S02- Attachment 1-RFQ 36C24825Q0788 Diagnostics Medical Physics Services-06-27-2025.pdf

36C24825Q0788

Table of Contents

SECTION B - ATTACHMENT S02- Attachment 1-RFQ 36C24825Q0788 Diagnostics

Medical Physics Services

B.1 CONTRACT ADMINISTRATION DATA

B.2 PERFORMACE WORK STATEMENT

B.3 PRICE/COST SCHEDULE

ITEM INFORMATION

SECTION C - CONTRACT CLAUSES

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

AND COMMERCIAL SERVICES (NOV 2023)

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) ...38

C.4 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.5 VAAR 852.219-73 VA NOTICE OF TOTAL SET-ASIDE FOR CERTIFIED

SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESSES (JAN 2023)

(DEVIATION)

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

CERTIFICATE OF COMPLIANCE FOR SERVICES AND CONSTRUCTION (JAN 2023)

(DEVIATION)

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

2018)

C.8 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.9 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (JAN 2025) (DEVIATION FEB 2025)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 S02- Copy of VACHS Equipment List for DMP Services Contract

SECTION E - SOLICITATION PROVISIONS

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

COMMERCIAL SERVICES (SEP 2023)

E.2 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.3 52.204-29 FEDERAL ACQUISITION SUPPLY CHAIN SECURITY ACT

ORDERS—REPRESENTATION AND DISCLOSURES (DEC 2023)

E.4 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.5 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.6 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.7 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (MAY 2024) (DEVIATION

FEB 2025)

SECTION B - ATTACHMENT S02- Attachment 1-RFQ 36C24825Q0788

Diagnostics Medical Physics Services

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C248

Department of Veterans Affairs

Network Contracting Office 8 (NCO 8)

VA Caribbean HCS (Admin Bldg)

#10 Calle Casia Suite #4M440

San Juan PR 00921-3201

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

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [x] After Inspection/Acceptance is completed.

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. https://www.tungsten-network.com/customer-campaigns/veteransaffairs/

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

AMENDMENT NO DATE

https://www.tungsten-network.com/customer-campaigns/veteransaffairs/

B.2 PERFORMACE WORK STATEMENT

DIAGNOSTIC MEDICAL PHYSICS ON-SITE SERVICES

A. PURPOSE: The Veterans Health Administration (VHA) has mandated that medical care facilities utilizing medical devices that emit radiation, both ionizing and non-ionizing, for diagnostic purposes, comply with the American College of Radiology

(ACR), the American Association of Physicists in Medicine (AAPM), the Food and

Drug Administration, the Mammography Quality Standard Act (MQSA) and the Joint

Commission (JC) standards. These standards require that medical physicists, certified for the modality(ies) they test, have inspected, and reviewed the system(s) to ensure they are safe for patient use and produce images that meet set standards.

B. BACKGROUND: The VHA is responsible for ensuring qualified personnel provide on-site diagnostic medical physics services under the terms and conditions stated herein and shall adhere to VHA Directive 1105.04 Fluoroscopy Safety, VHA

Directive 1105.05 Magnetic Resonance (MR) Safety, and VHA Directive 1129

Radiation Protection for Machine Sources of Ionizing Radiation. Medical devices that are used to measure radiation or use radioactive materials for patient care shall comply with Nuclear Regulatory Commission (NRC) regulations and VHA National

Health Physics permit conditions for the facility under the VHA Master Materials

License (MML). These devices are required to be calibrated and tested annually by qualified board-certified medical physicists to ensure the devices are safe for measuring patient radiation doses, radiation being emitted from patients, or radioactive samples.

C. SCOPE: The Contractor shall comply with radiation protection standards in 29 CFR

1910.1096 and 10 CFR 20 and immediately report any unsafe conditions with the potential to adversely impact the facility radiation workers or patients to the Radiation

Safety Officer (RSO). The contract requires one contractor to provide a “turnkey operation,” i.e., all inspection testing and calibration done by qualified diagnostic medical physicists directed to execute this contract, and their associated physics support equipment and services.

D. PLACES OF PERFORMANCE:

VA Caribbean Healthcare System (VACHS) VA San Juan | 10 Casia Street | San Juan, PR 00921-3201

VA Eurípides Rubio Clinic- Ponce Outpatient Clinic (POPC) | 1802 Navarra Street |

Ponce, PR 00716-2001

Mayaguez VA Outpatient Clinic (MOPC) | ST RD #2 Km.149.9, Ave. Algarrobo 175

|Mayaguez, PR 00682

E. POLICY/HANDBOOKS:

VHA Handbook 1907.01 Health Information Management and Health ReGPOCds:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9235 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9235

VHA Directive 1105 Management of Radioactive Materials:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9188

VHA Directive 1105.02 Nuclear Medicine and Radiation Safety Administrative Services:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=7519

VHA Directive 1105.03 Mammography Program Procedures and Standards:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=6423

VHA Directive 1105.04 Fluoroscopy Safety:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=7454

VHA Directive 1105.05 Magnetic Resonance (MR) Safety:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=6430

VHA Directive 1129 Radiation Protection for Machine Sources of Ionizing Radiation:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3081

VHA Directive 1200.05 Requirements for the Protection of Human Subjects in Research:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8171

US Nuclear Regulatory Commission for management and use of radioactive materials for medical use and radiation safety requirements, to include (but not limited to) 10 CFR

Parts 19, 20, 30, 33, 35, and 71

Regulations (NRC, 10 CFR) | NRC.gov

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

F. DEFINITIONS/ACRONYMS:

AAPM: American Association of Physics in Medicine

ABR: American Board of Radiology

ACR: American College of Radiology

AEC: Automatic Exposure Control

CBCT: Cone Bean Computer Tomography

CO: Contracting Officer

GPOC: Government Point of Contact

CPARS: Contractor Performance Assessment Reporting System

CR: Computed Radiology

CT: Computed Tomography

CTDI: Computer Tomography Dose Index

DAP: Dose Area Product

DMP: Diagnostic Medical Physicist

DR: Digital Radiology

DRL: Diagnostic Reference Level

EMR: Electronic Medical ReGPOCd

FOV: Field of View

GPOC: Government Point of Contact

HAS: Health Administration Services

HTN: Healthcare Technology Management

HVL: Half-Value Layer

JPSR: Joint Patient Safety Reporting

MRI: Magnetic Resonance Imaging

MQSA: Mammography Quality Standards Act

NCRP: National Council for Radiation Protection https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9188 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=7519 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=6423 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=7454 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=6430 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3081 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8171 http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

NHPP: National Health Physics Program

NM: Nuclear Medicine

PET: Positron Emission Tomography

PACS: Picture Archiving and Communication System

PWS: Performance Work Statement

QAP: Quality Assurance Program

RSO: Radiation Safety Officer

RW: Review Workstation

SMPTE: Society of Motion Picture and Television Engineers

SPECT: Single‐photon Emission Computed Tomography

TJC: The Joint Commission

TLD: Thermoluminescent Dosimeter

VA: Department of Veterans Affairs

VACHS: Veterans Affairs Caribbean Healthcare System

VHA: Veterans Health Administration

VISN: Veterans Integrated Service Network

G. WORK HOURS SCHEDULE:

1. Work Hours:

a. Normal Business Hours: 7:00 AM to 4:30 PM, Monday through Friday, excluding

Federal Holidays.

b. Emergency Hours: 24 hours per day, 7 days a week, 365 days a year. Telephone consultations shall be available 24 hours per day.

c. Holidays: The Contractor shall not schedule interfacing work (meetings, approvals, deliveries, etc.) with the Government on any established holidays in the federal service or any other day designated as a holiday in Federal Statutes or by Executive Order, except with the prior approval of the CO or the

Government Point of Contact (GPOC). The following days are observed by the

Department of Veterans Affairs:

1) New Year's Day (January 1)

2) Birthday of Martin Luther King, Jr. (Third Monday in January)

3) President ‘s Day (Third Monday in February)

4) Memorial Day (Last Monday in May)

5) Juneteenth (June 19)

6) Independence Day (July 4)

7) Labor Day (First Monday in September)

8) Columbus Day (Second Monday in October)

9) Veterans Day (November 11)

10) Thanksgiving Day (Fourth Thursday in November)

11) Christmas Day (December 25)

2. Schedule of Services:

a. Services shall be scheduled by the Contractor that provides not less than 45 days’ notice to the VACHS. The Contractor shall coordinate with the contract GPOC of each facility as well as the RSO. (Typically, scheduling can be accomplished and confirmed via email.

b. Scheduling for post repair testing shall be at the soonest available date(s) but cannot exceed 10 business days from repair.

c. Scheduling for post repair required testing on screening mammography shall be made at the soonest available date(s) but cannot exceed 3 business days from repair to minimize patient delay in follow up diagnosis or treatment.

d. All routine services shall be scheduled in advance to be performed during normal business hours: 7:00 AM to 4:30 PM, Monday through Friday, excluding Federal

Holidays.

e. The contractor shall submit an equipment annual certification schedule visits.

The equipment list shall be divided in four/quarterly evaluations visits for approval within two weeks from awarded contract and options. This will allow the

GPOC to coordinate with HAS and ensure the availability of the equipment, minimizing the impact on patient care.

3. In the event that an imaging diagnostic equipment experiences repairs, services might require URGENT response times, as a physicist will be required to test the equipment before patient care is allowed to begin. This urgent emergency work that could be performed outside of normal working hours of coverage shall be requested by the GPOC, RSO or by a designee of the HTM Office. The Contractor shall respond to GPOC by telephone within two hours and able to be on-site for emergency services within three days unless otherwise specifically required by specific date when on-site services are required.

H. PERSONNEL QUALIFICATIONS: The Contractor shall be responsible for employing technically qualified personnel to perform the work specified in this PWS.

The Contractor shall maintain the personnel, organization, and administrative control necessary to ensure that the work delivered meets the contract specifications and requirements. The work history of each contractor employee shall contain experience directly related to the task and functions he/she is intended to perform under this contract. The Government reserves the right, during to request work histories on any contractor employee for the purposes of verifying compliance with the contract requirements. Moreover, the Government reserves the right to review resumes of contractor personnel proposed to be assigned. Personnel assigned to, or utilized by, the Contractor in performance of work shall be fully capable of performing the requirements contained in the PWS in an efficient, reliable, and professional manner.

1. Specific Personnel Qualifications Requirements - Personnel assigned to or utilized by the contractor in the performance of this contract shall, as a minimum:

a. Holds board certification in diagnostic radiologic physics or radiologic physics by the American Board of Radiology (ABR) or in Diagnostic Imaging Physics by the American Board of Medical Physics, or in Diagnostic Radiological

Physics by the Canadian College of Physicists in Medicine .

b. For mammography, the qualified medical physicist shall meet MQSA qualifications to perform mammography inspections and can have state licensure in lieu of board certification.

c. For diagnostic computed tomography (CT), nuclear medicine, PET, Dental, Ultrasound or MRI, the qualified medical physicist shall document three (3) years of experience for the modality being inspected, and meet the following requirements in lieu of board certification:

1) A graduate degree in physics, medical physics, biophysics, radiologic physics, medical health physics, or a closely related science or engineering discipline from an accredited college or university

2) Formal graduate-level coursework in the biological sciences with at least one course in biology or radiation biology and one course in anatomy, physiology, or a similar topic related to the practice of medical physics

2. VA requires that Diagnostic Medical Physicists are credentialed through the local VA

Caribbean Healthcare System Credentialing and Privileging Office, i.e., VetPro. Link and/or paperwork to initiate the credentialing process will be made available to contractor after award. All personnel performing work at VACHS will be required to be credentialed through this office.

I. CONTRACT SPECIFICS:

1. Prior to beginning services at any of the Puerto Rico VA facilities specified above, the Contractor service representative shall report to the RSO in VACHS San Juan or the HTM Supervisor to sign in before any work is performed on the facilities, and to sign out after completion of assignment. The contractor shall furnish a detailed field service report, or equivalent, showing work completed to maintain operating efficiency of the equipment.

2. The contractors shall not have access to the VISTA computer network, nor shall the contractor access any PHI and or PII (electronic or hardcopy) at any time.

3. The contractor shall only respond to service calls placed from GPOC or the RSO.

The Government Point of Contact is Maria Anglada (facility Health Physicist), her office phone number is (787)641-7582 ext. 13933 and her email address is maria.anglada@va.gov or, the RSO, Lynes Matos, RSO, VACHS, her 24/7 phone number is (939)224-8056 and his email address is Lynes.matos@va.gov.

4. The Contractor shall respond to GPOC contact by telephone within two hours and be on-site for emergency services within three days unless otherwise specifically required by specific date when on-site services are required.

5. Contractor shall not perform any service that will result in additional charges without prior approval from the Contracting Officer.

J. SERVICES TO BE PROVIDED:

1. Equipment Testing – The Contractor shall conduct equipment inspections or quality control surveys of the imaging equipment modalities listed below to their required schedule to ensure the imaging equipment's compliance with applicable federal regulations, with current American College of Radiology

(ACR) recommendations, and with The Joint Commission (TJC) requirements.

In addition, the Contractor shall perform a full inspection of imaging equipment after repairs or modifications that may affect the radiation output or image mailto:maria.anglada@va.gov mailto:Lynes.matos@va.gov quality. Evaluations shall include, but not be limited to, monitoring the following basic performance characteristics.

a. Radiographic Fluoroscopic Equipment - Physics inspections of radiographic and fluoroscopic equipment shall comply with the most current revision of ACR-AAPM Technical Standard for Diagnostic Medical Physics

Performance Monitoring of Radiographic Equipment and ACR-AAPM

Technical Standard for Diagnostic Medical Physics Performance Monitoring of Fluoroscopic Equipment. The performance of each radiographic and fluoroscopic unit shall be evaluated and documented at least annually. This evaluation shall include, but not be limited to, the following tests (as applicable):

1) Mechanical and system safety evaluation.

2) Functionality of all system indicators and interlocks.

3) Radiation protection equipment.

4) Acquisition display monitor performance (quantitative and visual assessment).

5) Integrity of unit assembly.

6) Collimation and radiation beam alignment.

7) Fluoroscopic system spatial resolution.

8) Automatic exposure control system performance.

9) Radiation beam centering and light field congruency.

10) Accuracy of displayed radiation field size.

11) Positive beam limitation functionality.

12) Image quality: high contrast spatial resolution.

13) Image quality: low contrast resolution.

14) Image quality: flat-field artifact evaluation.

15) kVp accuracy and reproducibility.

16) Linearity of exposure versus mA or mAs.

17) Exposure reproducibility.

18) Timer accuracy and reproducibility.

19) Collimation and radiation beam alignment.

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

21) Image receptor entrance exposure.

22) Equipment radiation safety functions.

23) Review of adult protocols (fluoroscopic and acquisition).

24) Identification of isocenter location.

25) Table/pad attenuation measurement.

26) Fluoroscopic system high contrast spatial resolution.

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

28) Image quality assessment- system low contrast sensitivity.

29) Patient dose monitoring system verification. This includes, for fluoroscopy systems, the displays of cumulative air kerma and, if available, DAP.

30) Digital image receptor performance.

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

32) 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.) (Minimally chest, abdomen, and lumbar spine).

33) Fluoroscopic phantom image quality.

34) 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) shall be documented for each measurement).

35) Fluorographic (image reGPOCding) 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.) shall be documented for each measurement].

36) Interoperability assessment (connectivity to PACS, Radimetrics, software processing, etc.)

37) Scatter exposures to staff in both fluoroscopic and cine mode.

Note: The information on entrance exposure rates (or air kerma rates) from fluoroscopy and from fluorography, for each fluoroscope, shall be in a format suitable for providing to 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 shall be evaluated and documented at least annually. This evaluation should include, but not be limited to, the following tests (as applicable):

1) Component and Imaging Plate 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. Dental - The physics inspection shall conform to the Acceptance Testing and Quality Control of Dental Imaging Equipment including handheld x-ray systems, The Report of AAPM Task Group 175, September 2016. The performance of dental x- ray inspections shall be evaluated 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).

10) Scattered Radiation Survey.

11) Review of the technical QA program.

d. Dental CBCT 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 13 months, and after repairs to the CBCT unit that may affect the radiation output or image quality. In cases where the manufacturer provides a phantom and procedures to perform specific Quality Assurance (QA) tests these shall be performed in addition of the tests outlined in this PWS. Tests to include:

1) Radiation output Repeatability.

2) kVp Accuracy.

3) kVp Repeatability.

4) kVp Reproducibility.

5) Beam quality.

6) Radiation field of view (FOV).

7) Image Quality.

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

9) Accuracy of Linear Measurements.

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

11) Accuracy of Patient Dose Metric Indication.

12) Assess the accuracy of the indicated dose metric (typically DAP).

13) Patient Dose Assessment-From a scan or scans using the facility's standard techniques, reGPOCd the dose metric (typically

DAP) and compare to achievable levels and diagnostic reference levels (if available).

14) Review of the technical QA program.

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

e. CT Scanners - The physics inspection shall comply with the most current revision of to the ACR Computed Tomography Quality Control Manual and

ACR-AAPM Technical Standard for Diagnostic Medical Physics

Performance Monitoring (2017). The performance of each CT scanner shall be evaluated and documented annually. This evaluation should include, but not be limited to, the following tests (as applicable) and information:

1) Review of Clinical Protocols.

2) Image Uniformity.

3) Scout Prescription Accuracy.

4) Alignment Light Accuracy.

5) Image Thickness-Axial Mode.

6) Table Travel Accuracy.

7) Radiation Beam Width.

8) High-Contrast Spatial Resolution.

9) Low-Contrast Sensitivity and resolution.

10) Noise.

11) Spatial Resolution.

12) Geometric or Distance Accuracy.

13) CT Number Accuracy.

14) CT Number Uniformity.

15) Artifact Evaluation.

16) Safety Evaluation.

17) Visual Inspection-workload assessment.

18) Scatter and stray radiation measurements.

19) Audible/visual signals.

20) Posting requirements.

21) Image quality.

22) Acquisition Display monitor assessment.

23) Measures radiation dose (in CTDI vol) for imaging protocols for

Adult brain, Adult Abdomen and verifies the radiation dose produced is within +/- 20% of the measured CTDlvol values).

24) Measurement of radiation output of scanner (CT dose index

[CTDlvol] or other metric accepted by nationally recognized organization).

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

26) Comparison of calculated values to scanner-reported values using both 16 cm and 32 cm dosimetry phantoms.

27) Gray Level Performance of CT Acquisition Display Monitors.

28) Review of the technical QC program to ensure it includes:

29) Water CT number accuracy

30) Noise (CT number standard deviation)

31) Artifact Evaluation

32) Display devices (acquisition workstation and hard copy display unit)

33) Visual Checklist.

f. Mammography - The performance inspections shall be completed by a

MQSA certified medical physicist and shall be in accordance with the

Mammography Quality Standards Act (MQSA), latest requirements of the

ACR and of the VHA for the annual physics inspection of mammography equipment. Annual surveys shall not exceed 13 months from the previous survey. Board certified mammography qualified medical physicists inspecting mammography systems shall provide current documentation the individual is a qualified expert to do mammography performance surveys in accordance with the requirements outlined in the MQSA. All post repairs surveys for screening mammography shall be performed prior to clinical use, as shall all newly installed mammography systems. Inspection items may include, but are not limited to:

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) Review Workstation (RWS) tests.

g. MRI - The physics inspection shall conform to the ACR Magnetic

Resonance Imaging Quality Control Manual, latest edition. The performance of each MRI scanner shall be evaluated at least annually and documented. This evaluation should include, but not be limited to, the following tests (as applicable):

1) ACR Phantom Tests:

▪ Magnetic field homogeneity

▪ Geometric or Distance accuracy

▪ Inter-slice RF interference

▪ Slice position accuracy

2) High-Contrast Spatial Resolution:

▪ Low-contrast resolution

▪ Slice thickness accuracy

▪ Alignment light accuracy

▪ Soft copy displays

▪ Site phantom inventory

▪ Site RF coil inventory

▪ RF Coil Performance Tests

▪ Image Uniformity for all RF coils used:

o Volume coils' signal-to-noise ratio o Volume coils' image uniformity o Volume coils' ghosting ratio o Phased array coils' signal-to-noise ratio o Surface coils' signal-to-noise ratio

▪ Review of the technical QC weekly program to ensure it includes:

o Setup and Position Accuracy o Center Frequency o Transmitter Gain/Attenuation o Geometric Accuracy Measurements o High-contrast Spatial Resolution Measurements o Low-contrast Detectability o Artifact Assessment o Visual Checklist o Acquisition Display monitor assessment

h. Dual-Energy X-Ray Absorptiometry (DXA) - The physics inspection shall conform with the most recent ACR-AAPM Technical Standard for Diagnostic

Medical Physics Performance Monitoring of Dual-Energy X-Ray

Absorptiometry (DXA) Equipment. The performance of DXA inspections shall be evaluated annually. This evaluation shall include, but not be limited to, the following tests (as applicable):

1) Unit assembly integrity assessment.

2) Tube-image receptor assembly motion assessment.

3) Review of routine QC to verify that the density results remain in control.

4) Radiographic uniformity assessment if provided by the vendor.

5) Measurement of the entrance air kerma for the most common clinical procedures.

6) Verification of display dose and radiation output metrics (if applicable).

7) Acquisition display monitor's performance.

i. Ultrasound – The physics inspection shall comply with the latest ACR‐AAPM

Technical Standard for Diagnostic Medical Physics Performance Monitoring of Real-

Time Ultrasound Equipment. The test shall be conducted annually for each ultrasound unit and its transducers. For units with more than one transducer, the testing shall be done using the two transducers most commonly employed with the unit. It is recommended that these transducers represent different scan formats, such as one linear (or curvilinear array) and one sector (mechanical, phased, or vector).

These evaluations shall include, but not be limited to, the following tests (as applicable):

1) For all machines and transducers:

▪ Physical and mechanical inspection

▪ Uniformity and artifact survey

▪ Fidelity of ultrasound scanner electronic image display(s)

▪ Evaluation of QC program

▪ System Sensitivity

▪ Geometry accuracy

▪ Contrast resolution

▪ Spatial resolution

▪ Fidelity of the display device(s) used for primary interpretation

▪ Doppler functionality (quantitative or qualitative evaluation)

▪ Elastography functionality (quantitative or qualitative evaluation)

2) System Sensitivity/Penetration ‐ This test should be done with the following settings:

▪ Maximum transmit power

▪ Proper receivers gain and 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

3) 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?

▪ Electrical and Mechanical Safety and Cleanliness

▪ Are all GPOCds 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):

▪ 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

▪ 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

▪ For Laser Imager (Hard Copy Device).

o Prior to filming any images, an SMPTE test pattern created by the

Society of Motion Picture and Television Engineers (SMPTE), should be printed using the appropriate window width (WW) and window level (WL). If you are unfamiliar with this procedure, you should review Gray et al., “Test pattern for video display and hard‐ copy camera,” Radiology 145:519‐527 (1985), and then contact your local service engineer for assistance. 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 your service engineer for laser camera calibration before proceeding with any filming o Hard Copy Output Quality Test (Digital) (if applicable). This test, or a similar test specifically recommended by the hard copy equipment manufacturer:

i. Required Test Equipment

ii. Densitometer

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

iv. The same test image should be used each time

j. Nuclear Medicine SPECT/Gamma - The physics inspection shall conform to the

ACR-AAPM Standard for Nuclear Medicine Physics Performance of Gamma cameras. The qualified diagnostic medical physics shall also review the quarterly testing as outlined by the ACR. The performance of each nuclear medicine scanner shall be at least annually. This evaluation should include, but not be limited to, the following tests (as applicable):

1) Intrinsic Uniformity (for each camera head)-interdetector variability

(NEMA method)

2) System Uniformity for all collimators-interdetector variability

3) Intrinsic or System Spatial Resolution/linearity

4) System sensitivity (counter rate per unit activity & interdetector variability)

5) Relative Sensitivity

6) Energy Resolution

7) Count Rate Performance

8) Acquisition Display monitor assessment

9) Physical inspection, System Interlocks, and emergency shutdown mechanisms

10) Overall System Performance for SPECT

11) Uniformity and Artifact evaluation

12) Low contrast resolution

13) Spatial Resolution

14) Additionally, a review of the quality control program performed by the technologist shall be reviewed for:

▪ Daily uniformity Check.

▪ Daily CT Check (SPECT/CT).

▪ Uniformity Calibration (monthly or as specified by Manufacturer).

▪ Center-of-Rotation/Head Alignment (SPECT Systems).

k. 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 annually. For PET/CT units the CT shall be inspected at least annually per CT requirements listed on the CT Scanner part above.

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

1) Image Uniformity

2) Count rate performance (count rate versus activity), including count loss GPOCrection

3) Spatial resolution

4) Image quality

5) Accuracy of CT-based attenuation and scatter

GPOCrection, and SUV analysis

6) Image Co-registration

7) Safety Evaluation (mechanical and electrical)

8) Acquisition Display monitor assessment

9) Additionally, a review of the quality control program performed by the technologist shall be reviewed for:

▪ Daily PET Detector Check

▪ Daily Water CT Number and SD Check

▪ Daily Artifact Check

▪ Visual Checklist

▪ Monthly display Monitor SMPTE.

l. Dose Calibrator – Assessment for performance in acGPOCdance with manufacturers requirements (all used isotopes). Tests to include:

1) Constancy performed quarterly.

2) Accuracy performed quarterly.

3) Linearity performed quarterly over the range of activities administered.

4) Geometry performed annually.

m. Well Counter - Assessment for performance quarterly in acGPOCdance with manufacturers requirements (all used isotopes). Tests to include:

1) Minimal detectable activity verification.

2) Review of GPOCrection factors.

3) Auto calibration.

4) Constancy.

5) Reproducibility - Chi-Squared.

6) Minimal detectible activity.

7) Isotope Efficiencies both through factory installed software and manually.

n. Thyroid Uptake/Well Counter System - Assessment for performance quarterly in acGPOCdance with manufacturers requirements both uptake and well (most used isotopes). Tests to include:

1) Auto calibration.

2) Constancy.

3) Reproducibility - Chi-Squared.

4) Minimal detectible activity verification.

5) Isotope Efficiencies both through factory installed software and manually.

6) Review of QC program.

o. Linear Accelerators – The annual physics inspection of performance of the diagnostic components of the linear accelerator shall comply with the

AAMP TG-42, specifically for:

1) Image Quality (Planar kV, MV).

▪ Light-X-ray Alignment Accuracy.

▪ High contrast.

▪ Uniformity.

▪ Noise.

▪ Half-value layer.

▪ kVp accuracy.

▪ Radiation output.

▪ mA and mAs linearity.

▪ Artifact evaluation.

2) Image Quality for Cone Beam CT for head, pelvis, and spotlight protocols.

▪ High Resolution Contrast.

▪ Uniformity.

▪ Noise.

▪ In-Plane Distance Accuracy.

▪ Artifact Evaluation.

▪ CBCT CT Number Linearity.

3) CTDlvol for all CBCT protocols.

▪ Head.

▪ Image Gently.

▪ Pelvis.

▪ Pelvis large.

▪ Spotlight.

▪ Thorax.

4) Safety Inspection.

▪ Audio.

▪ Visual

p. 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. This should be done as listed below:

1) Perform a visual analysis of the 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 GPOCrect.

▪ Review the line pair patterns in the center and at each of the

GPOCners.

▪ 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 GPOCners (or all 4 sides, depending on the test pattern used).

2. Shielding Desing - The Contractor shall provide shielding design calculations, for each new, replaced, modified or relocated x-ray imaging system. The calculations for each shall comply with the National Council for Radiation Protection and Measurements

(NCRP) Report No. 147 (or the most recent version), and, for dental units, NCRP

Report No. 145 (or the most recent version) and shall be documented in a written report which includes a diagram showing adjacent areas and provided to the RSO within 5 working days after the evaluation has been completed.

3. Shielding Surveys - The qualified diagnostic medical physicist shall perform a shielding survey to verify the structural shielding was installed per the shielding design report and complies with the design goals. A written report of the shielding survey shall be provided to the RSO within 3 workings days after the shielding survey has been completed.

4. CT Protocols and Dose Optimization – The contractor shall review CT protocols at least annually. The contractor shall review CT and fluoroscopy protocols and include dose reduction techniques where applicable at least annually.

5. Quality Assurance Program - The contractor shall assist in the development of a comprehensive technical quality assurance (QA) program, which complies with

ACR recommendations for all modalities.

a. Review at least annually the QA program (e.g., technique charts, repeat/reject analysis monitoring, monitoring of exposure indices to radiographic image receptors, QA program for display monitors, QA for

CT, monitoring of dose metrics from fluoroscopy studies).

b. Written report of the results shall be provided to RSO, within 15 calendar days after performing the inspection.

c. Perform a follow-up inspection to verify compliance of any necessary

GPOCrective action performed to GPOCrect deficiencies found.

K. REPORTS: The Contractor shall provide a written report of the tests results to the RSO within 21 calendar days after completion of the inspection. All imaging equipment shall be inspected at least annually, not to exceed 13 months.

a. Electronic and written reports shall include:

1) Cover memo summarizing any results, issues (pass or fail) or recommendations for the equipment/device tested.

2) Specific to a single device (one report per device tested).

b. Written reports shall contain documentation of the following:

1) Date of testing.

2) Room number/Location of device tested.

3) Name of device tested including serial number and VA Inventory number (EE/SN).

4) Protocol of test performed (for each test).

5) Test performed including all measured data, all data analysis.

6) Copies of all acquired images analyzed (NM and PET systems).

7) Equipment used for testing, including phantoms.

8) Evaluation results.

9) Recommendations for GPOCrecting any problems identified.

10) Signature of the Diagnostic Medical Physicist.

11) Annually, copies of calibration reports for equipment used in testing of any device.

12) Annually, copies of continuing education for each physicist who performed any testing of devices.

c. Report of Deficiencies: Perform a full inspection of imaging equipment after repairs or modifications that may affect the radiation output or image quality.

1) Deficiencies or non-conformances discovered during the inspection shall be verbally communicated to the RSO prior to the qualified diagnostic medical physicist leaving the facility.

2) Deficiencies or non-conformances which represent unsafe conditions with the potential to adversely impact the facility radiation workers or patients shall be reported to the RSO immediately upon discovery.

L. EQUIPMENT ADDITIONS / DELETIONS

1. Diagnostic medical physics evaluations and equipment’s may be added, modified, or removed from the scope of services during the performance period of this contract. This may also include the adjustment of service hours and additional diagnostic medical physics tasks (e.g., shielding evaluations, equipment acceptance testing, or image quality assurance) necessary to maintain compliance with applicable regulations and accreditation standards

(e.g., VHA directives, ACR, MQSA).

2. Any modification, addition, or deletion shall be documented and incorporated into the contract through a supplemental agreement, executed and authorized by the

Contracting Officer. No change to the scope of services shall be considered valid unless formally approved in writing.

M. EMERGENCY RESCHEDULE CERTIFICATIONS

a. The contractor shall acknowledge and confirm any emergency rescheduling request within 24 hours of notification to establish the arrival time and emergency evaluation schedule. The contractor shall be capable of responding to the emergency within 72 hours of notification. If delays are anticipated notification shall be provided to the GPOC.

b. The contractor shall complete and submit a written report within 24 hours after the rescheduled evaluation has been performed. The report shall include findings, action taken and any deficiencies.

c. Any deficiencies or non-conformities identified during the evaluation shall be reported in writing to the RSO before the qualified diagnostic medical physicist departs the facility, with the intent to begin corrective actions and provide evidence of resolution before leaving the facility. Deficiencies or non-conformances which represent unsafe conditions with the potential to adversely impact the facility radiation workers or patients shall be reported to the RSO immediately upon discovery.

N. List of EQUIPMENT: See RFQ document attachments Section D - S02- Copy of

VACHS Equipment List for DMP Services Contract

B.3 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

The contractor shall create a certification equipment schedule divide in four quarters for the Government evaluation and approval.

Approved schedule shall be used to coordinate performance and invoice submittals.

0001AA

1.00 EA __________________ __________________

Quarter 1: Approved schedule shall be used to coordinate performance and invoice submittals.

Contract Period: Base POP Begin: 08-02-2025 POP End: 08-01-2026 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services PRODUCT/SERVICE CODE: H966 - Other Quality Control, Testing, and Inspection - Instruments and Laboratory Equipment

0001AB

Quarter 2: Approved schedule shall be used to coordinate performance and invoice submittals.

Contract Period: Base POP Begin: 08-02-2025 POP End: 08-01-2026 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services

0001AC

Quarter 3: Approved schedule shall be used to coordinate performance and invoice submittals.

Contract Period: Base POP Begin: 08-02-2025 POP End: 08-01-2026 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services

0001AD

Quarter 4: Approved schedule shall be used to coordinate performance and invoice submittals.

Contract Period: Base POP Begin: 08-02-2025 POP End: 08-01-2026 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services

3.00 EA __________________ __________________

AS NEEDED: Post repair testing of general radiology equipment (includes all modalities except advanced imaging equipment) Contract Period: Base POP Begin: 08-02-2025 POP End: 08-01-2026 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services

5.00 EA __________________ __________________

AS NEEDED: Post repair testing of advanced imaging equipment (CT, MRI, PET and NM).

Contract Period: Base POP Begin: 08-02-2025 POP End: 08-01-2026 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services

AS NEEDED: Post corrective action testing of general radiology equipment (includes all modalities except advanced imaging equipment).

Contract Period: Base POP Begin: 08-02-2025 POP End: 08-01-2026 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services

AS NEEDED: Post corrective action testing of advanced imaging equipment (CT, MRI, PET and NM).

Contract Period: Base POP Begin: 08-02-2025 POP End: 08-01-2026 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services PRODUCT/SERVICE CODE: H966 - Other Quality Control, Testing, and

Base Period Total:

1001AA

and invoice submittals.

Contract Period: Option 1 POP Begin: 08-02-2026 POP End: 08-01-2027

PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services

1001AB

and invoice submittals.

Contract Period: Option 1 POP Begin: 08-02-2026 POP End: 08-01-2027 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services

1001AC

and invoice submittals.

Contract Period: Option 1 POP Begin: 08-02-2026 POP End: 08-01-2027 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services

1001AD

and invoice submittals.

Contract Period: Option 1 POP Begin: 08-02-2026 POP End: 08-01-2027 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services all modalities except advanced imaging equipment)- Contract Period: Option 1 POP Begin: 08-02-2026 POP End: 08-01-2027 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services

MRI, PET and NM).

Contract Period: Option 1 POP Begin: 08-02-2026 POP End: 08-01-2027 equipment (includes all modalities except advanced imaging equipment).

Contract Period: Option 1 POP Begin: 08-02-2026 POP End: 08-01-2027 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services equipment (CT, MRI, PET and NM).

Contract Period: Option 1 POP Begin: 08-02-2026 POP End: 08-01-2027 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services PRODUCT/SERVICE CODE: H966 - Other Quality Control, Testing, and

Option Period 1 Total:

2001AA

and invoice submittals.

Contract Period: Option 2 POP Begin: 08-02-2027 POP End: 08-01-2028 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services

2001AB

and invoice submittals.

Contract Period: Option 2 POP Begin: 08-02-2027 POP End: 08-01-2028 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services

2001AC

and invoice submittals.

Contract Period: Option 2 POP Begin: 08-02-2027

POP End: 08-01-2028 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services

2001AD

and invoice submittals.

Contract Period: Option 2 POP Begin: 08-02-2027 POP End: 08-01-2028 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services all modalities except advanced imaging equipment)- Contract Period: Option 2 POP Begin: 08-02-2027 POP End: 08-01-2028 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services

MRI, PET and NM).

Contract Period: Option 2 POP Begin: 08-02-2027 POP End: 08-01-2028 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services equipment (includes all modalities except advanced imaging equipment).

Contract Period: Option 2 POP Begin: 08-02-2027 POP End: 08-01-2028 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services equipment (CT, MRI, PET and NM).

Contract Period: Option 2 POP Begin: 08-02-2027 POP End: 08-01-2028

Option Period 2 Total:

3001AA

and invoice submittals.

Contract Period: Option 3 POP Begin: 08-02-2028 POP End: 08-01-2029 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services

3001AB

and invoice submittals.

Contract Period: Option 3 POP Begin: 08-02-2028 POP End: 08-01-2029 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services

3001AC

and invoice submittals.

Contract Period: Option 3 POP Begin: 08-02-2028 POP End: 08-01-2029 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services

3001AD

and invoice submittals.

Contract Period: Option 3 POP Begin: 08-02-2028 POP End: 08-01-2029 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services all modalities except advanced imaging equipment)- Contract Period: Option 3 POP Begin: 08-02-2028 POP End: 08-01-2029 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services

MRI, PET and NM).

Contract Period: Option 3 POP Begin: 08-02-2028 POP End: 08-01-2029 PRINCIPAL NAICS CODE: 541380 - Testing Laboratories and Services equipment (includes all modalities except advanced imaging equipment).

Contract Period: Option 3 POP…