.4 DELIVERY SCHEDULE

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (DEC 2022)

C.2 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.3 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) ... 40

C.4 VAAR 852.201-70 CONTRACTING OFFICER'S REPRESENTATIVE (DEC 2022)

C.5 VAAR 852.219-74 VA NOTICE OF TOTAL SET-ASIDE FOR VERIFIED

VETERAN-OWNED SMALL BUSINESSES (NOV 2022)

C.6 VAAR 852.219-75 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING--

CERTIFICATE OF COMPLIANCE FOR SERVICES AND CONSTRUCTION (NOV 2022)

C.7 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV

2018)

C.8 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020) ... 46

C.9 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.10 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (MAR 2023)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (MAR 2023)

E.2 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.3 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.4 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (NOV 2021)

E.5 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (DEC 2022)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR: TBD

b. GOVERNMENT: Contracting Officer 36C259 Jennifer Balsiger

Department of Veterans Affairs

Network Contracting Office

NCO 19

6162 South Willow Drive, Suite 300

Greenwood Village CO 80111

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

[X] 52.232-33, Payment by Electronic Funds Transfer—System For Award Management, or

[X] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] 30 days in arrears.

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO DATE

B.2 PERFORMANCE WORK STATEMENT

PERFORMANCE WORK STATEMENT (PWS)

Medical Physicist Services

1. GENERAL:

1.1. SERVICES REQUIRED: The purpose of this contract is to provide Cheyenne

VAMC and Northern Colorado VA Outpatient Clinic with Medical Physicist Services. The Medical Physicist shall be certified by the American Board of Medical Physicists as well as, have authorization for the state of Colorado and Wyoming to transport TCM-99. The contracted Medical Physicist shall provide complete physics coverage as requested by Cheyenne VAMC and Northern Colorado VA Outpatient Clinic and specified in the statement of work.

1.1.1. Equipment Inspections:

The Contractor shall conduct equipment inspections and quality control surveys of the following imaging equipment. The Contractor shall ensure the imaging equipment’s compliance with applicable Federal regulations and ACR recommendations, and shall include, but not be limited to monitoring the following basic performance characteristics:

Cheyenne VAMC 2360 East Pershing Blvd. Cheyenne, WY 82001:

(4) dental bitewing x-ray

(1) panoramic dental x-ray unit

(1) mini c-arm

(2) GE C-arm

(2) portable x-ray units with detectors

(1) CT

(3) Radiology rooms (2 radiology suites/1 radiology-fluoroscopy suite

(1) nuclear medicine unit

(1) MRI suite

Northern Colorado VA Outpatient Clinic 4575 Byrd Drive Loveland, CO 80538:

(1) dental panoramic unit

(1) Radiology suite

(1) Radiology/Fluoroscopy suite

(1) CT

(2) handheld dental units

A. Radiographic and Fluoroscopic Equipment Physics inspections of radiographic and fluoroscopic equipment shall comply with the ACR Technical Standard for Diagnostic Medical Physics Performance Monitoring of Radiographic and Fluoroscopic Equipment. The performance of each radiographic and fluoroscopic unit will be evaluated annually. This evaluation should include, but not be limited to, the following tests (as applicable):

(1) Integrity of unit assembly.

(2) Collimation and radiation beam alignment.

(3) Fluoroscopic system spatial resolution.

(4) Automatic exposure control system performance.

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

(6) Image artifacts.

(7) Fluoroscopic phantom image quality.

(8) kVp accuracy and reproducibility.

(9) Linearity of exposure versus mA or mAs.

(10) Exposure reproducibility.

(11) Timer accuracy.

(12) Beam quality assessment (half-value layer).

(13) Fluoroscopic entrance exposure rate (or air kerma rate). Maximum output and output using a phantom representing a standard-size patient for all clinically used settings. [The mode of operation [e.g., magnification mode, frame rate, and any other mode selected) must be documented for each measurement.]

(14) Fluorographic (image recording) entrance exposure rate (or air kerma rate) for cine imaging, if performed and entrance exposure (or air kerma) for spot images (if performed). Maximum output and output using a phantom representing a standard-size patient for all clinically used settings. [The mode of operation (e.g., magnification mode, frame rate, etc.) must be documented for each measurement.]

(15) Image receptor entrance exposure.

(16) Equipment radiation safety functions.

(17) Patient dose monitoring system calibration. This includes, for radiographic systems, the metric of dose to the image receptor (IEC Exposure Index or proprietary index) and, for fluoroscopy systems, the displays of cumulative air kerma and, if available, DAP.

(18) Display monitor performance.

(19) Digital image receptor performance.

(20) Grids used with portable x-ray units shall be imaged for uniformity.

(21) For radiographic units, measurement of entrance skin exposure (or air kerma) for a standard-size patient for common radiographic projections and comparison to published diagnostic reference levels and achievable doses (e.g., ACR practice parameter.

A diagnostic medical physicist or medical health physicist is qualified to perform quality assurance testing of all fluoroscopes. A therapeutic medical physicist is qualified to perform quality assurance testing of fluoroscopes used in radiation oncology.

Note: The information on entrance exposure rates (or air kerma rates) from fluoroscopy and from fluorography, in Items (13) and (14) above, for each fluoroscope, shall be in a format suitable for providing too the physicians who operate the fluoroscope.

B. Computed Radiography (CR) and Digital Radiography (DR)

Physics inspections of CR and DR equipment shall comply with the American Association of Physicist in Medicine (AAPM) Report Number 93, Acceptance Testing and Quality Control of Photostimulable Storage Phosphor Imaging Systems. The performance of CR and DR will be evaluated annually. This evaluation should include, but not be limited to, the following tests (as applicable).

(1) Component and Imaging Plate (IP) Physical Inspection and Inventory.

(2) Imaging Plate Dark Noise and Uniformity.

(3) Exposure Indicator Calibration.

(4) Linearity and Auto-ranging Response.

(5) Laser Beam Function.

(6) Limiting Resolution and Resolution Uniformity.

(7) Noise and Low-Contrast Resolution.

(8) Spatial Accuracy.

(9) Erasure Thoroughness.

(10) Aliasing/Grid Response.

(11) IP Throughput.

(12) Positioning and Collimation Errors.

C. CT Scanners The physics inspection shall conform to the 2012 ACR Computed Tomography Quality Control Manual. The performance of each CT scanner will be evaluated annually. This evaluation should include, but not be limited to, the following tests (as applicable).

(1) Review of Clinical Protocols.

(2) Scout Prescription and Alignment Light Accuracy.

(3) Image Thickness – Axial Mode.

(4) Table Travel Accuracy.

(5) Radiation Beam Width (collimation).

(6) Low-Contrast Performance (sensitivity and resolution).

(7) High-Contrast (Spatial Resolution).

(8) CT Number Accuracy.

(9) Artifact Evaluation.

(10) CT Number Uniformity.

(11) Radiation output or Dosimetry (the scanner displayed CTDIvol values must be within +/- 20% of the measured CTDIvol values).

(12) Gray Level Performance of CT Acquisition Display Monitors.

(13) Image localization from scanned projection radiograph (localization image).

(14) Acquisition workstation display.

(15) Measurement of doses for verification of scanner performance and to allow for calculation of dosimetric quantities relevant to patient examination estimates.

(16) Comparison of calculated values to scanner-reported values. These comparisons should include both 16-cm and 32-cm dosimetry phantoms, as appropriate for the CT system and for use with the indicated protocols.

(17) Limited protocol review

a) The Qualified Medical Physicist must review a selection of the most commonly used protocols. These should include adult head and abdomen protocols and protocols for very high-dose procedures (e.g., brain perfusion).

b) Key elements associated with image quality should be reviewed:

kVp mA Rotation time Detector configuration Pitch Reconstructed image thickness Appropriate use of automated settings, such as tube current modulation, kVp selection, and image reconstruction parameters Accuracy of CTDIvol Compare CTDIvol to established reference values

(18) Safety evaluation

(19) Visual inspection

a) Workload assessment

b) Scatter and stray radiation measurements (if workload and other related parameters have changed since acceptance testing)

c) Audible/visual signals

d) Posting requirements

(20) Other tests as required by state or local regulations Quality Control Program

A continuous quality control (QC) program must be established for all CT systems with the assistance of a Qualified Medical Physicist. The Qualified Medical Physicist should determine tolerances in conjunction with manufacturer specifications, the frequency of each test, and who should perform each test based on facility usage and CT usage. The on-site radiologic technologist who has been designated will conduct the routine QC. The QC program shall minimally include:

Water CT number accuracy Noise (CT number standard deviation) Artifact evaluation

Display devices Acquisition workstation

Hard-copy display unit(s), if used for patient images

Visual checklist The results of the QC program must be monitored at least annually by the Qualified Medical Physicist. If measured values of QC parameters fall outside the established tolerances, the QC radiologist shall consult with the Qualified Medical Physicist. The Qualified Medical Physicist shall recommend or, when appropriate, initiate investigative or corrective actions. The Qualified Medical Physicist will assist in prescribing corrective actions for unresolved problems.

D. Dental The physics inspection shall conform to the Conference of Radiation Control Program Directors (CRCPD), Quality Control Recommendations for Diagnostic Radiography Volume 1 Dental Facilities July 2001. The performance of dental x-ray inspections will be conducted annually. This evaluation should include, but not be limited to, the following tests (as applicable).

(1) Collimation.

(2) Beam quality (half value layer).

(3) Timer Accuracy and Reproducibility.

(4) kVp Accuracy and Reproducibility.

(5) mA or mAs Linearity.

(6) Exposure Reproducibility.

(7) Entrance Skin Exposure Evaluation, with comparison to published diagnostic reference levels and achievable doses (e.g., NCRP Report No. 172).

(8) Technique Chart Evaluation.

(9) Image uniformity (artifact evaluation).

Dental CBCT Acceptance and Performance Testing Acceptance Testing. Acceptance testing and measurements of air kerma at the isocenter for each kVp station for a range of clinically used mAs settings will be performed initially when the CBCT unit is installed, and following any move of the CBCT to another area inside or outside the initial clinical site. This testing is to ensure that the equipment performance is in agreement with the manufacturer’s technical specifications.

Performance Testing. Each CBCT unit shall undergo periodic quality control tests to ensure that the performance of the machine has not significantly deteriorated and is operating within the manufacturer’s technical specifications. This performance testing is performed by a qualified expert annually, at intervals not to exceed 14 months, and after repairs to the CBCT unit that may affect the radiation output or image quality.

Some manufacturers provide a phantom and procedures to perform machine specific quality assurance (QA) tests. In cases where the manufacturer provides a phantom and procedures to perform specific tests, but the tests are not included in this SOW, then the manufacturer’s machine-specific QA tests shall be performed in addition to the QA tests in this SOW.

Acceptance and Annual physics testing for Dental CBCT

1. Radiation output Repeatability Make four measurements of the air kerma at the isocenter at a clinically used setting. The measurements should be less than +/-5% of the average of the five measurements and the measurements should be less than +/- 5% of the previous year’s measurement.

2. Radiation Output Reproducibility Measure the air kerma at the isocenter for each kVp station and a range of clinically used mAs setting. Compare the results to the baseline values established at the initial acceptance testing. The values should be +/-5% of the baseline.

3. kVp Accuracy Measure the kVp at all clinically used settings. The measured kVp should be +/-5% of the selected kVp.

4. kVp Repeatability Make five kVp measurements each for two clinically used kVp settings. All measured values should be +/-5% of the mean kVp.

5. kVp Reproducibility Measure the kVp at all available kVp settings. The measured values should be +/-5% of the baseline.

6. Beam quality Measure the half value layer (HVL) for aluminum. The minimum shall comply with Section F.4.d of the Suggested State Regulations for Control of Radiation, Conference of Radiation Control Program Directors.

7. Radiation field of view (FOV) Measure the width of the radiation field at the isocenter. The width of the beam should be 3 mm or 30% of the total nominal collimated width.

8. Image Quality Image the phantom provided by the manufacturer or another suitable phantom. Assess high contrast spatial resolution, uniformity of trans axial images, and image noise. Imaging uniformity shall be assessed over the entire range of axial images.

9. Accuracy of Linear Measurements

Using images of an appropriate phantom, assess the accuracy of distance measurements.

10. Accuracy of Patient Dose Metric Indication Assess the accuracy of the indicated dose metric- typically dose area product (DAP).

11. Patient Dose Assessment From a scan or scans using the facility’s standard techniques, record the dose metric (typically DAP) and compare to achievable levels and diagnostic reference levels (if available)

12. Review of the technical QA program The qualified expert shall review the technical QA program.

The review shall include a trend analysis of the QA data.

The results of the technical QA program review shall be included in the written report. Any trends that identify problems shall be included in the report along with recommended corrective actions.

13. Display Monitors Perform a visual analysis of the Society of Motion Picture and Television Engineers (SMPTE) test pattern.

Display the test pattern on the imaging console. Set the display window width/level to the manufacturer-specified values for the pattern. Do not set the window/level by eye;

doing so invalidates the procedure.

Examine the pattern to confirm that the gray level display in the imaging console is subjectively correct.

Review the line pair patterns in the center and at each of the corners.

Review the black-white transition.

Look for any evidence of “scalloping” (loss of bit depth) or geometric distortion.

Use a photometer to measure the maximum and minimum monitor brightness (0% and 100% steps) Measure additional steps within the pattern to establish a response curve.

Measure the brightness near the center of the monitor and near all 4 corners (or all 4 sides, depending on the test pattern used).

14. Viewing Conditions Assess the viewing conditions for the area in which the monitor used to evaluation the CBCT studies is located.

E. Mammography

The qualified diagnostic medical physicist inspecting mammography equipment must meet the qualifications outlined in the MQSA and shall provide the facility with up-to-date documentation demonstrating the qualified diagnostic medical physicist is MQSA qualified. Inspections of mammography equipment must comply with the latest requirements posted on the ACR Web site for the manufacturer of the digital mammography unit being inspected. Inspection items may include:

(1) Mammographic Unit Assembly Evaluation.

(2) Collimation assessment.

(3) Artifact evaluation.

(4) kVp accuracy and reproducibility.

(5) Beam quality assessment – HVL measurements.

(6) Evaluation of system resolution.

(7) Automatic Exposure Control (AEC) function performance .

(8) Breast entrance exposure, AEC reproducibility, and average glandular dose.

(9) Radiation output rate.

(10) Phantom image quality evaluation.

(11) Signal–to–noise ratio and contrast–to noise ratio measurements.

(12) View box luminance and room illuminance.

(13) Review Workstation (RWS) tests.

F. MRI

The physics inspection shall conform to the 2004 ACR Magnetic Resonance Imaging Quality Control Manual and subsequent revisions. The performance of each MRI scanner will be evaluated annually. This evaluation should include, but not be limited to, the following tests (as applicable).

(1) Magnetic field homogeneity.

(2) Geometric accuracy.

(3) Inter-slice RF interference.

(4) Slice position accuracy.

(5) High-contrast resolution

(6) RF coil performance.

(a) Volume coils’ signal-to-noise ratio

(b) Volume coils’ image uniformity

(c) Volume coils’ ghosting ratio

(d) Phased array coils' signal-to-noise ratio

(e) Surface coils’ signal-to-noise ratio

(7) Slice thickness accuracy

(8) Low-contrast detectability

(9) Soft copy displays

(10) Technologist’s QC program

(11) Site phantom inventory

(12) Site RF coil inventory

G. PET

The physics inspection shall conform to the ACR PET Phantom Instructions for Evaluation of PET Image, ACR Nuclear Medicine Accreditation Program PET Module. The performance of each PET scanner shall be evaluated quarterly.

For PET/CT units the CT must be inspected at least annually per Item C above.

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

(1) Uniformity.

(2) Spatial resolution.

(3) SUV analysis.

H. Nuclear Medicine The physics inspection shall conform to the ACR annual performance tests for nuclear medicine cameras. The qualified diagnostic medical physics shall also perform the quarterly testing as outlined by the ACR. The performance of each nuclear medicine scanner shall be performed annually. This evaluation should include, but not be limited to, the following tests (as applicable).

(1) Intrinsic Uniformity

(2) System Uniformity

(3) Intrinsic or System Spatial Resolution

(4) Relative Sensitivity

(5) Energy Resolution

(6) Count Rate Parameters

(7) Formatter/Video Display

(8) Overall System Performance for SPECT

(9) System Interlocks

(10) Dose Calibrators (Geometry, if applicable, Accuracy)

(11) Thyroid Uptake and Counting Systems

I. Ultrasound The physics inspection shall conform to the ACR performance tests for ultrasound. On an ongoing basis (annually), the following tests should be done for each ultrasound (US) unit. Testing should be done using two transducers commonly used with any unit employing more than one transducer. Data should be taken from testing of the transducers which are used for the most frequently occurring examination(s) at the site. It is recommended that these be of different scan formats such as one linear (or curvilinear array), and one sector (mechanical, phased, or vector).

(1) System Sensitivity/Penetration. This test should be done with the following settings:

• maximum transmit power

• proper receiver gain and time gain compensation (TGC) that allows echo texture to be visible in the deep region

• transmit focus at the deepest depth

• The maximum depth of visualization is determined by comparing the gradually weakening echo texture to electronic noises near the bottom of the image.

(2) Image Uniformity:

• Adjust the TGC controls and other sensitivity controls to obtain an image as uniform as possible.

• vertical or radially oriented streaks?

• dropouts?

• reduction of brightness near edges of the scan?

• brightness transitions between focal zones?

(3) Electrical and Mechanical Safety and Cleanliness

• Are all cords and cables intact (no frays)?

• Are all transducers intact without cracks or delamination?

• Are the transducers cleaned after each use?

• Are the image monitors clean?

• Are the air filters clean?

• Are the wheel locks in working condition?

• Are the wheels fastened securely to the US unit and do the wheels rotate easily?

• Are all accessories (VCR, cameras, etc.) fastened securely to the US unit?

(4) Gray Scale Photography (if applicable) – Do either (a), (b), or (c).

(a) For Scanners with a Discrete Bar Pattern Count the number of distinct gray bar steps on the viewing monitor.

Then count the number of steps visualized in the gray bar on the hard copy image.

(b) For Scanners with a Continuous Gray Bar Pattern Use calipers to measure the length of the black-to-white transition of the gray wedge on the viewing monitor. If the relative length of the black-to-white transition on the hard copy image is less, document how much is missing.

(c) For Laser Imager (Hard Copy Device) Prior to filming any images, a SMPTE test pattern should be printed using the appropriate window width (WW) and window level (WL).

If unfamiliar with this procedure, review Gray et al., “Test pattern for video display and hard-copy camera,” Radiology 145:519-527 (1985). When printed, the 95% density patch within the 100% square and the 5% density patch within the 0% square should be visible, and there should be no notable distortions or artifacts present. If these criteria are not met, contact the Chief, Healthcare Technology Management to coordinate for laser camera calibration before proceeding with any filming.

(5) Hard Copy Output Quality Test (Digital) (if applicable) This test, or a similar test specifically recommended by the hard copy equipment manufacturer.

Required Test Equipment

• Densitometer

• SMPTE Test Pattern or another similar test pattern or phantom image having a wide range of gray scales.

• The same test image should be used each time.

J. Display Monitors The annual performance evaluation conducted by the diagnostic medical physicist includes testing of image acquisition display monitors for maximum and minimum luminance, luminance uniformity, resolution, and spatial accuracy. The image acquisition display monitors for nuclear medicine, PET, CT, and MRI units shall be tested.

1.2. PLACE OF PERFORMANCE: Cheyenne VAMC at 2360 E. Pershing Blvd, Cheyenne, WY 82001-5356 and Northern Colorado VA Outpatient Clinic 4575 Byrd Avenue, Loveland, CO 80538.

1.3. AUTHORITY: Health Care Resources in accordance with Title 38 United States Code (USC) 8153 are to be furnished by the contractor on behalf of Cheyenne VAMC and Northern Colorado VA Outpatient Clinic.

1.4. POLICY AND REGULATIONS: Contractor shall comply with all applicable policies and regulations, including, but not limited to the following:

1.4.1. VA Directive 1663: Health Care Resources Contracting - Buying http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=347

1.4.2. VHA Directive 2006-041 “Veterans’ Health Care Service Standards”

(expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

1.4.3. VHA Directive 2010-018 “Facility Infrastructure”

www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2227

1.4.4. VHA Directive 1192 “Seasonal Influenza Prevention Program” https://www.publichealth.va.gov/docs/flu/VHA_Directive_1192_Sep

1.4.5. VHA Handbook 1100.17: National Practitioner Data Bank Reports -http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

1.4.6. VHA Handbook 1100.18 Reporting And Responding To State Licensing Boards -http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

1.4.7. VHA Handbook 1100.19 Credentialing and Privileging -

http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1806

1.4.8. VHA Directive 2012-030 Credentialing of Health Care Professionals – http://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=2815

1.4.9 VHA Handbook 1400.0 Resident Supervision, http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2847 http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=347 https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443 http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2227 https://www.publichealth.va.gov/docs/flu/VHA_Directive_1192_Sep http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1806 http://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=2815 http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2847

1.4.10 VHA Handbook 1907.01 Health Information Management and Health Records http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791

1.4.11 Privacy Act of 1974 (5 U.S.C. 552a) as amended, http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.5. DEFINITIONS/ACRONYMS:

1.5.1. ABR: American Board of Radiology

1.5.2. ACR: American College of Radiology (www.acr.org/)

1.5.3. ACO: Administrative Contracting Officer

1.5.4. AOA: American Osteopathic Association

1.5.5. BAA : Business Associate Agreement

1.5.6. CAMPEP: Commission on Accreditation of Medical Physics Educational

Programs (http://www.campep.org/default.asp)

1.5.7. CDC: Centers for Disease Control and Prevention

1.5.8. CEU: Certified Education Unit

1.5.9. CME: Continuing Medical Education

1.5.10. CMS: Center for Medicare and Medicaid Services

1.5.11. CO: Contracting Officer

1.5.12. COR: Contracting Officer’s Representative

1.5.13. COS: Chief of Staff

1.5.14. CPARS: Contractor Performance Assessment Reporting System

1.5.15. CPRS: Computerized Patient Recordkeeping System- electronic health record system used by the VA.

1.5.16. FSMB: Federation of State Medical Boards

1.5.17. Full Time Equivalent (FTE) – VA’s definition for full-time positions who work the equivalent of 80 hours every two weeks, 2,080 hours per year. In calculating FTE, any hours not worked on national holidays shall not be included.

1.5.18. HHS: Department of Health and Human Services

1.5.19. HICPAC: Healthcare Infection Control Practices Advisory

Committee- a federal advisory committee made up of 14 external infection control experts who provide advice and guidance to the CDC and the Secretary of HHS regarding the practice of healthcare infection control, strategies for surveillance and prevention and control of healthcare-associated infections in United States health care facilities.

1.5.20. HIPAA: Health Insurance Portability and Accountability Act

1.5.21. IGRT: Image Guided Radiation Therapy is the process of frequent two- and three-dimensional imaging, during a course of radiation treatment, used to direct radiation therapy utilizing the imaging coordinates of the actual radiation treatment plan.

1.5.22. IMRT: Intensity Modulated Radiation Therapy is the process of delivering highly conformal radiotherapy to the tumor while sparing the http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm http://www.acr.org/ http://www.campep.org/default.asp surrounding normal tissues by varying radiation intensity across treatment portals.

1.5.23. ISO: Information Security Officer

1.5.24. MU: Monitor Unit is a measure of the machine output of a linear accelerator in radiation therapy.

1.5.25. NHPP: National Health Physics Program provides regulatory oversight for the Nuclear Regulatory Commission master materials license issued to VHA to include permitting for use of materials, on-site inspections, and investigations of allegations, medical events, and incidents. In addition, they provide oversight for machine sources of ionizing radiation used for radiation therapy. They also provide assistance and technical information for uses of ionizing radiation for healthcare diagnosis and treatment and non-human biomedical research (http://www.patientcare.va.gov/NHPP.asp)

1.5.26. NROP: National Radiation Oncology Program

1.5.27. NRC: National Radiation Safety Committee

1.5.28. POP – Period of Performance

1.5.29. PWS: Performance Work Statement

1.5.30. QA/QI: Quality Assurance/Quality Improvement

1.5.31. QM/PI: Quality Management/Performance Improvement

1.5.32. QASP: Quality Assurance Surveillance Plan

1.5.33. QMP: Quality Management Program

1.5.34. RPC: Radiological Physics Center

1.5.35. SPE: Senior Procurement Executive

1.5.36. SRS: Stereotactic Radio Surgery is a minimally invasive form of surgical intervention which makes use of a three-dimensional coordinated system to locate small targets inside the body and to perform on them some action such as ablation, biopsy, lesion, injection, stimulation, implantation, radiosurgery (SRS), etc.

1.5.37. SRT: Stereotactic Radio Therapy

1.5.38. TJC: The Joint Commission

1.5.39. TLD: Thermoluminescent Dosimeter is a device that measures radiation dose

1.5.40. VA: Veterans Affairs

1.5.41. VAMC: Veterans Affairs Medical Center

1.5.42. VetPro: a federal web-based credentialing program for healthcare providers.

1.5.43. VHA: Veterans Health Administration

2. QUALIFICATIONS:

2.1. THE CONTRACTOR SHALL:

2.1.1. License: All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Providers who have ever had a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action, or denied upon application will not be considered for purposes of this contract.

http://www.patientcare.va.gov/NHPP.asp

1. Must be authorized in the state of Colorado and Wyoming to transport

TCM-99.

2. All services must follow guidance by the Joint Commission, NRC, ACR, and State of Colorado.

3. All licenses must be provided at time of quote submittal.

2.1.2. Board Certification: All providers shall be Board Certified. All continuing education courses required for maintaining certification must be kept up to date at all times. Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance.

1. Medical Physicists must be Board Certified in Medical Physics or

Therapeutic Medical Physics by the ABR and maintain licensure with the Board of Licensure for Professional Medical Physicists, if applicable. Certification must be maintained throughout the contract POP. In the event that the Contractor’s Medical Physicist(s) is/are not directly employed by the treating facility, documentation must be provided to ensure adequate certification.

2.1.3. Credentialing and Privileging: Credentialing and Privileging are to be done in accordance with the provisions of VHA Handbook 1100.19, referenced above.

The Contractor is responsible to ensure that the proposed physician(s) possess the requisite credentials enabling the granting of privileges.

1. If a contractor’s physician and/or contract provider(s) are not credentialed and privileged or have credentials/privileges suspended or revoked, the contractor shall furnish an acceptable substitute without any additional cost to the government.

2. Credentialing of Healthcare Professionals other than physicians: In accordance with VHA Directive 2012-030, all healthcare professionals who claim licensure, certification, or registration, as applicable to the position (this applies to all who are appointed or utilized on a full-time, part-time, intermittent, consultant, without compensation, on-station fee-basis, on-station contract, or on-station sharing agreement basis) and who are not currently credentialed in accordance with VHA Handbook 1100.19, must be credentialed in accordance with this directive.

3. All physicians who will provide services under this contract shall be appropriately credentialed and privileged according to the Bylaws and Rules of the contractor’s facility.

2.1.4. Technical Proficiency: The contractor’s physicians and other contract providers shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read, and write English fluently. The contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification, and/or licensure related to the provision of care, treatment, and/or services performed. The contractor’s physician(s) and other contract providers (s) shall have knowledge of professional care theories, principles, practices, and procedures to serve the patient population. The contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contract providers. Contract providers shall be responsible for abiding by the Facility’s Medical Staff By- Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

2.1.5. Continuing CME/CEU Requirements: The contractor shall provide the COR copies of current CMEs as required or requested by the VAHCS. Contract providers registered or certified by national medical associations shall continue to meet the minimum standards for CME to remain current. CME hours shall be reported to the credentialing office for tracking. These documents are required for initial and renewal privileging. Failure to provide this will result in loss of privileges.

2.1.6. Training: N/A Contractor will not be reporting to the VA for work, and will only be inspecting equipment.

2.1.7. Standard Personnel Testing (PPD): N/A Contractor will not be reporting to the VA for work, and will only be inspecting equipment.

2.1.8. National Provider Identifier (NPI): Contract physicians who provide billable healthcare services to VHA shall obtain NPI as required by HIPAA National Provider Identifier Final Rule, administered by the CMS. This rule establishes the assignment of a 10-digit numeric identifier for contractor staff, intended to replace the many identifiers currently assigned by various healthcare plans.

Contractor physicians must also designate their Specialist/Subspecialties by means of Taxonomy Codes on the NPI application. The NPI must be obtained via a secure website at http://nppes.cms.hhs.gov/NPPES

2.1.9. Conflict of Interest: The contractor is responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance. At the time of proposal, the contractor shall provide a statement that describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflict of interest relating to the services to be provided. The Contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services. The Contractor must also provide relevant facts that show how it’s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70, Organizational Conflicts of Interest (Jan 2008), and fully outlined in response to the subject attachment in Section D of the solicitation document.

2.1.10. Citizenship-related Requirements:

http://nppes.cms.hhs.gov/NPPES

1. The contractor certifies that they will comply with all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended;

its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement, and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals;

2. While performing services for VA, the contractor shall not knowingly employ, contract, or subcontract with an illegal alien; foreign national non-immigrant who is in violation of their status as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the contractor is required to comply with all E-verify requirements consistent with Executive Order 12989 and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations.

3. If the contractor fails to comply with any requirements outlined in the preceding paragraphs or its agency regulations, the VA may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by the Homeland Security, Immigration and Customers Enforcement and the US Dept. of Labor, shall be prohibited from working at the Contractor’s place of business that services VA patient referrals, or other places where the contractor provides services to veterans who have been referred by the VA, and shall form the basis for termination of this contract for breach.

4. This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001.

5. The contractor agrees to obtain a similar certification from its subcontractors. This certification shall be made as part of the offeror’s response to the RFP using the subject attachment in Section D of the solicitation document.

2.1.11. Annual Office of Inspector General (OIG) Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the Dept. of Health and Human Services OIG has established a list of parties and entities excluded from federal healthcare programs. Specifically, the listed parties and entities may not receive federal healthcare program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

1. Therefore, the contractor shall review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG website (http://oig.hhs.gov/exclusions/index.asp) to ensure that the proposed physicians are not listed. Contractor shall note that any excluded http://oig.hhs.gov/exclusions/index.asp individual or entity that submits a claim for reimbursement to a federal healthcare program or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMPs may also be imposed against the contractor that employs or enter into contracts with excluded individuals to provide items or services to the federal program beneficiaries.

2. By submitting their proposal, the contractor certifies that the HHS OIG List of Excluded Individuals/Entities has been reviewed and that the Contractors or firm is not listed as of the date of offer/bid was submitted.

2.1.12. Clinical/Professional Performance: The qualifications of contractor personnel are subject to review by Medical Center COS or his/her clinical designee and approval by the Medical Center Director as provided in VHA Handbook 1100.19. Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the VAMC COS and/or the Chief of the Service or his/her designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.

2.1.13. Non-Personal Healthcare Services: The parties agree that the contractor and all contractor physicians shall not be considered VA employees for any purpose.

2.1.14. Indemnification: The Contractor shall be liable for, and shall indemnify and hold harmless the government against, all actions or claims for loss of or damage to property or the injury or death or persons, arising out of or resulting from the fault, negligence, or act of omission of the contractor, its agents, or employees.

2.1.15. Prohibition against Self-Referral: Contractor physicians are prohibited from referring VA patients to contractors, or their own, practice.

2.1.16. Inherent Governmental Functions: Contractor and their physicians shall not perform inherently governmental functions. This includes but is not limited to the determination of agency policy, determination of federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for employment, approval of position descriptions and performance standards for federal employees, approving any contractual documents, approval of federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.1.17. No-Employee Status: The contractor shall be responsible for protecting contractor’s medical physicist. To carry out this responsibility, the contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

1. Worker’s Compensation

2. Professional Liability Insurance

3. Health Examinations

4. Income Tax Withholding

5. Social Security Payments

2.1.18. Tort Liability: The Federal Tort Claims Act does not cover contractors or contract physicians. When the contractor has been identified as a provider in a tort claim, the contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a contractor’s action or non-action shall be the responsibility of the contractor and/or insurance carrier.

2.1.19. Key Personnel: The contractor shall provide the number of qualified staff as is necessary to perform the services required under this contract, at the staffing level determined to be professionally acceptable by the Cheyenne VAMC and Northern Colorado VA Outpatient Clinic COS and in accordance with the American College of Radiology staffing guidelines.

1. The minimum number of Board-Certified Medical Physicists required to be on-site daily is one (1), as defined the section, Hours of Operation.

2. N/A

3. Personnel Substitutions: The contractor shall notify the CO, in writing, within 5 days after the occurrence of any of these events and provide the information required below.

2.1.19.3.1. The contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced.

The CO will notify the Contractor within 5 calendar days after receipt of all required information of the decision on the proposed substitutes. The contract will be modified to reflect any approved changes of key personnel.

2.1.19.2.2 The government reserves the right to refuse acceptance of any contractor personnel at any time after performance begins if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction, or negligence in performing directed tasks, or other conduct resulting in formal complaints by a patient or other staff members to designated government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the COS or designee show documented clinical problems or continual unprofessional behavior/actions with any contractor physicians, s/he may request without cause immediate replacement of said contractor physician. The CO and COR shall deal with issues raised concerning contractor’s physician conduct. The final arbiter on questions of acceptability is the CO.

2.1.19.3.2. Contingency Plan: Because continuity of care is an essential part of VAMC’s medical services, the Contractor shall have a contingency plan in place to be utilized if the contractor’s physicians leave the contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

3. VA Hours of Operation/Scheduling

3.1. VA Business Hours Clinic Schedule: N/A Contractor will have a set schedule of monthly equipment inspections approved by the facility COR.

3.2. Federal Holidays: The following holidays are observed by the Department of Veterans Affairs:

• New Year’s Day

• President’s Day

• Martin Luther King’s Birthday

• Memorial Holiday

• Juneteenth

• Independence Day

• Labor Day

• Columbus Day

• Veterans Day

• Thanksgiving

• Christmas

• Any day specifically declared to be a national holiday.

3.3. Cancellation/Rescheduling: Unless a state of emergency has been declared, the Contractor shall be responsible for providing services.

3.4. Emergency/Urgent Response Time: The Medical Physicist must be on location within 24 hours, excluding weekends/holidays, of notification from the COR, Contracting Officer, or Contract Specialist.

• For weekends/holidays Response Time: The Medical…