Description - Veterans Affairs
5. PROJECT NUMBER (if applicable)CODE7. ADMINISTERED BY2. AMENDMENT/MODIFICATION NUMBERCODE6. ISSUED BY8. NAME AND ADDRESS OF CONTRACTOR4. REQUISITION/PURCHASE REQ. NUMBER3. EFFECTIVE DATE9A. AMENDMENT OF SOLICITATION NUMBER9B. DATEDPAGEOF PAGES10A. MODIFICATION OF CONTRACT/ORDER NUMBER10B. DATEDBPA NO.1. CONTRACT ID CODEFACILITY CODECODE Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of OffersE. IMPORTANT:is extended, (a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAYis not extended.12. ACCOUNTING AND APPROPRIATION DATA(REV. 11/2016)is required to sign this document and return ___________ copies to the issuing office.is not,A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.15C. DATE SIGNEDB. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b). RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:D. OTHERBYContractor16C. DATE SIGNED14. DESCRIPTION OF AMENDMENT/MODIFICATION16B. UNITED STATES OF AMERICAExcept as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.15A. NAME AND TITLE OF SIGNER16A. NAME AND TITLE OF CONTRACTING OFFICER15B. CONTRACTOR/OFFERORSTANDARD FORM 30 PREVIOUS EDITION NOT USABLEPrescribed by GSA - FAR (48 CFR) 53.243(Type or print)(Type or print)(Organized by UCF section headings, including solicitation/contract subject matter where feasible.)(Number, street, county, State and ZIP Code)(If other than Item 6)(Specify type of modification and authority)(such as changes in paying office, appropriation date, etc.)(If required)(SEE ITEM 11)(SEE ITEM 13)(X)CHECKONE13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONSAMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT(Signature of person authorized to sign)(Signature of Contracting Officer)1250000204-24-2018None36C244Department of Veterans AffairsNetwork Contracting Office 4 36C244Department of Veterans AffairsNetwork Contracting Office 4 To all Offerors/Bidders VA244-17-R-095604-12-2018 XXX1X11. The purpose of this amendment is to make changes to sections of the solicitation to include: CLIN, PWS, Section E andthe QASP. 2. See Continuation Page for the answers to intersted offeror's Questions.3. All other terms and conditions remain unchanged. Shawn E. SmithContracting Officer CONTINUATION PAGEQ1.? What does the below segment of the CLINs table mean?:Board Certified Chief Therapeutic Medical Physicist Services (inclusive of on-call)20,800HoursDO NOT PRICEDO NOT PRICEAnswer: The table is formatted with the CLIN, as seen above, with Sub-CLIN’s listed below. Each Sub-CLIN identifies a Chief Therapeutic Medical Physicist (CTMP) that will be able to provide services under the new contract.Q2.? Attachment A:? has a list of diagnostic equipment. There should be a Diagnostic Medical Physicist responsible for that equipment not a Therapeutic Medical Physicist. Can you explain why this attachment is in the?solicitation?Answer: Attachment “A” is removed from solicitation.Q3. Will the government clarify the exact FTE requirements on this contract? There seems to be a discrepancy between Page 25, the synopsis, and the CLINs sections.Answer: The FTE requirement has changed to 1 FTE for CTMPThe current CLIN is replaced with the following CLIN, beginning on page 6:BASE ORDERING PERIOD YEAR 1: OCTOBER 1, 2018 – SEPTEMBER 30, 2019CLIN No.SUB-CLINDescriptionQty.UnitUnit CostTotalAnnual Cost0001NoneBoard Certified Chief Therapeutic Medical Physicist Services (inclusive of on-call)10,400 HoursDO NOT PRICEDO NOT PRICEKEY PERSONNELNone0001AABoard Certified Chief Therapeutic Medical Physicist NAME:_____________________ TITLE/LEVEL OF EXPERIENCE: ___________________________ Contract Period: Year 1 POP Begin: 10/01/2018POP End: 09/30/2019Hours$_______/hr.$________None0001ABBoard Certified Therapeutic Medical Physicist (Chief Back Up) NAME:______________________ TITLE/LEVEL OF EXPERIENCE: ____________________________ Contract Period: Year 1 POP Begin: 10/01/2018POP End: 09/30/2019Hours$_______/hr.$________CLIN 0001 TOTAL FOR YEAR 1:2,080Hours$____________________BASE ORDERING PERIOD YEAR 2: OCTOBER 1, 2019 – SEPTEMBER 30, 2020CLIN No.SUB-CLINDescriptionQty.UnitUnit CostTotalAnnual Cost KEY PERSONNELNone0001BABoard Certified Chief Therapeutic Medical Physicist NAME:_____________________ TITLE/LEVEL OF EXPERIENCE: ___________________________ Contract Period: Year 2POP Begin: 10/01/2019POP End: 09/30/2020Hours$_______/hr.$________None0001BBBoard Certified Therapeutic Medical Physicist (Chief Back Up) NAME:______________________ TITLE/LEVEL OF EXPERIENCE: ____________________________ Contract Period: Year 2POP Begin: 10/01/2019POP End: 09/30/2020Hours$_______/hr.$________CLIN 0001 TOTAL FOR YEAR 2:2,080Hours$____________________BASE ORDERING PERIOD YEAR 3: OCTOBER 1, 2020 – SEPTEMBER 30, 2021CLIN No.SUB-CLINDescriptionQty.UnitUnit CostTotalAnnual CostKEY PERSONNELNone0001CABoard Certified Chief Therapeutic Medical Physicist NAME:_____________________ TITLE/LEVEL OF EXPERIENCE: ___________________________ Contract Period: Year 3POP Begin: 10/01/2020POP End: 09/30/2021Hours$_______/hr.$________None0001CBBoard Certified Therapeutic Medical Physicist (Chief Back Up) NAME:______________________ TITLE/LEVEL OF EXPERIENCE: ____________________________ Contract Period: Year 3POP Begin: 10/01/2020POP End: 09/30/2021Hours$_______/hr.$________CLIN 0001 TOTAL FOR YEAR 3:2,080Hours$____________________BASE ORDERING PERIOD YEAR 4: OCTOBER 1, 2021 – SEPTEMBER 30, 2022CLIN No.SUB-CLINDescriptionQty.UnitUnit CostTotalAnnual CostKEY PERSONNELNone0001DABoard Certified Chief Therapeutic Medical Physicist NAME:_____________________ TITLE/LEVEL OF EXPERIENCE: ___________________________ Contract Period: Year 4POP Begin: 10/01/2021POP End: 09/30/2022Hours$_______/hr.$________None0001DBBoard Certified Therapeutic Medical Physicist (Chief Back Up) NAME:______________________ TITLE/LEVEL OF EXPERIENCE: ____________________________ Contract Period: Year 4POP Begin: 10/01/2021POP End: 09/30/2022Hours$_______/hr.$________CLIN 0001 TOTAL FOR YEAR 4:2,080Hours$____________________BASE ORDERING PERIOD YEAR 5: OCTOBER 1, 2022 – SEPTEMBER 30, 2023CLIN No.SUB-CLINDescriptionQty.UnitUnit CostTotalAnnual CostKEY PERSONNELNone0001EABoard Certified Chief Therapeutic Medical Physicist NAME:_____________________ TITLE/LEVEL OF EXPERIENCE: ___________________________ Contract Period: Year 5POP Begin: 10/01/2022POP End: 09/30/2023Hours/hr.$_______/hr.None0001EBBoard Certified Therapeutic Medical Physicist (Chief Back Up) NAME:______________________ TITLE/LEVEL OF EXPERIENCE: ____________________________ Contract Period: Year 5POP Begin: 10/01/2022POP End: 09/30/2023Hours/hr.$_______/hr.CLIN 0001 TOTAL FOR YEAR 5:2,080Hours$____________________OPTION YEAR 1: OCTOBER 1, 2023 – SEPTEMBER 30, 2024CLIN No.SUB-CLINDescriptionQty.UnitUnit CostTotalAnnual Cost1001NoneBoard Certified Chief Therapeutic Medical Physicist Services (inclusive of on-call)2,080HoursDO NOT PRICEDO NOT PRICEKEY PERSONNELNone1001AABoard Certified Chief Therapeutic Medical Physicist NAME:_____________________ TITLE/LEVEL OF EXPERIENCE: ___________________________ Contract Period: Option Year 1POP Begin: 10/01/2023POP End: 09/30/2024Hours$_______/hr.$________None1001ABBoard Certified Therapeutic Medical Physicist (Chief Back Up) NAME:______________________ TITLE/LEVEL OF EXPERIENCE: ____________________________ Contract Period: Option Year 1POP Begin: 10/01/2023POP End: 09/30/2024Hours$_______/hr.$________CLIN 1001 TOTAL FOR OPTION YEAR 1:2,080Hours$____________________OPTION YEAR 2: OCTOBER 1, 2024 – SEPTEMBER 30, 2025CLIN No.SUB-CLINDescriptionQty.UnitUnit CostTotalAnnual Cost2001NoneBoard Certified Chief Therapeutic Medical Physicist Services (inclusive of on-call)2,080HoursDO NOT PRICEDO NOT PRICEKEY PERSONNELNone2001AABoard Certified Chief Therapeutic Medical Physicist NAME:_____________________ TITLE/LEVEL OF EXPERIENCE: ___________________________ Contract Period: Option Year 2P POP Begin: 10/01/2024POP End: 09/30/2025Hours$_______/hr.$________None2001ABBoard Certified Therapeutic Medical Physicist (Chief Back Up) NAME:______________________ TITLE/LEVEL OF EXPERIENCE: ____________________________ Contract Period: Option Year 2POP Begin: 10/01/2024POP End: 09/30/2025Hours$_______/hr.$________CLIN 2001 TOTAL FOR OPTION YEAR 2:2,080Hours$____________________OPTION YEAR 3: OCTOBER 1, 2025 – SEPTEMBER 30, 2026CLIN No.SUB-CLINDescriptionQty.UnitUnit CostTotalAnnual Cost3001NoneBoard Certified Chief Therapeutic Medical Physicist Services (inclusive of on-call)2,080HoursDO NOT PRICEDO NOT PRICEKEY PERSONNELNone3001AABoard Certified Chief Therapeutic Medical Physicist NAME:_____________________ TITLE/LEVEL OF EXPERIENCE: ___________________________ Contract Period: Option Year 3POP Begin: 10/01/2025POP End: 09/30/2026Hours$_______/hr.$________None3001ABBoard Certified Therapeutic Medical Physicist (Chief Back Up) NAME:______________________ TITLE/LEVEL OF EXPERIENCE: ____________________________ Contract Period: Option Year 3POP Begin: 10/01/2025POP End: 09/30/2026Hours$_______/hr.$________CLIN 3001 TOTAL FOR OPTION YEAR 3:2,080Hours$____________________OPTION YEAR 4: OCTOBER 1, 2026 – SEPTEMBER 30, 2027CLIN No.SUB-CLINDescriptionQty.UnitUnit CostTotalAnnual Cost4001NoneBoard Certified Chief Therapeutic Medical Physicist Services (inclusive of on-call)2,080HoursDO NOT PRICEDO NOT PRICEKEY PERSONNELNone4001AABoard Certified Chief Therapeutic Medical Physicist NAME:_____________________ TITLE/LEVEL OF EXPERIENCE: ___________________________ Contract Period: Option Year 4POP Begin: 10/01/2026POP End: 09/30/2027Hours/hr.$_______/hr.None4001ABBoard Certified Medical Physicist NAME:______________________ TITLE/LEVEL OF EXPERIENCE: ____________________________ Contract Period: Option Year 4POP Begin: 10/01/2026POP End: 09/30/2027Hours/hr.$_______/hr.CLIN 4001 TOTAL FOR OPTION YEAR 4:2,080Hours$____________________OPTION YEAR 5: OCTOBER 1, 2017 – SEPTEMBER 30, 2018CLIN No.SUB-CLINDescriptionQty.UnitUnit CostTotalAnnual Cost5001NoneBoard Certified Medical Physicist Services2,080HoursDO NOT PRICEDO NOT PRICEKEY PERSONNELNone5001AABoard Certified Chief Therapeutic Medical Physicist NAME:_____________________ TITLE/LEVEL OF EXPERIENCE: ___________________________ Contract Period: Option Year 5POP Begin: 10/01/2027POP End: 09/30/2028Hours/hr.$_______/hr.None5001ABBoard Certified Medical Physicist NAME:______________________ TITLE/LEVEL OF EXPERIENCE: ____________________________ Contract Period: Option Year 5POP Begin: 10/01/2027POP End: 09/30/2028Hours/hr.$_______/hr.CLIN 5001 TOTAL FOR OPTION YEAR 5:2,080Hours$ ____________________TOTAL (5) YEAR BASE AND (5) OPTION YEARS 20,800Hours$ ____________________Q4. Is this an incumbent contract? If so, who is the incumbent? What was the incumbent contract dollar value?Answer: The incumbent is Radiological Physics Services, Inc. The dollar value is $297,648.00. Q5. Will the Government accept Joint Commission Qualified vendors, in addition to Joint Commission certified vendors? Our company is compliant with all JC requirements, but has never had a need to get the certification.Answer: Section 4 of the PWS and Section E discuss Joint Commission requirements.Q6. Reference page 5, para 4 under "Pricing Instructions" - "...the maximum quantity/contract quantity/amount, including the five year base and any option years exercised shall not exceed $6,000,000.00."?Is it possible to raise the maximum to $7,000,000.00?? In building our base line pricing model, we are over the 6M mark without allowing any adjustments for increases in wages, taxes, medical insurance costs.? For a 10 year contract, it is unrealistic to assume rates will stay flat.?Answer: The Minimum is changed to $145,910.70 and Maximum has changed to $2,938,362.37.Page 19, 2.1.2 Credentialing and Privileging – shall be removed from the PWS:Credentialing and Privileging –Credentialing and privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 referenced above. The Contractor is responsible to ensure that proposed physician(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any contractor’s physician (s) prior to obtaining approval by VAPHS Professional Standards Board, Medical Executive Board and Medical Center Director. If the Medical Physicist(s) and/or other contract provider (s) are not credentialed and privileged or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.Page 19, 2.1.2.2 Credentialing and Privileging– shall be replaced with the following language:Credentialing of Health Care Professionals other than physicians. In accordance with VHA Directive 2012-030, all health care professional who claim licensure, certification, or registration, as applicable to the position (this applies to all who are appointed or utilized on a full-time, part-time, intermittent, consultant , without compensation, on-station fee-basis, on-station contract, or on-station sharing agreement basis) and who are not currently credentialed in accordance with VHA Handbook 1100.19, must be credentialed in accordance with this directive.Page 19, 2.1.4 Continuing CME/CEU Requirements– shall be replaced with the following language:Continuing CEU Requirements: Contractor shall provide the COR copies of current CEUs needed to maintain their ABR board certification, or if requested by the VAPHS. CEU hours shall be reported to the credentials office for tracking. These documents are required for initial and renewal privileging. If maintenance of certification lapses or their certification is revoked, they shall be removed from the contract.Page 20, 2.1.5 Training– shall be replaced with the following language:Training (CPRS and VA MANDATORY): Contractor’s physician (s) and other contract provider (s) shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contractor’s physician (s) and other contract provider (s) as required by the VA. List all training, associated time and frequency. TrainingFrequency (once a year, etc.)Annual HoursCPRSOne time1 Hour 30 MinutesVA Privacy and Information Security and Rules of BehaviorOnce a year1 HourQ7. ?Page 23 - Para 2.9.2 "In the event a scheduled Medical Physicist is unable to complete an assigned shift, the contractor shall provide replacement Medical Physicist coverage within 2 hours..."?Can this be deleted?? Without having a backup Physicist on call every day, it is impractical to implement this requirement.? If the service insists on this requirement, can we add a CLIN line to have a backup Physicist added to the contract and be rotated into the schedule??Answer: Yes, this can be changed.Page 23, 2.9.1 and 2.9.2 – shall be replaced with the following language:The number of Medical Physicists required to be on site on a daily basis is 1 FTEE as defined in paragraph Hours of Operation in this section. FTEE is defined by VA as a minimum of 80 hours every two weeks and does not include holidays. “In addition to the Contract submitting potential candidate’s resume/ curriculum vita (CV) to Contracting Office to NROP for review and approval of Chief Therapeutic Medical Physicist as outlined in 4.5.1., the potential candidates shall submit a letter with the CV stating he/she will be available to perform these services during period of performance.”The Contractor shall be responsible for providing coverage to the VA during periods of vacancies of the Contractor’s personnel due to sick leave, personal leave, vacations and additional coverage as required. In the event a scheduled Medical Physicist is unable to complete an assigned shift, the contractor shall notify the Contracting Office Representative and/or VAPHS within 2 hours of shift. If a scheduled Medical Physicist will be unable to return to work the following day, the Contractor shall provide a replacement Medical Physicist and notify the Contracting Office Representative (COR) and/or the VAPHS immediately of the schedule change.Q8. Page 24 - Para 3.1 and 3.2 states the work schedule is from 8am to 6pm yet para 3.2.1 states that the HCP needs to be present during clinic hours starting at 7am.?Please clarify the hours the HCP is required to be on site.?Answer: The hours are 8:00 a.m. to 6:00 p.m. EST.Page 24, 3.2 and 3.2.1 – shall be replaced with the following language:Work Schedule: Monday through Friday, 8:00 AM – 6:00 PM. Work schedule for QA/AC testing may vary. The CTMP/TMP may perform work after normal business hours as their calibrations and measurements need to be done after patient treatments. However, the CTMP must be on-site during clinical operational hours at least 50% of the time.Contractor, Medical Physicist, shall be available and present in clinic during normal (VAPHS) clinic hours, (VAPHS) which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff. Q9.? Page 24 - Para 3.0?Please confirm there are no "on-call" requirements.Answer: There are no on-call requirements.Page 25, 4.1 Services Required – shall be replaced with the following language:Services required: 1.0 FTEE Chief Therapeutic Medical Physicist HoursPage 27, 4.4.1.2 Document Requirements – shall be replaced with the following language:4.4.1.2 Documentation Requirements – All clinical note documentation including, but not limited to continuing physics consultation which covers weekly chart review checks, special physics consultation notes, end of treatment notes and other required documentation, shall be recorded in CPRS in accordance with VA Rules and Regulations (see Section D, page 83 for CPRS User Guide and By-Laws and Rules of the Medical Staff of the VA RADIATION ONCOLOGY), including, but not limited to:4.5.1.2.1. Inclusion of correct Current Procedural Terminology (CPT) and diagnoses codes, and service connection of condition being treated on encounters;4.5.1.2.2. Electronic signature on all entries; timeframes for electronic signing, completion and closing of entries and encounters.Page 27, 4.4.2 Chief Therapeutic Medical Physicist – shall be replaced with the following language:Chief Therapeutic Medical Physicist: Each VHA facility with radiation oncology services must have a registration certificate that lists, by name, its Chief Therapeutic Medical Physicist (CTMP). These certificates, issued by NHPP, must be requested as follows. The request must describe the training, experience, and certifications of the contracted candidate. Such a request is usually sent by the Facility Director or, with permission of the Director, by the Radiation Safety Officer (RSO) with concurrence from the Radiation Oncology Service or Section Chief. Qualifications required to meet this mandate include education in medical physics, at least 5 years of experience, experience with particular treatment modalities, and experience with specific equipment and software as detailed below, and board certification in medical physics. Pages 27-28, 4.4.2.1 The following language shall be removed from the PWS:The Contractor must be willing to act as the emergency contingency RSO.The RSO function is to serve as a contingency plan in the event the current VAPHS RSO is unable to fulfill his/her duties for 60 days or more at no fault of the VAPHS.This function would serve for up to 1 calendar year to allow time for the VAPHS to find a permanent replacement.In the event that the medical physicist would act as the emergency contingency RSO, tasks that the physicist would be expected to perform would include but not be limited to: attend RSC meetings; review dosimetry reports; perform sealed source leak tests; perform the necessary quarterly QA/QC studies, and provide any necessary required training.The medical physicist would have to be approved by the VHA Radiation Regulators, (the NHPP) as RSO.Prior to award of contract, the Contractor shall submit its potential candidate’s resume/curriculum vita (CV), and with at least two (2) references letters from prior employers with firsthand knowledge of the candidate’s performance, to the Contracting Office for submission to the National Radiation Oncology Program for approval as Chief Therapeutic Medical Physicist.? In addition, the potential candidates shall submit a letter with the CV stating he/she will be available to perform these services during period of performance, and on-site at least 50% of the time per week.Page 29, 4.4.3.2 Availability– shall be replaced with the following language:4.4.3.2 Availability - Contractor’s Medical Physicists shall be available, when necessary, for consultation with the Radiation Oncologist and to provide advice or direction to technical staff when radiation treatments are being planned or when patients are being treated. Where possible, should be present to observe and/or help supervise complicated simulations and/or treatment set-ups. Contractor’s Medical Physicist must be present at the machine during patient setup for SRS/SRT and IGRT. Pages 32-33, 4.4.4 Medical Dosimetry Support – shall be removed from the PWS:Medical Dosimetry Support: The Contractor’s Medical Physicist is responsible for calculations/treatment plans during the Dosimetrist absence and support the dosimetrist in implementing physics guidelines. Shall carry out medical dosimetry functions with certified Medical Dosimetrist. Certification by the Medical Dosimetrist Certification Board and shall receive technical direction from the VA Radiation Oncologist and/or Contractor’s Medical Physicist. Alternatively, medical dosimetry functions may be carried out by a Medical Physicist or supervised designee. In either case, the Contractor’s Medical Physicist shall oversee the medical dosimetry functions of the Radiation Oncology Service, functions as a technical supervisor of medical dosimetry services and oversee medical dosimetry quality assurance activities. Shall perform, in conjunction with the Contractor’s Medical Physicist, treatment planning for SRS/SRT, HDR brachytherapy, IMRT, IGRT, and LDR brachytherapy. The Dosimetrist shall be present during patient treatment for HDR brachytherapy. The Dosimetrist shall also provide backup coverage during volume study procedures for LDR brachytherapy.Shall design treatment plans by means of computer and/or manual computation that will deliver a prescribed radiation dose and field placement technique in accordance with the VA Radiation Oncologist prescription to a defined tumor volume.Shall consider dose-limiting structures in the design of treatment plans and document dose in accordance with VA Radiation Oncologist prescription.Shall assist with treatment simulations and tumor localization on dedicated devices, including computer tomography and MRI, when indicated, for radiation therapy treatment planning.Shall assist in planning and oversee fabrication of compensating filters, custom shields, wedges, and other beam modifying devices.Shall assist in the planning, oversee and supervise production of molds, casts, and other immobilization devices.Shall assist radiation therapy staff in the implementation of the treatment plan including the correct use of immobilization devices, compensators, wedges, field arrangements, and any treatment variable associated with treatment planning implementation.Shall perform calculation methods for the delivery of prescribed dose, and subsequent documentation in patient files, and verification of the mathematical accuracy of all calculations using a system established by the Contractor’s Medical Physicist.Shall provide dosimetry and technical support to Contractor’s Medical Physicist, in radiation protection, qualitative and quantitative machine calibration, and quality assurance of the radiation therapy equipment. Assist in the application of specific methods of dosimetry, including ion chamber, TLD, or film measurements as directed by the Contractor’s Medical Physicist.Page 33, 4.5.1 Administrative– shall be replaced with the following language: Contractor’s staff shall attend service staff meetings, service quality assurance meetings, chart rounds, peer review conferences, and Radiation Safety Committee (CTMP) as required by the VA Chief, Radiation Oncology Service, COS or designee. Contractor to communicate with COR on this requirement and report any conflicts that may interfere with compliance with this requirement.Page 34, 5.1.1 Qualifications and Availability of Key Personnel – Performance Requirement– shall be replaced with the following language:5.1.1. Measure: Qualifications and Availability of Key PersonnelPerformance Requirement: Medical Physicists shall be Board Certified in accordance with ABR Standards the Contractor shall provide evidence that workload is distributed between 2 or more providers within the group and that treatment is provided in compliance within standard of care outlined in this PWS.Standard: All (100%) Medical Physicists shall be Board Certified in accordance with ACR Standards and available to provide the required scheduled services to veterans 100% of the time.Q10.? Page 78 - para E.1.3 (b)?makes reference to "primary care services" twice.? Should that be "Therapeutic Medical Physicist?"?Answer: Yes.Page 78, E.1.3 Technical (Non-Price) Proposal (b) – shall be replaced with the following language:(b) The Offeror’s response to the Past Performance portion of the proposal (Factor 2) should provide a list of the last three (3) contracts and/or subcontracts completed for Therapeutic Medical Physicist services during the past three (3) years and a list of all contracts and subcontracts currently in progress for Therapeutic Medical Physicist services. Include the following information for each contract and subcontract:Q11.? Page 80 - para (2) A.??Makes reference to "primary care services."? Should that be "Therapeutic?Medical Physicist?"?Answer: Yes.Page 80, (2) Factor 2 (A). Past Performance–shall be replaced with the following language:A. Offerors shall submit the information outlined below as evidence relevant past performance. Each offeror will be evaluated on his/her performance under existing and prior contracts for similar Therapeutic Medical Physicist services. Performance information will be used for both responsibility determinations and as an evaluation factor against which offeror’s relative rankings will be compared to assure best value to the Government. The Government will focus on information that demonstrates quality of performance relative to the size and complexity of the procurement under consideration. (Note: Past performance information may be submitted prior to submission of the other parts of the proposal, to assist the Government in reducing the evaluation period. Past Performance information may be e-mailed to Bruce Jackson II at Bruce.Jackson5@ Completed Mailed Proposal submissions still must contain a Volume of the past performance information upon submission. A confirmation E-mail will be sent to verify receipt of any Past Performance information submitted prior to the due date for receipt of proposals. The subject line of the email must state the contractor’s name, VAPHS Medical Physicist Solicitation and Past Performance).Q12. Is there a current incumbent chief physicist on contract?Answer: Yes.Q13. Are there other staff physicists in the RO department?Answer: No.Q14. What are the other providers in the RO department (e.g., oncologists, dosimetrists, therapists, etc.)?Answer: Two (2) Physicians, One (1) Dosimetrist, Five (5) Therapists, One (1) Supervisory Therapist, Two (2) Nurses, and One (1) LPN.Q15. What machines do they use?Answer: Trilogy Linear Accelerator Varian, Tomo Therapy Machines, PET CT for CT sim’s.Q16. Is this job routine department coverage or will there be commissioning of new machines involved?Answer: There will be commissioning of new machines.Q17. What is the patient case load for the RO department?Answer: The average is 25 consults a month, 55 follow-ups, 18 patients on treatment, and 15 CT simulations for a total of 113 patients.Q18. Any other duties the chief physicist needs to be responsible for?Answer: Section 4 of the PWS discusses the responsibilities of the Chief Physicist.Attachment D.4 QASP - is replaced with the revised QASP below:The contractor will be evaluated in accordance with the following:1.PURPOSEThis Quality Assurance Surveillance Plan (QASP) provides a systematic method to evaluate performance for the stated contract. This QASP explains the following:What will be monitored?How monitoring will take place.Who will conduct the monitoring?How monitoring efforts and results will be documented.This QASP does not detail how the contractor accomplishes the work. Rather, the QASP is created with the premise that the contractor is responsible for management and quality control actions to meet the terms of the contract. It is the Government’s responsibility to be objective, fair, and consistent in evaluating performance.This QASP is a “living document” and the Government may review and revise it on a regular basis. However, the Government shall coordinate changes with the contractor through contract modification. Copies of the original QASP and revisions shall be provided to the contractor and Government officials implementing surveillance activities.ernment Roles and ResponsibilitiesThe following personnel shall oversee and coordinate surveillance activities.a.Contracting Officer (CO) – The CO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United States in the contractual relationship. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment under this contract. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance.Assigned CO: Organization or Agency: b.Contracting Officer’s Representative (COR) – The COR is responsible for technical administration of the contract and shall assure proper Government surveillance of the contractor’s performance. The COR shall keep a quality assurance file. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf.Assigned COR: Organization or Agency: 3.Contractor RepresentativesThe following employee(s) of the contractor serve as the contractor’s program manager(s) for this contract.Primary:Alternate: __________________________________________________4.Performance StandardsThe contractor is responsible for performance of ALL terms and conditions of the contract. CORs will provide contract progress reports quarterly to the CO reflecting performance on this plan and all other aspects of the resultant contract. The performance standards outlined in this QASP shall be used to determine the level of contractor performance in the elements defined. Performance standards define desired services. The Government performs surveillance to determine the level of Contractor performance to these standards.The Performance Requirements are listed below in Section 6. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the standard and assign a rating. At the end of the performance period, these ratings will be used, in part, to establish the past performance of the contractor on the contract.5. Methods of QA Surveillance Various methods exist to monitor performance. The COR shall use the surveillance methods listed below in the administration of this QASP. a. DIRECT OBSERVATION: Routine observation of service operations, meeting participation, etc.b. PERIODIC INSPECTION: Inspections scheduled and reported weekly/monthly/quarterly/annually per COR. Monthly review of credentialing, privileging and training records to confirm staff on invoices meet the qualifications; review of monthly and quarterly management reports on compliance/deficiencies of services regarding performance metrics (e.g. clinic wait times, consult and encounter closeouts, unsigned medical records, required training, etc.).c. VALIDATED USER/CUSTOMER COMPLAINTS: Complaints received by Patient Advocate, Chief of Staff or Medical Center Director’s offices are forwarded to the Medical Director and are followed up for validation and resolution by the service within the required time period, and if not, are further investigated.d. RANDOM SAMPLING: Random unannounced inspections of records required to be maintained (e.g. radiation safety records, randomly selected patient files). e. Verification and/or documentation provided by Contractor: Training and occupational health documentation for individual staff; peer review conference/chart round results.6.SAMPLE QASP PERFORMANCE REPORT DATE:__________________MeasurePWSPara.PerformanceRequirementStandardAcceptable Quality LevelSurveillanceMethodMet AQL/DID NOT MEET AQL- CPAR RATING/ADD COMMENTSQualifications and Availability of Key Personnel2.1.1; 5.1.1CTMP shall be Board Certified in accordance with ACR Standards The Contractor shall provide evidence that workload is distributed between 2 or more providers within the group and that treatment is provided in compliance within standard of care outlined in this PWS.100% 100%Periodic Sampling of qualification documentation and medical records submitted in accordance with contractor reporting requirementsPatient Reports and Documentation4.4.1.2.1All notes must be electronically signed and all encounters closed within 24 pliance with VA Rules and Regulations95%Periodic Inspection and Random SamplingPeer Review Conferences/ Chart Rounds.4.4.1.1; 4.4.3.4Conduct Weekly Peer Review Conferences/Chart Rounds as required by the PWS.Peer Review Conferences/Chart Rounds conducted, documented and reported as required.90%Periodic Inspection, , and Verification and/or documentation provided by ContractorStandard Operating Procedures (SOP) for all radiotherapy techniques4.5.3.3; 5.1.2Reviewable documentation of all SOPs shall be maintained. Radiotherapy techniques such as 3DCRT, IMRT, IGRT, SBRT, SRS, Brachytherapy have written procedures.100% of procedures are documented and reviewed and updated annually.90%Periodic sampling.Quality Assurance/Quality Improvement (QA/QI) Documentation4.5.1.3; 5.1.3Reviewable records of device quality assurance shall be maintained. Daily, monthly and annual QA documentation for linear accelerators and CT Sim are accessible100% of QA/QI documents complete in accordance with ACR standards and reported as required to Tumor Board.90%Periodic sampling.Patient Safety/Radiation Safety4.5.3; 5.1.4Patient safety incidents, including medical events involving radioactive material and misadministration’s, must be reported.100% of incidents reported promptly (within 24 hours of discovery.)100%Direct Observation Chart Review/Physics Check/Consults4.4.3.4Completion deadlines met as assigned by Radiation Oncology Service Administration/CORChart Review/Physics Check/Consults are completed weekly.90%Report issued by Chief Radiation Therapist as well as Billing and Coding ServiceMedical Physicist Reports demonstrate ACR Standards5.1.5Contractor’s Medical Physicists shall develop and maintain a quality management program (QMP) for the dosimetry system(s) and all applications pertinent thereto. Said QMP shall define explicit evaluation criteria intended to ensure that the prescribed dose is delivered in a safe, consistent and accurate manner. Contractor shall provide the VA Radiation Oncology Service, with written reports of these activities. Quality management of radiation therapy equipment is primarily an ongoing evaluation of functional performance characteristics.All (100%) of required medical physicist reports documenting the successful evaluation of equipment performance (meeting or exceeding ACR Standards) to include therapy machines, radiation sources, and simulators for proper working order is required. All external review requirements per ACR Standards are met, including those of TJC100%Periodic Sampling and Random Sampling Maintains licensing, registration, and certifications6.6.1Updated Licensing, registration and certifications will be provided as they are renewed.100% Licensing and registration information kept current.100%Periodic Sampling and Random Sampling Mandatory Training2.1.5; 6.9.10.16Contractor completes all mandatory required trainingAll Training (100%) completed as required per VAMC policy100%Contractor to provide documented evidencePrivacy, Confidentiality and HIPAA4.3.1; 4.3.2Contractor is aware of all laws, regulations, policies and procedures relating to Privacy, Confidentiality and HIPAA and complies with all standards Zero breaches of privacy or confidentiality100%Contractor to provide evidence of annual training required by VAMC, reports violations per policy Professionalism/Conduct2.9.3.3; 5.2Contractor employees maintain excellent relationships with patients, Radiation Oncology staff members, VA Medical Center staff members, and vendors.Zero complaints from VA Medical Center staff members related to the contractor’s employee interfering with patient care or the ordinary operation of the facility.100%COR notification of complaints7.CPAR RAtings assigned to QASP ITEMS:Metrics and methods are designed to determine rating for a given standard and acceptable quality level. The following ratings shall be used (Reference: CPARS User Manual p. A2-1):Exceptional:Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.Note: To justify an Exceptional rating, you should identify multiple significant events in each category and state how it was a benefit to the GOVERNMENT. However a singular event could be of such magnitude that it alone constitutes an Exceptional rating. Also there should have been NO significant weaknesses identified. VERY GOOD:Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.Note: To justify a Very Good rating, you should identify a significant event in each category and state how it was a benefit to the GOVERNMENT. Also there should have been NO significant weaknesses identified.Satisfactory:Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.Note: To justify a Satisfactory rating, there should have been only minor problems, or major problems the contractor recovered from without impact to the contract. Also there should have been NO significant weaknesses identified.MARGINAL:Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.Note: To justify Marginal performance, you should identify a significant event in each category that the contractor had trouble overcoming and state how it impacted the GOVERNMENT. A Marginal rating should be supported by referencing the management tool that notified the contractor of the contractual deficiency (e.g. Management, Quality, Safety or Environmental Deficiency Report or letter).Unsatisfactory:Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.Note: To justify an Unsatisfactory rating, you should identify multiple significant events in each category that the contractor had trouble overcoming and state how it impacted the GOVERNMENT. However, a singular problem could be of such serious magnitude that it alone constitutes an unsatisfactory rating. An Unsatisfactory rating should be supported by referencing the management tools used to notify the contractor of the contractual deficiencies (e.g. Management, Quality, Safety or Environmental Deficiency Reports, or letters).8.DOCUMENTING PERFORMANCEa.The Government shall document positive and/or negative performance. Any report may become a part of the supporting documentation for any contractual action and preparing annual past performance using CONTRACTOR PERFORMANCE ASSESSMENT REPORT (CPAR).b. If contractor performance does not meet the Acceptable Quality level, the CO shall inform the contractor. This will normally be in writing unless circumstances necessitate verbal communication. In any case the CO shall document the discussion and place it in the contract file. When the COR and the CO determines formal written communication is required, the COR shall prepare a Contract Report (CR), and present it to CO. The CO will in turn review and will present to the contractor's program manager for corrective action.The contractor shall acknowledge receipt of the CR in writing. The CR will specify if the contractor is required to prepare a corrective action plan to document how the contractor shall correct the unacceptable performance and avoid a recurrence. The CR will also state how long after receipt the contractor has to present this corrective action plan to the CO. The Government shall review the contractor's corrective action plan to determine acceptability. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance and the acceptability of the Contractor’s corrective action plan.Any CRs may become a part of the supporting documentation for any contractual action deemed necessary by the CO. 9. COR AND CONTRACTOR ACKNOWLEDGEMENT OF QASPSIGNED:________________________________________COR NAME/TITLEDATESIGNED:________________________________________CONTRACTOR NAME/TITLEDATECONTRACT REPORT1. CONTRACT NUMBER2. Report Number for this Discrepancy3. TO: (Contracting Officer)4. FROM: (Name of COR)5. DATES a. CR PREPAREDb. Returned by Contractor:c. Action Complete6. Issue Identified (Describe in detail. Include reference to PWS Directive; attach continuation sheet if necessary.) 7. SIGNATURE OF CORDate:8. SIGNATURE OF CONTRACTING OFFICERDate:9a. TO (Contracting Officer)9a. FROM (Contractor)10. CONTRACTOR RESPONSE AS TO CAUSE AND ACTIONS TO PREVENT RECURRENCE. (Cite applicable quality control program procedures or new procedures. Attach continuation sheet(s) if necessary.)11. SIGNATURE OF CONTRACTOR REPRESENTATIVEDate:12. GOVERNMENT EVALUATION. 13. GOVERNMENT ACTIONS 14. CLOSE OUTNAMETITLESIGNATUREDATEContractor notifiedCORContracting OfficerEnd of Document ................
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