On-Site Physicist Safety Inspection (AMA BIG ELP)
The Department of Veterans Affairs is seeking Service Disabled Veteran Owned Small Business (SDVOSB) or Veteran Owned Small Business (VOSB) sources capable of meeting the requirement listed below. The acquisition will be accomplished using commercial item procedures in accordance with FAR Part 12.
NOTE: TO QUALIFY SDVOSB AND VOSB VENDORS MUST BE CERTIFIED IN THE VA VENDOR INFORMATION PAGES (VIP) DATABASE. THE VENDOR MUST BE REGISTERED AS A SMALL BUSINESS UNDER NAICS CODE 541690 TO BE CONSIDERED FOR AWARD.
The North American Industry Classification System (NAICS) is 541690. Any SDVOSB or VOSB firms who wish to identify their interests and capability to provide this product must provide product specifications, performance and delivery information by notifying the Contract Specialist no later than NOON PM Central Time, November 22, 2017. Notification shall be e-mailed to Ronalda Ohio, at ronalda.ohio@va.gov.
DISCLAIMER
This Source Sought Notice is issued solely for information and planning purposes only and does not constitute a solicitation. All information received in response to this Notice that is marked as proprietary will be handled accordingly. In accordance with the Federal Acquisition Regulation, responses to this notice are not offers and cannot be accepted by the Government to form a binding contract. Responders are solely responsible for all expenses associated with responding to this Notice.
PART A- SCOPE OF WORK
Contractor shall furnish all labor, material, supplies, equipment and qualified personnel to provide on-site Radiation Physicist services for the Department of Veterans Affairs (VA) VISN 17 which could include the following facilities (and associated Community Based Outpatient Clinics (CBOCs), as applicable): El Paso, TX; Amarillo, TX; and Big Spring, TX in accordance with the terms and conditions stated herein and must adhere to the VA Handbook 1105.04, Fluoroscopy Safety, dated July 6, 2012.
GENERAL REQUIREMENTS
PERFORMANCE:
The majority of work determined under this contract shall be performed during the VA Health Care System (VAHCS) regular administrative working hours of 8:00 AM through 4:30 PM, Monday through Friday excluding Federal Holidays. However, there may be times when the Contractor may be needed after regular working hours.
Federal Holidays:B The 10 holidays observed by the Federal Government are:
B B B B B B
New Year s Day Martin Luther King Jr. s Birthday
President s Day Memorial Day
Independence Day Labor Day
Columbus Day Veterans Day
Thanksgiving Christmas
Any other day specifically declared by the President of the United States to be a Federal Holiday.
When one of the holidays falls on Sunday, the following Monday shall be observed as a Federal Holiday. When a holiday falls on a Saturday, the preceding Friday shall be observed as a Federal Holiday.
All work shall commence within one week after receipt of telephonic, written or verbal notification and will proceed progressively without undue delay. All work shall be performed by competent physicists, experienced and qualified to work on the specific equipment, as described in the paragraph entitled Qualified Personnel. All work performed shall be in accordance with established commercial practices.
Check-in procedure: The contractor shall immediately notify Biomedical Engineering upon arrival and report directly to the Imaging and/or Dental Department to start and complete all services. In order to certify payment requests, the representative must leave, with the Biomedical Engineering (Biomed), a complete report of the type of services rendered.
PART B WORK REQUIREMENTS
MANDATORY SERVICES TO BE PERFORMED:
Perform radiation protection audits within VISN 17 to ensure compliance with the current Nuclear Regulatory Commission (NRC), American College of Radiology (ACR), and Mammography Quality Standards Act (MQSA) requirements. Change of times or dates must be coordinated with the above-mentioned department at least one week in advance. Provide written report of results to the Radiation Safety Officer (RSO) within five (5) working days of performance of the survey.
Review and analyze radiation exposure records throughout VISN 17, including Nuclear Medicine Service, Radiology Service, Dental Service and ancillary services which have radiation workers and provide appropriate recommendation to reduce exposure to ALARA. Provide results to the RSO within five (5) working days after review. To include initial testing of new and replacement x-ray imaging equipment, prior to first clinical use, as well as testing after repairs that may affect X-ray output or image quality.
Perform inspections on all medical equipment providing final reports to Biomedical Engineering within 5 days of completion of survey.
Perform Nuclear Medicine inspections on all equipment identified in paragraph 4. in accordance with the instructions in paragraph 3.G.
Provide consultation for additional services as needed, i.e., safety training.
Review Computed Tomography (CT) protocol optimization once a year.
Provide shielding design calculations for each new or replacement x-ray imaging system. The calculations for each shall conform to National Council on Radiation Protection & Measurements (NCRP) Report No. 147 or, for dental units, NCRP Report 145 and shall be documented in a written report, which includes a to-scale diagram showing adjacent areas.
Establish a skin dose program.
Review the radiation safety programs at all facilities within VISN 18 for all applicable services during each site visit.
Evaluate technical Quality Assurance (QA)/Quality Control (QC) program (technique charts, repeat/reject analysis, monitoring, monitoring of exposure indices to radiographic image receptors, QA program for display monitors, QA of CT, monitoring of dose metrics from fluoro studies) annually.
The contractor shall comply with all State and Federal rules, laws and regulations and maintain compliance with Occupational Safety and Health Administration (OSHA), The Joint Commission (TJC), ACR, Food and Drug Administration (FDA), and MQSA.
The contractor shall ensure referenced equipment meets NRC/TJC compliance and all Federal and State rules, regulations and laws.
RADIATION SURVEY:
Contractor shall conduct quality control surveys and certifications of the radiographic equipment listed below. The Contractor shall ensure the radiographic equipment s compliance with applicable federal and state regulatory requirements, and shall include, but not be limited to, monitoring the following basic performance characteristics:
All stationary, and mobile x-ray radiographic units, including dental units:
kV accuracy and reproducibility
Beam quality assessment (HVL)
Linearity of output as a function of mA and /or mAs
X-Ray Output
Tube Head leakage
Focal Spot Size
Scatter Radiation
Timer Accuracy
Reproducibility
Automatic exposure control performance
Entrance exposures for a phantom representing a standard patient and comparison to diagnostic reference levels
Collimation and beam alignment
Entrance Exposure Rate
Evaluation of grids for mobile radiographic units
Artifact Evaluation
For Direct Radiography (DR) radiographic systems, accuracy of exposure index
Computed Radiography (CR):
Relative Sensitivity Calibration Test
Shading Test
Contrast Evaluation
Sharpness Test
Laser Jitter Test
Image Noise/Artifact Test
Primary Erasure of Imaging Plate Test
Accuracy of Measurement Tools/Scale Test
System Linearity Test
Exposure index (International Electrotechnical Commission (IEC) or proprietary, e.g., S Number) Calibration
CT Scanners:
The testing shall substantially conform to the moat current ACR Computed Tomography Quality Control Manual. The testing of dosimetry shall include verification of the accuracy of displayed CTDIvol values.
Review of Clinical Protocols
Scout Prescriptions and alignment Light Accuracy
Image Thickness Axial Mode
Table Travel Accuracy
Radiation Beam Width
Low-Contrast Performance
Spatial Resolution
CT Number Accuracy
Artifact Evaluation
CT Number Uniformity
Dosimetry
Gray Level Performance of CT Acquisition Display Monitors
Fluoroscopes (Including, Interventional Radiology/Cardiac Catherization Lab, Electrophysiology (Ep) Lab, And Mobile C-Arms):
kVp accuracy and reproducibility
Beam Quality
Linearity
Reproducibility
Automatic exposure rate control performance
Fluoroscopy output (exposure rate or dose rate) for a phantom representing a standard patient
Fluoroscopy maximum dose rate
Collimator alignment
Safety evaluation
Cine output exposure rate or dose rate for a standard patient and maximum rate
High contrast spatial resolution
Low contrast spatial resolution
Image artifacts
Display monitor performance
Accuracy of indicated radiation doses metrics (air kerma at the reference point and Kerma Area Product (KAP))
Output for a phantom representing a standard patient and maximal output shall be measured for a variety of modes (continuous and pulsed, normal and mag modes, high dose rate mode, image recording modes, etc.). These shall include modes commonly used clinically. The report shall state the modes used for each measurement. For each C-arm fluoroscope, these data shall be placed in a table suitable for the operators of the fluoroscope.
Mammography:
Ensures that facility is compliant with ACR, FDA, MQSA and Veterans Health Administration (VHA) standards. The federal MQSA exempts the VA from the requirements of the act. However, Public Law 104-262 requires VHA mammography facilities to meet the basic requirements of the MQSA. The VHA requirements are contained in VHA Handbook 1105.03, Mammography Program Procedures and Standards.
Documentation must be current and on site to ensure FDA/ACR compliance (Continuing Medical Education (CME), surveyed facilities with mammography, etc.). Inspections of digital mammography equipment must comply with the latest requirements posted on the ACR website for the manufacturer of the unit being inspected. Inspection items may include:
Mammographic Unit Assembly Evaluation
Collimation assessment
Artifact evaluation
kVp accuracy and reproducibility
Beam quality assessment HVL measurements
Evaluation of system resolution
Automatic Exposure Control (AEC) function performance
Breast entrance exposure, AEC reproducibility and average glandular dose
Radiation output rate
Phantom image quality evaluation
Signal to noise ratio and contrast to noise ratio measurements
Viewbox luminance and room illuminance
Review workstation (RWS) tests
Magnetic Resonance Imaging (MRI):
Perform initial survey/inspection and yearly review of MRI unit ensuring that unit meets ACR requirements to meet accreditation by the ACR.
Magnetic field homogeneity
Geometric accuracy
Inter-slice Radio Frequency (RF) interference
Slice position accuracy
High contrast resolution
RF coil performance
Volume coils signal to noise ratio
Volume coils image uniformity
Volume coils ghosting ratio
Phased array coils signal to noise ratio
Surface coils signal to noise ratio
Slice thickness accuracy
Low contrast detectability
Soft copy displays
Technologist s QC program
Site phantom inventory
Site RF coil inventory
Nuclear Medicine (NM):
Evaluate Quality ControlB on Nuclear Medicine (NM) Units (in accordance with New Proposed Joint Commission Standard). Perform acceptance, performance, quality control, and Phantom tests SPECT to ensure the facility meets current Nuclear Medicine American College of Radiology (ACR) Accreditation Requirements. Perform the equipment performance evaluations required by the ACR for accreditation.B At least annually, a diagnostic medical physicist conducts a performance evaluation of all NM imaging equipment in accordance with ACR program requirements. The evaluation results, along with recommendations for correcting any problems identified, are documented and a written report is provided to the facility. The evaluations are conducted for all of the image types produced clinically by each NM scanner (for example, planar and/or tomographic) and include the use of phantoms to assess the following imaging metrics (as applicable):
Image uniformity/system uniformity
High-contrast resolution/system spatial resolution
Low-contrast resolution or detectability (not applicable for planar acquisitions)
Sensitivity
Energy Resolution
Count-rate performance
Artifact evaluationB B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B
Annual Accuracy CalibrationB for Dose Calibrators*
Performance of image acquisition monitors (maximum and minimum luminance, luminance uniformity, resolution, and spatial accuracy).
Annual Efficiency MeasurementsB and statistical accuracy for Well CountersB B
Operations Check Procedure and Efficiency Evaluation for Survey MetersB B B B B
Note: The contractor will need to supply the necessary testing equipment to complete the quality control.B B B B B
Positron emission tomography/Computed Tomography (PET/CT) services: At least annually, a diagnostic medical physicist conducts a performance evaluation of all PET/CT imaging equipment. The evaluation results, along with recommendations for correcting any problems identified, are documented. The evaluations are conducted for all of the image types produced clinically by each PET/CT scanner (for example, planar and/or tomographic) and include the use of phantoms to assess the following imaging metrics:
Image uniformity/system uniformity
High-contrast resolution/system spatial resolution
Low-contrast resolution or detectability (not applicable for planar acquisitions)
Artifact evaluation
Sensitivity
Energy resolution
Count rate performance
Performance of image acquisition monitors (maximum and minimum luminance, luminance uniformity, resolution, and spatial accuracy).
*Dose calibrators require some tests to be performed semi-annually
For all Bureau of Radiological Health (BRH) compliance tests, documentation of measured values used to certify compliance shall be provided.
Furnish a follow-up inspection to verify compliance of any necessary corrective action performed to correct deficiencies found.
Furnish a measured skin entrance dose (in mR or mrem) for each x-ray tube tested using typical technique for the unit under typical tests.
Furnish radiation dose rate for each mode of operation for typical prolonged fluoroscopically guided invasive procedures performed on fluoro units.
Survey shall be conducted once per calendar year with the intervals between annual inspections not to exceed 14 months as scheduled at mutually agreed upon times between the Imaging Service/RSO, Biomedical Engineering, and the contractor. Time of inspection is to be coordinated with Biomedical Engineering, and Imaging Service/RSO. Any equipment that is under repair at the time of inspection shall be scheduled for a later inspection at no additional expense to the Government.
Survey Schedule (including CBOCs, as applicable):
Facility
Delivery Schedule
Amarillo
The annual written report is to be completed and submitted during the month of September for the base and option years of the contract, if the Government exercises the renewal option period.
Big Spring
The annual written report is to be completed and submitted during the month of December for the base and option years of the contract, if the Government exercises the renewal option period.
El Paso
The annual written report is to be completed and submitted during the month of September for the base and option years of the contract, if the Government exercises the renewal option period.
RADIOGRAPHIC EQUIPMENT TO BE SURVEYED (NOTE: Equipment list is subject to change per each facility within VISN 18 due to possible equipment replacement):
Amarillo/Lubbock OPC:
Two R&F units GE Proteus (1T) and GE Advantx (2T)
Two RAD rooms Phillips Digital Diagnost (1T), Siemens Aristos (LOPC) (1T)
One Dexa Scan (Bone Density) unit GE Bone Density IDXA (1T)
One OR unit Zhiem C-Arm (1T)
Two CT scanners one x-ray tube each (Philips Brilliance/Hitachi Scenaria)2T
Three portable x-ray units one tube each (GE AMX )3T
Two C-Arms OEC C-Arm 9900 - One x-ray tube each (2T)
Four Dental units each one x-ray tube (2 units at Lubbock OPC)
Planmeca: Panorama/Bitewing at Amarillo and LOPC (4T)
Four Radiology Viewing Monitors Radiology Physician Room
Two Nuclear Cameras Philips Forte AZ and Siemens Symbia
One MRI Hitachi Oasis installed July 2017
Total 18 x-ray tubes
NOTE: Total inspection cost for Amarillo and Lubbock Outpatient Clinic (OPC) included mileage of $206 for each site/per visit. Consultation/Training has not been part of our inspections cost in the past.
Big Spring, TX:
One Computerized Tomography scanner
One Radiography & Fluoroscopy unit (dual detector)
One Direct Digital Radiography unit (dual detectors)
One Dual Energy X-ray Absorptiometry (Dexa) unit
Two Portable X-ray units
Eight Dental X-ray units
One CR Unit
El Paso, TX:
Two R&F unit each two x-ray tubes (4)
Two DR rooms each one x-ray tube
One Dexa Scan unit one x-ray tube
One Cysto unit one x-ray tube
One CT scanner one x-ray tube
Two portable x-ray units each one x-ray tube
Three C-Arms each one x-ray tube
Four Dental units each one x-ray tube
One MRI
Total 18 x-ray tubes
NUCLEAR MEDICINE EQUIPMENT TO BE INSPECTED (NOTE: Equipment list is subject to change per each facility within VISN 17 due to possible equipment replacement):
Amarillo/Lubbock OPC:
Philips Forte AZ
Siemens Symbia "E"
Captus 3000 Well Counter/Thyroid Probe
Capintec CRC 12R Dose Calibrator
Capintec CRC 127-R Dose Calibrator
Nuclear Med Audits
MRI
Big Spring, TX
Siemens Symbia S
Capintec CRC 15W w/ Well Counter Dose Calibrator
cont. Ionization Chamber Serial no-171339
Ludlum Model 2 Survey Meter (Geiger counter) w/probe
Ludlum Model 2 Survey Meter (Geiger counter) w/probe
Ludlum Model 2 Survey Meter (Geiger counter) w/probe
Radiation Safety Audits (quarterly, includes diagnostic radiology) (NRC regulations)
El Paso:
NA
OVER AND ABOVE REPAIR:
At the VA s option, the Contractor may be requested to provide a price quotation for a repair or other out of scope service. The repair job/service shall not be initiated until approval is obtained from appropriate Biomedical Engineering staff. Charges for repair, labor, and parts shall originate only when required and upon prior approval being granted by the VA COR and authorized by a signed modification to the contract/task order. The VA has sole discretion to select the Contractor who will provide these repair services and they will be ordered as a separate action (not necessarily as a part of this contract).
KEY PERSONNEL:
Key personnel will be identified in the proposal and shall be considered key personnel essential for the successful completion of the work performed under the contract. The contractor agrees that such personnel shall not be removed, diverted or replaced from the work without prior written approval of the Contracting Officer. The contractor shall submit written notice of proposed personnel changes to the Contracting Officer for approval at least thirty (30) business days in advance. No substitutions of key personnel shall be made during the initial 90 days of contract performance unless the key person leaves the employ of the company.
QUALIFIED PERSONNEL:
All Radiation Physicists performing services under this contract shall be board certified or board eligible from one of the following boards: American Board of Radiology, American Board of Medical Physics or American Board of Health Physics. Certification must be maintained throughout the contract performance period. Personnel must also have experience in Hospital Medical Physics.
MANAGEMENT, SUPERVISION, AND TRAINING:
Contractor shall be responsible for supervising the daily services of their personnel provided under this Contract; and shall provide and document orientation and training programs for all employees regarding safety, equipment management, and patient confidentiality appropriate to the service provided.
The Contractor shall have written policies and procedures regarding staff credentials.
Contractor shall provide orientation to designated staff to agency policy and procedures, and any agency processes necessary to cooperative functioning between the agency and facilities with the Veterans Integrated Service Network (VISN). Updates and refreshers shall be provided upon request and when policy, procedures, or processes change.
Contractor shall complete background investigations to ensure that employees do not have a record of criminal offenses or substantiated incidents of patient abuse; and, if required to perform their duties, employees are properly licensed and insured to operate motor vehicles.
QUALITY CONTROL:
The Contractor shall develop a Quality Control Plan which will provide the Contractor s strategy for monitoring performance internally, providing performance information to the Government, and reporting in compliance with the SOW. Within the Quality Control Plan, the Contractor shall propose and maintain an established reporting system to promptly notify VA of any problems, issues, risks, or concerns with workflow performance, programmatic improvement, security, and schedule adherence. Quality control is the exclusive responsibility of the Contractor.
The work performed under this contract shall be subject to evaluation by the Contracting Officer s Representative (COR) in accordance with the contract terms and conditions.
VA INFORMATION AND INFORMATION SYSTEM SECURITY/PRIVACY LANGUAGE:
The C&A requirements do not apply, and that a Security Accreditation Package is not required.
Ronalda Ohio
ronalda.ohio@va.gov
