Veterans Affairs



FedBizOppsModification to a Previous Notice*******CLASSIFICATION CODESUBJECTCONTRACTING OFFICE'SZIP-CODESOLICITATION NUMBERBASE NOTICE TYPERESPONSE DATE (MM-DD-YYYY)ARCHIVEDAYS AFTER THE RESPONSE DATERECOVERY ACT FUNDSSET-ASIDENAICS CODECONTRACTING OFFICEADDRESSPOINT OF CONTACT(POC Information Automatically Filled fromUser Profile Unless Entered)DESCRIPTION*See AttachmentAGENCY'S URLURL DESCRIPTIONAGENCY CONTACT'S EMAILADDRESSEMAIL DESCRIPTIONADDRESSPOSTAL CODECOUNTRYADDITIONAL INFORMATIONGENERAL INFORMATIONPLACE OF PERFORMANCE* = Required FieldFedBizOpps Modification to a Previous NoticeRev. March 2010J630-14-2-460-0018CALIBRATION OF x-rAY uNITSTHIS IS A REVISION TO THE ORIGINAL SOW10468-3904VA243-14-Q-052803-20-201430N811219Department of Veterans AffairsJames J. Peters VA Medical CenterNetwork Acquisition & Logistics(10N3NAL)130 West Kingsbridge RoadBronx NY 10468-3904ALETA JENNETTE-CONTRACT SPECIALISTaleta.jennette@VA NEW YORK HARBOR HEALTHCARE SYSTEMBROOKLYN CAMPUS800 POLY PLACEBROOKLYN, NEW YORK 11209This Sources Sought Notice is for informational and planning purposes only and shall be construed as a solicitation or as an obligation or commitment by the Government at this time. This notice is intended strictly for market research. The purpose of this Sources Sought notice is to determine interested and capability of potential qualifications of Small Businesses, including 8(a), HubZone and Service Disabled Veteran-Owned firms relative to the North American Industry Classification Code (NAICS) 811219 (Medical Equipment Maintenance).The Department of Veteran’s Affairs is seeking small business manufacturers, or distributors to small business manufacturers, of functionally equivalent service to supply Hospital Pajamas for our female patients to a VA hospital and all the surrounding areas of the hospital the following:Description: Annual calibration of the LINAC and annual QC of all X-ray units. Revised SOW for serviceANNUAL QC OF THE X-RAY UNITS AND LINEAR ACCELERATORS Introduction/BackgroundThe VA New York Harbor Healthcare System is dedicated to providing quality health care to veterans using the abilities of all employees supported by our commitment to education and research.We are recognized locally, regionally, and nationally as a leader in quality patient care, positive customer service, medical/allied health education, health-related research and employment opportunities. We seek to be the provider of choice of veterans and the community by offering an efficient, integrated quality health care system capable of providing a full range of primary, specialty and chronic health care services in a system that is readily accessible and responsive to change.Our key business drivers are quality, financial integrity, patient satisfaction and employee satisfaction.Because of potential hazards involved in the use of radioactive materials, the VA recognizes the need for a Radiation Safety Program. The program is intended to protect personnel from unnecessary radiation exposure, to prevent contamination of our natural resources and to meet the state and federal regulations governing the possession and use of radioisotopes. Radiation can be an invaluable tool in healthcare and research and properly used can provide great benefits to mankind with little or no attendant risk. However, improper use can bring risk of high radiation exposure resulting in chronic illness, injury or even death.The key objectives of the Radiation Safety Programs are:To make every reasonable effort to maintain radiation exposures, and releases of radioactive material in effluents to unrestricted areas As Low As is Reasonably Achievable (ALARA). The concept of ALARA is applied taking into account the state of technology and the economics of improvements in relation to benefits to the public health and safety, and other societal and socioeconomic considerationsTo ensure control of the possession and use of "Sources of Radiation" in VA operations, research and operating programs to minimize, insofar as practicable, hazards to personnel and loss of property arising from the use of such materialsTo ensure compliance with all Federal, State and local laws covering the use of such materials, machines and devices.Objectives/RequirementsAttached are the specifications regarding: (1) qualifications of the contractor physicists, (2) records and reports of the QC of each unit to include QC tests of diagnostic units,(4) patients’ dose calculations, (5) QC tests of linear accelerators, and finally in section (6) models and number of diagnostic x-ray units, linear accelerators and number of lead aprons provided. Essential specifications: The contractor must be knowledgeable regarding the JCAHO and New York State, New York City, FDA, ACR, AAPM standards for quality control of the X-Ray units and linear accelerators. The contractor must be board certified by the American Board of Radiology (ABR) or the American Board of Medical Physics (ABMP) for diagnostic and radiation therapy. The contractor must provide necessary information as described in section (1) for the VA panel to assess the qualification of the contractors. The contractor must have liability insurance.The QC report must contain information that is described in section (2) of the attachment. It is essential that the contractor follows reporting format as described in section (2). It is also essential that all described tests as indicated in section (3) and (4) for each unit be included in the report plus any other recommended tests e.g. recommendations from FDA, New York State, AAPM or ACR. All parameters and a brief explanation of each test must also be included in the reports. Three copies of the report must be provided by the contractor. One copy is to be sent to the Chief of the Service in which the X-ray units have been inspected, the second copy must be sent to the Radiation Safety Officer (VA Physicist) and a third copy is to be sent to the Chief, Biomedical Engineering. The contractor must notify the RSO of his inspection schedule at least two weeks in advance.The contractor must notify the Chief of the service (or his representative) and the RSO regarding any non-compliance items immediately after the inspection of the equipment when a unit output exposure level is above regulatory standards.Four of the diagnostic inspections and the annual calibration of the linear accelerator must be conducted in the presence of the RSO, VA's Health physicist. The reports will be reviewed by the VA RSO and the contractor must willingly answer any questions that the RSO has regarding the contractor's report.Annual therapy survey should be coordinated with the current medical physicist who works in the Radiation Therapy Service.The contractor is responsible for providing all calibration, scanning, and survey equipment necessary for the successful completion of the work detailed in the “Scope of Services”. The contractor must be available during the JCAHO visit. In this case a separate purchase order will be issued for the contractor. The contractor must be available when radiology service needs the contractor for different physics activities such as shielding assessment and QC of the new unit. In this case a separate purchase order will be issued for the contractor. Qualifications of the contractor:Qualification of the supervisor(s) of the group includes:Number of years’ experience in performing the annual QC of linear accelerator and QC of the X-ray units.Copy of certificate and educational degrees.Reference letters from the Chief of Radiology and the Radiation Therapy service regarding the supervisor (s) annual calibration of X-ray units and linear accelerators. Indicate % of the time that the supervisor(s) are physically present during the annual QC of linear accelerator and X-ray units. (Note that the % of the time that supervisor spends physically at the site during QC will be monitored by the VA staff; any deviation from the contractor’s statement will result in termination of the contract.)Indicate the current protocol that will be followed for QC of the linear accelerators and testify that the contractor has in his possession proper equipment to perform the procedures; this includes the list of the equipment.) Copies of the previous annual QC of linear accelerator, RF room and CT scan.Reporting and Recoding:The final written report must include: a. Date of inspection.b. Location of the X-ray unit (room number) and service/department.c. Manufacturer, model number, and serial number of the X-ray machine.d. Manufacturer, model number, and serial number of the tube.e. Brief explanation of each procedure of the QC test and parameters used.f. Brief explanation of all generated data or calculated results.g. Any advice regarding the JCAHO, New York State and Food and Drug Administration (FDA), American College of Radiology (ACR) standards, and AAPM (American Association of Physicist in Medicine) must be recorded in the summary of the report.h. Any non-compliance item, which is compared with the JCAHO, New York State and New York City, FDA, ACR and AAPM standards must be recorded in the summary of the report.i. List of measuring equipment and date of calibration.j. Provide a posting table of patient’s dose for each technique and skin entrance exposure dose to be posted in each room. k. Three copies of the report must be provided by the contractor. One copy is to be sent to the Chief of the service in which the X-ray units have been inspected, the second copy must be sent to the Radiation Safety Officer and a third copy is to be sent to the Chief, Biomedical Engineering. l. A table of the X-Ray units and the date of the inspection of each unit (similar to the attached table). See section (6).1. Specifications of Quality Control Tests of Diagnostic Units1.A. The following tests shall be performed on radiographic fluoroscopic units and portable X-ray units. 1. Collimator Field Size Indicator.2. Light Field/X-Ray Field Alignment3. SID Indicators.4. X-Ray Field/Image Receptor Alignment.5. Light Intensity of Field Localizing System.6. Positive Beam Limitation (PBL).7. Focal Spot Determination. (If it is required by City or State.)8. KvP Accuracy from minimum used to maximum KvP used. 9. Timer Accuracy for 10, 20, 50, 100, 200 , 500 mSec 10. Exposure Reproducibility.11. mA Linearity.12. Half-Value Layer (HVL). 13. Measure output (mR/mAs) at several KvPs in accordance with AAPM report # 25. Provide a characteristic output curve (mR/mAs) verses KvP for each diagnostic unit. 15. Comparison of measured output (mR/mAs) with the previous year and note of any discrepancy and provides suggestions according to the discrepancy. 14. Determine the dose to each radiation effected organ and Cancer Determination Index. (The contractor may use reference No.1.) 15. Provide a posting table of determined dose in step 14 for each technique which is used. The table will be posted in each room. Systems with AEC14. Exposure reproducibility of Fluoro. 15. Density Control Performance.16. Field sensitivity matching.17. Measure high contrast special resolution for all field of views and all available modes, e.g. continuous pulse/ digital modes. 18. Measure low contrast minimum detectable hole size. 19. Fluoro entrance exposure rate in: manual mode for different KvPs and automatic mode or any other available mode such as pulse mode/and or digital mode at different available field of views for: Small adult (pediatric), average adult, large adult and heavy patient.20. Provide a posting table of measured entrance exposure rate level to be posted in the RF room.20. Compare exposure rates levels with the previous year and note of any discrepancy and provides suggestions according to discrepancy. 21. Determine lead aprons integrity and make sure that necessary lead aprons, gonad leaded aprons or other are available in the room. Each lead apron should be labeled with room number, date of checks and also recorded on a hard copy for the department. 22. Report and record all non-compliance items. 23. Any other tests required by City or State. [1] Marvin Rosenstein, Ph.D. Handbook of Selected Tissue Dose for Projections Common in Diagnostic Radiology, U.S Department of Health And Human Services, December 19, 1998. 1.B. VARIOUS SAFETY CHECKS that shall be checked in each diagnostic X-ray room.a. Visual inspection of cables, connectors, etc.b. Fluoroscopic lead drapes.c. Warning light over entrance door.d. Door interlock- entrance door.e. Door interlock- control booth door.f. Radiographic tube locking devices.g. Collimator light.h. Console panel lights.i. Controls.j. Table controls movements and locks.k. Bucky trays.l. Fluoroscopic carriage movement and locks. m. Review the technologists’ QC logbook.1.C. Fluoroscopic and Cine imaging equipment. The contractor is expected to conduct, perform and report the following tests.1. X-Ray field -Image Intensifier Alignment. 2. KvP, Accuracy from 50 KvP to maximum available KvPs.4. Half-Value Layer. 5. Fluoro entrance exposure rate in: manual mode for different KvPs and automatic mode or any other available mode such as pulse mode/and or digital mode at different available fields of views for: Small adult (pediatric), average adult, large adult and heavy patient.6. Provide a posting table of measured entrance exposure rate level to be posted in the RF room. The post shall include specification of the unit, room number, department and exposure rates and signature of the physicist. 7. Compare exposure levels with the previous year and note of any discrepancy and provides suggestions according to discrepancy. 8. Fluoroscopic Image Evaluation:8.a Measure high contrast special resolution for all fields of views and all available modes, e.g. continuous, pulse/ digital. 8.b Measure low contrast minimum perceivable hole size.1.D. Dental Units: Intraoral, Panoramic and portable.1. Minimum source Skin Distances2. Radiation beam restricted device.3. Labeling cones or apparatus for different restricted beam devices4. HV layers for all available units.5. Patient exposure related to our film types.6. Provide a posting table showing patient’s exposure for all units. 7. Mechanical support.8. Availability of lead aprons.9. Review of film processor.1.E. Listed below are tests that the Contractor shall perform on the computerized Tomography (CT SCANNERS) on an annual basis.1. CT number accuracy of water, image noise, image uniformity.2. Image slice thickness and slice sensitive profile.3. Slice position accuracy.4. CT number scale accuracy. 5. Hard copy device.6. Dose profile width.7. Spatial resolution.8. Low-contrast sensitivity. 9. Patient’s dose: CTDI w for head, adult and pediatric abdomen.10 Determine CTDI vol: for available pitch and compare it with the manufacturor CTDI vol, and note any discrepancy. See reference [2]11- Determine: DLP(mGy-cm) for several exams such as: head, chest, abdomen & pelvis. 13- Calculate effective dose for pediatric and adult body. See reference [2]16. Scan Protocols.17. Review of the technologists’ logbook.18. The QC of all CTs must be performed in accordance with ACR requirements. ACR phantom must be used. Reference[2]: Report of AAPM Task Group 23, “The Measurement, Reporting, and Management of Radiation Dose in Ct”, January 2008. 1.F. Quality Control in Mammography shall be performed by the contractor on an annual basis which is listed below. (In accordance with FDA.)1. Mammographic Unit Assembly Evaluation.2. Collimation assessments.3. Focal spot size measurement4. KvP accuracy and reproducibility.5. Beam quality (Half value).6. Automatic exposure control.7. Uniformity of screen speed.8. Breast entrance exposure and average glandular dose.9. Image quality evaluation.10. Artifact evaluation.11. Review of the technologist’s QC logbook.12. Perform necessary tests as required by ACR, FDANote! Image quality evaluation for digital mammography must be performed in accordance with the manufacturer. 1.G. Tomo-graphic Tests1. Tomographic cut level.2. Tomographic cut thickness.3. Uniformity of exposure.4. Resolution plane of cut.6. All other tests as described for radiographic tests.1.H. Shielding Integrity of Lead Aprons Shielding integrity of lead aprons, lead gloves and lead collars throughout the hospital must be determined by the contractor. Defective aprons must be reported to the responsible service for disposal. Aprons which have passed the test must be labeled, with the date of test, name of service, room # and initial of the contractor. The contractor is expected to provide a list of lead aprons throughout the hospital. This report includes number of aprons gloves and collars in each room. Estimated total number of lead aprons, whole bodies, collars and gloves: 300Calculation of Entrance Exposure Dose and Organ Dose This inspection should include the calculation of a patient's entrance exposure dose and a patient's organ dose for all procedures performed in each X-ray room. A posting table of absorbed dose for each technique must be provided for each unit. Recent diagnostic units such as: CT, C-arm, Radiography and portable digital X-rays have a feature on which the dose to patient is given. This information is given by the Dose Area Product and or by the Dose to the patient. The contractor is expected to compare the dose values on each unit with his measurements. Linear Accelerators3.A The Annual Calibration of Linear Accelerators must be performed in accordance with the current published protocols accepted by nationally recognized bodies. Calibration is limited to but subject to change as current published protocols are updated.l. X-ray/electron output calibration constancy.2. Field size dependency of x-ray output constancy.3. Output factor constancy for electron applicators.4. Central axis parameter constancy (PDD<TAR).5. Off-axis factor constancy.6. Transmission factor constancy for all treatment accessories.7. Wedge transmission factor constancy.8. Monitor chamber linearity.9. X-ray output constancy vs. gantry angle.10.Electron output constancy vs. gantry angle.11.Off-axis factor constancy vs. gantry angle.12.Arc mode.Mechanical testing listed below shall be performed by the contractor on an annual basis.l. Localizing lasers.2. Distance indicator (ODl).3. Light/radiation field coincidence.4. Gantry/collimator angle indicators.6. Tray position.7. Applicator position.8. Field size indicators.9. Cross-hair centering.10.Treatment couch position indicators.11.Latching of wedges, blocking tray.12.Jaw symmetry.13.Field light intensity.14.Collimator rotation isocenter.15.Gantry rotation isocenter.16.Couch rotation isocenter.17.Coincidence of collimator.18.Gantry, couch axes with isocenter.19.Coincidence of radiation and mechanical isocenter.20. Table top sag.21.Vertical travel of table.Safety tests listed below shall be performed on an annual basis by the contractor.1. Door interlock.2. Audiovisual monitors.3. Emergency off switch.4. Wedge, electron cone interlocks.5. Follow manufacturers test procedures.3. B Specification of the current Linear accelerators:(1) Siemens Oncor ExpressionPhotons: 6 MV and 10 MVElectrons: 6 Mev, 9 MeV 12 MeV, 15 MeV, 18 MeV and 21 MeV,(2) Varian, TrueBeam STX: Photons: 6 MV and 10 MV and 15 MVElectrons: 6 Mev, 9 MeV 12 MeV, 15 MeV, 18 MeV In addition Multi-leaf Collimator, Digital Portal Imager,. IMRT Capability, Patient Positioning Lasers, Pinnacle (ADAC) Integrated Treatment Planning System, Impac (version 8.3) Record and Verify System.(2) VARION/True Beam 6FFF, 10FFF and 15 MV, Electrons 6,9,12,15,18, 21 Mev(2.a) Required training of VARION Operation: The following is a ROUGH outline of what is needed for TrueBeam OperationTraining Required for TrueBeam Annual QC. Operation of TrueBeam in Service mode. The service mode for the TrueBeam is much different from previous CLINAC’sBeam loading and deliveryLoading and delivery of MLC files, EDW plans, etc.ImagingOperation of Respiratory Gating SystemKnowing what not to change is very importantOperation of TrueBeam in Treatment ModeDelivery of select QA plansQA mode Operation of all mechanical technologyGantry, collimator, couch movementsOperation of OBI and MV detector elementsOperation of Brainlab EXACTRAC systemAccessory elements (electron cones, cone mount, etc)Respiratory gating cameraThe QC of all CTs must be performed in accordance with ACR requirements. ACR phantom must be used. MRIThe QC of MRI, Siemens/Symphony 1.5 Tesla must be performed in accordance with ACR requirements.Nuclear Medicine CamerasTwo Nuclear Medicine Cameras, SMV DST-XLE and GE-Infinia must be checked in accordance with the AAPM protocols.Place of PerformanceServices will be provided at the Radiation Safety Service located atVA NY Harbor Healthcare SystemBrooklyn Campus800 Poly PlaceBrooklyn, NY 11209ComplianceThe contractor(s) will be compliant with the Joint Commission Accreditation of Health Care Organization (JCAHO) and the VA Medical Center Regulations. Information Security and PrivacyThe contractor(s) will complete all NYHHS mandatory training which include but not limited to the following:CO Compliance and Business Integrity(CBI) AwarenessVA privacy and Information Security AwarenessPrivacy and HIPAA TrainingBilling/PaymentsThe Radiation Safety Service shall establish and maintain a record keeping system that will record the hours worked by the contractor employee(s). Contractors shall report to the COR or designee upon arrival at the facility.Invoices must be submitted to the COR delegated to this contract as well as submitted elsewhere as directed on the approved contract. The COR or designee will maintain all invoices and will review them for accuracy prior to payment. Contractor will be paid monthly, in arrears by certified invoice, after receipt of proper invoice. Invoice must reference the contract number and purchase order number, and contain the remittance name and complete address, including telephone number.Security ClauseContractor Personnel Security RequirementsAll contractor employees who require access to the Department of Veteran’s Affairs computer systems shall be subject of a background investigation and must receive a favorable adjudication from the VA office of Security Investigation Center prior to contract performance. This requirement is applicable to all subcontractor personnel requiring the same access. If the investigation is not completed prior to the start date of the contract, the contractor will be responsible for the actions of those individuals they provide to perform work for the VA. Position Sensitivity – The position has been designated as LOW RISKBackground Investigation – The level of background investigation commensurate with the required level access is NACIContractor responsibilitiesThe contractor shall bear the expense of obtaining background investigations. If the investigation is conducted by the Office of Personnel Management (OPM), the contractor shall reimburse the VA within 30 days.The contractor shall prescreen all personnel requiring access to the computer systems to ensure they maintain a US citizenship and are able to read, write, speak and understand the English languageThe Contractor shall submit or have their employees submit any required forms from the VA Office of Security and Law Enforcement within 30 days of receipt.Dress CodeDress code for contractor employees shall follow hospital policy.?ServiceLocationUnitManufacturerPrice??ROM #?Model???????1Cardiology10-213FluoroSiemens?????Coroskop???????2Cardiology10-215FluoroOEC???EPA LabC-arm9600???????3Dental BkI-1043IntraoralPlanmeca ?????????????4Dental BK10 New X-ray tube?????Intra oral?????????5Dental BKI-403PanoramicPlanmeca-?????promax???????6Dental BKService PortableGendex?????????????7Dental BKServicePortableGendex?????????????8Dental St. A-271PanoramicPlammeca?????promax???????9Dental St. A-271IntraoralSiemens ?????????????10Dental St.3 New Intraoral ???????????????11Dental St.?PortableGendex?????????????12GI4-301FluoroPhilips????C-arm????????13Nuclear2.nd floorSPECTInfina/GE??Med?CTHawkeya???????14OR?FluoroPhilips????C-armBV PULSERA???????15OR?FluoroPhilips????C-ArM Veradius???????16Radiology7th fl.MammoGE Seno DMR???????17Radiology?CT Toshiba ????Main BldAcq. 32.1????16 Slice????????18Radiology3Radiograph Picker????ChestGE???????19Radiology3-166SiemensArtis Zee????Artis Zee????????20Radiology8RadiographyGE????Rad.Advantx???????21Radiology8FluoroGE?????Advanta???????22Radiology9RadiographyGE????Rad????????23?9FluoroGE???????24Radiology10RadiographyGE????RadAdvantx???????25RadiologyPort.PortableGE???No.1EmergencyAMXIV Plus???????26RadiologyPort.PortableGE???No.2RadiologyAMXIV???????27RadiologyPort""???No.3 ?????????28RadiologyPort""???No.4 ?????????29RadiologyPortable""???No.5in st. Albans????????30RadiologyPortable"Carestream???Digital?????#1?????????31RadiologyPortable"Carestream???Digital?????#2?????????32RadiologyCTToshiba ?????Aquilion ?????64 Slice????????33RadiologyOPRadiographyPicker???Rad?MTX???G-723?????????34RadiologyOP ChestRadiograPicker???G-723?????????35Rad, SA4-A359DigitalPhilips???DigitalRadiography????????36TherapySimCT SimPhilips Brilliance ?????Big Bore?37UrologyOPFluoroPhilips????C-ArmBV300???????RadiologyMRISiemens/SymphonySiemens?LINACSimens ONCOR6 and 10 MV PhotonsElectrons 6,9,12,15,18, 21 Mev?Nuclear MedSMV DST-XLENuclear MedGE-Infinia???????LINACVarion/ True Beam6FFF, 10FFF and 15 MVElectrons 6,9,12,15,18, 21 Mev????????Lead Aprons300 piecesTwo days work??Note Item 4 contain 10 X-ray units for dental (intra Oral)?????Note Item 10 contain 4 X-ray units for dental (Intra-Oral)?????+ Annual QC of MRI and Two Nuclear Medicine Cameras. The QC of all CTs must be performed in accordance with ACR requirements. ACR phantom must be used. The QC of MRI, Siemens/Symphony 1.5 Tesla must be performed in accordance with ACR requirements.Two Nuclear Medicine Cameras, SMV DST-XLE and GE-Infinia must be checked in accordance with the AAPM protocols. Training Required for TrueBeam Annual QC. Operation of TrueBeam in Service mode. The service mode for the TrueBeam is much different from previous CLINAC’sBeam loading and deliveryLoading and delivery of MLC files, EDW plans, etc.ImagingOperation of Respiratory Gating SystemKnowing what not to change is very importantOperation of TrueBeam in Treatment ModeDelivery of select QA plansQA mode Operation of all mechanical technologyGantry, collimator, couch movementsOperation of OBI and MV detector elementsOperation of Brainlab EXACTRAC systemAccessory elements (electron cones, cone mount, etc)Respiratory gating cameraThis is a Request for Proposal or an announcement of a solicitation and a solicitation package exists at this time. Your responses will be used for market research purposes of the Government. The Government will not pay for any materials provided in response to this notice and submittals will not be returned to the sender.The applicable North American Classification System (NAICS) Code for this requirement is 811219 and the small business size standard is 500 Employees. Responses due are to be submitted by e-mail to Aleta.Jennette@. The information requested must be received no later than 3:00pm Eastern Standard Time on April 04, 2014. ................
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